New-York tribune., 1901-01-27
MILITARY SURGERY.
SOME LESSONS OF THE SPANISH w.p
REDUCED MORTALITY AMONG THE wor,SDrn-
EXPLORATION WITH X RAYS


non OF surgeon-General Sternberg. on the use
OF hontsen rays in the late war with Spain
one Oi the most striking OF these facts is that
the mortality among the wounded who were
unoer treatment was much lower than in any
other similar conflict in half a century
The percentage Of deaths among the injured
French in the war OF 1853 with Italy was Il. of
me frussians who invaded Denmark in 1864
about l5l2. Of the English in the Crimea in 1854
90 over 10 Of the Union soldiers in the Anaeri-
can Civil War nearly is O296 10 be exacu and
IN three or four modern European conflicts from
iV TO il per cent. The percentage among the
American troops in the Cuban war was only Goa
When comparison is made between the Civil
and Spanish wars. according 10 the region in
which the wounds were inflicted, it appears that
the chief Improvements which are discernihle
were in the results Of injuries in the chest the
eNtremites In the Civil War the mortality
Us per cent among men wounded in the chest,
whereas in the Cuban war il was only 1l.6-less
than half great. The dminution in deaths
from injuries 10 the upper eXtremities from
GA TO 20 per cent and in the lower extremi-
ties from lbs 10 l.6 per cent. In other parts Of
the body there little difference. Indeed
there was slight increase in the mortality from
wounds in the neck and spine instead of a de-
crease. The percentages for the neck in the
Civil and Cuban wars were 70 and %. respec-
lively, and for the spine 55l2 and 62l2.
EFFECT OF THE MODERN BULLET.
Captain Borden is willing 20 concede that part
Of the gain which has been made is due TO the
modern style Of bullet. This is much smaller
than the old musket ball. is coated with a thick
layer Of brass nickel steel, which gives the
projectile greater rigidity and il is sent at
higher velocity. One consequence OF this change
is that the modern bullet travels a much
straighter course than the old one. whether It
be bone or soft tissue that il encounters. An
other is that il almost invariably goes entirely
through the man. instead of lodging inside.
However when the projectile is fired az very
long range il is more likely TO lodge. This was
frequently the case in the Santiago campaign
Again, if the bullet first strikes some other
object outside the soldier, and ricochets, much
OF its force viii be spent and il may lodge. Such
bullets usually more or less deformed. and
viii even be discovered with the butt end fore
most.
But the writer OF this report insists that the
lessened mortality is also due 70 some extent 10
improved surgical methods. In the Civil War
surgeons knew practically nothing OF the rela-
tions between suppuration and blood poisoning
on the one hand and bacteria the other
"Asepsis" and ''antisepsis' had found their
way into practice or the dictionaries. Nowadays
the surgeon aims prevent thu Infection Of
wounds and II they are infected proceeds 10 kill
the germs tfai make mischief there. II has been
pretty well demonstrated that modern bullet
cas-ies in a few bacteria, but not enough to do
harm Nature immediately sets up warfare
on these few germs, and quickly isolates or kills
them. Hence il is the wise 81 policy nCt 10 inter
fere with the wound by probing or 10y efforts TO
remove a lodged bullet. These latter proceed
ings are pretty sure TO aggravate the trouble
and produce infection.
AGAINST PROBING WOUNDS IN THE FIELD.
Captain Borden quotes number OF European
authorities on this point, and the careful pursu-
ance OF the let alone policy in the Cuban war by
American surgeons still further demonstrates
the sOundness Of the reasoning. Ia the HELD
tosptal the facilities for sterilizing instruments
are SO poor that il is wise leave the bullets in
either 10 stay permanently OF for removal under
more favorable circumstances than to take
thena out unless there special and urgent
reasons for immediate extraction The new
system Of military surgery. then, recognizes the
fact thai in the vast majority Of cases bullet
,rounds are uninfected and applies occlu-
sive" or closing dressings thereto Where the
sertic character OF the injury is patent however
a,,tiseptics are freely used. But even SO, an
or,eration is avoided far as possible. Ampu-
,.tions are not resorted 10 frequently as for
rnerlv. Now the modern bullet fractures bone
into finer bits than the old one did, and thus