War Surgery and Medicine
When the New Zealand brigade went to Fiji in 1940 it had at first no specialist ENT service, but Major L. S. Talbot was sent there in January 1941. Very little equipment was available, and it had to be supplemented with what could be spared from Talbot's personal supplies. In 1942 more equipment became available, some from America. Clinical conditions were found to be much the same as those occurring in New Zealand, but the hot, humid climate was favourable to middle ear infections, and some ears that had been ‘dry’ for long periods became active. Likewise chronic page 455 nasal accessory sinus infections became troublesome and did not respond well to local treatment. Such cases often had to be employed at Base, or else returned home.
The climate of New Caledonia was much the same as that of Fiji during the summer and autumn months, and the high humidity at this period had much the same effect on middle ear diseases, sinus cases, and allergic manifestations. However, the cases did better in the winter, and the equipment provided was a very considerable improvement on that available in Fiji.
External otitis was very prevalent in the climate of the Pacific—in Fiji, New Caledonia, and the Solomons. By the time patients were referred to a hospital the infection, whether mycotic or bacterial at first, had usually become a mixed one, with great swelling and tenderness of the tissues of the external auditory canal, so that local treatment was difficult to apply effectively. The method found by Major Talbot to give the best response was the repeated application of hypertonic solutions, such as 15 to 20 per cent magnesium sulphate, sometimes introducing it into the depths of the canal with a blunt hypodermic needle. It was found that the patient was more quickly returned to full duty by a period in hospital to enable such treatment to be applied effectively. When the swelling was reduced, other treatments applied on gauze wicks could be used at the RAP. Complete cure was difficult, and the patient was usually left with a chronic or recurrent otitis which could to a certain extent be kept in check by daily ear toilet.