Before the advent of modern medical transportation, ambulances were made up of what?

Answer Horse-drawn wagons.

In 1865, the first Emergency Medical system was started in the city of Cincinnati, Ohio, by some hospital interns. The only means of transporting people in distress to the hospital was by horse-drawn carriage. This was uncomfortable when the jostling about affected injuries or caused nausea and offered little protection from the weather, but it was a service that people were grateful for nonetheless.

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