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Wars, Pestilence and the Surgeon's Blade - The Evolution of British Military Medicine and Surgery During the Nineteenth Century (Paperback)
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Wars, Pestilence and the Surgeon's Blade - The Evolution of British Military Medicine and Surgery During the Nineteenth Century (Paperback)
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Wars in the 19th Century were accompanied by a very heavy loss of
life from infectious diseases. Typhus fever, dysentery, malaria,
typhoid fever and yellow fever caused many more deaths than wounds
inflicted by enemy actions. During the Peninsular War, for example,
for every soldier dying of a wound, four succumbed to disease. This
book examines the development and evolution of surgical practice
against this overwhelming risk of death due to disease. It reviews
three major conflicts during this time: the Peninsular War, the
Crimean War and the Boer War and also considers many minor wars
fought by the British Empire in the intervening years, and
highlights significant medical and surgical developments during
these conflicts. War surgery in the first part of the 19th Century
was brutal, and it had to be carried out swiftly. It was performed
at speed because there were no anaesthetics and the wounded often
died during the procedure. Surgeons focussed their attention on
wounds of the arms and legs, because limbs were both easily
accessible to the surgeon (unlike organs inside the abdomen and
chest) and lent themselves well to amputation. This was commonly
the operation of choice for many war wounds of arms and legs. Some
surgeons performed more difficult surgical procedures to try to
preserve the limbs and attempted to repair damaged tissues, but
these operations took longer and caused greater suffering to the
patient. Abdominal and chest wounds were not treated since surgeons
did not have the means, the ability, or the understanding, to cut
into the abdomen and chest to repair the damaged organs
successfully. An important development which contributed to surgery
moving forwards was the discovery of general anaesthesia, which
became available in time for the Crimean War. However, whilst it
certainly rendered operations pain-free, it was associated with
significant numbers of deaths during surgery on wounded soldiers
because of the poorly understood effects that anaesthetics had,
particularly on the heart. As a result, operative surgery did not
extend its scope a great deal, and military surgery remained
focussed on surgery of the limbs. However, fewer amputations were
performed during the Boer War at the end of this period. Britain
sent observers to several wars in which it was not involved to
learn military lessons and to understand the medical and surgical
aspects of war. The American Civil War and the Franco-Prussian War
were two such conflicts. The Russo-Japanese War resulted in a very
significant advance in surgery for abdominal wounds, but Western
observers either failed to notice or ignored pioneering work
performed by a Russian female surgeon called Vera Gedroits. As a
result, when the Great War began in 1914, lessons had to be
re-learned by British surgeons, and many soldiers who suffered
penetrating abdominal wounds lost their lives when they should have
survived. Unfortunately, one of the hallmarks of war surgery is
that successive generations of surgeons make the same mistakes as
their forebears and the same lessons have to be learned time and
again.
General
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