FIGHTING WOUND SHOCK
“Base Hospital No. ----
“Amex Force, France
“Dear Mother,
“You ought to see your soldier son now! He looks about as military as
a smoked ham, and feels like--but my well-known delicacy halts me.
Never mind, I’m all here--barring a few pieces of bone that don’t
matter, and I have gained the honor of having been in the first wave
of the first Americans to go over the top at Cantigny.
“Incidentally I have the bullet that hit me, and one boche helmet. I
would have got more but my trip was short and sweet--some six hundred
yards at most before some unmannerly person slammed me over the knee
with a battle-ship, and I sat down to think it over. It struck me
suddenly that there was very little of interest to be seen, and it
would be a waste of time to go any further.
“From there to where I am now has been a series of more or less
painful transfers through first aid posts, dressing stations and
French hospitals, with a Red Cross train and a ninety kilometer ride
in an ambulance. I don’t think you have ever known the joy of a
ninety K. ride on the upper deck of a pitching ambulance. It’s an
experience. I appreciated the sensations of a pup with a tin can tied
to his tail.
“But all that is over and I’m settled at last, so far behind the
lines that the street lights of the town aren’t shaded at all. You
must not worry, Mother dear, for I’ll be as good as new in three
months, and while broken legs are not the sort of thing you go around
hunting for, they aren’t half as bad as a tooth ache, and mine is a
particularly well trained one and doesn’t hurt at all.”
By the time the news reaches us here in America that one of our beloved
has been wounded in France the worst is usually over and the patient
is often out of danger. It takes several days for such news to reach
Washington and be telegraphed to soldiers’ relatives, and if no second
telegram comes closely on the first we may be truly thankful.
My son was wounded on the twenty-eighth of May, and it was nearly a
month before I heard from him. If this had happened a year ago I should
have been paralyzed with fear, not because of the wound, but because
of dread of the after effects. One enormous advantage we have over our
splendid allies is that we not only benefit from their experience in
battle, but from their experience in the hospital. Wounds which for the
first three years of the war were impossible to cure are now in the
class called favorable.
It is this knowledge that helps to keep me in courage, and I hope it
will help all the others. We are too far away to realize the war, but
we know that our sons are in deadly peril from German shot and shell.
There has not been enough said about the magnificent work of the army
surgeons in restoring men. One of their greatest achievements was the
conquest of trench fever. In another chapter I shall tell that story.
In this one I shall tell of the great fight they have made--a fight
almost if not quite won--against a still more terrible malady, wound
shock.
Shock has been called the great mystery of the war. It followed severe
wounds, especially those of the abdomen and chest, but frequently it
occurred in men only slightly wounded. And it was horribly fatal.
Here was a case: A splendid young man of twenty-three was brought into
an advanced dressing station with a foot shot off. Not a fatal wound
in ordinary circumstances. But this man who, an hour ago, had been in
perfect health, now lay white as marble, cold and almost pulseless. The
wounded stump did not even bleed. In a short time he was dead. He was
shocked to death.
The best physicians in the world have been working for nearly four
years to find out why he, and others, died like that. They were
completely baffled at first, but they kept steadily on. They worked in
front-line trenches and even on the battle-field trying to understand
wound shock.
They undertook extensive and intensive laboratory work to discover the
blood changes that took place in men suffering from the strange malady.
To a great extent their work has been successful, and the work is
triumphantly going on.
The medical research department of the American Red Cross is now
conducting a series of experiments, and it might as well be admitted
at the outset that these experiments, which are to save men’s lives in
untold numbers, involve destroying some animal life. For this reason
the anti-vivisectionists, and that small section of the press which
supports their views, are at the present time hotly assailing the
research department of the Red Cross.
Says one statement of the opposition: “No expensively equipped
laboratory is needed to seek out wounded soldiers on the battle-fields
and give them aid and comfort in the hospitals; and it will cause deep
sorrow among innumerable contributors to know that the Red Cross is
going beyond the activities of its charter rights and is supporting a
cruel and disputed form of medical experimentation.”
Putting aside for the moment all except the first sentence of this
statement, “No expensively equipped laboratory is needed to seek out
wounded soldiers on the battle-fields and give them aid and comfort
in the hospitals,” the answer is that without the laboratory the
hospitals would be back in the days when gunshot wounds were treated by
having hot oil poured into them, and when the only way of dealing with
shattered limbs was amputation.
This war, particularly, has developed maladies and wound complications
undreamed of before. Shock is not exactly new. In civilian hospitals
it occurs after every operation. But the wound shock of this war is
new, and the doctors had to study it as a new manifestation.
Out of many cases take the following: A soldier member of a working
party, laying telephone wires one wet and muddy night, was hit by the
explosion of a shell. He was severely wounded, suffering a compound
fracture of one arm and some bad muscle lacerations. His comrades
picked him up and hurried him to the nearest dressing station, but by
the time he got there his wounds looked like dead flesh. There was no
bleeding and the man’s pulse was still.
He was conscious and mentally bright. “Hello, fellows,” he called out
to those who worked over him, and to the surgeon he said confidently:
“I’ve got a blighty, haven’t I?” Meaning a rest in a home hospital.
Even the surgeon thought so. The case was bad but the man seemed so
fit. Yet within an hour he was dead.
There was a sergeant, a hardworking, conscientious man, loved by his
fellows. A piece of shell got him as he lay asleep at the foot of a
dugout. Both feet were shattered. Within ten minutes the surgeons had
the man on the operating table, but he was another case of shock. He
died while they were working over him.
Shock has other ways of showing itself. A soldier, very badly wounded
in the chest and abdomen, was treated in the advanced dressing
station, and as he appeared to be normal in every way he was wrapped up
and sent in an ambulance to the evacuation hospital. Within a few hours
after he arrived, and when he was sleeping quietly, symptoms of shock
appeared.
He sat up in bed struggling and tearing at the bandages which covered
his chest. “Air!” he gasped. “I must have air! I can not breathe.”
Nurses and doctors surrounded the poor man, trying to alleviate his
intense agony. But they knew that this “air hunger,” as it is called,
was almost certainly a sign of rapidly approaching death.
The doctors had to find out what caused the conditions. They could not
tell by simply observing the shocked men. Too many of them died before
much observation could be made.
It did not help the doctors to observe that the blood pressure of such
patients went down and that most of the blood in their bodies seemed
to disappear. Where did it disappear? Nobody knew. The men’s pulses
stopped, their wounds ceased to bleed. Why? Why did they suffer this
awful air hunger? What relation had the low blood pressure to the
breathing capacity?
There was one way and one only for them to find out. They had to
anesthetize a great many guinea pigs, rabbits and other small animals
and subject them while unconscious, to conditions as nearly as possible
identical with those under which the men had developed wound shock.
Perhaps in future they will find another way. At present that is the
only way we have. Following experimentation they examined every organ
of the wounded animals, analyzed their blood, minutely studied them,
with the result that they know, if not all about wound shock, at least
something. They know a great deal about the causes and they are on the
track of the cure.
They know, for example, that tremendous changes take place in the
system following a battle. The men go into action with their hearts
beating abnormally hard and high. They are in a state of intense
excitement. When they are wounded there occurs a sharp reaction, both
mental and physical, partly because of the wound, partly because of bad
conditions which often precede going over the top.
Our men behind the line, even when they are exposed to occasional shell
fire, lead almost normal lives. They eat and sleep and keep fairly
comfortable, even in bad weather. But in the front trenches, it must be
admitted, only the sublime courage and devotion of the men enable them
to endure their surroundings with cheerful fortitude.
They have good food in the front trenches, the men have told me. But
they are sometimes short of water. They sleep in constantly interrupted
snatches. They are wet to the skin and sometimes very cold. They work
hard, and are tormented with the noise, the blasting of bullets, the
shriek of shells. Often when they go over the top they are tired as
dogs, their circulation is sluggish with cold, their bodies are full
of waste products.
The mad excitement of battle is followed by the shock of a wound. Icy
cold grips them. Their pulses stop. They have wound shock. The doctors
now know all this. They have devised, even in the advanced dressing
stations, means of keeping wounded men warm in heated blankets over
alcohol stoves. The hot tea they give the wounded now contains medicine
to counteract the intense acidity of the blood which experiments on
animals revealed as a part of shock.
Now, when a poor shocked wounded man struggles with air hunger, the
doctors can do something for him. A single injection works a miracle.
The struggle ceases immediately. In a few minutes he is asleep. In a
few hours he is smoking a cigarette and joking with the man in the next
bed. Thousands of lives, perhaps those of your son and my son, have
been saved already, because the doctors now know what to do to prevent
most wound shocks, and to cure the favorable cases.
Another thing that has killed thousands in this war is an infection
called gas gangrene. It is unlike any other gangrene known to the
medical world. It is caused by bacteria bred in the mud and filth of
the trenches, and by foreign bodies, bits of cloth and the like which
contaminate wounds.
But the gangrene does not always confine itself to the wound. A man
wounded in the shoulder may first show gangrene in the wound in his
arm. A few days later the gangrene may appear in his legs, and he dies.
The blood is not contaminated; that has been proved. The gangrene just
mysteriously moves around.
The army physicians have got to find out all about this frightful
condition, and how to combat it. They can do it only in a laboratory
and through animal experimentation. Why should we sentimentalize about
it? The animals die, but they suffer little, if at all. Our men suffer
most horribly, and all too often they die.
Remember also that when we send our soldiers out into the hell of
battle, artillery fire, machine guns, bombs, shrapnel, liquid fire,
poison gas, and all the other hideous inventions of German science, we
are subjecting them to vivisection of the worst possible kind.
They throw their bodies between the murderous Huns and the rest of the
world. Would you save a few thousand or a few million guinea pigs at
the expense of the ghastly suffering and death of one of those men? I
would not.