TRO RAMC Coll. /GOR [ JJi . t *. V *r* V ; > ..\- I ^ • i ^ V I 7 k * I i % ^ ffr /<vM i I REMARKS ON ARMY SURGEONS AND THEIR WORKS. : REMARKS ON ARMY SURGEONS AND THEIR WORKS. BY CHARLES ALEXANDER GORDON, M.D., C.B., DLPUTY INSPECTOR GENERAL OF HOSPITALS, ARMY MEDICAL DEPARTMENT. Reprinted from the “ Medical Mirror.” LONDON H. K, LEWIS, 136 GOWER STREET. MDCCOLXX. Digitized by the Internet Archive in 2016 https://archive.org/details/b28709408 INTRODUCTION. In preparing tlie following “ Remarks on Army Surgeons and their Works,” which first appeared in the pages of the Medical Mirror^ I was chiefly actuated by the circumstances I am about to state. A perusal of such of the works of members of the Army Medical Department as I have had access to convinced me that to those officers the soldier, his wife and children, are indebted for almost every improvement that has taken place in their condition, more especially from 1740 to the present date, or, in other words, during the last one hun- dred and thirty years. In specially referring to some of these improvements, I have, as will be observed in the text, been careful to note the page and book in which the earliest and most definite suggestions in regard to them occur ; but I confess that it has been a source of chagrin and disappointment to me to discover—as any person may, who takes the trouble to peruse the books I have quoted from, and the recently published official “ Reports” and “Evidences”—that while very many of the sugges- tions submitted by them have yet to be carried out, others have been adopted, but with this result, that the names of their original proposers arc not oidy unrecorded in connexion with them, but the sole credit claimed by amateurs and so-called “ sanitary reformers.” This must be patent to all who are even moderately well acquainted VI INTllODUCTION, with the literature of army sanitation. 1 have, tlier<;fore, felt what 1 trust is a natural desire to recover ha<;k to the Department of which I am a member the ci-edit which is its just due for what has been initiated by its mernbei-s. I have on many occasions during a somewhat long and varied military career found that while for the most part every consideration is paid in as well as out of the Service to the Army hledical Officer personally, but a very partial and inadequate knowledge prevails in regard to the extent, nature, and importance of his official duties. But 1 am led to hope that in the Notes now submitted I may have been able to communicate some information on this point, and thus make clear the intimate connexion existing between an efficient Medical Department and in the the general interests of the Military Service ; and, third place, I have been anxious, while claiming the credit for my brother Medical Officers for professional improvements introduced or furthered by them, to remind my brother medical men in civil life of some of the many obligations to which they and the public are indebted to the Army Surgeon for advances made in the science and art of medicine and of surgery. Many of these are mentioned in the body of my “ Eemarks but it may not be deemed inopportune if I allude here to a few of the ordinary and routine duties that have to be performed by the Medical Department as a body, premising that, like the individual portions of a huge mechanical appa- ratus, so with the Army, unless all its divisions work together harmoniously and well, the jarring, friction, and irregularities of any one or set of its items must neces- sarily impair or destroy the efficiency of the whole. As with a machine, so in the Army, all branches are of importance in so far as their individual and separat-e or functions are concerned ; no one wheel, for example, set of wheels, can efficiently perform other functions than those for which they have been shaped and appropriated ; so in the Army, the members of the several branches into which it has necessarily been divided, each in their own sphere exeeute the functions for which they have been appointed, but all labouring in harmony and unison to . INTRODUCTION, Vll produce one ultimate result, namely the efficiency of the Army for the double purpose of a shield of defence and weapon of offence. Let me now allude to a few of our duties, and of the positions in which we stand to thc^^A^- ing branches of this machine. In the first place, we have is sup- to see that suitable material in the shape of recruits the plied to the Army, for which purpose a knowledge of neces- duties required of soldiers in peace and in war is from sary, as well as the power of readily judging physical aspect the probabilities of the young man before routine us has of improving or degenerating by the new next place, to which he is about to be subjected. In the we are charged with the duty of preserving the soldiers, when obtained, in the highest possible condition of health, whether they are quartered at home or in the tropics, in times of epidemics, in war, or in the no^ less trying condi- occupation tions of temporarily holding in military unhealthy stations. As must be well known to all mem- bers of the Profession, this last duty involves fiir more accorded to the so- than is, according to popular idea, called sanitarian, who would seem to believe that nothing cleanliness, have further* is necessary than to maintain is free ventilation, and a certain amount of cubic (little ever said of superficial) space in dwellings. In order, however, that we may offer trustworthy views on hygiene, the properly so called, we must be acquainted with of soils science of geology, and the nature and property , we must have a knowdedge of meteorology in reference to thus means of pie- its bearing upon the human system ; serving health in a damp climate with great extremes of temperature and negative indications by the electrometer, would be exceedingly unsuited to a dry climate wdth small variations and the prevalence of positive electricit3^ That our v ews as to the suitability of particular places as essential that sites for barracks may be of any value, it is we should be acquainted with the conditions which affect heat the relative temperature as indicated by transmitted scientific and by solar radiation. To enable us to offer a obtained opinion in regard to tho food most likely to be with in a particular country, or the vegetables that may ; Vlll INTRODUCTION. greatest promise of success Ije cultivated there, we must know something of scientific and descriptive botany and of the natural distribution of plants ; and so on with various other examples of our duties in which special scientific knowledge is an absolute necessity. As a matter of course, we have to treat the troops when sick and wounded, sharing with them the risks of battle, of pestilence, and of all climates in which our forces are called upon to serve. At what cost to our members, in health and life, duties under such circumstances are per- formed is, unfortunately perhaps for us, not known to the general public, although familiar to all acquainted with the literature of the Army List, Gazettes, and despatches; while it is perhaps only the officers and soldiers with whom we are actually associated who bear willing testi- mony at the time of how arduous and trying our duties are ; far, be the fact remembered, that while in health our exposure and consequent risks are scarcely if at all less than those of the men actually fighting, we have under these circumstances to preserve our faculties proof against the excitement wffiich impels them to the on- slaught, meanwhile performing serious and infportant surgical operations. During pestilence, and while in unhealthy localities, we are necessarily exposed to the pernicious influences which affect the masses ; but are, in addition, subjected to others that affect us in an especial manner. Thus the wear and tear upon our system caused by excessive physical and mental labour under the most unfavourable circumstances are then at their greatest and while our vital powers are in these respects debili- tated, wm are in a peculiar manner exposed to the mor- bific influences inseparable from large accumulations of sick, perhaps from communicable ffisease in hospital, witness, as examples, outbreaks of cholera or of yellow fever. Nor are these all our professional duties. One day wm act as physician, the next as apothecary ; then we are called upon perhaps on the spur of the moment to perform a serious surgical operation, as for hernia, ligature of an artery, or an amputation ; and the day or night succeeding to officiate as accoucheur and sick nurse, especially on distant stations abroad. INTRODUCTTON. IX It becomes our duty to weed the regiments under our respective charges of those men whose, ailments or acci- dents are of such a nature as to be apparently not amen- here our duties are not only able to treatment ; and special in their nature, but altogether different from the Medical man’s in civil life. He treats his patients each with reference only to himself. We treat the soldier not so much in reference to himself as with regard to the efficiency of the general body of which he is an atom ; and inasmuch as the choice of an attendant does not rest with him, so, instead of his discharging his Medical man when no longer needed, the Medical Officer discharges him, perhaps very much against his will.