ATTENDING THE WOUNDED.

Wanganui Herald, Volume XLVIII, Issue 14015, 23 June 1913, Page 8

ATTENDING THE WOUNDED.

RAPIDITY NEEDED FROM SURGEONS AT WORK ON THE BATTLEFIELD. The fact that every surgeon in private practice is not necessarily a good military surgeon must bo thoroughly grasped. The latter must possess rapid decision and do a great deal with very little material, operate sparingly and send the wounded away from the scat of war as soon as pos.-ihlc. lie has neither the time uoi the 'convenience necessary to undertake minute operations, to perform exploratory laparotomy."and make intestinal sutures. ,fn undertaking such operations he would 'be useful to nobody, since for a more than doubtful result of advantage to a very small number ho would be losing precious moments which would undonhtly 1)0 profitable to other wounded. Dr Lucas Ciiampionuiere, house surgeon in a Paris hospital and Red eresent surgeon in Constantinople,' takes this view, as will he seen by the following extract from a letter addressed by him recently to the Journal dc Medicine ot dc Chirurgie Pratiques. He states that he performed very few severe operations, and says the reason for this is simple. In fact, from the point of view of the wounds he observed, the war may be divided into two phases—-one preceding, the other following Chntatdja. Before the battle of Chataklja the Turks went far from Constantinople, the ’transport service was not working, the railway was crowded and vehicles -auk up to the axle in the mire of the roads; the Turkish regiments were in flight and it was not possible to. send any of the wounded to the rear by the ambulance service. Each wounded man was therefore obliged to travel ten kilometres on ‘horseback oi .afoot, before finding an empty train bound for Constantinople. Of these wounded ninety per cent, were .suffering from shrapnel wounds. These are contused wound-, large in extent, with intense tumefaction of the surrounding region, hut they are uoi deep and are serious only because, not being properly dressed, they arc an easy prey for infection and an admirable terrain for septic absorption. There were less than twenty per cent, of bullet wounds, nndoiibtly became the precipitate flight of the Turkish troops prevented direct contact with the enemy. At Vera, where Dr. Lucas Championaicre principally treated the severely -.rounded, lie made the following observations:—All the serious wounds of the lower limbs comprised, shattered bones: they were compound fractures, open and already infected for some time, and ended in amputations. The most frequent type is the fracture of the tibia, which is split into four fragments, two of them lateral. The. wounds of the upper limbs were less serious, perhaps on account of the very great number of wounds of the hand, which had been properly dressed. 1 In a general manner Dr Eneas Chauipionuicre performed very few'operations. He remained faithful to the ideas of Drs Rcelus and Delorme. The surgery he has lieen practising has, apart from the amputation--. Leon principally that of enlarging the opening of the wounds and disinfecting them. He employed tincture of iodiue and above all, carbolic acid water, the tincture- of iodine at his disposal during the height of the action becoming very caustic for reasons that he could not discover. He. accordingly, in place of it, usid carbolic acid water, which gave admirable remits in infected compound fractures. In treating slight wounds he respected the bullet, according to the formula of his master. Dr Bcelns, and was astonished to see that this teaching was not adopted by the Turkish or foreign surgeons. The principle of the obligatory extraction of the bullet was put in practice even on the battlefield, and the terrible infection of certain wounds had no other cause. These art the first les-ous which Dr Lucas Championuicre lias learned from the surgery which he lias laid an opportunity of performing .since his arrival in Constantinople.