100 Years Ago - Wounded

https://www.thetimes.co.uk/article/mending-the-broken-soldier-l287twcsc?CMP=TNLEmail_118918_1894077

Mending the broken soldier

Some of the most cruel wounds are those in the jaw. The disfigurement is often horrible. Speech and mastication are equally impossible

August 12, 1916

By invitation of Sir Alfred Keogh, Director-General of the Army Medical Service, a representative of The Times has visited half-a-dozen of the great London military hospitals. The impression left by such a tour upon the layman’s mind is that the public have an utterly inadequate idea of the debt they owe to modern surgery at a time like this. Day by day the surgeons are giving the nation new men for old. They are doing more than would have been credible 20 years ago to rob war of its ultimate horror.
Out of hundreds of wonderful cases it is only possible to describe a few that may be taken as typical of this trade of mending soldiers. Take first the new nerve surgery. Here is a man with a bullet-hole near his collarbone which severed the nerve controlling the muscles of his wrist. The result was wrist-drop, and a hand which, until quite recently, would have been regarded as incurably useless. The two ends of the severed nerve have been freed from what had already become no more than a scar, they have been reunited, and there is every prospect that in less than a twelvemonth the hand will be almost as good as ever. “As simple as tying up the two ends of a cut telephone wire,” says the surgeon who operated. There are more remarkable nerve cases still. A man had part of the fleshy part of his arm shot away, carrying with it four inches of the nerve necessary to control the hand movements. The surgeon rang up several hospitals on the telephone till he heard of what he wanted - the amputation that afternoon of a healthy limb. The limb happened to be a leg, and it was amputated at 3.30 in the afternoon. No sooner was it off than four or five inches of practically living nerve were removed from the calf, placed in a saline bath, and rushed by taxicab to the other hospital. Here the patient was already under an anaesthetic. The wound in his arm was opened with the lancet, the ends of the indispensable nerve quickly found, and the circuit re-established, as it were, by means of the first patients four inches of filament. Today the man is in a fair way to regaining the full use of his hand.
Some of the most cruel wounds are those in the jaw. The disfigurement is often horrible. Speech and mastication are equally impossible. So the surgeons have found a means (involving the wearing for many weeks of what looks like a strange double net of false teeth) of gradually pressing back the remains of the jaw into their natural position, of restoring motion and flexibility to the lips, and of smoothing out the most ghastly of the scars. Where the injury is to the upper part of the face, resulting in, say, the removal of the nose and one eye, magical results are being achieved in a south-western district hospital by the provision of masks perfectly counterfeiting the lost section of the physiognomy. Lieutenant Derwent Wood, ARA, is the inventor of the plan. With the help of photographs of what a patient was like before being wounded, he will make a false nose of silvered copper, artistically painted to match the surrounding complexion, which will so far defy detection as to enable the owner to go out into the world again without shrinking, and play his old part in the affairs of men. To do that is to create value for the nation in the truest sense.
In this war the variety of sepsis that has claimed more victims than any other is that known in doctor’s slang as “gas gangrene”. Gas gangrene is caused by the presence in a wound of certain types of bacilli classed as “anaerobic”, ie, bacilli which cannot live in air, the vital principle of which is oxygen. They exist (like the tetanus bacillus) in cultivated soil, and it is because the war is being fought in France among the peasants’ fields that they are introduced so constantly by ricocheting bullets, or scraps of earth-stained clothing, into the wounds of our soldiers. Once there they set about producing tiny gas bubbles among the tissues, hence the name “gas gangrene”. But the gas they cannot endure is oxygen, and the obvious way to destroy them is to introduce oxygen into the innermost recesses of the wound. This is secured by various methods according to the nature of the injury. A hole right through the shoulder will be sterilized by the use of a wick drawing peroxide of hydrogen from a small tank above the bed. Another kind of wound will be sprayed with ozone, and a third more conveniently dealt with by means of a perforated tube fed with oxygen gas from a cylinder.
It would be possible to write of many other marvels - of the man who had a piece of shrapnel three-quarters of an inch square taken out of the back of his heart, while it lay beating in the surgeon’s hand; of the new anaesthetic which is so harmless that a patient can remain under it for two hours, yet smoke a cigarette in comfort within a quarter of an hour of regaining consciousness; or of the electrical treatment by which shrunken muscles are coaxed back to health and strength.

https://www.thetimes.co.uk/article/one-handed-golf-a-game-for-the-disabled-8lb5jh5nv?CMP=TNLEmail_118918_1894077

One-handed golf, a game for the disabled

It is wonderful to see the distance that the ball can be driven with the one hand, but what is more interesting is that there are some strokes in the game which can be done really better with the one hand than with two

August 26, 1916

There is a game which certainly, and for a pathetic reason, is about to come into greater vogue than it has ever had in the past - one-handed golf. So many poor fellows have returned, and are returning, from the great war minus a hand or arm that the art of making one hand do the work of two is being practised very assiduously; and we may deem them relatively fortunate who have not to regret a more grave loss.
It will be interesting to see what the more athletic of them are able to make of this golf stroke dealt with the one arm, and it is a comfortable reflection that far more fun is to be had out of the garne played with one hand than most people realize, and that it can be brought to a far higher standard than they suppose.
An instance in point was Ives, the one-handed French professional at La Boulle - he could play a game which would certainly have put him on the scratch mark in the handicap of most of our clubs, and there have been others no less effective in this country. It is wonderful to see the distance that the ball can be driven with the one hand, but what is more interesting is that there are some strokes in the game which can be done really better with the one hand than with two.
The present writer has been assured by a friend. who has worked at the one-handed game a good deal, that you can get out of a cramped place in a hazard far better with one hand than with two. And there is no doubt whatever that a skilled one-handed player can put much more cut on the ball, can make it sit down much more dead when it pitches off the approach stroke, than any man can with the two-handed grip.
If you consider the matter for a moment you will see that this must be so. With the one hand the quick turn, of the wrist can be put in just as the club comes to the ball, much in the same way as it is applied in the racket stroke. Try to put on cut with a racket held in the two hands and you will see at once that you are at a grievous disadvantage. You feel tied up and helpless. All this can be done, and has been done, with the clubs as commonly used in the game, and with no special study, given to the needs of a player who has lost an arm.

It remains to be seen what developments are possible when attention is paid to these needs. One of the largest of the athletic outfitting firms is making trial of various weights, lengths, and lies of clubs specially designed to suit the one-handed. It seems likely that they will be much helped by a shaped grip, that is to say, a grip indented with grooves for the fingers and thumb to rest in. In this way a greatly added steadiness and force of grip is given, and it also affords a tactile guide, supplementary to the guidance of the eye, for tho direction of the stroke. The player is able to feel as well as to see, when he has the club travelling in the right line.
A point that becomes evident as one practises the single-handed swing is that the ball must not be too near the right foot. It does not seem to pay to take up a stance like that for the lotting mashie stroke. It is better to stand rather “open.” In this way a flatter trajectory of swing is attained. It is a stroke in which there is very little of that body turn which is almost a main feature of the double-handed operation. We may look forward to much amusement from this one-handed golf in the future and it is quite possible that it may have some interesting and surprising revelations In store for us.


https://www.thetimes.co.uk/article/disabled-fighters-and-civil-life-9bkpmf8dt?CMP=TNLEmail_118918_1894077

Disabled fighters and civil life

As long as a wounded man remains in the Army he enjoys the privilege of their help, but when he is “boarded out” of the Army as unfit he is no longer entitled to Army treatment

August 30, 1916

The problem of the disabled soldier is at present engaging the anxious consideration of the authorities, both civil and military, and a solution is being sought for eagerly. This problem may be stated as follows: The treatment of disablement is largely in the hands of plastic and orthopaedic surgeons, who have performed marvels of healing during the present war. By means of all kinds of clever appliances they have loosened stiff joints, built up muscles and bones, provided “new faces” and generally brought order and hope out of chaos.
The great majority of these surgeons are whole-time officers in the Royal Army Medical Corps. As long as a wounded man remains in the Army he enjoys the privilege of their help, but when he is “boarded out” of the Army as unfit he is no longer entitled to Army treatment. And what then? He still needs the plastic surgeon and the orthopaedist as much as ever if he is to become a useful citizen. In fact a crisis in his treatment may have arrived. Yet his treatment stops and he is thrown upon resources less rich than those he has enjoyed.
Some attempts at a solution of this very real difficulty have been made, and perhaps the best is that represented by the so-called “Command Depot” at Tipperary, established there under the direction of Professor Sims Woodhead, of Cambridge. Here massage, electrical treatment, and drill of various kinds are given. Further, there are handicraft schools in which men are trained in crafts suitable to their abilities. In this work the military and medical authorities have received the cordial cooperation of a committee composed of the chairman and secretary of the Tipperary Technical Instruction Committee, members of public bodies, and others.
A hundred damaged men have been trained in motor driving and in ordinary road repair work. Also the theory of the motor engine is being taught in order that these men may be able to apply knowledge of it to farm work where motor engines are coming into use. Other branches of industry, french polishing, electric fitting, and typewriting are being taught. As a result of experience gained here the local executive committee have decided to equip and maintain a special institute in which discharged soldiers may attend classes organized for the men in the depot.
Here is the beginning of a solution. But the great difficulty is the need of surgeons skilled in plastic and orthopaedic surgery. The War Office does not undertake to make men fit for civil life, yet it possesses most of the orthopaedic surgeons. What is required evidently is a working arrangement between the War Office and the civil authorities by which the principle of the Command depot - another of these depots exists at Manchester under Dr Tait Mackenzie and more have been or are being founded - may be applied widely. Our aim is efficient citizens; this is the way to obtain them.