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(Copyright. 151». by the New York Herald Company—All Right? Reserved.) (Copyright. 1J19. In Canada by tha New York Herald Company )By FRANK P. STOCKBRIDGE.When the history of the Great War comes to be written from the perspectivewar. is so completely guarded that it now barely figures at all in army health reof twenty years henco tho conscientious | p^.rts. And before the United States ha«: historian will point to the marvellous ad- boon in the war a year there had beervanrrs in prer.ntive medicine, in curative“run ,t*in5'pneumonia, which holds every promise olmedicine, in surgical principles and technique, in sanitation and in personal hygiene as perhaps the most important group of scientific achievements brought about by the war and tho pressure of military necessity. In point of lasting and cumulative benefits to the people of the whole world, the new knowledge acquired of means of the prevention and cure of disease and the henling of in-uries, together with die application on the largest slt;ale in history of the accumulated scientific knowledge of the whole subject of individual and community heal ill, may well rank first, whether it l»e measured »n :crma of dollars and cents or in terms of personal happiness in its collective value to mankind.Whether th-' discovery of new medical and surgical measures ana the instruction of twenty thousand and more young physicians in their use is of greater importance than the training of more than three million young men in the rare of their own bodies and the elementary principles of community sanitation is too fine a point to be decided. The physicians who have served in the Medical Corps of the army and navy and the men who hava been subjected to their intensive hygienic training are coming hack into civil life as missionaries of health; their experience and new found knowledge will prove the greatest possible stimulus to theaccomplishing in the prevention of thi? disease what the anti typhoid vaccine ha^ done in its field.It is to the researches of the scientific staff of the Rockefeller Institute for Med I* enl Research that this new prophylactic is due, as well as many of the other remarkable medical and surgical discoveries made during the war. Ten weeks before the Seventy-seventh division was sent overseas from Camp Upton, about half the men were inoculated with this new serum. Not a single case of pneumonia developed among the men so inoculated, while among those not inoculated the prevalence of th** disease was greater than before. The extension of this method of preventing pneumonia to civilians as well as to the rest of the army is only a matter of obtaining a sufficient supply of the serum. Eventually it will be as readily obtainable everywhere os is the diphtheria anti-toxin. Serums which have proved effective r.gainst meningitis, dysentery nnd gas gangrene have also been developed by the Rockefeller Institute for the United States Army within the last year.One of the most important of all the medical discoveries due to the war is the Identification of th*» ebotie or body louse as a carrier of disease, and the development of means of combatting his activities. To the cootie have been traced the germs of typhus and of several other introduction of wise measnrcs for the gen- * diseases. Typhus, from time immemorial, eral elevation of the health of all the ha» keen Hie scourge of armies the worldpeople, and will make or a higher average of good health in the coming generation. Reserving for another article tho more distinctly hygienic prases of the subject, 1 tfhaU describe here some of tho most startling and important new discoveries and methods in medical and surgical practice that operated to make the American army in the great war the healthiest army In all history. and to bring about a higher percentage of complete recoveries from wounds received jn action than had ever occurred before in recorded military experience.ever. It is. indeed, known in some parts of the world as “army fever. In some counlries it is called prison fever. Wherever there are people living in crowded quarters, with more or less physical contact and under unclean and unsanitary conditions, typhus is a certain mrns.-c. It broke out in Serbia among the non-combatant population early in the war and tens of thousands of Serbians died from it. Many members of the American typhus commission sent to Serbia hy the Red Cross also caught the fever an!. H**!* At that time it was only suspectedNothing could better illustrate the Hint the body louse might be the prin.ripal carrier of this spotted fever. Nowprogress that has boon mode in the sci enco of preventive medicine since tin* civil.. - l,ie guilt has been definitely placed and* than to contrast the proportion of another of the world's chief cause* of deaths from disease nnd those from in- misery nnd death has come under the con-Juries in battle in that war and in the trol of man.trmrW\r fU'* Cm'n In lh* rivil :,r F morc *P«-,»cular than O.rse and 0..000 Northern aold.rn. were killed or mnny oil,or important advanooa j„ m.di-cine are the achievement* in surgr-ry whereby it j* now possible to bring backARTIFICIALLY ARMED BUT ARE COMPETENT MECHANICS. SCENE IN A FRENCH MACHINE SHOP.•o precise, nothing to mathematically exact, has ever been known to surgical science. More than a thousand army surgeons were given special two week courses of training in the Carrel-Dakin method at the Rockefeller Institute before being sent overseas; thousands of wounds that under old methods would have meant death or amputation were healed with the least possible reminders remaining to the victims.Under the direction of officers of the Medical Corps of the army remarkableon pumping, but the blood collects In tbs large veins of the abdomen and the patient literally bleeds to death in his own veins. After making this discovery, Dr. Porter worked out a method of stimulating the action of the lung# so as to draw the blood into the chest cavity and by thus forcing the circulation keep the victim alive until the fat particles could be absorbed. This is accomplished by forcing the patient to breathe a mixture of air and carbon dioxide, administered through a cleverly devised apparatus. It is simple, portable and instantly effective. Anotheradvance* have been made in the use 0f trinmph for Americ,D surgical science! the X-ray for the detection and exact* Elt;lua,,y as a permanent contri-]ecation of foreign bodies. Not only docs the perfected X-ray apparatus show byphotography the position of a bullet or a piece of shell, but by ingenious methods the exact depth below the surface is also determined. At the same time that the Roentgen photograph is being taken a powerful electro-magnet is brought over the patient s body. The surgeon places his hand as neariy as possible over the spot beneath which the piece of steel Is embedded. When the current is turned on the pull'' of the magnet on the embedded steel sets up a vibration which the surgeon's hand readily detects. The force of this vibration gives the clew u the depth of the steel below the surface. To use this method requires training and experience, and it is supplemented by other devices.Formerly the taking of an X-ray photograph was a matter of fifteen minute* or morc; the perfected army apparatus does the work in a few seconds. Moreover, there has been devised a pnrrnble X-ray ipparatus that can be sent up to the frontbution to surgery is the new ambrin•,• anaesthetic, the mercifnl invention of Dr. Gordon Edwards. Sprayed on a burn oran open wound, it instantly relieves paia; with its aid dressings can be changed and wounds treated without the slightest sensation on the part of the patient.The French and Italians have carried farther than have American surgeons tha plastic surgery that literally gives the man who has been wounded in the face a new -et of features. Some wonderful things ia this line have been done, however, by \mericans. A new rose has been made 'f bone from the patient's own shin and flesh aud skin from his forearm; shattered jaw* have beta replaced by silver 'bones, so adjusted that there is hardly in outward indication of an operation. And in the field of artificial arms and legs nd their perfect adaptation to the neces-ities of the dismembered. Amer.can etbods have superseded almost all thers. Artificial arm? and hands with vhich the soldier who has lost both arm* an write, handle knife and fork, lift aline hospitals.the generator being mounted flaw of water and perform many other in a motor truck, so that wounded men inthe last months of the war did not have to wait until they could be sent back to the base hospitals before their cases could be thoroughly dicgnos-d and frequently the bits of shell removed.It would he easy to write many page? of a newspaper description of surgical innovation? derived aid introduced by Americans in the war. The surgical worksimple operations, have been fitted; artificial legs and feet that enable their wearer oven to dance, have been brought to perfection by the staff of expert surgeons and limb makers working at tht Army Medical College and the Walter Reed Hospital at Washington. All of these Inventions, devices and discoveries are that much distinct gain, adapted m they are to the needs of a world in whichof our men in the -Medical Corps, both of disease and accident will still continue U the regular army and of the reserves, was take toll of human life swd limb, the marvel of the Allies, even os our ho*-1 when the United States entered th« pitals. their equipment and their nurses war the entire supply of surgical instro and nursing method* far excelled anything | mrnts on hand iu the United States wajdied of wounds, while lM.OtiO died of dL* ease. The latest revised casualty li-r of the War Department shows that in this war 44,7li1 American soldiers wwounded m«n from the very brink of theor died of wounds, and or., iaww“| STwho ''a' '°disease! (ompared with th-* m rtality am«ng men of the same average aces in civil life, there was a slightly larger proportion of deaths from disease in th* army. This was due entirely to the transmission of the highly communicable diseases. measles, tvurlet fever, meningitis • nd pneumonia. These took their heavies* toll among soldiers from mrnl district* who had ne\er been exposed to these infections, and their prevalence was the natural result of bringing them into close contact with men from every section of the country. With the exception of the four classes of infection named, there was ■ smaller proportion of deaths from disease in the Hrmy than in the same number of men of the same age in civil life.Typhoid, the scourge of all ronn-r wa.-s. was almost totally absent. This disease.similarly injured in any previous war. would Inevitably have perished; fo save limbs that formerly would have keen amputated; to patch up nnd rebuild maimed nnd shattered bodies and features into marvel I ou 8 semblances of their former selves, and t«» enable the man who has lost arms or legs to become a skilful, competent workman In spit© of his dismemberment. Surgery cannot yet restore sight to the blind nor hearing to those whose ear drums have been broken by the concussion of great guns, but short of these thorn is hardly a miracle imaginable that cannot to day be performed upon the unfortunate victims of war. While the value to it world at pence of the prevention nnd cure of disease is naturally greater than tho value of even the most mar-distinct added asset to the world’s wraith, in view of the wide variety of industrialnnd other accidents which may call them into play.l'erhnps the most important surgicalinstitute's staff. To Dr. Dakinbelongs!the credit of discovering a new antiseptic, hypochlorite of sodium. Chlorine, the same deadly gas that, as I have pointed out in a previous article in this series.contribution to the world's heritage of give* the killing power to phosgene, mus-health from the war is the discovery of tard gus and the rest of the deadly array a new and more positive and powerful | of war chemicals, is the germ-killing basis antiseptic than was known before and of of this new antiseptic. To combine i;a scientifically exact method of applyingit. so that, provided the prescribed technique is properly carried out. it cannot fail to heal even th- most seriously infected wounds. Much has been said about the Carrel-Dakin method of treating infected and other wounds. IIow marvellous it actually is in the precision with which it achieves its end is nut generally understood. It reduces the most difficult of all surgical problems to the same mathematical precision with which the simplest operation is performed.The Cnrrel-Dakin treatment is another product of the Rockefeller Institute's research, having been devised by Drs. Charles Dnkin and Alexin Carrel, two ofvellous possibilities of reconstructive which killed thousands in the Spanish surgery, these latter are, nevertheless, ajthe moat distinguished members of thet V ‘ • * ‘ ' Iwith other elements in a proportion that would prevent it from injuring raw tissues, whil© permitting it still to exercise all of it-** powerful germicidal effect van the problem Dr. Dakin solved. Dr. Carrel, the Americanized Frenchman whose surgical technique is the marvel of the medical world, the man who has performed and devised methods of performing more now and radical operations than any other surgeon of modern times, worked out the system of the application of the Dnkin solution to the deepest and most inaccessible wounds, and reduced his method to such an exact mathematical formula that any surgeon, once skilled io «*e method, can operate it with perfect results.The underlying principle of the Carrel Dakin method of wound treatment is that nature will heal any injury if given a free chance. First the wound must be cleaned out with the knife, ever particle of infected tissue cut away, no matter how deep the operator has to go. Then the Dakin fluid is applied, by means of an irrigating device invented by Dr. Carrel which leads the fluid through a number of tiny hollow rubber fingers” into every farthest recess of the wound. The exact number of fingers’* to bo used and the exact amount of fluid to be applied are carefully calculated in advance, proportionate to the area of exposed surface. The application ia precisely timed as to duration and frequency; the temperature of the wound, taken by a thermometer inserted under the dressings, is the gauge that determines whether tho instructions have been followed. Given a wound of a certain depth nnd extent, if tho prescribed method be followed, it can be predicted in advance, almost to an hour, when the outer lips of tho wound can be closed and the patient removed. Nothingpreviously scon in Europe. I am trying here, however, to limit the scope of this article fn scientific achievements that have a definite peace application. Rut among these, surely, is the discovery tv Dr. William Townsend Porter, of the Rockefeller Institute, of the cause of tfie formerly fatal condition known as surgical shock, and of a cure for it Shock is a terra used by surgeons in severul different connections. Broadly, it means mental nnd physical collapse. Shell shock ia n nervous condition, susceptible of cure. The form of shock arising from dread of the knife and the pain of an operation is purely mental in its origin and is effectually prevented hy the discovery by Dr. Crile. of Cleveland, of a way of blocking off communication throngh the nerves between the seat of operation nnd the brain. Rut surgical shock is a condition following severe injuries, ampntations or compound fractures. that is distinctly physical and not at all mental or nervous-In its origin.Dr. Porter discovered that surgical shock, which is frequently the cause of death after industrial accident hs well as on the battlefield, is caused by the entrance into the blood vessels of tiny globules of fat, either from the fatty layers just below the skin or from the marrow of broken bones. These fat globules choke the tiny capillaries and keep the blood from flowing to the hraln and the extremities; meanwhile, the heart keepsadequate for only a fraction of the probable need. Surgical instruments had bee* chiefly made iu Germany; almost every dealer in surgical instruments in America was au agent or a branch of a Germaa house. The peace rime supply of somt classes of instruments had been comini from England for the first two years ol the war in Europe, but that source wai shut off by England's own need*.One of the most vital and difficult tasks the Surgeon General's office uudertook was the establishment in America of a surgical instrument industry. The maker* of ordinnry needles could not make surgical needles. By adopting six standard sizes and shapes and placing contracts for ten million needles with the big sewing machine companies, the army was equipped as early as these were needed. Tested at the Bureau of Standards they were found to be superior to the best German needles, and America is now independent of Germany. Manufacturers of knivea were induced by big contracts to undertake the manufacture of surgical knives. Here, too, the German producl was improved upon. For artery forceps recourse was had to the manufacturers of scissors; now we make all we need in America. So. with many other kinds of surgical appliances and instruments, until America in every respect becaras independent, now and for all time, ol Germany or cuy other country.
Newspaper Details
Great Falls Daily Tribune
Great Falls, Montana, US
Sun, May 25, 1919
Page 24
Full Page
Clipped by
Canton S.
OK, USA 27 Mar 2023
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