Chapter IV: Medical Care

When a man is wounded he receives the very best care, for experience has taught France that for the conservation of man power this is of the highest importance. No matter how slight an injury may be, it is mandatory that a man receive the proper medical or surgical treatment, for it is the small and seemingly inconsequential wounds that develop blood poisoning, which means the amputation of arms and legs or even death itself. Consequently, the moment a man is injured he must present himself to the doctor for examination, thereby eliminating, as far as possible, any chance of complications.

The small percentage of infections in the army is surprising, in view of the conditions that exist, which are not always the very cleanest and best. These small wounds, to men who live in damp dug-outs, stand watch in wet trenches, suffer from irregularity of meals, insufficient rest and exposure, are all things that tend to lessen their resisting power and render them just that much more susceptible to the development of infection.

During the first year of the war the frequency of infection from deep wounds was alarmingly high and all efforts of the medical staff to cut it down seemed in vain. At this time Doctor Alexis Carrel of the Rockefeller Institute, after consultation with some of the heads of the French Medical Staff, made a study of this vexing problem and with the backing of this wonderful institution with its ample funds, working without the red tape that in most instances goes hand in hand with an endeavor of this kind, after a surprisingly short time, developed a treatment known as Irrigation Intermittent Carrel. The apparatus used consists principally of a reservoir or container attached to the bed of the injured at the proper elevation to insure a flow of the fluid.

Connected with this and inserted in the wound itself is a rubber tube by which the fluid is conducted to the field of injury. At regular, determined periods during the day and night the fluid is released from the container and allowed to flow through the wound, carrying off poisonous matter or arresting any infectious condition.

As it was soon seen that this was the best method for handling deep wounds, they set out to perfect the treatment. The fluid used was very costly, particularly as such large quantities had to be employed in this intermittent irrigation, consequently there followed a great deal of experimenting, which, however, did result in the perfection of the treatment, but Dr. Carrel went farther. He and his associates compiled a chart or card, which recorded the age of the patient, the square inches or area of the wound, and such other facts as enabled them, through the handling of so many cases, to establish and chart lines of healing showing the progress of the wound from day to day in its course of treatment, and giving such other information as the proper time of closing the wound and the discontinuing of irrigation, etc.

So accurate did this chart work out that it enabled them to control all cases by its use. Thus, in the event that a wound had not progressed properly in its healing by a certain day to the requirement shown on the chart, the deduction was that the case required special treatment and so it was immediately given the requisite attention. One can see the far-reaching effects from a military viewpoint of such a system.

With these charts to govern them, the doctors at the different base hospitals could compute very readily just how many beds in their hospitals were occupied by cases of this particular kind and with this method of treatment estimate very closely two to three weeks in advance how many patients would be released and the number of beds that would be available for new cases at any given time.

Still another forward step in military medication is in the treatment of burns. I saw in France a man who had been working with powder which in some way becoming ignited, burned one side of his face very badly. He was taken to the hospital and treated by the new method of spraying paraffin over the burn and allowing it to heal from the bottom—a method which eliminated all the scar tissue with the result that it was almost impossible to tell that he had ever been burned.

We see so many cases in this country of people whose faces are covered with scar tissue caused by burns because they had been treated by such methods as allowed the air to get at the field of injury, causing a scar tissue to form, which nothing will ever remove. But by healing from the bottom and developing toward the surface the natural functioning of the healthy tissue leaves the exterior appearance practically without a blemish. This in itself is a wonderful development. For if a person is burned and treatment is necessary, there is some consolation in knowing that he will not be forced to go through life with hideous scar tissue marrying his appearance for the want of proper treatment. In addition to the “M. D.,” there is, in each division, the Dental Corps.