Comments on the medical aspect of the Battle of Waterloo, 1815.

THE image of the Medical Department of the Army in the twenty years preceding 1815 had not been an impressive one. With a few notable exceptions the hospital staffs, in particular the 'mates', the purveyors and the apothecaries, had had a very bad name since the war started against the French in Flanders in 1793. Regrettably John Hunter who was Surgeon-General died in the same year, a year when a great expansion of the Army took place and brought in many broken-down practitioners, drunken apothecaries and rogues of every description. Indeed it has been said that in 1794 the mismanagement of hospitals had been exceeded only by the chaos in the Army as a whole, and this in turn by government mismanagement, and misappropriation of public funds. And the disastrous Walcheren expedition of 1809 had done little to inspire confidence. In the Peninsular Campaign of 1808-1812 this situation was only slightly better, and it was Napier (1812) in his History of the Peninsular War who wrote, 'where one soldier died for want of surgical skill, hundreds perished from the absence of medical organisation', and stated that the want of money, and the indifference of the part of the home authorities, greatly frustrated the unceasing efforts of Wellington and Sir James McGrigor (1771-1858) to better the lot of the sick and wounded. Between the regimental hospitals and the military hospitals there were no intermediate medical units of the nature of field ambulances. Neither were there medical vehicles to evacuate regimental sick and wounded to the hospitals: this depended partly on local resources and partly on the casual assistance of a weak, usually illdisciplined wagon train, furnishing only three wagons to a Division for general purposes. By comparison, the French seem to have had a more efficient casualty evacuation system. It is said that it was remarkable how rapidly the French sick and wounded were whisked away from the battlefield borne by stretcher bearer parties (Corps de Brancardiers) which had been introduced earlier by Baron Percy. Evacuation was then effected by Larrey's well disciplined ambulance cart units (Ambulance Volantes) consisting of horse-drawn well sprung two-wheeled and four-wheeled covered carts. A number of promising measures were effected after 1800: entrance examinations for surgeons' mates; the establishment, in 1806, at Edinburgh University of a Chair of Military Surgery with John Thomson (1765-1846), who had little, if any, military surgical experience, as the first incumbent. Then in 1809 the transference of control of the Army Medical Department from part-time civilian physicians and surgeons to full-time serving and experienced regular medical officers.