Wars, Pestilence and the Surgeon's Blade: The Evolution of British Military Medicine and Surgery During the Nineteenth Century

Description

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.

Steve heys was born in Accrington and was educated in England, Australia and Scotland. He graduated in Medicine from the University of Aberdeen in 1981 and undertook his surgical training in the North East of Scotland. He is a Fellow of the Royal College of Surgeons of Edinburgh, Glasgow and England and underwent research training in the Rowett Research Institute in Aberdeen, obtaining a PhD in 1992. He specialised in general and breast cancer surgery for many years before latterly concentrating on breast cancer together with his research interests in the role of nutrition in the causation of cancer. Steve has published more than 200 scientific papers, has written many book chapters on different aspects of surgery and has played many national and international roles in surgery and the provision of surgical services. Steve joins forces with Tom as co-author of this work which explores the development of surgery during the nineteenth and early twentieth century. As Professor of Cancer Surgery at the University of Aberdeen, as well as a former member of the RAMC (V) in the 51st Highland Brigade for 6 years, Steve too is conscious of the major contribution made by Sir James McGrigor both to Army Medical Services and to the University of Aberdeen where McGrigor co-founded the Aberdeen Medical Society and which he supported throughout his long and illustrious career. Tom Scotland - Born in St. Andrews and brought up in the East Neuk of Fife, Tom was educated at Waid Academy in Anstruther. He graduated in Medicine from the University of Edinburgh 1971, becoming a fellow of the Royal College of Surgeons of Edinburgh in 1975. He developed his interest in the Great War whilst a student, when there were still many veterans alive. He trained in orthopaedic surgery in Aberdeen, and after spending a year as a fellow in the University of Toronto, returned to take up the position of Consultant Orthopaedic Surgeon with Grampian Health Board and Honorary Senior Lecturer at the University of Aberdeen. His particular interests were knee surgery, paediatric orthopaedics and tumour surgery, and for three years was lead clinician for the Scottish Sarcoma Managed Clinical network. Over the years he has been a frequent visitor to the Western Front, and has found cycling the best way to visit different places. He has explored many areas of the Western Front with family and friends and since retiring from the National Health Service in 2007 has kept in touch with former colleagues by leading cycling expeditions to the Western Front. He has pursued his interest in the Great War by making a particular study of Aberdeen surgeon, Sir Henry Gray, who played a pivotal role in the development of surgery on the Western Front, and has given various lectures on the development of surgical services during the Great War. In retirement he has completely re-invented himself as a cycling orthopaedic historian.