Military surgeon

“ On the whole, it seems clear that the military surgeon must be guided by circumstances, since it may be far better to risk the chances of recurrent hæmorrhage, or the development of an aneurism or varix, all of which are amenable to successful treatment later, than those of gangrene of a limb or softening of the brain. ”

“ No portion of the military service has been more misrepresented than the medical department. An opinion seems to prevail quite extensively that the army surgeon is generally a young graduate, vain of his official position, who cares little for the health of the soldier, and glories in the opportunities afforded by a battle for reckless operations. ”

“ The achievements in the field of discovery of the chemist, the physicist and the biologist have given the military surgeon an advantage in diagnosis and treatment which was denied to his predecessors, and we are able to measure the effects of these advantages when we come to appraise the results which have been attained. ”

“ HOUGH military surgeons are technically non-combatants, yet practically they are as much exposed to peril as other officers, and frequently have to perform work demanding the greatest care and calmness under the most disturbing dangers. In gallantry and devotion to duty no other class of soldiers has surpassed them. The following is the story of the exploit of one of these brave men, Surgeon Jee, as told in his own words:—
On the advance of the force to relieve the garrison of Lucknow, under Generals Havelock and Outram, my regiment, the 78th Highlanders, led the way. ”

“ Meanwhile, The Surgeon General was maturing his plans for a medical museum, and on 1 August 1862, he gave to Surgeon Brinton the go-ahead sign, directing him "to collect and properly arrange in the 'Military Medical Museum' all specimens of morbid anatomy, both medical and surgical, which may have accumulated since the commencement of the Rebellion in the various U.S. hospitals, or which may have been retained by any of the Medical officers of the Army." ”

“ Although these affections are not likely to come often under the treatment of the surgeon in civil life, yet they are of much importance to the naval or military practitioner, since an accurate knowledge of them will lead him to institute a careful inquiry when a man complains of inability to sustain the fatigue of marching with the burden of a heavy knapsack ”

“ Many other factors, such as the physical and mental condition of the men, the facilities for affording first aid, and the transport arrangements, also play a part in determining the nature and condition of the wounds that have to be dealt with by military surgeons. ”

“ In response to this call, some who were whole and needed not a physician, as well as those who were sick, reported at the surgeon’s tent for prescriptions. Much used to be said by the soldiers in regard to the competency or incompetency of army surgeons. It was well understood in war time that, even though an examination of fitness was required of surgeons to secure an appointment in the army,—at least in some States,—many charlatans, by some means, received commissions. ”

“ In the hurry and confusion of a war, and amidst the pressure of hundreds of new cases in a day, what can the surgeons of the hospital be expected to do for science, or even for the improvement of medical and surgical practice?—The answer is seen in the new arrangements in England, where a statistical branch has been established in the Army Medical Department. Of course, no one but the practising surgeon or physician can furnish the pathological facts in each individual case; but this is what every active and earnest practitioner does always and everywhere, when he sees reason for it. ”

“ They trusted the women as they would have trusted men—passing the bullets which had been extracted from their persons from bed to bed and pronouncing the surgeon to be ‘wonderfully clever!’ The more convalescent patients visited the men40 who had undergone serious operations in the wards and cheered them with reminders that they were not ‘in the hands of the R.A.M.C.’ Their enthusiasm for the hospital was delightful and encouraging. ”

“ To all these the surgeons are to give such relief as lies in their power, a task the very thoughts of which would overcome physicians at home, but upon which the army surgeon enters with as much coolness and confidence as though he could do it all at once. He has learned to do what he can. Contenting himself with working day and night without respite, and often without food, until, by unremitting but quiet toil, the wants of all are relieved. No class of men in the army perform so great labors with so little credit as the surgeons. ”

“ Lord Strafford has sent one to his regiment, the Coldstream Guards, and Dr. Thomson has sent another. Young backs and young knees only can bend for consecutive hours over men lying on the ground. Doctors of fifty years of age cannot do it; they are physically unequal to the labor. A staff-surgeon half a century old on a field of battle is almost an absurdity in the art, if not in the science of surgery: he ought to be promoted to the rank of inspector. ”

“ During the last session of Congress an unsuccessful attempt was made to do away with the inferior titles of assistant surgeon and passed-assistant surgeon in the navy, and, in plain English, to call a surgeon a surgeon, as we call a spade a spade. The medical service of the army descends not only to the assistant surgeon, but also to the lower estate of acting assistant surgeon. ”

“ I have spoken of the bravery of the soldier as he lies under the surgeon's knife; but let us not forget the signal heroism of the surgeons themselves, and their staffs. They have given proof of a super-human courage and self-forgetfulness, and surgeons and doctors, stretcher-bearers and nurses, have frequently figured in the Army Orders for their absolute devotion to duty. In many cases the enemy granted no truce for the recovery of the wounded, and it was necessary to seek them under a hail of bullets and shell fire. ”

“ Troops of both nations used the hospital as long as it was open, and there was no difficulty in serving both masters. Inspection by highly placed officials of both Armies was constant; and these visits were often a source of amusement to the medical staff.
Senior officers of the British Army seldom came to Paris without including the Women’s Hospital in their round of inspection. Especial care was taken to receive these gentlemen with ceremony. The Médecin-en-Chef always took them round herself, and whenever possible the Chief Surgeon assisted too. ”

“ The organisation of the hospital proceeded rapidly, and the amount of heavy surgery and acute sepsis which came in taxed the energy and resources of the surgical staff. Dr. Garrett Anderson acted as chief surgeon and Dr. Gazdar took charge of the officers’ ward. Other workers fell into their places and a sort of routine was gradually evolved. The duties of administrator, or Médecin-en-Chef, fell to Dr. Flora Murray, and when she was not issuing stores or counting linen, she would be receiving the countless visitors who came to see the wards. ”

“ H-m, I know these ship's doctors, Mr. Merrick, and I wouldn't care to have you and your nieces trust your lives to one, in case you become ill. Believe me, a good physician is as necessary to you as a good surgeon. Do you know that disease will kill as many of those soldiers as bullets? ”

“ Nevertheless, and despite the handicap of limited space and facilities, the Museum was, as The Surgeon General described it in his 1920 report, a very valuable connecting link between the Medical Department of the United States Army and the general medical profession of the United States, from the stand-point of scientific medicine and surgery. ”

“ Much of the early exposure of these individuals dealt with the concept of mass casualties and thermonuclear warfare. In 1970, Dr. Louis M. Rousselot, Assistant Secretary of Defense for Health and Environment, an outstanding surgeon himself, realizing that, during the Korean and Vietnam conflicts, new surgical information had been learned or relearned and that this new information required broad exposure, tasked the Army Surgeon General to update the Emergency War Surgery Handbook. ”

“ I said, too, that I had once felt a strong desire to become an army surgeon, for the sake of the experience it would give me; but I think I have shown that amongst the privates of the vast army of work-a-day toilers, there is practice sufficient to satisfy the most exacting; and though the surgeon may not have to deal with sword-cut, bayonet, and bullet wound, there is enough work for busy hand and brain at home in his noble profession, whose mission it is to relieve the sick and wounded in the great battle of life. ”

“ Three long windows faced the courtyard; there was a great bunch of electric lights in the ceiling, and there was a constant supply of boiling water. What more could the heart of surgeon desire? There were two operating tables and an equipment of instruments to vie with any in a London hospital. Somebody must have been very extravagant over those instruments, I thought as I looked at them; but he was right and I was wrong, for there were very few of those instruments for which I was not grateful before long. The surgery of war is a very different thing from the surgery of home. ”

“ A surgeon on the field of battle can rarely have a patient brought to him, requiring amputation, under less time than from a quarter to half an hour; a surgeon in a ship may see his patient in less than five minutes after the receipt of the injury ”

“ The duties to which we then applied ourselves are easily imaginable; they included the setting of fractures, extracting of bullets, ligaturing arteries, resecting bones and joints, and assisting at the operation table. This last was frequently my province. I was under Dr. May, an experienced American surgeon, who, as I have mentioned earlier, had served in the Confederate Army. No one could be more considerate. ”

“ A young staff surgeon, the only medical man present, was kneeling at his side, and occupied in compressing some wounded vessels to arrest the bleeding, which, at the slightest stir of the patient, broke out anew. The remainder of the group were grenadiers of his own regiment, in whose sad and sorrow-struck faces one might read the affection his men invariably bore him.
“Is he coming? can you hear any one coming?” said the young surgeon, in an anxious whisper to the soldier beside him.
“No, sir; but he cannot be far off now,” replied the man. ”

“ As American Forces spread to theaters of active operations, the system of channeling pathological materials and information spread with them, with the chief surgeon of each oversea theater designating a medical general laboratory, usually at the principal general hospital in the area, to serve as its histopathologic center. ”

“ After the war he was stationed at different army posts east and west, and from 1875 to 1880 was surgeon in charge of the Soldiers' Home at Washington, from 1880 to 1887, working in the surgeon-general's office. ”

“ Who will question, that there is more merit in saving one limb by superior skill, than in lopping off a thousand with the utmost dexterity?
To treat surgical diseases as they ought to be treated, the practitioner must be thoroughly acquainted with the healthy and morbid structure; he must also have a mind vigorous and firm from nature, well instructed in the best precedents, and matured by observation.
Years are not the measure of experience. It does not follow, that the older the surgeon is, the more experienced and trustworthy he must be. ”

“ He insists that surgeons must learn by seeing surgical operations, and watching them long and diligently. They must be neither rash nor over-bold, and should be extremely cautious about operating. While he says that he does not object to a surgeon taking a glass of wine, the followers of this specialty must not drink to such an extent as to disturb their command over themselves, and they must not be habitual drinkers. ”

“ They showed no surprise, but were wont to develop amazing confidence in the ward doctors and to discuss the merits of the various surgeons in the square. Each man thought his ward the best ward in the hospital, and his doctor the best doctor on the staff; and many boasted to visitors and at tea-parties that the worst cases in the hospital were in their ward and under their doctor. The dental surgeon, whose skill in extraction was considered marvellous, never failed to thrill the men, and she was eagerly pointed out to friends or visitors. ”

“ The Disease is manifest by the great Swelling; and the Operation is perform'd with a Cane, or a Pipe made of Silver or Steel, with a sharp Stilet at the end; altho' the Ancients were wont to do it with a Lancet. The Patient being supported, sitting on a Bed, or in a great Elbow-Chair, to the end that the Water may run downward, {230}a Servant must press the Belly with his Hands, that the Tumour may be extended, whilst the Surgeon perforates it three or four Fingers breadth below the Navel, and makes the Puncture on the side, to avoid the White-Line ”

“ On the following day, the 6th of November, the hospital was ready for occupation; the plumber and gas-fitter were ejected, the pantry became an operating theatre, the greenhouse was converted into a linen room and packstore. In the evening the ambulances met the trains, and the large ward on the ground floor filled up. Before very long all the beds were occupied, and the Chief Surgeon and her two assistants were kept busy with severe cases and heavy surgery. The pressure of work continued until January; and both doctors and nurses had their hands full. ”