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THE WOUNDED IN THE WAR.
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high standing above the military age of service who would gladly, not to say eagerly, embrace such opportunity to be of service. Those of us who are associated with hospitals "Audi alteram partem." know well that there is no greater stimulus to thoroughness and efficiency on the part of the medical staff, from the highest to the lowest, than MEDICAL RECORDS OF THE WAR. is afforded by a good system of case reporting and To the Editor of THE LANCET. record. A case well reported is a case well studied; SiR,-It is noteworthy that we possess no com- and careful diagnosis and right treatment are the plete medical history of any of the numerous wars natural sequence. Wholly apart from the matter of in which the British army has been engaged during future utility, a committee charged particularly the last century. If, for example, any one of us with the oversight of the medical records of the war desires to inquire into the mortality from zymotic would contribute materially to the efficiency of the disease during the Crimean or even during the more medical service and the welfare of our troops. I am, Sir, yours faithfully, recent Boer war, there is no easily accessible J. GEORGE ADAMI. authoritative survey of the medical proceedings of McGill University, Montreal, Oct. 20th, 1914. to turn which we naturally for the either war required information. After much search we THE WOUNDED IN THE WAR. might, it is true, come across it in some
Correspondence.
excellent
article
contributed
to
the
JournaZ
To the Editor of THE LANCET.
of the R.A.M.C., but, again, we might not, or SIR,-May I venture to confirm the opinion we might hunt it down in the Annual Reports of the Director-General. But despite the abundant expressed elsewhere that the care of our wounded time and efforts which they represent Blue-books needs immediate supplementation, not by the and other official documents are not literature. appointment of a few consultant diagnosticians, As likely as not the library we are accustomed to but in notably increasing the staffs and equipment use does not stack these on its shelves. This of the base hospitals in France by sending out a is a defect which should be remedied in the number of hospital surgeons of experience ? The greatest and gravest war with which our country condition in which the wounded arrive here, the has ever been overtaken, a war in which, taking statements they make of the want of surgical into account the relatively small size of our army, attention during transport, especially in trains, the success will very largely depend upon the reduc- fact that many cases are prejudiced (some have tion of preventable disease to a minimum among even died) by being put on board ship when they our troops and upon the preservation of the should have been treated at a base hospital, are all of our men in a of clearly due to a shortage of experienced surgeons number state greatest possible health and strength upon the battle line, in which, on the other side of the Channel. There are a number of Territorial medical therefore, the Royal Army Medical Corps will be a like myself who found ourselves practiofficers foremost factor. by the War Department as soon cally unemployed to it if is be written must But such a history as we had completed the preparation of the base based it must be be and (1) (2) official ; upon volunteering, as I did on precise data. That is to say, from the beginning it hospitals. Intothereupon be transferred to the Active Service must be clearly borne in mind by the whole medical August 12th, I 16th a memorandum to addressed on List, August staff that the data bearing upon each case must be the to Director-General venturing suggest that as so collected and recorded as to be serviceable for future reference. In the matter of case reports under the circumstances of the present war sudden and records the Royal Army Medical Corps has a pressure on the bases must be expected, the of consultants as in the Boer war system that is beyond reproach. It must be appointment would not be so useful as the addition of a number remembered, however, that there are many of us to the Force as supernumerary Expeditionary voluntary agencies at work, hospitals equipped and manned by those hitherto unconnected with the surgeons of hospital experience who could be sent the principal medical officer to serve base hosarmy organisation. If any one unit fails to do its by was greatest. This duty it renders the whole record imperfect. It is pitals wherever the pressure not has so far been accepted, however, suggestion, essential, therefore, that a small and authoritative and one in favour of one’s own is though naturally body be appointed that, under the control of the I cannot help still feeling that our wounded view, shall have and Director-General, oversight, collection, not receiving all the surgical help their splendid preservation of hospital and other medical records. are services deserve. The active members of the Royal Army Medical I am, Sir, yours faithfully, Corps are rightly occupied in meeting the vital
VICTOR HORSLEY. needs of the moment; it would be unwise to demand that certain of their number be called off to take special charge of this work. It is doubtless VOLUNTEER SURGEONS FOR FRENCH this very devotion of a well-worked body to HOSPITALS. immediate needs that explains the non-existence To the Editor of THE LANCET. of authoritative medical histories of previous wars. The work could be accomplished equally well by SIR,-You were kind enough to publish on medical men of standing and authority outside the Sept. 26th a letter of mine written at Crepy-enservice, once they had familiarised themselves with Valois, in which, amongst other matters, I made an the statistical methods of the Director-General andappeal for surgeons for the French hospitals near his staff. Not mere clerks are wanted, but men the front. To that letter I am glad to say I had the possessing such status that their directions wouldlarge number of 153 replies, many of them from be accepted and fulfilled by the different hospital holding important positions in London and units. There can be no lack of medical men of hospitals as surgeons or anassthetists.
men provincial
high standing above the military age of service who would gladly, not to say eagerly, embrace such opportunity to be of service. Those of us who are associated with hospitals "Audi alteram partem." know well that there is no greater stimulus to thoroughness and efficiency on the part of the medical staff, from the highest to the lowest, than MEDICAL RECORDS OF THE WAR. is afforded by a good system of case reporting and To the Editor of THE LANCET. record. A case well reported is a case well studied; SiR,-It is noteworthy that we possess no com- and careful diagnosis and right treatment are the plete medical history of any of the numerous wars natural sequence. Wholly apart from the matter of in which the British army has been engaged during future utility, a committee charged particularly the last century. If, for example, any one of us with the oversight of the medical records of the war desires to inquire into the mortality from zymotic would contribute materially to the efficiency of the disease during the Crimean or even during the more medical service and the welfare of our troops. I am, Sir, yours faithfully, recent Boer war, there is no easily accessible J. GEORGE ADAMI. authoritative survey of the medical proceedings of McGill University, Montreal, Oct. 20th, 1914. to turn which we naturally for the either war required information. After much search we THE WOUNDED IN THE WAR. might, it is true, come across it in some
Correspondence.
excellent
article
contributed
to
the
JournaZ
To the Editor of THE LANCET.
of the R.A.M.C., but, again, we might not, or SIR,-May I venture to confirm the opinion we might hunt it down in the Annual Reports of the Director-General. But despite the abundant expressed elsewhere that the care of our wounded time and efforts which they represent Blue-books needs immediate supplementation, not by the and other official documents are not literature. appointment of a few consultant diagnosticians, As likely as not the library we are accustomed to but in notably increasing the staffs and equipment use does not stack these on its shelves. This of the base hospitals in France by sending out a is a defect which should be remedied in the number of hospital surgeons of experience ? The greatest and gravest war with which our country condition in which the wounded arrive here, the has ever been overtaken, a war in which, taking statements they make of the want of surgical into account the relatively small size of our army, attention during transport, especially in trains, the success will very largely depend upon the reduc- fact that many cases are prejudiced (some have tion of preventable disease to a minimum among even died) by being put on board ship when they our troops and upon the preservation of the should have been treated at a base hospital, are all of our men in a of clearly due to a shortage of experienced surgeons number state greatest possible health and strength upon the battle line, in which, on the other side of the Channel. There are a number of Territorial medical therefore, the Royal Army Medical Corps will be a like myself who found ourselves practiofficers foremost factor. by the War Department as soon cally unemployed to it if is be written must But such a history as we had completed the preparation of the base based it must be be and (1) (2) official ; upon volunteering, as I did on precise data. That is to say, from the beginning it hospitals. Intothereupon be transferred to the Active Service must be clearly borne in mind by the whole medical August 12th, I 16th a memorandum to addressed on List, August staff that the data bearing upon each case must be the to Director-General venturing suggest that as so collected and recorded as to be serviceable for future reference. In the matter of case reports under the circumstances of the present war sudden and records the Royal Army Medical Corps has a pressure on the bases must be expected, the of consultants as in the Boer war system that is beyond reproach. It must be appointment would not be so useful as the addition of a number remembered, however, that there are many of us to the Force as supernumerary Expeditionary voluntary agencies at work, hospitals equipped and manned by those hitherto unconnected with the surgeons of hospital experience who could be sent the principal medical officer to serve base hosarmy organisation. If any one unit fails to do its by was greatest. This duty it renders the whole record imperfect. It is pitals wherever the pressure not has so far been accepted, however, suggestion, essential, therefore, that a small and authoritative and one in favour of one’s own is though naturally body be appointed that, under the control of the I cannot help still feeling that our wounded view, shall have and Director-General, oversight, collection, not receiving all the surgical help their splendid preservation of hospital and other medical records. are services deserve. The active members of the Royal Army Medical I am, Sir, yours faithfully, Corps are rightly occupied in meeting the vital
VICTOR HORSLEY. needs of the moment; it would be unwise to demand that certain of their number be called off to take special charge of this work. It is doubtless VOLUNTEER SURGEONS FOR FRENCH this very devotion of a well-worked body to HOSPITALS. immediate needs that explains the non-existence To the Editor of THE LANCET. of authoritative medical histories of previous wars. The work could be accomplished equally well by SIR,-You were kind enough to publish on medical men of standing and authority outside the Sept. 26th a letter of mine written at Crepy-enservice, once they had familiarised themselves with Valois, in which, amongst other matters, I made an the statistical methods of the Director-General andappeal for surgeons for the French hospitals near his staff. Not mere clerks are wanted, but men the front. To that letter I am glad to say I had the possessing such status that their directions wouldlarge number of 153 replies, many of them from be accepted and fulfilled by the different hospital holding important positions in London and units. There can be no lack of medical men of hospitals as surgeons or anassthetists.
men provincial