BATTLE CASUALTIES

By Gilbert W.Beebe and Michael E. DeBakey. Spring-field, Illinois: Charles C. Thomas. 1052. 277 pp. $10.50.

The medical planning for the evacuation and treatment of the wounded that followed World War I did not completely envision the type of warfare or the type and magnitude of the casualties experienced in World War II. Quite naturally, programs and policies had to be altered substantially and quickly once World War II was under way. It is to be hoped that the past experience of these two wars, combined with the more recent medical task in Korea, will enable us to keep far reaching and flexible plans in readiness if we should again be involved in any armed conflict.

Dr. Beebe and Dr. DeBakey have unquestionably made a tremendous contribution to the thinking that goes into any such plan. In their book they have assembled a multitudinous amount of information concerning all the facets of the "incidence, mortality and logistical considerations" of the wounded.

The authors were both in the Office of the Surgeon General of the Army and are both completely familiar with the statistical maze which constantly flowed into that office from all theatres throughout the war. These statistics from thousands of observers throughout the Army have been collected, tabulated and brought into focus by the authors.

Out of this work they have, then, been able to determine analytically the incidence and location of hits and wounds, the death from wounding and the effects of weapons. These factors have been broken down into an exceptionably complete detail so that questions relating to battle injury have been intimately reduced to basic fundamentals.

A particularly pertinent section is that dealing with the "Logistical Problems of Personnel, Hospitalization and Evacuation in Forward Areas." In this portion, the emphasis on the number of doctors properly placed in the needed place at the best time is studied. It is here, for instance, that we find that to support 200,000 men for the highest three days of casualties of the First Army, the services of 86 surgeons backed up by 43 anesthetists are needed. Dr. Edward Churchill has added to the value of this section by his critical analysis of the "surgical implications in the evacuation and distribution of casualties." He puts forth a number of provocative proposals that will bear a good deal of consideration by our present planners.

The basic principle that the "fundamental determinant of the mortality among the wounded is the speed with which they are given medical care," is the real impetus for this book. In the words of the authors, however, no effort has been made to "develop a manual of solutions," but rather an effort to provide "the surgical planner with reference data and salient relationships needed to devise plans for the care of battle casualties." This, Doctors Beebe and DeBakey have more than adequately accomplished.