2021, Number 2
The second magazine of military-medical issues and trauma in Latin America (1875-1876)
Full text
10.35366/106728
Language: English/Spanish [Versión en español]
References: 32
Page: 146-151
PDF size: 230.58 Kb.
ABSTRACT
We describe the content of the second journal of military medicine and trauma in Latin America, the Anales de la Asociación Larrey (the first one being Bulletin of the Military Medical Corps of the Mexican Republic from 1857 to 1859, not located), journal of the same society that was edited by Dr. Manuel Saturnino Soriano and directed by Dr. Francisco Montes de Oca, from January 1875 to December 1876, which consisted of two volumes and 56 articles, the three areas with the largest number of articles being those of trauma (14%), therapeutic (12%) and surgery (8%), the style of the articles is mainly descriptions of cases and their evolution, the use of statistics began only to describe births and vaccination processes. Its surprising disappearance does not detract from the value of physicians who wish to contribute to the progress of military medicine, trauma, and medicine in general.INTRODUCTION
Our objective is to describe the contents of the second journal of military medicine and aspects of trauma in Mexico published in the 19th century, the background and most important characters that allowed, in a time of revolts and internal wars in our country,1 to develop one of the first means of medical information dissemination of this type in the American continent. It is also relevant to describe the kind of techniques used in that historical moment, which meant a parallel development of trauma management, but with proposals different from those of Europe.2 This is part of a sequence of works within the history of surgery in Mexico, which seeks to recover the antecedents of relevant facts and rescue the surgical means and the characters that gave prestige to national surgery.
MEDICAL JOURNALS IN THE 19
The first medical journal in the continent was El Mercurio Volante,3,4 founded by Dr. Ignacio Bartolache on October 17, 1772, with a limited edition of 16 issues, the last one published on February 10, 1773.5 At the beginning of the 19th century, the New England Journal of Medicine appeared in the United States in January 1812, being the longest continuously published medical journal in the world.6
According to the different authors, we can differentiate three periods in the writing of medical journals: from 1772 to 1864, when groups met to write, without a formal editorial committee and a determined continuity, manuscripts describing clinical cases. From 1864 to 1923, we found journals with a qualified committee, exchange with other journals in Europe and with continuity within the country, with a specific format and works with statistical studies of case series, the first journal of this type in our country being the Gaceta Médica de México.7,8 Finally, from 1923 to 2000, when physicians met in medical societies and institutions, we started to publish papers in a specific format with a multinational collegiate group. The tendency was to be read abroad.9 Perhaps it would be worthwhile to consider the computer era from 2000 when Mexico incorporated its collections into this new system.10,11
Of the medical articles of the 18th century, the first trauma articles were written by military physicians of the units known as presidios in the northern border of the country and are the result of the Creole enlightenment of the 18th century. Specifically, it was the description of a case of skull trauma operated by trephine by Dr. Sebastián Barceló in 1793 in the so-called Gazeta de México (sic).12,13 The other journals of the different medical academies of Mexico sporadically collected some work on trauma but without regularity.
UNKNOWN ANTECEDENT
The outstanding work of Dr. Pedro Vander Linden initiated not only improvements in the Military Health Service14 but also the academic renovation by pretending to find a military training hospital;15 at that time, the edition of the newspaper of the first Academy of Medicine was suspended, and there were no medical means of diffusion. Vander Linden conceived the idea of publishing a medical journal called El Boletín del Cuerpo Médico Militar de la República Mexicana from 1857 to 1859.16 The first to document the existence of this medium was Dr. Soriano before the National Academy of Medicine in his memoir.17 Still, I have not been able to locate this copy. Dr. Soriano described that the following doctors collaborated in this journal: Alfaro, Armijo, Balderas, Bocanegra y Caro, Borrayo, Burguichani, Carrión, Echeveste, Franco, González Huidobro, Garmendia, Hidalgo, Miranda, Mellet, Morón, Marroquí Joaquín, Marroquí José María, Pacheco, Peña, Portilla, Rivadeneyra, Ruíz, Sarlat, Serrano, Néstor Tellechea, Trejo, Tamés, Urueta and Villalobos Manuel.17 Therefore, this bulletin would be the first military medicine published in Latin America.
BEGINNING AND END OF A GREAT PROJECT
According to Dr. Flores y Troncoso, the Larrey Association was born in August 1873, when three young military physicians (Rocha, Figueroa, and Labastida, senior army surgeons) by initiative raised funds and founded a library in the Military Hospital of San Lucas (Mexico City), then suggested the idea of a "society" in August 1874. The newspaper appeared on January 1st, 1875 (Figure 1).18 During the two years it was published, it had members all over the country, some of them with a bright future, such as Dr. Eduardo Liceaga and Dr. Tobías Núñez (Table 1).
According to the journal, in its last issue, it announced that it had difficulties due to a lack of funds.19 Still, Dr. Francisco de Asís Flores y Troncoso stated in his book that it was a consequence of the triumph of the Revolution of 1876 and the subsequent changes in the personnel of the Military Medical Corps.18 Finally, unfortunately, the magazine disappeared.
JOURNAL CONTENTS
In the two short years of its publication, 61 papers were printed, 11 (18%) on trauma problems, although various topics were presented (Figure 2).
The paper entitled "Appreciation of the Sedillot procedure" describes the background and two cases operated by Dr. M.S. Labastida. Labastida, who describes perfectly how the distal third humeral pulse is searched in the arm, where the artery is dissected, and the "clot" is removed, from which we infer that it was a post-traumatic pseudoaneurysm, passing with two "blunt" Deschamps needles under the dissected artery and applying two ligatures, one distal and the other proximal to the lesion.20 Dr. Rafael Caraza ratified with a stab wound of the axillary artery, making dissection in the axillary pit, and ligating a distal and a proximal portion of the vessel without complications after two months;21 remains the doubt of whether it really would be the axillary artery since he does not mention the amount to which it was ligated. Lopez-Arayza described the third case of pseudoaneurysm due to a sharp weapon injury on a lesion of the distal third radial artery under the same system.22 It is noteworthy that all four cases occurred in an urban environment in peaceful situations. In contrast, Espinoza's work describes the management of humerus minute fractures; it is noteworthy that after observing that it was not a vascular lesion and that there was a loss of bone continuity, he bandaged the entire limb with sponges and took him on horseback to the hospital already in a state of shock; he splinted the extremity with two boards, which helped to stop the bleeding; a "cold water" irrigation system was used (this may be an exciting antecedent of Carrel's design of the early 20th century), and the wound was explored to extract projectile splinters. He was driven three days by four stretcher bearers to Mexico City; cures were done twice a day with Labarraque's solution, and after a month, he stopped suppurating with the described therapies.23
Among the surgical works, three urological works stand out, such as a carving performed by Dr. Montes de Oca following the technique of Jacques Gilles Maisonneuve (1809-1897).24 An interesting series was presented by Dr. Fenelon of nine ovarian cyst extractions by laparotomy, the largest of them measuring 56 by 61 cm, with deaths due to uncontrollable hemorrhage, advocating that they should be operated on at an "early" stage.25
CONCLUSIONS
Although the edition of this journal lasted only two years, it meant the passport to the academic maturity of our surgical professionals for national surgery. It was not only a means of diffusion but also the consolidation of our country's emergency system and the management of trauma.13 The existence of an independent media of the Gaceta Médica de México is the reflection of the intellectual maturity in the President Juarez era and the beginning of the Porfirian period, the fruit of the cultural contact of the German, French and Belgian currents of the Intervention era,26 and of the unfortunate battles that enriched the surgical arsenal of trauma, which would open the age of the surgeon in the factories and the cities with vehicles of the coming century.27
Regarding trauma management, we observed that initial management was given at the battlefront. The wounded person was transferred with daily cures along the way and the use of Labarraque liquor, already described in a previous paper,28 the use of splints and transport until the definitive procedure was performed, between three and 15 days after wounding, unless there was sudden bleeding. It is noteworthy that amputation was not the first instance29 as was done in other countries at that time. The aim was to preserve the pelvic and thoracic limbs, unlike in other countries where, for vascular injuries, the first instance was immediate amputation.30 Of the articles, some are true medical literary gems. Still, as they lack a title that describes their exact content, they can pass as inconsequential, such as that of Dr. Fenelón, that only bears the title "correspondence",25 losing the opportunity of the value of these manuscripts if they are not read carefully.
Despite the scarce edition of this journal and its heroic editor, Dr. Francisco Montes de Oca, who died in the campaign due to pneumonia in 1885,31 both were the seed of the next generation of trauma surgeons and military physicians who generated a group of mature surgeons capable of gathering their experience and contributing with original proposals.2 There are no trauma statistics in this journal, even though the same editor, Dr. Manuel Saturnino Soriano, will be one of the first to publish works in this area with descriptive statistics.17
Unfortunately, many hemerographic and bibliographic collections are lost or belong to unavailable private collections. The study of our cultural heritage could be complemented by factional struggles, as Dr. Francisco de Asis Flores y Troncoso mentioned.17 The preservation of these resources in digital systems, such as the extraordinary compilation of the National Academy of Medicine in 2009 of the journal Gaceta Médica de México, should be a national priority in all cities of the country concerning all our collections of books and medical journals in Mexico, not only for the sake of preserving something historical but also because in many of them there are first works such as the pseudoaneurysms published in the journal Anales de la Asociación Larrey, which help us to understand our past so that, through history, we can even obtain new answers to our clinical problems in the centuries to come.
REFERENCES
AFFILIATIONS
1 General Surgery Service, Hospital General de Zona No. 50 del Instituto Mexicano del Seguro Social. Department of Surgery, School of Medicine, Universidad Cuauhtémoc San Luis Potosí. San Luis Potosi, Mexico.
Ethical considerations and responsibility: Data privacy. According to the protocols established in our work center, it is declared that the protocols on patient data privacy have been followed and their anonymity preserved.
Funding: No financial support was received for this work.
Disclosure: None of the authors have a conflict of interest in the conduct of this study.
CORRESPONDENCE
Carlos Agustín Rodríguez-Paz, MD. E-mail: rodriguezpazca@ucslp.net / ticitlhuasteco@msn.comReceived: 12/06/2020. Accepted: 01/12/2022