The sun. [volume] (New York [N.Y.]) 1833-1916, 1898-07-31

~NANAN 1NAaA VI NAA0
necessity OF making tho lrst aid 10 tho wound
cd so complete as to elude the most common
causes OF death that emergency hospitals wero
established In cities. The injured were liable
to full into incom potent hands, which was not
formerly locked mon rs 10 grave n matter.
Now it Is known that tho first surgeon TO touch
q case must have all tho appliances and con-
vcniences and all tho knowledge and skill,
and also the sense OF the importance Of his
duty. to enable him to defeat the enterprise OF
the minute enemies Of life. 1t il known that
any attempt to dlslniect n wound thoroughly
in the street or at a corner store Is impractical
bic. For the same reasons IL cannot DO done
on the battlefield. Probing for bullets on the
field Is intcrdicted. All the instructions glvon
by authorities In military surgery direct that
tho arrest OF homorrhnGo. which Is tho single
immediate danger, shall DO effected by the use
OF the elastic bRndagc. II is safe to trust to
this entirely for four or Ave hours, but not
longer. As it completely checks the now Of
bloodto tho injured part. serious consequences.
including ganGrene. might follow IL too long
continued.
1T is ono OF the characteristics OF modern
surgery. which I have already indicated. to
treat wound Of tho extremities as though saw
ing them was a matter OF course. Amputation
" not thought o. except in the comparatively
few cases in which the soft parts. involving also
the vessels and nerves. are so lacerated as to
make the nutrition Of the injured limb i'm
possible. In the civil war IL was tho exceptional
limb that was spared. the first suggestion, save
in the case OF slight flesh wounds. being ampu-
tation. because n stump was less dangerous
than a wound. 1t would surprise tho ancient
surgeon to learn in what a percentage Of cases
primary operation 10 not indicated In
the new surgery. DR.. Sem. the chief
operating surgeon with Skaters army. q
recognized authority. says operative i~nterfer-
ence 10 indicated in all penetrating gunshot
wounds OF the skull, while gunshot wounds of
the chest are to be treated by Theoretically seal
ing the wounds under the ~strictest aseptic con-
ditions. Penetrating gunshot wounds OF the
abdomen. which were formerly regarded as
equivalent to death. can be subjected to opera
ton with many chances OF success. II q patient
is in such a condition that he Is likely to sur
vlve the comparatively slight shock OF the OPP
GRAFTON. laparotony Is performed II life Is
threatened by hemorrhage. 1t is possible to
save the lives Of persons whose intestines have
been perforated many times by a bullet. Such
wounds were formerly always mortal. A study
OF the practice of modern military surgery
shows that in a vast majority OF wounds
it Is the dressing and not the operation that
10 chiefly depended on. Chest wounds are the
most dangerous. but frequently the hemor-
rhage. which is the only cause for fear when the
possibility OF poisoning has been excluded. stops
automatically. 1t should be obvious that the
surgeon can work to advantage only in hospital
and not in the field. The modern soldier is
provided with q first-aid package. consisting Of
powder composed of boracic and ~salicylic acid.
O roll of absorbent cotton and steriliZed gauze.
with q few safety pins. The intelligent use Of
these will be all many wounds reQuire and in
more severe cases they will keep the wounded
from danger until they reach q hospital. The
litter bearers should be able to apply the wind
lass bandage where there Is hemorrhage in
wounds of the extremity. 1t is worth noting
that in the case of a fractured and splintered
bone operation is not indicated and no effort is
made to remove the s~plinters.
Il had q talk with an intelligent man who
was wounded in the battle Of July l. He is q
Harvard man and obviously trustworthy. In a
long and tedious and very painful walk. some
| times a crawl. in search OF u hospital. he and
| several other wounde men sat down by o little
stream to attend to their injuries. Here We
found our hrst-help packages most useful he
! said. After binding up one another's wounds
with the bandages. using the disinfecting pow
der as directed. many Of us no longer needed
the hospital. But we saw no persons who rep
resented the hospital AS we were still under
fire and had to keep behind the bank Of the
| w SoNopo S"O bAAASSS hhNNS " vi NAA
about US. perhaps We should not have
| expected them to be in the vicinity
He said it was only by accident that
| they discovered O main road that would take
them to the rear. Those who reached . hospi-
tai found the surgeons overworked and were
compelled either to wait for hours or go else
where. This soldier was ono OF the many
wounded who overcrowded the Seneca,
which purported to be n hospital ship. On this
steamer surgical attention was virtually out of
the question. The story OF that experience has
been published. and without exagGeration. 1t
must be admitted that. although the system
as planned for the hospital service is superb
and wholly practicable. there was q measure OF
failure with Gen. Skaters army. for reasons
still 10 be discovered.
IT have no doubt that Gen. Sternberg Is right
about Red Cross nurses in the field. 1t is not
only no place for women. but they can do MOTH
ing there that men cannot do much better.
Properly carried out, the hospital system OF the
army leaves nothing for women nurses to do in
time Of battle. There is a large enough corps
OF hospital men-3 percent. Of the enlisted men.
as l have said-to follow up the advancing line
of battle. pick up the wounded and apply band
ages where hemorrhage threatens life. and carry
the helpless TO the hospital. In the more perma-
nent hospitals there is need OF the services OF
trained nurses. and to these hospitals the wound
ed are sent as rapidly as possible. ! have no
doubt the failures at Santiago will serve as a
useful lesson. and that they will never be re-
peatcd. They would be impossible In the case
OF any division OF the Seventh Army Corps,
whose service I have examined. The men in
the hospital corps now In Florida have been
more thoroughly drilled in their work than
any company in the manual OF arms. Wome
in the rear Of any division Of this corps In time
| ~ hatfIa UnnId onlv hn In thA Vvay md could