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A MODEL SPANISH HOSPITAL.
“ The Spaniards fought like furies, and two redoubts, which they blew up at the moment when they were entered by the French soldiers, produced a tableau than which it was impossible to imagine anything more frightful and more horrible. The general was struck by a shell, which caused him to share the lot of the brave who gloriously terminated their career on that day. There were seven hundred men wounded, a third of them very severely. They were all operated upon and dressed within the first twelve bours. Subsequent events were more fortunate for the French arms, and the fortress of Figueras, a chef d'auvre of Vauban, fell. The provisions de guerre et de bouche found in the magazines were immense ; • I never saw,' says Larrey, * such beautiful hospital stores: the bandages were like batiste, and the liut was as fine as byssus, the silk of which the mantles of the Roman emperors were formerly made. It was inade up in little packets, tied with favours of different colours, by the Queen of Spain and the ladies of her court."
PREPARATION BEFORE EXPEDITION FOR EGYPT.
“I wrote to the schools of medicine of Montpellier and Toulouse, to request them to send me, with the least possible delay, a certain number of surgeons, well-instructed, courageous, and capable of bearing painful and tedious campaigns. Scarcely was my invitation known in the schools, when the honour of sharing in our perils and our glory became an object of warm contention, and shortly a hundred and eight surgeons (exclusive of the regimental medical officers) were united under my orders. I employed those who were at Toulon, during our short stay there, in preparing thirty chests of dressing materials, fit to be carried on the backs of animals in the rear of the divisions. The surgeons, at the same time, were exercised in the practice of their art, in the military hospital of instruction of the place. I had a complete collection made of instruments and utensils of surgery, and a sufficient number of flexible litters, easy to be carried into all sorts of places. Desgenettes directed the preparation and reception of medicines. The other branches of the medical service were equally provided for by the administrators in chief of the army. We are not informed as to how many acres of lint, gallons of balsam of capivi, or tons of sticking-plaster, were ennbarked ; but we are assured, that everything necessary or likely to be useful was provided, and that the medical stores were separated and distributed among the ships, ready for use in case of an action at sea, or at the moment of disembarkation. Doubtless they were not packed by hundreds-weight in bales, at soine wholesale drug warehouse, and shot from waggons into the hold of a transport, there to be buried under a cairn of shot and shell. The surgeons were also disposed of among the transports, and so distributed, that no vessel of above a hundred men was unprovided with a medical officer."
SUFFERINGS OF THE FRENCH IN EGYPT, AND HOW THEY WERE MET. "It was not until the fifth day that the French arrived at Damanhour, the first spot offering them any resource; and never did army experience so great vicissitudes, and so painful privations, as during the march. Struck with the rays of a burning sun, marching, all on foot, over a sand more burning still, traversing immense plains frightfully arid, where they barely found a few mitches of muddy water, almost solid, the most vigorous soldiers, devoured by Thirst and overcome by heat, sank under the weight of their arms. The luanner in which death approached these sufferers was strange. “They perished
by extinction. This death,' says Larrey, 'appeared to me sweet and calm; for one of them said to me, at the last moment of his life, that he found him
II in a state of comfort inexpressible.' They were also continually harassed "Y swarms of Arabs, among the first of whose victims was a surgeon of the
ambulance. Amidst these troubles, Bonaparte was kicked by an Arab hors. receiving a very severe contusion on his right leg, which threatened mischief, but the case was very soon brought to a happy conclusion by the cares Larrey, notwithstanding the painful march and the natural activity of the patient, which forbade repose. Arrived at Cairo, Larrey lost no time in orzu ising a sort of head-quarters for his department. He formed a school of practcal surgery for the instruction of the young surgeons of the army, ax addressed to his colleagues, surgeons of the first class, a memoir on the epidem: ophthalmia, which began to show itself, in a formidable manner, among the troops. Tlie climate and the sabres of the Mamelukes provided patients in abundance, many of whom had limbs cut clean off by those terrible weapes The repose, too, they were beginning to enjoy after the first storm had passe) over, was disturbed by what the Frenchman calls a revolt of the people & Cairo, in the course of which he had himself a narrow escape, when passos through a · horde of assassins,' in a vain atteinpt to assist General Dupuy, sb was mortally wounded by a lance. On returning to his duty, what was lb astonishment to find the bleeding corpses of two worthy comrades, Rousse and Mongin, surgeons of the first class, stretched on the threshold of the hospital, where they fell fighting with many other brave soldiers. They caused the asylum of the sick to be respected, but it was at the cost of their lives.'
“ Larrey accompanied Bonaparte throughout the campaign of Syria, ao took his part in all the important transactions of that disastrous expedition. In foreseeing and preparing to meet the new forms of danger, and the unpre cedented difficulties of this warfare, he showed his accustomed penetration, as) the fertility of his mind. His ambulance carriages, for example, were no longer available, and he therefore procured a hundred wicker-work cradles, which he had suspended, by pairs, by means of elastic straps, one on either side of the humps of fifty camels. In each of these baskets a wounded man could lie di full length, The means of transport were, he says, the first object of his attention. He himself mounted a dromedary, and rod hither and thither over the desert, to whatever spot was most encumbered with the sick or wounded. In the course of this service, the want of materials for broth for his patients taught Larrey the use of a dead camel, which he found to be very superior to horse flesh, being nourishing, and very agreeable to the taste. Before St Jean d'Acre the plague showed itself among the troops with frightful violence, and there was great difficulty experienced in the establishment of hospitals Scarcely any spot could be found safe from the sorties of the besieged. The only beds procurable for the sick were the leaves of reeds, of which there was but a scanty supply. Wine, vinegar, and medicines were wanting. There was great misery, in every form, experienced by the whole army. During the siege, Larrey never enjoyed a moment of calm and of perfect repose. The wounded amounted to about 2000, among whom were many officers of rank. Cafferelli, who had honoured Larrey with his esteem and friendship, and who had even conceived a project for the improvement of the condition of military surgery, he was, to his eternal regret, unable to save. The chief engineer, Sanson, Duroc, Eugene Beauharnois, Lannes, Arrighi, narrowly escaped. The latter, when in the breaching battery, had his carotid artery divided by a ball, and was only saved by the promptitude of a gunner, who afterwards became Monsieur Pelissier, an officer in the Imperial Guards, in thrusting his fingers into the wound, and keeping them there until Larrey arrived, and secured the bleeding vessel, in the midst of a storm of bullets and balls. At length, after thirteen successive assaults, the genius of Bonaparte yielded before the obstinacy of Sir Sydney Smith; and the siege of Acre having been raised, it was determined to retreat upon Egypt, carrying off all the wounded. For this purpose, as Larrey states, Bonaparte gave up his own horses, and marched on foot with the army. The evacuation of the wounded was accomplished with great success, and Larrey refers to it with satisfaction, as a grand triumph of
field surgery. He seems, truly, to have been very glad to get back to Cairo, near which they were met by General Dugua, who came out, at the head of the garrison, to welcome and assist their return. "With what pleasure,' exclaims Larrey, did we again see our brave companions ! Fatigued by the labours of a long campaign, enfeebled by continual privations, blackened by the burning sun of the desert, we embraced brothers and friends, bound to us by interest and glory, in the spot where we had created a new country, in the midst of a strange people.'
LIKE FERTILITY OF RESOURCE AT TIIE PYRAMIDS. " At the first battle of Aboukir, Larrey again evinced his aptitude in accommodating means to ends, by substituting hospital boats for carriages or camels, and in the conveying the crowd of wounded men without any accident to Alexandria. These boats were provided with flexible litters, wine, vinegar, brandy, so as to form a sort of reserve magazine of medical munitions. The routine practice of that army was manifestly for each officer, charged with a department or a post, to do the best he possibly could to advance the service, caring little for old formularies or customs. There was no waiting for orders from a departmental chief at Paris ; whatever was known to be necessary and possible was resolved upon, and done at the same instant."
THE DEPARTURE FROM EGYPT INCIDENTALLY REVEALS THAT ONE ENGLISH
HOSPITAL WAS WELL MANAGED DURING LAST WAR —— THE CAUSE OF THIS
“ At the conclusion of the Egyptian campaign nothing succeeded.' Sickness increased. The hospitals became over-crowded, and the material and personal means of performing the duty daily grew less. In the defence of Fort Marabou two surgeons were killed, and a third had a leg shot away; while, during the blockade of Alexandria, the cavalry horses had to be killed for food for the sick—and very good broth their flesh made, and very agreeable to eat, with some little care in the preparation, although certain pusillanimous and unenlightened persons murmured against its use. "At least,' says Larrey, I was very happy by my example to establish confidence in this fresh provision, the only kind we were able to get.' At length matters arrived at an extremity, and a council of war having been held, at which the two chief medical officers assisted, it was agreed that further resistance was impossible. A capitulation was accordingly concluded, the report of the medical officers being annexed to the articles, and the arıny was allowed to return to France with all the honour's of war. The moment the capitulation was signed, Larrey visited the English camp and hospitals, of which he gives a favourable account. The field-hospi. tals, he says, were well kept, and provided with everything necessary, under the direction of the inspector-generall (M. Yonck, as he calls him), who had the entire medical and administrative control of the service, with no middleman between him and the General-in-Chief. Larrey and M. Savaresi, then acting physician-in-chief, were named members of the Commission of Armament for carrying out the terms of the capitulation, and to them, in concert with Inspector General Young, was confided the arrangements necessary for the removal of the sick and wounded. Thirteen hundred of these, not including a corps of invalids, were embarked in twelve hospital ships, and sailed with the army. Three hundred were left at Alexandria, confided to the care and kindness of Inspector-General Young, and two months later they all returned cured to France."
The reader will find allusions made to Mr Young in the interesting lecture of Sir George Ballingall, at pp. 474-5 of the present Number.
THEORY AS TO OPERATIONS. “ It is a canon of Larrey's, that in order to afford important operations a fair chance of success, they should be performed within the first twenty-four hours after the shock of the wound that renders them necessary. The proper method is, he says, to place the field hospitals as near as possible to the line of battle, and to form head-quarters, to which all the wounded requiring operations should be brought to be operated upon by the surgeon-in-chief, or under his immediate observation. One ought always to begin with those most dangerously hurt, without regard to rank or distinctions. Those less injured can wait till their brothers-in-arms, horribly mutilated, have been treated, otherwise these will cease to exist in a few hours, or not live beyond the morrow. It is easy for those slightly wounded to repair to the hospitals of the first or second line, especially for officers, who commonly do not want means of transport."
THE RUSSIAN FIELD. “ The march from Posen to Pulstusk and back to Warsaw, accomplished by the French Imperial Guard in nineteen days, was one of extreme difficulty. In many parts the men marched through thick mud, reaching to their waists and to the bellies of the horses; yet the field hospital kept its place, and the light spring waggons, on two wheels, were found to work better than four-wheeled carriages, or even bat-horses. The sick list grew larger accordingly, a circumstance which Larrey turned to advantage, by devoting one day in each week to a clinical conference at his hospital at Warsaw, where he was about to open a complete course of military surgery, when the trumpet again sounded, and, on 1st of February 1807, he was obliged to follow the army. There was about three feet of snow on the ground, and the thermometer was six or seven degrees below zero R. when they left Warsaw. At the battle of Eylau, fought on the 7th of the same month, Larrey, being the only inspector-general present, had the direction of the medical service, and his account of his work is truly terrible. The army bivouaked on the night of the 6th; the thermometer that morning having fallen to thirteen or fourteen degrees below zero. The field hospital was in open barns, from the roof of which the straw had been taken for the use of the horses. The wounded were laid upon the refuse of this straw, covered with snow. The cold was so extreme that the instruments often fell from the hands of the assistants. Larrey happily retained a supernatural strength, excited, no doubt, by the grand interest with which those honourable victims inspired him. The ardent desire,' he continues, 'that we felt to save the lives of these brave men made us persevere. The night arrived, and we had not had a moment's time to satisfy the wants of nature. And in the midst of what torturing scenes had we to discharge our sad, but useful duty! While I operated I heard my services called for from all sides, with the most pressing entreaties. It is true that the moans of these intrepid soldiers were succeeded, after the operations, by a prodigious calm and a sort of internal satisfaction which they expressed by demonstrations of the most lively grati. tude. They no longer seemed to be occupied by their personal sufferings; they prayed for the preservation of our Emperor, and the success of our arms.' It was upon this occasion that the alarm was given, by the advance of the enemy, to which we adverted in a previous page. It was quieted by a successful charge of the cavalry of the guard, made in the midst of whirlwinds of the thickest snow. All the severe wounds of the guards, and most of those of the soldiers of the army, were dressed within the first twelve hours, and then only had the medical officers a moment of rest. We passed the night,' says Larrey, 'on the frozen snow, around our bivouac fires. Never did I pass through a day so painful ; never was my soul so deeply moved. I could not restrain my tears even when I strove to sustain the courage of my wounded.' Another of Larrey's canons of military surgery ruled the proceedings of the
ensuing day; the wounded were all removed—the worst cases to Eylau, the remainder a distance of fifty-five leagues, to Inowraklaw, beyond the Vistula. Prompt evacuations of the wounded, upon the bases of military operations, Larrey considers to be necessary, in order to prevent the epidemics that always attend the crowding of a multitude of sick into one place, and also to be useful in raising the spirits of the men, and highly beneficial as regards the effects of motion upon the wounds, which heal better even when it is somewhat rough. The results justified the theory upon this occasion as upon many others; but it must not be forgotten that the operation demanded much care and forethought on the part of those who conducted it The AssistantSurgeon-in-Chief, Paulet, was ordered to repair immediately from Warsaw to Inowraklaw, to make the necessary preparations for the reception of the convoys, each of which was accompanied by a sufficient number of medical officers, sub-officers, and hospital men. Their quarters and soup were made ready for them, at each station, by sub-officers, who marched in advance ; and M. le Commissaire Ordonnateur Dufour displayed a zeal and activity in all those administrative operations that entitled him to the gratitude of the troops. The services of Larrey and Percy in this battle were rewarded by crosses of Commanders of the Legion of Honour, and the rank of Chevalier was conferred on many of their subordinates."
EXPEDIENTS AS TO DIET AND SURGICAL APPLIANCES. “ The wounded collected in the isle of Lobau suffered much from a grand penury' of commissariat supplies. An excellent soup was, however, made of horse-flesh, and seasoned with gunpowder, the latter of which, we are assured, did not, as might be supposed, impart its black colour to the broth, which was clarified in the process of cooking.
“ At Witpsk, a considerable battle was fought; and there the sufferings which subsequently reached so unparalleled a height, began. The surgeons were obliged to use their shirts for the first dressing of the wounded ; and the misery of the disabled Russians, who had been abandoned or forgotten, was extreme. Four hospitals were established at Witpsk. At Smolensko, where the grand army had 1,200 killed, and 6,000 wounded, the appropriate penalty of its grandeur became still more galling. It was necessary to use the records found in the Archives for dressings ; the paper was emploved for bandages, the parchment for splints, tow and the down of the birch-tree served for lint. Forced to imagine the means of supplying their wants, they bedded the sick upon heaps of paper.”
HOW TO AVOID FROST-BITE. "Owing to the deficiency of superior medical officers, Larrey himself was obliged to perform about 200 amputations in the first twenty-four hours after Borodino), and that in despite of a bitter northerly blast, which rendered it very difficult to keep the wax torches lighted during the night. Over the horrors of Moscow, and of the retreat, we must not linger. Larrey lived and worked through them all, bravely struggling in vain efforts to do his duty, even long after the disorganisation of the army had unmistakeably commenced. Death approached him in every shape. At Dorogobouje, he barely escaped with life from the flames of a burning hospital, in which many victims perished. While his comrades sank under the influence of cold, in which Reaumur's thermometer fell to nineteen degrees below zero, the Baron, always marching on foot, and careful never to approach a fire, escaped."
DEVOTION OF THE SOLDIERS TO LARREY. “At the passage of the Beresina, a touching proof was afforded that the misery of the wretched crowd of fugitives had not deadened their sense of honour and