AUGUST 27, 1914] 
NATURE 
€65 
TREATMENT OF THE WOUNDED. 
my the meeting of the Academy of Sciences, 
held in Paris on Monday, August I0, a 
paper, of particular interest at the present time, 
was read by Inspector-General Edmond Delorme 
dealing with the treatment of the wounded in 
modern warfare.t General Delorme became a 
surgeon in the French Army during the last 
Franco-Prussian War, and has devoted his life 
to the advancement of military surgery, his text- 
book on that subject being recognised everywhere 
as a standard work. His opinion of the wounds 
inflicted by modern weapons is by no means 
pessimistic :— 
“The military surgeons, at the present time,’’ he 
writes, ‘‘must adopt the most conservative methods of 
treatment in the great majority of military wounds; 
indeed, such methods must be applied in practically 
every case of bullet wound. The opening of a modern 
bullet wound is so small that if the surgeon adopts 
strict antiseptic or aseptic dressings and refrains from 
probing the wound or making a systematic search for 
foreign bodies arrested in its track, it is possible to 
give the most favourable prognosis for wounds of this 
class. Thanks to aseptic and antiseptic methods of 
treatment, the wounded run less risk than in former 
times.” 
The pointed bullet, employed by the German 
Army, leaves very narrow wounds of entrance 
and exit when it penetrates the more fleshy parts 
of the body, but its track in the tissues themselves 
is marked by a considerable degree of destruction. 
Still, such cases, in General Delorme’s opinion, 
should recover in the course of several days or 
perhaps weeks. On the other hand, wounds from 
shrapnel, or from deformed bullets, are often ex- 
tensive, open, and complicated by the intrusion of 
clothing or other foreign bodies. Such wounds 
are not necessarily dangerous, but they frequently 
suppurate and require close attention when the 
wounded are being transported to the hospital at 
the base. 
One naturally pays the closest attention to what 
General Delorme has to say regarding wounds 
of the abdomen—so fatal in former wars. During 
the last twenty years surgeons have so improved 
their technique that they now perform abdominal 
operations as safely as those on the limbs. 
‘“The treatment of wounds of the abdomen,”’ writes 
General Delorme, ‘‘deserves the closest attention of 
surgeons, particularly of those working at the front. 
We have new methods at our disposal which may 
ameliorate the results of a class of cases always re- 
garded as of grave import. The advisability of operat- 
ing on such cases in civil practice is open to discussion, 
but the case in war is quite different. In war the 
surgeons must lay aside any idea of opening the 
abdomen. The experience of all recent wars is against 
such means—experience in the Transvaal, Manchuria, 
the Balkans. In the Transvaal, even when abdominal 
operations were carried out by the most eminent sur- 
geons, under the best conditions, it was found that 
those who were operated on yielded a smaller per- 
centage of recoveries than the cases which were not 
subjected to operation.” 
1 “‘Blessures dé Guerre, Conseils aux Chirurgiens.” Par M. Edmond 
Delorme. Comptes rendus, August 10, p. 394. 
NO. 2339, VOL. 93| 
The modern German bullet, in full flight, leaves 
a very small wound on the wall of the abdomen, 
and seldom infects the wound by carrying clothing 
in front of it. The perforations produced by such 
bullets in the loops of intestine are minute and 
tend to close spontaneously. In some cases the 
bullet may pass between loops, leaving the 
intestinal wall intact. 
The natural and salutary inclination on the part of 
the wounded to relieve both bladder and bowels, allow- 
ing the patient rest for some time, instead of hurrying 
him to the transport, allows a natural exudate to form 
round the wounded parts and favours the process of 
healing. For wounds of this kind the ancient methods 
of treatment seem best: absolute repose, refraining 
from prolonged transport, total abstinence from food 
and drink for several days, rinsing of the mouth, 
hypodermic injections of artificial serum, the adminis- 
tration of opium, and placing the patient in a half- 
sitting (Fowler’s) posture. 
It will be thus seen that the leading military 
surgeon of France advises conservative methods 
of treatment. We do not doubt that he is right. 
During an extensive action the surgeons at the 
front are suddenly overwhelined by thousands of 
patients. It would be impossible to undertake, 
even were it advisable, prolonged and tedious 
operations—to give attention to one case and neg- 
lect the remaining ninety-nine. Fortunately, at least 
in General Delorme’s opinion, such operations at 
the front are unnecessary; the surgeon’s business 
is simply to see that the wounded are placed in 
the best circumstances to allow their natural re- 
cuperative powers to have the best chance of 
exerting themselves. 
Much of the paper to which we have directed 
attention is of a purely technical nature and 
directly concerns only surgeons of the navy and 
army. But much of it concerns us all, and we are 
glad to think that as our arms of precision have 
improved our methods of treating the injuries 
produced by such improvements have not lagged 
behind. 
NATURAL HISTORY, INFORMAL AND 
FORMAL} 
(1) HE first of the books before us aims rather 
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history. It tells, with many a winding bout of 
linked fancy, of the yearnings of a boy and of a 
somewhat introspective stag. Never since the 
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like this mood the book may be recommended, 
for it is curiously wrought and daintily embel- 
lished. 
(2) The second book on the list strikes quite 
another strain: its author has certainly succeeded 
in his object, which is to introduce those of his 
fellow-creatures who love to live under the green- 
1 (x) ‘ The Trail of the Sandhill Stag.” By E. T. Seton. Pp. 93+ plates. 
(London; Hodder and Stoughton, 1914.) Price 3s. 6d. net. i 
(2) “Wild Game in Zambezia.” By R. C. F. Maugham. Pp. xii+376+ 
plates. (London: John Murray, 1914.) Price ras. net. ; 
(3) ‘Animal Communities in Temperate America as Illustrated in the 
Chicago Region.” A Study in Animal Ecology. By Dr. V. E. Shelford. 
Pp. xiii+362. (Chicago: University of Chicago Press; London: Cambridge 
University Press, n.d.) Price r2s. net. 
