CARE OF WOUNDED ON WAR FRONTS.

Star (Christchurch), Issue 11729, 20 June 1916, Page 3

CARE OF WOUNDED ON WAR FRONTS.

WONDERFUL PROGRESS IN SURGICAL TREATMENT. (By JAMES J. WALSH, M.D., Ph.D.) In the midst of tho more than two months of fierce battling around Verdun, with so many interludes and incidents for diversion's sake along other parte of the line, it has been some consolation to know that during the second year of war arrangements have gradually been organised for the almost immediate care of wounded soldiers, so that tho long delays which usually aro so fatal and always so full of suffering for the wounded are now avoided. Tho French and English havo both now reached such organisation of immediate care that at most places along the line patients are cared for very frequently within an hour or two of the time when they are wounded, and practically always within an hour or two of the time when they como into the charge of the Army Medical Department. Doubtless a great many persons were surprised to learn of the wonderfully good health enjoyed by the soldiers in the trenches in the midst of their exposure. For in spite of the fact that modern life would seem to have relaxed the physical fibre of our generation so that trench existence, a reversion to that o/ the cave man, would seem almost impossible to us, the soldiers have displayed a fine, healthy reaction to it. Sir James Crichton Browne, a scentific sanitarian of distinguished eminence in England, declared that the health of tho troops taken all in all was at least as good as if they had remained at home in England and that the divath rate was actually lower among them than in. that of any of the English cities. The men between twenty and forty represent, of course, the picked lives of the country, and yet this low death rate shows that human nature is capab'e of bearing even he hardships of the trench warfare without loss of resistive vitality. It only remains now to be told that the wound'er are being cared for with the highest surgical skill so immediately after their wounds that it is probably they are in better condition so far as treatment goes than they would be if injured in any country place or even a suburban town almost anywhere in England or France. RECOVERY OF. THE WOUNDED. It is no wonder, then, that the statistics of the recovery of the wounded is so favourable. In a recent lecture before the French Institute Dr Jacques Bertillon, director of the medico-sur-gical statistics of tho French army, announced that the mortality of sick and wounded had been reduced to eighteen per thousand. Early in the war the mortality had reached fiftythree per thousand. A mortality of eighteen per .thousand is not much higher than that of :nost of our large cities, as regards the whole population. The saving of the wounded is particularly striking. Sir Frederick Treves, the distinguished English surgeon, who is looked upon as one of the world's best authorities in surgery, has recently been at the front, and is enthusiastic about the organisation of the surgical department of the army. As Sir Frederick, went.through the South African War and the Russo-Japanese War, ho does not make his investigations of conditions of tho present war without ample experience as to the difficulties nor without knowledge of much worse conditions in spite of tho best possible good will and the most painstaking and self-sacrificing efforts on the part of army medical departments. He said:— "Those who are familiar with the medical dispositions in the South African War will find in this campaign an advance in. tho anedical services so great aud so wide extending as to amount to an actual revolution. Not only has the sick and wounded soldier never been so well cared for in any campaign as in the present, but it is even difficult to suggest in what way his welfaro could be further promoted." DETAILS OF FINE ORGANISATION. This is of course only a generic expression, and might possibly be thought io represent a report meant to encourage the nation, and especially the newer (ranks of Kitchener's soldiers who aro going into the war. Sir Frederick Treves, however, has not hesitated to give specific details and to describe some of the conditions as they actually... exist to illustrate the almost perfect arrangements that have been made. The dressing stations have to be very close to the lines, and therefore surgeons and patients incur some clanger, but everything is thought of aud even an underground shelter is provided for the patients and medical aud surgical attendants whenever the enemy's fire becomes too hot. Sir Frederick Treves takes as his first illustration a surgical station just behind the English line at Les Brebis. He says : " We should note, in tho first instance, such an advanced dressing station as that at Les Brebis. The place is a mining village well within range of the enemy's fire; indeed, some twenty shells have fallen into the area on the morning of our visit. The hospital is a building that was used by miners as an entertainment hall. This hall makes an excellent ward, provided with every necessary detail for tho care of the wounded. Attached is a small, carefully equipped operation room where operations of an urgent nature, such as the arrest of an hemorrhage, could be carried out. Here

also wounds may bo cleaned find redressed, fractures more comfortably adjusted and injections of anti-tetanus Rerum given. Close at hand were two dug-outs into which patients could be taW if tlv shelling threatened the building. Tho whole station was .simple, efficient, and exactly equipped for'its limited purpose. There was nothing Inching and yet nothing superfluous, and the possible necessity for extreme mobility was kept prominently in mind." TEXT DRESSING STATION"?. Tent dressing stations, which may bo set up anywhere and rapidly removed if necessary, but which in the meantime provide every and even the most advanced surgical care, are the most prominont feature of tho immediate tiraatmfent of the wounded. Tents appeal to one as rather cheerless and in the winter cold and uncomfortable places in which to care for ill and wounded, but they are well warmed' and lighted and patients are not delayed long in them, and they make excellent clearing stations for passing the wounded from the front on and yet giving them that intermediate care which is often life saving and which always serves to prevent complicaf'ons, to lessen seqneala? and to make the patients feel that they are being constantly cared for, and al this means pvfv ro much for their encouragement and thorough reaction toward recovery. The private soldier even feels that his treatment is of the verv best, and that though ho may be only a "Tommy" from the ranks some of the best surgical advice and treatment, both as regards the operator and the consultant, arc provided for him. No wonder, then, that he proceeds to get well so promptly and satisfactoyr. Sir Frederick Treves has been quit© in bis preiso for these tent dressing stations, which might possiblv be considered as little better than makeshifts, but which prove on careful investigation to be magnificent examples of what modern sivrtreons can accomplish even in such straitened circumstances. NIGHT OPERATING. Most of the ■wounded are brought back to these stations during tho night, -Mid the thoroughness of the complete arrangements for their care will perhaps best be understood from the fact that no matter what the hour of their arrival operations begin at once and are carried on until the last patient is cared for, even though this should require operating on the part of. tho surgeons the wbolo night through. In this matter the modem arrangements for the care of wounded soldiers aro an imitation of t the caso of those injured in *»svil life. It scarcely seems to matter what tho numbers may be, they are successfully disposed of. At Lapugnoy, with its 376 beds, somewhat more than two thousand wounded soldiers have been successfully treated in a single day. At the clearing station at Bailleul Sir Frederick Treves notes ■ that the enormous nmuber of moro than sixty thousand ill and wounded soldiers have passed through the hospital since it was opened. 'The number of major operations performed is -well above one thousand