WONDERS OF MODERN SURGERY

Dominion, Volume 9, Issue 2885, 25 September 1916, Page 4

WONDERS OF MODERN SURGERY

A TOUR OF MILITARY HOSPITALS

..A., party, of. journalists have just completed"a. tour of military hospitals, authority to inspect having been given by the Director General. Vivo wero visited, and a sixth establishment at which visitors wero received was theRoyal Army Medical College. The first: 'hospital visited was tho Royal , Her-; berfc at AVoolwich, where there is ac 7 : commodation for 98tf patients. The: party were introduced to tho staff in. a theatre where is claimed to he iri- : stalled the finest X-rays onfit in the. kingdom. Patients wero brought in, and it was noticed that they arc conveyed from the wards lying upon their own beds in all cases of sorious in.jury. The sleeping couch is movable on "wheels, and consequently there is no need- to lift the sufferer. As distinct from "locating" work tho rays may he used in malignant diseases. Unfortunately up to now it has not been possible to' secure absolute safety for the operator.' --.... - ■. Ono of the most remarkable of the cures described is that of the location of a bad fracture in the'limb and the. insertion of a steel plate. It was an operation on a healed wound in the leg, and caused no discomfort.' This fixing of plates on .'extensive fractures is quite modern work. In former days operation's involving the removal _ of bone invariably meant tho shortening of a limb, hut this permanent disadvantage no. longer results to the patient, jlen have, been so operated upon who are now once more at "the front. One soldier was seen who three-weeks-ago underwent the femoral operation by the introduction of a- six-inch plate; It was the left leg which had been fractured. The plate can now be felt beneath the incision, but there is no pain. A New Form of injury. In oiie of .the wards the writer was shown tho'modorn treatment'in cases of .wrist-drop,' where tho muscles used in raising the -hand are paralysed by injury on the field. This form of paralysis is due cither to a division ot the nerve'or to its being so affected that for the time being its conducting I power is absent. These cases are numerous. Electrical treatment visually carried put before the operation, for the- reason that it is often impossible to say-whether the nerve is divided 'or concussed by the proximity of tho bullet' The surgeons do what is-possible to. frcb the nerve, and where the nerve is divided they join the ends together, and so in time promote .its conductivity. It often takes six or nine months' to obtain a complete recovery, . .. ... Until the war there was no experience of this particular kind of nerve injury to go upon. The War Office' took the matter up and started departments in the various command depots where the patients could get eleotrical treatment and massage. The staff at the Herbert" Hospital can point to between, three .aiid. four thousand successful operations, and the amputations :a'ro":to be almost counted on the fingers hand. Of major operations there have "not. been more than twenty,'five in all. Where death of the limb is -feared from acute infection preventive doses of serum are administered. Somo time was spent in inspecting cases of gas-gangrene. One of the most interesting is that of a patient who was wounded in the shoulder— from front; to back—as recently as ..J.u1y,,29, and..was,., brought ..into Jiospi)talV?6n- August 2i-" : This lisl'a- caW-of infection by'bacilli from'-; tho "soil, driven in by the bullet, which may ho a' ricochet (a rebound through being fired at a low elevation). Mud-covered clothing worn by- the ; combatant, _ if particles carried away in the lino of the projectile, may also produce infection. Oxygen is the , enemy of those bacilli—they cannot live in .it, .but they thrive'ill .the wound. 'Fighting Bacilli. ■" This particular patient when admit'ted appeared to be hopelessly septic,' And iii the depth of the wound were found "gas. bubbles". due to the infection and needing . to be combated energetically. A., large opening was made, and by the use of an ingeniously, constructed apparafcis peroxide ■of'-hydrogen was-soaked-through, conveying oxygen into the area in which the .organisms had secured a lodgment. Ah alternative method of fighting bacilli . is'; to place'a- perforating tnbo in position and force tho oxygen through it into" the tissues. In a case of gasgangrene, where the wound is large and more superficial than that- already mentioned,' a piece of-gauze is used and: kept wet with peroxide and yet tho patient gets constant circulation of air. .One portion of the ■'range of hosnital buildings at' Woolwich is occupied by wounded prisoners of war. These Germans, all anparently very young, and some quite juvenile, will be drafted to the internment camps. Some are severe, others are slight cases. Tho prisoners wear a dark bluo'hospital dress with a large red disc of .cloth as a distinguishing mark. The treatment is ■in all respects tho same as. that'given to bur men—Briton and German fare aliko both in respect to rules of living and ward accommodation. The -visit was brought to' a close by an inspection of "plant" installed for electrical- treatment of injury, and for counteracting tendencies to; muscular atrophy. Stationary roiving and cycling are two of the methods used for giving stimulus to the muscular svstem". A man mav put in a good mileage on a _ "push-bike" without leaving tho dormitory, or if be hnvn. "wot|bnli". tendencies he can get into the sliding seat of an outrigger and qualify himself for "the .junior' sculls." Tho. D.itionts arc ever ready to make the best of. circumstances, however adverse, and their spirit is wonderful. Rosliapins Limbs. Thft military hospital at Hammersmith afforded the newspaper men an opportunity of witnessing remarkable work in the domain of medico-thera-peutics. Cases regarded elsowliero as almost, if not quite, hopeless are sent to this institution, so that.tho injured may be given, so to speak, a last chance. The patients am numerous, ■ .and include Hermans, amongst whom there have been some severe eases; Moulds from actual. injuries are exhibited, and instances arc given in'which our o«n men have attributed the peculiar character of their wounds to the expanding of soft-nosed bullets. A. 'cleverly constructed splint will enable a patient by the graduated turning of a screw to get his limb back to the normal. Electro-therapeutic treatment simply means'that by stimulation through a current, the surgeons educate the wasting muscles of a limb to react. A remarkable instance of cure in this hospital is that of a Soldier whoso original injury was a shrapnel wound through the head of the tibia. After thirteen, months spent under treatment he had been brought to Hammersmith, and at the end of six.weeks he is ablo to walk. Another patient suffers from failure of the knee-joint through a. lorry accident on Salisbury Plain. A druc is driven into the joint to <;et rid of fluid, and a return to hciiKli.r condition is assured. . Of tho cases of trench foot the corrected position of both feet is secured by two operations; and after being nino.months in bed tho patient walks the entire length of the ward to greet

tho visitors, wliom ho. smilingly informs that he has his "boots on for the first'-time to-day." Fully to realise what tho skill'of the surgeon has accomplished hero the. reader must needs see—as the visitors naw —a real case of-- trenctl foot; It is a- hideous deformity, and must cause incalculable suffering to its victim. What is being accomplished at Hammersmith by sursical science would fill a- volume. A soldier with complote paralysis owing to a. division of the main norve finds himself ablo once more to extend his fingers by. tho simple transference of six muscles from the .front to the back of tha wrist, -''