On Christmas Day, 1942, the U S Naval Hospital at Mare Island, California, received 179 patients, the first casualties to arrive after the Japanese attack on Naval and Army facilities in Hawaii.(1)
Evolution of Burn Therapy
Humans have suffered from burns since the discovery of fire. The earliest western description of topical burn therapy is found in the Ebers Papyrus (~1500 BCE). This detailed the sequential application of black mud, boiled cow dung, and other similarly disgusting substances.(3) To Hippocrates is attributed the avoidance of infection by simple cleansing of burn wounds with clear water or wine. Rhazes (9th C) popularized “white ointment” made of white lead, rose oil and wax, while Avicenna at about the same time recommended cooling burn wounds (to relieve pain) with ice water. The French barber-surgeon Ambroise Pare’ (1582) noted that onions or onion juice applied to burns prevented the formation of blisters; this treatment was used in the Russian army into World War II. (4) Various applications continued to be advocated up through the early 20th Century. While World War I surgeons continued the use of a variety of ointments, often paraffin-based, they also struggled to prevent infection, which had become the scourge of burn patients. The use of tannic acid applications became fashionable in the 1930s.(3)
In the Pearl Harbor action, 60% of patients admitted had clinically significant burns. These patients were treated in a variety of ways, including the tannic acid method. Navy medical officers at Pearl Harbor used silver nitrate, gentian violet and sulfanilimide in mineral oil to fight infection.(5)
Flit Gun Treatment
When the Pearl Harbor casualties arrived at Mare Island, they received the “Flit gun” treatment, an innovation developed by Dr Ralph Pendleton in his Salt Lake City practice before he was drafted into the Navy. Consisting of a mixture of melted paraffin, petrolatum jelly, castor oil, sulfanilimide, and traces of camphor, menthol and eucalyptus oil, the treatment was sprayed onto the patients’ burns by use of a flit gun, a common device for spraying insecticide. The patients loved the treatment because it gave them immediate relief from their pain, and, because no dressing was required, they didn’t have to suffer the painful removal of gauze dressings “stuck” to their burns.(2)
“Flit” was a mineral oil-based insecticide manufactured by Standard Oil Company of New Jersey. The insecticide was delivered by use of the Flit Gun, and was popularized in advertisements created by the then-unknown cartoonist Dr Seuss. The ads, which highlighted the phrase “Quick, Henry, the Flit!”, ran from 1928 until 1945.(1) A. L. Clifton, Captain, Medical Corps, U. S. Navy, Commanding Officer, U. S. Naval Hospital, Mare Island, Cal. to Rear Admiral Ross T. McIntire, Navy Surgeon General, December 29, 1941, in National Archives I, Record Group 52 (Records of the Bureau of Medicine and Surgery), Entry 15A, Box 122 File NH15 (A1-1 to L9-3) 1936 – 1941. (2) “Medicine: Burns at Mare Island”, Time Magazine, November 16, 1942, found on line at http://www.time.com/time/magazine/article/0,9171,932877-1,00.html, accessed 10 June 2011. (3) Fernandez, Roberto J., “The Historical Evolution of Burn Surgery”, submitted for the 2010 Howard A Graney Competition for Undergraduate Writing in the History of Surgery, http://www.dmu.edu/departments/academic/Surgery/fund/Fernandez%20Historical%20Evolution%20of%20Burn%20Surgery.pdf, accessed 11 June 2011. (4) Hauben, D J, and D Mahler, “On the history of the treatment of burns”, Burns 7, No. 6, pp 383-388 (1981). (5) “The History of the Medical Department of the United States Navy in World War II – A Narrative and Pictoral Volume” (Navmed P-5031, Volume I, p 64. Washington, GPO, 1953.
© 2011 Thomas L Snyder