24. Ibid., 851.
25. Garrison, Notes on the History, 162.
26. A. G. Chevalier, “Hygienic Problems of the Napoleonic Armies,” Ciba Symposium 3 (1941–1942): 975.
27. Colin Jones, The Charitable Imperative: Hospitals and Nursing in Ancien Régime and Revolutionary France (London: Routledge, 1989), 228.
28. After the battle of Marengo in 1800, France signed a treaty with Austria and England in 1802. Napoleon was regarded in France as a peacemaker, and the military hospitals were dismantled. Shortly after the demobilization of the hospitals began in 1803, the War of the Third Coalition broke out. Napoleon won so quickly at the battle of Austerlitz that the defects of the dismantled military medical system were not appreciated, and the dismantlement of the hospitals was allowed to continue.
29. Garrison, Notes on the History, 169.
30. A similar outbreak of ophthalmia among French troops in Syria six hundred years earlier had crippled the army and forced a retreat. Given the prevalence of hospitals dedicated to treating blind Crusaders during the Middle Ages, it seems reasonable that ophthalmia presented a serious disease threat to these armies.
31. Garrison, Notes on the History, 166.
32. For cold injury rates in all the wars from the Napoleonic Wars to World War I, see Charles Schechter and Irving A. Sarot, “Historical Accounts of Injuries Due to Cold,” Surgery 63, no. 3 (March 1968): 535.
33. Blaine Taylor, “Some Medical-Historical Aspects of the Later Napoleonic Wars, 1812–1815,” Maryland State Medical Journal, December 1978, 27.
34. Launcelotte Gubbins, “The Life and Work of Jean Dominique, First Baron Larrey,” Journal of the Royal Army Medical Corps 22 (1914): 188.
35. Sieur, “Tribulations of the Medical Corps,” 855.
36. Wangensteen et al., “Wound Management,” 224.
37. Chevalier, “Hygienic Problems,” 979.
38. Wangensteen et al., “Some Highlights,” 224.
39. Lyman A. Brewer, “Baron Dominique Jean Larrey (1766–1842): Father of Modern Military Surgery, Innovator, Humanist,” Journal of Thoracic and Cardiovascular Surgery 92, no. 6 (December 1986): 1097.
40. E. Robert Wiese, “Larrey: Napoleon’s Chief Surgeon,” Annals of Medical History 1 (July 1929): 444.
41. These wagons were called ourgons.
42. Wiese, “Larrey.”
43. Taylor, “Some Medical-Historical Aspects,” 27.
44. David M. Vess, “French Military Medicine during the Revolution,” PhD diss., University of Alabama, 1965, 118–19. This outstanding research work deserves to be published.
45. F. M. Richardson, “Wellington, Napoleon, and the Medical Services,” Journal of the Royal Army Medical Corps 131, no. 1 (1985): 9–10.
46. Wiese, “Larrey,” 44.
47. Garrison, Notes on the History, 164.
48. Chevalier, “Hygienic Problems,” 976.
49. Richard L. Blanco, “The Development of British Military Medicine, 1793–1814,” Military Affairs 38, no. 1 (February 1974): 5.
50. Robert M. Feibel, “What Happened at Walcheren: The Primary Medical Sources,” Bulletin of the History of Medicine 42 (1968): 64.
51. Taylor, “Retrospect of Naval and Military Medicine,” 622.
52. Garrison, Notes on the History, 167.
53. Taylor, “Retrospect of Naval and Military Medicine,” 622.
54. Garrison, Notes on the History, 167.
55. Taylor, “Retrospect of Naval and Military Medicine,” 622.
56. Ibid.
57. Blanco, “Development of British Military Medicine,” 9.
58. G. A. Kempthorne, “The Medical Department of Wellington’s Army,” Journal of the Royal Army Medical Corps, February–March 1930, 214.
59. Richard L. Blanco, Wellington’s Surgeon General: Sir James McGrigor (Durham, NC: Duke University Press, 1974), 117–19.
60. Kempthorne, “Medical Department,” 214.
61. J. M. Matheson, “Comments on the Medical Aspects of the Battle of Waterloo, 1815,” Medical History 10 (1966): 205.
62. Blanco, Wellington’s Surgeon General, 147.
63. A. Campbell Derby, “The Military Surgeon—Not Least in the Crusade,” Canadian Journal of Surgery 28, no. 2 (1985): 183.
64. M. K. H. Crumplin, “Surgery at Waterloo,” Journal of the Royal Society of Medicine 81, no. 1 (January 1988): 38. Also by the same author, see “Vascular Problems at the Battle of Waterloo,” European Journal of Vascular Surgery 137, no. 1 (April 1987): 137–42.
65. Crumplin, “Surgery at Waterloo,” 40.
66. Ibid.
67. Blanco, Wellington’s Surgeon General, 147.
68. Peter Alexander Young, “The Army Medical Staff: Its Past Services and Its Present Needs,” Edinburgh Medical Journal 4 (1898): 17.
69. Robert L. Reid, “The British Crimean Medical Disaster: Ineptness and Inevitability?,” Military Medicine 140 (June 1975): 424. Another important work based on original sources is Joseph O. Baylen and Alan Conway, eds., Soldier-Surgeon: The Crimean War Letters of Dr. Douglas A. Reid, 1855–1856 (Knoxville: University of Tennessee Press, 1968).
70. Reid, “The British Crimean Medical Disaster,” 424.
71. Garrison, Notes on the History, 171.
72. Ibid.
73. Ibid.
74. Reid, “The British Crimean Medical Disaster,” 424.
75. G. H. Rice, “The Evolution of Military Medical Services from 1854 to 1914,” Journal of the Royal Army Medical Corps 135, no. 3 (1989): 149.
76. Reid, “British Crimean Medical Disaster,” 422.
77. Owen Wangensteen and Sarah D. Wangensteen, “Letters from a Surgeon in the Crimean War,” Bulletin of the History of Medicine 43, no. 4 (July–August 1969): 376–79.
78. George Halperin, “Nikolai Ivanovich Pirogov: Surgeon, Anatomist, Educator,” Bulletin of the History of Medicine 30, no. 4 (July–August 1956): 351.
79. Rice, “Evolution of Military Medical Services,” 148.
80. G. A. Kempthorne, “The Medical Department in the Crimea,” Journal of the Royal Army Medical Corps 53, no. 55 (August 1929): 132.
81. John Sweetman, “The Crimean War and the Formation of the Medical Staff Corps,” Journal of the Society for Army Historical Research 53, no. 214 (1975): 113.
82. Kempthorne, “Medical Department in the Crimea,” 138.
83. Reid, “British Crimean Medical Disaster,” 422.
84. Nelson D. Lankford, “The Victorian Medical Profession and Military Practice: Army Doctors and National Origins,” Bulletin of the History of Medicine 54 (1980): 513–14.
85. Sweetman, “Crimean War,” 114.
86. Reid, “British Crimean Medical Disaster,” 423.
87. Kempthorne, “Medical Department in the Crimea,” 138.
88. W. A. Eakins, “Thomas Crawford: Regimental Medical Officer in the Crimea, 1855,” Ulster Medical Journal 51, no. 1 (1982): 47–48.
89. Shepard, “Smart of the Knife,” 112.
90. Ibid., 113. The fact that bleeding remained a common practice during the war did little to help speed the recovery of the wounded. Lord Raglan ordered twelve thousand leeches to be sent from Myrna for this purpose. They all arrived in tightly sealed jars, quite dead.
91. Sweetman, “Crimean War,” 118.
92. Chamberlain, “History of Military Medicine,” 240. See also P. S. London, “An Example to Us All: The Military Approach to the Care of the Injured,” Journal of the Royal Army Medical Corps 134 (1988): 83–85.
93. Ian Fraser, “The Doctor’s Debt to the Soldier,” Mitchiner Memorial Lecture, Royal Army Medical College, June 8, 1971, 63.
94. Sieur, “Tribulations of the Medical Corps,” 211.
95. Ibid., 212.
96. Ibid.
97. Ibid., 217.
98. Ibid., 219.
99. Ibid., 220.
100. Samuel Ramer, “Who Was the Russian Feldsher?,” Bulletin of the History of Medicine 50, no. 2 (1976): 213.
10
1. Garrison, Notes on the History, 171.
102. Halperin, “Nikolai Ivanovich Pirogov,” 351.
103. Ibid., 350.
104. Ibid., 354.
105. Fraser, “Doctor’s Debt to the Soldier,” 63.
106. Ibid.
107. Wolfe, “Genesis of the Medical Department,” 840.
108. Grissinger, “Development of Military Medicine,” 322.
109. Wolfe, “Genesis of the Medical Department,” 23.
110. Grissinger, “Development of Military Medicine,” 324–25.
111. Thomas R. Irey, “Soldiering, Suffering, and Dying in the Mexican War,” Journal of the West 11, no. 2 (1972): 285.
112. Stewart Brooks, Civil War Medicine (Springfield, IL: Charles C. Thomas, 1966), 74.
113. F. William Blaisdell, “Medical Advances during the Civil War,” Archives of Surgery 123, no. 9 (September 1988): 1045.
114. Ibid.
115. Brooks, Civil War Medicine, 74.
116. Ibid.
117. Ibid., 99.
118. Aldea and Shaw, “Evolution of Surgical Management,” 558.
119. Brooks, Civil War Medicine, 100.
120. Ibid.
121. Blaisdell, “Medical Advances,” 1049.
122. Ibid.
123. Willis G. Diffenbaugh, “Military Surgery in the Civil War,” Military Medicine 130 (1965): 491.
124. Aldea and Shaw, “Evolution of Surgical Management,” 558.
125. Brooks, Civil War Medicine, 95.
126. Robert F. Weir, “Remarks on the Gunshot Wounds of the Civil War,” New York State Journal of Medicine 82, no. 3 (1982): 392.
127. David T. Courtwright, “Opiate Addiction as a Consequence of the Civil War,” Civil War History 24, no. 2 (1978): 104–5.
128. Ibid., 106.
129. Ibid., 101.
130. Brooks, Civil War Medicine, 8.
131. Stanley B. Burns, “Early Medical Photography in America: Civil War Medical Photography,” New York State Journal of Medicine 80, no. 9 (August 1980): 1447.
132. McCord, “Scurvy as an Occupational Disease,” 590.
133. John F. Fulton, “Medicine, Warfare, and History,” Journal of the American Medical Association 153, no. 5 (October 1953): 180.
134. Brooks, Civil War Medicine, 106.
135. Taylor, “Retrospect of Naval and Military Medicine,” 615.
136. Brooks, Civil War Medicine, 41.
137. Miller J. Stewart, Moving the Wounded: Litters, Cacolets & Ambulance Wagons, U.S. Army, 1776–1876 (Johnstown, CO: Old Army Press, 1979), 26.
138. Ibid., 33.
139. Ibid., 36.
140. Taylor, “Retrospect of Naval and Military Medicine,” 617.
141. Stewart, Moving the Wounded, 182.
142. Brooks, Civil War Medicine, 37.
143. Estelle Brodman and Elizabeth B. Carrick, “American Military Medicine in the Mid-Nineteenth Century: The Experience of Alexander H. Hoff, M.D.,” Bulletin of the History of Medicine 64 (Spring 1990): 71.
144. Brooks, Civil War Medicine, 37.
145. Brodman and Carrick, “American Military Medicine,” 72.
146. Philip A. Kalisch and Beatrice J. Kalisch, “Untrained but Undaunted: The Women Nurses of the Blue and the Gray,” Nursing Forum 15, no. 1 (1976): 21–22.
147. Chamberlain, “History of Military Medicine,” 248.
148. Reasoner, “Medical Supply Service,” 17–18.
149. Burns, “Early Medical Photography,” 1447.
150. Brooks, Civil War Medicine, 24.
151. Burns, “Early Medical Photography,” 1450–57.
152. Brooks, Civil War Medicine, 28.
153. Blaisdell, “Medical Advances,” 1048.
154. Brooks, Civil War Medicine, 46.
155. Ibid.
156. Ibid., 47.
157. Kalisch and Kalisch, “Untrained but Undaunted,” 24–25.
158. Blaisdell, “Medical Advances,” 1046.
159. Richard B. Stark, “The History of Plastic Surgery in Wartime,” Clinics in Plastic Surgery 2, no. 4 (October 1975): 511.
160. Ibid.
161. Leonard D. Heaton and Joe M. Blumberg, “Lt. Colonel Joseph J. Woodward (1833–1884): U.S. Army Pathologist-Researcher-Photomicroscopist,” Military Medicine 131, no. 6 (June 1966): 534.
162. Burns, “Early Medical Photography,” 1463.
163. Ibid., 1464.
164. Frank R. Freeman, “Administration of the Medical Department of the Confederate States Army, 1861–1865,” Southern States Medical Journal 80, no. 5 (May 1987): 632.
165. Gordon E. Dammann, “Dental Care during the Civil War,” Illinois Dental Journal (January–February 1984): 14–15.
166. Burns, “Early Medical Photography,” 1464–65.
167. Peter D. Olch, “Medicine in the Indian-Fighting Army, 1866–1890,” Journal of the West 21, no. 3 (1982): 32.
168. Ibid.
169. Ibid., 34.
170. Grissinger, “Development of Military Medicine,” 338.
171. As noted in chapter 2, for example, the British did not have a comprehensive pension system even after the Crimean War.
172. For more on the general subject of military psychiatry, including its history and development, see the following from Richard A. Gabriel: No More Heroes; Soviet Military Psychiatry: The Theory and Practice of Coping with Battle Stress (Westport, CT: Greenwood Press, 1986); Military Psychiatry: A Comparative Perspective (Westport, CT: Greenwood Press, 1986); and The Painful Field: The Psychiatric Dimension of Modern War (Westport, CT: Greenwood Press, 1988).
173. Albert Deutsch, “Military Psychiatry: The Civil War,” in One Hundred Years of American Psychiatry, ed. J. K. Hall, G. Zilboorg, and H. A. Bunker (New York: Columbia University Press, 1944), 367.
174. Dorothea Dix was a major force in encouraging humane treatment for the insane in the United States.
175. Germany and Russia were the home of nosological biological psychiatry, and Russian neurologists serving in the Crimean War were the first to take systematic notice of psychiatric casualties. This interest was continued after the war and eventually resulted in the first military medical system for dealing with psychiatric casualties on the battlefield during the Russo-Japanese War of 1905.
176. Donald Lee Anderson and Godfrey Tryggve Anderson, “Nostalgia and Malingering in the Military during the Civil War,” Perspectives in Biology and Medicine 28, no. 1 (Autumn 1984): 156. See also George Rosen, “Nostalgia: A ‘Forgotten’ Psychological Disorder,” Psychological Medicine 5 (1975): 340–41.
177. Gabriel, No More Heroes, 57.
178. Rosen, “Nostalgia,” 342.
179. Gubbins, “Life and Work of Jean Dominique,” 188. Larrey treated the disorder by offering officers suffering from nostalgia bribes and better food if they would remain at their posts.
180. Deutsch, “Military Psychiatry,” 377.
181. Ibid., 370–72; and Weir, “Remarks on Gunshot Wounds,” 393, for the tendency to confuse psychiatric symptoms with malingering.
182. Ibid., 377.
183. Ibid., 372.
184. Ibid., 384.
185. McGrew, Encyclopedia of Medical History, 323.
186. Halperin, “Nikolai Ivanovich Pirogov,” 348.
187. Aldea and Shaw, “Evolution of the Surgical Management of Wounds,” 599.
188. Halperin, “Nikolai Ivanovich Pirogov,” 348.
189. Fraser, “Doctor’s Debt to the Soldier,” 65.
190. After the Prussian defeat at Jena in 1808, the army was reformed under the direction of Gerhard von Scharnhorst, who invented the prototype of the German general staff system that became the hallmark of German military efficiency for the next hundred years.
191. Garrison, Notes on the History, 168.
192. Ibid., 163.
193. Ibid., 169.
194. Stewart, Moving the Wounded, 18.
195. Fielding H. Garrison, “The Statistics of the Austro-Prussian War (‘7 Weeks’), 1866
, as a Measure of Sanitary Efficiency in Campaign,” Military Surgeon 41 (1917): 711.
196. The German Army, along with others, sent observers to the respective sides in the Civil War. These observers prepared staff reports on various aspects of the war.
197. Garrison, “Statistics of the Austro-Prussian War,” 711–13.
198. Ibid., 713.
199. Ibid.
200. Sieur, “Tribulations of the Medical Corps,” 219.
201 Fraser, “Doctor’s Debt to the Soldier,” 65.
202. Lawson, “Amputations through the Ages,” 225.
203. McGrew, Encyclopedia of Medical History, 23.
204. Sieur, “Tribulations of the Medical Corps,” 219.
205. Valentine A. J. Swain, “The Franco-Prussian War, 1870–1871: Voluntary Aid for the Wounded and Sick,” British Medical Journal 29, no. 3 (August 1970): 514.
206. Chamberlain, “History of Military Medicine,” 246.
207. Swain, “Franco-Prussian War,” 512.
208. Ibid.
209. Henry E. Sigerist, “War and Medicine,” Journal of Laboratory and Clinical Medicine 28, no. 5 (February 1943): 535.
6
THE TWENTIETH CENTURY
The Emergence of Modern Military Medicine
As the twentieth century began, general and military medicine stood on the threshold of remarkable progress in their ability to save lives. The period witnessed the most important advances in disease prevention and surgical knowledge in human history. Medicine had become fully integrated into the larger web of general scientific exploration and discovery to where it finally stood as an equal partner in developing and sharing new scientific discoveries. This trend toward the integration of science and medicine, first begun by the Germans in the 1870s, has become the major characteristic of modern medicine in all developed societies. The walls between academic and scientific disciplines have largely crumbled, and the old prejudices between surgeon and physician have finally disappeared.
The advancement in medical knowledge and technique characteristic of postindustrial societies was already evident at the turn of the century and has resulted in the rapid application of these discoveries to military medicine. In turn, the press of war and the social organization of research increased the military medical establishment’s ability to make contributions to general and specialized medicine that would have probably taken years to occur in peaceful times. For example, military doctors achieved almost all the early advances in immunization and the prevention of communicable disease.1 The general mobilization of civilian medical resources for wartime use brought many new problems to the attention of the civilian medical establishment and at the same time provided its practitioners the opportunity and resources to address them through wartime service. Except for social rank, now no significant differences remain between military and civilian medical practitioners. Moreover, neither medical establishment is able to generate significant new knowledge without quickly attracting the attention of the other.
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