Tuesday, October 4, 2011

Oral History: Milton Bell on World War II medicine and penicillin

from our extensive files of oral histories...

Telephone interview with A. Milton Bell, World War II pharmacist's mate aboard USS Rixey (APH-3). Conducted by Jan K. Herman, Historian, Bureau of Medicine and Surgery, 18 September 1995.

I would like to talk to you about your experiences on the Rixey. When did you join the Navy?

I joined in 1942 on Whitehall Street in Manhattan. I went on active duty in December '42 and was shipped out to Great Lakes. I was a hospital apprentice first class. While I was in boot camp, I took the test and made third class. I went through boot camp there and then spent most of my time giving shots during the physicals they were giving the boots. We had about 100,000 boots there at the time. We were among the last ones who volunteered. They used the draft after that.

I then worked there for a while as a dental assistant. I was an assistant to Frederick Felix Molt. He was one of the designers of many of the instruments that are still used in dental surgery today. I then made second class at Great Lakes.

I wanted to be a dentist. I didn't do that great in college. Quite frankly, one of the reasons I volunteered was to get everybody off my back. So I went into the Navy and learned how to be a good student. Then I was shipped out of Great Lakes. I went to California with Acorn unit 146, and then with a Marine unit. Then they broke up the acorn unit and put me on a ship to Noumea, New Caledonia to Base Hospital 107.

When did you go aboard the Rixey?

I was assigned to the Rixey from Base Hospital 107. They needed a first class pharmacist's mate and I had just made first class. That was in December of '43. I was in charge of the pharmacy. We made up all the prescriptions, all the cough medicines. When soldiers or marines came on board and got seasick we gave them pink APCs. They were like Anacin but were colored pink. We would take a bottle of a thousand APCs and put a big label on it--"seasick tablets." You'd be surprised how many guys got better.

In our role as a troop transport, we sometimes had troops on board 6 or 8 weeks. They practiced climbing down nets into boats and getting ready for landings. We would rehearse with them as well.

You participated in several invasions?

I was at Lingayen, Luzon, and a week before Okinawa we hit Kerama Retto. From there we were at Ie Shima. There they had problems securing it because the Japs were holed up in caves. And that's where Ernie Pyle died. From there we went to Okinawa.

While we were getting ready for invasions, we made plaster bandages and prepared burn dressings. We treated a lot of burn cases.

You actually had penicillin as early as '43?

It was already on board when I arrived, but we didn't know how to use it properly. We prepared the penicillin in a 50cc syringe. Then we would give 25 individual shots of 2cc each. Each cc was the equivalent of l0,000 units. Today, a 250-gram pill equals a quarter of a million units! Each shot we gave was 20,000 units and we would have to give it every 4 hours around the clock. And the needles got pretty dull because we didn't have disposables. We had little half-inch needles. We autoclaved them, put them on the syringe, gave the guy a shot, removed the needle from the syringe, dropped it in the pot, and then re-autoclaved them.

Going back to the penicillin for a minute, what form did you get it in?

As I recall, it came in powdered form in bottles and we kept it refrigerated. We added saline to it and then shook it up and then it was ready for injection. It was an early form of penicillin. In fact, to us the whole war was the three Ps--plasma, penicillin, and plaster.

You also said you were making bandages.

We were making plaster bandages which were coarse 6-inch bandages. We took the bandage off one reel and wound it onto another reel passing it through dry plaster. The plaster would then be picked up in the gauze of the bandage. We made a bandage that would be 5 or 6 yards long and rolled into a roll about 2 1/2 inches in diameter. We then wrapped it in plain wax paper and stored it in a box in a dry area. When you needed the bandage, you put it into a stainless steel tub filled with water.

What kind of wounds would you treat with those bandages?

The plaster bandages were used for broken legs, broken arms, and for body casts. Let's say someone got shot in the clavicle. He would need a body cast that would hold the shoulder up to immobilize the clavicle. For burn cases, which we had a lot of, we used finer bandages about 2 1/2 or 3 inches wide. We used tongue depressors to fold the bandage back on itself, back and forth, so it would fit in a 1-pound can. You know how a Simonize can looks? The Navy bought cans like that filled with petrolatum but they weren't sterile. We removed the petrolatum and heated it in a little pot on a hot plate. After packing the can with the bandages, we poured the petrolatum over them, sealed the can and autoclaved it so it was sterile. When burn cases came aboard and the skin just came off, we sprinkled the burns with a little sulfathiazole and covered them with the petrolatum impregnated bandages. The patients felt better when you covered their burns, but that treatment also caused terrible scarring. It was the wrong treatment but we didn't know it at the time. Today, you treat them differently.

For anesthesia, we used sodium pentothal, which was new at that time. I became an anesthetist. When I wasn't in the boat transferring patients from the beach to the ship, I would be aboard assisting in surgery doing anesthesia and helping suture the patients.

We used to cut down on the vein on the arm below the elbow and put a cannula in so that if you had to give the patient plasma, serum albumen, or whole blood, you could administer it quickly and continuously when needed. If you were giving anesthesia, we used the same cannula for that. We would make up a big batch of sodium pentothal in a 50cc syringe and then administer a half cc at a time. If the patient were awake, you'd have him count backwards starting from a hundred...99, 98, 97... By the time he reached 80 he was asleep. We did amputations and all kinds of heavy surgery with sodium pentothal.

When you say you "cut down" on an artery do you mean you exposed the vessel so you could get into it?

Yes. We had to expose the vein with instruments so we could get into it with a cannula. We then tied the cannula in place with suture cord so it wouldn't pull out. Then we could administer plasma, serum albumen, whole blood, or sodium pentothal without having to stick the patient each time. And the cannula remained in the arm until we had to take it out. That's something we learned to do as corpsmen.

You also said that beside plasma and serum albumen, you had whole blood.

Very often we would get blood that was out of date. We then got the crew to give blood. It was almost like a direct transfusion. If we needed A blood we asked for an A and verified it by their dogtag. And then a crew member or one of the marines or soldiers we were carrying would be placed on the table and we took a pint of blood. Then we'd transfuse it right into the patient. The donors then got 2 ounces of whiskey but not immediately. We "owed" it to them. That's what they were entitled to and the captain would sign off on it. I think they got Canadian Club.

Speaking of alcohol, we did have some problems with alcohol and morphine syrettes. Someone was stealing them out of the kits. Then when you needed the morphine, you didn't have it. So we tried to hide it. Those of us who were on the shock team would keep the morphine in our own pockets.

You said you were on a shock team. What kind of equipment did you have? Did you have a kit or special instruments?

We had a scissor and a very sharp knife. We also had plasma and needles and I learned how to get into a vein quickly. I was very good at it. You had to be very careful you didn't cut through a vein or artery. We lost a few patients in surgery that way. Once, when we were transferring patients from Guam to Hawaii, one of the doctors elected to remove a bullet from a patient's neck. We prepared for surgery. About 10 minutes into the surgery, he accidently cut the carotid artery. The patient died on the table and we buried him at sea. Things like that happened.

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