SURGERY OF THE WAR.

51 to extort fees from the pockets of their to look after their interests, and claim from the State even-handed justice to a useful, dignified, and honourable class of its servants ? I remain, Sir, your obedient servant,

army, more especially in its want of of the sick and wounded in the Avon steamer, to which we drew attention at the period. We do not believe ic is a time to heap all sorts of complaints on the head of Dr. Lawson, and make him the convenient scapegoat of mismaANOTHER SUFFERER. nagement nearer home. Parliament has much to answer for January, 1854. in its systematic neglect of navy and army surgeons, and if, in the retributive nature of evil, we are now paying the penalty of such neglect and old abuses, the lesson is one which should THE WAR. not be lost, but referred to the proper quarter, not visited on subordinate medical surgeons in the Crimea, like Dr. Lawson. It does not appear to us an opportune moment for too much [FROM OUR SPECIAL CORRESPONDENT.] V’e read every day the most detailed and accufault-finding. HEIGHTS ABOVE SEBA.STOPOL, December 14th, 1854. rate accounts of hospital movements inside the French lines :-. SHORTLY ttfter my joining the Guards in Bulgaria, fever but there is after all in our mismanagement that and cholera broke out in their worst form. One day alone our Parliament and War-office authorities might not remedy. we lost ten, the draft suffering the most, and the health The French are beginning to say we are a little (le toop with of the men generally continued very indifferent, all being our sick and wounded. Our surgeons go out from England with weakly and not able to eat, until three weeks before they set some fabulous idea that they are to have medical and surgical sail for the Crimea, when the men had regained their appetites appliances; that the Greenwich pensioners, or bandsmen, somewhat, and had more life in them. I was left behind near are to act as hospital orderlies. But nothing of the kind Varna, with 150 sick of my own regiment, who were drafted is the happy result. The medicines all go to the bottom forward as they gained sufficient strength, till at last I had few of the sea, and who are the men, says the Constitutionnel, of my own men left, and then I was given those also left behind that removed the English wounded? Not our infirmiersby the Highland brigade, (the 44th,) and, at one time, the 38th. men trained to the duty; but English bandsmen, who themAfter a time I was sent down to Scutari, and had seventy selves were sick, and had their instruments to carry. The wounded handed over to me. While here, there were many English also had a new force-"Vingt quatre pauvres petits deaths from secondary operations: one, a case of purulent in- diables dans la faiblesse d’aloscence specialement choisis." But fection after Syme’s operation at the ankle. Nearly all the these were only like the other War-office arrangements; the primary operations did well; at least, of those who reached surgeons too were out of the way, and in the wrong place. Scutari, and it was astonishing with what rapidity the simple We do not allude to those mistakes now in any factious penetrating gun-shot wounds healed; also, how much quicker mood, but that younger surgeons on active military service the wounds in the men healed than similar ones received by the should not suffer from a continuation of such things ;-that a officers; probably they were not kept so strict. The most penny-wise-and-pound-foolish economy in human life should curious case I saw was a gun-shot wound in a corporal. The be visited on the proper authorities at home, whether they be ball had entered about two inches above the outer side of the in or out of it. Our last accounts tell of new parliament condyle of the femur, and had made its exit on the outside of hospitals established near Constantinople, in consequence of the same leg, close to the upper end of the fibula, but not in- old ones at Scutari and Pera having got so choked from had very profuse purulent secretion from the original mismanagement and neglect--secondary amputations, juring it. He knee-joint, and amputation was performed, when it was found purulent intection, tetanus, &c., the result ot old. neglected that the course of the ball had been anything but a straight wounds. If we speak so often of the French and English one; it had, in fact, before making its exit, gone the complete hospitals, it is that the contrast forces itself on every one. circle of the knee-joint, its course being indicated by the carti- The French well observe, nothing can be done without lage covering the ends of the femur and tibia being removed by hospital orderlies. The English do everything by oratory in the ball as clean as by a chisel, leaving the cancellated ends of parliament. After the battle, the work of the soldiers and the bone rough and exposed. The wound was inflicted at drummers ceases : after the battle, the work of the hospital Alma; the operation was performed in the beginning of No- orderlies begins. The wounded are to be found and brought vember. The man was alive when I left Scutari. I was only together ; simple fractures are not to be made compound there two weeks before I was ordered up here, or I could have by thrusting them through the skin. Water is to be propicked you out some interesting cases, as I know the interest cured for the surgeon; fires to be lighted; the wounded to you take in all that goes on here. I had not a single death be tended in a thousand ways; the sick or dying soldier to be amongst those under my care during the time 1 was there. I comforted or advised. In all these things the English medical suppose that I was fortunate in having more favourable cases; department is as deficient now as it was in Mr. Guthrie’s only one wounded of my own regiment fell to my lot. Since time. Parliament is to be convened again in a few days. my arrival here the weather has been very variable; all our Overtures of peace, of a very satisfactory description, are pendtents have been blown down once, during a hurricane of wind, ing; yet we trust the present moment will not be lost for a rain, hail, and snow. We have had fine cold days and fine hot thorough consideration of the whole subject by a parliamentary days, and at one time the roads to Balaklava very bad, and committee or otherwise. Were younger surgeons, who are the commissariat bad. The French have lately assisted us in intended for the army, to go through a complete course of with our sick. Since the battalion left Varna I had not seen a military surgery, as recommended in the letter of Sir George case of cholera till my arrival here; but I am sorry to say it has Ballingall, -were our system of military hospitals assimiagain paid us a visit. We have lost ten men of the last draft, lated more to that of the French.-were our military system and ten old soldiers. in medical affairs not so tied up with Horse Guard authorities, but more left to the proper moral sense of military medical officers, a revolution of no ordinary kind would be already

only constructed members, and not

medical

department of the

management

nothing

SURGERY OF THE WAR.

completed.

Mr. Guthrie, the best authority in Europe on such matters, SYMPTOMS of reviving activity and of important movements, is barely tolerated, while a crowd of young ladies has visited the operating-theatres of the hospitals in London, and are going diplomatic and otherwise, as regards our army before Sebas- out to work a revolution so long advocated by us in the army topol, lead us to continue our notices of the condition of our medical department, but as often thwarted. Meanwhile, in sick and wounded there and at Constantinople. We wish as the Crimea., we learn that, in addition to the ambulance much as possible to confine ourselves to incidents and facts, wagons sent out, are several store wagons, forge carts, and and such facts we shall not in vain, we are sure, bring before moveable surgeries, with a pamphlet by Mr. Uuthric, as to their several uses and contents ; but in place of being at the our readers, as who, from the first personage in the realm, down field of Alma or Inkermann, they have now come too late, and to the lowest, does not feel for the sufferings and sickness of are detained at Balaklava, and whether they are to be made our wounded at present in Turkey. into fire-wood, or the forge and surgery adapted to shoe the We regret to find, both from our own special correspondents ambulance mules, is scientifically canvassed : no hospital as well as public conversation on the matter, in medical and orderlies, no organization, everyone lost in amazement at our military circles, that the general disorganization of the hospital forges and surgeries and Greenwich pensioners. service in the East, instead of being lessened, is every day beAll our’last letters from the Crimea confirm the intelligence coming more glaring and unmitigated. A Court of Inquiry that, so crowded have the military hospitals become, that new has been held, to investigate the charges brought against the hospitals are now eagerly sought after. New military hospitals

52 for the English army have been established at Smyrna, Abydos, The wards and corridors, halls and staircases, Kulowlee, &c. of the building at Scutari, where Miss Nightingale prosecutes her labours, having got choked up with the straw-beds and litters of the thousands of sick and wounded, dysentery, ditrrhcea, with the dozen other diseases of these frightful scenes, have rendered the crowding already a source of disease itself. The last two thousand patients, rendered Ito?-,3 de co/K.&a;’ in the trenches opposite to Sebastopol, were sent to Scutari, but there was no room for them. On the 19th of December we learn that the hospital at Scutari contained 4221 sick and wounded, which will be best conceived by imagining seven crowded hospitals as large as Guy’s. A thousand more are at Balaklava, waiting the means of transit. The hospital tents and hospitals are all alike full of sick, with a singular and deadly preponderance, as we have already more than once remarked, of dysentery, diarrhœa, and typhoid, placing all scientific surgery and science alike at defiance, and reducing the army to the one sad dead level of suffering and despair. Of the last 150 deaths in the hospital at Scutari, ending December 19th, in continuation of those already noticed in THE LANCET, we regret to find not less than 112 sinking from dysentery and - diarrhosa, or what the French call ’’ cholera without the capacity for cholera." Amongst the Turkish troops, plague, cholera, and typhoid predominate. In the French hospitals, on the contrary, the most intricate and scientific problems in scientific surgery are being worked out-resection of the heads of bones containing bullets; operations like Chopart’s on the foot, &c. General Canrobert estimates, at present, the sick and wounded of the French army at 3749, including nearly 1400 wounded—the army of France, 60,000 men; so that the sick and wounded of the French forces amounted only to 1 in 15; while, on the other hand, our entireforces, estimated at half that of our allies, or 30,000, gives us for the new year, 1 in 3 hors de combat. The hospital at Scutari is, as we have said, six or seven times the size of Guy’s, and can easily accommodate 4000 beds; while the hospitals of the French at Pera, from 10th October to 1st December, accommodated, including the number abovegiven, in all 8000 French sick and wounded. We have inadvertently turned to these subjects of medical and hygienic inquiry, from the dreadful prevalence of dysentery and cholera; but if we turn to scientific surgery, with which we set out, on several points on which we have made inquiry, we find all authorities in the French journals Without at present encumbering the matter with agree. statistics, we find the result of primary amputation far superior to secondary, so much so as to banish the latter from practice in the time of war in French hospitals. The healing of the stumps has been better in the French than English hospitals; on this account purulent infection, the bane of our English army, is almost unknown after primary operations in the hospitals and ambulances of the French. In operations on the Russians, though at first stated that the enemy were very hardy, and resisted the pain of the knife and traumatic accidents, it appears they have been amongst the most sensitive to these diseases, such as tetanus, &c. Two resections of the head of the humerus have been performed successfully on them-one coxo-femoral amputation, Chopart’s operation, &c. On all these points the reports of the French hospitals are most instructive. Every encouragement is given by the Emperor of the French to young surgeons who distinguish themselves ; and while a premium is held out in England for incompetency in the army,-while in the navy an ennobling profession is degraded to the level of the trade of carpenter or gunner,-we find amongst our French friends a noble rivalry to raise each branch of the public medical service in general estimation, the organization of the hospitals perfect in its way, and only one thing indispensably necessary to all, that they should do honour to France, and reflect credit on the advancing knowledge of the age, and the march of humanity.

HOSPITAL GANCRENE, in at Scutari.

an

endemic form, has visited

" A great anxiety is in consequence evinced," saysthe Times, " to get those amputatecl away who thus far have not been attacked. It is difficult to conceive anything more distressing than the spectacle of a poor fellow rallying stoutly and hopefully from his wounds, but in the midst seized by a complaint which makes it requisite to burn the sores into huge holes with caustic. Such, however, are the penalties we pay for crowded wards and defective medical

the

hospitals

arrangements.’’

Medical News. ROYAL COLLEGE

SURGEONS.—Tile

OF

following gentle-

having undergone the necessary examinations for the diploma, were admitted Members of the College at the meeting men

of the Court of Examiners on the Sth inst. :BICKNELL, HERMAN, Herne Hill, Dulwich. DAVEY, RICHARD STAINES, Walmer. DE NICEVILLE, CHARLES FpANCis HIPPOLITE, Clifton, Bristol. HARDWICK, ROBERT GEORGE, Leeds. HARRIS, WILLIAM HENRY, Army. HEPWORTH, ALFRED JOSEPH LuMLEY, Army. JACOB, EDWARD LoNG, Christ’s Hospital. MORRIS, CHARLES FREDERICK, Truro, Cornwall.

near

morris, WILLIAM, Army. PooLE, GEORGE KENNETT, H.E.I.Co.’s Service, Bengal. STEWART, THOMAS HOWARD, Plymouth. VIGURS, CHAMBRE ROBERT CoRKER, Middlesex Hospital. At the same meeting of the Court, Mr. JAMES YOUNG passed

his examination for naval surgeon. This gentleman had previously been admitted a member of the College, his diploma bearing date 3rd May, 1850. Messrs. Alfred Septimus Pratt and William Pratt also passed their examinations for naval

assistant-surgeons. APOTHECARIES’ HALL.—Names of gentlemen who passed

their examination in the science and practice of Medicine, and received certificates to practise, onThursday, Janzta?-y 4th, 1855. HARDWICK, ROBERT GEORGE, Leeds. JACOB, EDWARD LONG. MORRIS, JOHN ALBERT, Caerleon, Monmouthshire.

THE MIDWIFERY BOARD.-The Council of the

College of Surgeons met

Royal

to the late Dr. James Reid. From the several distinguished obstetricians who presented themselves as candidates, the council selected Dr. Charles West to fill the vacant chair. on

Thursday

to

appoint

a successor

ST. BARTHOLOMEW’S HOSPITAL.-An Alderman of the of London, offers for competition among the pupils of this an appointment in the medical staff of the East India Company, in the Presidency of Bengal. Application to be made before the 14th inst. to the authorities of the school. We believe this to be amongst the last of these gifts or endowments, as the new Medical Board has now come into operation, and thirty such appointments are to be made, for which there are already thirty-five candidates.

City

school,

CHABiNG-CBOSs HOSPITAL.-There

are to be two assisthe Charing-cross Hospital appointed, as the necessities both of the school and patients demand such inDr. Willshire, who has been lecturing on the practice crease. of medicine since the death of Dr. Rowland, and Dr. Salter, the lecturer on physiology, have been selected by the medical committee to fill the offices in question, and which selection, there can be no doubt, will be approved of by the governors at their next meeting.

tant-physicians to

WOUNDED OFFICERS

IN

LONDON.-A board of medical

officers meets twice a week now in London at the Ordnance Medical and Military Department, for the examination of sick and wounded officers sent home from the Crimea. The applications of late have become so numerous, and the duties so onerous, it is suggested that the labours be divided, and the board meets every day or every other day. The cases of intermittent fever, dysentery, and gun-shot wounds are very

military

numerous.

ETHNOLOGY

IN

IRELAND.-The

Royal Academy

in

Dublin met on the 8th inst. It was stated thatnext to Copenhagen, this body had now the largest collection of skulls, antiquities, &c., in the north of Europe. Dr. Neligan, Sir Robert Kane, and others, addressed the meeting, calling one of the members to order for mixing up other matters with the subject under discussion. A committee was ultimately arranged for

ethnological inquiries. APPOINTMENTS.-Dr. B. W. Richardson has been elected

Physician to the Blenheim-street Dispensary. -Thomas Bellot, Esq., R.N., F.R.C.S.E., is appointed Hospital-Surgeon, at Therapia, to join H.M. flag-ship, Black Sea fleet. Commission dated November, 1854