Red Medicine

Russian casualties so far total 5,000,000 men. Of these, about 3,000,000 have been wounded--presenting the biggest problem in military medicine yet faced by any nation in this war. Some 70%--or well over 2,000,000--of these casualties, the Russians claim, have been patched up and returned either to the active front or to noncombatant army tasks.

These facts come from a comprehensive report on Russian military medicine, released this week by Russian War Relief, Inc., which so far has purchased some $4,000,000 worth of medical supplies for Russia.

The Russians also claim that only 1.5% of their wounded have died. If accurate, this is an unprecedented record, surpassing even that of U.S. military surgeons who saved 96 out of every 100 men wounded at Pearl Harbor.

In 1914, with only 24,000 doctors in the whole country, Russian military medicine was worse than that of any other big combatant. But while building a huge army during the last 15 years, the Russians also built a huge medical service. Medical colleges were expanded from 13 in 1914 to 72 in 1939. Russia now has over 160,000 physicians, a sevenfold increase since 1914 --but still 20,000 fewer than the U.S. has with 25% fewer people.

New Wars; New Wounds. Russian statistics show how mechanization of war has changed the military surgeon's problems. Says the Red Army's Chief Surgeon Nikolai N. Burdenko: "The percentage of bullet wounds is comparatively small; most casualties are now due to bombing, mortar fire and grenades." In World War I, 50% of wounds were caused by shrapnel (or shell fragments); today 95% belong to this category (counting each wound separately--one man often receives several wounds at the same time). Next to wounds of the arms and legs, the largest group of major wounds involves the skull and brain.

Mortality from brain wounds in the last war was 35% in Russia; now it is about 5%. According to Deputy Health Commissar S. Milovidov, deaths from stomach wounds have dropped 33%, from head, jaw and thorax wounds 50%, from spinal column injuries 80%.

"FrontLine Girl Friends." Gravest menace to the wounded soldier is not his wound itself but the triple threat of shock, infection and delay--each of which once killed more men than flying bits of metal. In Russia, as elsewhere, plasma transfusions have reduced effects of shock, which is essentially a disorder of the blood stream (the body tissues seem to absorb the blood's natural plasma). Sulfa drugs and tetanus serum have reduced danger of infections. In use of antitoxin for gas gangrene--the bacterial infection that causes a wound to froth--Russia claims to be well ahead of other nations. Said Dr. Hugh Cabot, famed Boston surgeon, recently: "We are still wondering whether we can get a vaccine for gas gangrene . . . but [the Russians] have the vaccine and they have reduced the fatality rate to about one and a half percent, as against about 50% in the last war."

Dr. Yefim I. Smirnov, Chief Medical Administrator of the Red Army, reports: "During the first World War, stretcher bearers as a rule set out to pick up the wounded after heavy action was over, usually at night. The result was that many wounded died after lying on the field six or eight hours without assistance--died not of their wounds but of loss of blood or the rapid spread of infection. . . . In the Red Army a strict rule has prevailed since the first day of the war: the wounded are carried off the battlefield immediately, regardless of enemy fire. . . ."

Stretcher-bearer teams have been banished from the battlefield. Instead, medical orderlies work singly, crawling across fields while fighting is still going on and retrieving the wounded on their backs. Nearly all the soldier-toting orderlies are young women--Russian women are brawny. The soldiers call them jrontoviye podrugi (frontline girl friends).

"We suffer big losses in medical orderly personnel," Dr. Smirnov admits, "but the number of soldiers' lives saved is tremendous." A girl who totes 40 casualties from the battlefield is awarded the Order of the Red Banner--provided she also brings in their rifles or machine guns. If she rescues 80 soldiers and their weapons, she gets the Order of Lenin. One 23-year-old girl shouldered and hauled in 100 men in a single day. "I was frightened," she said. "Afterward I was tired."

Flying Coffins. From front-line dressing stations, the wounded are usually whisked to base hospitals by air ambulances (as the U.S. Army also plans to do). Most of the pilots are women. Most of the planes are antiquated models. The wounded are not only packed into the fuselage but into coffinlike boxes built atop the wings. An old two-seater can carry a dozen casualties per trip. This is a vast improvement over World War I's hospital trains, in which the wounded were often hauled and jolted for days while their infections festered.

New Techniques. War always gives doctors a chance to develop new techniques. Some recent Russian developments:

> Grafting of nerves from corpses to living persons has been developed by Surgeon A. S. Vishnevsky.

> Gaping wounds are healed by covering them with the treated peritoneum--the inner lining of the visceral cavity--of an animal. This strange bandage, developed by Professor V. Krause, clings to the wounded flesh, forming a reliable protection and leaving a slight, very flexible scar.

> Thrombin, a whitish fluid which coagulates blood and stops bleeding, is being produced in useful quantities for the first time by Dr. E. I. Kudryashev of Moscow. He explains: "The ferment [thrombin] was first obtained in 1912. . . . American scientists succeeded in isolating thrombin, but in very small quantities. So for a long time its use was confined to experimental purposes. Not so long ago I found a method of obtaining thrombin in thousands of quarts, and it is now being used in many hospitals in our country."

> Red Army nurses always carry 200 cc. (about 6 1/2 oz.) of blood of the "universal" type in an ampule--named for its inventor, Dr. S. Seltsovsky of Kiev--provided with a sterilized rubber tube, needle and filter. Blood transfusions can thus be given to wounded soldiers even before the nurse shoulders and carries them, with their guns, off the battlefield.

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