- Email: [email protected]
MILITARY MEDICINE.
MILITARY MEDICINE.--THERAPEUTIC SI’LENECTOMY.
THE
LANCET.
LONDON:SATURDAY, MAY 18, 1929.
MILITARY MEDICINE. THE Fifth International Congress of Military Medicine and Pharmacy, whose proceedings are reported in THE LANCET last week and this, came to The Congress was in a conclusion on Saturday last. every way a success, and hearty congratulations may be offered upon this fact to the Director-General of the Army Medical Services, Sir MATTHEW FELL, alike President of the Congress and the main-spring of its activities. In his inaugural address Sir MATTHEW - expressed well the essential objects of the Congress, when he pointed out that medical services in the navies, armies, and air forces of a nation were united by the common bond of membership of the medical profession, and should take full advantage of international exchanges of ideas and experiences, directed towards the care and treatment of the sick and wounded in war. For here each nation, in whatever position of alliance or of enmity it may find itself, will have the identical desire to relieve the misery of the combatants. Only by organised meetings at reasonable intervals can the results of such ideas and experiences be considered in their real bearing upon i the different organisations set up to deal with the immense mass of human suffering which war must
inevitably bring. But--and this it is important to recollect-while medical service, as arranged for national defence or offence, functions in accordance with the principles and limitations required by the commands of the forces which are served, the congresses of the officers who discharge these responsibilities must be of great benefit to civil medicine and indeed to all the world, for they will assist in the application of advances in medical science to peace conditions. The aim to-day among all civilised nations of medical endeavour for military purposes makes for the maintenance of the highest standards of hygiene and sanitation, and while the efforts during actual war must be directed almost to producing the least possible delay in the sick and wounded within the immediate zone of medical care, the general lessons of value to civil communities receive, remarkable illustration thereby. So that from the military necessities of a war period there springs the permanent development of health measures for all. The point was well made by Lord MOYNIHAN when he introduced the name of FLORENCE NIGHTINGALE into his eloquent address at the Guildhall banquet, for from what that great woman did in the Crimean War sprang the whole of the nursing service as it exists to-day in this country, in civil as well as in military hospitals. And much of the extensive and intensive research conducted in the laboratories of the belligerent services during the late war is now bearing fruit in civil hospitals and in public health administration ; so that it is for the advancement of the good of all that the lessons of this work should be regularly reviewed in the light of progressive
exclusively
bringing
development. The impressions of those who
attended the Congress, both its scientific sessions and its many social diversions, all went to prove that the labours of the
1041
conveners and of the officiate were well repaid in results. First there was a distinct development of international friendship in spite of the difficulty of language, and may not too much be made of this difficulty ? Most of the representatives present at the Congress knew some English and some French ; most of their hosts knew some French ; and in dialogue, at any rate, the advantage could be reaped of a common education along special lines and having a high standard. This ensured that, however imperfect might be the command of each other’s language, conversations, though started in a halting manner, would often develop into real intercourse as each found a way to understanding the other. But it must be admitted that the English were usually the slower to take the plunge, the less ready to guess at meanings, and the more self-conscious of their limitations. None the less a real interchange of view was often effected between members of the Congress upon such matters as the standardisation of certain essentials of war equipment, the work which is done here by the various committees of the Red Cross-for example in laying down forms for the recording of casualties-and the regulations in our own army concerning the details of first field dressings, the uniformity of stretcherfittings, and many analogous matters. No doubt the great difference in our military organisation, as a
and permanent one, including completely separate services for the Army, Navy, and Air Force must have given our foreign guests a great deal to think about, much, we trust, to admire, and something perhaps to criticise ; but in one respect criticism was wholly withheld, for of the nursing in our Service hospitals our foreign guests spoke with unbounded admiration, contrasting it with the nursing made possible under a conscription system. That these
voluntary
things should have been discussed by men of experience face to face will produce valuable consequences, and it is to the fine cooperation of our civil medical bodies that the great occasions for such discussions were due last week. We feel that we are speaking in the name of the organisation of the Military Congress when we speak thus of the hospitality extended to the members.
THERAPEUTIC SPLENECTOMY. ALMOST the only thing a surgeon can do to the spleen is to remove it, and we may well feel a little surprise that this drastic form of intervention should have found an undisputed place in therapeutics For little is really known of the physiology of the organ and no more of the part it plays in pathology, and the operation was originally undertaken on the crude assumption that in certain diseases the spleen was enlarged, and therefore presumably a diseased structure which the body would be better without. Of late years, however, splenectomy has gradually been assigned a settled role in the treatment of one or two conditions whilst leaving considerable excuse for doubt in others. Since the total experience of one person can never be very large, owing to the rarity of splenic disorders, it is useful to pool the knowledge obtained from various sources, and hence a good deal of interest attaches to the recent debate on this subject at the Royal Society of Medicine, reported in our last issue. Dr. HUGH THURSFJELD cleared the ground by making a clear statement of the few undisputed facts of splenic physiology, pointing out that the spleen has been proved to be a reservoir of blood which can be tapped at need; that it certainly plays some part in infections, as it
THE
LANCET.
LONDON:SATURDAY, MAY 18, 1929.
MILITARY MEDICINE. THE Fifth International Congress of Military Medicine and Pharmacy, whose proceedings are reported in THE LANCET last week and this, came to The Congress was in a conclusion on Saturday last. every way a success, and hearty congratulations may be offered upon this fact to the Director-General of the Army Medical Services, Sir MATTHEW FELL, alike President of the Congress and the main-spring of its activities. In his inaugural address Sir MATTHEW - expressed well the essential objects of the Congress, when he pointed out that medical services in the navies, armies, and air forces of a nation were united by the common bond of membership of the medical profession, and should take full advantage of international exchanges of ideas and experiences, directed towards the care and treatment of the sick and wounded in war. For here each nation, in whatever position of alliance or of enmity it may find itself, will have the identical desire to relieve the misery of the combatants. Only by organised meetings at reasonable intervals can the results of such ideas and experiences be considered in their real bearing upon i the different organisations set up to deal with the immense mass of human suffering which war must
inevitably bring. But--and this it is important to recollect-while medical service, as arranged for national defence or offence, functions in accordance with the principles and limitations required by the commands of the forces which are served, the congresses of the officers who discharge these responsibilities must be of great benefit to civil medicine and indeed to all the world, for they will assist in the application of advances in medical science to peace conditions. The aim to-day among all civilised nations of medical endeavour for military purposes makes for the maintenance of the highest standards of hygiene and sanitation, and while the efforts during actual war must be directed almost to producing the least possible delay in the sick and wounded within the immediate zone of medical care, the general lessons of value to civil communities receive, remarkable illustration thereby. So that from the military necessities of a war period there springs the permanent development of health measures for all. The point was well made by Lord MOYNIHAN when he introduced the name of FLORENCE NIGHTINGALE into his eloquent address at the Guildhall banquet, for from what that great woman did in the Crimean War sprang the whole of the nursing service as it exists to-day in this country, in civil as well as in military hospitals. And much of the extensive and intensive research conducted in the laboratories of the belligerent services during the late war is now bearing fruit in civil hospitals and in public health administration ; so that it is for the advancement of the good of all that the lessons of this work should be regularly reviewed in the light of progressive
exclusively
bringing
development. The impressions of those who
attended the Congress, both its scientific sessions and its many social diversions, all went to prove that the labours of the
1041
conveners and of the officiate were well repaid in results. First there was a distinct development of international friendship in spite of the difficulty of language, and may not too much be made of this difficulty ? Most of the representatives present at the Congress knew some English and some French ; most of their hosts knew some French ; and in dialogue, at any rate, the advantage could be reaped of a common education along special lines and having a high standard. This ensured that, however imperfect might be the command of each other’s language, conversations, though started in a halting manner, would often develop into real intercourse as each found a way to understanding the other. But it must be admitted that the English were usually the slower to take the plunge, the less ready to guess at meanings, and the more self-conscious of their limitations. None the less a real interchange of view was often effected between members of the Congress upon such matters as the standardisation of certain essentials of war equipment, the work which is done here by the various committees of the Red Cross-for example in laying down forms for the recording of casualties-and the regulations in our own army concerning the details of first field dressings, the uniformity of stretcherfittings, and many analogous matters. No doubt the great difference in our military organisation, as a
and permanent one, including completely separate services for the Army, Navy, and Air Force must have given our foreign guests a great deal to think about, much, we trust, to admire, and something perhaps to criticise ; but in one respect criticism was wholly withheld, for of the nursing in our Service hospitals our foreign guests spoke with unbounded admiration, contrasting it with the nursing made possible under a conscription system. That these
voluntary
things should have been discussed by men of experience face to face will produce valuable consequences, and it is to the fine cooperation of our civil medical bodies that the great occasions for such discussions were due last week. We feel that we are speaking in the name of the organisation of the Military Congress when we speak thus of the hospitality extended to the members.
THERAPEUTIC SPLENECTOMY. ALMOST the only thing a surgeon can do to the spleen is to remove it, and we may well feel a little surprise that this drastic form of intervention should have found an undisputed place in therapeutics For little is really known of the physiology of the organ and no more of the part it plays in pathology, and the operation was originally undertaken on the crude assumption that in certain diseases the spleen was enlarged, and therefore presumably a diseased structure which the body would be better without. Of late years, however, splenectomy has gradually been assigned a settled role in the treatment of one or two conditions whilst leaving considerable excuse for doubt in others. Since the total experience of one person can never be very large, owing to the rarity of splenic disorders, it is useful to pool the knowledge obtained from various sources, and hence a good deal of interest attaches to the recent debate on this subject at the Royal Society of Medicine, reported in our last issue. Dr. HUGH THURSFJELD cleared the ground by making a clear statement of the few undisputed facts of splenic physiology, pointing out that the spleen has been proved to be a reservoir of blood which can be tapped at need; that it certainly plays some part in infections, as it