November 01, 2020

A Surgeon is Born

A Surgeon is Born
Nikolai Pirogov portrait by Ilya Repin (1881)

In war, people die from bullets and grenades, from bombs and missiles, but also from dysentery and typhus, not to mention infection of their wounds. And the further back in history we go, the more common it was for hapless soldiers to be done in by disease, in some cases before they ever reached the field of battle, in others, having survived the bullets and bombs, only to succumb to an infected scratch.

A wound, even one that today we would think of as rather harmless, would begin to fester, the infection would spread, and death would come simply because doctors did not yet know how to sterilize instruments or properly clean the spot where the bullet or bayonet had entered the body. And once the infection began, especially if it turned gangrenous, the only (and by no means certain) way to save the life of the wounded was to amputate, to cut off the arm or the leg and offer at least a chance to survive.

Before the use of anesthesia, the approach to amputation was simple: patients would be given a bullet to hold between their teeth, so that they wouldn’t scream or bite off their tongue, or they were given a glass of vodka, the higher the proof the better, so that the ensuing fog would at least somewhat drown out the agonizing pain. Sometimes, patients would just be hit over the head in the hope they would stay unconscious for the duration of the operation. Eventually, of course, they came to, and there was plenty of pain still to be endured, along with the likelihood of infection.

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Tags: warmedicine

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