SURGICAL MIRACLES.

Lyttelton Times, Volume CXVII, Issue 17279, 21 September 1916, Page 2

SURGICAL MIRACLES.

MENDING BROKEN SOLDIERS. REMARKABLE OPERATIONS. [From Ocr Correspondent.] LONDON, August 15. A number of English journalists wero recently conducted over half a dozen typical military hospitals in the metropolitan area to see for themselves the magnificent efforts that the medical and surgical fraternity are making to mend the gallant lads broken in the war. The impression left by such a tour upon ihe lay mind is that tho public possesses an absurdly inadequate idea cf the debt that they owe to modern surgery at a time like this. Day by day the •urgeons are making—if not new men for old—at least men who may become useful citizens out of shot and shellmangled human beings who, less than a score of years ago, must have died a lingering death, or have continued useless to the community. Cripples for life many of them must have been save for tho wonderful progress made in :urgical science, tho X rays and tiio marvellous effective new antiseptic treatment. NERVE MENDING. Out of hundreds of wonderful cases it is only possible to describe a few that, may bo taken ns typical of this trade of mending soldiers. Take first the new nerve surgery. Here is a man with a bullet hole near his collarbone which severed tho nerve controlling the muscles of his wrist. The lesult was “wrist-deep,” and a hand which, until quite recently, would have been regarded as incurably useless. Tho two ends of tho severed nerve have been freed from what had already become no more than a scar, they have been reunited, and there is every prospect that in less than a year the hand will ho almost as good as ever. Hero is another and even more remarkable nervo case. A man had part of the fleshy part of his arm shot away, carrying with it four inches of the nerve necessary to control the hand movements.’ Tho surgeon telephoned to several hospitals till he heard of what ho wanted —-the amputation that afternoon of a healthy limb. . The limb appeared to he a leg, and it was amputated at 3.30. No sooner was it off than four or five inches of practically living nerve wore removed from the calf, placed in a saline bath, and rushed bv taxicab to the other hospital. Heie the patient was already under ana?sthct:c The wound in his arm was opened, the ends of the indispensable nerve found, and the circuit re-estab-lished, as it wore, by means of the first patient's four inches of filament, today tho man is in a fair way to regaining tho full use of his hand. HEART AND LUNG WOUNDS.

Two of tho jnost remarkable operations performed during the war have succeeded in removing a bullet lrom a man’s lung in tho one case and a piece of shrapnel from a man s heart m the other. In tho former ease a young Irishman was shot in the abdomen witn a bullet which struck upwards and lodged in the lung. It was found by the X-rays and removed, and tho man is on tho point of leaving hospital almost quite well. In the second case the man comnlained of severe pain in the region of the heart, especially when he bent, and lie had great difficulty in walking. The rays showed a hard substance at tho back of the heart, and the surgeon, in the course of tho operation, had to nut hi s hand behind the heart and tako away the shrapnel—which was ot the Bize of a halfpenny—with lus lingers. Air was pumped into tho mans lungs throughout, and all other precautions were taken to keep him alive during this touch-and-go process. F ortunately there was no spurt of blood when the shrapnel was removed, and, the operation having been performed m March, the man is now perfectly well. treating old fractures.

Tho Rovnl Herbert Hospital at Shooters Hill had recently an old ease of /bad bone-setting in the leg. The Xrays showed tlio two bones of the fracture to overlap no less than 2}m, and the fracture was eight weeks old. The surgeons, cutting away only an eighth of an inch of the two bones, brought them together perfectly, as shown again bv the X-rays, and fixed them in position with a steel plate, which, remains screwed on the bone. The man wiii be able to walk as well as ever. | In the septic cases here the visiting 1 journalists saw the very process of I limbs being saved from amputation I by the intense injection into the affected wound of peioxide of hydrogen, 'or I a steadv draining of the wound by saline, the injured part being caned in muslin, so that it is reached by the filtered air. “ GAS GANGRENE.” In this war the variety of sepsis that has claimed more victims than any other is that known in medical jargon as ‘gas gangrene.” Gas gangrene is caused by the presence m a wound of ceitain types of bacilli which cannot live in air, the vital principle of which is oxygen. They exist (like the tetanus bacillus) in swarms in highly cultivated soil, and it is because the war is being fougnt iu France among the peasants’ fields that they are introduced so constantly by ricocheting bullets, or scraps of earth-stained clothing, into the wounds of our soldiers. Once tliero, they set about producing tiny gas bubbles among the tissues; hence the name ‘‘gas gangrene.” But the gas

they cannot endure is oxygen, and the obvious way to destroy them is to introduce oxygen into the innermost recesses of the wound. This is secured by various methods, according to the nature of the injury. A hole right through the shoulder will be sterilised by the use of a wick drawing peroxide of hydrogen from a small tank above the bed. Another kind of wound will be sprayed with ozone, and a third more conveniently dealt with by means of a perforated tube fed with oxygen gas from a cylinder. DISFIGURED FACES REPAIRED. Another important consideration that calls forth the utmost ingenuity of tbo modern specialist is the removal, ns far as possible, of tho trace of injuries sustained. In this war of high explosives severe injuries to the face are unhappily common, and even where a satisfactory care is effected the victim is not infrequently, more or less, disfigured for life, and in some casps tbe effect is so repulsive that tho “cured” man might well hesitate to mix again with his felloe-men. It is here that one of the greatest triumphs of modern surgery comes in. The results may be seen at the Wandsworth Hospital, wliero the new art is extensively practised. The work is done by, or under the supervision of, Mr Francis Derwent Wood, the world-famous sculptor. Metal masks aro largely used, together with artificial eyes. The masks are of copper, silvered over, and they are almost infinite in sizo and shape, in order that each may correspond with tho ‘exact nature of the injury to be concealed. • A concrete case will serve to illustrate tho procedure. One poor fellow had had one eye destroyed, there was a deep cavity in the region of that organ, his nose was gone, and his upper lip was badly disfigured. A mask was made to resemble the missing part of his face, an artificial eye was obtained that exactly resembled the one remaining, and an artificial moustache was even attached to that part of the mask that represented the Upper lip The result as shown in a series of photographs of the man taken before the injury, after recover}’ from the injury, and after “ repairs,” is, that in facial appearance he is now almost exactly like what he was before he saw .the fighting line. Caro is taken, of course, to impart a flesh colour to the mask, and so successful is the result that at tho distance of a few feet no trace of tiie injury would be seen by a casual vis-a vis. * It is only on a close inspection that one can discern the dividing line between the real and the artificial flesh. This soldier’s face is truly a fine “feather in the cap” of the repairers; indeed, they have achieved something bordering on tho miraculous. Some of tho most cruel wounds are those in the jaw. The disfigurement is often horrible. Speech and mastication are equally impossible. So the surgeons have found a means (involving the wearing for many weeks of what looks like a strange double set of false teeth) of gradually pressing back the remains of tho jaw into their natural position,, of restoring motion and flexibility to the lips, and of smoothing out the most ghastly of the scars. It would be possible to write of scores of other marvels, but space forbids. Mention, however, must be made of the new anesthetic, which is so harmless that a patient can remain under it for two hours, jrot smoke a cigarette in comfort within a quarter of an hour of regaining consciousness.