Medicine: The Surgeons of Leningrad

Professor N. Blinoff of the Leningrad Postgraduate Institute did not know that his beleaguered city would soon be free (TIME, Feb. 1) when he cabled to Britain a description of care of the sick and wounded during 17 months of siege. So his account, printed in the British Medical Journal, is only a fragmentary outline of a historic chapter of medical improvisation.

In the early stages of attack (September 1941), when the population (some 3,000,000) was tripled by an influx of soldiers and civilians from outlying districts, shells and bombs caused many civilian casualties. At the same time wounded soldiers began to arrive. The military took over all the hospitals. New hospitals had to be set up for civilian wounded.

New surgeons had to be found, too, because most Leningrad surgeons were in the Army. The Institute gave courses which made emergency surgeons out of ordinary doctors in two weeks. Even then, nothing but wounds and emergencies could be attended to; “planned operations” had to wait.

Men in White. Wound treatment was kept simple: gunshot wounds had their edges cut away, were not sewed up; wounds involving bone were usually put in plaster casts (the Orr-Trueta method which got its first full tryout in the Spanish War; TIME, July 8, 1940), and left alone, perhaps for weeks. “Some surgeons made a habit of using sphagnum moss* for surgical dressings.”

“Then severe cold weather set in; . . . the electricity supply failed in most of the buildings, so work had to be done with the aid of oil lamps or night lights. Then the water supply gave out. . . . By using fences and wooden huts as logs the staffs of the hospitals were able to raise the temperature several degrees above freezing point.”

Men in Furs. “The doctors made their rounds in fur overcoats covered by white gowns. . . . The wounded often had to lie in bed fully dressed. [I] frequently had to do blood transfusions in a fur coat and a fur hat and keep [my] hands warm by putting them in warm water.” Operating rooms in most hospitals were too cold to use and work on wounds had to be done in the wards.

“The severe cutting down of rations and the intensely cold weather produced a peculiar disease—an alimentary emaciation . . . with a variety of surgical complications such as gangrene of fingers, trophic ulcers [sores caused by poor nutrition] . . . avitaminosis.”

Fortunately, all nonessential civilians had been evacuated and the bombardment lessened so that some beds could be devoted to medical as well as surgical cases. Never was there any lack of blood for transfusions: it came from volunteers, even though they were slowly starving.

Men at Study. With the spring came proof “that surgeons were active even during the worst part of the blockade.” Surgical conferences began in which men summarized what the winter’s work had taught them. There were reports on wound treatment, conservation of blood, preparation of dried plasma, transfusions, treatment of alimentary emaciation, and a “detailed account of the biochemical changes in the blood of emaciated patients.”

The first spring meeting was attended by only 150 doctors, but 400 surgeons attended the conferences held by the health department in September—”in spite of heavy gunfire and bursting bombs during the sittings, the hall was full all the time.”

* Moss used by florists in packing and potting