The Honorary Physicians and Surgeons to the Sovereign.

THE institution of appointments as Honorary Physician and Honorary Surgeon to the Sovereign was the culmination of some fifty years' endeavour to secure for medical officers some reward for distinguished service, and it may be, permissible to review the stages by which this was achieved. The distinCtions generally available to combatant officers at the beginning of the nineteenth century were three-Mention in a Commander-in-Chiefs despatches, published in the London Gazette; for field officers, appointments to the Order of the Bath; and riominations to the Royal Household. Each of these was successively secured for medical officers. It is well known that the first mention in a public despatch of the services of medical officers was made by the Duke of Wellington after the siege of Badajos (April 181-2), at the importunity of his Principal Medical Officer, Dr. (later Sir) James McGrigor. There had previously been instances of surgeons being brought to notice in the reports of commanders of lower formations, an example being the mention by the Commander of the 3rd Cavalry Brigade of the conduct of· Surgeon Lyss at the battle of Laswarree (November 1, 1803). But G. J.Guthrie, lecturing at Westminste~ Hospital on December 2, 1837, says of the batt~e of Albuhera (May 16, 1811): "The General and Staff Officers obtained stars or ribbons; the officers commanding regiments, whether in or out of action, received medals, many of them were promoted, the regimen~s inscribed Albuhera on their colours in letters of gold ... the poor doctors alone got nothing"!; and as late as 1856, Dr. (later Sir) Andrew Smith, DirectorGeneral of the Army and Ordnance Medical Department, complaining to the Stafford Committee2 of the paucity of honours conferred on officers of the Medical Department, said it had "never been the practice to introduce medical officers into despatches .... It was a novelty in the Crimea." He added that as so many surgeons had been brought favourably to the notice of the Commander-in-Chief, but never mentioned in the official despatches, that he had