The sun., 1918-08-07
THE UNIFIED SURGICAL COMMAND ON
THE WESTERN FRONT.
Encouraging Report Made in Medical Work
Centralized Units
Lieutenant TBnfravoues IN lie Temps.

the new system was applied on full
scale.
The wounded who flowed back were
OF two great categorios, those who
had to be operated upon on the spo,
and those who could stand a Journey
The former were cared for in the
establishments existing Just to the
rear OF the lines. or which had been
moved to the rear (I know dressing
station chiefs who picked UP all their
baggage and effects in tho morning,
moved the whole shop twenty kilo.
meters to the rear and operated that
same evening in their regretted quar-.
ters. And this three times in SIX
daysD
For the other category CHOSE abs
to traveD a wide distribution was ar
ranged; a lateral distribution from
Rouen to Barbecue and dispersal Tar
to the rear, particularly toward Paris
and thereabouts. Thus, divided among
a great number OF hospitals, the
wounded got the best possible atten.
ton. 1t was really the "industrializa-
ton" OF surgery. Such was the ex-
cellent result of the new iden.
The system functions so well be.
cause, for one thing, NJ. Mourier
personally superintends It's execution.
ready to note at their start any i'm
projections which might develop In
practice. He watched from the begin
ming to the very last minute, quitting
Mont Notre Dame. for example Just
fifteen minutes before the Germans
arrived.
A method such as that which am
explaining requires the closest init
macy and cooperation between the
ambulance service and the medical
service in order that its full fruits
may be reaped. Here, for instance.
Is a master station, the nerve centre
Of a network Of rail lines, and further
on Is a station where there Is an
evacuation hospital: shall they send
train load Of wounded through the
railroad centre toward the hospital
station unless they are sure the train
will arrive in so many hours?
Obviously not. Therefore, you see
the necessity OF a perfect understand
ing between the surgical command and
the command which directs the auto
mobiles. the railroads sand the con-
voys of horse drawn ambulances.
Plainly one Of the chief advantages
OF a single command for the medical
service Is not TO have one branch
arrayed against the other, but on the
contrary, while putting the railroad
station commander in his proper place
the motor transport chief in his. and
the surgeon in his, still to realize the
almost perfect collaboration OF the
station master, the motor chief and
the surgeon.
Results Justify the scheme. Early
reports coming from Rouen and Bar
le-Duc, the extreme points Of evacu-
alton. show that the wounded arrived
in plenty Of time to be treated eff
GENTLY.
Incidentally. another fortunate fact
has been determined. Formerly 1t was
CT nsidered that after a fixed delay
tsiN hours for certain wounds) in
lection became incurable and opera
ton useless. But during these lates,
battles 1t has been ascertained that
this delay may be prolonged without
III effects to fifteen, eighteen and even
twenty hours. 1t seems this is due 70
two reasons: first. the new conditions
Of warfare; second, improved surgiCa.
methods.
During the period Of the war 4
position, the earth of the trenches
which worked into the wounds WAS
so polluted that unless the wound
was eNcised promptly infection made
!, swift progress. In the war OF move
ment, after the first days, the wounds
caused by shell fragments became
rare; the majority Of injuries We?'
caused by bullets. The bullets did 10:
always ricochet. but even when they
did touch the ground the earth which
J they CARRIE into the wound was sl
: little befouled that infection was slow
to develop. or perhaps did not develop
at all.
Now as to the improved surgical
methods. DIR. Carrel overcame sup
puration and destroyed it by using IN
appropriate liquid; 1t is sort OF
chemical scalpel" Our surgeons clear
away with the knife the contaminated
: flesh, thHs hindering the birth of in
lection. Bu; II this does not suffice
they finish by using the Carrel system
But, it is asked, with such an infuN
OF wounded. are not the hospitals
gorged? No. In Paris. for example
the equipment of our surgeons re-
moved from temporary stations at th,
front. which were abandoned during
the German advance, has served u
! outfit new and permanent places where
, they operate day and night.