444 
Experience  of  a  Pharmacist,  Etc. 
(  Am.  Jour.  Pharm. 
)  July,  1920. 
rival.  When  a  man  is  wounded  on  the  field  he  is  picked  up  by  the 
regimental  stretcher  bearers  and  carried  to  the  first-aid  dressing 
station,  which  may  be  but  a  stone's  throw  to  the  rear  in  any  avail- 
able shelter  such  as  a  dry  shell  hole  or  within  the  remaining  walls  of 
a  shattered  building.  The  dressings  that  are  applied  are  intended 
primarily  to  arrest  the  flow  of  blood  and  bind  up  the  wounds  suffi- 
ciently for  the  man  to  be  transported  to  the  Field  Hospital.  This  is 
back  of  the  artillery,  just  beyond  the  range  of  enemy  fire.  Wounded 
are  then  transferred  to  the  Evacuation  Hospitals  and  mobile  or- 
ganizations farther  in  the  rear.  These  organizations,  moving 
forward  or  receding  with  the  line,  although  their  facilities  are  limited, 
perform  every  type  of  operation,  among  the  commoner  ones  being 
amputations  and  transfusions. 
Wound  bacteriology  is  a  development  of  the  past  war  and  rep- 
resents the  work  primarily  of  the  French.  Gas  gangrene,  which 
was  prevalent  during  our  Civil  War,  ran  its  course  unchecked  until 
the  exact  nature  of  the  organisms  infecting  wounds  was  learned, 
this  being  in  the  second  year  of  the  war.  With  the  knowledge  that  the 
grave  speticemia  from  war  wounds  was  due  primarily  to  two  groups 
of  bacteria — the  streptococci  and  the  gas  producing — there  de- 
veloped the  Carrel-Dakin  solution  and  surgical  intervention.  Our 
routine  procedure  in  the  culture  of  wounds  was  to  send  to  the  oper- 
ating room,  empty,  sterile,  capillary  pipettes  or  sterile  swabs  im- 
mersed in  several  Mils,  of  neutral  bouillon.  The  pipette  was  filled 
or  the  culture  media  inoculated  with  the  exudate  of  the  wound 
during  debridement  and  returned  to  the  laboratory.  Five  sub- 
cultures were  subsequently  made.  The  first  was  dextrose  bouUion 
for  all  aerobes;  the  second,  plain  boullion  overlaid  with  a  layer  of 
oil,  previously  boiled  and  rapidly  chilled,  for  anaerobes;  third,  dex- 
trose agar,  overlaid  with  oil,  to  observe  colony  formation  and  gas 
production;  fourth,  litmus  milk,  the  ideal  media  for  gas  producing 
anaerobes;  and  fifth,  an  agar  plate  of  whole  defibrinated  human  blood 
for  hemolytic  bacteria.  After  eight  hours  of  incubation,  a  report, 
sufficiently  complete  to  determine  the  mode  of  treatment,  could  be 
generally  sent  the  ward  surgeon. 
The  flora  that  wounds  present  is  very  great,  every  Organism  of 
the  gastro-intestinal  tract  being  represented.  The  characteristics 
of  a  gas  infection  are  the  nauseating  odor,  the  formation  of  bubbles 
of  gas  in  the  exudate  upon  the  application  of  slight  pressure  to  the 
surrounding  parts,  accompanied  by  a  crackling  sound.    Any  ar- 
