TRENCH SURGERY

New Zealand Times, Volume XLIII, Issue 9869, 15 January 1918, Page 8

TRENCH SURGERY

NEW METHODS IN USE

SAMPLES OF THE EXPER lENCE OF SURGEONS. ■Trenqli surgery is just as different from earlier war surgery as trench fighting is from tire former art and science of war. For twenty years past Army surgeons hare been priding themselves' on the fact that war surgery was coming nearer and nearer the standard of cleanliness, and certainty of results of peace-time surgery. <■ Glean wounds and quick healing are coming to be the rule in canvas-covered field hospitals as well as in the whitetiled, glass-roofed temples of healing at home. And when this war broke out we prepared our operating kits in full and blissful confidence that his onward and upward course would he continued and even brought nearer the goal of complete asepsis and no pus or visible scars. But a bitter awakening was in store for us; within tnree weess of mud and sneh-fire we had slumped hack thirty years in our surgical methods and proDlerns, and had to begin all over again, almost from where Lister did. And the fierce ancient battle between asepsis and anti-sepsis broke out afresh, and raged with fury. Almost the whole trend of development in modern weapons and armament seemed to be heading towards waking the wounds inflicted more and more nearly genn-lreo or aseptic. THE HIGH VELOCITY BULLET. The high velocity rifle bullets, for instance, were driven through the grooves of the rifle barrel at such enormous pressure and friction, that their surfaces were literally sterilised by heat, and unless they happened to strike the ground first and "ricochet,” entered the body almost as clean and aseptic as a surgeon’s knife in the operating theatre. Further than this, instead of being round or dome-shaped, they were pencil-shaped and pointed, and their nose or tip so sharp and smooth and polished that it was almost impossible for it to catch threads or scraps of the clothing carry them into the ivound with it, which was a very serious form of deep infection in the days of round bullets, or even of sword and sabre cuts. So important indeed was it that soldiers were required to take a bath and put CP clean underwear the night or morning before going into action, so that if any scraps of clothing were carried' into the wounds they would be as clean and free from germs as possible. I saw two cases in French hospitals, in which one single pocket of a huge shell wound kept on obstinately discharging and refusing to heal for weeks after the rest of the wound was closed. Finally a radical operation was decided upon, and a free incision made right down from the surface, laying open the pocket, and in one case a scrap of cloth from the patient’s tunic was discovered, and in the other a larger rag, with a button still stitched to it. , . , . Furthermore, . these high,*;- velocity bullets ;at average ranges were still whirling swiftly when they struck and literally drilled their way through the tissues so cleanly and smoothly that .Unless they struck a- bon© or penetrated the heart or a big blood-vessel or the brain or spinal cord, thev did astonishly , little damage, and the wounds healed' surprisingly quickly and kindlyIn ■ met, cold-blooded military exports were actually advising j against the use of high velocity or pencilshaped bullets in wars against savage or , barbarous tribes, because they simply : would not stop a rush. A charging Zulu or Somali warrior, for instance, might be drilled through with half a dozen bullets without stopping him or even cheeking his onrush, unless one of them happened to strike a big vessel or the spinal cord. While the shock of the old-fashioned leaden or . soft-nosed bullet, .! : which would spread and mushroom the moment it struck a bone or even a tough tendon, would usually Knock him down and put him put of the fight at once, even ir it did not kill him.

Bullet -wounds, whether rifle or ma-chine-gun, in this war. are regarded almost as a trifle providing that they have not struck a bone or an artery or a nerve trunk, or perforated the intestines. Time and again, when watching the dressing of some hideous, still gaping shell wound, I have noticed little circular brownish scabs, about tlhe size of a dime, with a reddish ring round thorn, on the arm, shoulder, hip, or, leg of the patient. These puzzled me at first, because they did not look just like surface wounds or burns of any sort, and they were evidently not boils—until I inquired and discovered that' they were the scaas of bullet wounds which had drilled right through the limb or the fleshy part of the shoulder or hip, and were now practically healed and dry, five, seven, nine days after they had been inflicted.

In that sense, as also in the sense that less than 15 per cent, of the wounds of this war are bullet wounds, and two-thirds of them from machineguns,. the rifle has almost ceased to bo a deadly weaponSWORD AND BAYONET WOUNDS. As for the sword-wounds and bayonet wounds, well, swords have become pretty nearly parlour ornaments in modern war, and bayonet wounds, while dangerous on. account of their depth and their narrowness, which prevents through drainage, are not very likeiy to be infected, because, as recent tests have shown, germs of any sort cannot thrive or live long upon polished metal surfaces. Besides, for some singular reason, bayonet-wounds have become the rarest surgical curiosities in this war.

One surgeon inspector-general!, In charge of three armies, with whom i. was visiting the field hospitals, told me that he had seen exactly four cases of bayonet wounds since the war began, and he had been in it from the battle of the Marne. And one of those cases was a spy, who had suddenly been discovered in the fighting line in a French uniform, and who had been promptly perforated like a pin-cushion, "and yet be did live.” said the inspector, with a smile and a shrug. Another division surgeon, of two years’ experience, told me that he had only seen four, and that one of thoso was in the leg of an officer, who, leading a charge and leaping down into an enemy front-line trench, spiked himself on the point of a rifle with fixed bayonet, which load been left standing against the wall of t.na trench.

And these are samples of the experi-

ence of surgeons in both armies on. the Western front. The scarcity of bayo-; net wounds ,is almost incredible, even after allowing for the fact that this is so overwhelmingly a war of artillery, and especially' as both newspapers and “official communiques” have reported quite a considerable amount of fighting at close quarters, clearing trenches with the bayonet, and forth.—Woods Hutchison, M.D.