Dr James Le Fanu on the genius who saved the skin of Spitfire pilots
James Le FanuBy Dr James Le Fanu
12:00AM BST 26 Sep 2000
DURING the Battle of Britain Hermann Goering asked the Luftwaffe fighter ace Adolf Galland what would be needed to defeat the RAF. He replied, tersely: "Spitfires". Last weekend, as this formidable fighting machine circled Westminster Abbey to mark the 60th anniversary of the climax of that great battle, the cheering veterans below would have recalled how they had been able to outshoot their German foes.
"The Spitfire was so instinctive to fly, the pilot could forget the controls and concentrate on the all-important gun sight, while throwing his aircraft around the sky," wrote Taylor Downing in last month's History Today. "This gave them that vital edge over their opponents in a situation where a fraction of a second could decide the outcome of an aerial duel.
"The Spitfire was the masterpiece of the aeronautical engineer Reginald Mitchell, who designed its uniquely strong and thin elliptical wings that made it 'a dream to fly' while terminally ill with cancer. It did, however, have one terrible drawback, of which the brave pilots who took it up into the air over the Kent countryside were very much aware. They were practically sitting on the two fuel tanks, placed one above each other, which together held almost 80 gallons of petrol and could only too easily be ignited by an enemy bullet.
"The pilot is hurled like a blazing torch from his plane or lies unconscious against red-hot metal," observed the Australian surgeon Archie McIndoe, whose job it was to try and repair the horrendous burns they sustained. The fragile eyelids simply evaporated, leaving the cornea of the eye unprotected; the nose and lips were similarly destroyed, and the face and hands misshapen by scar tissue.
The process of reconstruction involved up to 30 operations spread over two or three years, a gruelling ordeal through which McIndoe sustained his patients by his forceful character and sympathetic manner. He was a brilliant surgeon but also an intuitive genius, who realised that to have any hope he first had to discard the conventional way of treating burns.
Burns rapidly turned septic as the proteinacious fluid leaking from the raw exposed surface provided an almost ideal medium for bacteria to grow and propagate. This vulnerability to infection was minimised by anointing the burnt area with tannic acid, which encouraged the formation of a hard protective scar, but which also, like a splint, fixed the tissues and joints in non-functional and incongruous positions.
McIndoe had to come up with some other prevention against infection. His solution - immensely time-consuming and painful for his patients - was to leave the burn exposed but keep it clean with antiseptic dressings that were changed every two hours. This was combined with a daily saline bath, during which every orifice, cavity and burnt surface was thoroughly irrigated. Later, the now-supple and germ-free burns were covered with skin grafts.
McIndoe personally looked after 3,600 patients during the War. The aesthetic results, given the horrendous nature of the original injuries, were impressive, though scarcely perfect. But time proved a great healer; the scars merged into the wrinkles of old age and, astonishingly, skin grafts borrowed from other parts of the body acquired the natural contours of facial expressions.
The septic complications of burns were an even greater hazard for the casualties of Hiroshima and Nagasaki, as the radiation from the fall-out of the atomic bombs also destroyed the protective white blood cells.
Toyoyasu Kobatake was on his way to school in Hiroshima when the air-raid sirens went off. As he looked up at the sky, he saw a B-29 bomber, "its wings glittering gold with the reflection of the rising sun". Seconds later there was an enormous flash and "the bomb blast threw my body into the doorway of a nearby house".
Miraculously, he survived, and managed to get home. But the following day he lapsed into delirium from the fever brought on by the bluish-white swellings seeping from the burn on the backs of his legs and arms.
"It seemed as though there was absolutely no cure for this," he writes in his short account, My experience of the Hiroshima atomic bomb, until a neighbour gave his mother a litre-bottle of cucumber fluid. She soaked some cotton wool in it and "all of a sudden I started to sleep comfortably".
When the precious fluid ran out, his mother took to grating cucumber directly onto his burns, which then soaked up the swellings. In this way, "I was able to recover completely without a single scar". Astonishing.
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