Military surgeons work by one rule of thumb: patch up and move on. At frontline dressing stations neither time nor sentiment is wasted on the hopelessly injured. A seriously wounded man has to survive the long stretcher trip through collecting station, hospital station, evacuation hospital to base hospital, some 30 or 40 miles behind the lines, before he is permitted the medical luxuries of thoroughgoing surgical care.
Though overworked army surgeons in World War I had to work thus, with a lick & a promise, great were the medical lessons they learned. Brilliant U. S. Neurologist Harvey Gushing, confronted with crowding thousands of head wounds such as he had never seen before, devised a dozen new brain operations by the light of a kerosene lamp in French front-line operating shacks. Tetanus, great killer in all previous wars, was practically eliminated by routine injections of anti-tetanic serum to all wounded soldiers. Fatalities from black gas gangrene were greatly reduced by immediate injections of vaccine, a treatment developed by famed U. S. Pathologist William H. Welch. The late Spanish war taught doctors a rapid, efficient blood-transfusion technique. But military surgery remains essentially a problem in organization, and doctors aim primarily to sort and shift casualties, to move them on like "factory goods on a conveyor belt." Experts claim that eight operating teams, of nine men each (including anesthetists and nurses), can handle 120 serious surgical cases in ten hours.*
Most U. S. casualties in World War I were caused by gunshot, shrapnel, shell and rifle wounds. Most frequently injured organs were spinal columns. In decreasing order: abdomens, chests, heads. Exactly how casualties will line up in World War II, no one can yet predict, for new weapons cause new types of wounds. For every known type, army physicians are prepared. Many British surgeons carry an up-to-date handbook on war surgery, newly published by Drs. Philip Henry Mitchiner and Ernest Marshall Cowell.†
Penetration v. Laceration. Battlefield wounds are of two main types: penetrating, lacerating. Penetrating wounds are caused by bomb fragments and bullets, lacerating wounds by high explosive bombs. "Secondary bodies" may also act as missiles. "Thus the contents of a victim's pockets," say Drs. Mitchiner and Cowell, "may be peppered by the force of the burst bomb, and such things as ... penknives, coins and pencils may be found distributed in the body, and occasionally outside objects such as pebbles, bits of masonry, and even the bones and soft tissues of a nearby victim may cause wounds." Grease, dirt and bits of clothing are driven into wounds. It is a military axiom that "every wound is infected."