Bombs and Bandages

Civilian casualties from air raids present a gruesome but not a professionally difficult problem to medicine. Nowadays medical treatment for civilians in wartime is primarily a problem in organization, and to doctors air raids mean nothing more than a monstrous epidemic of chest, neck and skull wounds, of broken arms, legs and backs. Furthermore, while an ordinary epidemic catches doctors unawares, this era's doctors have had plenty of time to prepare for war.

Last week, as the first bombs bit into Warsaw pavements, Polish doctors had made no plans for the epidemic of war. Air raid casualties were picked up like victims of everyday auto accidents, packed into ambulances, rushed to overcrowded hospitals. Frantic radio appeals were broadcast for blood donors, volunteer ambulance drivers, nurses and stretcher bearers.

Until the Munich pact last fall, British doctors, like the Poles, gave little thought to the prospect of war. But immediately after Munich, Dr. John Henry Hebb of the Ministry of Health and President Colin D. Lindsay of the British Medical Association began working feverishly on medical A. R. P. When war came last week they had mapped detailed plans down to the last patch of adhesive tape for the treatment of bombed civilians. Far more flexible and expensive than the French and German plans for civilian medical care, the British war system will cost -L-27,000,000 and guard the health of citizens more vigilantly than in times of peace.

Patients' Progress. All last week, ambulances and lumbering green busses carried convalescents and minor cases out of large London hospitals, drove them home, or off to private houses in the countryside. At least 300,000 hospital beds stand empty, all over Britain, ready to receive victims of the first air raid.

London has been divided into ten medical zones, each containing 20 first-aid stations and one large central hospital. As soon as a citizen is felled by steel scraps or toppling masonry, he will be carried to the nearest first-aid station, or picked up by one of the numerous trucks ("mobile units"), which, manned by doctors, will cruise around stricken areas. Smaller first-aid stations are set up in public laundries, baths, and in most public buildings. Almost all stations are equipped with shower baths to "decontaminate" victims of poison gas.

Patients wounded near the Thames will be carried down the river on converted pleasure steamers to central zone hospitals. At zone hospitals desperate cases will receive immediate attention, but all those who can survive will be immediately examined and shipped for surgical treatment to base hospitals in safe districts some 20 miles out of London.

Drugs and Blood. Among the huge supplies of surgical materials stored up by the Government: 600,000 doses of tetanus antitoxin; 13,000,000 yards of gauze bandage; 225,000 stretchers. Over 100,000 donors in the London area, mostly women, are having their blood typed, expect to be ready for transfusions within a few minutes' notice. Blood of the universal Type Four, which can be safely used for all persons, has been stored in refrigerated banks, in special air-tight bottles.

As soon as war began, all precious radium supplies were sunk in shafts 60 feet deep, widely scattered throughout the country.

Medical Revolution. With the coming of war, almost all private medical practice ceased, for 95% of Britain's 61,000 physicians pledged their aid to the Government. Each physician who is assigned to an ambulance, first-aid post, or hospital, will draw a salary ranging from $2,500 to $7,500 a year for full-time services. All physicians remaining in private practice, and making more than their "normal" peacetime income will be required to place their surplus profits in a pool, to be divided among Army and Navy doctors at the war's end. Medical care for the 1,000,000 school children who were evacuated from large cities and compensation for victims of air raids will be paid by the Government.

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