Struggle in Russia

When the coalition forces were tortured by bad weather, logistics, and health problems, the Russian army also welcomed the arrival of an important figure.

He is Nikolai Pirogov. This man is not a general or a powerful man, but a surgeon.

Perhaps around the world, more people know Nightingale than know his name. Even in Russia, not many people know him, but his significance to the Russian army is definitely higher than that of Nightingale. superior!

Pirogov was born in Moscow in 1810. He entered Moscow University to study medicine at the age of fourteen. At the age of twenty-five, he became a professor at the German University in Dorpat (now Tartu, Estonia), and later served as a professor of surgery at the St. Petersburg Military Medical College.

In 1847, he served as an army doctor in the Caucasus, where he pioneered the use of ether for field surgery. At the same time, he published articles in several Russian-language publications between 1847 and 1852 to introduce ether anesthesia technology.

He emphasized in these publications that allowing patients who had just been sent to the hospital to absorb ether could not only relieve pain and panic, but also keep them calm and prevent coma, which would help surgeons determine which patients needed immediate surgery.

Of course, these things are very superficial and not necessarily correct. Pirogov's most important achievement is the first wounded and sick casualty triage system during the Crimean War.

Upon arriving in Seystopol, Pirogov was immediately angered by the chaos and inhumanity with which the wounded and sick were dealt with.

He saw thousands of wounded people being evacuated to Perekop on uncovered carts. Many people froze to death on the way, and many of the survivors suffered severe frostbite and required amputation.

Due to lack of transportation, many wounded were dumped in dirty barns or simply abandoned on the roadside.

There is also an acute shortage of medicines, because many doctors and medical staff secretly sell the medicines and then use inferior substitutes. The injured must bribe the doctors if they want to receive real treatment.

In addition, the Russian army's field hospital was too small, with only 2,000 beds in total. As a result, after the old eunuch recklessly committed suicide, 12,000 wounded people came in at once, and it was immediately overcrowded.

Not only is it overcrowded, the conditions of the hospital are also very crude, and most of the medical staff are half-baked. They are more like "charlatans" than doctors. They used butcher's dirty machetes for surgery, and had no idea about the dangers of infection due to hygiene requirements. Pirogov even found some wounded lying in a pool of his own blood for two weeks!

After arriving in Sevastopol, Pirogov began to issue orders to the hospital and gradually implemented the wounded triage system he created. The situation at the time was very chaotic. Every time he was shelled, all the wounded were sent to the hospital one after another. Not only There was no order, and more importantly, the dead, dying, those in need of first aid, and those with only scratched skins were all mixed together.

At the beginning of the period, Pirogov immediately dealt with the seriously injured people and asked the nurses to send them directly to the operating room. However, while he was still concentrating on treating the wounded, wounded people in various other conditions kept coming, making it impossible for him to perform surgery. .

Especially when he treated the wounded who were so seriously injured that there was almost no hope of treatment, the wounded who had a chance to be treated deteriorated and died because they waited too long.

"I finally realized that it was pointless, so I decided to be more decisive and rational!" Pirogov recalled; "In terms of saving lives, the simple organization of the dressing station is much more important than treating the wounded!"

His solution is a simple triage system. After the injured are sent to the hospital, they are immediately screened by experienced doctors and divided into three groups. Those with serious injuries who can be saved are sent to the operating room immediately, while those with minor injuries are left to them. After receiving a number, they were sent to the dressing station on one side for junior doctors to debridement and bandage. Those with serious injuries and hopeless injuries were sent to the church on the other side, where nurses and priests were responsible for taking care of them until they died.

Tolstoy witnessed the changes in the field hospital with his own eyes, and later described the situation to readers in "Sevastopol in December", praising Pigrov's contribution.

In addition, Pigroof also vigorously promoted anesthesia, which greatly improved the work efficiency of him and other surgeons. They had three operating rooms working seven hours a day and could complete one hundred amputations a day.

In addition, he also developed a new technique, such as amputation at the ankle, where he would leave part of the calcaneus to give the foot some support.

Generally speaking, when he performs amputation surgery, he chooses the incision to be lower than other doctors, trying to minimize the wound and blood loss, because he knows that blood loss after surgery is a serious threat.

More importantly, he also knew the threat of infection. Although he thought that wound infection was caused by pollutants in the air, he specially separated the wounded who had clean wounds after surgery from those whose wounds were suppurating and had gangrene.

Through these pioneering measures, Pirogov achieved a survival rate that was much higher than that of British and French military hospitals. 65% of the injured who had their arms amputated there survived. Thigh amputation was the most dangerous and common operation during the Crimean War. Pirogov's survival rate was 25%, while the French and British troops did not even have 10%.

I have to say that this is a slap in the face for Britain and France, whose medical technology should be more advanced in theory. Especially the British, these hard-headed gentlemen are more out of date and more old-fashioned than the last.

For example, when it comes to anesthesia technology, Russia and France are relatively supportive, but the United Kingdom is strongly opposed to it. For example, Dr. John Hall, the chief medical officer of the British Army, issued a memorandum warning all surgeons under him: "Do not treat serious gunshot wounds." and other open injuries... because, no matter how barbaric it may seem, being stabbed is a powerful and effective stimulus, and it is better to hear a man scream madly than to watch him sink silently into his grave!"

I could only shed a few tears for the poor British wounded. The injuries were already painful enough, but they had to be tortured again by the butcher doctor. A considerable number of the wounded could be said to have died of pain on the operating table.

It's just that those tyrannical British doctors don't care about that. They mostly promote how brave their patients are and how unafraid of pain. They say that no one can truly describe the courage of warriors. They smile at the pain. Will surrender in the face of death.

It is also said that the spirit defeats the body. In Crimea, soldiers kept walking into the hospital with a dangling arm or a smashed elbow, telling them that their condition was not bad and asking them to have surgery quickly because they still had Such nonsense as rushing back to continue fighting.

To be honest, there may be such people, but that is not because they are brave, but because they are afraid of these butcher-like doctors. Their aggressive style makes the wounded afraid of staying in the hospital, and they are eager to escape!