The lesson which the experience of the Russian army of 1828 and 1829
taught the world of the mortal dangers of Bulgaria was lost on the
British Government, which sent its own troops there in 1854, to be
exposed to, and wither before, the same destructive influences. But at
length sickness prevailed to such an extent, and death made such havoc,
in the army in the East, that England's great sympathies were roused,
and the Ministers' attention was drawn to the irresistible fact, that
the strongest of Britain's soldiers were passing rapidly from the camp
to the hospital, and from the hospital to the grave. Then a doubt
occurred to the minds of the men in power, whether all was right in the
Crimea, and whether something might not be done for the sanitary
salvation of the army. They sent a commission, consisting of Dr. John
Sutherland, one of the ablest sanitarians of the kingdom, Dr. Hector
Gavin, and Robert Rawlinson, civil engineer, to the Black Sea, to
inquire into the state of things there, to search out the causes of the
sufferings of the army, and see if there might not be a remedy found and
applied. At the same time, Miss Nightingale and a large corps of
assistants, attendants, and nurses, women of station and culture and
women of hire, went to that terrible scene of misery and death, to aid
in any measures that might be devised to alleviate the condition of the
men. Great abuses and negligence were found; and the causes of disease
were manifest, manifold, and needless. But a reform was at once
instituted; great changes were made in the general management of the
camp and hospitals and in the condition of the soldiers. Disease began
to diminish, the progress of mortality was arrested, and in the course
of a few months the rate of death was as low as among men of the same
ages at home.
This commission made a full report, when they returned, and described
the state of things they found in the Crimea and on the shores of the
Black Sea,--the camps, barracks, huts, tents, food, manner of life, and
general sanitary condition of the troops, their terrible sufferings, and
the means and ways of caring for the sick, the measures of reform which
they had proposed and carried out, and their effects on the health of
the men. This report was published by the Government.
Besides this commission, the Government sent Dr. Lyons, a surgeon and
pathologist of great learning and acumen, to investigate the pathology
or morbid condition of the army. According to his instructions, he spent
four months in the Crimea and at the great hospitals on the Bosphorus.
He examined and traced the course of disease and disturbance in the sick
and wounded. He made very many thorough examinations after death, in
order to determine the effects of vitiating influences upon the
organization, and the condition of the textures and organs of the body
in connection with the several kinds of disorders. Dr. Lyons's extremely
instructive report was published by national authority as one of the
Parliamentary folio volumes. After the war was over, Dr. W. Hanbury and
Staff-Surgeon Matthew, under the direction of the Secretary of War,
gathered, analyzed, and prepared the records of all the surgeons of the
several corps of the Crimean army. To these they added a long and
valuable treatise on the nature and character of the diseases, and their
connection with the condition and habits of the men. These are published
in two very thick folio volumes, and give a minute and almost daily
history of the life, labors, exposures, privations, sufferings,
sickness, and mortality of each regiment. These two works, of Dr. Lyons
and Drs. Hanbury and Matthew, show the inseparable connection between
the manner of living and the health, and demonstrate that the severe
life of war, with its diminished creation of vital force, by imperfect
and uncertain nutrition and excessive expenditure in exposures and
labors, necessarily breaks down the constitution. It subjects the body
to more abundant disorders, and especially to those of the depressive,
adynamic type, which, from the want of the usual recuperative power, are
more fatal than the diseases of civil life. These works may be
considered generic as well as specific. They apply to and describe the
sanitary condition and the pathological history of all armies engaged in
hard and severe campaigns, as well as those of the Crimea. They should,
therefore, be read by every Government that engages in or is forced into
any war. They should be distributed to and thoroughly understood by
every commander who directs the army, and every surgeon who superintends
the sanitary condition of, and manages the sickness among, the men; and
happy will it be for those soldiers whose military and sanitary
directors avail themselves of the instructions contained in these
volumes.
There are several other works on the Crimean War, by surgeons and other
officers, written mainly to give a knowledge of the general facts of
those campaigns, but all incidentally corroborating and explaining the
statements in the Government Reports, in respect to the health and
sufferings of the British and French armies. In this view, Dr. Bryce's
book, "England and France before Sebastopol," and M. Baudens's and M.
Scrive's medical works in French, are worthy of great attention and
confidence.
The most important and valuable work, in this connection, is the Report
of the British Commission appointed in May, 1854, "to inquire into the
regulations affecting the sanitary condition of the British army, the
organization of the military hospitals, and the treatment of the sick
and wounded." This commission included some of the ablest and most
learned physicians and surgeons in the civil and military service, some
of the most accomplished statisticians, sanitarians, army-officers, and
statesmen in the United Kingdom. They were authorized to inquire into
the habits and duties, the moral and sanitary condition of the army, the
amount and kinds of sickness, the causes and frequency of death, and the
means of improvement. This commission sat for a long time in London.
They called before them fifty-three witnesses, among whom were Sir
Benjamin Brodie, the leading surgeon of England, Dr. Andrew Smith,
Director-General of the Medical Department of the Army, Thomas
Alexander, Inspector-General of Hospitals, Major-General Airey,
Quartermaster-General, Dr. John Sutherland, late Crimean Commissioner,
and one of the leading authorities of Great Britain in all sanitary
matters, Dr. William Fair, the chief and master-spirit of the
Registry-Office, and the highest authority in vital statistics, Colonel
Sir Alexander Tulloch, author of the elaborate and valuable reports on
the mortality in the British army, Francis G. P. Neison, author of
"Contributions to Vital Statistics," Miss Nightingale, and others,
surgeons, officers, purveyors, engineers, soldiers, and medical and
sanitary scholars.
The commission put forth 10,070 interrogatories relating to everything
connected with the army, the persons and the _matériel_, to officers,
surgeons, physicians, health-officers, soldiers, nurses, cooks,
clothing, food, cooking, barracks, tents, huts, hospitals, duties,
labors, exposures, and privations, and their effects on health and life,
in every climate, wherever British troops are stationed or serve, at
home and abroad. The same inquiry was extended to the armies of other
nations, French, Turkish, Russian, etc. To these questions the witnesses
returned answers, and statements of facts and opinions, all carefully
prepared, and some of great length, and elaborate calculations in
respect to the whole military and sanitary science and practice of the
age. A large part of the inquiry was directed to the Crimean army, whose
condition had been, and was then, a matter of the most intense interest.
Many of the witnesses had, in various ways, been connected with that
war: they were familiar with its history, and their answers revealed
much that had not before been known. The result of all this
investigation is published in a folio volume of 607 pages, filled with
facts and principles, the lamentable history of the past, painful
descriptions of the present, and wise suggestions for the future
management of the army; and the whole is worthy of the careful attention
of all who, as projectors, leaders, or followers, have anything to do
with the active operations of war.
The Crimean War has this remarkable interest, not that the suffering of
the troops and their depreciation in effective power were greater than
in many other wars, but that these happened in an age when the
intelligence and philanthropy, and even the policy of the nation,
demanded to know whether the vital depression and the loss of martial
strength were as great as rumor reported, whether these were the
necessary condition of war, and whether anything could be done to lessen
them. By the investigations and reports of commissions, officers, and
others, the internal history of this war is more completely revealed and
better known than that of any other on record. It is placed on a hill,
in the sight of all nations and governments, for their observation and
warning, to be faithful to the laws of health in providing for, and in
the use of, their armies, if they would obtain the most efficient
service from them.