Gangrene Treatment in the Early 20th Century

[Tuckerfan]

I’m currently writing a book on Tuckers (I bet you’re suprised;)) and I got to thinking about the event which inspired the invention of the electric starter. A friend of the president of Cadillac was killed when the hand crank on the Caddy he was trying to start hit him in the jaw, breaking it. He contracted gangrene because of this and later died. Given that antibiotics hadn’t been discovered as of yet, and surgical techniques weren’t nearly as sophisticated as they are now, So what did they do? And how did they (if they did) disinfect the wound?

[FRDE]

I am pretty sure that in WWI they used maggots to eat out gangrenous matter.

Also I heard some time ago that there is currently a market for sterile maggots for the same thing.

Sorry - no cites - but these might jog someones memory.

[Duck_Duck_Goose]

Well, FWIW, this is what I found:

http://www.worldwidewounds.com/2003/july/Clewlow/Vet-History-Review.html

In Mayhew’s *Illustrated Horse Doctor *[51] (1904), we find the use of the word pus as well as suppuration being used. Engravings are included in this work to help illustrate the different types of wound. A lotion which Mayhew recommended for lacerated wounds contained a mixture of tincture of cantharides, chloride of zinc and water. Generally he suggested the avoidance of all poultices. Mulder [52] cites the US Department of Agriculture’s Special Report on Diseases of the Horse (1911), which lists new wound antiseptics including bichloride of mercury, carbolic acid, aluminium acetate, borasic acid, creolin, Lysol, iodoform and tannic acid. With the introduction of sulphonamides and then penicillin in the 1930s and 1940s, great advances in wound treatment became possible, especially where entry into a body cavity had occurred.

The pioneer of aseptic surgery, Joseph Lister, concluded that wounds became infected because of the entry of germs from the air. Using carbolic acid (phenol), as an antiseptic agent, he worked with James McCall [53] (1834-1915), the founder of the Glasgow Veterinary College, to develop his methods using horses and calves. During the twentieth century, the use of chemical agents such as proflavin and hydrogen peroxide were introduced to supplement or replace the plant products that had been in use for centuries.

Yep, it’s a “history of veterinary medicine” web page. Dunno if that helps, but it shows the disinfectants that were around, although some of them must’ve stung like a bastard, and they might have been hesitant to pour, say, Lysol into an open human wound.

Anyway, pouring disinfectant into a wound (presumably) on the side of your face where the crank hit you wouldn’t necessarily have prevented gangrene. I find that the current treatment to prevent gas gangrene in open fractures, arrived upon after 150 years of research, is to completely remove all possible contaminated tissue from around the wound under the most stringent antiseptic procedures, disinfect it heavily, administer massive doses of antibiotics, and pray.

http://www.bonetumour.org/book/Truma/chapter24/CHAP24.html

Even pouring a modern disinfectant like hydrogen peroxide into the wound likely wouldn’t have helped him, as gas gangrene is caused by an anaerobic spore-forming bacteria that is ubiquitous. There are still 3,000 civilian cases of it a year, with mortality rates ranging from 25% to 100%, so even SOFTA modern medicine finds it challenging.

Gas Gangrene (Clostridial Myonecrosis): Background, Pathophysiology,...

So what they would have done back then would be to set the fracture, sew up the presumed skin lacerations, clean the wound with some kind of currently medically fashionable disinfectant, and pray.

[irishgirl]

Treatment of gangrene was and is to remove as much of the gangrenous tissue as possible, so at some point during his illness (hopefully not, but possibly if he took a while to die) someone might have cut away the dead, infected tissue and drained any abcesses that formed.

Hopefully they would have had ether or chloroform to hand when they did that.

[wolf_meister]

This might be an intersting footnote for your book, particularly if you are going to discuss gangrene in any detail.
Here’s a short article about someone who died of gangrene in 1926.
Bobby Leach - truly an ironic death.

When did the guy with the broken jaw die of gangrene? (Just curious)

[Tuckerfan]

@wolf_meister

This might be an intersting footnote for your book, particularly if you are going to discuss gangrene in any detail.
Here’s a short article about someone who died of gangrene in 1926.
Bobby Leach - truly an ironic death.

When did the guy with the broken jaw die of gangrene? (Just curious)

Looks to be around 1910 or so.

Coincidentally, the death of a friend from complications due to a jaw broken while hand-cranking his automobile impelled engineer Charles Kettering to replace the hand crank with an electric starter. In 1910, he modified Coleman’s design and made it practical. It was tested successfully on Cadillac cars of 1911 and first installed by Cadillac on production models in 1912. These starters also worked as generators once the engine was running, a concept that is now being revived in hybrid vehicles. By 1920, nearly every car had a self-starter.