Neurologists during Wars Tatu L, Bogousslavsky J (eds): War Neurology. Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 77–92 (DOI: 10.1159/000442595) Neurology and Neurologists during the Franco-Prussian War (1870–1871) Olivier Walusinski Family Physician, Brou , France Abstract ‘All those whose spinal cord or brain The Franco-Prussian War (1870–1871) ended with the had been reached by bullets firm establishment of the French Republic and with Ger- were like corpses, in a deathlike coma.’ man unity under Prussian leadership. After describing the Emile Zola (1840–1902) [1] events leading to the war, we explain how this conflict was the first involving the use of machine guns; soldiers were struck down by the thousands. Confronted with To Let Loose the Dogs of War smallpox and typhus epidemics, military surgeons were quickly overwhelmed and gave priority to limb injuries, Chancellor Otto von Bismarck (1815–1898) in considering other wounds as inevitably fatal. Here, we Prussia and Emperor Napoleon III (1808–1873) present detailed descriptions of spinal and cranial injuries in France each desired a war, as much to resolve by Léon Legouest and of asepsis prior to trepanning internal political difficulties as to ensure their su- by Ernst von Bergmann. Both the war and the Commune premacy in Europe. Prussia, which had just won had disastrous effects on Paris. Jean-Martin Charcot con- the war against Austria at Sadowa (3 July 1866), tinued to work intensely through the conflict, caring for initially benefitted from a certain degree of ac- numerous patients at La Salpêtrière Hospital according commodation by Napoleon III, allowing Bis- to his son Jean-Baptiste’s account, which we’ve also ex- marck to attempt to unify the German states cerpted below. As for young Dejerine, he treated the around Prussia. With abundant capital and la- wounded from France who had taken refuge in Switzer- bour, Bismarck rapidly organised a large and well- land. Désiré-Magloire Bourneville also took heroic initia- trained army with the support of a powerful steel tives, as did Charles Lasègue, Alfred Vulpian, Alix Joffroy industry that had grown rich from deposits in the and Victor Cornil. © 2016 S. Karger AG, Basel Ruhr valley. Luxembourg was a personal posses- sion of the King of Holland. To give the illusion of All translations by the author, except the Jean-Baptiste Char- rewarding and avenging French public opinion, cot writings, which were originally published in English. Napoleon III, hurt by the defeat of his imperial Downloaded by: Verlag S. KARGER AG, BASEL 172.16.6.1 - 4/13/2016 10:57:50 AM armies in Mexico, decided to buy Luxembourg in meeting with Bismarck on 15 September 1870. To December 1866. The following month, Bismarck agree to peace, Bismarck demanded that France declared he would not let a German region fall surrender Alsace and part of Lorraine, which was into French hands. War seemed imminent. Napo- totally unacceptable to the republicans. Part of the leon III, who knew that the French army was dis- government retreated to Tours to plan the next organized after its defeat, retreated, accepting phase of the war, just before Paris was surrounded peace talks. During this time, the French war min- by Prussian troops. Gambetta organised and ister failed to reform conscription procedures equipped an army of 600,000 men. These impro- and thus to rebuild an operational army. France vised soldiers, lacking in equipment and proper was diplomatically isolated, with a small, poorly leadership, initially had the advantage of their trained army, but the country still believed in its numbers at a time when Prussian troops were im- military superiority due to its new rifle, the ‘Chas- mobilised in Metz and Paris. However, the capitu- sepot’ , and its new weapon, the machine gun. Al- lation of General François Achille Bazaine (1811– though peace reigned between liberals and repub- 1888) in Metz, clearly a mark of hostility to the licans, a victorious war was considered at the newly proclaimed Republic, freed up Prussian court of Napoléon III as the surest means of tri- men. Deploying rapidly towards the South, these umphing over the republican opposition and re- troops crushed the Loire army headed towards storing the Empire’s prestige. Bismarck thought Paris at Loigny, between Chartres and Orléans. In that a war against France would help him consol- early December 1870, the Paris army failed to idate German unity around Prussia. A previous break through the German blockade of the capital. diplomatic incident involving the French ambas- Refusing to lose hope, Gambetta worked out a sador to Germany – the falsification of the Ems new plan. An army from the north of France and dispatch – was enough to stir French public senti- a new army from the Loire were to converge on ment into an outrage and leave the Germans feel- Paris, while the eastern army commanded by ing indignant. General Charles-Denis Bourbaki (1816–1897) was to re-capture Belfort and cut off provisions to Prussian troops in the east. During the particu- After the Defeat, the Republic in France and larly cold winter of 1871, the Loire army was de- the Revolutionary ‘Commune’ in Paris feated in Mans, while the northern army was de- feated in Saint-Quentin. General Bourbaki lost at On 19 July 1870, France declared war against Ger- Héricourt and only escaped capitulation by taking many, sending 265,000 French soldiers to con- refuge in Switzerland. Paris and its famished oc- front 500,000 Germans. By 6 August 1870, Alsace cupants surrendered on 23 January 1871. As a was lost, and Lorraine was captured soon thereaf- provisional government was struggling to form, ter. Part of the French army was surrounded at ‘La Commune’, a terrible civil conflict fuelled by Metz, another part at Belfort. After this succession the miserable conditions in Paris, broke out be- of reverses, on 2 September 1870, the Battle of Se- tween socialist revolutionary groups and the sol- dan left Napoleon III a prisoner of the Germans, diers of the government that existed by law only, along with 100,000 of his men. Once the Sedan that of Adolphe Thiers (1797–1877) in Versailles. disaster became known in Paris, Léon Gambetta A second siege of Paris ended in what was known (1838–1882) declared the downfall of Napoleon as the ‘bloody week’, 21–28 May, during which III. On 4 September 1870, the Third Republic was government troops pushed back the popular Pari- proclaimed in Paris. Representing the provisional sian forces street by street towards East Paris. government, Jules Favre (1809–1880) had a secret There were countless cruel exactions [2] . 78 Walusinski Tatu L, Bogousslavsky J (eds): War Neurology. Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 77–92 (DOI: 10.1159/000442595) Downloaded by: Verlag S. KARGER AG, BASEL 172.16.6.1 - 4/13/2016 10:57:50 AM Fig. 1. Charcoal drawing by Paul Richer (1849–1933). Loigny’s battle, 2 December 1870, by night. (Postcard, private collection of the author.) Military Health Services in 1870 of isolating contagious patients, something the French overlooked at that time. In the United Care of the injured on the battlefield was first States, medical progress was made during the provided in an organised manner by Dominique- Civil War (1861–1865) by the facts that nurses Jean Larrey (1766–1842) and Pierre-François were incorporated into each combat unit and Percy (1757–1825) during the wars of Napoleon chloroform was used as anaesthesia. I. The French surgeon Venant Antoine Léon During the War of 1870, the poor organisation Legouest (1820–1889) noted that from 1840 to of French medical care was apparent from the 1850, ‘Algeria served as the military surgery school start of fighting. Mobile field hospitals were man- for our physicians, before the Oriental War. Ger- aged by the support corps and not located in man military surgery, which hadn’t benefitted combat areas. Due to insufficient personnel, from the opportunities of its French counterpart to equipment, bandaging, medication and the in- practise on the battlefield, nonetheless profited ability to keep up with troop movements, many from the precious occasions for observation during wounded soldiers had to be abandoned, resulting the First Schleswig War (1848–1851) and the last in a horrid mortality rate. There were no trained Austrian campaigns in northern Italy’ [3] . In par- personnel with the specific duty of clearing the ticular, the Germans had learned the importance battlefield of wounded men, who arrived in im- Neurology and Neurologists during the Franco-Prussian War 79 Tatu L, Bogousslavsky J (eds): War Neurology. Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 77–92 (DOI: 10.1159/000442595) Downloaded by: Verlag S. KARGER AG, BASEL 172.16.6.1 - 4/13/2016 10:57:50 AM Fig. 2. The crypt, the ossuary. Battles’ Museum. Loigny la Bataille (France). The skulls show evidence of cranial penetrating gunshot wounds. Mairie de Loigny la Bataille (Eure et Loir, France) with kind permission. provised horse-drawn vehicles on straw beds af- soldiers took them off. French infantrymen did ter prolonged delays that sometimes lasted sev- not have helmets [3] . eral days and favoured contamination, not to The sick outnumbered the wounded by a fac- mention the fact that haemostasis had not been tor of five. The deadliest battles were fought achieved for their wounds. Drinking water was in against smallpox, typhoid fever, dysentery and ty- very short supply, and soon famine set in ( fig. 1 ). phus, in addition to frostbite and gangrene dur- Amédée Dechambre (1812–1886) writes of ‘la- ing the winter of 1870–1871, which was partic- mentable and often repeated scenes of exhausted ularly cold.