Advice to Officers in India/Chapter 8
1. SERVICE IN THE FIELD.— Within the last four- teen years, the armies of India have been engaged in no less than seven great wars; viz., in Afghanistan and China; in Gwalior and Scinde; in the Sutlej and Punjaub campaigns; and latterly, in Burmah; and honorary distinctions have been granted for no less than eighteen general actions; viz., Kelat-i-Gilzee, Candahar, Ghuznee, Cabul, Jellalabad, Meeanee, Hyderabad, Maharajpore, Punniar, Moodkee, Ferozeshahur, Alliwal, Sobraon, Mooltan, Chillianwalla, Goojerat, to which may be added the numerous actions in China and Burmah. Extending over the same period,nearly as many little wars have been carried on within our own refractory provinces, of which Fame now takes no account. Few armies in the world have therefore seen so much service, or had their discipline and efficiency so urgently put to the test; and hence the reason for their being at all times, and in all places, ready to take the field.
2. RENDEZVOUS.—When a campaign is about to open, a point of rendezvous is given, and troops are ordered thither from distant stations throughout India. Time enough is in general allowed to provide extra camp equipage, and the medical officer takes care that his own department is complete. He makes indents on the engineer or the barrack department for doolies; on the commissariat department for bearers and carriage; and on the nearest medical depot for instruments and medicines, special directions for which will be found in the Medical Code.
3. BAGGAGE.—For his own personal use, an assistant-surgeon,entering upon his first campaign, will find a single pole tent,nine feet square inside, with a verandah of three feet, and double kanats or walls, the best description. This gives perfect protection against heat and cold, wind and rain;is easily pitched and loaded, and is easily carried by a couple of camels. I think the regulation tent of twelve or fourteen feet square inside,with a four-feet verandah and outer walls,unnecessarily large, and so much more unwieldy, as not to be worth the great extra trouble attending it. When camels are procurable, a couple of camel trunks, a low legged charpay or bed to fit over the trunks, a good tarpaulin, a folding table and a chair, form the usual load for another camel, while the crockery, pots and pans, &c., &c., form a load for a Cooly, who carries them in a couple of baskets, called petarahs, suspended from the ends of a bamboo, called a bangy. With a horse, three-camels and a Cooly, and a well regulated mess in his regiment, an officer is fit for any campaign, and few enter upon one with less baggage.
4. LINE OF MARCH.— Troops upon the march in India always start very early, so as to be at their journey's end before 8 a. m., or before the heat of the day is disagreeable. The reveillie sounds in the darkness of the night, at four, three, or even two in the morning, when every man starts to his feet, and before he has had time to dress, the tent is unlaced, ready to be struck, and before the hour has expired, the whole canvas city is down,packed up, and fast upon the camels. Each regiment forms line upon the front of its own camp; and, when the advance is sounded, takes its place in the order of march. The surgeon falls in in rear of his regiment, along with the adjutant, closely followed by his doolies. The baggage follows in rear of the whole force, and when that is large, the last camel has not left the old camp when the first enters the new, the line of march being one continued stream of beasts of burden. Nor is there the least confusion on the march, nor delay in finding their position in the new camp.
5. CAMP.— Every regiment has its large distinguishing flag; every tent its perch stuck into the place for its pole, all laid off byline and compass the evening before, by the quartermasters of corps, who always go forward in the afternoon; and,before nine, or at latest ten o'clock, the new camp is again complete,in all the order and regularity of the preceding day, with its streets and squares and bazars; its baking ovens, and its shambles. The camp of a large army is a sight worth seeing, and may extend, from flank to flank, two or three miles, and with as much, or even more, regularity and order than that of a city. Each regiment occupies its place in front of the line, the tents for the soldiers first and those for the officers, one continuous street from right to left, the baggage and bazars in rear. Fresh meat, fresh butter, warm loaves and new laid eggs, are as easily-got as in a cantonment. Tradesmen of all sorts ply their trades; cutlers, shoemakers, tinkers, blacksmiths, carpenters,tailors, corn dealers,cloth merchants, confectioners, jewellers and money-changers; in fact, all the necessaries, and many of the luxuries, of life, are procurable in every large camp. Nor are amusements wanting. After the fatigue of the march is over, in the afternoon, quoits, cricket, &c., are practised. Some stroll out with their gun, and supply an extra dish of game to the mess-table, whilst others transfer the features of the landscape to their portfolios. Upon the line of march,it is remarkable that very little sickness takes place, and the Surgeons never have so little professionally to do.
6. FOREIGN SERVICE.— A campaign, under the above circumstances, will appear mere feather-bed work; but affairs undergo a wonderful change on foreign service, and the tug of war is then felt in real earnest. Every idea of luxury and comfort must then be left behind, and a new regime must be submitted to, consistent with the nature of the country, the seat of war. On board ship, the utmost discomfort is to be expected; such a thing as a cabin is entirely out of the question; room on deck for a chair by day and a mattrass by night, and a seat at the dinner-table, is the utmost accommodation to be looked for. The deck, from stem to stern, is crowded with soldiers, and the very ship heels from side to side with the top weight.
Government pay liberally on account of officers embarking on foreign service. They are not charged for passage, and their table expenses are also in a great measure paid by Government. Great confusion in embarking and disembarking, is almost unavoidable; tents and stores are in the hurry mislaid, or unapproachable, and on landing are not to be found. Hence, exposure to the intense heat of the sun by day and the comparative cold at night; to wind, and rain, and damp, and malaria; to hunger and thirst, and great bodily exertion and fatigue in getting into position to meet the enemy. As the army advances into the interior, its difficulties probably increase. riage may not be procurable, unless for a very limited quantity of essentials, and the means of transporting a tent out of the question. The country may be found desolate and deserted; the crops destroyed; the cattle driven far beyond reach; the towns burnt to the ground; the roads broken up, and the bridges broken down; the wells poisoned by putrid carcasses; the means of subsistence—the rough rations of the commissariat; and the bivouac the only alternative; and even that disturbed by midnight attacks along the line of outposts.
7. DISCIPLINE.— Military discipline is as rigidly adhered to, even in the presence of the enemy,as in a cantonment. If a petty theft be committed by a camp follower, the thief, if caught, is immediately punished; if a soldier be detected plundering, he is liable to be flogged by a provost sergeant, upon the spot; if an officer be guilty of any gross breach of duty, he may be brought before a court martial, and be cashiered; if even a Cooly be found dead in camp, a court of inquest is immediately assembled, to ascertain the cause of his death. Even divine service is performed when the bugle may summon the congregation to disperse, and stand to their arms; and a funeral party may be hurried from the graves of their comrades that fell in battle, to meet the enemy in another battle equally destructive of life.
8. ROUTINE.— The amount of official correspondence on all matters of duty is in India very great, but on emergencies in the field these are not invariably exacted. Supplying the wants of the service is the first duty. Official adjustment of accounts the second! For example, when in medical charge of a brigade of troops at the outpost of Sultanporc, Oude, I indented amongst other things for—quinine, and the quantity was sanctioned by the Superintending-surgeon, though only a portion could be spared from the medical depot. I knew that there was plenty of quinine in the private dispensary at Cawnpore, and ordered the remaining portion from it, and forwarded the bill to the proper authorities for payment,and it was paid. Again, on my assuming medical charge of the civil station of Gowhattyr in Assam, I found scurvy epidemic amongst the prisoners, and that many had died of it. In the Kassya Hills, adjoining, limes are indigenous. I bought them by the basketful, served them out as a daily ration to the prisoners, with the most beneficial effect, and was reimbursed by the payment of the contingent bill. Again, after the capture of Rangoon, and before I had access to my hospital stores, cholera broke out in a very violent form, and I had most of my wants supplied from the commissariat only simple receipt roughly written in camp. Had that department acted up to the strict order of duty, many days might have passed before I could have got the supplies, and disastrous consequences might have ensued. Afterwards, when an extensive ruin was allotted as an hospital for the artillery, instead of making official indents for repairs, and pressing the already overworked barrack department to have done what they could not do for weeks, I borrowed a lot of tools, set all my dooly bearers to collect materials, engaged carpenters, bought what I could not find in the ruins of the town, and by personal superintendance, in a few days, made a comfortable hospital. My own house I began on the 4th of May and took possession of it on the 12th of May, and I was better quartered than most officers. No surgeon who knows his duty is embarrassed by the dread of responsibility, and when the public stores are not available, he buys what he wants if he can, and his contingent bill, when forwarded through the proper channel, is paid.
9. CONVEYANCE OF SICK.—The usual mode of conveying the sick and wounded is the same now as in the days of Clive, viz., by the dooly—a sort of bed, with four low legs and corded bottom, suspended on a bamboo pole, over which is fixed a waterproof top with dependant curtains; the patient reclining at full length. For the conveyance of a dooly six men called bearers are allowed; two in front and two in rear, the other two relieving them alternately. When an army takes the field, one dooly is allowed for every hundred natives,and for every ten European soldiers; so that the bearers alone of a European regiment of 1000 strong amount to 600 men.
If the bearers were equal to their work and the doolies always serviceable, officers would not complain of the dooly as a mode of transport, for it has the advantage of being waterproof and of forming a good bed in camp. But the system is notoriously inefficient. The doolies are all supplied by contract from the barrack department—most rickety constructions, always breaking down and always undergoing repairs. Indeed it is the interest and the practice of the bearers to render them unserviceable, for a broken dooly is much easier carried than a sound one, with a wounded soldier in it. The bearers are men collected by the commissariat by a sort of press-gang or conscriptive system—men who never carried a dooly before, mere Coolies; and passed into the service to be discharged at the end of the campaign, their number, not their efficiency, being the chief object. I have rarely found the bearers equal to their work, and have often been obliged to set apart two sets to one dooly, having the other conveyed on a cart. They are a troublesome, unmanageable set of men, at all times a great incumbrance to an army, and in a general action, when most needed, they are too often dispersed in search of plunder. They are told to look on the superintending surgeon as their commanding officer, and the regimental surgeon, who ought to have the control over them, with magisterial power to inflict corporal punishment for neglect of duty, finds his authority quite limited.
Several great improvements upon the dooly have at various times been suggested to the authorities by officers of experience, but the old rotten antiquated system is to this day adhered to. When lately at Sebastopol,I could not help admiring the transport system of the French army, and copied from it into the English army, the Cacolet and the Ambulance. The Cacolet is a sort of iron chair, folding up like the step of a coach, with arms, belts, and cushions, either for the sitting or the recumbent posture, one being fixed on each side of a mule, by which a brace of sick men are carried smartly along with ease and comfort to themselves and credit to the transport establishment. The ambulance is a large waggon on springs, and on four wheels drawn by four mules, capable of containing four patients in the recumbent posture in rear, and four or six in the sitting posture in front, with compartments under the front seats for medicine and instruments. The interior is fitted with four portable beds, two above two, that slide into grooves and admit of being pulled out in rear and carried like a hand-barrow to a distance to receive a wounded man, and again of being slid bodily into their places. It struck me forcibly that both of these modes of conveyance were admirably adapted for India, the Cacolet on the back of a camel and the Ambulance drawn by bullocks.
There is another very essential article of which hospitals are much in want, and that is a pair of stout compact trunks with compartments for medicines and instruments, to be carried on a bangy by a Cooly. At present these essentials are stowed away in bulk in a pair of petarahs, of all shapes and sizes, often made of basket work. These ought to be of some regulation pattern. Iron would be the best material, and Government could not supply such things so cheap or so efficient as by sending out from England apair of such boxes for every regiment in India. The freight would cost nothing, as they could be filled with articles sent out for the public service.
Much as the transport for the sick in the Crimea excels that in India, so much does our tent system in India surpass the Crimean; and the Indian army may congratulate itself in being the best tented army in the world.
10. PREPARATIONS FOR ACTION.— The doolies are entrusted to the hospital sergeant, or havildar, whose duty it is to see the wounded brought to the rear immediately. The best way of carrying the instruments and dressings, is to have them laid out in order in a dooly, to be distinguished from the rest by a couple of yards of bandage, tied to either end of the pole; a dozen or more rollers should be ready prepared; ligatures waxed,and cut into convenient lengths; the tourniquets made to run easy; the saws found not to lock; the knives and needles oiled; the sponges washed and wet; chloroform and a bottle or two of port wine; and last, and yet of most importance, a mussuck, or sheepskin of good water. A few portable tourniquets should be distributed amongst the officers, with instructions how to apply them, in case of hæmorrhage. An amputating table should not be forgotten, which can be stowed in a dooly. The young assistant will do well to wrap a pillow and a counterpane,a bottle of beer and a few biscuits,up in a bundle, and stow them away in the dooly; he may have occasion to dine on the one, and to bivouac in the other, and think himself lucky in having them. To take care of others the first thing is to take care of ones'self!
It may appear ridiculous to warn him against the risk of losing his regiment in a dark night; but when many columns are moving at the same time, some direct, some oblique, and some retrograde, and all at a rapid pace, a sharp look out is necessary to prevent losing one's regiment; for, if once separated from it, it is no easy matter to find it again.
11. POSITION OF SURGEONS.—During a general action, the position of the medical officers is immediately in rear of their regiments, far enough away to be beyond the reach of round shot, and yet near enough to see the last graze.
The surgeons of brigades generally unite, and establish a joint hospital in rear of the centre regiment, thus affording the very great advantage of mutual advice and assistance. Should the line advance, the surgeons advance with it; should it fall back, they fall back accordingly; should the rear be threatened, they must advance to the column; or should the brigade be broken, they must take shelter under the nearest regiment, or in the field hospital; for no guard is allowed to regimental hospitals, further than the band boys. Most operations are performed on the spot, either with or without chloroform. Wounded men, of all arms, that come their way, are to be attended to as ready as those of their own brigade, even the wounded men of the enemy. During the Punjaub campaign, wounded Seiks were to be found in most hospitals, receiving the same care as our own soldiers. It must be borne in mind, that more substantial dressing, and a freer use of the suture are more necessary in the field than in a cantonment, so as to meet the probable failure of straps of plaister on the march.
12. FIELD HOSPITAL.—The field hospital is generally placed about 500 yards in rear of the centre of the line,and is distinguished by a large red flag. A field surgeon,a medical Storekeeper,and a number of Assistant-surgeons, are attached to it; and an ample supply of every article requisite for the sick and wounded. A strong mounted guard is allowed for its protection. After a general action, every exertion should be made to get the hospital tents pitched and the wounded collected and attended to. Should an immediate advance be made in pursuit of the enemy, all the wounded should be sent to the field hospital, or should time not admit of that, they must be left on the ground, sending information to the superintending surgeon, who will make arrangements for their care.
13. A STANDING CAMP.—But a general action is not the most trying part of a surgeon's duty in an enemy's country. Circumstances and seasons may render long halts unavoidable; and the ease and indolence, and suspense of a fixed position,becomes a very serious matter. Seeing no enemy,and yet not thinking it safe to go beyond the picquets; every day rife with its rumours of the approach of the enemy, next day to be contradicted; hoping from month to month for terms of peace, yet doomed to prolonged uncertainty. All standing camps become unhealthy generally from neglect in the conservancy department. The excitement that kept all well during active service,is now followed by its collapse; suspense becomes burdensome; the soldier's mind rusts like the sword in the scabbard, for want of exercise. Keeping it cheerful and healthy becomes burdensome, and a task that he neglects. "Hope deferred maketh the heart sick;" men's minds become morbid; the body sympathises with the mind, and in its turn becomes predisposed to disease and Cholera, Dysentery or Fever becoming epidemic, may, in a few weeks, decimate the force. During eighteen months' continuance of the late Burmese war, the European troops were decimated three times, a rate of mortality equal to that of the Crimea.
14. EXPOSURE OF SURGEONS.—A prevailing opinion exists that the medical officers in action are never exposed to the fire of the enemy, This is a great mistake; for in the returns of every battle, their names will be found in the lists of killed or wounded. I myself have on different occasions seen men killed and wounded. within a few yards of me; and at the capture of the Great Pagoda of Rangoon, two of my party standing round me, were wounded by musketry, whilst I was performing an amputation; yet, because surgeons are put down as non-combatants, they get no credit for such exposure. Even their attendance upon their patients, labouring under malignant contagious diseases, is not appreciated. No small share of moral courage is necessary to approach the bed side of a patient suffering from confluent small-pox, or typhus, or yellow fever, and administer to his wants. I have known officers who would have led their companies into action with the greatest heroism, shrink from the contagion of a sick room, and even dread coming in contact with a Doctor after such a visit,through fear of contagion.
15. NEGLECT OF SURGEONS.—'Tis strange, but no less true, that the world is unjust to the medical profession; of all the most difficult. A soldier may sacrifice thousands of lives by his ignorance and incapacity, yet no tribunal awaits him. A judge may pass the most unjust sentence, and be convicted of having done so by his superior judges reversing his sentence; yet the world think nought the worse of him for his want of skill. Even in the Church, the greatest heresies are introduced, but the reverend apostate only becomes more popular, and rejoices in his converts; but if a physician makes a mistake, and prescribes a wrong medicine, or an over-dose, or is unsuccessful in the reduction of a dislocation, or the union of a fractured limb, though from no fault of his, but from some hereditary taint in the patient's constitution,his professional character is materially injured; probably he is prosecuted for damages, or arraigned for culpable homicide.
Even our greatest generals have been neglectful of the services of their medical officers. How seldom do their names appear in a gazette? and, even though mentioned, how seldom does that lead to honour or reward? Every surgeon in India, who has seen much service, has had the mortification of seeing officers of the same standing, and of the same service as himself, promoted by brevet to the rank of major and lieutenant-colonel,probably with C.B. in addition, whilst the batta and the medal have been thought enough for him! Let us look over the medical list of the Indian army consisting of nearly nine hundred officers, and we will find only two with C.B. attached to their names, and only one raised to the rank of Knight.
Every public department has its honours and rewards, as the highest incentive to the effective performance of duty,and the higher these honours are in proportion to its importance.
Who will say that the restoration to health of the sick thousands of all armies is not an important charge? but how few are the rewards! The Surgeon's sense of duty, and his philanthropy,are expected to do for him (and how seldom do they fail?) what promotion and royal honours do for his brother officer of the line. The fortunes of individuals are often influenced by accidents, and that of departments appears subject to the same laws; and I have often thought that it would have been better for the profession, had Marlborough or Wellington suffered the amputation of an arm or a limb upon the field of battle, and under fire.
The spirit of army discipline seems to be to place the Surgeons in a subordinate position in all public duty. When a medical officer is tried by court martial upon matters entirely medical, such a thing as one or two medical officers being members of the court, is unheard of; and yet it would contribute greatly to the efficiency of such a court that they should form part of it. Even in courts of inquest, where the opinion of the Surgeon is paramount, he must hold a place subordinate to a young ensign as president. Indeed, he is generally ordered to attend the court of inquest and give in his report for the comment of the young ensign.
Even in the article of dress, army surgeons have been treated with indignity. About four years ago, Assistant-surgeons wore the dress of lieutenant, and Surgeons that of captain of the regiment to which they were posted. But as the occasional change of regiments entailed the expense of a change of uniform,it was ordered that the medical officers should have one standing uniform in all regiments. This was a move in the right direction; but it was done, as usual, in a humiliating way! by stripping off their lace and facings and reducing their dress below the respectability of a staff sergeant. No soldier can be indifferent as to his dress. The French army can give us good examples in it.
The time was, when Divinity, Law and Physic stood on the same pedestal on the world's Acropolis; but the latter has been shuffled off into the streets. Yet an unprejudiced examination will show that their fortunes are in inverse ratio to their deserts. We have in these late days seen medicine confer the greatest blessings on suffering humanity that man can confer upon man; viz., surgical operation without pain, and parturition without consciousness, and we have seen the discoverer of that blessing still unhonoured beyond his profession; but we are not aware that law and divinity have made corresponding improvements: that the crooked path to justice has been made more straight, or that the morality of the world has made any remarkable advances. In the days of ancient Greece—in the days of Machaon, Hippocrates and Æsculapius, such men were treated as guardian angels, when pestilence was monthly decimating the population; they were raised to the highest honours when alive, and worshipped as gods when dead. We are proud to imitate these refined people in most of their manners and customs, but on a subject which all men hold most sacred, the health of our armies, we haggle with the profession as if we were bargaining for haberdashery or horse power. It is not so in the French Army neither of the present day nor of the First Napoleon.
Divinity and Law have their numerous representatives in the Councils of the land who watch over their interests with a jealous eye, and preserve their status in society;but Medicine has no representative either in Parliament or in the Court of Directors, and till it has, there seems no hope of its position being restored to it.
I make these remarks with no disrespectful feelings towards our Honourable Masters;for if I had my career to begin again, I should wish for no better field than entering their service as an Assistant-surgeon,in hopes of seeing it raised from its present degraded position. My present object is the improvement of that service,in which I have spent the best years of my life; and if I have probed old sores rather deeply, and applied the cautery some what freely, it is only in accordance with the precepts of the profession, that must often give pain in order to cure.