On the verge of death. Treatment of wounds in World War II 1812
At the forefront of medicine
As mentioned earlier, the main striking factor in the fields of World War II was a gunshot weapon. So, in the battle of Borodino, the proportion of such wounded in hospitals was about 93%, of which from 78% to 84% with bullet wounds, the rest were hit by artillery. It can also be assumed that the wounds from sabers, broadswords and the peak were much more deadly, and the unfortunates simply did not have time to get to the dressing points and hospitals. Be that as it may, field doctors had to deal primarily with gunshot wounds. For this purpose, military medical kits — corps, regiment and battalion — were manufactured at the tool factory created by Jacob Willie in 1796. The simplest, of course, was the battalion, which included all 9 devices for resection and amputation. In the regimental set there were already 24 medical instruments, allowing, among other things, to connect and disconnect tissues. The corps medical kit consisted of 106 (according to other sources, 140) devices with which it was already possible to operate on severe craniocerebral wounds.
How did the doctor begin to work with the patient in a military temporary hospital? First of all, the depth of a bullet wound and the presence of foreign bodies in it were determined. The surgeon, if necessary, removed a splinter or bullet with his fingers, forceps, spatula and other suitable devices.
В historical literature was the memoirs of an officer of the Russian army, illustrating the everyday life of the hospital:
Bleeding, which was inevitable during wounds on the battlefield, was stopped by pulling with plaits, laying snow or ice (“removing frost”), as well as by tamponization, for example, with chewing paper. If necessary, they could cauterize with hot steel, often in this role the blade of a suitable saber or broadsword played. In those days, they were already familiar with the methods of ligation of large bleeding arteries and, if time allowed and an experienced doctor was present, such a stunning operation was carried out using an arterial hook. To wash the wound, red wine or pure cool water was used, to which salt and lime were often added. This was followed by drying and tight dressing of the wound. Sometimes gaping wounds were sealed with plaster or simply sutured. The soldiers were bandaged with improvised materials, and batiste shawls were used for generals and officers. As mentioned earlier, the main danger of injuries, especially gunshot wounds, was the development of "Antonov fire", or anaerobic infection. They fought with this “only through suppuration”, which was regularly freed from pus or “defecated”. In some cases, small fragments and bullets were not specially removed from shallow wounds, but waited for the foreign body to come out with pus. They “defecated” the wound, releasing blood from nearby veins, as well as dissecting the skin around the wound “lips” with lancets. In some cases, the larvae of flies played a positive role, which often caused insanitary conditions in festering wounds - under the supervision of doctors, insects cleaned wounds and accelerated healing. Russian doctors and leeches did not forget - they were applied to inflamed tissues to remove "bad" blood. All surgical procedures, as can be understood from the description, were extremely painful for the wounded. Trying to avoid death from a “nervous shock” (pain shock), the doctors at the most critical moments anesthetized the soldiers with ordinary vodka, and the officers were supposed to use opium and “sleepy potions” for this purpose. First of all, such simple anesthesia was used for amputations of limbs. In the Russian army, the deprivation of people’s hands and feet was not abused, as in the French troops, where safety amputation was practiced, but often it was impossible to do without it. Mortality after such operations was quite high, and the most difficult for the doctors caused high traumatic amputations of the thigh and shoulder from the cannonball or saber. In such cases, it was necessary to completely remove the remnants of the limb, which most often led to the death of the unfortunate.
During amputation, soft tissues were dissected by lancets and amputation knives, and bones were sawn with special saws. Infectious inflammation of bone tissue (osteomyelitis, or “caries”, which clearly became the diagnosis of amputation of the limb) became a real disaster in severe bullet wounds.
In the memoirs of participants in the events of the Patriotic War there are such lines cooling blood:
Medicines, which at that time did not differ in variety, played an important role in therapy. Russian doctors used camphor and mercury, hoping in vain for their supposed anti-inflammatory and soothing effect. An abscess was used to treat abscesses, wounds healed with olive and sunflower oil, vinegar stopped bleeding, and opium, in addition to its anesthetic effect, was used to slow intestinal motility, which helped with injuries to the abdominal cavity.
The best in their field
A surgeon at a military hospital in the beginning of the 19th century had to be able to carry out six types of operations: connections, disconnections, extraction of foreign bodies, amputation, addition and rectification. During the first wound dressing it was required in the instructions to expand it “in order to change its property and give it the appearance of a fresh and bloody wound”.
Particular emphasis was on the expansion of wounds of the extremities in areas with large muscle mass:
The historian of medicine, doctor of sciences, professor S. P. Glossy in his publications gives an example of the treatment of traumatic aneurysms (cavities) of large blood vessels. Injured were prescribed
Concussions in Russian hospitals were treated simply with peace and observation of the patient, burns were plentifully greased with sour cream, honey, oil and fat (which often caused complications), frostbites were treated with ice water or snow. However, such “warming” of a frostbitten limb often led to gangrene with all the ensuing consequences.
For all the effectiveness of the field medicine of the Russian army, there was one serious drawback, expressed in the outdated treatment of fractures at that time. In the war, to immobilize the limbs, sponges or “apparatus for bandaging fractures” were used, while the doctor from Vitebsk, Karl Ivanovich Gibenthal, suggested using plaster bandages. But a negative review by the professor of the St. Petersburg Medical and Surgical Academy, I.F. Bush, precluded the use of gypsum for immobilizing fractures. Plastering of fractures came into the practice of Russian field doctors only in the era of the legendary Nikolai Ivanovich Pirogov.
An important factor that influenced the effectiveness of the medical service of the Russian army was a chronic shortage of personnel - only 850 doctors participated in the war. That is, one doctor immediately had 702 soldier and officer. Unfortunately, increasing the size of the army at that time in Russia was easier than supplying the necessary number of doctors. At the same time, Russian military doctors managed to accomplish incredible feats - mortality in hospitals was miserable for that time 7-17%.
It is important to note that the saving tactics for treating limb wounds had a positive effect on the fate of the 1812 war veterans of the year. Many seriously wounded soldiers continued to serve for five to six years after the end of the war. So, in the list of soldiers of the Life Guards of the Lithuanian Regiment, dated 1818 year, you can find the following lines:
Private Semen Andreev, years old, 34. He was wounded in the thigh of his left leg right through with damage to his veins, which is why he owns it badly. To the garrison garrison.
Private Dementium Flowerbed, 35 years. He was wounded in the right arm at the shoulder, as well as in the left leg, which is why he has poor control over both the arm and the leg. To the garrison garrison.
Private Fedor Moiseev, 39 years. He was wounded in the left arm with fragmentation of bones, which is why he owns it poorly; also in the right of the abscess the veins are damaged, which is why the index finger is brought down. The guard officer is disabled.
Private Vasily Loginov, 50 years. He was wounded by buckshot in the metatarsus of his left leg with bone fragmentation. The guard officer is disabled.
Private Franz Hazel, 51 year. Injured by a bullet in the right leg below the knee and in the left leg in the thigh with bone damage. To the garrison. ”
War heroes with fairly severe wounds were demobilized only in the 1818 year. In France, at that time, tactics of preventive amputation triumphed, and soldiers with similar injuries were guaranteed to be left without fragments of arms and legs. In Russian hospitals, the disability of patients at discharge usually did not exceed 3%. It is worth remembering that military doctors had to work in an era where there was no effective anesthesia, and they did not even suspect aseptics with antiseptics.
Emperor Alexander I in his Manifesto of November 6 of November 1819 of the year noted the exceptional importance of Russian military medicine on the battlefield, thanking the doctors from contemporaries and descendants:
- Evgeny Fedorov
- web.archive.org, 1812.nsad.ru, pics.meshok.net
- Russian medicine against Napoleon’s weapons
"Antonov fire" and "vinegar four thieves." Military medicine in World War 1812 of the year
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