Surgery in World War II, Thoracic Surgery

To undertake a comprehensive review of such a massive subject as thoracic surgery during the Second World War is, indeed, a Herculean task. The sheer volume of material encompassed in such a study would tend to make the final result merely a list of statistical analyses so often encountered in the medical literature of today. Instead, the editors have accomplished a remarkable feat by interpreting these data and translating the results into an extremely valuable discussion of the basic principles derived from their experience. This second and final volume of the series expands and elaborates on the material presented in the first volume published in 1963. As in the first volume, this report deals with thoracic and cardiovascular trauma encountered in the Mediterranean and European theaters of operation. Special attention is devoted to "certain complications of these injuries whose significance was realized, or fully realized, for the first time in World War II." These complications include retained foreign bodies, the "wet lung" syndrome, hemothorax and its progression to hemothoracic empyema. The book is divided into three sections. I. Special types of wounds of the chest; II. Complications of wounds of the chest; III. Observations on wounds and diseases of the chest in the Zone of Interior. The first section includes thoracic, cardiac and thoracoabdominal wounds. The material is presented in a straightforward factual manner. The discussion of each type of injury follows the same general format, i.e., general considerations of the injury, the pathologic physiology and the management. Excellent presentation of pertinent case material is utilized to document each subject. The development of newer concepts of management constitutes the most interesting aspect of this section. By far the most absorbing and readable chapters are found in the second section. The concept of the "wet lung" syndrome and its prophylaxis and management are very lucidly presented. Hemothorax and its complications, organization and infection, are discussed in a most complete and elucidating manner. This is the high point of the entire volume. The sequential development of an organizing hemothorax is illustrated remarkably well by excellently reproduced histological sections. The author then proceeds with a well-grounded discussion of the necessity for and timing of decortication in these cases. The patients encountered in the Zone of Interior include the more difficult therapeutic problems and complications as well as the commonly encountered pulmonary disease processes present in any large population. Of special interest is a …