Evening Republican, Volume 20, Number 235, Rensselaer, Jasper County, 30 September 1916 — MAGIC OF SURGICAL SCIENCE IS MAKING NEW MEN OF OLD [ARTICLE]

MAGIC OF SURGICAL SCIENCE IS MAKING NEW MEN OF OLD

Some Remarkable Instances Where Operations Have Practically Rebuilt Vital and Important Portions of the Human Body That Had Been Shot Away in the Battles—“ Gas Gangrene” Is Surgeon’s Worst Enemy.

London.—The marvelous progress that has been made in recent times in surgical science is most impressively revealed by a journey to some of the larger military hospitals, made possible through the courtesy of Sir Alfred Keogh, director general of the army medical service. In all the hospitals what the medical staff set above all is conservative surgery—that is to say, the saving of limbs in order that the patients may remain useful members of the community. Thus, at the Herbert hospital, at Shooter’s Jgljl, there have been since the beginning of the war from three to four thousand operations, and Colonel Simpson, the officer in charge, declared that he did not believe there had been in all more than 25 primary amputations. The impression left by a tour of these hospitals upon the layman’s mind is that outsiders have an utterly inadequate idea of the debt they owe to modern surgery at a time like the present. Day by day the surgeons are giving to the nation new men for old. They have embarked upon a great mission of hope among the nation’s soldiers. They are doing more than would have been credible twenty years ago to rob war of its ultimate horror. Out of the hundreds of wonderful cases brought to one’s notice during these visits It Is only possible to describe a'few that may be regarded as typical of this trade of mending soldiers. Take first the new nerve surgery. Here is a man with a bullet hole near his collar bone which severed the nerve controlling the muscles of the wrist. The result was “wrist drop” and a hnnd which until quite recently would have been regarded as incurably useless. The two ends of the 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 be almost as good as ever. “As simple as tying up the two ends of a cut telephone wire,” says the surgeon who operated, , Amazing Nerve Cases. There are more remarkable nerve cases still. A man had part of the fleshy portion of his arm shot .away, carrying with it four inches orMhenerve necessary to control the hand movements. The surgeon rang up several hospitals on the telephone till he heard of what he wanted, the amputation that afternoon of a healthy limb. The limb happened to be a leg, and it was amputated in the afternoon. No sooner was it cut off than four or five inches of practically living nerve were removed from the calf, placed In a saline bath and rushed by taxi to the other hospital. Here the patient wns already under an anesthetic. The wound in his arm was opened with a lancet, the ends of the Indispensable nerve quickly found and the circuit re-established, as it were, by means of the first patient’s four inches of filament. Today the man is in a fair way of regaining the full use of his hand. Bone surgery on rather similar lines Is more familiar, but hardly less surprising when you meet and . talk to a man who converses with the aid of a lower jaw part of which was only a few weeks ago part of his right leg. It was mended with two and one-half inches of one of his shin bones. The shin has quite healed, and the hole will be completely filled with new bone before long, so accommodating is nature when treated with knowledge. Another patient is perfectly happy and prosperous with three inches of the fibula of his left leg neatly mortised in the humerus of his right arm. He, too, will finally suffer no loss of bone whatever. The variants of such operations are endless and only limited

by the Ingenuity and enterprise of each surgeon. Cprpentry and Legs. Of remarkable examples of carpentry applied to broken limbs most hospitals have two or three, if not more, on hand. A young fellow was brought into the hospital with one leg shortened by five Inches, owing to the ends of the broken bone overlapping. He seemed a hopeless cripple. The leg was rebroken under an anesthetic, an eighth ofc an Inch cut off from each side qf the fracture so as to secure a smooth joint, and a steel plate fastened on with gix screws, precisely us one would mend the broken leg of u table. The plate and screws will remain In position as a permanent addition to the soldier’s anatomy, for steel will not rust among the tissues. And the man has a leg practically as long and w straight Tather stronger than, U was Intended to be by qature. Some of the most cruel wounds are those In the jaw, but even here what the skill and patience of the surgeon have been able to do is wonderful. One poor fellow who had been provided with a new roof to his mouth was one of the most cheerful of the patients. His comic songs are the delight of the ward. You cease to be amazed at any height of human skill or human courage after a few hours in any of these military hospitals. You know for certain then that man Is unconquerable. Where the injury Is to the upper part of the face, resulting In, say, the removal of the nose and one eye, magical results are being achieved in a southwestern district hospital by the provision of masks perfectly counterfeiting tlje lost section of the physiognomy. Lieut. Derwent Wood is the jhiventor of the plan. With the help of photographs of what a patient was like before being wounded he will make a false nose of silvered copper, artistically painted to match the surrounding complexion, which will so far defy detection as to enable the owner to go out lntq the world again ■ without shrinking and play his old part In the anairs of men. • A Remarkable Operation. Here is another remarkable case. Not long ago a wounded Guardsman was brought Into the Queen Alexandra hospital at Millbank, suffering from a Examination under The X-rays showed that a piece of metal as large as a halfpenny and much thicker gad entered the breast and lodged in the region of the heart. It was, in fact, actually touching the heart and impeding its action. . An operation was decided on, and the surgeon thrust his hand right Into the opening and pulled out the piece of metal, which Is preserved as a souvenir. There was a danger that during anesthesia the lungs would collapse, and therefore ether was pumped into them to keep them distended. That gallant Guardsman Is now out and about, and it is declared that he will pot feel the slightest*ill effects from his strange* experience. In this hospital there is at present a Serbian officer who was wqunded in his own country and brought to England for treatment. It was a case of severe injury to the jaw. Lieut. Sir Francis Farmer removed a piece of hone about two and a half inches long from the tibia of the patient, and, having carefully prepared a bed in which to place it, fixed it in the jaw. The leg is now healed and the patient can eat wonderfully well. But this refitting and, as it were, rebuilding of citizens is not enough. They must first be snatched from that progressive process of destruction associate?! with thf dreaded word sepsis, that creeping death of the tissues which is the surgeon’s most remorseless enemy. And here again one encounters the marvellous. In this war the variety of sepsis that

has cl a 1 l.iea more, victims than any other Is that known in doctor’s slang as “gas gangrene.” Gas gangrene is caused by tbe presence In a wound of certain types of badllll classed as “anaerobic,” that Ir, bacilli which cannot live In air, the vital principle of which Is oxygen. They exist —like the tetanus bacilli—ln cultivated soil, and it is because the war Is being fought in France among the peasants’ fields that are introduced so constantly by ricocheting bullets or. scraps of earth stained clothing Into the soldiers’ wounds. y Once there they set übout producing tiny gas bubbles among the tissues, hence the name “gas gangrene.” But the gas they cannot endure is oxygen, nndj the obvious way to destroy them Is to Introduce oxygen 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 sterilized by the use of a wick drawing peroxide of hydrogen from a small tank above the bed. Another kind of wound may be sprayed with ozone and the third more conveniently dealt with by means of a perforated tube fed with oxygen gas from a cylinder. The operations to which reference has been made would doubtless be described as severe even by the surgeons themselves; nevertheless, modern science has robbed them of most of their terrors. The Improvements in anesthetics have been such that it Is no uncommon thing for an operation to last two hours and for the patient to feel no ill effects from the drug a quarter of an hour after he recovers consciousness. Some, Indeed, will be smoking a cigarette within that space of time. The secret lies in the administration of oxygen with the anesthetic.