Surgery in war by Alfred John Hull

By Alfred John Hull

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CHAPTER II THE GENERAL CONDITION OF THE WOUNDED IN writing of the general condition of wounded men in a book of this size, one is bound to speak almost entirely of shock. Soldiers in the fighting line are healthy men and are very unlikely to be suffering from diabetes and other diseases which may profoundly modify surgical interference. have been well They and in trench warfare, at any has the effect of exposure exhaustion been rate, rather than of muscular fatigue. So the condition fed, of the patient is due almost entirely to the site and nature of the wound, the length of exposure before the wounded man has any attention, and the delay, often unavoidable, before he gets proper surgical treatment.

The dressing is carried by the patient, and consists a cyanide gauze pad fixed to a bandage. An attempt has been made to render the dressing more efficient by providing ampoules containing 2 per of The aphorism, " The patient's life is in the hands of the man who applies the first field " is no longer true. The missile will, in dressing cent, iodine. most cases, carry infection into the depths of the wound, and the severe infection producing anaerobic disturbances is siderable depth. probably usually carried to con- The first field dressing will, there- fore, only prevent a secondary contamination of the wound from the patient's clothes and skin.

Flow of lymph is induced from the wound as part of the (6) A reaction of the tissues. (7) Fsetor is rapidly eliminated. and irritation occur they can be easily controlled by reducing the concentration of the antiseptic. (9) The practical advantages of this antiseptic for field use are: (a) It can be used as a dry powder and, therefore, obviates the difficulty of procuring water. (6) It can be introduced into the gauze pad of the first field (8) If (c) Where water is available the same powder can be made as a lotion for general use.

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