TRENCH SURGERY.

Taranaki Herald, Volume LXVI, Issue 16037, 23 January 1918, Page 4

TRENCH SURGERY.

NEW METHODS FOR NEW WAYS OF WARFARE. {By Woods Hutchinson, M.D., in the Daily Chronicle.) . Trench surgery is just as different from earlier war surgery as trench fighting is from, the termer- art and science of war. For 20 years past army surgeons have been priding themselves on the fact that war surgery was becoming nearer and nearer the standard of cleanliness and certainty of results of peace time surgery. Clean wounds and quick healing arc coming to be the rule m canvas-revered field hospitals as well as in the whitetiled, glass-roofed temples of healing at homo. And when the war broke out wo prepared our operating kits in full and blissful confidence that thus onward and upward course would bo continued, and even brought nearer the goal of complete asepsis and no pus or visible scars. 1 But a bitter awakening was in store for us; within three weeks of mud anc shell fire, we had slumped back 30 years in our surgical methods and problems, and bad to begin all over again, almost from where Lister did. And the fierce ancient battle between asepsis and anti-asepsis broke out afresh, and raged with fury. Almost the whole trend of development in modern weapons and armament seemed to be beading towards making the wounds inflicted more and more i early germ-free oraseptio. THE-HIGH-VELOCITY BULLET. Tho 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 “richochet,” entered tne 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 o. the clothing and carry them into th wound with it, which was a very serious form of deep infection in the days o round bullets, or even of sword and sabre cuts. So important indeed was it that soldiers were required to take a hath and put on clean underwear the night oi morning before going into action, s that if any scraps of clothing were carried into the wound they would be as clean and free from germs as possible. I saw two cases in French hospitals in which one smgle 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 i 1 button still stitched to it. I Furthermore, these high velocity bullets at average ranges wore still whirl- ' ing swiftly when they struck, and literally drilled their way through the tissues so cleanly and smoothly that unless they struck, a hone or penetrated the heart or a big blood vessel or the brain or spinal cord, they did astonishingly little damage, and the wounds healed surprisingly quickly and kindly. In fact, cold-blooded military experts were actually advising against the use’ of high .velocity or bullets

in wars against savage or barbarous tribes, because they simply wan Id not stop a rush. A charging Zulu or Somali wairior, for instance, might be drilled through v/ith half a dozen bullets without stopping him or oven checking his onrush, unless one of them happened to -strike a big vessel or t; spinal cord. While the shock of the oldfashioned leaden or soft-nosed bullet, which would spread and mushroom the moment it struck a bone, or even . tough tendon, would usually knock him down and put him 'out of the fight at once, even if it did not kill him. Bullet wounds, whether rifle or machine gun, in this war are regarded : most as a trifle, providing that they, have not struck- a hone or an artery or a nerve trunk, or perforated the intestines. Time and again, when watching the dressing of some hideous, stil. gaping shell wound, I have noticed little circular brownish scabs, about the sire of a dime, with a reddish ring round them, 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 on inquiring that they were the scars of bullet wounds which had drilled right through the limb or the fleshy part of the shoulder or hip, and wore now practically healed and dry—five, seven, nine days after they ha'd been inflicted. In that sense, as also m the sense that less than 15 per cent, of tin wounds of this war are bullet wounds, and two-thirds of them from' machineguns, the rifle has almost ceased to b. a deadly weapon. SWORD 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 likely 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-goneral, 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 ho 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 Eerforated like a pin-cushion, “and yot e 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 these 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 tifle with fixed bayonet, which had been left standing against the wall of the trench. And these are samples of the experience of surgeons in both armies on the western front. The scarcity of bayonet 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 tranches with the bayonet and so forth.