J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

134 J8cboes of tbe )past.

EVENTS IN INDIA, 1857-1858.

By LIEUTENANT-COLONEL G. A. KEMPTHORNE, D.S.O., Royal Army Medical Oorp8.

THE PERSIAN WAR. THE honours, Reshire, Bushire, Koosh-ab, borne on the colours of the Durham Light Infantry, commemorate the part taken by their 2nd Battalion, formerly the Company's 2nd Bombay Europeans, in the Persian War. The remaining British regiments which participated were the 14th Hussars, the 64th (1st North Staffords) and the 78th (2nd Sea forth Highlanders). The exciting cause was the refusal of the Persians to evacuate Herat, and the ,first objective was Bushire in the Persian Gulf, which was occupied- by a force sent from Bombay after some resistance on December 10. Major­ General .Tames Outram having arrived with more troops, an expedition to the mouth of the Euphrates followed, and a detachment, ascending the

river in three steamers, ,defeated the enemy at Ahwaz. There were several Protected by copyright. minor engagements, in some of which a spirited resistance, was offered, bllt our battle casualties were few. The main feature of the campaign was the cold, drenching rain and the mud, which literally tore the boots off the men's feet. That the sick-rate was a low one was much to the credit of Outram, who devoted infinite care to his men's well-being. The depressing _ conditions may have contributed to the suicide of the second ill command and the naval commodore, which occurred within a few days of each other. Surgeon M. 8tovell, of the Company's Service, was superintending surgeon; a field hospital accompanied the force, which had also its full regimental, medical establishmeuta 'and regimental hospitals. 'rhe greater part of the

troops returned to India in April, where more serious work awaited them. http://militaryhealth.bmj.com/

THE INDIAN MUTINY. The indiscipline of the native troops of the Bengal army, which for some years had been steadily increasing, culmina.ted on Sunday, May 10, 1857, in a rising of the Indian regiments of the garrison. Though there were British troops in the station, the mutineers, who were joined by the disorderly element in the bazaar, were. permitted, after sacking and burning the European bungalows in their lines and murdering many of their occupants, to march unmolested to .. At that station, which was held by an Indian brigade, the regiments joined the sepoys from )\!leerut, on October 2, 2021 by guest. , massacred most of the Europeans in the civil station, and, having shot several of their officers, occupied the city. The survivors escaped to Meerut or Karnal. Outbreaks quickly followed in other stations, where officers and civilians with their wives and families were either murdered, closely besieged, or became fugitives on the countryside. Among the early victims J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

G. A. Kempthorne 135

of the Mutiny were a number of officers of the Bengal Medical Department who were either killed outright or lost their lives in trying to reach the nearest British garrison.- rrhe British troops, of which there were nominally 38,000 in the East Indies, were at this time widely dispersed. Some were 'still in F~rsia, three battalions on the Bengal establishment were in Burma, four, with the bulk of the European artillery, were in the Punjab, three in the Simla hills, and one in Oude. There was no scheme drawn up for a general mobilization. The contractors on whom the Army depended for transport and supply were, in the general disturbance, not forthcoming. Medical organization, like that of the Army generally, was on regimental lines, and neither stores nor doolies could be produced off~hand to provide even for the small force which was hurriedly collected round Ambala. The M edical Departments of the three Presidencies were administered by their Medical Boards. The system was already recognized as unsatisfactory, and, six months later, the Boards were replaced by Directorates. Meanwhile, Dr. Edmund Tritton, one of the Calcutta Board, assumed the duties of Superintending Surgeon to the column, assembled under General Anson, the Commander-in-Chief in Bengal. Protected by copyright. The main centres to be dealt with were three: Delhi, Cawnpore, where 150 British soldiers with the civilians of tbe station were besieged in tbeir cantonment, and , the capital of Oude, where the 1:32nd, some gunners, and a few loyal native troops held out under Sir Henry Lawrence, the Commissioner. Of these, Delhi, as the centre of the rebellion, and the seat of the former Mogbaldynasty, whose representative the rebels bad made their nominal leader, was considered of supreme importance.

DELHI. General Anson, who was in Simla when he received the news of the events at Meerut, ordered the 75tb (1st Gordons) from Kasauli to Ambala, http://militaryhealth.bmj.com/ where there were already the 9th La,ncers and some of the Bengal Horse Artillery. The Sirmur Batta,lion of Gurkhas waR sent to join the Carabiniers and 60th at Meerut. The 1st Bengal Fusiliers (Munsters) were also brought up, arriving on elephants, with neither tents nor luggage. He himself arrived at Ambala on May 15, and led out the troops, including in the column the 60th Native Infantry. This corps was a few days later dis­ carded as disloyal. On the following day he reached Karnal; where he died of cholera, introduced by the regiments marching down from the hills. Sir Henry Barnard then took command, and, marching on the 27th, reacbed on October 2, 2021 by guest. Alipur on June 7, where .he was joined by the Meerut troops and Hodson's

1 These included Dr. Christie, 3rd Cavalry, Meerut, May 10; Surgeon Smith; of the Invalid Establishment, May 10; Assistant Surgeon A. Dopping (54th N.I.), Delhi, May 11; H. H. Bowling, Shahjehan,pur ; J. M. Hay, Civil Surgeon, and G. Hansbrow, Superintendent of the gaol at Bareilly, both hung after.a form of trial, May 31; IN. B.McEgan and wife (12th N.I.), Jhansi, June 8; Superintendent Surgeon K. W. Kirke, Gwalior, June 14. J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

136 Events in India, 1857-1858 Horse under Brigadier Archdale Wilson. Here also there arrived a light train and the Sirmur Gurkhas, bringing the number of fighting men up to about 15,500, with 22 field guns. The Gurkha was a far less familiar figure on the plains of India than he has since become. Writing of another detachment, their medical officer expressed a poor opinion of their probable value in the field. "They suffer much from the heat, as much as we do. They march with umbrellas and often with fans. They have no notion of keeping together, and are the dirtiest set I ever saw in my life. They eat ravenously and their food is uncooked, or nearly so. ' fJ.'hey take no care or notice of their sick." There had been many casualties from the heat, The British marched in their shirt sleeves with a white cover and curtain over their forage caps, Protected by copyright.

l.( n f iZ .b "- L

oJaba (if; http://militaryhealth.bmj.com/

Haidarabad o

which afforded but poor protection from the sun. On June 8 Barnard engaged the mutineers in a strong position at Badli-ki-Serai; and drove them into Delhi at' a cost of 182 casualties. The force then occupied the ruined cantonment on the Ridge. fJ.'here was no question of a siege. The city was seven miles in circumference, and for the next two months the . small body of troops was fully engaged in holding its own against constant on October 2, 2021 by guest. attacks. In the sweltering heat the men had no other shelter than their bell tents, but two or three bungalows which had escaped destruction were available for the worst of the sick and wounded. Speaking of the medical arrangements, Lord Roberts, in " Forty One Years in India," wrote: "The Delhi Force was fortunate in its medical officers. Some of the best in the J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

G. A. Kempthorne ·137'

Army were attached to it, and all ~hat was possible to be done for the sick and wounded was done, but the poor fellows had a bad time of it. Those who could bear the journey were sent away to Meerut and Ambala,'but, even so, with the relief thus afforded, the hospitals were terribly over­ crowded. Anresthetics were freely used, but antiseptics were practically unknown, consequently many of the wounded died, and few amputation cases survived." Barrack construction in the plains was at the time sWl in its infancy. The Indian troops built their own lines; the regimental hospitals were mainly thatched barrack huts with a mud floor hardened with cow dung, For some years, however, so-called sanatoria had existed at various places in the hills, such as Kasauli and Landour, and to these some of the more transportable cases found their way. Station hospitals there were none. On June 27 the rains broke, and there was a great access of cholera cases. On July 5 Sir Henry Barnard was attacked, and died within a few hours. The flies swarmed. Roberts, as a D.Q.M.G., was responsible for camp conservancy, and the disposal of the bodies of dead transport animals he found an almost impossible task. The jackals helped, and he gratefully acknowledged the services of hundreds of adjutant birds who Protected by copyright. made an un wonted appearance in the district. Reinforcements came in driblets, but on July 22 the arrival of the Punjab Movable Column under Brigadier John Nicholson raised the number of effectives on the Ridge to nearly 8,000. In addition there were, in spite of evacuation, 1,535 sick and wounded. By September 6 all possible reinforcements had arrived, when the swelling sick list rendered a decision imperative aH to whether an assault should be attempted or the force withdrawn.1 General 'Wilson, now in command, hesitated. Apart from the risk of failure, he seems to have feared that success might mean the dissolution of his army, which wouid scatter about the city in search of loot. But on the early

morning of the 14th the assault began. The men were told that all http://militaryhealth.bmj.com/ who fell were to be left on the ground. If the attack succeeded, doolies would be brought up; if it failed, wounded and sound, alike were to blO) prepared for the worst. By evening a small portion of the walls was in our hands with a loss of 1,104 killed and wounded; by the 20th, aher fierce street fighting, the whole city was won. Among the wounded was the heroic Nicholson, who was shot through the chest. The sack of Delhi had already begun, and the bearers who were carrying him: awa;y set down the dooley and went off to plunder. Lord Roberts, passing by, found him alone and in great pain. Collecting some bearers with difficulty, he despatched him to the hospital on the Ridge where' he died nine days on October 2, 2021 by guest. later. The regimental surgeons accompanied the assaulting cblumn. A regi­ mental aid post had been established at the end of some of the streets, when

I As an example, the 52nd, which arrived from the Punjab three weeks before. 600 strong, mustered 245. J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

138· Events in India, 1857 -1858

a party of rebels established themselves ill one of the houses and commenced firing from the roof. Surgeon H. T. Reade of the 6Ist promptly drew his sworn, and, calling upon the few soldiers who were near to follow, succeeded, under a very heavy fire, in dislodging the enemy from their position. Of the ten men who undertook this duty, two were killed and six wounded. Surgeon Reade received the . Lord Roberts wrote of the : "The behaviour of the troops was beyond all praise; their constancy was un wearied, their gallantry most conspicuous; in thirty-two different fights they were victorious over long odds, being often exposed to an enemy ten times their number, who more­ over had the advantage of ground and superior artillery. For three months, day after day,· and for the greater part ·of the day, every lllan had to be con­ stantly under arms, exposed to a scorching Indian sun, which was almost as destructive as, and much harder to bear than, the enemy's never ceasing fire. 'l'hey saw their comrades struck down by cholera, sunstroke. and dysentery, more dispiritingo./), thousand times than. .the daily casualties in action. They beheld their enemies reinforced, while their own number rapidly decreased. Yet they never lost heart. The effective force at Delhi never amounted to 10,000 men. Of these 992 were killed and 2,845 Protected by copyright. wounded, besides hundreds that died from disease and exposure."1 The incidence of disease varied considerably in the different units. Cholera, which was never entirely absent, caused heavy wastage in the Sth, 52nd and 61st. rrhe 60th, which was generally acknowledged to be the finest battalion at Delhi, suffered less. If there was one redeeming feature amid many.others conducive to bad health on the Ridge, it was the absence of the temptations of the bazaar and the curse of idleness. Innes, in his "History of the 1st Bengal Fusiliers," notes that the sick-rate in his battalion was .but little above that usual in cantonments, which he ascribes to the fact that the men were kept busy. . General Wilson in his despatch of September 22, lS57,stated: "With http://militaryhealth.bmj.com/ the medical arrangements of the Superintending Surgeon, B. Tritton, I have every reason .to be satisfied and he is entitled to my cordial. acknow­ ledgments. 'l'he labours of tpe Medical Department have been unceasing, notwithstanding there has ilOt been at any time the slightest failure in the arrangements for the care and comfort of the very numerous patients." He also mentioned Officiating Superintending Surgeon C. McKinnon, in medical charge 1st Brigade H.A.; Surgeon J. H. Kerr Innes, 60th; J. P. Brougham, 1st Bengal Fusiliers; E. Hare, 2nd Bengal Fusiliers; Assistant Surgeons J, Clifford, 9th Lancers; W. F. Mactier, on October 2, 2021 by guest. . personal staff; and Surgeon D. Scott, medical storekeeper. The following medical officers served with British regiments at Delhi. 6th Dragoons.-Assistant Surgeons Stuart Moore (fatally wounded), D. S. Smith. .

1 On October 19 there were present 9,699 effectives. 2,368 sick, and 617 wounded. J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

G. A. Kempthorne 139 9th Lancers.-Assistant Surgeons J. J. Clifford, D. S. Sinith. 52nd (2nd Oxford L.I.).-Surgeon W. J. Ingham, Assistant Surgeons C. A. lnnes, H. A. Gogarty. 60th (K.R.R.).-Surgeon J. H. Kerr Innes. 61st (2nd Glosters).-Surgeon H. T. Reade, Assistant Surgeons R. McNab, C. M. M. Miller, A. Hoyle. 8th (King's Livelpool).-Surgeon F. C. Annesley, Assistant Surgeons '1'. J. Biddle, W. H. Yates. 75th (1st Gm'don Highlandet·s).-Surgeons J. Coghlan (died on march), C. Dominichetti, Assistant Surgeons A. H. Fraser, S. A. Lithgow (wounded); W. S. Whylock. 1st Bengal Fusiliers (1st Munste1·s).-Surgeoll J. P. Brougham, Assistant Surgeon Charles (both of the Company's Service). 2nd Bengal Fusiliers (2nd l'}Iunsters).-Surgeon E. Hare (Company's Service). Corps unidentified.-Assistant SurgeonD~ R. Rennie, A.M.D. The battle casualties among the medical personnel were not excessive; Stuart Moore died from wounds received at the Battle of Ghazi-ud-din­ Nuggur before Delhi was reached, Assistant Surgeon T. H. Woodward was Protected by copyright. killed August 31, Assistant Surgeon W. W. Ireland of the Bengal Artillery was on August 25 shot through the eye, the bullet passing below the brain and out behind the ear. He more or less recovered, and died in 1909. The number of officers of the Bengal Medical Department present at one time or another during the siege seems to have been something like forty. LUCKNOW. At Lucknow Sir Henry,Lawrence, the Commissioner in Oude, had fore~ seen the storm, and when it broke the British retired to the Residency and neighbouring houses which had been to a certain extent fortified for a siege and provisioned. After a small and rather disastrous engagement http://militaryhealth.bmj.com/ with the mutineers, the British troops and a fi;lW loyal sepoys were also withdrawn within the defences. The area occupied was a space of abont thirty-seven acres with a perimeter of a mile. The space was filled by the Residency and various private houses, including that of Assistant Surgeon Joseph Fayrer, who had the post of Residency Surgeon. The houses were distributed as posts, each with its own garrison. The stretlgth of the defending force was 1,700, of which 500 belonged to the 32nd (D.C.L.I.), nearly 200 being officers of mutinied regiments with other details including

a detachment of the 84th, and 150 civilians. There were 800 natives and on October 2, 2021 by guest. 600 women and children. The enemy outside was estimated at 6,000 and was continually reinforced. On the second day of the siege Sir Henry Lawrence was wounded by a fragment of shell which bnrst in his room where he was writing. Fayrer, who first attended him, stated, "I found a large fragment had shattered the upper part of the thigh bone, passing through the thigh and gluteal J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

140 Events in India, 1857-1858 regIOn of the left side. I believe also that the bones of the pelvis were injured. I consulted other medical men, including Dr. Partridge and Dr. Ogilvie, but all agreed that the injury was of too serious a nature to leave anybope of recovery." He died on the morning of July 4. On the 20th Major Banks, the second civil officer, was I{illed, when Oolonel Inglis of the 32nd assumed chief command. Apart from the fire of the enemy and the constant strain or watching the extended and weak defences with an inadequa,te force, the insanitary conditions prevailing contributed to the losses of the garrison. The followers were reduced by desertions, and few men capable of bearing arms could be spared for the work of conservancy. The stagnant pools caused by the rain could not be drained and bred mosquitoes; the offal and dead animals lying about attracted' myriadR of flies. The area in which com­ parative shelter from the heat and the enemy's fire could be obtained was limited; overcrowding resulted, and contagious disease spread. The banquet hall was turned into a hospital where similar overcrowding pre­ vailed. There was a high case mortality, and all amputations proved fatal. Few children survived the siege. Oolonel lnglis stated in his despatch, " Besides heavy visitations of cholera and smallpox, we also had to contend Protected by copyright. against a sickness which has almost universally pervaded the garrison. Com­ mencing with a very painful eruption it has merged into a low fevercom­ bined with diarrhma, and, although few or no men have actually died from its effects, it leaves behind a weakness and lassitude which, in the absence of all material substances save coarse beef and still coarser flour, none have been able to get over ."1 The medical officers took their share of the fighting, besides performing their ordinary duties. The senior was Surgeon C. Scott of the 321ld, of whom one of the garrison wrote: "Though apparently rough, his arrival was always hailed with pleasure by everyonE' in hospital. For some poor soldier he usually had a trifling present, and though he bestowed his favours http://militaryhealth.bmj.com/ with a degree of roughness bordering on rudeness, sometimes, he did so in order not to have the thanks of the recipient. The 32nd all looked to him as a father."2 William Boyd was his assistant surgeon. The remaining officers, all of the Company's service, were Surgeon W. Brydon, of the 71st N.L, who had survived the Kabul retreat, and was severely-wounded during the siege; Surgeon Ogilvie, the SanitaryOommissioner; Surgeon Oampbell of the 7th Light Cavalry; Surgeons -Pitt, 13th N.L, and Wells 48th; Assistant Surgeons: J. Fayrer, Residency Surgeon; R. Bird of the Artillery, S. B. Partridge, A. M. Greenhow, J. B. MacdonaJd, E. Darby, on October 2, 2021 by guest. Hadow, and Mr. Apothecary Thomson. Macdonald died of cholera, and Darby was mortally wounded. Between June 30 and September 26, of the

1 Surgeon Home of the relieving force found no definite cases of scurvy among the garrison. Fresh beef was issued throughout the siege, but green vegetables were unobtainable.

2 Hees, "Siege of Lucknow." J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

G. A. Kempthorne 141

fighting men, 140 Europeans were killed and 190 wounded. r.rhe strength had fallen from 927 to 577; showing that many others had died. Of the natives, 130 were dead and 230 had deserted. Of the women, 2 had been killed, 9 had died. Of the children, 53 had died. On September 25, Generals Havelock and Outram with reinforcements fought their way into Lucknow. The events leading to the First Relief of Luclmow, so called, may now be followed. Early in June Benares with the supremely important military depot at Allahabad were secured by the energy and initiative of Colonel NeiU with some companies of the Madras Europeans which had been brought by sea to Calcutta. The railway ran as far as Raniganj, about 120 miles, and, the troops were entrained as fast as they could be disembarked from the flats in the river. So little was the situation appreciated by the railway officials that the stationmaster insisted that the train must be started before one of the companies, which was ten minutes late, had arrived. The guard and engine-driver were equally obstructive, and Neill promptly put them under a guard and took charge of the station. On arrival at railhead the men were pushed on in every conveyance that could be found. N eill himself reached Benares with a handful of his command on June 3. The Protected by copyright. . sepoys resisted disarmament and opened fire on the British. They were dispersed and ruthlessly pursued into the surrounding country. A few days later the fort at Allahabad was reinforced and the whole district reduced to order. Mutiny and murder were punished with a firm hand, in some cases by hanging, in others by blowing from the guns. A medical officer has recorded his impressions of the last operation. "After the explosion the grouping of the men's remains in front of each gun was various and frightful. One man's head was perched upon his back, and he was staring round as if looking for his legs and. arms. All you see at the time is a cloud like a dust-storm composed of shreds of clothing, burning

muscle, and frizzling fat with lumps of coagulated blood. Here and there http://militaryhealth.bmj.com/ a stomach or a liver comes falling down III a stinking shower." It was indeed difficult to estimate the range of these fragments of humanity, which we read of elsewhere as ruining the magnificent uniforms of the Bengal Horse Artillery drawn up for the parade. Neill, who had a proper contempt for the mutineers if firmly dealt with by a disciplined force, fixed oJ? Cawnpore as his next objective, and had already despatched a small column in that direction when Brigadier-General Havelock arrived to take over command. A week later the relief force started along the Grand Trunk Road in pouring rain, 1,403 British and 561 Indian troops. It was the worst season of the year; most of the British on October 2, 2021 by guest. had only winter clothing, but the Madras Europeans were provided with white smocks and trousers and had curtains over their forage caps. The road was one scene of desolation, every bungalow pillaged and burnt to the ground by the natives, in return for which all their villages were burnt down and the bodies of rebels were hanging by half-dozens from the boughs J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

142 Events in India, 1857-1858 of the trees on the roadside. The following composed the,' cplumn : H.M. 64th (1st. N. Staffords), 78th (~nd Seaforth Highlanders), 84th (2nd York and Lancaster Regiment), the H.E.I.C.'s Madras Europeans(lst R. Dublin Fusiliers), R.A. (76), Bengal Artillery (40), Volunteer Cavalry (20), and Irregulars (543). At Fatehpur there was a brush with the enemy, and, 80s 'il; foretaste of the future, there were twelve deaths from sunstroke. On the 15th the rebels were again routed with a loss on our side of twenty casualties.' On arrival at Maharajpore it was decided to press on, leaving the field hospital and baggage behind. As Cawnpore was approached the men fell down in numbers from heat stroke and exhaustion. On the 17th Havelock fought his way in to find he had arrived too late. The column during the previous nine days had marched 126 miles. Apart from battle casualties, cholera had appeared, and there now remained a little over 1,500 men fit for duty. The happenings at Cawnpore were briefly as follows. On June 6 the sepoys rose and proclaimed Nana Sahib, the adopted son of the last ()f the Pe shwas, sovereign of the Mahrattas. The British under the command of Sir Rugh Wheeler, a veteran officer, were besieged in a feeble entrench-' Protected by copyright. ment thrown up round two barra&k blocks in the cantonment.l These were one-storied buildings with thatched roofs, surrounded by an earthern parapet five feet high. The space was crowded, the heat intense, and the water supply from a well, which was under continual fire. A second well ontside the parapet served as a cemetery, and received the bodies of 250 persons during the siege. On the fourth day the buildings, which gave some protection to the sick, wounded, and women and children, were set alight by red-hot cannon balls, forty helpless patients were bUl'llt to death, and surgical instruments and medical stores destroyed. For twenty-two days the garrison held out against constant attacks and artillery fire,

making numerous gallant sorties in which some of the enemy's guns were http://militaryhealth.bmj.com/ spiked. Rations were reduced to a handful of atta and dhal daily .. At length terms were' agreed to under which the survivors were t() be trans­ ported in boats to Allahabad. The boats were fired on, those who were not killed outrigbt were dragged ashore, the men were then killed, the women' and children were hacked to pieces by sweepers armed with swords a fort­ night later. The names of eight medical officers, with those of their wives and children, are found in the list of the g~rrison. Of these, Christopher Garbett, Superintending Surgeon, and Collyer of the 53rd N .I., died during the siege. W. R. Boyes, medical storekeeper, D. Macaulay, Artillery, , R. P. Rarris, Civil Surgeon, A. W. E. Newenham, R. D. Allen, and J. P. on October 2, 2021 by guest. Bowling were murdered.

1 84th Regiment (60), 32nd (74), all invalids, Madras European'Regiment (15), ArtillerY (59). Officers of Native regiments (100), women and children (400),civilians (about 100),; natives (abont 100). J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

G. A. Kempthbrne 143 The names of those who died at Cawnpore deserve honourable remem­ brance. Amid the shocking details of their ultimate fate, the gallant and spirited nature of the garrison's defence against overwhelming odds is liable to be forgotten. Havelock spent a week in Cawnpore, while Colonel Neill with 250 men was brought up to take charge of the city. The General was in considerable anxiety as.to the effect the halt would have on the men exposed after an exhausting march to the temptations of a captured town. He wrote to the Commander-in-Chief, " I have ordered all the beer, wine, spirits, and every drinkable thing in Cawnpore to be purchased by the Commissariat .... If it remained at Cawnpore it would require half my force to keep it from being drunk up by the other half, and.I should not have a soldier in camp. " As things were, there was great increase in sickness. On the 26th the river was crossed, but, after several skirmishes with the rebels, Havelock was compelled by diminishing numbers and the impossibility of disposing of his sick and wounded to return to Cawnpore. One sixth of his men had perished, half in battle and half by disease.1 Of the 1,415 British re­ maining, 335 were in hospital and seventy more were unfit to march. The deaths were six 'a day, and the senior medical officer was constrained to Protected by copyright. point out that in six weeks the force would cease to exist. H~.velock wrote, " The medical men yesterday recommended repose, but I cannot halt while the enemy keeps, the field, and in truth, our health has suffered less fearfully e~en in bivouac than in cantonment." Nevertheless the column was now marched and fought to a standstill. Shortly afterwards Sir James Outram came in with reinforcements, bringing the numbers up to something over 3,000, and, on the evening of September 18, leaving 400 convalescents to hold Cawnpore, Havelock recrossed the , marching for four days in heavy rain. On the 23rd, with slight opposition, he reached Alum Bagh within two miles of Luclmow,

which was occupied, and here the field hospital and heavy baggage was http://militaryhealth.bmj.com/ deposited. On the 25th, advancing bya devious route, involving a circuit of some five miles and much street fighting, he reached the Residency. The only chance for those who feU was to be taken on in doolies. These, with the rearguard, were forced to take refuge in a building called the Moti Mahal, nearly a mile from the Residency, where they were closely besieged. The regimental rp.edical officers of the 78th, Surgeon J oseph J ee and Assistant Surgeon V. M. McMaster, were hard put to it to keep the bearers together, and, with the help of the escort, to get the wounded under cover, in which work they displayed the utmost gallantry and devotion. A party was sent on the following day to extricate them. In. on October 2, 2021 by guest. removing the wounded, the convoy in charge of Surgeon A. D. Home of the 90th and his assistant surgeon, W. Bradshaw, was misled by their

1 The deaths in the 78th from July 1 to December 31, 1857, were, in battle 94, from cholera 69, other causes 28. J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

144 Events in India, 1857-1858

guide, andwa,s trapped in a small square where it came under heavy fire. The assistant surgeon in the rear of the convoy, ably assisted by his apothecary, Mr. Hurst, succeeded in extricating twenty of the doolies, which, with great difficulty, he ~onveyed safely to the Residency. Forty remained, the bearers of which had either been killed or had run away. vVith these remained also Surgeon Home and eight others, who, occupying one of the houses, for some hours kept the enemy at bay and to a great extent protected the helpless wounded. At length the house was set on fire, the party was driven to anot.her refuge, and the wounded were cut to pieces or burnt to death in their doolies. Home and six survivors held out for over twenty-four hours, when relief came. All four officers above mentioned received the Victoria Cross.' The casualties in the two' days fighting amounted to 119 killed, 339 wounded, and 77 missing, the last all being killed. The only fatality a,mong the officers of the medical service was Assistant Surgeon A. H. B'artrum of the Artillery, whose wife was awaiting his arrival in the Residency . . After the arrival of the relieving force the defences were set in order

and extended. The strain on the defenders was relaxed, but the siege Protected by copyright. continued. r:J;'he field hospital was brought in under cover of night, but most of the medical stores remained in the Alulll Bagh.2 There were no medical comforts and chloroform had run out. The hospital was securely barricaded ., without detriment to ventilation," tents were pitched, and fresh buildings taken up for the hospital patients, whose number was now increased from 130 to 627. Old tents were cut up for bedding. Surgeon Scott of the 32nd continued to perform the duties of superintending surgeon. Under the direction of Dr. Ogilvie, the Sanitary Commissioner of Oude, the defences, including the posts recaptured from the rebels, were reduced to something like a sanitary condition. It will be seen that Havelock's relief of Lucknow was no relief at all, http://militaryhealth.bmj.com/ and Sir Colin Campbell, who arrivl'ld at Calcutta in August as Commander­ in-Chief, realized that the withdrawal of the garrison was the most urgent and pressing operation. to be undertaken. Various reinforcements had come in, but nothing was ready. He arranged for all fresh units landing in India to be issued with white cotton clothing, and issued a memorandum on clothing, diet, exercises, hours of sleep. _etc., for their instruction. Hegiments were pushed up country as fast as possible, usually by bullock dak, in carts containing six men each, and with relays of bullocks every ten miles. In November, 4,500 men had been collected at Cawnpore, and, leaving General Wyndham with an independent force to look after that on October 2, 2021 by guest.

, Assistant Surgeon Bradshaw was selected as the recipient by the regiment, which was granted a V.C. for disposal. 2 The wounded left on the 25th with Surgeon rnnes of the 84th and Dominichetti of the 75th, sixty-four in number, remained there. Both these surgeons were mentioned in the Commandant's despatch. J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

G. A. Kempthorne 145 citv, Sir Colin advanced towards Lucknow. Of this column, Dr. J. C. Br~wn of the Bengal Horse Artillery was the Superintending Surgeon. On November 9 they reached the Alum Bagh. Working round the out­ skirts of the town, the Dilkusha Palace, with its walled inclosure, was then occupied .. Here the Field General Hospital was placed. About the same time General Headquarters was established in the Martiniere College. The next objective was the Sikandar Ragh, which was carriedort the 16th by the 53rd (1st King's Shropshire L.I.), the 9.3rd (2nd Argyll and Sutherland Highlanders), and the Sikhs. The historian of the 93rd gives some details of the work of their medical officers. "The regimental hospital had been established by Dr. Munro early in the day beneath the walls of the Sikandar Bagh and, through the struggle and in the midst of the hottest fire, he, as well as his assistants, Sinclair, Menzies, and Bell, were to he seen exposing themselves fearlessly in attendance on the wounded." 1 Fighting continued all the following day, fresh positions were won, and the troops took up positions to cover the withdrawal of the garrison from the Residency. There were a thousand helpless persons, sick, wounded, women, and children, and the removal of these in the face of the enemy was a most delicate operation; but, before dawn on the 23rd, they were Protected by copyright. safely assembled at the Dilkusha. To provide sick transport, the regimental doolies were requisitioned, the patients in the regimental hospitals along the line of evacuation having been first moved to the Dilkusha. From here they were picked up again when the force withdrew. On the 27th, leaving General Outr'am with a few troops to hold' the Alum Bagh, Sir Uolin marched towardsCawnpore with his enormous convoy. The march was an anxious one, for news had come in that Windharn had been assailed by the Mahratta leader, Tantia Topi, and driven into his entrenchment. rrhe Bridge over the Ganges was secured and, after allowing sufficient time for the women and sick to get wellon the road to Allahabad,the enemy was attacked and dispersed, with a loss to onr­ http://militaryhealth.bmj.com/ selves of no more than ninety-eight casualties. The losses of Sir Colin Campbell's force by the enemy's action were not severe. Between November 12th-and 22nd there were 123 killed and 429 wounded, the strength being about 4,500. Surgeon Scott and the nine other surviving medical officers of the original garrison received the thanks of the Governor-General, who also acknowledged the good service rendered by Surgeon J.C. Browneof the Bengal Horse Artillery, Superintending. Surgeon of the relieving force. Browne, Brydon and Ogilvie received the C.B. General Windham In his

despatch mentioned Senior Surgeon Elliot, C.B., of the Royal Artillery,his on October 2, 2021 by guest. Principal Medical Officer. We will now enumerate the officers of the British Medical Service who took part in the above operations so far as they can be -ascertained.

1 Burgoyne, " Historical Records of the 93rd." 10 J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

146 Events in India, 1857-1858

Lucknow Garrison. 32nd. (1st D.C.L.I.) Surgeon Charles Scott,l Assistant SurgeonWilliam Boyd.' Havelock's Colurnn. RA., Assistant Surgeon J. Irvine 1; 5th (Northumberland) Fus., Surgeon W. K. Swettenham (W), Assistant Surgeons T. R Whitty, F:Collins, M. Grant; 64th (1st N. Staffs}) Assistant Surgeon R Lundy; 78th (2nd Seaforth Highlanders), Surgeon Joseph Jee,l V. M. McMaster,l T. Carew (W), Evans; (3'2nd attached), A. W. Beveridge; 84th (2nd York and Ll:tncs), Surgeon F. W. lnnes,l Assistant Surgeons J. T. La Presle, G. B. Poppelweel; 90th (2nd Cameronians), Surgeon A. D. Home,' Assistant Surgeons W. Bradshaw,1 R W. Jackson,C. R. Nelson (died September 18, 1857).

Colin Ca1npbell's Fot'ce (November 9 to December, 6, 1857). (Excluding the above.) Superintending Surgeon J. C. Browne, Bengal H.A.,I P.M.O. British Troops East of Lucknow, Staff Surgeon J. C. G. Tice,1 Staff Surgeon 2nd Class P. J. Clarke. Protected by copyright. 2nd Dragoon Guards, Surgeon H. H. Massy, Assistant Surgeons L. H. Robotham, R. F. Andrews; 9th Lancers, Assistant Surgeons S. Fuller, A. McArthur (W) ; R.A., Senior Surgeon R. C. Elliott, C.B.,l Assistant Surgeon J. Barker; 8th (King's Liverpool), Surgeon F. C. Annesley, Assistant Surgeons C. Domnichetti,1 W. H. Yates; 23rd (RWelch Fus.), Surgeon P. Laing, Assistant Surgeon H. '1'. Sylvester, ye.; 34th (1st Border), Assistant Surgeons R. J. Worthington, W. Hayward, W. 1'. Paliologus; 38th (1st S. Staffs), Surgeon T. E. Wall, Assistant Surgeon '1'. Wright; 42nd (1st Black Watch) Surgeoll J. S. Furlong, Assistant Surgeons A. Maclean, A. Hooper; 53rd (1st K.S.L.I.), Surgeon J. Grant,! Assistant

Surgeons R. H. Beale, R. Hungerford; 64th, Assistant Surgeon R. McNab ; http://militaryhealth.bmj.com/ 70th (2nd East Surrey), Surgeon John Fraser, Assistant Surgeon Joseph Watts; 82nd (2nd S. Lanes), Surgeon H. D. Fowler, Assistant Surgeons R. W. Carter, W. H. Muschamp; 88th (1st Connaught Rangers), Assistant Surgeons T. R Williams, W. W. Meade; 93rd (2nd Argyll and Sutherland Highlanders), Surgeon W. Munroe, Assistant Surgeons W. Sinclair, R. Menzies, J. N. Bell; Rifle Brigade, Assistant Surgeons J. Reade, Alexander Guthrie, H. M. Fraser. After the Battle of Cawnpore Sir Colin Campbell proceeded to clear the country between the Jumna aud the Ganges, in order to secure the on October 2, 2021 by guest. communications between the North-West Provinces and Calcutta. Rein­ forcements continued to arrive from England, and in March, 1858, he advanced again on Lucknow,having some 30,000 men at his disposal. He had a full medical staff with his army. Superintending Surgeon Brown:

1 These were mentioned in despatches. J R Army Med Corps: first published as 10.1136/jramc-57-02-08 on 1 August 1931. Downloaded from

OUTTfmt LitemtuTe 147 was still with the force, and a Queen's officer, J ohilMcAndrew, whom we first met in Afghanistan as a most efficient regimental surgeon, was Inspector of Regimental Hospitals, British Troops. During the autumn Dr. ]'orsyth had become Director-General of the Medical Department at Calcutta, and Inspector-General William Linton had assumed the office of Inspector-General of British Hospitals. After twenty days' fighting the rebels were cleared out of Lucknow, our casualties during that time amounting to 127 killed and 595 wounded. There was considerable sickness, but there were now ample stores, medicines, and attendants to cope with it. The regimental hospitals established at Lucknow are described as most efficient and creditable to the Medical Department. "For every wounded or sick man there was an attendant with a hand punkah to brush away the flies." Meanwhile, in Oentral India, Sir Hugh Rose was conducting a campaign probably more strenuous and exhausting to those engaged than any other in those strenuous two years. (To be continued.)

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'l'HE PARIS OORRESPONDENT. When should Anti-tetanus Serum be Given? The Lancet. 1931, i, 1049. This question was reported on to the Academy of Medicine of France by a commission of twelve members: MM. Roux, Vaillard, Dopter, Vallee, Walther, Bazee, Hartmann, Balthazar, Faure, Mauclere, Auvray and Gosset. In April, 1931, they reported that they had unanimously come to the following conclusions, which were also agreed to by the Academy :--

The most thorough clpansing and disinfecting of wounds, especially of http://militaryhealth.bmj.com/ lacerated wounds, is essential, as is also the removal of foreign bodies. Anti-tetanus serum should be given for all lacerated wounds, and for less serious wounds containing foreign bodies or soiled with earth. The serum should be given for all subungual wounds and for even slight wounds of the feet. Serum treatment need not be used in superficial, easily-cleansed wounds not complicated by foreign bodies or by earth contamination. One of the statements made by Roux in his memorandum was that where foreign bodies cannot be removed at once, there should be undertaken active immunization by Ramon's tetanus anatoxin. He advised that, after on October 2, 2021 by guest. the wound had been cleansed and dressed, the first injection of anatoxin should be given, followed a quarter of an hour later by the ordinary injection of anti-tetanus serum; then, fourteen days later, a second injection of ana­ toxin should be given and, fourteen days later, a third and last injection. Roux added, "It is superfluous to insist on the advantage of active immunization should war break out."