The Providence news. (Providence [R.I.]) 1891-1906, 1898-08-03
WOUNDS in BATTLE.
Danger Of Infection Of Wounds
EVIL Of Rsdrsssisg.


Danger Of Infection Of wounds The
EVIL Of RsdrsssisE
IN the current issue of the Medical
at length the result OF his experiences
with the wounded after the battle OF
Santiago and descltbes in detail large
number of cases. military surgery"
he says. differs in no essential respect
from emergency surgery In civil prac-
tice. The surgeon in daily practice has
learned long ago that every accidental
wound must practically be regarded
and treated as an infected wound" 1t
was found that 1the wounds made by
the Mauser bullets were clean. and bits
OF clothing or other infected substances
were seldom carried into the tissues.
Nevertheless. suppuration occurred in
many cases. and the many failures in
protecting the more serious wounds
against infection, are attributed by
Surgeon Col. Sem to three principal
causes:
1. Inadequate supply of first Dress
ings; 2. faulty application OF hrst Dress
ing, and 3. unnecessary change OF dress.
ing. The last was due In many eases
to the demands OF the patients. who
did not consider themselves properly
treated unless the dressings were
changed when they reached the general
hospital at Siboney, and the surgeons
often yielded to their insistence. 1t 10
difficult to eradicate the old belief that
the oftener a wound is dressed the
quicker II will heal.
"The evil OF meddlesome surgery"
says DIR. Sem, has become very ap-
parent during our brief Cuban cam.
paign, and has taught US an important
lesson that must be needed In the fu-
ture." He lays much stress upon the
value and Importance Of the nrst dress-
ing.
"The fate Of the wounded rests in the
hands of the one who applies the nrst
dressing" The effects OF bullet wounds
in the soft tissues of the body were
carefully studied. and 1t was found that
a week or ten days after the wound was
received the swelling of the tissues had
In all cases nearly or entirely obliterat-
ed the tubular wound.
'I have no further doubt" adds DR..
Sem, that the new bullet will become
encapsulated and remain harmless In
the tissues as readily, or more SO. than
the old fashioned leaden bullet"
IT was a surprise to the surgeons TO
find that in more than 10 per cent. of all
the wounded the bullet was lodged In
the tissues. This number was vastly
greater than had been anticipated, but
study of the bullets recovered re-
vealed the cause. Most Of them were
deformed, showing that they had been
detected from some hard object. or had
passed through some resisting medium.
The ground upon which the battle was
fought is stony and covered with trees
and thick undebrush, furnishing the
most favorable conditions for detection
OF the missiles. Even those hit by
Spanish bullets were struck, as II weres
by accident.
Or. Sem speaks very highly Of the
value of the X-ray In military practice.
All the bullets removed on board the
hospital ship Relief were located In this
manner, and a large collection OF ska.
graphs was made by DR.. Gray, who was
in charge of the scientific work on the
ship.
sThe work done by DR.. Gray will con-
stitute an essential and enduring corner
stone of much-needed modern work
on military surgery. Aside from num-
erous doubtful cases the X-ray enabled
the surgeons to determine the existence
or absence Of fractures in many instan-
ces where they had to depend exclus-
lively upon 1t. The x-ray has become an
indispensable resource to the military
surgeon in active service"
From among the 127 wounded on the
Relief Dr. Sem selected number OF
cases and described them In detail for the
purpose Of showing the effects of the
small-calibre bullet. both immediate
and remote, on the different organs
and regions Of the body. Detection OF
the bullet within the body was excep-
tional. and as rule the wound canal
was perfectly straight. from entrance
to exit. Many cases of gunshot wounds
i'm the head survived long enough to be
transported to the general hospital az
eiboney, but the patients died within II
days after receiving the injury.
In all such cases infection within the
skull was the immediate cause OF death.
Wounds in the neck were marked by
the peculiar symptoms that the men did
not know that they had been injured
until some time after they were struck.
All who received gunshot wounds or
the spine In which the cord was serious
ly damaged have died or will die In the
near future" Death in such cases re-
suited from infection OF the wound. In.
juries to the spine which did not affect
the cord frequently gave rise to tem-
porary paralysis.
During the war Of the rebellion Il
was found that men had a better
chance of life when the bullet passed
through the chest than when II re-
mained in the body. The same result
was found In. Cuba, although not so
marked 1.-THE number OF those with
chest wounds who lived long enough to
reach the hospital on the coast Ii as
tonishing. and. what Is still more sur
prising, In the fact that unless the hem
orrhage was severe the symptoms we're
mild some of the patients being con-
fined to bed only for a few days."
Experience with the wounded In Cuba
demonstrates that not infreQuently
cases of penetrating gunshot wounds OF
the abdomen will recover without ac-
tive surgical interference, especially
those in the upper part. Injuries to the
extremties required very few amputa-
tions, as all the surgeons realized the
Importance Of conservative measures In
the treatment Of such injuries, and
limited amputation to cases In which
the condition Of the soft tissues pre-
cluded any other course.