STUDY OF FIFTH ARMY HOSPITAL BATTLE CASUALTY DEATHS 
A PRELIMINARY REPORT 
IN THREE VOLUMES 
SNYDER and CULBERTSON 
VOLUME ONE STUDY OF FIFTH ARMY HOSPITAL BATTLE CASUALTY DEATHS 
An Analysis of Case Reports from Field and Evacuation Hospitals 
on 145Q Fatally Wounded American Soldiers 
A PRELIMINARY REPORT 
IN THREE VOLUMES 
by 
HOWARD E. SNYDER, COLONEL, MO, IDS 
Surgical Consultant. Fifth Army. 
and 
JAMES W. CULBERTSON, CAPTAIN, MO, AUS 
Surgical Service, 8th Evacuation Hospital 
Gardone Riviera,- Italy 
September 1945 FOREWORD 
This report is submitted as a comprehensive survey and partial 
analysis of available information on battle casualty deaths reported 
by Fifth Army hospitals. Time has not permitted further consoli- 
dation and interpretation of the findings, or exposition on the 
lessons which may be drawn from this study. 
A tremendous amount of work has been involved in the prepar- 
ation of this material. Captain James W, Culbertson must be credit- 
ed with the major share. His patient, exacting, critical examination 
of the records and careful appraisal of the accumulating statistical 
information done much to insure the accuracy of this report. 
He devoted his entire time to this -oroject from Aoril until September 
191+5 with the exceution of one week when he returned to the Sth 
Evacuation Hospital to do surgery at the time of the Po Valley 
offensive. 
Brigadier General Joseph I, Martin, Army Surgeon at the time 
the study was started, encouraged and helped make -oossible this 
reoort. Colonel Charles 0. Bruce, the Fifth Army Surgeon during 
the latter months of the study, has given needed advice and has 
provided all necessary clerical assistance. 
Major Richard A, Morrissey, Statistician in the Surgeon’s 
v 
Office,has also been a source of great encouragement. He has lent 
valuable advice and has made specific contributions to this reuort. 
His continued interest has been most stimulating. The assistance of the clerical staff has "been most excellent. 
Sergeant Merl Phinney has worked with the authors the past U months. 
It was he who key-punched all the machine records cards in the 
final preparation of the report. His assistance in preparing tobies 
and in many ether respects has been invaluable. Sergeant Linton 
Eincher worked for one month accumulating data on time lags and 
plasma and blood transfusion therapy and was most helpful. In the 
final preparation of the report all of the clerical staff in the 
Surgeon!s Office and men from the 8th and 38th Evacuation Hospitals 
worked overtime, in a spirit of cheerful cooperation, to complete 
the report before our departure from Italy. 
The staff of the 2nd Medical Laboratory and the 15th General 
Medical Laboratory have been most helpful in providing reports on 
the microscopic examination of tissues, "Mie staffs of the 
Machine Records Unit (Mobile) and the 60th Machine Rocords Unit 
(Eixed) have rendered great assistance respectively in advice re- 
garding preparation of the code for the machine records cards and 
in providing assistance and facilities for the machine computation 
of statistical data, finally, the Adjutant Generalrs staff has been 
most cooperative in giving their time and skill in reproducing this 
report at a time when it was inconvenient. 
To all above as well as the ma.ny individuals who have not been 
mentioned the authors express sincere appreciation for their un- 
selfish contributions. 
| \ tr \ A £. <1 -v\ "V. 
HOWARD E. SHYDER, Colonel, MC TABLE 
0 3? 
COUTBNTS Table of contents 
VOLUME OKS 
Table Page 
FOREWORD ii 
INTRODUCTION 1 
SECTION I 
REGION, TIPS, AND DISTRIBUTION OF WOUNDS 
AND CERTAIN GENERAL CONSIDERATIONS * , 5 
Preliminary Remarks 6 
I BATTLE CASUALTY DEATHS (1I+50 CASES), DISTRIBUTION 
BY REGION OF PRINCIPAL WOUND g 
II DEATHS AS RELATED TO HOSPITAL ADMISSION, ANESTHESIA, 
AND SURGERY 9 
III HOSPITAL BATTLE CASUALTY ADMISSIONS DYING BEFORE 
ANESTHESIA AS COMPARED WITH THOSE DYING DURING 
ANESTHESIA OR SURGERY AND WITH THE TOTAL BATTLE 
CASUALTY DE-THS IN ARMY HOSPITALS 10 TABLE OB CONTENTS 
Tati e 
Page 
IV DEMONS TRAT ION OF EFFECT OF INCREASED EFFICIENCY OF 
EVACUATION FROM FORWARD AREAS ON HOSPITAL MOR- 
TALITY (AIT INCREASE) AID THE REMAINING FAVORABLE 
TREND AFTER EXCLUSION OF THOSE CASES DYING- 
BEFORE ANESTHESIA 11 
Y BATTLE CASUALTY DEATHS LISTED AS TO PRINCIPAL WOUND 12 
YI C-iSUATIYE AGENTS AS RELATED TO PRINCIPAL WOUND (l) 13 
YU CAUSATIVE AGENTS (2) AND CHARACTER OF WOUNDS lH 
VIII HOSPITAL BATTLE CASUALTY DEATHS LISTED AS TO PRINCIPAL 
WOUND, WITH PERCENTAGE OF HOSPITAL RATTLE CASUALTY 
A AM I SSI OxIS J 3 
IX RATTLE CASUALTY DEATHS LISTED AS TO PRINCIPAL WOUND 
AND RELATED TO HOSPITAL ADMISSION, ANESTHESIA, 
AND SURGERY l6 
X NUMBER OF CASES IN EACH PRINCIPAL WOUND GROUP BY 
PERIODS 17 
XI PERCENTAGE OF CASES IN EACH PRINCIPAL WOUND GROUP BY 
PERIODS IS 
Hcaai-kc 19 
XII DISTRIBUTION ACCORDING TO PRINCIPAL WOUND OF CASES 
WITHOUT ASSOC LA TED WOUNDS IN OTHER REGIONS, COM- 
PARED WITH ALL CASES IN ’THE SERIES 20 
XIII PRINCIPAL AND ASSOCIATED WOUNDS; NUMBER OF CASES 
EXHIBITING BACK TYPE 21 
XIV REGIONAL DISTRIBUTION OF PRINCIPAL AND ASSOCIATED 
WOUNDS, SHOWING THE NUMBER OF CASES EXHIBITING 
EACH 22 TABLE of contents 
TaLle Page 
INCIDENCE ASSOCIATED WOUNDS AS RELATED TO PRINCIPAL 
' WOUND? 25 
XV CASES WITH ASSOCIATED HEAD AND INTRAVERTEBRAL 
WOUNDS 25 ' 
XVI CASES WITH ASSOCIATED MAXILLOFACIAL WOUNDS 26 
XVII CASES WITH ASSOCIATED CERVICAL WOUNDS 27 
XVIII CASES WITH ASSOCIATED THORACIC WOUNDS 28 
XIX CASES WITH ASSOCIATED ABDOMINAL WOUNDS 29 
XX CASES WITH ASSOCIATED UPPER EXTREMITY WOUNDS 
WITHOUT INVOLVEMENT Op BONE 30 
xxi Cases with associated utter extremity wounds 
WITH BONE INVOLVED 31 
XXII CASES WITH ASSOCIATED LOWER EXTREMITY WOUNDS 
WITHOUT INVOLVEMENT OF BONE 32 
XXIII CASES WITH ASSOCIATED LOWER EXTREMITY WOUNDS 
WITH BONE INVOLVED - 33 
XXIV INCIDENCE OF ARTERIES INJURED (excluding traumatic 
amputations) 
XXV INCIDENCE OF NERVES INJURED (excluding traumatic 
amputations) 3& TABLE OP CONTENTS 
Tati© 
Page 
SECTION IX 
SURGERY. ANESTHESIA, REPLACEMENT THERAPY, 
CHEMOTHERAPY5 OXYGEN THERAPY, AND 
MISCELLANEOUS DATA AND OBSERVATIONS 38 
Preliminary Remarks 39 
XXVI PRIMARY OPERATIONS AS RELATED TO PRINCIPAL WOUND 1+1 
XXVII DEBRIDEMENT OE OTHER WOUNDS ASSOCIATED WITH PRIMARY 
OPERATION FOR THE PRINCIPAL WOUND I4.3 
XXVIII SUBSIDIARY OPERATIONS AT THE TIME OE THE PRIMARY 
OPERATION AS RELATED TO PRINCIPAL WOUND I|I+ 
XXIX OPERATING TIME EOR PRIMARY SURGERY AS RELATED TO 
PRINCIPAL WOUND 1+6 
XXX SECONDARY (LATER) OPERATIONS AS RELATED TO PRINCIPAL 
WOUND I+3 
XXXI ANESTHESIA EOR PRIMARY SURGERY AS RELATED TO 
PRINCIPAL WOUND 52 
XXXII ANESTHESIA JOR SECONDARY SURGERY AS RELATED TO 
PRINCIPAL WOUND 5I+ 
XXXIII OXYGEN THERAPY AS RELATED TO PRINCIPAL WOUND 56 
XXXIV CHEMOTHERAPY AS RELATED TO PRINCIPAL WOUND 57 
XXXV INTRAVENOUS PLASM THERAPY 3EEORB ADMISSION TO 
HOSPITAL AS RELATED TO PRINCIPAL WOUND 58 
XXXVI INTRAVENOUS PLASMA THERAPY AFTER .ADMISSION TO 
HOSPITAL BEFORE SURGERY AS RELATED TO PRINCIPAL 
WOUND 60 TABLE QP CONTENTS 
Table Pag© 
XXXVII INTRAVENOUS PLASMA THERAPY DURING- SURGERY AS 
RELATED TO PRINCIPAL WOUND 62 
XXXVIII INTRAVENOUS PLASMA. THERAPY AFTER SURGERY AS HE* 
LATED TO PRINCIPAL WOUND 6U 
XXXIX BLOOD TRANSFUSION THERAPY BEFORE SURGERY AS R5U 
LATED TO PRINCIPAL WOUND 66 
XL BLOOD TRANSFUSION THERAPY DURING SURGERY AS RELATED 
TO PRINCIPAL WOUND 68 
XL I BLOOD TRANSFUSION THERAPY AFTER SURGERY AS RELATED 
TO PRINCIPAL WOUND 70 
XLII SYSTOLIC BLOOD PRESSURE ON ADMISSION TO HOSPITAL AS 
RELATED TO PRINCIPAL WOUND 72 
XL III LOWEST RECORDED SYSTOLIC BLOOD PRESSURE FOR CASES 
IN SHOCK AS RELATED TO PRINCIPAL WOUND 7^ 
XLIV NATURE OF EVIDENCE FOR SHUCK IN CASES WITHOUT RE- 
CORDED HYPOTENSION AS RELATED TO PRINCIPAL WOUND 75 
XLV URINARY uUTPUT AS .RELATED TO PRINCIPAL WOUND 76 
XLVI MISCELLANEOUS OBSERVATIONS AS RELATED TO PRINCIPAL 
WOUND 77 
XLVII DATA RELATIVE TO DISTRIBUTION OF DEATHS IN FIELD 
AND EVACUATION HOSPITALS 78 
XLVII I POST MORTEM EXAMINATIONS AS RELATED TO PRINCIPAL 
WOUND 79 TABLE OT CONTENTS 
Table Pa^e 
SECTION III 
CAUSES OP DEATH 
Part 1 
General Observations ' 80 
Preliminary Remarks 81 
XLIX IMMEDIATE CAUSE OE DELATE S5 
L THE LEADING CAUSES OE DEATH IN 1)450 BATTLE CASUALTY 
DEATHS, SHOWING THE NUMBER OE CASES BY PERIOD 88 
LI THE LEADING CAUSES CE DEATH IN 1H50 BATTLE CASUALTY 
DEATHS, SHOWING PERCENTAGE DISTRIBUTION BY PERIOD 89 
LI I THE LEADING CAUSES OE DEAmH IN 1U5O BATTLE CASUALTY 
DEATHS, SHOWING THE PERCENTAGE OE THE TOTAL BATTLE 
CASUALTY ADMISSIONS BY PERIOD 90 
LIII REGION OF IMMEDIATE CAUSE OE DEATHS NUMBER OE CASES 
BY PERIOD 91 
LIY REGION OE IMMEDIATE CAUSE OE DEATH? PERCENTAGE DIS- 
TRIBUTION BY PERIOD 92 
LV REGION OE PRINCIPAL WOUND COMPARED WITH REGION OE 
IMMEDIATE CAUSE OE DEATH, WITH PERCENTAGES 
OE CASES STUDIED 93 
LYI REGION OE IMMEDIATE CAUSE OE DEATH AS RELATED TO 
REGION OE PRINCIPAL WOUND, DETAILED QR 
LYI I REGION OE PRIMARY TRAUMA LEADING TO DEATH?, NUMBER OP 
CASES BY PERIOD 96 TABLE OF CONTENTS 
Talle Page 
LVIII REGION OF PRIMARY TRAUMA LEADING TO DEATH* PERCENTAGE 
DISTRIBUTION BY PERIOD 97 
LIX PRIMARY TRAUMA LEADING TO DEATH AS RELATED TO PRINCIPAL 
WOUND ? GENERAL 98 
LX REGION OF PRIMARY TRAUMA LEADING TO DEATH AS RELATED 
TO REGION OF PRINCIPAL WOUND, DETAILED 99 
Remarks 101 
LXI TOTAL REPORTED INCIDENCE OF SHOCK IN 1I150 BATTLE 
CASUALTY DEATHS 102 
LXI I TOTAL REPORTED INCIDENCE OF INTRACRANIAL CONDITIONS 10k 
LXIII TOTAL REPORTED INCIDENCE OF MAXILLOFACIAL CONDITIONS 105 
LXIV TOTAL REPORTED INCIDENCE OF CERVICAL CONDITIONS 106 
LXV TOTAL REPORTED INCIDENCE OF INTRAVERTEBRAL CONDITIONS 107 
LXVI TOTAL REPORTED INCIDENCE OF EXTREMITY CONDITIONS 10S 
LXVII TOTAL REPORTED INCIDENCE OF THORACIC CONDITIONS 109 
LXVIII TOTAL REPORTED INCIDENCE OF ABDOMINAL CONDITIONS 113 
LXIX TOTAL REPORTED INCIDENCE OF CLOSTRIDIAL MYOSITIS 
OR CERE 13 PIT IS 117 
LXX TOTAL REPORTED INCIDENCE OF EMBOLISM, INFARCTION, 
AND THROMBOSIS 11S 
LXXI TOTAL REPORTED INCIDENCE OF MISCELLANEOUS DATA 119 TABLE OE CONTENTS 
VOLUME TWO 
Table Pag© 
SECTION III 
CAUSES OE DEATH 
Part 2 
Detailed Observations 120 
Preliminary Remarks 120 
Causes of Death in Those Cases in Which the Principal 
Wound Was Intracranial I 121 
LXXII IMMEDIATE CAUSE OE DEATH 121 
LXXIII THE ETIOLOGY OE SHOCK IN ITS INCIDENCE AS A CON- 
TRIBUTORY OR ASSOCIATED CONDITION 122 
LXXIV DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY 
OR ASSOCIATED CONDITION 123 
LXXV INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 12*1 
LXXVI MAXILLOEACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIAT- 
ED CONDITIONS 125 
LXXVII THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 126 
LXXVIII ABDOMINAL CONTRIBUTORY OR ASSOCLA.TBD CONDITIONS 129 
LXXIX INTRAVERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 131 TABLE OE CONTENTS 
Tatiq Page 
LXXX CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION • 132 
LXXXI EMBOLISM. INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS I33 
LXXXI I MISCELLANEOUS DATA 13I4. 
Causesof Death In Those Cases in Which the Principal 
Wound Vas IntravertetralS 135 
LXXXIII IMMEDIATE CAUSE CE DEATH 136 
LXXXIV THE ETIOLOGY OF SHOCK IN ITS INCIDENCE AS A COIL 
TRIBUTORY OR ASSOCIATED CONDITION 137 
LXXXV DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY 
OR ASSOCIATED CONDITION 3,33 
LXIXTJ INTRACRANIAL CONTRIBUTORY OR ASSOCIATEn CONDITIONS 139 
LXXXVII MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIAT- 
ED CONDITIONS * nHo 
Notes There is an inadvertent hiatus Between -cages 
lUO and 150. 
LXXXVI11 INTRAYERTEr tlAL AND EXTREMITY CONTRIBUTORY OR ASSOCIAT- 
ED CONDITIONS 150 
LXXXIX THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS l^l 
XC ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS I53 
XCI CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 15U TABLE OF CONTENTS 
Tahle 
Pa^9 
XCII EMBOLISM* INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 155 
XCIII MISCELLANEOUS DATA I56 
Causes of Death in Those Cases in Which the Principal 
Wound Vas Maxillofacial* 157 
XCIV IMMEDIATE CAUSE OE DEATH 15S 
XCV THE ETIOLOGY OF SHOCK IE ITS INCIDENCE AS A CONTRIB- 
UTORY OR ASSOCIATED CONDITION 159 
XCVI DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY OR 
ASSOCIATED CONDITION l60 
XCVII INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS l6l 
xcvi11 Maxillofacial and cervical contributorr or associated 
CONDITIONS 162 
XGIX INTRAVERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 163 
C THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS l6U 
Cl ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 165 
CII CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 166 
ClII EMBOLISM. INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 167 
CIV MISCELLANEOUS DATA 168 TABLE OF CONTENTS 
Tahle Page 
Causes of Death in Those Cases in Which the Principal 
Wound Was Cervical! 169 
GV IMMEDIATE CAUSE OF DEATH 170 
CVI THE ETIOLOGY OF SHOCK IN ITS INCIDENCE AS A CON- 
TRIBUTORY OH ASSOCIATED CONDITION 171 
CVII DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY 
OR ASSOCIATED CONDITION 172 
CVIII INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 173 
CIX MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 17I4. 
CX INTRAVERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 175 
CXI THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 176 
CXII ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 17s 
CXIII CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 179 
CXIV EMBOLISM, INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS ISO 
CXV MISCELLANEOUS DATA 121 
Causes of Death in Those Cases in Which the Principal 
Wound Intrathoracic! 122 
CXVI IMMEDIATE CAUSE OF DEATH 120 
GXVII THE ETIOLOGY OF SHOCK IN ITS INCIDENCE AS A CONTRIB- 
UTORY OR ASSOCIATED CONDITION 123 TABLE OF CONTENTS 
Taile Rage 
CXVIII DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY 
OR ASSOCIATED CONDITION lgl| 
CXIX INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS IS5 
CXX MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 
CXXI INTRAVERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS Igy 
CXXII THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS Igg 
CXXIII ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS iqi 
GXXIV CLOSTRIDIAL MVOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION I93 
CXXV EMBOLISM* INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS I9U 
CXXVI MISCELLANEOUS DATA I95 
Causes of Death in Those Cases in "Which the Principal 
Wound Was Thoraco-ahdemlnal 5 19 6 
CXXVI I IMMEDIATE CAUSE OF DEATH I96 
CXXVIII THE ETIOLOGY OF SHOCK IN ITS INCIDENCE AS A CONTRIB- 
UTORY OR ASSOCIATED CONDITION l^g 
CXXIX DATA ON 3IOCK IN ITS INCIDENCE AS A CONTRIBUTORY 
OR ASSOCIATED CONDITION 199 
CXXX INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 200 
CXXXI MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 201 TABLE OF CONTENTS 
Table Page 
OXXX.I I INTRA VERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 202 
CXXXIII THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 203 
CXXXIV ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 206 
CXXXY CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 209 
CXXXYI EMBOLISM, INFARCTION* AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 210 
CXXXVII MISCELLANEOUS DATA 211 
Causes of Death in Those Cases in Which the Principal 
Wound Was Combined Intra-abdominal and Intra- 
thoracicS 212 
CXXXYI11 IMMEDIATE CAUSE OP DEATH 21J 
CXXXIX THE ETIOLOGY OF SHOCK IN ITS INCIDENCE AS A 
CONTRIBUTORY OR ASSOCIATED CONDITION 21 k 
CXL DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY 
OR ASSOCIATED CONDITION 215 
CXL I INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 216 
CXLII MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 217 
CXLI 11 INTRAVERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 21S 
CXLIV THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 219 
CXLV ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 222 TABLE OF CONTENTS 
Table Page 
CXLVI CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 225 
CYLVII EMBOLISM* INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 226 
CXLVIII MISCELLANEOUS DATA 227 
Causes of Death, in Those Oases in Which the Principal 
Wound Was Intra-abdominalS 22S 
CXLIX IMMEDIATE CAUSE OF DEATH 229 
CL THE ETIOLOGY OF SHOCK IN ITS INCIDENCE AS A OONTRIB-* 
UTORY OR ASSOCIATED CONDITION 23O 
CLI DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY OR 
ASSOCIATED CONDITION 2JL 
CLII INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 232 
CLI 11 MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 233 
CLIV INTRAVERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 
CLV THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 235 
CLVI ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 237 
CLVII CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 2Ul 
CLVIII EMBOLISM, INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 2^2 
CLIX MISCELLANEOUS DATA 2^3 TABLE OF CONTENTS 
Tail Q Page 
Causes of Death in Those Cases in Which the Principal 
Wound Was Abdominal Wall 2 
CLX IMMEDIATE CAUSE OF DEATH 2U5 
CLXI TABLE CE CONTRIBUTORY OR ASSOCIATED CONDITIONS OF 
WHICH NONE WERE REPORTED 2U6 
CLXI I INTRA VERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 2.kj 
CLXIII THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 2U8 
CLXIV ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 2kS 
CLXV CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION ' 250 
CLXVI EMBOLISM* INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 251 
CLXVI I MISCELLANEOUS DATA 252 
Causes of Death in Those Cases in Which the Principal 
Wound Was Upper Extremity, Soft Tissue Only! 253 
CLXVI 11 IMMEDIATE CAUSE OE DEATH 2$k 
CLXIX THE ETIOLOGY- OE SHOCK IN ITS INCIDENCE AS A 
CONTRIBUTORY OR ASSOCIATED CONDITION 255 
CLXX DATa ON SHOOK IN ITS INCIDENCE AS A CONTRIBUTORY OR 
ASSOCIATED CONDITION 256 
CLXXI INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 257 
CLXXII MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 258 TABLE OF CONTMTS 
Table Page 
GLXXIII 1NTRA VERTEBRAL AND EXTREMITY CONTRIBUTORY OE 
ASSOCIATED CONDITIONS 259 
CLXXIV THORACIC CONTRIBUTORY OE ASSOCIATED CONDITIONS 260 
CLX27 ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 261 
CLXXVI CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 262 
CLXXVI I EMBOLISM, INFARCTION,. AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 263 
CLXXVIII MISCELLANEOUS DATA 26k 
Causes of Death In Those Cases in Which the Principal 
Wound Was Upper Extremity, Bone and Soft Tissuel 265 
CLXXIX IMMEDIATE CAUSE OE DEATH 266 
CLXXX THE ETIOLOGY OE SHOCK IN ITS INCIDENCE AS A CONTRI3-, 
UTORY OR ASSOCIATED CONDITION 267 
CLXXXI DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY OR 
ASSOCIATED CONDITION 26S 
CLXXXI I INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 269 
CLXXXI 11 MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 270 
CLXXXIV INTRA'VERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 271 
CLXXXV THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 272 
CLXXXVI ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 273 
CLXXXVII CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OE ASSOCIATED 
CONDITION 27^ TABLE OE CO MEETS 
Tahl © Pag© 
CLXZKVIII EMBOLISM, INFARCTION, AID THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 275 
CLXXXIX MISCELLANEOUS DATA 276 
Causes of Death in Those Cases in Which the Principal 
Wound Was Lower Extremity, Soft Tissue Only! 277 
CXO immediate cause oe death 27s 
CXCI THE ETIOLOGY OE SHOCK IN ITS INCIDENCE AS A CONTRIB- 
UTORY OR ASSOCIATED CONDITION 279 
CXCI I ’ DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY OR 
ASSOCIATED CONDITION 280 
CXCI 11 INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 2S1 
GXCIY MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 282 
CXCV INTRAVERTEBRAL AND EXTREMITY CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 283 
CXCVI THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 2SU 
CXCVII ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 285 
CXCVIII CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 286 
CXCIX EMBOLISM, INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 287 
CC MISCELLANEOUS DATA 288 Table oe contents 
Tall e Pago 
Causes of Death in Those Cases in Which the Principal 
Wound Was Lower Extremity, Bone and Soft Tissues 2&9 
CCI IMMEDIATE CAUSE OF DEATH 290 
GOII THE ETIOLOGY OF SHOCK IF ITS INCIDENCE AS A CONTRIB^ 
UTORY OR ASSOCIATED CONDITION 291 
CCIII DATA ON SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY OR 
ASSOCIATED CONDITION 292 
CCIV INTRACRANIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 293 
CCV MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 29^ 
CCVI I NT RA VERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 295 
CCVII THORACIC CONTRIBUTORY OR ASSOCLATED CONDITIONS 296 
CCVIII ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 29S 
CCVIX CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 300 
OCX EMBOLISM, INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 301 
CCXI MISCELLANEOUS RATA 302 
Causes of Death in Those Cases in Which the Principal 
Wound Was Unclassified, Multiple? 3^3 
CCXI I IMMEDIATE CAUSE OF DEATH 30^ 
CCXIII THE ETIOLOGY OF SHOCK IN ITS INCIDENCE AS A CONTRIB- 
UTORY OR ASSOCIATED CONDITION 30S table oe contents 
Table Page 
CCXIV DATA OH SHOCK IN ITS INCIDENCE AS A CONTRIBUTORY OR 
ASSOCIATBS CONDITION 306 
CCXV INTRACRANIAL CONTRIBUTORY OH ASSOCIATED CONDITIONS 307 
CCXYI MAXILLOFACIAL AND CERVICAL CONTRIBUTORY OR ASSOCIATED 
CONDITIONS 30S 
CCXVII INTRAVERTEBRAL AND EXTREMITY CONTRIBUTORY OR 
ASSOCIATED CONDITIONS 309 
CCXVII I THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 310 
CCXIX ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 313 
OCXS CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIATED 
CONDITION 315 
CCXXI EMBOLISM, INFARCTION. AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 316 
CCXXII . MISCELLANEOUS DATA 317 TABLE OP CONTENTS 
VOLUME THESE 
Table Page 
SECTION IV 
SPECIAL STUDIES OH 
I NTEA-A3DOM I UAL WOUNDS 3IS 
Preliminary Eemarki' ■<* -y 319 
Part 1 
Those Cases in Which the Principal Wound Was Intra~ 
abdominal and the Immediate Cause of Death Was 
Shock (17S Cases) 3^3 
CCXXIII DATA EELATIVB TO HOSPITAL ADMISSION, ANESTHESIA, AND 
SURGERY 32U 
CGXXIV CAUSATIVE AGENT AND TYPE OP WOUND 325 
CCXXV ETIOLOGY OP SHOCK 326 
CCXXVI COMPARISON OP CASES WITH AND WITHOUT PBEITONEAL 
CONTAMINATION 327 
OCXXVII ADMISSION HLOOD PRESSURE AND LOWEST EECCEDED BLOOD 
PSESSUEE 328 
CCXKVIII INCIDENCE OP ASSOCIATED WOUNDS 329 
CCXXIX ANESTHETIC AGENTS USED IN CASES DYING DUEING 
ANESTHETIC INDUCTION, DUEING SUEGEEY, AND 
APTBE SURGERY 330 TABLE OE CONTENTS 
Pag© 
CCXXX OPERATING- TIME IN CASES DYING DURING OR AFTER 
SURGERY 33I 
CCXXXI PLASM THERAPY PRIOR TO ADMISSION 332 
Remarks 333 
CCXXXI I PLASM THERAPY AFTER ADMISSION BUT BEFORE SURGERY 33I+ 
CCXXXI 11 PLASM THERAPY DURING SURGERY 335 
CCXXXIV PLASM THERAPY AFTER SURGERY 336 
CCXXXY BLOOD TRANSFUSION THERAPY BEFORE SURGERY 337 
CCXXXYI BLOOD TRANSFUSION THERATY DURING SURGERY 33S 
CCXXXYII BLOOD TRANSFUSION THERAPY AFTER SURGERY 339 
CCXXXYI 11 TIM LAGS? WOUNDING TO DEATH IN CASES DEAD ON 
ARRIVAL OR DYING ON ADMISSION 3I4O 
CCXXXIX TIME LAGS? WOUNDING TO DELATH IN CASES LIVING AT 
LEAST ONE HOUR AFTER ADMISSION BUT DYING 
BEFORE ANESTHESIA 3I+I 
CCXL TIM LAGSt WOUNDING TO DEATH IN CASES DYING 
DURING ANESTHETIC INDUCTION 3^2 
CCXLI TIMS LAGS? ADMISSION TO SURGERY IN FIELD AND 
EVACUATION HOSPITALS IN CASES DYING DURING 
PRIMARY SURGERY 3I43 
Remarks 3^ 
CCXLII TIM LAGS: WOUNDING TO DEATH IN CASHS DYING 
DURING PRIMARY SURGERY 3^5 
CCXLIII TIM LAGS: WOUNDING TO ADMISSION TO FIELD AND 
EVACUATION HOSPITALS IN CASES DYING AFTER 
PRIMARY SURGERY 3^6 TABLE OF CO ITEM'S 
Table Page 
CCXLIV TIME LAOS: ADMISSION TO SURGERY IN FIELD AND 
EVACUATION HOSPITALS IN OASES DYING AFTER 
PRIMARY SURGERY 3I+7 
COXLV TIMS LAGSs SURGERY TO DEATH IN FIELD HOSPITALS 
IN CASES DYING AFTER PRIMARY SURGERY 3I1S 
CCXLVI TIMS MGS: SURGERY TO DEATH IN EVACUATION 
HOSPITALS IN OASES DYING AFTER PRIMARY SURGERY 3I+9 
CCXLVI I MISCELLANEOUS DATA 35O 
GCXLVIII PLASMA AND BLOOD TRANSFUSION THERAPY IN THE 13 OASIS 
EXHIBITING PULMONARY EDEMA 351 
CCXLIX MISCELLANEOUS DATA ON THE 13 CASES EXHIBITING PULMONARY 
EDEMA 352 
Part 2 
Those Oases in Which the Principal Wound Was 
abdominal and the Immediate Cause of Death Was 
Not Shock (23O Oases) 353 
COL DATA RELATIVE TO HOSPITAL A EMISSION, ANESTHESIA, AND 
SURGERY 35^ 
OCLI INCIDENCE OF SHOOK ;.S A CONTRIBUTORY OR ASSOCIATED 
CONDITION 355 
CCLII FURTHER ANALYSIS OF SHOCK AS A CONTRIBUTORY OR 
ASSOCIATED CONDITION 356 
CCLIII MISCELLANEOUS FINDINGS IN CASES IN WHICH SHOCK WAS 
A CONTRIBUTORY OR ASSOCIATED CONDITION 357 TABLE OE CONTENTS 
Tahl© Pag© 
CCLIV ADMISSION BLOOD PRESSURE AND LOWEST RECORDED BLOOD 
PRESSURE IN CASES IN WHICH SHOCK WAS A 
CONTRIBUTORY EACTOR 356 
CCLV INCIDENCE OE ASSOCIATED WOUNDS 359 
CCLVI ANESTHETIC AGENTS USED IN OASES DYING DURING ANES- 
THESIA, DURING SURGERY, AND AETER SURGERY 360 
CCLVI I TIME LAGS: WOUNDING TO AMISSION TO El ELD HOSPITALS 361 
CCLVIII TIME LAGS: WOUNDING TO ADMISSION TO EVACUATION 
HOSPITALS 362 
CCLIX TIME LAGS; ADMISSION TO SURGERY IN EIELD HOSPITALS 363 
CCLX TIME LAGS: ADMISSION TO SURGERY IN EVACUATION 
HOSPITALS 36U 
CCLXI TIME LAGS: SURGERY TO DEATH IN EIELD HOSPITAL CASES 365 
CCLXII TIME LAGS: SURGERY TO DEATH IN EVACUATION HOSPITAL 
CASES 366 
Part 3 
Those Cases in Which the Principal Wound Was Intr&- 
ahdominal and Peritonitis Was Evident or 
Suspect to Be Present 3^7 
Remarks * 
CCLXII I DATA RELATIVE TO HOSPITAL ADMISSION, ANESTHESIA, 
AND SURGERY 3^9 TABLE OF CONTENTS 
TaLle Page 
CCLXIY OPERATING TIMS POE PRIMARY SURGERY 37O 
CCLX7 DATA RELATI7E TO PRIMARY SURGERY 371 
CCLX7I SECONDARY OPERATIONS AID OXYGEN THERAPY 372 
CCLX7II DATA ON CHEMOTHERAPY 373 
CCLX7111 ADMISSION BLOOD PEESSUEB 37I+ 
CCLXIX SHOOK DATA - 375 
CCLXX DATA ON UEINAEY EXCEETION 376 
CCLXXI NUMBER OE AUTOPSIES 377 
CCLXXII IMMEDIATE CAUSE OE DEATH 378 
CCLXXIII ETIOLOGY OE SHOCK AS A CONTEIBUTOEY OE ASSOCIATED 
CONDITION 379 
CCLXXI7 DATA ON SHOCK IN ITS INCIDENCE AS A CONTEIBUTOEY OE 
ASSOCIATED CONDITION _ 3SO 
CCLXXT INTEACEANIAL, MAXILLOFACIAL, CER7ICAL. INTEA7EETE3EAL, 
AND EXTREMITY CONTEIBUTOEY OE ASSOCIATED CONDITIONS 3SI 
CCLXX7I THORACIC CONTRIBUTORY OE ASSOCIATED CONDITIONS 3S2 
C0LXX7II ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 38^ 
CCLXX7III CLOSTRIDIAL MYOSITIS AS A CONTRIBUTORY OR ASSOCIAR. 
ED CONDITION 3^7 
CCLXXIX EMBOLISM, INFARCTION, AND THROMBOSIS AS CONTRIBL 
UTCEY OR ASSOCIATED CONDITIONS 3SS 
CCLJXX MISGDLLA.IJBOUS data 3^9 TABLE OB CONTENTS 
TaUl e Page 
TIME LAG-S ILT THOSE CASES IE WHICH PERITONITIS WAS 
THE IMMEDIATE CAUSE OE DEATH* 390 
CCLXXXI WOUNDING TO El ELD HOSPITALS 390 
CCLXXXII WOUNDING TO EVACUATION HOSPITALS 391 
CCLXXXIII ADMISSION TO SURGERY IN EIELD HOSPITALS 392 
CCLXXXIV ADMISSION TO SURGERY IN EVACUATION HOSPITALS 393 
CCLXXXV SURGERY TO DEATH IN EIELD AND EVACUATION HOSPITALS 39 U 
TIME LAGS IN THOSE CASES IN WHICH PERITONITIS WAS 
CONTRIBUTORY RUT NOT THE IMMEDIATE CAUSE OE DEATH? 393 
CCLXXXV I WOUNDING TO EIELD HOSPITALS 395 
CCLZXXVII WOUNDING TO EVACUATION HOSPITALS • 396 
CCLXXXVIII ADMISSION TO SURGERY IN EIELD HOSPITALS 397 
CGLXXXIX ADMISSION TO SURGERY IN EVACUATION HOSPITALS 39S 
CCXC SURGERY TO DEATH IN EIELD AND EVACUATION 
HOSPITALS 399 TABLE OP CONTENTS 
TaLl0 Page 
SECTION Y 
SPECIAL STUDIES ON ALL THE OASES 
(523) IN WHICH THE IMMEDIATE CAUSE 
03P DEATH WAS SHOCK l|02 
Preliminary Remarks U03 
CGXCI LOCATION OE THE PRINCIPAL WOUND I40U 
CCXCII DATA RELATIVE TO HOSPITAL ADMISSION* ANESTHESIA, 
AND SURGERY ' I4O5 
CCXCIII ETIOLOGY OE SHOCK 1|06 
CCXCIY ADMISSION BLOOD PRESUHE )+07 
CCXCV LOWEST RECORDED BLOOD PRESSURE IjQg 
CCXCYI PLASMA THERAPY 3EE0RS ADMISSION U09 
CCXCYII PLASMA THERAPY AFTER ADMISSION, BEFORE SURGERY lfl.0 
CCXCYIII PLASMA THERAPY DURING SURGERY Ull 
CCXCIX PLASMA THERAPY AFTER SURGERY 1+11 
CCC BLOOD THERAPY BEFORE SURGERY Ul2 
OGGI BLOOD THERAPY DURING SURGERY 1+13 
CGCII BLOOD THERAPY AFTER SURGERY 1+13 
OCCIII PRIMARY OPERATIONS PERFORMED l+ll+ 
CCCIV DEBRIDEMENT ASSOCIATED TOTH PRIMARY OPERATION 1+15 
CCCV SUBSIDIARY OPERATION AT TIME OF PRIMARY OPERATION Ul6 TABLE OF CONTENTS 
Ta”bl e Pa^e 
CCCYI OPERATING TIMS POP PRIMARY SURGERY 1+17 
CCCYII SECONDARY (LATER) OPERATIONS 1+1S 
CCCYIII ANESTHESIA FOR PRIMARY SURGERY l+l9 
CCCIX ANESTHESIA FOR SECONDARY SURGERY 1+19 
CCCX OXYGEN THERAPY 1+20 
CCCXI URINARY EXCRETION AND UREMIA 1+20 
CCCXXI CHEMOTHERAPY 1+21 
CCCXI 11 AUTOPSIES PERFORMED 1+21 
CCCXIV MISCELLANEOUS OBSERVATIONS 1+22 
CCCXY INTHaGRANIAX. CONTRIBUTORY OR ASSOCIATED CONDITIONS 1+23 
CCCXVI MAXILLOFACIAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 1+21+ 
CCGXYII CERYIGAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 1+21+ 
CCCXYIII SPINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 1+25 
CCCXIX EXTREMITY CONTRIBUTORY OR ASSOCIATED CONDITIONS 1+25 
CCCXX THORACIC CONTRIBUTORY OR ASSOCIATED CONDITIONS 1+26 
CCCXXI ABDOMINAL CONTRIBUTORY OR ASSOCIATED CONDITIONS 1+29 
CGCXXII MISCELLANEOUS CONTRIBUTORY OR ASSOCIATED CONDITIONS I+31 
CCCXXIII EMBOLISM* INFARCTION, AND THROMBOSIS AS CONTRIBUTORY 
OR ASSOCIATED CONDITIONS 1+32 HOLE OE COITEITS 
Tafble P 3,0:0 
TIME LAGS IN C-iSES DEO Oil .-ARRIVAL 03 DYING ON 
.OMI 3 31 OH: U33 
CCCaXIV WOUNDING TO DEATH U33 
Tl.’ii LOO Xi'i CASEo juX VING AT jj3•>.c>T ONE .ioUR AYTEH. 
-OMISSION JUT DYING _OYG3E .OESTHSSIA: ' 
CCCXKV WOUNDING TO if I.TLX) HOSPITAL * 1+3^ 
CCJXXVI WOUNDING TO EVACUATION HOSPITAL U35 
CCCaTvII WOUNDING TO DEATH IN YIELD HOST IT-AL COES I+36 
CCCZXVIII WOUNDING TO DEATH XL EVACUATION HOSPITAL CASES U37 
TUG LA&S IN CASTS DYING DURING AESTHETIC INDUCTION — 
CCAHARISON 0? YIELD AND EVOUATJON HOSPITAL CASES: l£S 
CCCXXIX WOUNDING TO HOSPITAL .OMISSION, ADMISSION TO 
SURGERY, AND WOUNDING TO DEATH l£g 
TIME LAGS IN CASES DYING DUPING PRIMARY SURGERY 
COM? API SON ON YIELD -ND EVACUATION HOSPITAL CASES; U39 
CCCXZX FUNDING TO ADMISSION H39 
CCCZXZI .OMISSION TO SURGERY 1|N0 
CCC XXXII WOUNDING TO DEOH i+lj-1 
time los in Cases dying oter teliahy surgery — 
COMPARISON 05' YIELD OD EVACUATION HOSPITAL COES; 1&2 
cccxxxm wounding to .omission khz 
CCGXXXIV ADMISSION TO SURGERY U)+3 TAjLE oe oohtbhts 
TaLle Pa<?e 
CCCXXXV SURGERY TO DEATH IN FIELD HOSPITALS kkk 
CCCXXXVI SURGERY TO DEATH IN EVACUATION HOSPITALS lp+5 
CCCmYII WOUNDING TO DEATH IN FIELD HOSPITALS UU6 
CCCXXXVIII WOUNDING TO DEATH IN EYACUATION HOSPITALS I+I17 
SECTION VI 
APPENDICES l&g 
Appendix 
A DISTRIBUTION OF FIFTH ARMY RATTLE CASUALTY DEATHS 
NOT STUDIED IN THIS REPORT I&9 
2 CORRECTION OF TOTAL RATTLE CASUALTY ADMISSION 
FIGURES FOR EACH PERIOD TO AGREE WITH PROPORTION OF 
TOTAL DEATHS THAT WERE ANALYSED FOR THIS REPORT I15O 
C DISTRIBUTION OF ASSOCIATED WOUNDS RELATED TO REGION 
OF THE PRINCIPAL WOUND U51 
D FURTHER CLASSIFICATION OF GASES WITH PRINCIPAL WOUNDS 
OF CHEST TO SHOW HBMlTHORAX INVOLVED AND RELATIVE 
IMPORTANCE OF AD DOM INAL AND THORACIC COMPONENTS 
WHEN DOTH WERE PRESENT 
S DISTRIDUTXON AMONG FIFTH ARMY FIELD AND EVACUATION 
HOSPITALS OF THE 1U5O RATTLE CASUALTY FATALITIES 
STUDIED 1+55 
F POSTMORTEM STUDIES DY PERIODS U57 VOLUME ONE 
INTRODUCTION STUDY OF FIFTH ARMY HOSPITAL BATTLH CASUALTY DEATHS 
A PPALI MI NAPY HSPOP.T 
INTRODUCTION 
From the 1st of January l°Uh until the surrender of German Armies 
in Italy on the 2nd of May Ql,631* of the America! Soldiers serv- 
ing in Fifth Army were killed, wounded, or injured in action. Of these 
16,618/ died on the battlefield or before reaching a hosrtital install- 
ation. Many were treated and returned to duty from the division area. 
A few were admitted directly to Base Hospitals. Of the remaining, 
63.02U** who were admitted to Fifth Army hospitals, only 1631** died 
therein. Records of iMll or of these hosuital battle casualty 
deaths were available for this study. In a.ddition the records of thirty 
nine (39) who were dead on arrival at a hospital we re utilized in many 
sections of this report. Gross post-mortem findings formed a part of 
775 of these records. Microscopic autopsy reports were received on 
Most of the clinical records v/ere fadrly complete. In some, however, 
much desirable information was missing. 
The study was made with the assistance of machine records methods. 
A vast amount of statistical material has been assembled. In this pre- 
limina.ry renort, no attempt is made to discuss in detail the analytical 
and statistical findings. A table of contents is included which is of 
value in utilizing the renort for reference work. A brief discussion 
precedes the tables in each of the main sections, and in some instances, 
the subsections, and individual tables, of the report. 
* Adjutant General1s figures - Killed in Action ulus Mounded in Action. 
** Figures from MTOUSA M.J. Form 86f. 
/ Combination KIA (AG) plus DOW (AG) minus hospital. B.C. deaths (S6f) It may "be assumed that the lUll hospital battle casualty deaths 
studied are truly representative of the total of 1631 who (according 
to MTOUSA Form S6f) died in Fifth Army hospitals. Beginning 1 Jan 
the Surgeon, Fifth Army, requested submission of a complete record on 
all battle casualties dying in Fifth Army hospitals. From the 1 Jan 
I9UJ to 2 May the Wound Classification Eepcrt submitted by the 
hospitals listed 5S,b77 battle casualty admissions and 1562 battle cas- 
ualty deaths in hospitals. Appendix A lists the hospitals and shows by 
period the missing cases for each hospital. Some of the missing battle 
casualty death reports were never submitted. Some were not on hand at 
the time this study was initiated. 
The figures secured from the hospital Wound Classification Re- 
ports, however, are lower than those reported on the MTOUSA Form S6f. 
From the. latter, the figure for battle casualty hospital admissions is 
63.02U and for battle casualty hospital deaths is 1631. These larger 
figures have been used in setting as the portion studied, of all 
the hospital battle casualty deaths, e,nd have been correspondingly re- 
duced when calculating percentage mortalities. In calculating percent- 
ages of total battle casualties, or battle casualty hospital admissions, 
by period, correction has been made for the percentage of cases studied 
during each period. (See Appendix 3) 
The Adjutant General’s figures and the MTOUSA M,3. Form 86f includes 
the injured in action as well as the wounded in action (WIA) and killed 
in action (KIA). Of the deaths studied only a few who had crush injuries 
might be regarded as injured rather than wounded in action. All of these 
crush injuries (20) resulted from falling stones or bricks, set in motion 
2 by the explosion of an enemy shell and most of these had wounds in ad- 
dition to crush injury. It may be said then, that the deaths studied 
represent a. considerably larger percentage of wounded in action who 
died, than the percentage of which is based upon the total (1631) 
of wounded and injured in action who died in Fifth Army hospitals dur- 
ing the period studied. 
The breakdown of injured in action and wounded in action is not 
available for either hospital battle casualty admissions, or for the 
total resulting from the sum of the Adjutant General’s figures on wound- 
ed in action plus killed in action. 
The thirty nine (3°) records of battle casualties dea.d on arrival 
at a hospital comprise all the records submitted on this class of deaths 
Statistics a„re not available to determine their percentage of the en- 
tire group of "DOA's". Host of them were unquestionably patients whom 
the last medical officer who saw them, expected to rerch the hospital 
alive. This group has be°n included in the Wound Classification Tables, 
Causes of Death Tables, and in many instances has been singled cut for 
individual study »s compared to those who died shortly after admission, 
before anesthesia, during anesthetic induction, during primary surgery, 
and efter primary surgery. The cases have not been included in tables 
dealing with "hospital Battle Casualty Deaths" or in any of the percent- 
age tables based on hospital battle casualty admissions, or the total 
of wounded in action plus killed in action. 
The information recorded in the tables of tMs report was first 
recorded in code form so that it might be transferred to machine records 
3 cards. Study of the cases end the primary recording of these data con- 
sumed the entire time of one of us, for a -period of a little ov-r three 
months. The other of us studied each case, and checked the recorded 
data. Sack item was carefully weighed, matters calling for opinion were 
discussed, and all Questions hie data, were recorded a,s questionable. The 
completed machine records .cp.rds were checked by hand for accuracy. The 
cs.rds were punched by our own clerk. All machine counting and record- 
ing of date- was done by the two of us and the same clerk. Many checks 
were made on the validity of the machine tabulations. The writers feel 
that the margin of error in this method was no greater than, if as great 
as, the -nersonsl error in manual counting. 
More dataware accumulated than in this preliminary 
report. Figures on time lags are available on call cases in which the 
information was in the record. Stadios on all cases with Nephropathies, 
fat embolism, shock, thoraco-a/bdcminal wounds, and intra-thoracic wounds 
have been made. Those studies are comparable in scope to that study 
on cases with intra-abdominal wounds which is presented in this report. 
It is hoped that the statistical information in this preliminary 
report will be of value to those studying a.nd writing upon war surgery 
now. SECTION I 
REGION, TYPE, AI'TD DISTRIBUTION OE DU10S 
AND 
CERTAIN GENERAL CONSIDERATIONS The simple classification of cases by region of principal wound 
in Table I is presented for comparison with similar tables, on hospital 
battle casualty admissions, as well as deaths, which are available for 
all of the Tunisian, Sicilian and Italian Campaigns. 
Tables II and III present some very interesting data worthy of 
some discussion. It must be remembered that casualties at the Anzio 
Beachhead* were included in the first two periods, and unquestionably 
increased the percentage of those dying before anesthesia and the total 
hospital battle casualty mortality in the first two periods. The reduc- 
tion in the latter mortality figure from in the first period to 
2.0 in the last is dependent on more than the Anzio factor. The re- 
duction in the percentage of those dying before anesthesia is in part 
due to general adoption of improved methods of Resuscitation, and a 
more available supply of blood. 
Morrissey** has called attention to the direct relationship of the 
percentage mortality of battle casualties admitted to hospitals, the per- 
centage mortality of battle casualties admitted to hospitals dying before 
anesthesia, and the percentage hospital battle casualty deaths comprise 
of the total who die of wounds (includes killed in action, died of 
wounds). He has shown that the latter percentage varies widely. At 
Anzio, l6$ of all battle casualty deaths occurred in hospitals. (The hos- 
pital mortality was 5,7$)* May l°hU h.21 of all battle casualty 
deaths died in hospitals (hospital mortality 1,7C% In dune IQULl, 15$ 
* 22 Jan to 2h May I9UH 
** See Table IV page pi of this report and Appendix of history of 
Fifth Army Medical Service., 
6 of sill battle casualty depths were in hospitals (hospital mortality 2.gp). 
In October 7.6b$ of all battle casualty" depths were in hospitals, 
(hospital mortality 2.1p). When evacuation to the forward hospital of 
the wounded is easily accompli shod the hospital mortality rises, Thus 
hospital mortality tends to inversely with the -percentage who are 
killed in action or die of wounds before reaching a hospital. However, 
Morrissey further shows in Table IV that there has been a steady, gra- 
dual decrease in the percentage, the deaths occurring during and after 
surgery, comprise of total battle casualty deaths. Table III shows a 
slight increase throughout the four periods in the percentage deaths 
during Surgery comprise of the deaths studied, but a decrease in the per- 
centage these deaths comprise of battle casualties admitted to hospitals. 
Table V lists battle casualty deaths according to principal wound 
groups. These figures may be compared with those in Fifth Army Wound 
Classification reports since 1 August 1$UU, Many of the Tables in all 
sections deal with various factors in relation- to these fourteen (lU) 
principal wound groups. 
7 TABLE I 
BATTLE CASUALTY DEATHS (1450 cases) 
DISTRIBUTION BY REGTOtt OF F tncital WOUND 
Abdomen 
54.3 
Head 
297 
Chest 
277 
Lower Extremity 
14.5 
Spine 
27 
Meek 
25 
Upper Extremity 
u 
Face and Jaws 
a 
Unclassified Multiple Wounds 
114. 
TOTAL 
1450 TABLE II 
DEATHS AS RELATED TO HOSPITAL ADMISSION, ANESTHESIA 
'“and surgery" 
- 
JAlMiAR 
19 44 
APR-JULY 
1944 
AUG-DEC 
1944 
JAM-MAY 
1945 
TOTAL 
Dead on Arrival 
7 
16 
9 
7 
39 
Dying on Admission, 
Lived less than 1 hour 
27 
27 
12 
8 
74. 
Died before Anesthesia 
Excludes those DOA & those 
dying on admission 
157 
108 
48 
24 
337 
Died during anesthetic 
induction 
e 
3 
4 
1 
16 
Died during primary 
surgery 
20 
25 
19 
11 
75 
Died after primary 
surgery 
310 
303 
192 
104 
909 
TOTAL 
529 
482 
284 
15$ 
1450 rp A T5T TP TTT 
x 1-3....) Job 1.J.JL 
HOSPITAL BATTLE CASUALTY ADYTS~TOWS DUX’ BEFORE AS 
COMPARED WITH THOSE DYT?TG DURING AHEST'FISIA hr SURGERY AUD 
WITH THE TOTALS BATTLE CASUALTY DEATHS IW JW HOSPITALS 
Ja n 
rfer 
19-44 
Apr 
Jul 
1944 
Aug 
Dec 
1944 
Jan 
Play 
1945 
Total 
Deaths studied* 
522 
466 
275 
148 . 
1411 
Deaths before anesthesia 
184 
135 
60 
32 
411 
Deaths during anesthesia or 
surgery 
28 
28 
23 
12 
91 
Percentage of deaths studied 
who died before anesthesia 
35.34 
29.0% 
21. S%> 
21.6% 
29 c 16 
Percentage of deaths studied 
who died during anesthesia or 
surgery 
5.36 % 
6.09% 
3.36% 
C .20% 
6.45 i 
Total battle ca.sualty 
admissions** 
132r 2 
. 19876 
13464 
1262 
54514 
Percentage of battle casualty 
admissions who died before 
anesthesia 
1.39 % 
0,684 
om% 
0.444 
0.152% 
Percentage of battle casualty 
admissions who died during 
anesthesia or surgery 
0.211 
0,1414 
0,1714 
0.16% 
; 0,1674 
Total percentage of battle cas- 
ualty admissions who died in 
Army hospitals 
3.94$ 
2.344 
2.0% 
2.0456 
2.594 
(*) Excludes Deed on Arrival 
(**) Corrected to allow for percentage of 
period. See Appendix B 
deaths not studied 
during 
each 
10 TABLE IY 
Of EffECT Of INCREASED EffIClENGY Of EVACUATION fEOM fORWARD 
AREAS ON HOSPITAL MORTALITY (AN INCREASE) ANN THE REMAINING- fAVOEABLE 
TREND AfTER EXCLUSION Of THOSE CASES* DYING BEfORE ANESTHESIA 
JAN- 
ME 
15^+ 
APE- 
JUL 
19UU 
AUGL 
DBG 
I9I+I+ 
JAN- 
MAY 
19^5 
Total killed, wounded, and injured 
in action 
2U.351 
32,026 
22,1+69 
12,556 
Total killed in action plus died of wounds** 
(total battle casualty deaths) 5,0^2 
6,366 
1+.23U 
2,506 
Percent mortality of the killed, wounded, 
and injured in action 
20.70$ 
19.28$ 
18.Sl+$ 
l°.96$ 
Total battle casualties admitted to 
ho spi tal s 
lU,^Pg 
23,H1 
16,221 
9,19^ 
Total battle casualties dying in hcsp. 
570 
5I+2 
332 
205 
Percent mortality of battle casualties ad- 
mitted to hospitals 
3.9W 
2.31+$ 
2.05 $ 
2,0l+$ 
Percent of total battle casualty deaths 
dying in hospitals 
11.3$ 
3.5$ 
7. Si 
6.8$ 
Percent of hospital battle casualty deaths 
who died prior to anesthesia 
35.5$ 
29.0$ 
21.8$ 
21.6/5 
Percent of hospital battle casualty deaths 
who died after reaching anesthesia 
7*3$ 
6.2$ 
6.1)+$ 
5.3/ 
Percent of total killed, vrunuod, and in>~ 
vjurcd in action who died aficr reaching 
anesthesia 
1.515$ 
1,200$ 
1,160$ 
1.050$ 
*A variable quantity influenced by conditions affecting efficiency of,evacua 
tion to hospitals as well as by professional care before and after admis^^n. 
**Does not include those few deaths which ■ 
occured in base hospitals 
• 
Note: This table wa.s conceived and prepared by Major Richard A, Morrissey, 
SnC., Statistician, Fifth Army Surgeon’s Office, 
11 TABLE V 
BATTLE CASUALTY DEATHS LISTED AS TO IRINGIFAT. WOUND 
1. 
Intra-abdominal (Abd) ** 
408 
II. 
Intracranial (Cran) 
297 
TIT. 
Thoraco-abdominal (Th Abd)* 
212 
IV. 
Intrathoracic (Thor)* 
138 
V. 
Lower extremity, with bone involvement (LR, B) 
114 
VI. 
Unclassified, multiple wounds (Un MW) 
114 
VII. 
Combined intra-abdominal & intrathoracic (GoA & T)* 
59 
VIII. 
Lower extremity, soft tissue only (IE, S) 
31 
IX. 
Intravertebral (Spin) 
27 
X. 
Cervical (Cerv) 
25 
XI. 
Upper extremity, with bone involvement (TIE, E) 
1.0 
XII. 
Maxillofacial, with bone involvement (Max?) 
8 
XIII. 
Upper extremity, soft tissue only (UE,S) 
4 
XIV. 
Abdominal wall (AbdW) 
3 
Note: 
total 
In Appendix G the above groups of cases are represented si 
1/50 
.imply by 
the corresponding Roman numeral and abbreviations listed above. 
* More detailed classification of these 3 groups depicted in Appendix 0# 
12 TABLE VI 
CAUSATIVE AGENTS AS RELATED TO IRIFCXFAI. WOUNDS (1) 
Bullet ? 
Bullet? 
Bullet? 
High ex- 
High ex- 
High ex- 
MISSILE 
uncles- 
rifle 
machine 
plosive, 
plosive, 
plosive, 
s if ied 
gun 
unclas- 
sified 
shell 
ml ne 
F RING UAL WOUND; 
Intracranial 
19 
8 
6 
37 
181 
10 
Intravertebral 
2 
2 
2 
2 
14 
0 
Maxillofacial 
0 
0 
1 
1 
4 
0 
Cervical 
3 
0 
2 
4 
13 
1 
Intrathoracic 
20 
1 
9 
12 
79 
2 
Thorac o-abdominal 
35 
7 
7 
11 
130 
10 
Combined intr°-abdom. 
&,intrathoracic 
2 
1 
0 
8 
37 
4 
Intra-abdominal 
54. 
11 
15 
40 
254 
9 
Abdominal well only 
0 
0 
n 
u 
0 
3 
0 
ext, soft tis; 
sue 
* 
only 
0 
0 
0 
0 
2 
0 
Uprcr ext. bone A 
soft tissue 
0 
0 
0 
4 
6 
0 
Lower ext. soft tis; 
sue 
only 
5 
0 
1 
£ 
14 
2 
Lower ext. bone & 
soft tissue 
2 
0 
2 
21 
59 
19 
Unclassified, multiple I 
1 
0 
15 
65 
13 
TOTAL 
143 
31 
45 
160 
861 
70 
Continued next p~go 
13 TABLE VII 
CAUSATIVE AGEUTS (2) I'W CHARACTER OF FOUNDS 
High ex- 
T’UTSSELE plosive 5 
booby 
trap 
T-T p 
bomb 
H, H,j No 
blast record 
of 
agent 
Pen.-5 
wd, 
P erf,/ 
wd o 
PRINCIPAL HOUND; 
Intracr'nial 0 
17 
2 
17 
199 
42 
Intravertcbral 0 
2 
0 
3 
19 
5 
Max5llofacio1 0 
0 
1 
1 
4 
1 
* 
Cervical 0 
2 
0 
0 
16 
1 
Tntrr. thoracic 0 
I 
1 
10 
94 
33 
Thoraco-abdominal 0 
8 
0 
4 
152 
67 
Combined intra-abdominal 
& ’ nt r at hor ac ic 0 
3 
2 
2 
' 47 
11 
Intra-abdominal 0 
12 
1 
12 
287 
12,6 
Abdominal wall only 0 
0 
0 
0 
2 
0 
Upper ext, soft tissue 
- only 0 
0 
0 
2 
3 
0 
Upper ext, bone % 
soft tissue 0 
0 
0 
0 
5 
1 
Lower ext. soft tissue- 
only 0 
2 
1 
1 
12 
7 
Lower ext. bone & 
soft tissue 0 
7 
0 
4 
47 
21 
Uncla,s s if ie d , mult ip 1c 2 
10 
2 
5 
78 
17 
TOTAL 2 
67 
10 
61 
965 
332 
(*) Penetrating wound or wound 
s (number 
of 
cases - not 
number 
of 
wounds), 
(/) Perforating wound or wounds (number 
of 
cases - not 
number 
of 
0 
1 
• 
u TASKS VIII 
HOSPITAL BATTIT CASUALTY D~AT'TS LJSTFD AS TO PRINCIPAL WOULTD 
WITH PFRGET'TTAGL OF HOSPITAL BAT TIL C" 3IJALTU ADMISSIONS * 
PRINCIPAL WOUND Uo 
. of Deaths 
Feresr 
Hosp . 
sions 
it of total* 
B.C. Admis- 
I. 
IntTa-abd ominal 
402 
0.737% 
II. 
Intracranial 
208 
0.528$ 
III. 
T hor ac o-abdominal 
210 
0.3^5$ 
TV, 
Intrathoracic 
131 
0.341$ 
V. 
Loner extremity (Bone involvement) 
110 
0.202$ 
VI. 
Unclas s if ied 3 multip1c wound a 
106 
0.194$ 
VII. 
Combined intra-abdominal and 
intrathoracic 
57 
0.104$ 
VIII. 
Loner extremity, soft tissue only 
30 
0.055$ 
IX. 
Intravertebral 
27 
% 
0.04,9$ 
X. 
Cervical 
25 
0.046$ 
XI. 
Upper extremity (Bone involvement) 
10 
0.018$ 
XII. 
Maxillofacial 
8 
0.014;,$ 
XIII. 
Upper extremity, soft tissue only 
4 
0.007$ 
XIV. 
Abdominal wall 
3 
0.005$ 
TOTAL 
1411 
2.59 % 
(*) Figure of 63,024- admissions corrected 
battle casualty deaths not studied. 
to allow for 13.5$ 
(DOA’s not included) 
of hospital 
15 TAILS IX 
BATTLE CASUALTY DEATHS LISTED AS TO FRINCIFAL WOUND 
AND RELATED TO HOSPITAL ADMISSION, ANESTHESIA, AND SURGERY 
Dead 
Dying* 
Died / 
D led 
Died 
Died 
on 
on 
before 
during 
during 
after 
arrival 
admission 
Anesthesia 
anesthetic 
induction 
primary 
surgery 
primary 
surgery 
PRINCIPAL WOUND; 
Intra-abdominal 
6 
12 
45 
B 
20 
317 
Intracranial 
9 
17 
37:2 
0 
6 
123 
Thoraco-abdominal 
a ‘ 
3 
20 
2 
29 
156 
Intrathoracic 
7 
13 
35 
2 
8 
73 
Lower ext. bone & 
4 
14 
IB 
0 
5 
73 
soft tissue 
Unclassified mul- 
B 
7 
45 
2 
3 
49 
tiple 
Combined intra-ab- 
2 
3 
6 
1 
2 
45 
dominal & intrathoracic 
Lower ext. soft 
1 
2 
5 
0 
0 
23 
tissue only 
Intravertebral 
0 
0 
10 
0 
0 
17 
Cervical 
0 
2 
5 
0 
2 
16 
Upper ext. bone & 
0 
1 
2 
0 
0 
7 
soft tissue 
Maxillofacial 
0 
0 
0 
1 
0 
7 
Upper ext. soft 
0 
0 
4 
0 
0 
0 
tissue only 
♦ 
Abdominal wall 
0 
0 
0 
0 
0 
3 
only 
TOTAL 
39 
74 
337 
16 
GRAND TOTAL: 
75 
1450 
909 
* Lived less than 
one hour. 
/ Excluding those 
in first 
and second 
columns. 
16 TABLE X 
LUMBER OF CASES IN EACH BRINGIPAL WOUND CROUP BY PERIODS 
1 
! 
J an. - 
Mar. 
1944 
April- 
July 
1944 
August- 
December 
1944 
J an, - 
May 
1945 
Total 
Intra-abdo mi na1 
152 
154 
86 
56 
408 
Intracranial 
104 
86 
60 
47 
297 
Thoraco-Abdominal 
65 
79 
44 
24 
212 
Jntrathoracic 
51 
47 
29 
11 
158 
Lower extremity, with bone involvement 
49 
4l 
17 
7 
114 
Unclassified, multiple wounds 
42 
46 
18 
8 
114 
Combined intra-abdominal & intrathoracic 25 
18 
11 
7 
59 
Lower extremity, soft tissue only 
17 
6 
6 
2 
51 
Intravertebral 
7 
5 
9 
6 
27 
Cervical 
7 
11 
2 
5 
25 
Upper extremity, with bone involvement 
5 
5 
0 
0 
10 
Maxillofacial, with bone involvement 
2 
X 
S 
1 
2 
8 
Upper extremity, soft tissue only 
2 
1 
1 
0 
4 
Abdominal wall 
TOTAL 
529 
0 • 
482 
0 
284 
0 
155 
.-5 
1450 
17 TABLE XI 
PSRCSI TACr’i: CF CAS To II SACM PRIKOIPAL JCURD TROUP 31 - SKIDDS 
Jan, - 
Mar 
1944 
rrf 
/O 
Apr11- 
July 
1944 
% 
Au pus t- 
Qecember 
1944 
rtf 
/O 
J an. - 
May 
1945 
7° 
Jan. 
1944 
thru 
May 1945 
I ntra-ab d o ui nal 
28.7 
27.6 
50.5 
25.2 
28.1 
Intracranial 
19.7 
17.6 
21.1 
50.5 
20.5 
Theracc-abdor i naI 
12.5 
16.4 
OO 
15.5 
14.6 
r 
Intrathoracic 
9.6 
9.7 
10.2 
7.1 
9.5 
Loner extremity, with bone involvement 
9-5 
so 
6.0 
4.5 
7.6 
Unclasified, multiple wounds 
7-9 
90 
6.5 
5.2 
7.8 
Combinsd intra-abdominal & intrathoracic 
4.4 
5-7 
5.6 
4.5 
4.1 
Lower extremity, soft tissue only 
5.2 
1.2 
2.1 
1.5 
2.2 
Intraspinal (i.e., intravertebral} 
1.5 
1.5 
5.2 
5.9 
1.9 
Cervical 
1.5 
2.5 
0.7 
5.2 
1.7 
Upper-extraity, with bone involvement 
0.9 
1.5 
O.C 
0.0 
0.7 
,I 'axillofacial, nith bone involvement 
0.4 
0,5 
0.4 
1.5 
0.6 
Upper extremity, soft tissue only 
0,4 
0.2 
0.4 
0.0 
0.5 
Abdominal ’.rail 
TOTAL 
0,6 
o.c 
c.o 
0.0 
0.2 
100.0 
ioo. 6 
100.0 
100.0 
100.0 
18 The remaining tables in Section I deal exclusively with principal 
and associated wounds. Table XII shows that only one-third of the cases 
in this series of deaths studied did not have wounds other than those 
confined to the region of the principal wound listed. It further gives 
the number and percentage of cases in each principal wound group in whom 
there were no associated wounds. 
Tables XIII and XIV list the number of cases exhibiting each type of 
principal and associated wound. There are no duplications; a wound listed 
in one category does not appear in another. 
Tables XV through XXITI represent in detail the regional distribution 
of associated wounds in relation to the site of the principal wound. The 
same information is presented in more compact form for reference in Appen- 
dix C. In all of these tables the figures indicate the number of cases 
exhibiting associated wounds of a particular typo in a certain region 
rather than the number of individual wounds present in the event there 
were multiple wounds of the same type in any given region. 
Tables XXIV and XXV show the reported incidence of arteries and 
nerves injured, whether in principal or associated wounds, excluding 
traumatic amputations. The figures here represent the number of indi- 
vidual arteries and nerves injured rather than the number of cases in- 
volved, except for the "multiple” columns, which indicate number of cases 
(the individual structures involved having been recorded under their appro- 
priate headings). It should be emphasized that the reported incidence in 
these two tables probably is lower than the actual incidence, especially 
for the nerves. 
19 TABLE XII 
DISTRIBUTION ACCORDING TO PRINCIPAL WOUND OF CASES WITHOUT ASSOCIATED 
WOUNDS IN OTHER REGIONS, COMPARED WITH ALL C..SES IN THE SERIES 
- } 
-to 
rt3 
•P S 
3 O 
o t 
rC 
•P T3 
•H O 
& -P, 
C'J 
m n-i 
o o 
to o 
Ci to 
O to 
r~1 
All Cases 
Percentage 
Intra-abdominal 
131 
408 
32*1 
Intracranial 
138 
297 
46.5 
Thoraco-abdominal 
98 
212 
46.2 
Intrathoracic 
37 
138 
26.8 
Lower extremity, with bone involvement 
49* 
m/ 
43.0 
Unclassified, multiple wounds 
0 
114 
0.0 
Combined intra-abdominal & intrathoracic 
7 
39 
11.9 
Lower extremity, soft tissue only 
14 
31 
43.2 
Intraspinal (i♦e., intravertebral) 
1 
27 
3.7 
Cervical 
* 
5 
25 
20.0 
Upper-extremity, with bone involvement 
2 
10x 
20.0 
Maxillofacial, with bone involvement 
1 
8 
12.5 
Upper extremity, soft tissue only 
0 
4 
0.0 
Abdominal wall 
0 . 
2 
0.0 
TOTAL 
483 
1450 
33*3 
* Including 1? traumatic amputations. 
/ Including 43 traumatic amputations* 
x Including 2 traumatic amputations. 
. 
20 t:jdle xiii ■ 
PRINCIPAL ADD ASSOCIATED HOUNDS; 
lumber of cases exhibiting each type 
Principal 
Wound 
associated 
'./ound 
Total 
Intracranial 
29? 
60 
351 
Eye cr orbit* intracranial lesion present 
0 
25 
23 
Eye or orbit; no intracranial lesion present 
0 
43 
43 
Scalp only 
0 
27 
27 
Maxillofacials bone & soft tissue 
8 
63 
73 
Maxillofacial; soft tissue only • 
0 
114 
114 
Cervical: general 
12 
104 
116 
Cervical: with carotid artery involved 
7 
2 
9 
Cervical; v/ith larynx or trachea involve*.'. 
6 
9 
13 
Spinal cord or intravertebral nerves 
27 
85 
112 
Chest wall only 
0 
86 
86 
Intrathoracic 
138 
94 
232 
Abdominal nail only 
3 
64 
67 
Intra-abd omi n al 
408 
20 
428 
Combin'd intra-abdominal & intrathoracic 
39 
10. 
69 
Thoraco-abdominal 
212 
7 
219 
Upper extremity: bone & soft tissue 
10 
226 
236 
Upper extremity: soft tissue only 
4 
266 
270 
Lower extremity; bone & soft tissue 
114 
188 
302 
Lower extremity; soft tissue only 
31 
333 
S6ii 
3166 
TOTaLs 
1336 
I830 
Unclassified cases (Eo principal wound selected)* 11.4. 
Total Cases. 145 0 
wounds present included in above categories of 
associated 
wounds. 
21 TABLE XIV 
REGIONAL DISTRIBUTION OF JRINGIPAL ASSOCIATED WOUEDS SHCHING 
THE MJMZ2R OF CASES EAHI3ITIEG EACH- (l) 
Princi- 
pal wound 
Associated 
wounds 9 
evident/ 
Total 
1. 
BEAD 
Eye or orbit 
0 
23 
23 N 
Intracrani al, known 
297 
60 
357 
Scalp (without known intracranial wound) 
0 
27 
.. 
Subtotal 5 
297 
112 
409 
2. 
x1 ACii Ai D J A < • S 
Bone and soft tisane 
8 
63 
73 
Eye or orbit 
0 
43 
43 
Soft tissue only 
0 
114 
nip. 
Subtotal: 
8 
CM 
CM 
232 
3. 
KECK 
General (excluding spinal) 
12 
ic4 
116 
With carotid artery involved 
7 
2 
9 
With larynx or trachea involved 
6 
13_ 
Subtotal} 
23 
113 
0 
—Kj~ 
1—1 
4* 
SPINAL COBB CP INIB AVEBTES3AL NERVES 
27 
83 
112 
5- 
CHEST 
Chest wall only 
0 
86 
86 
Combined intra-abdominal & intrathoracic 
18 
8 
26 
Intr athoracic, known 
138 
94 
232 
Thoraco-abdominal 
121 
Jl 
126 
Subtotal: 
277 
193 
470 
6, 
ABDOi.EN 
Abdominal wall only 
3 
6 4 
67 
Combined intra-abdominal <1 intrathoracic 
41 
2 
43 
Intr a-abd cminal, known 
408 
20 
428 
Thor aco-abdomi nal 
91 
2 
. 9.3__ 
Subtotal: 
543 
88 
631 
/ 
* 
Suspected associated wounds as follows: 
Intracranial 33 
Intrathoracic 6l 
Intra-abdominal 30 
Total 126 
Not the total number of wounds present 
22 
Continued next page TABLE XIV Coat’d. 
REGIONAL DISTRIBUTOR OF PRINCIPAL AND ASSOCIATED OOTIDS SHOWING 
THE TFffiER OF CASES EXHIBITING EACH (2) 
Principal 
Wound 
Associated 
Wounds, 
-/idont 
Total 
7. TTPPER ET’RATTY 
Soft tissue only 
3 
256 
250 
Soft tissue 1 artery 
0 
5 
5 
Soft tissue & artery & bone 
0 
11 
11 
Soft tissue h artery & bone & nerve 
1 
1 
2 
Soft tissue & art or y P* nerve 
1 
2 
3 
Soft tissue & bone 
6 
189 
195 
Soft tissue & bone & nerve 
1 
8 
9 
Soft tissue & nerve 
0 
3 
3 ■ 
Tr a urna tic anput a t i o n 
17 
19 
Subtotal; 
U 
492 
50 6 
8. LT/SR F.TTRTT'TITY 
Soft tissue only 
17 
316 
333 
Soft tissue & artery 
12 
12 
24 
Soft tissue 1 artery R bone 
u 
13 
27 
Soft tissue & artery & bone 1 nerve 
3 
2 
5 
Soft tissue 1 artery R nerve 
1 
0 
1 
Soft tissue A bone 
53 
145 
198 
Sdft tissue &’ bone & nerve 
1 
6 
7 
Soft tissue & nerve 
1 
5 
6 
Tr a urn at ic ar sputa t i on 
A3 
22 
65 
Subtotal: 
145 
521 
666 
9. ARTERIES INT'RSD . (excluding those in tra 
umatic amputations) 
Axillary 
4 
Brachial 
13 
F omoral 
28 
Intra-abdomi na1 
32 
Intracranial (artery or venous sinus) 
30 
Intrathoracic 
9 
Multiple 
5* 
Others 
4 
Popliteal 
8 
Radial or ulnar 
:4 
Subclavian 
3 
Tibial or peroneal 
23 
Subtotal: 
155 
155 
* Not included in totals. 
Continued on 
next pay 
Continued on noxt page. 
23 TABLE XIV Cont1d. 
REGIONAL DISTRIBUTION OF PRINCIPAL AND ASSOCIATED ROUNDS Si CUING 
THE NUMBER OF CASES EXHIBITING EACH (3) 
Princi- 
Associated 
pal wound 
wounds5 
evident 
TOTAL 
10. I-ERVSS INJURED (excluding those in 
traumat i c amputat ions) 
Brachial plexus 
8 
Femoral 
O 
Median 
4 
Multiple 
6* 
Other nerve (extracranial or extraspinal) 
4 
Other plexus 
2 
Peroneal 
2 
Padial 
7 
Sciatic 
10 
Tibia1 
6 
Ulnar 
8 
Unclassified 
1 
Subtotal: 
34 
34 
11. TOTALS 1336 
2039 
3375 
12. UNCLASSIFIED (as to principal wound) 
Multiple wounds (included above among 
associated wounds) 114 
TOTAL CASKS 1430 
* Not included in totals 
24 TABLE XV 
INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO IRING IF AL WOUNDS: 
GASES WITH ASSOCIATED HEAD AND INTRAVERTEBRAL WOUNDS 
Intra- 
Intra- 
Eye or orbit 
Scalp 
Intra- 
ASSOCIATED WOUNDS 
cranial, 
cranial, 
associated with 
only 
verte- 
known 
suspected 
cranial wound 
bral 
(Spinal, 
PRINCIPAL WOUND; 
Intracranial 
0 
0 
22 
0 
2 
Intravert ebr al 
2 
0 
0 
0 
0 
Maxillofacial 
0 
A 
0 
1 
0 
Cervical 
1 
0 
00 
1 
0 
Intrathoracic 
2 
6 
0 
5 
22 
Thoraco-abdominal 
6 
2 
0 
2 
19 
Combined intra-abdominal 
& intrathoracic 
7 
2 
0 
3 
5 
Intra-abdominal 
2 
6 
0 
7 
26 
Abdominal wall only 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
1 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
1 
0 
0 
0 
Lower ext. soft tissue 
• only 
1 
0 
0 
2 
1 
Lower ext. bone & soft 
tissue 
0 
3 
0 
5 
0 
Unclassified multiple 
39 
10 
3 
1 
10 
TOTAL 
60 
35 
25 
27 
85 
25 TABLE XVI 
INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO PRINCIPAL WOUNDS: 
CASES WITH ASSOCIATED MAXILLOFACIAL WOUNDS 
Maxillofacial, 
Maxillofacial, 
Eye or orbit 
ASSOCIATED WOUNDS 
bone & soft 
soft tissue 
assoc, with 
tissue 
only 
maxillofacia* 
wound 
PRINCIPAL WOUND; 
Intracranial 
35 
25 
11 
Intravertebral 
1 
1 
0 
Maxillofacial 
0 
0 
i 
5 
Cervical 
2 
A 
0 
Tntrathoracic 
5 
U 
A 
Thoraco-abdominal 
3 
3 
2 
Comb tried intra-abd omi nal 
& intrathoracic 
1 
9 
5 
Intra-abdomt nal 
A 
15 
2 
Abdominal wall only 
0 
0 
0 
Uprer ext. soft tissue 
only 
0 
1 
0 
Upper ext. bone & 
soft tissue 
0 
2 
1 
Lower ext. soft tissue 
only 
0 
3 
0 
Lower ext. bone & soft 
tissue 
1 
10 
3 
Unclassified multiple 
13 
27 
12 
TOTAL 
65 
114 
4-5 
26 TABLE XVII 
INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO PR INCH AL WOUNDS; 
CASES WITH ASSOCIATED CERVICAL WOUNDS 
ASSOCIATED WOUNDS 
Neck, 
general 
Neck with 
carotid artery 
Neck, with 
larynx or 
trachea 
PRINCIPAL WOUND: 
Intracranial 
17 
* 
0 
2 
Intravertebral 
21 
0 
1 
Maxillofacial 
3 
0 
0 
Cervical 
0 
0 
1 
Tntrathoracic 
14. 
1 
0 
Th or a c o - abd o m in a 1 
12 
0 ■ 
1 
Combined intra-abdominal 
0 
0 
2 
& intra-thoracic 
Tnt r a - abd o m i na 1 
9 
0 
0 
Abdominal wall only 
0 
0 
0 
Upper ext, soft tissue 
only 
0 
0 
0 
Upper oxtc bone & 
soft tissue 
0 
0 
0 
Lower ext. soft tissue 
only 
1 
0 
0 
Lower ext. bone & soft 
tissue 
4 
0 
0 
Unclassified multiple 
23 
1 
2 
TOTAL 
104 
2 
O 
/ 
27 TiJ3LE XVIII 
INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO PRINCIPAL WOUNDS: 
CASES WITH ASSOCIATED THORACIC WOUNDS 
Chest 
Intra- 
Intra- 
Combined intra- 
Thoraco- 
ASSOCIATED WOUNDS 
wall 
thoracic, 
thoracic, 
abdominal & 
abd ominal 
only 
evident 
suspected 
intrathoracic 
PRINCIPAL WOUND: 
Intracranial 
11 
2A 
U 
2 
I. 
Intravertebral 
s 
A 
. 7 
3 
0 
0 
Maxillofacial 
1 
0 
0 
0 
0 
Cervical 
1 
B 
3 
1 
0 
Intrathoracic 
0 
0 
0 
0 
1 
Thoraco-abdominal 
0 
U 
0 
0 
0 
Combined intra-abdomi- 
nal & intrathoracic 
1 
1 
0 
0 
0 
Intra-abdominal 
a 
6 
17 
0 
1 
Abdominal wall only 
i 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
i 
0 
3 
0 
0 
Upper ext. bone & 
soft tissue 
i 
0 
1 
0 
0 
Lower ext. soft tissue 
only 
i 
0 
0 
0 
0 
Lower ext. bone & soft 
tissue 
B 
2 
2 
1 
0 
Unclassified multiple 
15 
32 
IB 
A 
2 
TOTAL 
B6 
% 
61 
B 
5 
28 TABLE XIX 
INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO PRINCIPAL WOUNDS: 
CASES WITH ASSOCIATED ABDOMINAL WOUNDS 
ASSOCIATED WOUNDS 
Abd ominal 
wall only 
Intra- 
abdominal 5 
known 
Intra- 
abdominal, 
suspected 
PRINCIPAL WOUND 
• 
Intracranial 
11 
5 
0 
Int r avert obr a1 
1 
0 
0 
Maxillofacial 
0 
0 
1 
Cervical 
0 
0 
0 
Intrathoraclc 
B 
1 
A 
Thoraco-abdominal 
0 
0 
0 
Combined intra-abdominal 
&'intrathoracic 
0 
0 
0 
Intra-abdominal 
0 
0 
0 
Abdominal wall only 
0 
0 
0 
Upper ext. soft tissue 
only 
1 
0 
1 
Upper ext. bone & 
soft tissue 
3 
0 
0 
Lower ext. soft tissue 
only 
6 
0 
0 
Lower ext, bone & soft 
tissue 
15 
2 
2 
Unclassified multiple 
19 
12 
22 
TOTAL 
64. 
20 
30 
29 TABLE XX 
INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO PRINCIPAL WOUNDS: 
CASES WITH ASSOCIATED UPPER EXTREMITY WOUNDS WITHOUT INVOLVEMENT OF BONE 
ASSOCIATED WOUNDS: 
Soft 
tissue 
only 
Soft 
tissue & 
artery 
Soft 
tissue & 
artery & 
nerve 
Soft 
tissue & 
nerve 
FRINCIFAL WOUND: 
Intracranial 
52 
1 
1 
0 
Intravertebral 
6 
0 
0 
0 
Maxillofacial 
3 
0 
0 
0 
Cervical 
A 
0 
0 
0 
Intrathoracic 
28 
1 
0 
1 
Thoraco-abdominal 
29 
1 
1 
3. 
Combined intra-abdominal 
& intrathoracic 
V, 
0 
0 
0 
Intr a-abdominal 
63 
2 
0 
1 
Abdominal wall only 
2 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
6 
0 
0 
0 
Lower ext. b one & soft 
tissue 
17 
0 
0 
0 
Unclassified multiple 
.32 
0 
0 
0 
TOTAL 
256 
5 
2 
3 
30 TABLE XXI 
INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO PRINCIPAL WOUNDS: 
CASES WITH ASSOCIATED UPPER EXTREMITY WOUNDS WITH BONE INVOLVED 
ASSOCIATED WOUNDS; 
Soft 
tissue & 
bone 
Soft 
tissue 
& artery 
& bone 
Soft 
tissue & 
bone & 
nerve & 
artery 
Soft 
tissue 
& bone 
& nerve 
Trau- 
matic 
ampu- 
tation 
PRINCIPAL WOUND: 
Intracranial 
2A 
1 
0 
1 
1 
Intravertebral 
A 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
Cervical 
A 
0 
1 
0 
0 
Intratheracic 
33 
0 
0 
1 
0 
Thorac o-abd ominal 
31 
1 
0 
1 
2 
Combined intra-abdominal 
& intrathoracic 
11 
A 
0 
1 
1 
Intr a-abdomina1 
3A 
3 
0 
1 
0 
Abdominal wall only 
0 
0 
0 
0 
0 . 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
0 
0 
0 
0 
Lower soft tissue 
only 
3 
0 
0 
0 
1 
Lower ext. bone & soft 
tissue 
IS 
0 
0 
2 
2 
Un cla s sif ied mult iple 
27 
2 
0 
1 
10 
TOTAL 
189 
11 
1 
8 
17 
31 TABLE XXII 
'INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO PRINCIPAL WOUNDS: 
CASES WITH ASSOCIATED LOWER EXTREMITY WOUNDS WITHOUT INVOLVEMENT OF BONE 
ASSOCIATED WOUNDS: 
Soft 
tissue 
only 
Soft 
tissue & 
artery 
Soft 
tissue & 
artery & 
nerve 
Soft 
tissue & 
nerve 
PRINCIPAL WOUND: 
Intracranial 
37 
1 
0 
0 
Intravertebral 
3 
0 
0 
0 
Maxillofacial 
1 
0 
0 
0 
Cervical 
3 
0 
0 
0 
Intrathoracic 
26 
0 
0 
0 
Thoraco-abdominal 
4-3 
0 
0 
0 
Combined intra-abdominal 
& intrathoracic 
25 
1 
0 
2 
Intra-abdominal 
135 
6 
0 
2 
Abdominal wall only 
1 
0 
0 
i 
0 
Upper ext. soft tissue 
only 
1 
0 
0 
i 
b 
Upper ext, bone & 
soft tissue 
2 
0 
0 
6 
Lower ext. soft tissue 
only 
0 
0 
0 
1 
Lower ext. bone & soft 
tissue 
0 
1 
0 
0 
Unclassified multiple 
39 
3 
0 
0 
TOTAL 
316 
12 
0 
5 
32 TABLE XXIII 
INCIDENCE ASSOCIATED WOUNDS AS 
RELATED TO PRINCIPAL WOUNDS 
CASES WITH ASSOCIATED LOWER EXTREMITY WOUNDS WITH BONE INVOLVED 
Soft 
Soft 
Soft 
Soft 
Trau- 
ASSOCIATED WOUNDS: 
tissue 
tissue 
tissue 
tissue 
me tic 
& bone 
& artery 
& artery 
& bone 
ampu- 
& bone 
& nerve 
& nerve 
tation 
& bone 
PRINCIPAL WOUND: 
Intracranial 
21 
2 
0 
0 
1 
Intravertebral 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
Cervical 
0 
0 
0 
0 
0 
Intrathoracic 
11 
3 
0 
0 
0 
Thoraco-abdominal 
13 
3 
0 
0 
1 
Combined intra-abcominal 
& •intrathoracic 
9 
0 
1 
0 
2 
Intra-abdonr nal 
55 
2 
0 
3 
5 
Abdominal wall only 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
1 
0 
0 
0 
0 
Upfor ext. bone & 
soft tissue 
3 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
3 
0 
0 
0 
1 
Lower ext. bone & soft 
tissue 
1 
0 
0 
2 
2 
Unclassified multiple 
28 
3 
1 
1 
10 
TOTAL 
145 
13 
2 
6 
22 
33 TABLE XXIV 
INCIDENCE OF ARTERIES INJURED (1) 
(Excluding Traumatic Amputations) 
ARTERIES INJURED 
Axillary Brachial Femoral Popliteal Radial Tibial 
or or 
ulnar peroneal 
F RING UAL WOUND: 
Intracranial 
0 
3 
1 
0 
0 
1 
Intravertebral 
0 
0 
0 
0 
0 
' 0 
Maxillofacial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 
0 
0 
1 
0 
Tntrathoracic 
1 
1 
1 
0 
0 
2 
Thoraco-abdominal 
0 
2 
0 
1 
0 
2 
Combined intra-abdominal 
& intrathoracic 0 
2 
0 
0 
2 
2 
Intra-abdominal 
1 
U 
7 
n 
0 
1 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
1 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
1 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
9 
0 
0 
3 
Lower ext. bone & soft 
tissue 
0 
0 
6 
5 
0 
8 
Unclassified multiple 
0 
1 
_ L ... 
2 
1 
1 
TOTAL 
u 
13 
2 8 
8 
u 
20 
Continued next page 
3U TABLE XXIV Cont’d. 
INCIDENCE OF ARTERIES INJURED (2) 
(Excluding Traumatic Amputations) 
Intra- 
ARTERIES INJURFD abdominal 
Intra- 
cranial* 
Intra- 
tkoracic 
Multiple 
Others 
Sub- 
clavian 
PRINCIPAL WOUND: 
• 
Intracranial 
1 
28 
0 
2 
0 
0 
Intravertebral 
0 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 
0 
0 
\ 
3 
3 
Intrathoracic 
0 
0 
7 
0 
0 
0 
T hor ac o - a bd om ina 1 
a 
0 
1 
1 
0 
0 
Combined intra-abdominal 
& intrathoracic 
1 
0 
0 
0 
0 
0 
Intra-abdominal 
26 
0 
0 
1 
0 
0 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Uprer ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
0 
0 
0 
0 
0 
Lower ext, soft tissue 
only 
0 
0 
0 
0 
1 
0 
Lower ext. bone & soft 
tissue 
0 
0 
0 
1 
0 
0 
Unclassified multiple 
0 
2 
1 
0 
0 
0 
TOTAL 
32 
30 
9 
5 
A 
3 
(*) Artery or venous sinus. 
35 TABLE XXV 
INCIDENCE OF NERVES INJURED (l) 
(Excluding Traumatic Amputations) 
NERVES INJURED 
Brachial Median 
plexus 
Rad ial 
Ulnar 
Other 
nerve* 
Other 
plexus 
TRIMS UAL WOUND; 
Intracranial 
0 
0 
1 
1 
0 
0 
Intravertebral 
2 
0 
0 
0 
0 
0 
Maxi Hof acial 
0 
0 
0 
0 
0 
0 
Cervical 
3 
1 
1 
0 
2 
0 
Intrathoracic 
2 
0 
0 
1 
0 
0 
Thoraco-abdominal 
0 
1 
0 
1 
0 
1 
C o mb ined int r a - abd ora i na 1 
& intrathoracic 0 
0 
2 
0 
0 
0 
Intra-abdominal 
0 
1 
2 
0 
1 
1 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
0 
1 
1 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Lower ext. bone & soft 
tissae 
0 
1 
0 
3 
0 
0 
Unclassified multiple 
1 
0 
0 
1 
1 
0 
TOTAL 
8 
A 
7 
8 
A 
2 
(*) Extracranial or extravertebral 
Continued next page 
36 TABLE XXV Contfd 
INCIDENCE OF NERVES INJURED (2) 
(Excluding Traumatic Amputations) 
NERVES INJURED Femoral Multiple 
Peroneal 
Sciatic T 
ibial Unclassified 
I RING UAL WOUND: 
Intracranial 
0 
0 
0 
0 
0 
0 
Introvertebral 
0 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
' 0 
0 
0 
Cervical 
0 
2 
0 
0 
0 
0 
Intrathoracic 
0 
0 
0 
0 
0 
0 
Thoraco-abdominal 
0 
0 
0 
0 
1 
0 
C onb in ed in t r a - abd om ina 1 
& intrathoracic 
0 
1 
1 
2 
1 
0 
Intra-abdominal 
0 
0 
0 
6 
0 
0 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
1 
Upper ext. bone & 
soft tissue 
0 
0 
0 
0 
0 
0 
Lower ext, soft tissue 
only 
2 
0 
0 
0 
1 
0 
Lower ext, bone & soft 
tissue 
0 
2 
1 
1 
2 
0 
Unolass if ied mult ip1c 
0 
1 
0 
1 
1 
0 
TOTAL 
2 
6 
2 
10 
6 
1 
37 SECTION II 
SURGERY, ANESTHESIA, 
REPLACEMENT THERAPY* CHEMOTHERAPY, OXYGEN THERAPY 
.AND 
MISCELLANEOUS DATA & OBSERVATIONS The tables in this section are largely self explanatory. 
Primary operations, debridements, subsidiary opera.tions, operating 
time, secondary operations,, and anesthesia for primary and secondary 
surgery are presented in the order named. 
Table XXXIII presents’the recorded information relative to 
oxygen therapy. There was no record of oxygen therapy in HS6 of 
the 1U5O deaths. It is most probable that oxygen was given at times 
without making an entry on the patientls record. It is known, 
however, that oxygen therapy was indicated at times when it was not 
given. The cases listed in the column devoted to oxygen therapy 
during operation are, with few exceptions, those to which oxygen 
was administered as a part of the anesthetic mixture. 
Table XLVII shows that the deaths studied occurred in 
evacuation hospitals, and 505 in field hospitals. In the group of 
65 cases that ware seen in a field hospital and transferred to an 
evacuation hospital for surgery, those with intracranial wounds 
(32 cases) hea.d the list. The policy of transferring nearly all with 
intracranial wounds to an evacuation hospital for surgery accounts 
for this figure, and it is fair to assume that few if any of these 
would have survived had they been held in the field hospitalsr The 
same is not true of the 10 cases with unclassified multiple wounds, 
and the 8 cases with intrathoracic wounds in this grotto.. Many of 
these might have survived had they been held for surgery in the field 
hospital. These two principal, wound groups are the ones in which 
the transportability of the battle casualty is most apt to be 
39 overestimated# 
Table XL Till on post-mortem examinations, shows that there were 
675 cases in which there was no record of autopsy, It is known 
that a number of autorsies were done that were not reported. However, 
many more should have been done and in many instances would have 
been done, had the -pressure of work with living battle casualties 
not been so great* It was demonstrated time and again tha.t every 
surgeon should do or witness the post-mortem examination on all of 
his patients that die. His Judgment and ability in the problems 
of war surgery particularly, develop much more rapidly and to a 
far greater degree when this is done routinely. Microscopic 
examinations of tissues from all the important organs is likewise 
most valuable, Excellent reports from the Second Medical Laboratory 
and the 15th General' Medical Laboratory constitute a part of the 
record of many of the deaths studied. The high incidence of fat 
embolism was not appreciated until Lt. Col, Tracy 3. Mallory advised 
us of its incidence in the mlcrosco-oic sections of tissues from 
battle casualty deaths. Microscopic examination of tissues :n those 
dying with rlgment nephropathies has been quite valuable. Gross 
arid micros ceric autorsy studies should bo required on all battle 
casualty deaths. Their educational by-products contribute to the 
effectiveness of an army. TABLE XXVI 
PRIMARY OPERATIONS AS RELATED 
TO PRINCIPAL ROUNDS (1) 
Amputat ion 
PRIMARY OFEHAT10MS 
Craniotomy Debride- 
ment only 
Laminec- 
tomy 
Other 
operations 
F RING UAL MOUND; 
Intracranial 
3 
101 
20 
0 
2 
Intravertobral 
0 
0 
5 
12 
0 
Maxillofacial 
0 
0 
5 
0 
2 
Cervical 
0 
1 
11 
0 
6 
Intreathoracic 
2 
1 
40 
4 
1 
Thornco-abdominal 
5 
0 
6 
0 
0 
Combined intra-abdominal 
& intrathoracic 
. 8 
0 
1 
1 
1 
Intra-abd ominal 
11 
0 
5 
3 
0 
Abdominal wall only 
0 
0 
1 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
2 
0 
5 
0 
0 
Lower ext. soft tissue 
only 
5 
0 
16 
0 
0 
Lower ext. bone & soft 
i: is sue 
4.0 
0 
36 
0 
1 
Unclassified multiple 
8 
5 
25 
3 
2 
TOTAL 
84 
108 
176 
23 
15 
Continued next page 
kl TABLE XXVI Cont’d 
IRDt/iRY 0FEEi\TT0N3 A3 RELATED 
TO PRINCIPAL WOUNDS (2) 
r rimary oierat ions 
Laparotomy 
Thoraco- 
laparotomy 
Thoracotomy 
Abd ominal 
stab with- 
out laparo- 
tomy 
I RING CAL WOUND: 
Intracranial 
5 
0 
0 
0 
Intravertebral 
0 
0 
0 
. 0 
Maxillofacial 
0 
0 
0 
0 
Cervical 
0 
0 
0 
0 
Intrathoracic 
2 
0 
33 
0 
Thoraco-abdominal 
100 
12 
109 
18 
Combined intra-abdominal 
6c intra-thoracic 
A2 
0 
7 
0 
Intra-abdominal 
327 
1 
0 
0 
Abdominal wall only 
2 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
Upper ext.'bone & 
soft tissue 
0 
0 
0 
0 
Lower ext. soft tissue 
. only 
2 
0 
0 
0 
Lows? ext. bone Sc soft 
tissue 
1 
0 
0 
0 
Unclassified multiple 
8 
1 
p 
1 
TOTAL 
AC9 
u 
151 
19 
k2 TABLE XXVII 
DEBRIDEMENT OF OTHER FOUNDS ASSOCIATED WITH 
IRIMARY DERATION FOR THE FRINCIIAL WOUND * 
DEBRIDEr'EMP 
All 
wounds 
Omitted 
deliberately 
No statement 
regarding 
Partial 
TRIMCHAL TOUND: 
Intracranial 
84 
3 
12 
10 
Intravcrtcbral 
9 
0 
3 
0 
Maxillofacial 
0 
2 
0 
0 
Cervical 
1 
$ 
1 
0 
Intrathoracic 
27 
2 
7 
5 
T hor nc o- abd ominal 
Combined intra-abdominal 
113 
3 
44- 
19 
oc intrathoracic 
39 
2 
2 
3 
Intr a-abd ominal 
204 
14- 
92 
22 
Abdominal wall only 
Upper ext, soft tissue 
2 
0 
0 
0 
only 
Upper ext. bone & 
0 
0 
0 
0 
soft tissue 
Lower ext. soft tissue 
1 
1 
0 
0 
only 
Lower ext. bone & soft 
7 
0 
0 
0 
tissue 
23 
9 
B 
2 
Unclassified multiple 
16 
5 
3 
3 
TOTAL 
526 
4.6 
172 
64 
(*) Not including those 
chief operation. 
cases ir 
i which debridement was the pri 
.mary (i.e., table mni 
SUBSIDIARY ODER AT TONS AT THE TRIE OF THE IR DIARY 
OIERATION AS RELATED TO THING UAL WOUNDS (1) 
Orchid- 
SUBSIDIARY OPERATIONS ectomy 
• 
Other 
operation 
Repair Syapath- 
of ectomy 
artery 
Trache- 
otomy 
Vitallium 
cuff used 
in artery 
PRINCIPAL MOUND: 
Intracranial 
0 
0 
0 
0 
1 
0 
Int r aver tebral 
0 
6 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
2 
0 
Cervical 
0 
1 
1 
0 
3 
1 
Intrathoracic 
0 
5 
0 
0 
1 
0 
Thoraco-abdominal 
0 
B 
0 
0 
0 
0 
Combined antra-abd ominal 
8c intrathoracic 
0 
A 
0 
0 
1 
0 
Intra-abdominal 
2 
21 
1 
1 
1 
0 
Abdominal wall only 
0 
1 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Lower ext. bone & 
soft tissue 
1 
2 
1 
1 
0 
0 
Unclassified multiple 
2 
1 
0 
1 
3 
0 
TOTAL 
5 
A9 
3 
3 
12 
1 
Continued next page 
kk TABLE XXVXII Cent * d 
SUBSIDIARY OIEHATTOYS AT THE TB® OF THE PRIMARY 
OFFRATION AS RELATED TO rRIIICHAL ROUNDS (2) 
SUBS TDIARY 01ERATIONS' 
Bronchos- 
copy 
Cast or 
plaster tion 
splint 
i- Inter- 
costal 
nerve 
block 
Ligation 
of 
artery 
Maxillo- 
facial 
repair 
THING IT AL MOUND: 
Intracranial 
1 
12 
5 
1 
10 
9 
Intravertebral 
0 
5 
0 
0 
0 
1 
Maxillofacial 
0 
0 
1 
0 
0 
4- 
Cervical 
1 
1 
0 
0 
8 
1 
Intrathoracic 
12 
12 
0 
7 
3 
5 
Thoraco-abdominal 
IB 
12 
1 
5 
U 
1 
Corabined intra-abdominnl 
& intrathoracic 2 
\ 
B 
0 
0 
4- 
0 
In t r a - abd omina 1 
5 
4-3 
0 
1 
. 23 
5 
Abdominal wall only 
0 
1 
0 
0 
0 
O’ 
Upper ext. soft tissue 
only 
0 
0 
0 
o 
0 
0 
ext. bone & 
soft tissue 
1 
2 
0 
0 
1 
1 
Lower ext, soft tissue 
only 
0 
8 
0 
0 
10 
0 
Lower ext. bone A soft- 
tissue 
0 
51 
1. 
0 
8 
1 
Uncla a s if ied mult iplo 
1 
16 
1 
0 
6 
3 
TOTAL 
a 
171 
9 
14- 
77 
31 
U5 TABLE XXIX 
OPERATING TIME FOR TRPIRRY SURGERY 
AS RELATED TO J RING UAL ROUNDS (1) 
TP1E PT MINUTES 
Less than 
30 
30- 
59 
60- 
89 
90- 
119 
120- 
150- 
179 
PRINCIPAL MOUND; 
Intracranial 
2 
3 
8 
7 
8 
5 
Intravertcbral 
1 
0 
0 
0 
2 
0 
Maxillof acial 
0 
0 
0 
0 
1 
1 
Cervical 
1 
0 
0 
1 
1 
0 
Jntrathoracic 
0 
u 
2 
2 
4 
3 
Thoraco-abd orainal 
1 
2 
8 
6 
11 
B 
Combined intra-abdominal 
& intrathoracic 
0 
0 
1 
0 
1 
2 
Intra-abdominal 
A 
4- 
6 
9 
16 
17 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upner ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper .ext. bone & 
soft tissue 
0 
0 
0 
1 
0 
0 
Lower ext, soft tissue 
only 
0 
1 
0 
3 
0 
0 
Lower ext, bone & 
soft tissue 
0 
u 
6 
3 
2 
2 
Unclas s if ie d multiple 
2 
1 
2 
4. 
2 
3 
TOTAL 
11 
19 
33 
36 
4,8 
4.1 
Continued next page 
1+6 TA3LB XXIX Cont!d 
OPERATING TIME FOR I RI”A.RY SURGERY 
AS RELATED TO T RING UAL WOUNDS (2) 
TT/'E PT MINUTES 
180 
209 
210- 
239 
24-0- 
299 
300- 
360 
More 
than 
360 
No 
record 
I RING IT AL MOUND; 
Intracranial 
5 
0 
1 
1 
2 
87 
Intravortebral 
0 
0 
0 
0 
0 
15 
Maxillofacial 
1 
0 
0 
0 
0 
A 
Cervical 
0 
0 
2 
0 
0 
13 
Intrathoracic 
0 
1 
0 
1 
1 
63 
Thoraco-abd ominal 
5 ‘ 
A 
3 
5 
1 
131 
C ombined intra-abdominal 
& intrathoracic 
A 
1 
1 
'1 
0 
36 
Intra-abdonrnal 
19 
8 
6 
1 
0 
2A7 
Abdominal wall only 
0 
0 
0 
0 
0 
3 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper Q&/. bone 8c 
soft i issue 
0 
0 
0 
0 
0 
6 
Lower ext-, soft tissue 
only 
0 
0 
0 
0 
0 
18 
Lower ext. bone & 
soft tissue 
2 
0 
0 
0 
0 
59 
Unclassified multiple 
1 
0 
0 
2 
0 
35 
TOTAL 
3? 
u 
13 
11 
L 
717 TABLE XZX 
SECONDARY (LATER) DERATIONS 
AS RELATED TO I RING UAL WOUNDS (1) 
Abdominal 
Ampu- 
Broncho- 
Cast or 
Crani- 
Cystos- 
SECONDARY (LATER) 
stab 
tation 
scopy 
plaster otomy 
tomy 
OPERATIONS without 
splint 
laparotomy 
THING UAL WOUND; 
Intracranial 
0 
1 
2 
2 
16 
0 
Intravertebral 
0 
0 
1 
1 
0 
2 
Max: ill of acial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 
0 
0 
0 
0 
Intrathoracic 
0 
1 
1 
3 
1 
1 
Thoraco-abdominal 
1 
1 
3 
0 
1 
0 
Combined intra-abdominal 
& intrathoracic 
0 
0 
0 
0 
0 
0 
Intra-abdominal 
0 
4- 
2 
0 
0 
‘ 3 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext. bone 8c 
soft tissue 
0 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
0 
2 
0 
0 
0 
0 
Lower ext. bone 8c 
soft tissue 
0 
6 
0 
0 
0 
1 
Unclassified multiple 
0 
0 
0 
0 
3 
0 
TOTAL 
1 
15 
9 
6 
21 
7 
Continued next page 
US TABLE XXX Cnnt * d 
SECONDARY (LATER) OPERATIONS 
AS RELATED TO I RING UAL WOUNDS (2) 
Dcbride- 
SECONDARY (LATER) ment 
01ERAT IONS 
Died 
dur ing 
sec ond ary 
surgery 
Drainage 
tube to 
pleural 
sac in- 
serted 
Dressing* Fasci- 
otomy 
Incision 
of 
abscess 
IRINCH AL NOUND 
Intracranial 
7 
1 
1 
0 
0 
2 
Intravertebral 
1 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
0 
Cervical 
1 
1 
0 
0 
0 
0 
Intrathoracic 
2 
0 
K 
0 
0 
0 
Thorac o-abdominal 
5 
0 
5 
0 
0 
1 
Combined intra-abdominal 
Sc intrathoracic 0 
0 
1 
0 
0 
0 
Intra-abd ominal 
7 
0 
0 
0 
0 
0 
Abdominal wall only 
0 
0 ■ 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext. bone Sc 
soft tissue 
1 
0 
0 
1 
0 
0 
Lower ext. soft tissue 
only 
3 
0 
0 
1 
1 
0 
Lower ext. bone Sc 
soft tissue 
3 
0 
0 
3 
0 
0 
Unclassified multiple 
2 
2 
0 
0 
0 
1 
TOTAL 
32 
4 
11 
5 
1 
u 
(*) Recorded only when 
done 
under anesthesia. 
Continued next page 
2+9 Table XXX Cont'd 
SECONDARY (LATER) 01 SEAT IONS 
AS RELATED TO I RING UAL WOUNDS (3) 
Lamin- 
SECONDAHY (LATER) ectomy 
OTERATIONS 
Lapar 
otomy 
- Opening 
' of 
colostomy* 
Other 
opera- 
tions 
Removal of 
f ore ign 
body 
Renal 
decapsu- 
lation 
rRIYCTFAL TOTTED; 
Intracranial 
0 
1 
0 
3 
0 
0 
Int r ave r t o br a 1 
0 
0 
0 
0 
0 
0 
Maxillofac ial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 
0 
1 
0 
0 
Intrathoracic 
1 
0 
0 
0 
0 
0 
Thoraco-abd orainal 
0 
3 
0 
0 
0 
0 
C ombined intra-abdominal 
& intrathcracic 
0 
1 
0 
0 
0 
1 
Intra-abdominal 
0 
2 
A 
0 
1 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext. bone Sc 
soft tissue 
0 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Lower ext. bone & 
soft tissue 
0 
2 
0 
0 
0 
0 
Unclassified multiple 
0 
1 
0 
0 
0 
0 
TOTAL 
1 
13 
2 
8 
0 
2 
(*) Recorded only when 
done 
under , 
anesthesia, 
Continued next page 
50 TABLE XXX Cont 
SECONDARY (LATER) OPERATIONS 
AS RELATED TO PRINCIPAL WOUNDS (/,) 
Secon- 
SECONDARY (LATER) dary 
OPERATIONS closure 
Sympath- 
ectomy 
- Third 
or 
more 
opera- 
tions 
Thoraco- 
laparo- 
tomy 
Thorac- 
otomy 
Trache- 
otomy 
PRINCIPAL WOUND: 
Intracranial 
1 
0 
6 
0 
0 
0 
Intravertebral 
0 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 
0 
0 
0 
0 
Intrathoracic 
0 
0 
0 
0 
1 
0 
Thoraco-abdominal 
2 
0 
u 
0 
1 
0 
Combined intra-abdominal 
& intrathoracic 
0 
0 
0 
0 
0 
0 
Intra-abd ominal 
5 
0 
3 
0 
0 
0 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Uprer ext. soft tissue' 
Sc bone 
0 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Lower ext. bone Sc soft 
tissue 
0 
0 
1 
0 
0 
0 
Unclassified multiple 
0 
0 
0 
0 
0 
0 
TOTAL 
8 
0 
14 
0 
2 
0 
51 TABLE XXXI 
ANESTHESIA FOR PRIMARY SURGERY 
AS RELATED TO PRINCIPAL WOUNDS (1) 
Ether, 
Ether, 
Ether, 
Ether, 
Endo- 
Nitrous 
AESTHETIC AGENTS 
closed 
Flagg 
omen 
unclas- 
tracheal 
oxide 
AND 5.FTF0DS 
system 
method 
drop 
sif ied 
PRINCIPAL WOUND; 
Intracranial 
16 
1 
5 
24 
31 
8 
Xntravertebral 
2 
0 
0 
5 
4 
2 
Maxillofacial 
2 
0 
1 
0 
2 
\ 
2 
2 
Cervical 
6 
0 
1 
0 
5 
Intrathoracic 
31 
0 
■ 1 
20 
33 
22 
Thoraco-abdominal 
89 
1 
5 
55 
100 
77 
Combined intra-abdominal 
& intrathoracic 
23 
0 
1 
19 
22 
20 
Intra-abdominal 
119 
2 
25 
107 
112 
96 
Abdominal wall only 
0 
0 
0 
2 
1 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
1 
0 
0 
1 
2 
1 
Lower ext. soft tissue 
only 
4 
0 
5 
4 
0 
4 
Lower ext. bone & 
soft tissue 
20 
0 
1 
IB 
6 
16 
Unclassified multiple 
11 
0 
G 
22 
16 
9 
TOTAL 
324 
4 
45 
277 
331 
262 
Continued next page 
52 TABLE XXXI Cont?d 
ANESTHESIA FOR PRIMARY SURGERY 
AS RELATED TO I RING UAL WOUNDS (2) 
Local 
No record, Other 
Lentothal 
Regional 
Spinal 
ANESTHETIC AGENTS 
AND METHODS 
or none 
agent* sodium 
I RING XT AL "'OUND: 
Intracranial 
A2 
31 
0 
33 
1 
0 
Intravertebral 
5 
5 
0 
0 
0 
0 
Max illof ac la 1 
1 
3 
0 
1 
0 
0 
Cervical 
3 
7 
0 
3 
0 
0 
Intrathoracic 
9 
IB 
1 
11 
0 
0 
T h or ac o-abd omina1 
Combined intra-abdominal 
3 
35 
0 
3 
0 
0 
& intrathoracic 
f 
1 
4. 
1 
3 
0 
0 
Intra-abdominal 
0 
96 
1 
i 
8 
0 
0 . 
Abdominal wall only 
Upper ext. soft tissue 
0 
1 
0 
1 
0 
1 
only 
Upper ext. bone 1 soft 
0 
0 
0 
0 
0 
0 
t? ssue 
Lower ext. soft tissue 
0 
2 
0 
3 
0 
0 
only 
Lower ext. bone & soft 
0 
3 
0 
7 
0 
1 
tissue 
0 
23 
0 
9 
0 
1 
Unclassified multiple 
3 
U 
0 
B 
0 
0 
TOTAL 67 
(*) Including ethyl chloride 
2A2 
used for 
3 
induction 
90 
• 
1 
3 
53 TABLE mil 
ANESTHESIA FOR SECONDARY SURGERY 
AS RELATED TO FRU'ICIEAL BOUNDS (1) 
Ether, 
Ether, 
Ether, 
Ether, 
Endo- 
Nitrous 
ANESTHETIC AGENTS 
closed 
Flagg 
open 
unclas- 
tracheal 
oxide 
AND METHODS 
system 
method 
drop 
sified 
PRINCIPAL WOUND: 
Intracranial 
1 
0 
0 
2 
3 
1 
Intravertebral 
0 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 
0 
0 
0 
0 
Intrathoracic 
0 
0 
0 
1 
0 
0 
Thoraco-abdominal 
2 
0 
0 
0 
0 
2 
Combined intra-abdonr nal 
& intrathoracic 
1 
0 
0 
0 
0 
1 
Intra-abdominal 
2 
0 
1 
5 
3 
2 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Uprer ext. bone & 
soft tissue 
0 
0 
0 
1 
0 
0 
Lower ext. soft tissue 
only 
2 
0 
1 
2 
0 
2 
Lower ext. bone & 
soft tissue 
0 
0 
0 
7 
0 
0 
Unclass If ie d mult iple 
1 
0 
0 
1 
1 
1 
TOTAL 
9 
0 
2 
19 
7 
9 
Continued next page 
5^ TA3LE XXXII Gont•d 
ANESTHESIA FOR SECONDARY SURGERY 
AS RELATED TO I RING UAL WOUNDS (2) 
ANESTHETIC AGENTS 
AND I'TETHODS 
Local 
No record 
or none 
, Other 
agent* 
Fentothal Regional 
sodium 
Spinal 
PRINCIPAL WOUND: 
Intracranial 
5 
10 
0 
5 
0 
1 
Intravertebral 
0 
3 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
1 
0 
1 
0 
0 
Intrathoracic 
1 
4- 
0 
0 
0 
0 
Thor aco-abd omina1 
3 
8 
0 
0 
0 
1 
Combined intra-abdominal 
& intrathoracic 
0 
1 
0 
0 
0 
1 
Tntra -abd orainal 
3 
13 
0 
3 
0 
2 
Abdominal wall only 
0 
0 ' 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext, bone & 
soft tissue 
0 
1 
0 
0 
0 
0 
Lower ext, soft tissue 
only 
0 
2 
0 
1 
0 
0 
Lower ext. bone & soft 
tissue 
1 
t 
5 
0 
2 
0 
0 
Unclassified multiple 
3 
9 
0 
1 
1 
0 
0 
TOTAL 
16 
4.8 
0 
13 
0 
5 
(*) Including ethyl chloride 
used for induction, 
• 
55 TABLE XXXIII 
OXYGEN TESEAFY 
AS RELATED TO i-RIL-CIi-L -'OUND 
Oxygen 
before 
opera- 
tion 
Oxygen 
during 
opera- 
tion 
Oxygen 
after 
opera- 
tion 
No record 
of oxygen 
ERINCI11X ./OuKD; 
Intracranial 
23 
21 
20 
240 
Intravertebral 
4 
2 
3 
18 
kaxillofacial 
0 
2 
0 
6 
Cervical 
8 
8 
2 
13 
Intrathoracic 
22 
33 
24 
r 
Thor aco-abd omi nal 
18 
93 
39 
90 
Combined intra-abdominal 
L intrathoracic 
12 
24 
9 
24 
Intra-abdominal 
26 
131 
63 
22? 
abdominal wall only 
0 
1 
1 
1 
Upper ext, soft tissue only 
1 
0 
0 
3 
Upper ext. bone & soft 
tissue 
0 
l 
1 
9 
Lower ext. soft tissue only 
1 
r* 
5 
7 
21 
Lower ext. bone & soft 
tissue 
6 
21 
21 • 
72 
Unclassified multiple 
13 
13 
4 
88 
TOTAL 
CASES 
136 
3&3 
194 
866 
56 TABLE XXXIV 
CHHtOTUEPAPY AP EELATEI TC PI: r0UI,D 
; CT2TI0:Ti:TIC I FUG":* 
I ID r'ODA U: EE; 
penicillin 
alone 
Culfon- 
eroid e 
alone 
Penicillin 
and 
Tulfonamide 
n od a 
given 
Ho soda 
/report - 
ed 
No record of 
chemotherapy 
PRINCIPAL * OUI'TD: 
ntracranial 
50 
37 
23 
17 
48 
I87 
ntravertebral 
8 
4 
4 
2 
8 
11 
axillofacial 
i 
2 
l 
0 
0 
1 
5 
f 
er. ical 
r' 
D 
a 
1 
0 
4 
16 
ntrathoracic 
12 
21 
19 
3 
33 
86 
horac o-abdominal 
37 
38 
30 
7 
83 
87 
ombined intra-abdoraiiu 
1 13 
13 
3 
4 
19 
26 
intrathoracic 
n t ra-abe ora nal 
47 
12? 
71 
10 
191 
163 
bdominal v.all only 
0 
1 
0 
0 
1 
2 
pper ex''-, soft tissue 
1 
0 
0 
1 
0 
3 
only 
pper ext. bone & 
l 
3 
0 
’1 
4 
4 
soft tissue 
bv.er ext. soft tissue 
4 
13 
3 
4 
14 
ll 
only 
ovver ext . bone & 
12 
33 
14 
7 
45 
33 
soft tissue 
nclassified multiple 
13 
13 
9 
,3 
23 
77 
TOTAL 
203 
335 
179 
39 
481 
733- 
Excluding sulfanilamide applied to ounds at time of first aid dressing. 
Including 26 cases in vhich soda vas given '..itbout a sulfonamide as an adjuvant 
to blood transfusion therapy. 
57 TABLE XKXT 
INTRAVENOUS PLASMA THERAPY BEFORE ADMISSION TO HOSPITAL 
AS RELATED TO PR TUG IT AL WOUNDS (1) 
UNITS OF UUMA.N TLASMA: 
(One unit is 250cc) 
O 
1 
2 
3 
4 
5 
FRITCUAL mr-7D: 
Intracranial 
161 
55 
40 
19 
14 
2 
Intravert ebr a1 
10 
7 
4 
4 
1 
0 
Maxillofacial 
5 
1 
2 
0 
0 
0 
Cervical 
13 
3 
L, 
2 
1 
i 
Intrathoracic 
57 
12 
34 
13 
9 
3 
T1" orac o-abd ominal 
65 
32 
40 
34 
25 
8 
Combined intra-abdonrnal 
& 5 ntr ath or ac ic 
19 
11 
10 
B 
5 
3 
Intra-abdominal 
148 
43 
96 
40 
34 
21 
Abdominal wall only 
3 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
4 
0 
0 
0 
0 
0 
Uprer ,:xt, bone & 
soft tissue 
4 
1 
0 
1 
1 
2 
Lower ext. soft tissue 
only 
IB 
2 
5 
3 
1 
0 
Lower ext, bone & 
soft tissue 
36 
13 
£1 
16 
12 
4 
U no la s s if ie d, mul t ip le 
57 
19 
15 
14- 
3 
2 
TOTAL CA33S 
600 
199 
271 
154 
106 
46 
(*) No record of plasma adn 
asnistration, or 
none 
given. 
Continued next page 
58 TA3LE XXXV Cont’d 
INTRAVENOUS I LAS HA THERAPY BEFORE ADMISSION TO HOST ITAL 
AS RELATED TO PRINCIPAL WOUNDS (2) 
UNITS OF HTTMAT'T 
(One unit is 250cc) 
6 
7 
8 
o 
/ 
10 
11 or 
more 
I RING IT AL WOUND: 
Intracranial 
3 
2 
1 
0 
0 
0 
Intravertebral 
0 
0 
0 
i 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 
1 
0 
0 
0 
Intrathoracic 
6 
3 
0 
1 
0 
0 
Thor s co-abdominal 
3 
2 
2 
1 
0 
0 
Combined intra-abdominal 
& intrathoracic 
2 
0 
0 
0 
0 
1* 
Tnt ra-abdomina1 
15 
5 
3 
1 
1 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext, soft tissue 
only 
0 . 
0 
0 
0 
0 
0 
Upper ext, bone & 
soft tissue 
0 
0 
0 
0 
0 
1-JHHr 
Lower ext. soft tissue 
only 
1 
0 
1 
0 
0 
0 
Lower ext. bone & 
soft tissue 
4 
A 
2 
1 
1 
0 
Unclassified, multiple 
1 
0 
3 
0 
0 
0 
TOTAL CAbBS 
(*) 12 units 
(**) 14 units 
(-jHHf)ll units 
35 
16 
13 
5 
2 
3 
59 HiBLE XXXVI 
INTRAVENOUS FlA.SMA THERAPY AFTER ADMISSION TO HOST ITAL BEFORE SURGERY 
AS RELATED TO FRTNCITAJ. HOUHDS (1) 
UNITS OF HUMAN PLASMA 
(One unit 250cc) 
0* 
\ 
1 
2 
3 
■ 4- 
5 
I RING UAL WOUNDS: 
Intracranial 
18$ 
24 
4-3 
15 
11 
B 
Intravertebr al 
11 
3 
8 
0 
1 
1 
Maxillofacial 
5 
0 
n 
1 
0 
0 
Cervical 
20 
3 
0 
2 
0 
0 
Intrathoracic 
83 
13 
16 
13 
7 
4- 
Thoraco-abdomlnal 
13b 
23 
26 
13 
3 
4- 
Combined intra-abdominal 
& intrathoracic 
34. 
6 
8 
3 
• 4- 
1 
Intra-abd ominal 
243 
27 
61 
33 
20 
5 
Abdominal wall only 
2 
0 
0 
1 
0 
0 
Uprer ext, soft tissue 
only 
2 
1 
0 
0 
0 
0 
Upper ext, boned 
soft tissue 
7 
1 
0 
0 
0 
0 
Lower e:t. soft tissue 
only 
20 
I, 
3 
1 
3 
0 
Lower ext. bone & 
soft tissue 
$B 
14 
11 
6 
6 
6 
Uncla s s ified s multiple 
$8 
15 
18 
5 
4 
5 
TOTAL CASSS 
871 
134- 
195 
93 
59 
34- 
(*) No record of plasma administration, or 
none 
given. 
C o nt inue d next p a r?Q 
6o TABLE XXXYI Cont'd 
INTRAVENOUS TLASHA TH5RAIT AFTER ADMISSION TO HOST ITAL BEFORE) SURGERY 
AS RELATED TO F RING UAL WOUFDS (2) 
U'TITS OF HUMAN PLASMA 
(One unit is 250cc) 
6 
7 
3 
9 
10 
11 or 
more 
PRINCIPAL WOUNDS; 
Intracranial 
5 
1 
1 
1 
*1 
-L. 
2* 
Intravertebral 
2 
0 
0 
0 
0 
Maxillofacial 
0 
1 
0 
0 
0 
0, 
Cervical 
0 
0 
0 
0 
0 
0 
Intrathoracic 
0 
1 
0 
o 
1 
0 
T hora co-abd ominal 
1 
0 
1 
1 
1 
0 
Combined intra-abdominal 
& intrathoracic 
3 
0 
0 
0 
0 
0 
Intr a-abd om?* nal 
6 
2 
2 
2 
0 
2x 
Abdominal wall only 
0 
0 
0 
n 
0 
0 
Ur per ext, soft tissue 
only 
0 
1 
0 
0 
0 
0 
Uprer ext. bone A 
soft tissue 
1 
0 
0 
1 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Lower ext. bone A 
soft tissue 
L 
2 
3 
1 
1 
2xx 
Unclassifled s mult5ple 
U 
0 
1 
0 
1 
3xxx 
TOTAL CA33S 
26 
C'r 
i. 
8 
6 
5 
11 
(*) 11 units (x) 13 units (xxrx) 13 un3-ts 
17 units 13 units U units 
(**) If units (xx) 12 units 29 units - (Given over period 
17 units of I, days - abd „ wound, severed pap- 
litea? artery, multiple fractures, 
clostridial myositis) 
6l TABLE XXXVII 
INTRAVENOUS rXASMA THERAPY DURING SURGERY 
AS RELATED TO TRINCUAL WOUNDS (1) 
UNITS OF HUMAN T LAS Mil 
(One unit is 250cc) 
1 
2 
3 
A 
5 
PRINCIPAL NOTH®: 
Intracranial 
280 
8 
6 
1 
1 
1 
Intravertebral 
26 
0 
0 
1 
0 
0 
Maxillofacial 
c 
0 
0 
0 
0 
0 
Cervical 
22 
0 
1 
0 
1 
0 
Intrathoracic 
133 
3 
1 
0 
1 
0 
Thora co-avdon"nal 
193 
A 
10 
0 
1 
1 
Conbined ?ntra-abdominal 
& intrathoracic 
AB 
I 
2 
2 
0 
1 
Intra-abdominal 
356 
8 
19 
10 
6 
2 
Abdominal nail only 
3 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
A 
0 
0 
0 
0 
0 
Upper ext. bone 1 
soft tissue 
10 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
22 
o 
1 
2 
A 
0 
Lower ext, bone 1 
soft tissue 
96 
3 
12 
1 
i 
0 
Unclessified, multiple 
108 
A 
2 
0 
0 
0 
TOTAL CASUS 
1309 
36 
5A 
15 
15 
5 
(*) No record of plasma admi 
nistration. or 
none 
given. 
Continued next page 
62 TABLE XXXVII Cont^ 
lOTRAVT-MOUS PLASMA. THERAPY DURING SURGERY 
AS RELATED TO PRINCIPAL WOUNDS (2) 
UNITS OF HUMAN FLA3?TA; 
(One unit is 250cc) 
6 
7 
8 
9 
10 
11 or 
more 
PRINCIPAL UOUUD: 
Intracranial 
0 
0 
0 
0 
0 
0 
Intravertebral 
0 
0 
0 
0 
0 
0 
Maxi Hof acial 
0 
0 
0 
0 
0 
0 
Cervical 
1 
• 0 
0 
0 
0 
0 
Tntrathoracic 
0 
0 
0 
0 
0 
0 
Thorneo-abd ominal 
1 
1 
1 
0 
0 
0 
C omb:: ned i ntr a - abd omi nal 
& intrnthoracic 
1 
0 
0 
0 
1 
0 
Tnt r a - abd ominal 
1 
0 
2 
1 
1 
0 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. sofx tissue 
only 
0 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
0 
0 
0 
0 
0 
Lower ext. soft tissue, 
only 
0 
0 
0 
0 
0 
0 
Lower ext. bone & 
soft tissue N 
0 
0 
0 
1 
0 
0 
Unclassifieds multiple 
0 
0 
0 
0 
0 
0 
TOTAL CA33S 
L 
1 
3 
2 
2 
2 
63 TABLE XXXVIII 
INTRAVENOUS PLASM THERAPY AFTER SURGERY 
AS RELATED TO PRINCIPAL WOUNDS (1) 
UNITS OF HUMAN FITS'IA: 
(One unit is 250cc) 
0* 
1 
2 
3 
L 
5 
PRINCIPAL WOUND: 
Intracranial 
275 
7 
6 
0 
1 
0 
Intravertebral 
25 
1 
1 
0 
0 
0 
Maxillofacial 
7 
n 
1 
0 
0 
0 
Cervical 
23 
2 
0 
0 
0 
0 
Intrathoracic 
127 
3 
6 
0 
1 
0 
Thoraco-abdominal 
103 
11 
7 
2 
3 
1 
Combined intra^abdominal 
& intrathoracic 
A6 
3 
L. 
2 
1 
0 
Intra-abdominal 
331 
16 
H 
12 
12 
L 
Abdominal wall only 
2 
0 
0 
1 
0 
0 
Upper ext, soft tissue 
only 
L 
0 
0 
0 
0 
0 
Upper ext, bone & 
soft tissue 
9 
0 
1 
0 
0 
0 
Lower ext. soft tissue 
only 
23 
5 
2 
0 
0 
0 
Lower ext. bone & 
soft tissue 
93 
2 
7 
u 
3 
1 
Unclassified, multiple 
103 
2 
6 
0 
]_ 
0 
TOTAL CAS3S 
1251 
52 
65 
21 
22 
6 
(*) No record of plasma administration; or 
none 
given. 
Continued ne?rb page 
6U TABLE XXXVIII Cont*d 
BfTRAVFUOUS ILASMA, THERAPY /.FT51R SURGERY 
AS RELATED TO PRINCIPAL WOUNDS (2) 
UNITS OF HUMAN ILA3MA: 
(One unit is 250cc) 
6 
7 
8 
9 
10 
11 or 
more 
FR~FCIT AL FOUND: 
Intracranial 
2 
1 
3 
1 
0 
0 
Tntravertebral 
0 
0 
0 
0 
0 
0 
Maxillof acial 
0 
0 
0 
- 0 
0 
0 
Cervical 
0 
0 
0 
0 
0 
0 
Intrathoracic 
0 
0 
1 
0 
0 
0 
Tboraco-abdominal 
3 
0 
1 
0 
1 
0 
C ombi ned in tr a - a bd oral nal 
& 5ntrathorac5.c 
2 
1 
0 
0 
0 
0 
Int ra-abdominal 
6 
0 
0 
0 
2 
1* 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Uprer ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Urrer ext, bone & 
soft tissue 
0 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
1 
0 
0 
0 
0 
0 
Lower ext. bone & 
soft tissue 
1 
1 
1 
1 
0 
0 
Unclassified? multiple 
0 
1 
1 
0 
0 
0 
TOTAL C^SSS 
15 
L 
7 
2 
3 
1 
(*) 12 units 
65 TABLE XXXIX 
BLOOD TRANSFUSION THERAPY BEFORE SURGERY 
AS RELATED TO PRINCIPAL WON'T) (1) 
IT'TITS OF WHOLE BLOOD: 
(One unit is 500cc) 
0* 
1 
2 
3 
A 
5 
PRINCIPAL WOUND: 
Intracranial 
211 
37 
27 
Q 
✓ 
6 
2 
Tnt r avert cbr al 
u 
A 
5 
2 
1 
1 
Maxillofac ial 
5 
1 
1 
1 
0 
0 
Cervical 
12 
A 
3 
A 
1 
0 
Tntrntboracic 
66 
29 
18 
8 
C 
/ 
6 
0 
Thora c o-abdominal 
7 e 
33 
39 
23 
18 
6 
Combined intra-abdominal 
& intratboracic 
25 
Q 
9 
6 
5 
1 
Intro-abdominal 
165 
56 
65 
A5 
Al 
V, 
Abdominal wali only 
2 
1 
0 
0 
0 
0 
Uprer ext. soft tissue 
only 
3 
0 
0 
1 
0 
0 
Up* er ext. bone & 
soft tissue 
7 
1 
1 
. 0 
1 
0 
Lower ext. soft tissue 
only 
22 
1 
2 
3 
2 
1 
Lower ext., bone & 
.soft tissue 
53 
16 
16 
7 
10 
7 
Uncla s s ifie d, mult iple 
AA 
27 
15 
12 
9 
3 
TOTAL CLASSIS 
707 
219 
201 
121 
103 
41 
(*) No record of intravenous 
ad ministr ation 
of blood? or 
none 
given. 
Continued next page 
66 TABLE XXXIX Cont'd 
BLOOD TRANSFUSION THERAPY BEFORE SURGERY 
AS TED TO BRING UAL WOUND (2) 
UNITS OF WOLF BLOOD? 
(One unit 13 500cc) 
6 
7 
B 
9 
10 
11 
PRINCIPAL WOUND: 
♦ 
Intracranial 
3 
1 
1 
0 
0 
0 
Intravertebral 
0 
0 
0 
0 
0 
0 
Rax?llofacial 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 
0 
0 
1 
0 
Intratboracic 
1 
0 
1 
0 
0 
0 
Thoraco-abd ominal 
B 
3 
1 
3 
0 
0 
Combined 5ntra-abdominal 
& -ntratboracic 
2 
0 
0 
1 
1 
0 
Intra-obdominal 
11 
z. 
2 
1 
3 
0 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. 30ft tissue 
only 
G 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Lower ext. bone & 
soft tissue- 
2 
2 
1 
0 
0 
0 
Unclassifled, multiple 
2 
0 
1 
0 
0 
1 
TOTAL CASSIS 
29 
11 
7 
5 
5 
1 
67 TAHL3 XL 
BLOOD TRANSFUSION THERATY DURJTr SURGERY 
AS RELATED TO PRINCIPAL WOUND (1) 
UNITS CF WOLF BLOOD; 
(One unit is 500cc) 
0* 
1 
2 
3 
4 
5 
PRINCIPAL WOUND; 
Intracranial 
243 
20 
21 
8 
2 
0 
Tnt r aver to br al 
21 
2 
1 
2 
0 
1 
Lax 5 LI of acini 
8 
0 
0 
0 
0 
0 
Cervical 
21 
3. 
2 
0 
0 
0 
Jntrat’-oracic 
117 
9 
7 
1 
3 
0 
T h or aco-abd omina 1 
132 
15 
3A 
16 
r, 
3 
Combined 5ntra-abdominal 
& 
34 
8 
6 
5 
2 
2 
Intr a- abd ominal 
257 
30 
53 
29 
18 
6 
Abdominal wall only 
3 
0 
0 
0 
0 
0 
Upner ext. soft tissue 
only 
A 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
10 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
19 
A 
3 
4 
1 
0 
Lower ext. bone & 
soft tissue 
72 
6 
i 
22 
6 
n 
2 
Unclassified, multiple 
96 
8 
5 
0 
1 
2 
TOTAL CASBS 
1037 
103 
154 
71 
33 
16 
(*) No record of intravenous 
administr at ion 
of blood 
I, or 
none 
given. 
Continued next pe.ge 
6g TABLE XL Cont'd 
BLOOD TRANSFUSION- THERAPY DURING SURGERY 
AS RELATED TO I RING IT AL (?) 
TT'TTTS 0? T7H0LL BLOOD: 
(One unit 's 500cc) 
6 
7 
B 
9 
10 
11 
PRINCIPAL WOBND: 
Tntracranial 
2 
0 
1 
0 
0 
0 
Jntravortebral 
0 
0 
0 
0 
0 
0 
! Tax? Hof - dal 
0 
0 
0 
0 
0 
0 
Cervical 
0 
0 . 
1 
0 
o 
o 
Tntrathoracic 
1 
0 
0 
0 
0 
0 
Thornco-abdonline1 
6 
0 
1 
0 
0 
0 
Combined intrn-abdominn1 
& A ntratV' orac ic 
1 
1 
0 
0 
0 
0 
Intrr-abdominal 
5 
3 
1 
4 
1 
1 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
o 
0 
0 
0 
0 
0 
Upper ext, bone A 
soft tissue 
, 0 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
Lower ext. bone & 
soft tissue 
3 
1 - 
0 
0 
1 
0 
Unclas s if1od, multiplo 
0 
2 
0 
0 
0 
0 
TOT AX CASBS 
IB 
7 
4 
L 
2 
1' 
6q TABLE 2LI 
BLOOD TRANSFUSION THERAPY /..FTER SURGERY 
AS RELATED TO PRJUCIFAL WOUND (1) 
IHTT3 OF WHOLE BLOOD; 
(One unit is 500cc) 
0* 
1 
2 
3 
A 
5 
IRINCUPAL WOUUD: 
Intracranial 
267 
11 
10 
2 
A 
1 
Intravertebral 
23 
2 
2 
0 
0 
0 
Maxillofacial x 
6 
1 
1 
0 
0 
0 
Cervical 
20 
A 
0 
1 
0 
0 
Tntratboracic 
112 
13 
5 
A 
3 
1 
T heraco-rbdomina1 
159 
26 
U 
2 
1 
2 
A 
Combined intra-abdominal 
& intrathoracic 
A3 
5 
7 
1 
3 
0 
Intra-abdominal 
207 
AS 
30 
13 
10 
9 
Abdomina1 wall only 
3 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
only 
A 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
9 
0 
1 
0 
0 
0 
Lower ext. soft tissue 
only 
23 
3 
2 
0 
3 
0 
Lower ext. bone & 
soft tissue 
00 
11 
A 
5 
3 
5 
Unclassified, multiple 
93 
10 
7 
2 
2 
0 
TOTAL Cases 
1129 
134 
S3 
30 
30 
20 
(*) Ho record of intravenous 
ad ministration 
of blood 
, or 
none 
given, 
Continuod next page 
70 TABLE XLI Cont!d 
BLOOD TRANSFUSION THERAPY AFTER SURGERY 
AS RELATED TO PRINCIPAL WOUNDS (2) 
"HOL7' BLOOD: 
(One unit is 500cc) 
6 
7 
8 
9 
10 
11 
12 
PRINCIPAL WOUND; 
Intracranial 
1 
0 
1 
0 
0 
0 
0 
Introvertebral 
0 
0 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
0 
0 
Gcrv? cal 
0 
0 
0 
0 
0 
0 
0 
Introthoracic 
/ 
0 
0 
0 
0 
0 
0 
0 
Thoraco-abd ominal 
1 
0 
2 
2 
0 
0 
0 
Combined intro-abdominal 
& intrathorocic 
0 
0 
0 
0 
0 
0 
0 
Tntra-obdominal 
4- 
1 
2 
2 
n 
0 
1 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
0 
Upror ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 
0 
Upper ext. bone & 
soft tissue 
0 
0 
0 
0 
0 
0 
0 
Lower ext. soft tissue 
only 
0 
0 
0 
0 
0 
0 , 
0 
Lower ext. bone & 
soft tissue 
0 
2 
1 
0 
1 
0 
0 
Unclassified, multiple 
0 
0 
0 
0 
0 
0 
0 
TOTAL CASES 
B 
3 
6 
L 
2 
0 
1 
71 TABLE XLII 
SYSTOLIC BLOOD PFOLSURL 01. ALLIS': 101; TO HOSPITAL 
AS PLLATEI TO PRINCIPAL DOLT® (1) 
ARTERIAL TEUDIOU 
IL; i-m. Hg. 
Zero 
2-33 
40-33 
60-o3 
70-73 
80-38 
PRINCIPAL V;0UPD; 
Intracranial 
7 
0 
4 
8 
6 
5 
In t r av e rt eb ral 
o 
J 
0 
2 
0 
0 
2 
Maxillofacial 
0 
0 
1 
0 
0 
0 
Cervical 
2 
0 
1 
0 
1 
0 
Intrathorccic 
3 
0 
2 
2 
j 
7 
Th o r a c o - abac mi n a 1 
3 
1 
7 
6 
5 
10 
Combined intra-abdominal 
7 
0 
3 
3 
0 
3 
& intratlioracic 
In t r a- a be! oui ncl 
30 
1 
13 
9 
8 
14 
Abdominal vail only 
0 
0 
0 
0 
0 
0 
Upper ext. soft tissue 
0 
1 
0 
0 
0 
only 
Upper ext, bone & 
soft tissue 
2 
0 
0 
0 
W 
0 
Lover ext. soft tissue 
1 
1 
0 
0 
0 
1 
only 
Lover ext. bone & 
8 
0 
2 
4 
0 
2 
soft tissue 
Unclassified, multiple 
10 
0 
4 
6 
0 
TOTAL 
88 
3 
' 40 
33 
23 
43 
CASES 
(Continued on next page) 
72 TABLE ALII Contact 
SYSTOLIC BLOOD PRESSURE OK ADMISSION TO HOSPITAL 
AS RELATED TO PRINCIPAL FOUND (2) 
ARTERIAL TENSION 
IN mm. Hg. 
90-98 
100-118 
120-138 
140-158 
160 
or 
more 
No 
record 
PRINCIPLE WOUND: 
Intracranial 
7 
28 
25 
21 
12 
174 
Intravertebral 
2 
4 
0 
0 
0 
14 
Maxillofacial 
0 
0 
0 
0 
1 
6 
Cervical 
2 
1 
k 
1 
0 
13 
Intrathoracic 
6 
3 
7 
0 
0 
98 
Thoraco-abdominal 
2 
21 
8 
3 
0 
141 
Combined intra-abdominal 
3 
3 
2 
0 
0 
35 
& intrathoracic 
Intra-abdominal 
11 
19 
17 
1 
0 
285 
Abdominal wall only 
0 
1 
0 
0 
0 
2 
Upper ext. soft tissue 
0 
0 
0 
0 
0 
1 
only 
Upper ext. bone & 
0 
0 
0 
0 
0 
8 
soft tissue 
Lower ext. soft tissue 
1 
1 
2 
2 
0 
22 
only 
Lower ext. bone & 
4 
5 
2 
2 
1 
84 
soft tissue 
Unclassified, multiple 
1 
2_ 
3 
1 
0 
Ik 
TOTAL CASES 
39 
97 
70 
31 
14 
959 
73 TABLE XLIII 
LOY'EST RECORDED SYSTOLIC BLOOD PRESSURE* FOR CASES IN SHOCK 
AS RELATED TO PRINCIPAL WOUND 
ARTERIAL TENSION 
IN mm. Hg 
Zero 
2-38 
40-53 
60-78 
80-88 
90-98 
PRINCIPAL W0U1®; 
Intracranial 
16 
0 
5 
18 
10 
10 
Intravertebral 
3 
0 
3 
1 
2 
5 
Maxillofacial 
0 
0 
1 
0 
0 
0 
Cervical 
4 
0 
2 
0 
1 
3 
Intrathoracic 
13 
0 
2 
i 
7 
10 
9 
Thoraco-abdominal 
18 
1 
10 
23 
12 
5 
Combined intra-abdominal 
11 
0 
3 
4 
6 
l 
& intrathoracic 
Intra-abdominal 
58 
3 
19 
21 
18 
16 
Abdominal wall only 
0 
0 
0 
0 
0 
0 
Upper ext* soft tissue 
only 
2 
0 
1 
0 
0 
0 
Upper ext. bone & 
3 
0 
0, 
0 
0 
0 
soft tissue 
Lower ext., soft tissue 
3 
1 
0 
2 
1 
1 
only 
Lo\er ext. bone & 
14 
1 
4 
12 
3 
3 
soft tissue 
Unclassified, multiple 
13 
0 
5 
9 
6 
5 
TOTAL CASES 158 
6 
57 
97 
69 
58 
* Excludi ng a gradual terminal 
decline 
immediately preceding 
death. 
7^ TABLE XLIV 
NATURE OF EVIDENCE FOR SHOCK IN CASES T.TTHCUT RECORDED HYPOTENSION 
AS RELATED TO PRINCIPAL HOUND 
B.P. 100 
or more 
but pulse 
rapid & 
weak* 
BoP, 100 Presence Shock 
or more of shock suspected 
but shock recorded by infer- 
recorded ence 
Therapy 
suggests 
shock 
No evi- 
dence of 
shock 
PRINCIPAL WOUND: 
ntracranial 
10 
0 
30 
13 
63 
122 
ntravertebral 
0 
0 
3 
0 
4 
6 
axillofacial 
0 
0 
0 
1 
4 
2 
ervical 
1 
0 
3 
1 
5 
5 
ntrathoracic 
o 
p 
0 
23 
24 
40 
7 
loraco-abdominal 
5 
0 
44 
17 
72 
5 
umbined intra-abdominal 
0 
0 
10 
1 
19 
2 
& intrathoracic 
itra-abdominal 
8 
2 
93 
45 
119 
6 
odominal wall only 
0 
0 
0 
0 
0 
3 
bper ext. soft tissue 
0 
0 
0 
i 
0 
0 
only 
Dper ext. bone & 
0 
0 
0 
0 
4 
3 
soft tissue 
b' er ext. soft tissue 
0 
0 
10 
3 
4 
6 
only 
Bwer ext. bone & 
1 
0 
2b 
ll 
34 
5 
soft tissue 
Uclassified, multiple 
1 
0 
31 
17 
20 
7 
TCTiX Cases 
29 
2 
273 
134 
388 
179 
*No comment on shock in 
the case 
renorts. 
75 TABLE XLV 
URINARY OUTPUT AS RELATED TO PRINCIPAL ,,rOUUD 
URINARY EXCRETION 
Output Apparently Anuria* 
adequate adequate 
but record 
incomplete 
Oliguria/ Oliguria No 
recorded suspected record 
IRT-CITAL WOUND; 
Intracranial 
3 
9 
2 
3 
2 
278 
Tntravertebral 
0 
3 
0 
1 
2 
21 
Maxillofacial 
0 
0 
0 
0 
0 
B 
Cervical 
2 
1 
0 
1 
0 
21 
Intratboracic 
5 
2 
1 
2 
0 
128 
Tboraco-abdominal 
7 
6 
5 
U 
7 
173 
Combined intra-abdominal 
& intrathoracic 
2 
0 
0 
7 
0 
50 
Tntra-abdominal 
12 
7 
13 
32 
11 
333 
Abdominal wall only 
0 
0 
0 
0 
0 
3 
Urper ext. soft tissue 
only 
0 
0 
0 
1 
0 
3 
Upper ext. bone Sc 
soft tissue 
1 
0 
0 
0 
0 
9 
Lower ext. soft tissue 
only 
1 
1 
1 
3 
1 
24 
Lower ext. bone Sc 
• 
soft tissue 
3 
3 
0 
9 
0 
99 
Unclassified multiple 
1 
1 
0 
L 
2 
106 
TOTAL 
37 
33 
22 
77 
25 
1256 
CASES 
(*) Less than lOOcc 
per diem 
• 
(/) 100 to 800cc per 
1 diem. 
76 TABLE XLVI 
rUSCELUNEOUS OBSERVATIONS iJ3 RELATED TO PRINCIPAL WOUND 
Burns 
Coma on 
Exposure, 
Hemorrhage, 
Peritoneal 
Tourni- 
present 
admission 
severe, 
before 
admission 
profuse, 
after ad- 
mission 
closure 
impossible 
quet 
us ed 
before 
admis- 
s ion 
KENCIE/X WOUND: 
racranial 
4 
16? 
4 
15 
0 
1 
ravertebral 
0 
1 
0 
0 
0 
0 
illofacial 
1 
1 
0 
0 
0 
0 
vical 
0 
4 
0 
5 
0 
1 
rathoracic 
3 
9 
1 
0 
0 
1 
raco-abdominal 
i 
0 
3 
4 
1 
bined intra-abdominal 
0 
3 
0 
1 - 
1 
1 
Sc intrathoracic 
ra-abdominal 
0 
y 
8 
2 
29 
3 
7 
eminal wall only 
0 
0 
0 
0 
0 
0 
3r ext. soft tissue 
0 
1 
0 
0 
0 
0 
>nly 
Br ext. bone & 
0 
1 
0 
0 
0 
.3 
soft tissue 
Jar ext. soft tissue 
1 
1 
1 
1 
0 
3 
snly 
sr ext. bone & 
4 
4 
1 
3 
0 
1-9 
5oft tissue 
t'.assified, multiple 
ii 
16 
1 
1 
0 
55 
TOTiX 
28 
218 
10 
58 
8 
4-2 
CAS3S TABLE XLVXI 
DATA RELATIVE TO DISTRIBUTION OF DEATHS 
IN FIELD AND EVACUATION HOSPITALS 
TYIA 0? HOSPITAL TN 
WEIGH PATTEHT DIED 
Field 
Hospital 
Evacuation* 
Hospital 
Transfer 
a) 
Transfer 
(2) 
PRINCIPAL WOUND: 
Intracranial 
25 
272 
4 
32 
Int ra vc r t e br a 1 
2 
25 
0 
5 
Maxillofacial 
0 
8 
0 
1 
Cervical 
9 
16 
0 
1 
Tntrathoracic 
54- 
3 
8 
Thor c co- -'bd ominal 
113 
99 
7 
2 
C ombincd intra-abdominal 
& intr"thoracic 
29 
30 
1 
0 
Int r a - abd o m in a 1 
215 
193 • 
7 
3 
Abdominal wall only 
1 
2 
1 
0 
Upper ext. soft tissue 
only 
1 
3 
0 
0 
Upper ext. bone & 
soft tissue 
2 
8 
1 
3. 
Lower ext. soft tissue- 
' 
only 
5 
26 
. 2 
0 
Lower ext. bone & 
soft tissue 
32 
82 
2 
2 
Unclassifled, multiple 
17 
97 
2 
10 
TOTAL 
505 
94 5 
30 
65 
CASES 
(*) In clud ing f igurcs 
in third and 
fourth columns. 
(1) primary surgery 
done in field 
hospital, nd patient died in 
cvacua- 
tion hospital after transfer.. 
(2) p-tient seen in 
field hospital 
and transferred 
to evacuation 
hospital 
for primary surgery. 
78 TABLE xlyiii 
POST MOFTET EUITNATIOir. Ar FLLATEX' TO PRINCIPAL ’ OUliD 
No 
Gross 
Gross 
Gross 
autopsy 
reported, 
reported 
and 
done 
but no 
micro. 
mi era 
micro- 
not re- 
reported 
scopic 
ported 
PRINCIPAL " CULL : ‘ 
Intracranial 
141 
48 
10 
98 
Intravertebral 
13 
1 
1 
12 
Kaxillofacial 
2 
3 
0 
3 
Cervical 
8 
9 
1 
7 
Intrathorccic 
69 
2 
33 
Thoraco-abdominal 
79 
76 
13 
44 
Cor bined intra-abdominal 
• 13 
22 
1 
21 
& intra-thoracic 
Intra-obdomina1 
193 
130 
14 
71 
Abdominal rail only 
2 
0 
0 
1 
Upper ext. soft tissue 
3 
1 
0 
0 
only 
Upper ext. bone & 
6 
2 
0 
2 
soft tissue 
Lov.er ext. soft tissue 
11 
3 
3 
10 
only 
6j 
Lover ext. bone & 
20 
10 
24 
soft tissue 
• , 
Unclassified, multiple 
73 
14 
4 
. 23 
TOTAL 
CAS3S 
675 
365 
61 
3k 9 
79 SECTION III 
CAUSES OE DEATH 
Part 1 
C-eneral Observations PRELIMINARY REMARKS 
Section III deals with causes of death, and is perhaps the most 
interesting part of the report. More time and thought have been 
expended in its preparation than in the preparation of any other 
section. Certain problems were encountered in the classification and 
arrangement of this material. The Adjutant General of the Fifth 
Army and the Adjutant General of the United States Army report battle 
casualty deaths as f!killed in action0 or "died of wounds0 (the 
latter includes those dying of injuries incurred in action). Hos- 
pitals report deaths according to a classification of principal 
wounds. Generally speaking, all battle casualties who die, are said 
to die of wounds or injuries incurred in action. All of the cases 
reported in this study may be said to have died, of wounds and/or 
injuries incurred in action against the enemy. Table LVII on page 
96 classifies the cases as to region of primary trauma leading to 
death. This classification is comparable to those mentioned above. 
For the purposes of this study, however, such classifications have 
been deemed inadeouate. 
A battle casualty who suffers a laceration of the popliteal 
artery may or may not loose sufficient blood to lea.d to severe shock, 
and death. If he does, the primary cause of death according to 
conventional reports is a wound of the posterior aspect of the knee, 
with laceration of the popliteal artery. For the purposes of this 
report, the important desideratum in such a case is that the 
immediate or precipitating cause of death is shock (peripheral 
vascular failure). 
81 While fully aware of the controversial nature of the subject, 
we have elected to include the uncorrected state of shock as an im- 
mediate or precipitating cause of death, along with other more specific, 
standard diagnoses. It may be contended of course, that such patients 
actually die of their wounds and the severity of the trauma attending 
them, and that the shock which is present is a syndrome reflecting 
a profound pathologic alter-a tion of normal hemodynamics and is not 
an acceptable diagnosis. However, in this study, as stated above, 
each case has been classified as to primary trauma leading to death 
(the conventional primary or basic diagnosis), and the liberty of 
employing the concept of the state of shock as a "diagnosis" for the 
immediate or precipitating cause of death (the conventional secondary 
diagnosis) allows for a more complete classification of the causes of 
death for comparison and study. This sots in relief that important 
group of cases which succumbed from the gravity of their wounds in a 
state of uncontrolled shock. It seems that this group of cases is 
worthy of the special attention afforded by such a classification. 
Shock was selected as the immediate cause of death in 523 cases 
in our series. A special study was made on this groun and is pre- 
sented in Section V. The criteria used in naming shock as an immediate 
cause of death are discussed there and are apparent in the information 
tabulated. 
"Neural trauma and/or intracranial hemorrhage or clot" was listed 
as the immediate cause of death in 213 cases and is second on the 
list of the immediate causes of dea,th in Table XLIX, The relative 
inportance as lethal factors of the brain damage produced by the missile 
82 and the damage produced by an expanding intracranial hematoma was 
often difficult to determine. It seemed unwise, considering the in- 
formation available and our Qualifications to evaluate it, to attempt 
to separate these cases into two groups. It may he mentioned here that 
only 15 cases in whom the principal wound was intracranial were listed 
as dying of shock, while 210 were listed as dying of neural trauma or 
clot. (AH of the 235 cases in these two categories were listed also 
under the heading "Primary trauma, leading to death, intracranial"). 
Tables L to LII deal with the twelve leading causes of death. 
Nephropathies were third on the list, and their incidence was relatively 
constant except during the first three months of the period covered by 
this report. The low incidence at that time may be attributed to 
failure of recognition and is therefore apparent rather than real. 
In the first period covered clostridial myositis was the third 
leading cause of death, the 35 cases comprising 6,5$ of all deaths, and 
0.28$ of hospital battle casualty admissions. In the last period it 
fell to the bottom of the list, with only one death attributed to it, 
comprising 0.6$ of the deaths studied, and only 0.01$ of all battle 
casualties admitted to The educational program concerning 
clostridial myositis and study of the -problem conducted by Major Floyd 
Jergesen and Lt, Colonel F,A, Simeone, more complete surgery on all 
wounds, the more liberal use of blood, and the advent of the extensive 
% 
use of -penicillin were important factors in effecting this striking 
reduction in mortality (and the corresponding reduction in the incidence 
which is evident in reports to Fifth Army). 
Peritonitis tended to show a slight increase in its percentage of 
the total battle casualty admissions and a more pronounced increase 
S3 in its percentage of the deaths studied. There are two factors which 
may have contributed. First is the reduction in mortality from shock, 
clostridial myositis, extremity wounds (See Tables LVII & LVIII), and 
unclassified wounds in the course of the 17 months covered by the study. 
This has led to a relative increase in peritonitis deaths, deaths from 
intracranial wounds, and other wounds or complications, the incidence 
of which is at this time more or less inevitable. The second factor 
is the increase in the percentage of autopsies performed (See Appendix 
E), which probably accounts for the apparent but slight increase in the 
number of peritonitis deaths as compared to hospital battle casualty 
admissions. 
The only striking variation in mortality from pneumonia is in the 
April-July period, in which pneumonia deaths comprised only 1.2$ 
of the deaths studied as compared to the average of 3»kfo for all four 
periods. It is the only one of the four periods which did not include 
winter months. 
Attention is directed to the incidence of fat embolism. This 
diagnosis was not recorded except when microscopic reports indicated 
large amounts of fat in the pulmonary sections and the record indicated 
a clinical behaviour Justifying the diagnosis. It may be noted (See 
Table LXX) that the diagnosis of fat embolism was evident in 22 
additional cases in which it was listed as contributory condition 
rather than the immediate cause of death. 
Thrombotic embolism, & tracheobronchial obstruction from aspirated 
voraitus, blood, or mucus, appear quite prominently in the leading causes 
of death. Their relative incidence showed a definite increase and the 
actual incidence perhaps a slight increase in spite of recognition of their 
importance & inauguration of prophylactic measures early in the campaign. TABLE XLIX 
IMMEDIATE CAUSE OF DEATH 
SHOCK 5?3 
NEURAL (BRAIN) TRAUMA &/OH 
INTRACRANIAL HEMORRHAGE OR CLOT 213 
PIGMENT NEPHROPATHY 6S 
PERITONITIS 65 
CLOSTRIDIAL MYOSITIS 51 
PNEUMONIA 3+9 
PAT EMBOLISM 27 
THROMBOTIC EMBOLISM 20 
1 
SPINAL CORD TRAUMA l6 
TRACHEO-BHONCHIAL OBSTRUCTION, 
ASPIRATED VOMXTUS 11 
TRACHEO- BRONCHIAL OBSTRUCTION, 
BLOOD AND MUCUS 11 
CEREBRAL ISCHEMIA g 
ANESTHETIC AGENT 7 
EMPYEMA. THORACIS 7 
INTRACRANIAL BLAST TRAUMA ALONE 5 
CELLULITIS (Extra neritoneal) h 
MYOCARDIAL DECOMPENSATION k 
CORONARY OCCLUSION 3 
PULMONARY BLAST TRAUMA ALONE 3 
RESPIRATORY OBSTRUCTION ABOVE TRACHEA 3 
ABSCESS, INTRA-ABDOMINAL 2 
Continued on next *oage 
83 TABLE XII.£ Cont 'd 
IMMEDIATE CAUSE OF DEATH (Cont) 
AIH, EMBOLISM 2 
INFARCTION OE LUNG 2 
INTESTINAL OBSTRUCTION 2 
INTRACRANIAL BLAST & OTHER TRAUMA 2 
MENINGITIS, INTRACRANIAL 2 
PULMONARY BLnST AND OTHER TRA.UMA 2 
VENTRICULAR ARREST 2 
ABSCESS, INTRACRANIAL 1 
INFARCTION, BRAIN & LUNG X 
MELIASTINIAL HEMORRHAGE 1 
MEDIASTINITIS 1 
MENINGITIS, SPINAL 1 
PNEUMONITIS 1 
RESPIRATORY FAILURE, CAUSE UNDETERMINED 1 
SEPSIS UNCLASSIFIED, ABDOMINAL 1 
SEPSIS UNCLASSIFIED, EXTREMITY 1 
SEPTICEMIA 1 
TEORACO„ABDOMINAL TRAUMA, UNCLASSIFIED 1 
TRANSFUSION REACTION 1 
OTHER INTRA-ABDOMINAL CONDITION 2 
OTHER INTRACRANIAL CONDITION 1 
UNDETERMINED THORACIC CONDITION 12 
Continued on next nage 
86 TABLE XUX Cont'd 
IMMEDIATE CAUSE OF DEITH (Cont) 
UNDETERMINED 
INTRA-A3D0MINAL CONDITION 
4 
UNDETERMINED ABDOMINAL WALL CONDITION 
1 
-L 
UNDETERMINED 
INTHACRANIAL CONDITION 
1 
UNDETERMINED UNGLASS HI ED 
-JOi* 
TOTAL? 
li+50 
* See Volume 
Two for analytical data on 
this .^rouT), 
8? TABLE L 
THE LEADING- CAUSES CF DEATH IN 1)450 BATTLE CASUALTY DEATHS, 
SHOWING THE NUMBER OF CASES BY PERIOD 
JAIL .MAH 
19U1+ 
APR-JULY 
19UU 
AUG-DEO 
19^ 
JAN-MAY 
lQ)j-5 
TOTAL 
Shock 
1S3 
IQU 
91 
55 
523 
Neural trauma &/or intra- 
cranial hemorrhage or clot 
65 
66 
U5 
36 
212 
Ncuhrouathy 
9 
25 
26 
8 
68 
Peritonitis 
13 
26 
IQ 
7 
65 
Clostridial myositis 
33 
11 
k 
1 
51 
Pneumonia 
20 
6 
17 
6 
Fat embolism 
5 
Q 
Q 
27 
Thrombotic embolism 
3 
12 
1 
2 
20 
S-pinal cord trauma 
6 
1 
6 
3 
16 
Tracheo-bronchial obstruc- 
tion, a.spirated voraltus 
3 
1 
3 
k 
11 
Tracheo-bronchlal 0 os trac- 
tion:, blood & mucus 
1 
k 
3 
3 
11 
Cerebral ischemia 
2 
1 
2 
3 
8 
Others in vhich immediate 
cause of death is kno^n 
28 
25 
2k 
9 
86 
Hemainder in which immediate 
cause of death is undeter- 
mined, unclassified 15^- 
101 
3k 
Ik 
303 
TOTAL: 
529 
US2 
28U 
155 
1U5O 
88 TABLE LI 
THE LEADING CAUSES OE DEATH IN 1U50 BATTLE CASUALTY DEATHS, 
SHOWING PERCENTAGE DISTRIBUTION BY PERIOD. 
JAN-MAH APH-JULY 
19HH 19^ 
AUGL.DEC 
13kk 
JAIL-MAY 
19U5 
JAN-I+1+ 
thru 
MAY-1+8 
Total Cases 
529 
1+82 
28U 
135 
IU50 
Shock 
3h,6/, 
1+0*3 $ 
32.056 
35-5^ 
36.1 $ 
Neural Trauma &/or Intra- 
cranial Hemorrhage or Clot 
12.3 
13.7 
15.a 
23.2 
1U.7 
Nephropathy 
lo7 
5.2 
9.2 
5*2 
Peritonitis 
2.5 
5^ 
6.7 
1+.5 
Clostridial Myositis 
6.5 
2,3 
l0l+ 
0.6 
3*5 
Pneumonia 
2*6 
1.2 
6c0 
3*9 
3.^ 
Fat Embolism 
0,9 
1.9 
3.2 
2,6 
1.9 
Thrombotic Embolism 
0„9 
2,5 
o,i+ 
1.3 
l.U 
Soinal Cord Trauma 
1,1 
0.2 
2,1 
1.9 
Id 
Tracheo-bronch:lal Obstruction, 
Asn 1 rated 7omi t ..s 
0.5 
0.2 
1.1 
2.6 
0,8 
Tr ache o-bro nohi ax Obstraction0 
Blood & Mu u& 
0.2 
0,8 
lol 
lc9 
0.8 
Cerebral -''schemla 
0,2 
0,7 
1.9 
0,6 
. TOTAL■ 
6K Zi> 
VjM 
T^.li 
85.1$ 
73.$ 
89 TABLE LII 
THE LEADING- GAUGES OE DEATH I IT 1U50 BATTLE CASUALTY DEATHS f 
SHOWING- THE PEHCEITTAGB OE THE TOTAL BATTLE CASUALTY 
ADMISSIONS* BY PEHIODS 
JAIL. MAH 
1944 
APH-JUL 
1944 
AUG-EEC 
1944 
JA E-MAY 
1945 
JA3SL44 
thru 
MAY-45 
Shock 
l .38$ 
.08$ 
0o 676 $ 
0.750$ 
.960$ 
Neural Trauma &/or Intra- 
crania,! Hemorrhage or Clot 
.49 
.35 
0.33^ 
0.490 
0.390 
Peritonitis 
0.063 
0I26 
0.193 
0.110 
.125 
Clostridial Myositis 
0o 280 
0.055 
0.030 
0.010 
0.094 
Pneumonia 
0.160 
0.030 
0.126 
O', 080 
0.090 
Pat Embolism 
c,.o4o 
o.o4o 
0.067 
0.050 
0.050 
Thrombotic Embolism 
j.040 
O0O60 
0.010 
0.030 
0c04o 
Suinal Cord Trauma 
O.C50 
0.005 
0.050 
0*040 
0.030 
Tracheo-bronchial Obstruetion 
Aspirated Vomitus 
0.020 
0,005 
0.020 
0.050 
0.020 
Tracheo-bronchial Obstruction 
Elood & Mucus 
0.010 
0.020 
0.020 
o.o4o 
0.020 
Cerebral Ischemia 
0.020 
0,005 
0.015 
o.o4o 
0,015 
♦Corrected to allow for the uercenta^e 
of hosuital battle 
casualty deaths 
not studied in each ueriod. 
See Anuendiz. 
90 TABLE LIII 
PEGIOH 0? MEDIATE CaUSE 0E DEATH 
HUMBEP OE CASES BY PERIOD 
I9UU 
APIUJUL 
19UU 
AUG-DEC 
IQUU 
JAE-MAY 
19U5 
TOTAL 
Shock * 
183 
1°2 
°3 
55 
523 
Intracranial 
73 
71 
U8 
U2 
23U 
Thoracic 
U7 
21 
158 
Ahdomi non elvi c 
30 
UT 
18 
15U 
Sxtrenifcy 
32 
8 
3 
2 
U5 
Spinal 
6 
1 
9 
3 
19 
Miscellaneous (general) * 5 
3 
3 
0 
11 
Cervical 
1 
1 
0 
0 
2 
Maxillofacial 
0 
1 
0 
0 
1 
Undetermined, 
unclassified 15U 
101 
3^ 
lU 
303 
TOTAL 
529 
Us 2 
2SU 
155 
IU50 
•Generalized conditions invlving more than one 
region 
91 liv 
3EGI0H OF HilEDLTTE CAUSE OF DEATH 
PEHCEHTAGE DISTRIBUTION 3Y PEHIOD 
JAK.MA3. 
APH..JUL 
1QUU 
AUG-DEC 
1QUU 
jail. Hay 
loi+5 
TOTAL 
Shock* 
314.6" 
c4 
32.7^ 
35=50 
36.1;? 
Intracranial 
13-7 
ik.l 
16,9 
27a 
16a 
Thoracic 
g0U 
9,U 
16.5 
13.6 
110 *'9 
AMominopelvic 
12,3 
16.5 
11,6 
10.6 
Extremity 
6.0 
1-7 
1.1 
1.3 
3-1 
Spinal 
i.i 
0 02 
3-2 
1.9 
1.3 
Miscellaneous 
(general)* o»9 
O.U 
oa 
0.0 
0.8 
Cervical 
0o6 
0 = 2 
0*0 
0.0 
0.1 
Maxillofacial 
0 .0 
0 o 2 
0.0 
0.0 
Ool 
Undetermined, 
unclassified 29.1 
21.0 
12o0 
9.o 
20.9 
TOTAL 
, ICO# 
100# 
100# 
100# 
100# 
* Generalized 
conditions involving 
more than 
one region. rT'I:BLV') LV 
3EGI0H OE PHJNCIPAL WOUND COM?ABED 
WITH HUG ION OE IMMEDIATE CAUSE OE DEATH 
Pegion of 
pri nofoal 
wund 
Percentage 
of cases 
studi ed 
Regions of 
of cause 
death 
Percen- 
tage of 
cases 
s tudi ed 
All do mi nr 1 
5^3 
37.5:* 
13k 
10, 6$ 
Intracranial 
297 
20c 5 
23k 
l6.1 
Thoracic 
277 
19.1 
158 
O 
0 
O 
1—1 
Sxtremity 
159 
11,0 
U5 
3.1 
Int ravert ebral 
27 
1,8 
19 
1.3 
Cervical 
25 
1.7 
2 
0.1 
Maxillofacial 
8 
0.5 
1 
0,1 
Unclassified 
Ilk * 
7*9 
303 /■ 
20,9 
General x 
11 
0,8 
Shock 
523 
36,1 
TOTAL 
Ihw 
Cases 
\R 
o 
o 
r—i 
1^50 
Cases 
100$ 
* Multiple wands. 
/• Cause of death 
undetermined. 
x More than one 
region involved by ca 
use of death. 
excludi ng 
shock. 
93 TABLE L'rI 
REGION OF IMMEDIATE CAUSE OF DEATH AS RELATED TO 
REGION OF PRINCIPAL WOUND (l) 
Abdonv. 
Cer- 
Extremity 
Intra- 
Maxillo- 
CAUSE OF DEATH 
inal 
vi cal 
cranial 
facial 
PRINCIPAL WOUND 
• 
Intracranial 
2 
0 
3 
221 
0 
Intraver t ebral 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
Cervical 
1 
2 
0 
k 
0 
Intrathoracic 
3 
0 
1 
3 
0 
Tho r ac o- abdo mi nal 
25 
0 
0 
1 
1 
Combined intra-abdominal. 
Ik 
0 
0 
1 
0 
& intrathoracic 
In t r a- abdo mi nal 
S9 
0 
1 
0 
0 
Abdominal wall only 
l 
0 
0 
c 
0 
Upper ext. soft tissue 
l 
0 
0 
0 
0 
only 
Upper oxt. bono & 
0 
0 
1 
0 
0 
soft tissue 
Lower oxt. soft tissue 
5 
0 
g 
0 
0 
only 
Lower oxt. bone & 
S 
0 
22 
1 
0 
soft tissue 
Unclassified, multiple 
5 
0 
3 
3 
0 
TOT^L 
15U 
2 
U5 
23 k 
1 
Continued on next page 
9/r TABLE UrI Gont’d 
REGION of immediate cause of death as belated to 
REGION OF PRINCIPAL WOUND (2) 
Sninal 
Thoracic 
General* 
Shock Undetermined, 
GAUGE CE DEATH 
unciassified 
phincipal wound 
I ntra. cranial 
1 
15 
0 
15 
4o 
Intravertobral 
16 
1+ 
0 
4 
3 
Maxillofacial 
0 
3 
0 
1 
4 
Cervical 
0 
4 
0 
11 
3 
Intrathoracic 
0 
37 
1 
70 
23 
Thoraco-abdominal 
0 
20 
1 
11s 
46 
Combined intra-abdominal 
0 
7 
1 
25 
11 
& intrathoracic 
Intra-abdominal 
0 
33 
4 
178 
91 
Abdominal wall only 
0 
1 
0 
0 
1 
Uopor ext. soft tissue 
0 
0 
0 
2 
1 
only 
Uryoer ext. bone & 
0 
0 
1 
3 
5 
soft tissue 
Lower ext. soft tissue 
1 
3 
1 
9 
4 
only 
Lower ext. bone & 
0 
15 
2 
41 
20 
soft tissue 
Unclassified, multi-nlo 
1 
10 
0 
1+6 
46 
TOTAL 
10 
15s 
11 
523 
303 
* Involving more than one 
region? 
a miscellaneous stout), 
excludi n^ 
shock. 
95 TABLE LTrII 
REG I Oil OF PRIMARY TRAUMA LEADING TO DEATH 
HUMBER OF CASES 3Y PERIOD 
JAE-MAH 
iQl|U 
APE.JUL 
19UU 
AUG--DEC 
19UU 
JAK-MAY 
19U5 
TOTAL 
Primary Trauma 
Abdo mi nor el vi c 
12k 
131 
80 
33 
36S 
Intracranial 
97 
81 
57 
U6 
281 
Tho r ac o- abdo mi nal 
6a* 
7^ 
23 
20 2 
Extromi ty 
S3 
58 
28 
9 
17S 
Unclassified, multiple 
S3 
55 
25 
12 
175 
Thoracic 
UU 
30 
11 
134 
Combined thoracic & 
abdominal 
18 
17 
10 
8 
53 
Cervical 
8 
10 
2 
6 
26 
Spinal 
7 
1+ 
8 
6 
25 
Maxillofacial 
1 
3 
1 
1 
6 
Undetermined * 
2 
0 
0 
0 
2 
TOTAL 
529 
U82 
2Sk 
155 
1^50 
*Hecord inadequate in 
description 
of wounds. 
96 TABLE UrIII 
REGION OE PRIMARY TRAUMA LEADING- TO DEATH 
PEECENTAGE DISTRIBUTION 3Y PERIOD 
J AU-MAP 
13kk 
APH-JUL 
iqi+U 
AUGw-DEC 
IQl+U 
JAIL MAY 
I9U5 
TO Till 
Primary Trauma 
Abdominopelvic 
23*5% 
27-2/0 
28, 2<f0 
21, % 
25.^ 
Intracranial 
is,3 
i6,s 
20 ol 
29.7 
19. k 
Tho r a c o-abdo mi nal 
11.7 
15.3 
15-1 
lU.8 
13.9 
Extremity 
15.7 
12.0 
9-9 
5-8 
12.3 
Unclassified,, multiple 
15.7 
11. k 
8.8 
7-7 
12.1 
Thoracic 
8.5 
10.2 
10.5 
7-1 
9.2 
Combined thoracic & 
abdominal 
3.^ 
3.6 
3-5 
5-2 
3-7 
Cervical 
1-5 
2c 1 
.7 
3.9 
I08 
Sninal 
1.3 
c 8 
2.8 
3.9 
1.7 
Maxillofacial 
0 2 
. 6 
• 6 
.U 
Undetermined 
.U 
.0 
.0 
• V- 
.1 
TOTAL 
100$ 
100$ 
100$ 
100$ 
100$ 
97 TABLE LIX 
PRIMARY TRAUMA LEADING TO DEATH AS RELATED TO PRINCIPAL WOUND 
HECrICN 
Prf. ncipal 
Wound, Wo. 
of Cases 
Primary 
Trauma, Wo. 
of Gases 
AMc mi nop el vl c 
4ll 
368 
Combined intra-abdominal 
& intra-thoracic 59 
53 
Thoraco-abdominal 
212 
202 
Thoracic 
138 
134 
Cervical 
25 
26 
Ex’cremi by 
159 
178 
Intracranial 
207 
281 
Maxillofacial 
S 
6 
Intravertebral 
27 
25 
Unclassified, multiple 
114 
177 
TOTAL! 
1U50 
1450 
98 TABLE LX 
KEG I ON OF PRIMARY TRAUMA LEADING TO DEATH AS RELATED TO 
REGION OF PRINCIPAL WOUND (l) 
Abdomino- 
Cer- 
Combined Extreme 
Intra- 
Maxi110- 
PRIMARY TRAUMA 
pelvic 
vical 
thoracic 
ity 
cranial 
facial 
& abdo- 
minal 
PRINCIPAL WOUND 
Intracranial 
1 
0 
0 
. U 
276 
0 
Intravertebral 
0 
0 
0 
0 
0 
0 
Maxillofacial 
0 
0 
0 
0 
0 
6 
Cervical 
0 
2k 
0 
0 
0 
0 
Intrathoracic 
0 
1 
0 
2 
0 
0 
Tho rac o-abdominal 
2 
0 
0 
0 
0 
0 
Combined intra-abdominal 0 
0 
51 
0 
1 
0 
& intrathoracic 
Intra-abdominal 
363 
0 
0 
10 
0 
0 
Abdominal wall only 
1 
0 
0 
0 
0 
0 
Upper exto soft tissue 
0 
0 
0 
1+ 
0 
0 
only 
Upper ext. bone & 
0 
0 
0 
9 
0 
0 
soft tissue 
Lower ext, soft tissue 
0 
0 
0 
30 
0 
0 
only 
Lower cxt„ bone & 
0 
0 
2 
110 
0 
0 
soft tissue 
Unclassified, multiple 
1 
1 
0 
9 
k 
0 
TOTAL 
368 
26 
53 
172 
281 
6 
Continued on next page 
99 LX Cont’d 
REGION OP PRIMARY TRAUMA LEADING TO DEATH AS RELATED TO 
REGION OP PRINCIPAL WOUND (2) 
Spinal Thoracic 
Thoraco- 
Undetermined, 
Undetermined, 
PRIMARY TRAUMA. 
abdominal 
multiple 
no information 
PRINCIPAL WOUND 
Intracranial 
0 
0 
0 
16 
0 
Intravertebral 
25 
0 
0 
2 
0 
Maxillofacial 
0 
0 
0 
2 
0 
Cervical 
0 
0 
0 
1 
0 
Intrathoracic 
0 
123 
1 
11 
0 
Tho rac o-abdo mi nal 
0 
2 
200 
8 
0 
Combined intra-abdominal 
0 
0 
0 
7 
0 
& intrathoracic 
I n t r a- ab do mi nal 
0 
1 
1 
33 
0 
Abdominal wall only 
0 
0 
0 
2 
0 
Upper ext. soft tissue 
0 
0 
0 
0 
0 
only 
Upper ext. bone & 
0 
0 
0 
1 
0 
soft tissue 
Lower ext. soft tissue 
0 
0 
0 
1 
0 
only 
Lower ext. bone & 
0 
0 
0 
2 
0 
soft tissue 
Unclassified, multiple 
0 
8 
0 
S9 
2 
TOTAL 
25 
202 
.... 175 
2 
100 REMARKS 
The Tables which follow deal with the total reported incidence 
of immediate and contributing causes of death. In this report, they 
are the best source of information regarding the incidence of any one 
condition. All of the figures in the left hand column under ’’Immediate 
Cause of Death" represent evident or confirmed incidence. The figures 
in the middle column represent both evident and suspected evidence but 
in every instance they are separated and prouerly identified by the 
index column. The same applies to the total figures in the right 
hand column. 
We believe the figures are lower than the actual incidence inas- 
much as they represent only the reported incidence, knowing that at 
times the records are not complete. The incidence figures on shock are 
perhaps nearer the actual than most of the other figures, because 
many indications of the presence of shock may be found in the record 
when it is present. 
101 TABLE LXI 
total reported* incidence of shock in 14.50 
BATTLE CASUALTY DEATHS (l) 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
SHOCK 
Cardiorespiratory embar- 
rassment plus trauma & 
hemorrhage 
147 
135 
282 
SHOCK 
Gardiorcspe embarrassment plus 
trauma & hemorrhage plus con- 
tamination or sepsis 
72 
u* 
00- 
- 
o 
cm 
H 
SHOCK 
Contamination or sepsis plus 
trauma & hemorrhage 
120 
186 
306 
SHOCK 
Trauma & hemorrhage 
IS 2 
■ \ 
370 
552 
SHOCK 
Type undetermined 
2 
1 
3 
TOTAL 
523 
750 
1273 
*P rob ably somev/hat lovrcr than the 
actual incidence* 
Continued next page. 
102 TABLE LXI Cont'd 
TOTAL REPORTED* INCIDENCE OF SHOCK 
IN L450 U.S. BATTLE CASUALTY DEATHS (2) 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
SHOCK 
Corrected by therapy 0 
339 
339 
SHOCK 
Suspected,not proven 0 
76 
76 
SHOCK 
Successful correction doubtful 0 
207 
207 
SHOCK 
Un corrected 523 
128 
651 
TOTAL 523 
750 
1273 
Shock death suspected 0 
128 
123 
*F robably somewhat lower than the actual incidence. 
103 TABLE LXII 
TOTAL REPORTED* INCIDENCE 0? INTRACRANIAL CONDITIONS 
IN U50 U. S. BATTLE CASUALTY DEATHS 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported ' 
Incidence 
Abscess 
1 
10 
11 
Blast trauma, evident 
7 
17 
24- 
Blast trauma, suspected 
0 
29 
29 
Cerebral death suspected 
0 
57 
57 
Enccphalomalac ia 
0 
60 
60 
Fungus, cerebral, septic 
0 
2 
2 
Hygroma 
0 
4 
4- 
Is chcmia 
8 
u 
22 
Meningitis 
2 
7 
9 
Trauma and/or hemorrhage, evident, 
unclassified / 
213 
155 
368 
/ 
Intracranial trauma,' unclassified, 
V 
suspected 
0 
16 
16 
Other intracranial condition 
1 
0 
1 
Undetermined intracranial 
condition 
1 
0 
1 
somewhat loner them the a 
ctual incidence» 
/As distinguished from blast trauma 
* 
104. TABLE LXIII 
total reported* incidence of MAXILLOFACIAL CONDITIONS 
IN 14-50 BATTLE CASUALTY DEATHS 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
Maxillofacial trauma 
0 
182 
182 
Maxillofacial hemorrhage 
0 
9 
9 
Respiratory obstruction due 
- 
- 
- 
to plugging of airway 
1 
2 
3 
Respiratory obstruction 
due to edema or hemorrhage 
0 
2 
2 
Maxillofacial s ops is 
0 
4- 
4- 
*Probably somewhat lower than the 
actual incidence, 
105 TABLE lxiv 
TOTAL REPORTED * INCIDENCE OE CERVICAL CONDITIONS 
IN 1U50 BATTLE CASUALTY DEATHS 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
Cervical trauma 
0 
108 
108 
C ervi cal hemo rrhage 
0 
27 
27 
Laceration. fatal. carotid, 
or subclavian artery 
0 
I].*# 
u 
Respiratory obstruction duo 
to edema or hematoma 
2 
10 
12 
Respiratory obstruction due 
to plugging of airway 
0 
9 
9 
Cervical sepsis 
0 
3 
3 
♦Probably somewhat lower than 
the actual incidence. 
**Immediate cause of death, listed as shock 
•a 
106 TABLE LXV 
TOTAL REPORTED* INCIDENCE OF INTRAVERTEBRAL CONDITIONS 
IN 1/+50 BATTLE CiiSUALTY DEATHS 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
Intravertebral trauma 
16 
88 
104 
Hematonyelia 
0 
19 
19 
Hemorrhage 
0 
13 
13 
Meningitis 
1 
1 
2 
Transection of cord, complete 
0 
24-** 
24 
Transection of cord, partial 
0 
11** 
11 
i 
*Probably somewhat lower that 
the actual incidence* 
**Includes cases from those in 
was intravertebral trauma. 
whom the immediate 
cause of death 
107 TABLE LXVI 
TOTAL REPORTED-"- INCIDENCE OF SmTP'IITY CONDITION 
IN I45O BATTLE GASTTALTY DEATHS 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
Extremity trauma, unclassified 
0 
669 
669 
Clostridial myositis of ex- 
tremity, evident 
44* 
3** 
52 
Clostridial myositis of ex- 
tremity, suspected 
0 
23** 
23 
Crushing trauma 
0 
3 
3 
Extremity hemorrhage 
0 
U2 
U2 
Extremity sepsis (not 
clostridial) 
0 
53 
53 
Extremity sepsis, unclassified 
1 
0 
1 
Frostbite or immersion syndrome 
0 
3 
3 
* Probably somewhat lower than the actual 
incidence. 
** Also included in table on Clostridial Infections. 
109 TABLS L'nrII 
TOTAL PJIPORT3D* INCIDENCE OF TEORACIC CONDITIONS 
IN 1U50 BATTLE CASUALTY DEATHS (l) 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Henorted* 
Incidence 
Thoracic trauma, unclassified 0 
176 
176 
Thoraco-.ahdomi.ned. treuma 1 
ik 
15 
Combined intra-abdominal & 
intir thoracic trauma 0 
k 
Atelectasis, severe 0 
33 
33 
Atelectasis, slight or moderate 0 
71 
71 
Blast trauma, evident 5 
Zk 
89 
Blast trauma, suspected 0 
77 
77 
Bronchial fistula, evident 0 
21 
21 
Bronchial fistula, susaected 0 
5 
5 
Cardiac trauma, evident 2** 
31 
33 
Cardiac trauma, suspected 0 
29 
29 
Conti nuing intrap1eural 
hemor rhage C 
S 
B 
Coronary occlusion 3 
0 
3 
Crushing trauma, evident 0 
5 
5 
Crushing trauma, suspected 0 
1 
1 
Dilatation of heart, severe 0 
2S 
28 
Dilatation of heart, slight or 
moderate 0 
61 
6l 
♦Probably somewhat lower than the actual 
3 nc:.denc'e0 
♦♦Also included with coronary occlusions,, 
109 
Continued on next nage TABLE? LTCrII Gont’d 
TOTAL REPORTED* INCIDENCE 03 THORACIC COHDITIOHS 
13 3.1*50 BATTLE CASUALTY DEATHS (2) 
Immediate 
Cause of 
Heath 
Contributory 
or Associated 
Condi tion 
Total 
Henorted* 
Incidence 
Empyema, mild or moderate 
0 
17 
17 
Empyema, severe 
7 
6 
13 
Empyema, suspected 
0 
12 
12 
External hemorrhage from ches 
wall 
t 0 
2 
2 
Eat embolism rvulmonsry, evident 27** 
20 
U9 
Eat embolism pulmonary, su sweated 0 
65 
65 
Hemowneumo thorax, evident 
0 
3^7 
3 w 
Hemo-nneumothorax, suspected 
0 
6i 
61 
Hydrothorax, severe 
0 
9 
9 
Hydro thorax, al ight or moderate 0 
77 
77 
Infarction of lung 
6** 
9 
Intrapulmonary hemorrhage, 
mild or moderate 
0 
192 
192 
Intramilmunary hemorrhage, 
severs 
0 
63 
63, 
Intrapulmonary hemorrhage, 
suspected 
0 
3b 
36 
Lung abscess 
0 
i h 
Ik 
Mediastinal- edema 
0 
5 
5 
Medi as t i nal emphys ema 
0 
16 
16 
somewhat lower than 
the actual inc 
’.dense.. 
♦♦Also included in table on Embolism, Thrombosis, and Infarction, 
.110 
Continued on next page TABLE LT'rII Oont'd 
TOTAL HEP0HT3D* INCIDENCE OF THOHACIC CONDITIONS 
IN 1U50 battle casualty deaths (3) 
Immediate 
Cause of 
Peat h 
Contributory 
or Associated 
Condition 
Total 
Hep or ted* 
Incidence 
Mediastinal hemorrhage 
1 
29 
30 
Medias binitis 
1 
If 
5 
Myocardial 
evident 
If 
112 
116 
Myocardial decompensation, 
suspected 
0 
211 
211 
Other thoracic conditions 
0 
Ilf 
Ilf 
Pleural contamination from 
abdomen, evident 
0 
22 
22 
Pneumonia, mild or moderate 
0 
100 
100 
Pneumonia, severe 
1+q 
22 
71 
Pneumonia, susoected 
0 
28 
28 
Pneumonitis 
1 
l>f 
15 
Pr. ot'j 10 thoi* ax wi thou t hemo tho rax 
0 
5 
5 
Pulmonary edema, severe 
0 
204 
20 If 
Pulmonary edema, slight or 
moderate 
0 
1^5 
llf5 
Purul en t hronchi bis 
0 
35 
35 
Suhp1eural emohys eraa 
0 
5 
5 
Tension pneumothorax, evident 
0 
18 
18 
♦Probably somewhat lower than 
the 
i ac tual 
incidence 
**Poe s not include the 3 cases 
of 
co ro nary 
occlusion 
Continued on next page 
TV) TABLE LXVTI Gont*d 
TOTAL REPORTED INCIDENCE OF THORACIC CONDITION 
IN 14.50 BATTLE GASNALTY DEATHS (A) 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
Tension pneumothorax, 
suspected 
0 
7 
7 
Thrombotic embolism 
pulmonary, evident 
20** 
14,** 
34. 
Thrombotic embolism, 
pulmonary, suspected 
0 
17** 
17 
Trachao-bronchial obstruction, 
aspirated vomitus 
11 
21 
32 
Tracheo-bronchial obstruction, 
blood and mucus 
11 
103 
1 u 
Tracheo-bronchial obstruction, 
suspected 
0 
25 
25 
Unrepaired wound of diaphragm 
0 
26 
26 
Venter' :u~ ar arrest 
2 
0 
2 
Undetermined thoracic condition 
i 12 
0 
12 
* Probably somewhat lower than the actual incidence 
** Also included in table on embolism, thrombosis, and infarction. 
112 TABLE LW111 
TOTAL HHPOHTED* INCIDENCE OF ABDOMINAL CONDITIONS 
IN 1U50 BATTLE CASUALTY DEATHS (l) 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
Abdominopelvic trauma 
0 
lU? 
li+7 
Combined intra-abdominal & 
intrath oraci c trauma 
0 
k 
k 
Tho rac o—abdomi nal t rauma 
0 
lU 
Ik 
Abscess, oxtraperiboneal'1 ' 
0 
12 
12 
Abscess, intraperitoneal 
2 . 
15 
17 
Adrenal hemorrhage 
0 
15' 
15 
Adrenal trauma 
0 
8 
8 
Adynamic ileus, mild or moderate 0 
36 
36 
Adynamic ileus, severe 
0 
k2 
k2 
Adynamic ileus, suspected 
0 
1 
1 
Blast trauma, evident 
0 
26 
26 
Blast trauma, suspected 
0 
20 
20 
Cellulitis etc, mural & extra- 
peritoneal 
k 
20 
2k 
Clostridial myositis of trunk 
( abdominal), evident 
•J** 
Ij** 
11 
Clostridial myositis of trunk 
(abdo mi nal), susp ec t e d 
0 
10** 
10 
♦Probably somewhat lower than 
the actual incidence. 
♦♦Also reported in table on Clostridial 
ffyositis. 
Continued on next page. 
113 TABLE LXVIII Cont'd 
TOTAL HEPOHTED* INC IDENGS OF A3 NOMINAL CONDITIONS 
IN 1U5O BATTLE CASUALTY DEATHS (2) 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condi t ion 
Total 
Reported* 
Incidence 
Contamination from hollow viscus 0 
U67 
U67 
Crushing trauma, evident 0 
6 
6 
Crushing trauma, susnected 0 
6 
6 
Evisceration, postoperative 0 
7 
7 
Evisceration, preoperative 0 
76 
76 
Evisceration, postoperative & 
preoperative 0 
2 
2 
Gangrene of howel, advanced 0 
9 
9 
Gangrene of hovel, early 0 
13 
13 
Gastric dilatation 0 
36 
36 
Xiemo rrhage, p ri mary 0 
1+99 
Hemorrhage, recurrent or 
delayed 0 
26 
26 
Hepatic degeneration?toxic C 
75 
75 
Hepatitis, epidemic, evident 0 
7 
7 
Hepatitis, epidemic, suspected ( 
U 
Hepatitis, septic?secondary 
to trauma,evident 0 
IS 
IS 
Hepatitis, septic, secondary 
to trauma, suspected 0 
IS 
18 
Inflammation of G_I tract 0 
7 
7 
Intestinal obstruction,. 
(mechanical) mild or moderate 0 
s 
• 
8 
* Prohahly somewhat lower than the * 
actual 
incidence. 
Continued on next page. 
1U  LXVIII Cont’d 
TOTAL RSPORTHI* INCIDENCE OP ABDOMITAL CONDITIONS 
IN 1U50 BATTLE CASUALTY DEATHS (3) 
Immediate 
Cause of 
Peath 
Contributory 
or Associated 
Condition 
Total 
Heported* 
Incidence 
Intestinal obstruction, 
(mechanical) severe 
2 
6 
6 
Intestinal obstruction, 
(mechanical) suspected 
0 
3 
3 
Leaking suture line 
0 
8 
8 
Nephropathy, pigment, evident 
68 
31 
99 
Nephropathy, pigment, suspected 
c 
s 
8 
Nephropathy, toxic, degenerative 
0 
26 
26 
Operative wound infection 
c 
17 
17 
Other abdominal condition 
2 
23 
25 
Pancreatic hemorrhage 
0 
6 
6 
Pancreati c trauma 
0 
2S 
25 
Peritonitis, mild or mod. 
0 
92 
92 
Peritonitis, severe 
6s 
US 
113 
Peritonitis, suspected 
C: 
63 
63 
Penal sepsis (parenchymal) 
0 
5 
5 
Penal trauma, evident 
0 
127 
127 
Henal trauma, suspected 
0 
11 
11 
Sepsis, abdominal, unclassified 
1 
0 
1 
Splenic degeneration, toxic 
0 
28 
28 
Splenomegaly 
0 
31 
31 
Unrepaired wound of hollow 
Viscus** 
0 
33 
33 
* Probably somewhat lower than the actual 
** Recorded only for patients who had intra 
incidence. 
-peritoneal surgery. 
Pago 115 TABLE LXVIII Cont»d 
TOTAL REPORTED* INCIDENCE OF ABDOMINAL CONDITIONS 
IN II15O BATTLE CASUALTY DEATHS (L) 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
To tal 
Penorted* 
Incidence 
Ureter traumatized or tied, 
evident 0 
12 
12 
Ureter traumatized or tied, 
susnected C 
3 
3 
Urinary tract sensis 0 
11 
11 
Undetermined abdominal wall 
condition 1 
0 
1 
Undetermined intra-abdominal 
condition U 
o 
k 
Undetermined: contamination 
and/or hemorrhage suspected 0 
s6 
86 
. 
* Probably somewhat lower than the actual 
incidence. 
116 TABLE LXIX 
TOTAL REPORTED* INCIDENCE OF GLCSTRICIAL MXQ3ITIS OR 
GSREBRITIS IN U50 BATTLE CASUALTY DEATHS 
Immediate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
Total 
Reported* 
Incidence 
Clostridial nyositis of extremity 
evidont 
4 6 
8 
54 
Clostridial myositis of extremity 
suspected 
0 
28 
28 
Clostridial myositis or ccrebritis 
head, neck, or trunk evident 
of 
5 
4 
9 
Clostridial myositis or ccrebritis 
head, neck, or trunk suspected 
of 
0 
10 
. 10 
TOTAL 
51 
50 
101 
*Probably somewhat lower than the actual incidence 
• 
117 TABLE LXX 
TOTAL REPOSTED* I NCI MCE OR EMBOLISM, 
INFARCTION, AND THROMBOSIS IN 1U50 
BATTLE CASUALTY DEATHS 
/ 
Iramedi ate 
Cause of 
Death 
Contributory 
or Associated 
Condition 
To tal 
Deported* 
Incidence 
Emboli sm, 
air, evident 
2 
2 
k 
Embolism, 
air, susuected 
0 
12 
12 
Embolism, 
fat, evident 
27 
22 
Uq 
Embolism, 
fat, suspected 
0 
65 
65 
Embolism, 
thrombotic, evident 
; 20 
lU 
3^ 
Emboli sm, 
thrombotic, suspected 0 
17 
17 
Embolism, 
thrombotic, and in- 
fare ti on 
0 
5 
5 
Infarction alone 
3 
13 
16 
Infarction and thrombosis 
0 
99 
9 
Thrombosis alone, evident 
0 
35 
35 
Thrombosis alone, suspected 
0 
3 
3 
* Probably somewhat lower than the actual 
incidence. 
118 TABLE LXYI 
TOTAL REPORTED* I NCI DEUCE CF MISCELLANEOUS DATA 
IN 1450 BATTLE CASUALTY DEATHS 
Immediate 
Cause of 
Death 
Contributed 
or Associated 
Total 
Reported* 
Incidence 
Anaphylaxis, suspected 
0 
2 
2 
Anemia, refractory or severe 
0 
13 
13 
Anesthetic agent, cause of death 7 
0 
7 
Anesthetic agent, suspected 
0 
25 
25 
Blast death, suspected 
0 
29 
29 
Jaundice 
0 
2 4 
24 
Malnutrition, severe 
0 
10 
10 
Morphine poisoning, cause of 
death 
0 
0 
0 
Morphine poisoning, suspected 
0 
U 
4. 
Other contributory conditions 
0 
2 
2 
Sopticema (excluding clostridial) 1 
1 
£ 
Transfusion reaction severe 
1 
6 
7 
Respiratory failure cause 
undetermined 
1 
0 
1 
Undetermined unclassified 
303 
0 
303 
* Probably somewhat lower than 
the actual 
incidence. 
119