Index

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– 769 –

Index

Abdominal injuries, 223–77

anaesthesia, 124, 241
anuria, 256–7
blood loss, 236, 269
blood plasma, 253–4
burst wound, 261
complications at Base, 260–4
colon, 244–6, 263
diagnosis, 232–5
drainage, 250
evacuation, 257–9
gastric suction, 254–5
in First World War, 223–4
in Italy, 227–8
in North Africa, 33
in Pacific, 273
in South African War, 223
intravenous fluids, 254
kidney infection, 262
kidney injury, 249
late case, 239–40
liver, 247–8
missile causing, 273
nursing, 252–3
operatability, 237–9
operative technique, 240–52
optimum time for operation, 227–30
penicillin, 250
pensions survey, 264, 273–4
place of operation, 230–2
post-operative progress, 255–7
priority of operation, 227–30
problems at the Base, 260
rectum, 246–7
resuscitation, 235–7
shock, 235–7, 254
staffing of FSUs, 232
statistical surveys, 264–73, 276–7
sulphadiazine, 225, 249
small intestine, 244
summary of article, 274–5
summary of developments, 225–7
theatre technique, 240–4
thoraco-abdominals, 250–2, 270
treatment, 274–6

ACCIDENTAL INJURIES, 379–80

comparison with battle casualties, 379
football, 379
jeep, 379
motor cycle, 379
statistics, 379–80

AIR TRANSPORT, 44, 45, 79, 84–7
AMERICAN ARMY. See UNITED STATES ARMY
AMOEBIASIS. See DYSENTERY, AMOEBIC
AMPUTATIONS, 302–23

amputee in New Zealand, 304, 314–16
artificial limbs in New Zealand, 304
between the wars, 304
comparison with 1 NZEF, 321
delayed primary suture, 312
guillotine amputation, 303, 306–7
in Greece, Crete, and Libya, 307
in First World War, 302–4
in Italy, 312–13
in North Africa, 25
in USA and Canada, 315, 320
indications for amputation, 305
invalids to New Zealand, 314
late amputation of foot, 312
level of primary amputation, 305, 313
Medical Research Council, 305–6
penicillin, 312
recommendations for future, 316–17
Roehampton experience, 305, 315, 318–20
report by J. K. Elliott, 315–16
reviews at surgical conferences, 308–1
sites of election, 305, 318
survey by Consultant Surgeon, 311–12
statistics, 321–3
traumatic amputation, 7, 34, 313

ANAEMIA

secondary, 37
tropical macrocytic, 731–2

ANAEROBIC INFECTION, 7, 21, 42, 129-32
(see also GAS GANGRENE)
ANAESTHETICS, 121–8

British specialists, 123
complications, 126
cyclopropane, 122–3
ether, 125–6
in abdominal injuries, 124, 241
in burns, 124, 344, 351
in chest injuries, 124
in different units, 123–4
in different types of cases, 123–4
in First World War, 42, 121–2
in forward surgery, 59, 67, 123
in head injuries, 137, 149, 151
intravenous ether, 125
Macintosh ether apparatus, 122
organisation of services, 126–7
pentothal sodium, 122
recommendations for future, 127–8

ANKYLOSTOMIASIS. See HOOKWORM
ANXIETY STATE. See NEUROSIS

– 770 –

ANURIA

following sulphonamides, 13
in abdominal injuries, 256–7
in shock, 116
use of crystalloids, 115–16

ARMOUR

protection for abdomen, 276
protection for chest, 218–19
protection for spine, 164

ASTHMA, 580–1

recrudescence in Middle East, 580
unsuitability of asthmatics for overseas service, 580

AUSTRALIAN ARMY

air ambulance, 79
5 Aust GH in Greece, 460
experience in abdominal surgery, 238
experience in chest surgery, 195–7, 201, 206
experience in knee-joint injuries, 385
experience re infectious diseases, 753
investigations re Q fever, 586
transfusion service, 95
treatment of burns, 347

Blast injuries, ears, 452–3
BLOOD TRANSFUSION (see also SHOCK)

amount of blood required, 99, 100
at Base hospitals, 104–5
British service in Middle East, 95
British service in Italy, 102–3
in abdominal injuries, 236, 253–4, 269
in burns, 37, 342–3
in campaigns, 99–100, 103–4, 110–11
in First World War, 94
in forward surgery, 44, 48, 68
in gas gangrene, 130
in Pacific, 106
in wound treatment, 19
NZ unit experience Alamein to Tunis, 99–101
NZ unit experience Italy, 103–4
NZ unit set up, 96–7
plasma produced, 95, 118
preservation of blood, 100–1
quantity and temperature, 100, 112–13
rate of administration, 113
reactions, 117
recommendations for future, 107–8
storage of blood, 118
taking and giving sets, 95
taking of blood, 100

BRAUN SPLINT, 287–9
BRITISH ARMY

anaesthetists attached to NZ units, 59, 127
blood transfusion service in Middle East, 95, 99, 101
blood transfusion service in Italy, 102–3
blood transfusion service in England, 95, 102, 116–17
investigation re foot disability, 399–400
Medical Research Council re amputations, 305
Medical Research Council re burns, 344
neurosis in First World War, 631
neurosis in England, 631–3
penicillin experiments at Tripoli, 14
statistical survey of knee-joint injuries, 385
tetanus in First World War, 133

BRITISH ARMY MEDICAL UNITS

neurosurgical units, 52, 144–6, 149–50, 152, 163
surgical teams, 48, 61, 228
transfusion units, 48, 61
vascular centre, 335–6
189 Br Fd Amb in Crete, 81
151 Br Lt Fd Amb, 84
CCS at Trasimene, 86
24 CCS in Greece, 81
1 CCS in Italy, 33
5 CCS in Vasto, 148
7 GH in Crete, 43, 81, 460
15 Scottish GH in Cairo, 59, 95, 140, 146, 744
26 GH in Athens, 81
98 GH in Bari, 148

BRITISH MEDICAL RESEARCH COUNCIL UNITS

Research unit in MEF, 107–8, 109–10, 114, 239
shock unit in Italy, 108–9, 112–14, 116, 254

BRONCHITIS, 578
BURNS, 340–56

admissions to hospital, 355
anaesthesia in, 124, 344, 351
blood transfusion, 37
blood plasma, 342, 343
classification of, 341
evacuation of cases, 351
hands, 348–9
infection, 349–50
in First World War, 340
mustard gas burns, 352–3
penicillin, 346
phosphorus burns, 353–4
resuscitation, 341–3
saline baths, 30, 347–8
skin grafting, 38, 340–1
statistics, 355–7
sulphonamides, 344, 345–6
summary, 354–5
tannic acid, 340, 343–5
tulle gras, 344

BUTTOCK WOUNDS, 7
Canadian army

CCS at Rimini battle, 86
digestive disorders in Army, 622
investigations re Q fever, 584
opinions re amputations, 315, 320

– 771 –

CARPAL SCAPHOID, 291
CARREL-DAKIN TREATMENT, 3–5, 11, 25, 27, 42, 195, 279, 284, 302, 387
CASUALTIES IN CAMPAIGNS, 87–92
CAUSALGIA, 179
CEREBRO-SPINAL FEVER

incidence, 566
in First World War, 566
in Middle East, 567
in New Zealand, 566
sulphonamides, 567

CHEST INJURIES, 194–222

anaesthesia, 124
armour for protection, 218
atelectasis, 204
chronological survey, 196–9
clotted haemothorax, 198, 209–10
complications, 195
evacuation to Base, 208
evaluation, 218
foreign bodies, 210–12
haemothorax, 203, 206–7
in First World War, 194–5
infection, 205, 217–18
operation, 200–1
Pacific theatre, 199
penicillin, 198, 202, 204, 209
pensions review, 219–21
recommendation for future, 219
respiratory exercises, 199, 214–15
resuscitation, 200
special chest units, 195–6, 215
statistics, 216–18, 222
sucking chest, 201–2
summary of war experience, 218–19
X-rays, 213

CLOSED PLASTER TREATMENT, 5, 6, 10, 20, 28–9, 36–8, 280, 290
CRYSTALLOIDS, in shock, 115–16
Debridement, 5, 28, 36, 149–50
DEHYDRATION, 29, 68, 78, 116
DELAYED PRIMARY SUTURE, 11, 26–7, 283, 312
DENGUE, 548–51

clinical features, 549–51
in Pacific, 548–51
source of infection, 549

DENTAL ASPECT PLASTIC SURGERY, 373–8
DERMATITIS. See SKIN DISEASES
DESERT SORES. See SKIN DISEASES
DIARRHOEA, 479 (see also DYSENTERY)
DIPHTHERIA, 570–3

cutaneous infection, 570–1
immunisation, 572
incidence, 570, 572
polyneuritis, 570
statistics, 573
wound infection, 23, 38, 570

DISEASE, INCIDENCE IN 2 NZEF, 748–61

mortality in 2 NZEF, 750–1
statistical tables, 753–61

DYSENTERY, BACILLARY, 479–85, 492

in First World War, 479–80
in Middle East, 480–83
in Pacific, 483
statistics, 492
sulphaguanidine in, 482, 484
treatment, 484

DYSENTERY, AMOEBIC, 485–92

in First World War, 479
in Middle East, 485–6
in Pacific, 486–7
post-war experience, 488–91
treatment, 487–8

DYSPEPSIA, 621–9

associated neurosis, 622
causes, 624
diagnosis, 625–6
disposal, 628
incidence, 623
surveys of cases, 622
treatment, 627

EAR, NOSE, AND THROAT CONDITIONS, 447–59

admissions to hospital, 458–9
blast injuries, 452–3
boarding of recruits, 447
in First World War, 447
in Middle East, 447–54
in Pacific, 454–6
invalids cent to NZ, 458
operations, 451–2
otitis externa, 449, 455
otitis media, 449–50, 454
otosclerosis, 456
pensions statistics, 457
recommendations for future, 457–8
shortage of specialists, 448
sinusitis, 450–1
staffing in 2 NZEF, 447–8
statistics, 457–9
tonsillectomy, 452

EDUCATION

in hygiene, 707–33
in malaria precautions, 519, 524, 533–4
in venereal disease precautions, 597–8

EPILEPSY, 138–9, 158–9 (see also HEAD INJURIES)

– 772 –

EQUIPMENT

of a field operating unit, 62
of a field transfusion unit, 96

ESSENTIAL HYPERTENSION, 658–87

association of neurosis, 682–5
First World War cases, 658–68
Home Service personnel, 680–2
incidence amongst Maoris, 685–6
Second World War cases, 668–82

EVACUATION OF WOUNDED

from forward areas, 20, 45, 55, 78–81
of abdominal cases, 257–9
of burns cases, 351
of chest cases, 208
to New Zealand, statistics, 40

EXHAUSTION, PHYSICAL, 637 (see also NEUROSIS)
EYE INJURIES. See OPHTHALMOLOGY
FACIAL INJURIES. See PLASTIC SURGERY
FEMUR, FRACTURE OF, 278, 287–9

infection 284
invalids sent to NZ, 296–7
treatment, 287–9

FIELD SURGICAL UNIT, 45–50, 62–4, 232
FIELD TRANSFUSION UNIT, 41–92
FILARIASIS, 552

in Pacific, 552
pensions review, 553

FIRST WORLD WAR

abdominal surgery, 223–4
amputations, 302
anaesthetics, 42, 121–2
blood transfusions, 94
burns, 340
cerebro-spinal fever, 506
chest surgery, 194–5
death from disease, 758
dysentery, 479–80
ear, nose, and throat, 447
foot disabilities, 391
forward surgery, 41–3
fractures, 278–80
gas gangrene, 3, 22, 42, 129
head injuries, 136–9
hernia, 406
knee injuries, 381
knee wounds, 387
malaria, 578
nerve injuries, 166–70
neurosis, 630
ophthalmology, 428
pneumonia, 579
shock, 93–4
spinal injuries, 162
tetanus, 133
tuberculosis, pulmonary, 588
typhoid fever, 493
typhus fever, 557
varicose veins, 418
vascular injuries, 324–5
venereal disease, 597
wounded, statistics of, 40
wound treatment, 3–5

FLY CONTROL. See HYGIENE
FOOD CONTROL. See HYGIENE
FOOT DISABILITIES, 391–405

care after illness, 403
examination of recruits, 391–2
footwear and its repair, 401–3
function of foot, 398–400
graduated training, 392, 400
in Crete, 394
in First World War, 391
in Middle East, 394
in New Zealand camps, 393
invalids sent to NZ, 405
investigation in British army, 399–400
Maori foot, 393, 402
operative treatment, 396
psychological aspect, 400
remedial training, 392
remedial treatment, 396–8
skin disease, 404
summary, 404–5
types of feet, 394–6

FOREIGN BODIES, REMOVAL OF, 3, 8, 9, 29, 32, 33, 210–12
FORWARD SURGERY, 41–92

anaesthesia, 59, 67, 123
analysis of casualties, 88–92
CCS development, 51–2
classification for operation, 55–6, 72–3
Consultant Surgeon, 61–2
dehydration, 68, 78
dressings, 69
equipment of Field Operating Unit, 62–4
evacuation to Base, 77–81
FSU development, 45–50, 62–4
in different campaigns, 81–7
in First World War, 41–3
in Italy, 45
in Middle East, 43–5, 81–7
in Pacific, 92
MDS development, 50–1, 58
operating theatres, 62–4
operation at MDS or CCS, 56–8
operative technique, 73–4
post-operative care, 75–6
pre-operative ward, 71
records, 69, 71, 74
resuscitation, 68–75
specialist surgery, 52–3, 56
splinting of fractures, 66–7, 70
staffing of MDS and CCS, 58–72
transfusion officers, 59
treatment of special wounds, 76–7
time factor, 53–5

– 773 –

treatment

at RAP, 65–9
at ADS, 69–71
at MDS, 71–77
in field, 64–5

wounded, by parts affected, 89–91
wounded, by campaigns, 87–8
X-rays, 72

FRACTURES, 278–301

bone fragments, 3, 32, 33, 35, 278, 284–5
carpal scaphoid, 291–3
closed plaster treatment, 280
delayed primary suture, 283
femur, 278, 287
hip, 28
humerus, 86
in First World War, 278–80
in Spanish War, 280
infection, 278, 284
jaw, 361–4
late operations, 286
leg, 290
non-union, 285
organisation of orthopaedic surgery, 293
os calcis, 291
patella, 289
penicillin, 15, 18, 35, 283
radius and ulna, 287
splinting, 66–7
statistics, 295–301
summary of treatment, 294–5
Tobruk splint, 281, 288–95
treatment of different fractures, 286–93
use of plates and screws, 281
wound treatment, 282–3

GALLIPOLI

dysentery in, 479
hepatitis, 497

GAS GANGRENE, 7, 21–2, 129–32

blood transfusion, 131
claustridial myositis, 132
in Crete, 28
in First World War, 3, 22, 42, 129
in Italy, 22, 132
in Libya, 29–30
penicillin, 131
prevention, 328–9
serum, 120–1
signs of anaerobic infection, 131
sulphonamides, 131
surgery, 36

GASTRIC SUCTION, 254–5
GRADED PERSONNEL

statistics of, 759–60

GUILLOTINE AMPUTATION, 303, 306–7
HAEMORRHAGE

abdominal injuries, 236
control in the field, 65–6
secondary, 29, 33, 260, 332–3
use of tourniquet, 65

HAEMORRHOIDS, 425–6
HAEMOTHORAX. See CHEST INJURIES
HEAD INJURIES, 136–61

anaesthesia, 124
at Base Hospital, Cairo, 146–8
epilepsy, 138–9, 158–9
in First World War, 136–9
in Italy, 148–50
in Middle East, 140–8
late effects, 138–9, 152–3
neurosis with, 649
neurosurgical units, 140–8
penicillin, 150
pensions results, 155–60
recommendations for future, 154–5
repair bony defects, 139, 151–2
statistics of invalids, 160
summary, 154
treatment, 141–53

HEPATITIS, INFECTIVE, 497–517

clinical features, 506–11
epidemic of 1942 (Western Desert), 498–9
epidemic of 1944 (Italy), 500–1
hospitalisation, 505
incidence in 2 NZEF, 502, 512
peripheral lobular necrosis, 514–16
pre-war knowledge, 497
serum jaundice, 513–14

HERNIA, 406–17

British Army experience, 413–14
grading and invaliding, 408–9
in First World War, 406
in Home Guard, 407
in Middle East, 408
medical examinations, 406
operation overseas, 408–10, 413
operative techniques, 411
pensions survey, 414–16
recommendations for future, 416–17
recurrence, 412
statistics, 412–16
trusses, 407

HIP-JOINT WOUNDS, 33, 287, 389
HOOKWORM, 562–5

clinical features, 562–3
in Pacific, 563–5

HOSPITAL BED STATES, 756
HYGIENE, 707–33

climatic conditions, 710
clothing, 719, 731
conservancy, 712, 720, 728–9, 731
fly control, 721, 730
food, 714, 724–5, 731–2
incidence of disease, 726–7
in Middle East, 710–28

– 774 –

inoculations, 707
in Pacific, 728–33
insect control, 725–6, 732
laundry, 722
Maadi Camp, 710–15
man management, 707–8, 718–19
mobilisation camps, 707
organisation, 715–17
planning for 2 NZEF, 708–9
ration scale, 709–14
refuse disposal, 720–1, 729
showers, 722
swimming baths, 714
training and education, 717–18
water supply, 714, 723, 730

HUMERUS FRACTURE, 286
HYPERTENSION. See ESSENTIAL HYPERTENSION
INCIDENCE OF DISEASE, 726–7, 748–61 (see also DISEASE)
INFECTION OF WOUNDS (see also specific injuries)

chest wounds, 206–7, 217–18
cross infection, 23
fractures, 278, 284
head wounds, 138
in Middle East, 24–5, 28, 33
types, 21–3

INFLUENZA (see also RESPIRATORY DISEASES)

in Middle East, 577–8
in New Zealand, 577–8

INOCULATIONS, PREVENTIVE, 493–6, 559
INTRAVENOUS FLUIDS, 254
INVALIDS

numbers sent to NZ, 757–8

ISCHAEMIA, 180–1, 368–9
J FORCE (2 NZEF, Japan)

incidence of venereal disease, 608, 615

KNEE-JOINT INJURIES, 381–6

diagnosis, 382
experience in other forces, 385–6
operation, 383
osteochondritis dessicans, 384
results, 383–4
summary, 386

KNEE-JOINT WOUNDS, 387–90

drainage, 388
excision of patella, 389
exercises, 388
First World War, 387
penicillin, 388

KOKKINIA PW HOSPITAL, 460

surgical work, 461–4

KRAMER SPLINT, 29, 66, 281
LABORATORY

review of work at a general hospital, 741–7
staffing problems, 745–7
suggestions re equipment, 747

LAMSDORF PW HOSPITAL

treatment given, 468

MALARIA, 518–47

administrative order (Pacific), 544–7
anti-mosquito squads, 520, 534
atebrin, 530, 536
clothing, 536
control units, 522, 523, 533–4
DDT, 519, 525
education and training, 519, 524, 533–4, 536
Greece, 520
in First World War, 518
in Italy, 523–8
in Middle East, 518, 522–3
in New Zealand, 541–3
in Pacific, 528–41
mepacrine, 524
pensions aspect, 543
repellents, 534
statistics, 527–8, 538–9
Syria, 521–2
treatment, 536–8, 541

MAN MANAGEMENT, 707–8, 718–19
MAORIS

effect of head injuries, 155
foot disabilities, 393, 402, 736
health, 734–6
incidence of

essential hypertension, 685–6
infective hepatitis, 503
neurosis, 636, 736
tetanus, 133–4
tuberculosis, 591, 734–5

MAXILLO-FACIAL INJURIES. See PLASTIC SURGERY
MEDICAL RESEARCH COUNCIL

Memo on amputations, 305–6
Memo on burns, 344
shock research unit, 108

MENINGITIS, 566–8

lymphocytic, 567
meningococcal, 566
pneumococcal, 567
streptococcal, 567
treatment, 568

– 775 –

MISSILES CAUSING WOUNDS, 6, 273
MOBILE SURGICAL UNIT, 29, 44, 140, 143, 195
MORTALITY

from abdominal injuries, 229–30, 264–73
from accidental injuries, 380
from chest injuries, 216–18
from disease, 750
from gas gangrene, 132
from head injuries, 143, 148, 150
from tetanus, 134
from wounds in action, 91, 218

NECK INJURIES, 7
NERVE INJURIES, 166–93

appendix; detailed results of treatment, 187–93
causalgia, 179
closed injuries, 180
in First World War, 166–70
in Second World War, 170–93
ischaemia, 180–1
nerve grafting, 175
nerve repair, 168–74
recommendations for future, 186
recovery after suture, 177–8
results of treatment, 183–93
splints, 167, 175–6
statistics, 186–7
treatment, 181–3

NEUROSIS, 630–57

incidence, 637
in England, 631, 651–3
in eye cases, 429
in First World War, 630
in foot disabilities, 400
in Middle East, 632–7
in Navy, 646–7
in Pacific, 645–6
in skin diseases, 694
Maoris, 636
medical boarding, 643–4
medical examinations for courts martial, 641–3
nomenclature, 637–8
pensions aspect, 650
recommendations for future, 653–5
statistics, 655–7
symptoms, 638–9
treatment, 639–41, 648–9
with dyspepsia, 622
with head injury, 649–50
with hypertension, 682–5

NEUROSURGERY. See HEAD INJURIES
NOSE CONDITIONS. See EAR, NOSE, AND THROAT CONDITIONS
NURSING SISTERS, 41, 47, 232, 253
NUTRITIONAL DEFICIENCY

of proteins, 19
of vitamins, 255–63

NZ ARMY MEDICAL UNITS

NZ CCS, 41, 92 (see also FORWARD SURGERY)
abdominal surgery, 229
chest surgery, 202
1 NZ GH
Diphtheritic infection in, 23
in Greece, 44
laboratory work at, 141–4
transfusion unit, 96
2 NZ GH, 149
Survey abdominal cases, 260–2
wound treatment at, 33
3 NZ GH
amoebiasis at, 485
colon cases at, 263
mustard gas burns at, 352–3
penicillin experiments at, 14
reserve surgical teams, 48
sandfly fever at, 555
NZ Mobile Surgical Unit, 29, 44, 140, 143, 195, 228
1 NZ Stationary Hosp, in First World War, 137

OCCUPATIONAL THERAPY, 737–40
OPHTHALMOLOGY, 428–46

battle casualties, 435–8
equipment, 438–9
hysteria, 432–4
infection, 434–5
in First World War, 428
in Middle East, 428
in Pacific, 441
medical boarding, 430, 432, 444
mobile optician unit, 429
pensions figures, 444
psychoneurosis, 429
recommendations for future, 442–3
rejection of recruits, 428
statistics, 436, 440, 443–5
supply of spectacles, 428
sympathetic ophthalmia, 438
trachoma in Fiji, 441–2
visual grading, 431–2, 443–4
volume of work, 428, 440

PACIFIC CAMPAIGN

abdominal injuries in, 273
blood transfusions in, 106
dengue fever in, 548–51
digestive disorders in, 624
dysentery in, 483, 486–7
ear, nose, and throat, 454–6
forward surgery, 92
hookworm in, 563–4
hygiene in, 728–3
malaria in, 528–41
neurosis in, 645–6
ophthalmology in, 441
shock in, 106
skin disease in, 697–700
statistics, 760
wound treatment in, 38

– 776 –

PATELLA, 289
PENICILLIN

conference at Tripoli, 14