ORIGINAL ARTICLES 8. Crawforo ES. Bomberger RA. Glaeser OH. et al. Ao_iliac occlusive disease. Factors influencing. survival and function following reronstructi.ve operation over a 2>year period. Surgery 1981; 90: HISTORY OF MEDICIl'iE 1055-1067. 11I.. 9. Nevelsteen A. Wourers L. Suv R. Aortofemoral Dacron reconstruction for aorto-iliac occlusive disease. A25-year survey. E';" JVase Su')I 1991; S, 179-186. 10. Reddy E. Robbs jY, Human RR. Rajaruthnam P. Early results of aortobifemoral bypass - a comparison between Black and wlUte patients. S AIr JSu')I 1982; 2ft 283-288. MEDICAL RECIPIENTS OF THE 11. Seftel He The rarity of coronary heart disease in South African blacks. S AIr Med J1978; ~ 9'J. 105. 12. Seeda. YK. Maye! FGH. Khan S. et al. Risk factors for coronary heart disease in the Indians of VICTORIA CROSS DURING THE Durban. S AIr Med J1990; 78, 447-454. 13. Seedat Yl<. Mayet FGH. Gouws E. Risk factors for coronary heart disease in the white ANGLO-BOER WAR, 1899 -1902 community in Durban. S AIr Med J1994; ~ 257·262. 14. Clarke RJ, Provan JL The Surgical treatment of aorto-iliac occlusion Br JSurg 1969; 56:: ~2.55. 15. Darling RC, Brewster DC, Hallet ]W, Darling RC ill. Aorta-iliac reconsl:ruction. SUTg CIin North Am 1979; 5~ 565-580. JC de Villiers, CV Small 16. Talkington CM. Thompson JE. Prevention and management of infected prostheses. Surg Clin North Am 1982; 6Z, 515-530. 17. Robbs jY, Reddy E, Ray R Antibiotic prophylaxis in aortic and peripheral arterial surgery in the presence of infected extremity lesions. Results of a prospective evaluation. Drugs 1988; 35: 141­ The most democratic and at the same time the most exclusive 150. ofall orders ofchivalry - the most enviable order ofthe 18. Goldman L, CaIdera DL, Nassbaum SR. Multifactorial index of cardiac risk in non-cardiac Surgical procedures. N Engl JMed 1977; 297, 845-850. Victoria Cross.' 19. Hoffman OM, Robbs JV. Systemic complications after elective abdominal aortic surgery - a retrospective analysis. S AIr JSu')I 1989; 27, 125-128. Prince Edward ofWales, later King Edward VII 20. Reddy E, Robbs]'l, Rubin J. Abdominal aortic aneurysm resection - operative and long-term results. S AIr Med J1985; 67, 921·923. The need for a British decoration for valour in time pf war 21. Boucher CA. Brewster DC, Darling RC, et al. Determination of cardiac risk by dipyridamole-­ became apparent during the Crimean War, and in J;esponse to thallium imaging before peripheral vascular swgery. N Engl JMed 1985; 3U, 389-394. 22. Madiba lE, Mar.; M, Robbs)v. Aortobilemoral bypass in the presence of superficial artery this Queen Victoria instituted the Vi.ctoria Cross (VC) in a occlusion. Does the profunda femoris artery provide adequate runoff? JR Coli Su')I Edinb 1998; warrant dated 29 January 1856. The essential qualification was 43,31()'313. the performance of 'some signal act of valour or devotion in Accepted 4 fan 1999. the presence of the enemy'. At the Queen's request, the cross was to be cast from the metal of cannons captured during the Crimean War, and to this day ingots melted from the guns captured at Sebastopol are held in stock at the Central Ordnance Depot for this purpose.' The demand has never exceeded the supply of metal - fewer than 1 500 of these crosses have been awarded since 1854, when the first warrant became active. There have been a number of warrants since that time, but they have served merely to broaden the scope of the award and to deal with practical matters related to it. The essential qualification for earning the VC has, however, remained unchanged.' During the Anglo-Boer War, which followed less than 50 years later, the VC was awarded 78 times, including seven times to medical officers who distinguished themselves by unusual bravery. However, the award of this distinction to medical officers did not occur as a matter of course. When the first two medical men who received the VC in the Anglo-Boer War, namely Major Babtie and Lieutenant Douglas, were recommended for this award, an editorial in the BM] indicated an anomaly in this procedure. The brave actions of these two officers had been reported in telegrams and in correspondence from the front, but they had not been mentioned in dispatches, where such recommendations are properly made. In this . editorial the rumour that the Commander-in-Chief at the time 7 Finsbury Avenue, Newlands. Cape Town J C de Villiers, MD. FRCS (Engl, FRCS (Edinl. Emeritus Professor of Neurosurgery. University ofCape Town Groote Schuur Hospital. Cape Town CV Small. BA, Senior Administrative Officer December 1999, Vo!. 89, No. 12 SAMJ , ORIGINAL ARTICLES was against the bestowal of the VC on medical officers was Medical Corps (RAMC), with which he served in South Africa also mentioned. Apparently Sir Redvers Buller had excluded a from the beginning of the war. During the battle of non-medical candidate from consideration for the VC on the Magersfontein (11 December 1899) Lieutenant Douglas RAMC basis that he was only obeying orders and doing his duty.3 It was the medical officer in charge of the Black Watch (Second was pointed out that such a restriction on awarding the VC Battalion Royal Highlanders), which suffered so heavily in that would be contrary to the Queen's intention in establishing this encounter. Later that morning he lost touch with the Black award 'for conspicuous bravery in action, without any Watch and was attending the wounded of another unit when distinction whatsoever as to rank, corps, or class'. This matter he was called to attend a wounded officer of the Gordon was apparently resolved for the time being, but was raised Highlanders in the front line of fire. He immediately made his again with the last award of the VC in that war, namely to way across open land under heavy fire to within about 250 Surgeon-Captain Martin-Leake. yards of the Boer trenches where he attended to Captain The seven medical officers who received the VC will be Gordon, Major Robinson and some wounded men. Despite the presented in chronological order. persistent heavy fire he continued to attend to the wounded until a general retire was ordered. Later that day, while procuring water for the men of the Black Watch, he suffered a HENRY EOWARO MANNING DOUGLAS severe facial wound from a shell fragment. The VC was (1875 - 1939) conferred on him for these acts of heroism.' Born at Gillingham, Kent on 11 July 1875, he received his As well as the advance on Kimberley, Lieutenant Douglas education in Edinburgh, took the Scottish triple qualification in also took part in operations in the Cape Colony and Orange 1898, and in July of the same year entered the Royal Army River Colony. He was mentioned in dispatches in March 1900, and for his activities in the South African campaign he received the Queen's medal with two clasps as well as the Distinguished Service Order (DSO). He was invalided to England in 1901 but served with the RAMC in a number of subsequent campaigns, namely East Africa (1904), Somaliland (1903/4), India (1904­ 1908), Serbo-Turkey (1912/13), and Serbo-Bulgaria (1913). These activities earned him several decorations. During the 1914 - 1918 war he served for 4 years in France, mostly as Assistant Director of Medical Services (ADMS) and later at Archangel again as ADMS of the British troops in Russia. He was mentioned in dispatches twice, and received a brevet as a Colonel and the Companion of the Order of St Michael and St George (CMG) as well as the French Croix de Guerre with Palm. In 1926 he was appointed Deputy Director of Medical Services of the Scottish Command in Edinburgh and later that year became Commandant of the Army Medical College at MilIbank. On promotion to Major General he went to India as Deputy Director of the Southern Command at Poona, and retired from the RAMC in 1929' He died in 1939 at Droitwich in Worcester. WILLIAM BABTIE (1859 - 1921) Major Babtie, a Scot by birth, obtained his Bachelor of Medicine in 1880 and entered the Army Medical Service the next year. By 1893 he had attained the rank of Major and after a spell as Senior Medical Officer in Crete, for which he received the CMG, he was sent to South Africa on the staff of the Natal Army in 1899. It was at the battle of Colenso that Major Babtie, Major-General Henry Edward Manning Douglas, Vc, CMG, DSo. under extremely difficult circumstances, distinguish.ed himself (Photograph: Courtesy of the Army Medical Services Museum, and earned the Vc. Aldershot.) -~ Descriptions of this act of bravery were provided by two of Salonika. In 1912 he was created a CB (military), in 1916 a Babtie's medical colleagues who were in South Africa at the Knight Commander of the Order of St Michael and St George time, namely Dr Arthur Conan Doyle and Mr Frederic Treves. (KCMG) and a Knight Commander of the Order of the Bath Colonel Long had rapidly brought his batteries of field (KCB) in 1919 - the year that he retired with the rank of artillery to within 1 000 yards of the enemy and in doing so Lieutenant General. He died on 11 September 1920 while on had outstripped the infantry brigades on their flanks and holiday in Belgium.' opened fire. 'Suddenly there was poured upon them from the shelter of a mimosa wood such a torrent of lead that in a EDGAR THOMAS INKSON (1872 - 1942) moment there was scarcely a horse or man standing:' 'Officers and men were falling fast.