PART II.

REVIEWS AND BIBLIOGRAPHICAL NOTICES.

Rapport au Conseil de Santé des Armés. Sur les Resultats des Service Medico-Chirurgical aux Ambulances de Crimée et aux Hôpitaux Militaires Français en Turquie pendant la Campagne d'Orient, en 1854, 1855, 1856. Par J. C. CHENU, Docteur au Médecine; Médecin Principal. Folio, pp. 732. Paris: Victor Masson et Fils. 1865.

FULLY ten years have elapsed since the fall of Sebastopol, the crowning act of one of the most memorable campaigns of modern times-more splendid for the vanquished than the victors; and the history of the great events of the years '54, 55, '56 is yet to be written.

As a valuable contribution to the medical and surgical history of the war in the East the Report of M. Chenu will prove acceptable to all, more especially to those who took part, in person, in the events which he describes in such fulness of detail.

M. Chenu insists, at the outset, on the great importance of duly estimating the effects of disease on armies in the field; an important truth, which cannot be too often impressed on statesmen and commanders, who, willing enough to bring all a nation's resources to bear on the material of destruction requisite for campaigns of any magnitude, too often exhibit a spirit of parsimony in providing for the hygienic and medical wants of the troops engaged. Medicine has at all times striven to do her part; but until a post of higher authority is assigned at the council of war to the surgeon or physician-general of the army, we must still expect to hear of unnecessary sacrifice of life by fever or plague, and be content to believe that "the exigencies of military service" demand in each campaign a holocaust of perhaps the best lives which the nation prodigally furnishes from her most promising youth.

"War," says M. Chenu, "as military medical officers have not ceased to proclaim, and has been again recently well said by Dr.

Marrion, Physician-in-Chief to the Navy-war inspires generally in the world only the idea of combats, of strife more or less deadly. The soldier seems made only to be either killed or wounded. We forget too easily that the proportion of those who succumb to diseases, due, in great part, to immaturity of constitution, is infinitely superior to the number of those who are struck down by the fire of the enemy. We do not think sufficiently on those destructive scourges which fasten upon the flanks of an army perfectly provisioned with all the munitions of war, but always taken unprepared by those avalanche-like epidemics, which it would not be at all impossible to foresee, and the gravity of which might be moderated by measures which we shall indicate presently in speaking of recruiting and of the uniform regimen of an army in the field."

Perhaps in no campaign on record do the statistics now available so entirely and finally prove the truth of the positions here laid down. In the pages of M. Chenu we find summed up, not alone the total forces engaged on all sides, with the losses in killed, wounded, and dead of disease, but a considerable statistical return of the absolute number of projectiles of all kinds employed in both the Russian and the allied camps.

Some idea may be formed of the magnitude of the medical requirements of the French army from, or on consideration of, the following statistical returns. The highest number the French army ever attained at any period of the war in the Crimea appears to have been 150,000 men. The return for January, 1856, shows a total of 144,000. To maintain the army in an efficient state a total of 309,268 men were, at various periods, sent to the field of action from France and Algiers.

The following table shows the total losses in the various armies engaged, as summed up by M. Chenu:

The numbers of the Turkish and Russian armies are given only

approximately. The details for the French, English, and Piedmontese armies are as follows

French Army, 1st April, 1854, to 6th July, 1856, and subsequent Deaths, to December, 31, 1857.

Total of troops sent out, 309,268.

Different diseases and cholera, from 1st April, 18,078

Entries into Hospitals

or Ambulances

Killed, Died, or
Disabled

8,084

1854, to 20th September, 1854,

Taking into account that in many instances the same sick and wounded must appear in the returns of consecutive hospitals, and the cases of the same individuals returning to the same hospitals once, twice, or oftener for wounds or diseases, M. Chenu estimates the actual total of wounded and sick at 225,000.

Amongst the deaths in hospital are to be noted 4,513 from cholera, and 463 from frost-bites. No account have yet been forwarded of those who must have died of the effects of wounds after the return of the army to England.

In the army of Piedmont, with a total of 21,000 men sent out, we find the return as follows:

Let us now turn to the consideration of the means of destruction employed on all sides—and in no previous campaign have such ample materials been made available-to enlighten us as to the statistics of the agents of destruction, and the result thus produced as compared with those due to the invasion of disease.

The following table indicates approximately the number of projectiles employed in the Crimea by the various forces engaged, with the results in killed and wounded:

This gives a proportion of about one killed or wounded for every 500 projectiles (accurately, within a fraction of one to 512). We cannot very well see how to accommodate the figures with M. Chenu's statement that, deducting deaths by explosion of mines, powder magazines, and various other causes, the proportion is one killed or wounded to every 1,000 projectiles.

The excess of small-arm fire over that of guns of large calibre throwing round-shot, grape, &c., appears to be infinitely greater than what we presume would accord with popular estimate. It is estimated, in the returns of which M. Chenu has availed himself, thus during the campaign:

The Russians fired 2,800,000 large projectiles, solid or hollow.

42,200,000 balls.

VOL. XLIII., No. 85, n. s.

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M. Chenu does not furnish any statistics to show what comparative amount of destruction was due to large and small projectiles respectively. Our own experience goes to show that, while shell and round shot produced, in numerous instances, very destructive effects, accompanied not alone with great loss of life, but much dismemberment and disfigurement of body, by far the largest proportion of deaths and wounds were due to the bullet.

Of the great skill of the Russian troops in the use of small-arms abundant evidence is on record. Not less can be doubted their energy and activity in immediately availing themselves of every improvement effected in the construction of instruments of offence and defence, and projectiles of all kinds. The following incident communicated to ourselves at the time, by a very distinguished medical officer at the head-quarters of the French army, may be cited as an apt illustration of what is here stated:

The form of bullet known as the balle Nessler, and employed largely, as shown by the above tables, was the invention of an officer serving with the French troops in the Crimea. It was a bullet of short axis, consisting of a hemi-spherical head, very short cylindrical body, and deeply cupped base. The model of this projectile was, as we are informed, invented in the Crimea by M. Nessler, and sent to Paris to be manufactured in quantity for use in the field. Before the French supply arrived a ball of this identical construction was fired, and with effect, from the Russian side; and the writer has himself removed a balle Nessler (now in his possession) from a deep-seated wound of the neck. The conclusion is obvious, but the explanation not easy.

While the killed and wounded are seen to be as 1 to 500 for the projectiles employed, the killed and deaths from wounds show as 1 to 3.76 to the deaths from disease.