Evening journal., 1915-06-18
WOUNDED BETTER
TREATED Than IN 81
Thermometers, HemoStatic
Forceps and X-Rays In
known During Civil War
GREAT ADVANCE
MADE IN SURGERY

MADE I'm OONOEN L
The contrast between the surgery
OF the Civil War and that Of the pres
ent war was the subject of an ad=
dress delivered before the Philadel-
phia County Medical Society Few
weeks ago by Or. w. W. Keen, emeri-
tus professor OF surgery at Jefferson
Medical School Dr. Keen was an
army surgeon during the Civil War.
His address has been published in
the New York Medical Journal
Dr. Keen started by declaring that
the FIRST notable difference is in the
weapons Of warfare and described the
bullets used 80 years ago and those
of today. In the Civil War the mimic
ball, named after French officer
who devised IT, consisted wholly of
lead lt measured an inch In length
and its base was half an inch across.
Il weighed zoo to 500 grains q l-2 to
] S-4 ounces.) It's muzzle velocity was
963 feet a second and its enectlve
range about 1000 yards. The modern
missile is smaller and lighter. II has
a leaden core incased in a cupro-nick-
el-steel Jacket Il is cylindrical, ter
minating i'm a pointed forward end. It's
weight varies from 139 to 175 grains.
II is an inch and a quarter long and
a quarter of an inch inl diameter at
he base.
"The shorter the range" said Dr.
Keen, "the greater the explosive eff
iect. even in soft muscles. AT long
range It may simply perforate the
bone, especially near joints where the
bone is spongy in texture. The
trenches in Belgium and France are
generally separated by short or some
times a very short distance. The
violent explosive effect at short range
has given rise to the charge by both
sides In the present war that dunn
dunn bullets were being used.
think that the most competent testi-
mony Is that the charge on both sides
is incorrect. the explosive effect Of
the swiftly moving and swiftly revolv-
ing modern missile and the possible
rupture of the jacket causing the err
ror."
Shrapnel, DIT. Keen described as
hollow metal she'll filled with round
leaden bullet balls about half an inch
in diameter, weighing from 100 to 40
grains each and each shell contains
from $50 to 100 OF these balls. When
the she'll bursts Il scatters these balls
in a shower over a wide area. The
balls produce severe wounds and the
ragged fragments of the shell itself
produce the most CHASTITY and eX-
tensive wounds One Belgian soldier
had IL of these balls lodged in his
body and he recovered IN the Russo
To la "a Nfn o.
the greater number of wounds were
from shrapnel. Until these two wars
about 80 per cent. of the wounds were
from rifle bullets
Method Discovered by Accident.
The weapons having been described.
Or Keen paid some attention 10 mod
ern surgery from the time Of AM
hroise Pare who founded 10 in the
middle of the sixteenth century. In
Pare's time, 90 counteract poison
caused by a gunshot wound. boiling
OH or tar was poured on the wound.
Bleeding after amputation was
siaunched by the application of a
red-hot iron. The hot oil and pitch
gave out one day and Pare was com
PEELED to use muscle ointment and
dexterous handaging. He spent that
night IN misery fearing his patients
would incur dmeful dangers. but to
his surprise found the new method Of
treatment better than the old. In 1862
he banished the hot iron and tied the
blood vessels 10 stop bleeding.
From the cruel time of Pare" said
Or. Keen, TO that Of the Civil War
there was a gradual but steady i'm
provement, but not until anaesthetics
slew the demon of pain was the sur
Eeon aught but a minister of horrible
Euffering
''rhe hypodermic syringe was not in
wide general use even toward the
close of the Civil War. II reached its
present perfection only In 1865. We
had the ordinary and dangerous
probe. This may he described as a
slender flexible silver finger to detect
the course and if possible. the pres.
Bence of a bullet. but in our ignorance
of bacteriology. not beng sterilized
Il was also a means of carrying in
fection deep into the wound. We uset
only the ordinary marine or toile
sponges. After an operation they wer,
washed in ordinary water TO cleans,
them of blood and pus and were useC
In subsequent operations. In our liz
norance of bacteriology we did no
know that they Earbored multitude,
of germs which infected every wounC
in which they were used. Apart from
knives. saws, forceps and needles. tn,
foregoing list practicaiiy completes
our means and methods OF surgica
diagnosis and treatment IN the six
ties"
DR.. Keen then told Of what sur
geons now have. The first he men
toned was the thermometer. and n,
described how during the Civil Wal
the doctor had to feel the patients
arm or neck by his own hand Il
decide whether there was fever. The
thermometer was first used in 1868
The early thermometers were the or.
ulnary long ones. DIR. Keen said .he
nrst clinical thermometer he ever saw
vas brought to him in 1876 by DR.
Welr Mitchell, and II has not beer
broken. Clumsy hands and fingers
were the only means of separafins
tne edges Of wound to examine n,
depth. Now there are retractors n
various kinds.
Arrest Of HemOrrhage.
Among the greatest Improvement
m arresting hemorrhage are ON
hemostatic forceps," continued n,
Keen. In the Civil War each arter
had TO be caught Aid held nv a to,s