There is now a record of the application of modern dentistry, by employment of the X-ray and producing radiograms to be studied care fully, that not only is of great value in imme diate treatment, but will continue to be in all reconstructive work.
There can be no question but that the wear ing of steel helmets has lessened scalp and skull wounds and injuries of the upper portion of the face and neck by a large percentage.
It is interesting to note that in shaping the latest patterns they had had in mind even greater protection. The one objection has been their weight.
It is a matter of great interest to note the similarity of wounds in connection with the American Civil War and the European War.
The free use of shrapnel presents. a bullet producing a wound very much like that of the Minie ball of the Civil War, but the bullet of the machine gun of to-day is not so destruc tive as that of the rifles during the earlier con flict.
Aside from this progress, to which we have referred, the study and treatment of tetanus be came a very important subject. The first year of the war very rapidly developed the danger of immediate infection of the wounds, and a large percentage of the cases when they reached the,base hospitals were in an infected, suppura tive condition. In association with these wounds was also the development of cases of acute tetanus, largely thought due to the nature of the infective soil where the fighting oc curred, and here, near the battle line, laboratory work has been of great assistance. The con sequence is that prophylactic treatment by use of the tetanus antitoxin serum, in all lacerated and dirty wounds, lessened the number of these cases very decidedly.
The British were slow in making use of this antitoxin. The American military surgeon had learned from civil life its great value and was at once prepared to employ it. Here credit should be given to the great State of New York in early establishing a State laboratory for the study and free distribution of this serum to its boards of health.
The one great department that can be classed as a division of military surgery will be known as orthopedic or reconstructive work, and the hospitals that have been established by the United States government will undoubt edly result in the restoration of the functions of various portions of the body in a manner hitherto deemed impossible.
Reconstructive occupational therapy in the study and treatment of lesions of the organic nervous system is apparently receiving a good deal of attention.
Shell shock is a new term, possibly to be followed by a better interpretation of this new lesion in war surgery, but its proper under standing and treatment is being worked out in a most admirable manner. There can be no doubt that men are seriously affected by the bursting and passing of shells and the firing of these high explosives. The system receives a shock that afterward manifests itself in various ways. The patient may become temporarily insane, his mentality receiving a severe shock in many forms. It may be only functional and disappears when surroundings are such as to restore his confidence, returning him to his former normal courage and ability to get con trol of himself. There have been a good many of these cases, and great care must be exer cised that no injustice be done in their diagnosis and treatment.
The treatment of gunshot wounds of the face and jaws have attracted much attention. In the building up of the face, the nose, and especially that portion that relates to fractures of the upper and lower jaws, our military surgeons have recognized the aid of the up-to date dentist.
During the entire time of this World's War civil practice has been quite entirely over shadowed, the study and treatment of wounds received in battle claiming the greater atten tion.
In the tare of wounds it was early observed that prompt treatment was of great import ance. The removal of all possible sources of infection, giving a clean incision in the soft parts, then bringing them together, resulted in excellent recoveries.
It wasoassumed that wounds passing beyond the eighth hour were in danger of infection and more serious complications, giving a pro longed and anxious line of treatment.