THE IODINE TREATMENT OF WOUNDS.
[To THE EDITOR OF THE "SPECTATOR.") Sin,—In your last issue " F. H. C.-D." urges immediate investi- gation by the authorities of this "invention," and quotes a French newspaper article in support of it. While not claiming to be an authority on the question of the best treatment for the wounds of warfare, I am, as a surgeon, naturally interested in it. And, as it happens that a letter of mine on the iodine treatment was published in the British Medical Journal of November 7th, I may be permitted brief comment on a matter which is of prime importance at this time. The iodine treat- ment of wounds is not a recent " invention," as " F. H. C.-D." seems to believe. It has, in different forms, been introduced and reintroduced repeatedly in surgical practice. In cirri practice it has recently had a fresh " boom," and at the present time its vogue appears to be once more on the wane. In military practice, where conditions and circumstances of wounds are so different, the iodine method may conceivably prove to be superior to others as a first-aid dressing.
Such articles as that which your correspondent quotes, how- ever, are not helpful in coming to a decision. That article teems with misleading statements. Two may be instanced. The first concerns the wounds to be treated : " The bullet itself when it strikes direct . . . is aseptic. Moreover, such a bullet does not carry with it into the wound any part, of the clothing." That is more or less true of rifle and machine-gun bullets at effective range. It is, however, notorious that the vast majority of our British casualties are produced by shell and shrapnel, which carry into the wound not only portions of
the clothing, pocket contents, and accoutrements of the wounded man, but also, in some cases, of those of the man in front of him. Such wounds are necessarily septic. The second statement concerns the agent proposed for the treatment: "Painting with iodine renders aseptic the dirtiest skin." Whether it does or does not when in actual contact with the newly washed skin (as in civil practice) is a matter at present in dispute. The point is that in warfare the iodine rarely reaches the skin. It is painted on a surface formed of clotted blood, of earth from the wet trenches, and of the epidermal accumulations of unwashed weeks. Even if all the virtues claimed in the article quoted on behalf of iodine be granted, what practical relation has a small quantity of iodine with a small brush in a "small glass tube" to the surface extent of a shell wound ? The question of military wound treatment is of prime importance at present. Many of its aspects cannot with advantage be discussed outside medical journals, and my excuse for this letter to the Spectator is that " F. H. C.-D.'s" kindly heart has prompted him, with the best of motives, to lay before the public a very misleading newspaper article.—
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