Surgeons at War: Medical Arrangements for the Treatment of the Sick and Wounded in the British Army during the late 18th and 19th Centuries (Contributions in Military Studies)

Kaufman examines the training and status of British military surgeons during the late 18th and 19th centuries. Their management of the sick and wounded during the wars with France leading up to and including the Peninsular War is also described. He concludes with an analysis of the medical problems associated with the Crimean War. Using important contemporary texts, Kaufman describes the personalities who served in the British Army Medical Department during the late 18th and 19th centuries, when diseases caused a much higher mortality than injuries sustained in battle. Many military surgeons were only poorly trained, and the management of the sick and wounded only gradually improved over this period despite significant advances in medicine, surgery, and hygene. Government spending cuts after the Peninsular War greatly depleted the medical service of the army so that by the time of the Crimean War it was unable to cope with a European-style war. Deficiencies were recognized and, in the case of the medical services, this led to the establishment of the Army Medical School in 1860. This analysis should be of particular interest to serving military medical officers and to historians and other researchers interested in the management of 18th and 19th century armies in times of peace and war. Contents 6 Preface 8 1. Introduction 12 Military Medicine and Surgery during the 18th and early 19th centuries 12 Medicine in the Navy 13 Military Surgeons in the Army during the 18th Century 16 The Military Surgical Hierarchy during the 18th Century 19 Military Surgery and Military Surgeons 20 John Hunter, Surgeon-General and Inspector of Regimental Hospitals, 1790–1793 22 George Guthrie, Military Surgeon 26 Sir Charles Bell, Anatomist, Scientist, and Civil Surgeon 30 Military Administrators of the 18th and Early 19th Centuries 32 The Army Medical Board (1793–1809) 40 Anomalous Arrangements within the Artillery and Engineer Arms of the Service—the Ordnance Medical Department 45 2. The Wars against France 1793–1815 56 The Wars against France Leading up to the Peninsular War 56 The Peninsular War, 1808–1814 70 The Battle of Waterloo 91 The Light Mobile Ambulances Designed by Larrey, and the Mobile Ambulance Units 95 Removal of the Casualties from the Battlefield—The British Approach 96 The Formation of a Hospital Corps to Assist the Medical Officers in their Duties 98 3. The Regius Chair of Military Surgery at the University of Edinburgh 1806–1856, and the Regius Chair of Military Surgery at the Royal College of Surgeons of Ireland, Dublin, 1855–1860 110 Background 110 Factors Leading to the Establishment of the Regius Chair of Military Surgery in Edinburgh 111 The First Holder of the Edinburgh Chair: John Thomson 113 The Second Holder of the Edinburgh Chair: George Ballingall 116 Effectiveness of Thomson's and Ballingall's Teaching 121 Ballingall’s Evidence Presented before the Royal Commissioners in 1826 Regarding the Teaching of Military Surgery and Other Topics 125 Ballingall’ s Other Activities 126 Withdrawal of Government Funding for the Regius Chair of Military Surgery in Edinburgh in 1856, and from the Regius Chair of Military Surgery in Dublin in 1860 127 4. The Crimean War 140 Political Conditions that Led to Hostilities in the Crimea 140 State of Medical Services for a Campaign in the East—Problems Encountered by Dr. Andrew Smith, Director-General of the Army Medical Department 146 Staffing within the Medical Department 148 Competence of the Medical Officers to Deal with the Medical and Surgical Situations They Would Encounter in the Crimea 150 Problems Encountered by the Medical Staff in the Crimea 152 The Base Hospitals 153 Newspaper Coverage of the Crimean War 155 Problems with the Transport of the Sick and Wounded to the Base Hospitals at Scutari 156 Florence Nightingale and her Nurses 158 The Conditions in which the Men Lived during the First Winter (1854–1855) 163 Medical Conditions during the Spring Months (1855) 166 The Fall of the British Government 167 Activities of the Commissions and the Select Committee 168 Resurgence of Hostilities (1855) 173 The Civilian Doctors who Volunteered for Service in the Crimea 175 The Civil Hospital at Smyrna 175 The Final Stages of the Crimean War: The Fall of Sebastopol 178 Contribution of the Navy to the Crimean Campaign 179 The Fate of Dr. (Later Sir) Andrew Smith 180 Concluding Observations Regarding the Crimean War 181 Appendix: British, French and Russian Casualties During the Crimean War 182 5. Education of Medical Officers during the Post-Crimean War Period 192 The Establishment of the Army Medical School at Fort Pitt, Chatham (1860), and its Relocation at Netley (1863) 192 The Hospital to be Associated with the Army Medical School 195 The Difficulties Encountered by Medical Officers in the Three Branches of the Service, the Army, Navy, and Indian Medical Service, during the Period Between the Crimean War and 1879 196 Entry Requirements into the Different Branches of the Service 197 Conditions of Service in the Army Medical Department during the Early Post-Crimean War Period 198 Conditions of Service in the Naval Medical Department 199 The Evolution of the Army Medical Corps 200 Changes Brought about toward the End of the 19th Century with the Establishment of the Royal Army Medical Corps in 1898 201 6. Conclusions: The 19th Century—a Century of Conflict 204 Selected Bibliography 222 Index 228 A 228 B 229 C 229 D 230 E 231 F 231 G 231 H 231 I 232 J 232 K 232 L 232 M 233 N 234 O 234 P 234 Q 235 R 235 S 235 T 236 U 236 V 237 W 237 Y 238 Military Medicine And Surgery During The 18th And Early 19th Centuries 1 -- Medicine In The Navy 2 -- Military Surgeons In The Army During The 18th Century 5 -- Military Surgical Hierarchy During The 18th Century 8 -- Military Surgery And Military Surgeons 9 -- John Hunter, Surgeon-general And Inspector Of Regimental Hospitals, 1790-1793 11 -- George Guthrie, Military Surgeon 15 -- Sir Charles Bell, Anatomist, Scientist, And Civil Surgeon 19 -- Military Administrators Of The 18th And Early 19th Centuries 21 -- Army Medical Board (1793-1809) 29 -- Anomalous Arrangements Within The Artillery And Engineer Arms Of The Service--the Ordnance Medical Department 34 -- 2. Wars Against France 1793-1815 45 -- Wars Against France Leading Up To The Peninsular War 45 -- Peninsular War, 1808-1814 59 -- Battle Of Waterloo 80 -- Light Mobile Ambulances Designed By Larrey, And The Mobile Ambulance Units 84 -- Removal Of The Casualties From The Battlefield--the British Approach 85 -- Formation Of A Hospital Corps To Assist The Medical Officers In Their Duties 87 -- 3. Regius Chair Of Military Surgery At The University Of Edinburgh 1806-1856, And The Regius Chair Of Military Surgery At The Royal College Of Surgeons Of Ireland, Dublin, 1855-1860 99 -- Factors Leading To The Establishment Of The Regius Chair Of Military Surgery In Edinburgh 100 -- First Holder Of The Edinburgh Chair: John Thomson 102 -- Second Holder Of The Edinburgh Chair: George Ballingall 105 -- Effectiveness Of Thomson's And Ballingall's Teaching 110 -- Ballingall's Evidence Presented Before The Royal Commissioners In 1826 Regarding The Teaching Of Military Surgery And Other Topics 114 -- Ballingall's Other Activities 115 -- Withdrawal Of Government Funding For The Regius Chair Of Military Surgery In Edinburgh In 1856, And From The Regius Chair Of Military Surgery In Dublin In 1860 116 -- 4. Crimean War 129 -- Political Conditions That Led To Hostilities In The Crimea 129 -- State Of Medical Services For A Campaign In The East--problems Encountered By Dr. Andrew Smith, Director-general Of The Army Medical Department 135 -- Staffing Within The Medical Department 137 -- Competence Of The Medical Officers To Deal With The Medical And Surgical Situations They Would Encounter In The Crimea 139 -- Problems Encountered By The Medical Staff In The Crimea 141 -- Base Hospitals 142 -- Newspaper Coverage Of The Crimean War 144 -- Problems With The Transport Of The Sick And Wounded To The Base Hospitals At Scutari 145 -- Florence Nightingale And Her Nurses 147 -- Conditions In Which The Men Lived During The First Winter (1854-1855) 152 -- Medical Conditions During The Spring Months (1855) 155 -- Fall Of The British Government 156 -- Activities Of The Commissions And The Select Committee 157 -- Resurgence Of Hostilities (1855) 162 -- Civilian Doctors Who Volunteered For Service In The Crimea 164 -- Civil Hospital At Smyrna 164 -- Final Stages Of The Crimean War: The Fall Of Sebastopol 167 -- Contribution Of The Navy To The Crimean Campaign 168 -- Fate Of Dr. (later Sir) Andrew Smith 169 -- Concluding Observations Regarding The Crimean War 170 -- Appendix British, French And Russian Casualties During The Crimean War 171 -- 5. Education Of Medical Officers During The Post-crimean War Period 181 -- Establishment Of The Army Medical School At Fort Pitt, Chatham (1860), And Its Relocation At Netley (1863) 181 -- Hospital To Be Associated With The Army Medical School 184 -- Difficulties Encountered By Medical Officers In The Three Branches Of The Service, The Army, Navy, And Indian Medical Service, During The Period Between The Crimean War And 1879 185 -- Entry Requirements Into The Different Branches Of The Service 186 -- Conditions Of Service In The Army Medical Department During The Early Post-crimean War Period 187 -- Conditions Of Service In The Naval Medical Department 188 -- Evolution Of The Army Medical Corps 189 -- Changes Brought About Toward The End Of The 19th Century With The Establishment Of The Royal Army Medical Corps In 1898 190 -- 6. Conclusions: The 19th Century--a Century Of Conflict 193. Matthew H. Kaufman. Includes Bibliographical References And Index. While there were excellent schools of military medicine and military surgery on the continent of Europe that had been established during the eighteenth century, no courses of instruction were available in Britain for those who planned to enter as medical officers in the army.