17,1 Banister: Military and Civilian Surgeons 15 
readiness to adopt the preventive methods of the military sur- 
geon, such as typhoid and venereal prophylaxis. 
Then came the World War, and the civilian practitioner 
covered himself with glory through his patriotism in rallying 
to the flag and his scientific medical knowledge. Prior to April 
6, 1917, the regular army had but 447 medical officers, and 1,600 
_Yeserve officers who were in civil life. During the war period 
35,000 civilian practitioners joined the colors, and about 20,000 
served as medical officers of the draft boards in making physical 
examinations. Over 14,000, the cream of the medical profes- 
sion in the United States, served in France; and never before in 
history, with the combination of both the military surgeon and 
the civilian practitioner, have the soldiers of armies been so well 
taken care of, both in the prevention of disease and in its cure, 
and under such unfavorable conditions as prolonged trench 
warfare, It is true war claimed its millions in dead and dis- 
abled, but they were the legitimate losses of war, from shot 
and shell and gas. 
The control of smallpox and typhoid, the two great scourges 
of armies, was almost absolute. Typhus fever was held in 
abeyance in armies fighting in Europe by the discovery that 
the body louse is the transmitter of that disease, and by the 
extensive system of delousing the armies employed back of the 
lines; tetanus, by antitetanic serum which was required by 
orders to be administered to all wounded at the first practicable 
point, and each wounded man’s field card showed where and 
when it was administered. The infection of wounds by the gas 
bacillus was prevented to a great extent by the debridement 
operation, which consisted of laying open the wound freely, 
and removing all dead or devitalized tissue, including muscle, 
bone, tendons—in fact, every dead tissue—and removal of all 
foreign bodies. Unless this was done the dreaded gas infection 
was very apt to occur. Then there was the Carrell-Dakin 
treatment of wounds, in which the open wounds were lightly 
packed with gauze, and kept wet with the Carrell-Dakin solution 
until the fixed hospital was reached. Then, by frequent cultures 
made from the discharges from the wound, it was found that, 
when the organisms had been reduced to a certain number per 
field of the microscope, the wound could be sutured with con- 
fidence that it would then heal by first intention. This treat- 
ment saved many lives and prevented much disability. The 
louse was found to be the cause not only of typhus fever but 
also of trench fever. 
