Medicine Looks Ahead 233 



In cases where the fracture wound was healing, Orr en- 

 cased it in plaster. But in cases where the wound was still 

 infected, he made a plaster cast with a sort of window which 

 allowed him to dress the wound daily. When he got home and 

 began to take off the casts, Orr discovered something strange. 

 The closed casts, which should have caused trouble because 

 they didn't permit regular dressing of the wound, appeared 

 to have speeded the healing of the wounds. The legs and arms 

 encased in casts with windows for daily dressing and drainage 

 did not show much improvement. 



Orr thought this all over and wrote a paper which sug- 

 gested that leaving the wound undisturbed, and letting nature 

 take its course, was more important than daily treatments. 

 No one paid much attention to the paper, but Orr began to 

 use his method and it worked better than any other. His 

 patients, and curious doctors, were annoyed by the overpow- 

 ering smell of the casts after a week or two. Surely the leg or 

 arm must be rotting away under the cast. But when Orr inves- 

 tigated he found that the wound was healing rapidly. It was 

 not, however, until Orr used his cast treatment successfully 

 on stubborn osteomyelitis cases (bone infections) that a num- 

 ber of surgeons began to follow his methods. 



Several thousand miles away, in Spain, Jose Trueta, chief 

 surgeon of the General Hospital of Catalonia, was using Orr's 

 method. When the Spanish Civil War broke out, Trueta's 

 hospital served as a base hospital for the Spanish Republican 

 Army and he soon was busy on fracture cases from the front 

 lines and the bomb-shattered buildings of Barcelona. He cut 

 away the dead and dying tissue from hundreds of shattered 

 legs and arms, aligned the fragments of bone, cleaned the 

 wounds, packed them with gauze, and put them in plaster 

 casts. When the odor of the casts got too strong he took 

 them off, cleaned the already healing wounds, and put fresh 

 casts on. 



