Plaster and Stench

Striking medical victories scored by British surgeons amid the muck and terror of the recent Allied withdrawal from Flanders were noted in London last week by the authoritative Lancet.

In their desperate need to deal at top speed with tens of thousands of wounded who had to be rushed on to steamers in the Channel with the Nazis only a few jumps behind, hard-pressed, sweating surgeons had to have some new and faster technique of treating wounds. Fortunately, most of them had read last winter the revolutionary work on wound surgery written after the small-scale war in Spain by brilliant Dr. Josep Trueta of Barcelona, now in England (TIME, Jan. 15). In treating 1,073 projectile fractures, Surgeon Trueta obtained wholly satisfactory results in 976 cases and there were only six deaths. His method: instead of lengthy and painstaking work in old-fashioned suturing and splinting (sewing up wounds and applying strips of wood in the bandage like stays in a corset), the wound is thoroughly trimmed of all germ-breeding dead tissues, soothed with vaseline gauze and sealed raw in a swiftly and easily wound-on cast of bandages soaked in plaster of Paris.

When Spanish wounded so treated began to hobble and be carried over into France as refugees, what was most noticeable was the terrific stench. This at first suggested to French surgeons that the plaster casts must be quickly ripped off and stinking human members amputated. The French soon learned, however, to let plastered Spanish wounded alone, observed that, while the odor for a time became almost unbearable, the end result was nearly always satisfactory. Last week the British Lancet said nothing about a heroic stench, said flatly that results of the Barcelona method have been so good in Flanders that from now on suturing applied on the battlefield must be considered "almost criminal."

Quoting Dr. William Heneage Ogilvie of London, especially enthusiastic about plaster, the Lancet summed up: "Once a wounded man has undergone efficient surgical treatment and has been put in plaster, he is safe--he may be blown out of an ambulance, derailed in a train, crashed in an aeroplane or torpedoed at sea, he may be left for weeks in a cellar . . . but so long as the plaster holds he will come to no harm." French surgeons in the War of 1870 pioneered the plaster closed method and in World War I it was used to some extent by U. S. Army Surgeon Hiram Winnett Orr, now of Lincoln, Neb., who contributed a preface to Dr. Trueta's book, Treatment of War Wounds And Fractures (Hoeber; $2.50).

The Lancet also reported that sulfanilamide administered to wounded in Flanders proved another victorious medical technique. After this treatment, said the Lancet, "The condition of the men who have received no surgical treatment . . . is ... far better than that of men evacuated under similar circumstances during the great German attack over the same country in 1918."

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