- 
 
 LIBRARY 
 
 fj E.C.GARDNER. 
 
 - R F~~*. 
 
 Read , and then return. 
 


 
 V 
 
ON 
 
 MILITARY AND CAMP HOSPITALS, 
 
 HEALTH OF TROOPS IN THE FIELD. 
 
 THE RESULTS OP A COMMISSION TO INSPECT THE SANITARY ARRANGE- 
 MENTS OP THE FRENCH ARMY, AND INCIDENTALLY OP 
 OTHER ARMIES IX THE CRIMEAN WAR. 
 
 BY 
 
 L. BAUDENS, 
 
 INSPECTOR AND MEMBER OF THE COUNCIL OF HEALTH OF TIIK FRENCH ARMIES, 
 
 FORMERLY SURGEON-IN-CHIEF, AND FIRST PROFESSOR, OF THE 
 
 PERFECTING SCHOOL OF VAL DE-GRACE, ETC., ETC. 
 
 mtb ^nnota&b bn 
 FRANKLIN B. HOUGH, M.D., 
 
 LATE AN INSPECTOR OF THE IT. S. SANITARY COMMISSION. 
 
 NEW YOEK: 
 BAILLlfiRE BROTHERS, 440 BROADWAY. 
 
 LONDON : 
 
 H. BAILLIERE, 
 REGENT ST. 
 
 MELBOURNE: 
 F. BAILLIERE, 
 
 COLLINS ST. 
 
 PARIS : 
 
 J. B. BAILLIERE BT FILS 
 RUE HAUTEFEUILLE. 
 
 MADRID : 
 
 BAILLY-BAILLIBRE, 
 CALLE DEL PRINCIPE. 
 
 1862. 
 
BIOLOGY 
 UBRARV 
 
 Entered, according to Act of Congress, in the year 1862, l>j 
 
 BAILLIEEE BROTIIEES, 
 
 In the Clerk's Office of the District Court of the United States for the Southern 
 District of New York. 
 
 K. CUAIGHEAD, 
 
 Printer, Slfreotyper, anil Klertrotyper 
 
 tfl,S3,anrfS.5 Ceiif 
 
ADMINISTRATIVE AND MEDICAL OFFICERS 
 
 OT TKB 
 
 OIP THE TJNITEID STATES, 
 
 THIS LITTLE VOLUME OF 
 
 3&MfUltS Of 
 8ANITABT INSPECTION AND CONSERVATIVE SURGERY 
 
 IN THE 
 
 French Army of the Crimea, 
 
 IS RESPECTFULLY DEDICATED 
 
 BY THE 
 
 translator. 
 
 M234S7 
 
TRANSLATOR'S PREFACE. 
 
 THE acknowledged value of the experiences of the 
 French Army in the Crimean war, has suggested the 
 translation of the present volume, with the desire to 
 render the results of the dearly-bought lessons of that 
 campaign useful to the American Armies in the present 
 war for the preservation of our national Government. 
 
 It became the painful duty of the historians of the 
 Crimean war to record many errors and oversights, 
 resulting in a most fearful loss of human life. When 
 these faults were discovered, their remedy was attempt- 
 ed by the medical and administrative officers of the 
 army, with as much success as their resources allowed ; 
 and the expedients adopted for relief, in a wild and 
 desolate region, at a great distance from their supplies, 
 are at once suggestive and profitable to every person 
 who may be concerned in the health of armies. In the 
 translation, the French weights and measures have 
 been mainly changed to their corresponding values 
 known and used in the United States, precisely or 
 approximately, according to the original intention of 
 the author. In rough estimates the metre has been 
 called the yard, an allowance being made when the 
 numbers were large ; but in every case where precise 
 quantities are expressed, the rendering has been care- 
 fully made, and in some instances both denominations 
 have been retained. 
 
Vlll TRANSLATOR S PREFACE. 
 
 Money has occasionally been allowed to remain in 
 francs, and decimals have been used in expressing parts 
 of a given measure, as pounds, gallons, and feet, instead 
 of the lower denominations. 
 
BIOGRAPHICAL NOTICE. 
 
 JEAN-BAPTISTE Louis BAUDENS, the author of this volume, 
 was born at Aive (Pas-de-Calais), in 1804, and received the 
 degree of Doctor of Medicine in Paris, in 1837, having pre- 
 viously served in the medical corps of the French Army in 
 Algeria. He was employed successively in the hospitals of 
 Lille, Strasbourg, and Paris, and obtained in each the prizes in 
 Surgery and Anatomy. As Aide-Major in Africa, he succeeded 
 in forming a hospital of instruction at Algiers, where he gave 
 clinical lectures. Upon his return to France, his eminent 
 services in Africa, which had been witnessed by the princes of 
 Orleans, gained him rapidly a fine position in the profession, and 
 a wide circle of beneficent influence. He became Surgeon-in- 
 Chief of the military hospital of Val-de-Grace, in Paris, where 
 he remained ten years. 
 
 On the 25th of July, 1855, he was appointed Medical Inspec- 
 tor to the French Army in Corsica, Italy, and the Crimea, and 
 his subsequent history is detailed in this volume. The intelli- 
 gence and devotion with which he engaged in this service 
 gained him the approbation of his government, but cost him his 
 life. Returning to France, he prepared the volume now given 
 to the public in an English dress, but the miasmatic exposures 
 which he had encountered in the camps and hospitals of Con- 
 stantinople and the Crimea, planted the seeds of disease, which 
 terminated in death from cancer of the liver on the 27th of 
 January, 1858. He was the author of more than twenty 
 works, chiefly upon military and hospital surgery. 
 
AUTHOR'S PREFACE. 
 
 WHILE on my mission in the Army of the East, 
 Marshal Vaillant, Minister of War, did me the honor 
 to write : 
 
 "We wish you to turn to account the important 
 mission with which you have been intrusted in the 
 East, and desire you to report what you have seen of 
 the state of our military and field hospitals, and how 
 our establishments for restoring health in the army of 
 the East compare with those of previous wars, the 
 efforts of the hospital service, and everything upon 
 which our physicians have bestowed so much zealous 
 devotion, intelligence, and heart. You will be expected 
 to describe the diseases that prevail, and those that we 
 should apprehend ; the means employed to prevent or 
 remove them, and the operations of surgery, with their 
 successful or fatal issue. 
 
 " You will report your views concerning the present 
 organization of the health service, and its operation in 
 our hospitals, the army, and the interior, and upon the 
 improvements that should be made in it. I shall attach 
 great importance to your views upon these subjects. 
 The English and Sardinian armies may fwnish facts for 
 comparison, if not for instruction, and upon this subject 
 we should take large and liberal views. I will not pre- 
 sume to lay down a plan, but, my dear doctor, you see 
 what I desire, and no Medical Inspector has for a long 
 time been placed in so fine a position for rendering sub- 
 stantial services to Science." 
 
 On the same day I received from Baron Charles 
 Dupin, Senator, and Member of the Institute, another 
 letter, of which the following are extracts : 
 
xii AUTHOR'S PREFACE. 
 
 " The Medical Service of our armies was never better 
 organized, its agents better instructed or more zealous, 
 and its materiel more complete, or in better state for 
 use. A report from you, as Inspector General, upon 
 the condition of the Medical Service in the Crimea and 
 at Constantinople, its extraordinary services under fire, 
 in three battles, and in a memorable siege, the assistance 
 prepared at the theatre of combat, and in places where 
 inventive genius and a love of humanity must supply 
 all our wants, so far away from France, and in a rude 
 season of the year. In addition to these, the develop- 
 ment of epidemics, the cholera and typhus, may double 
 the ravages of war ; and there will be afforded you an 
 opportunity for rendering sublimer services than ever 
 fell to the lot of Larrey, your predecessor, in the history 
 of our armies. 
 
 "I have given you, sir, a brief and imperfect pro- 
 gramme, drawn at too great a distance, and with a 
 hand little competent, but with an earnest and vivid 
 regard for the honor of France, and the glorious titles 
 earned by the armies which you have the honor to 
 represent. I doubt not but that in our army of the 
 East, Science will attain new facts in the art of healing. 
 You will assuredly collect and weave them into a pic- 
 ture, in which Art shall recognise the master's hand." 
 
 These noble suggestions pointed out to me an end so 
 elevated that I dare not hope to attain it, but they 
 decided me in undertaking this labor, which the Revue 
 des Deux Mondes first published,* and which I here 
 collect in a volume. 
 
 The grand memories of the Crimean war belong 
 chiefly to history ; and now wise and useful measures, 
 as well as errors and faults, may be discussed with 
 equal loyalty and double profit, to the end that hence- 
 forth, instructed by experience, we may be able with 
 certainty to adopt the one, and carefully avoid the 
 other, 
 
 * The numbers for February 15th, April 1st, and June 1st, 1857. 
 
THE CRT MEAN WAR. 
 
 PART I. 
 
 THE CAMPS, 
 
 THE war of the East, so full of instruction in military 
 science, was not barren of medical teachings. Its field 
 of observation, vast indeed, and often melancholy, fur- 
 nished opportunities for submitting to decisive proof, 
 and sometimes even for settling, grave problems of 
 hygiene, medicine, and surgery, which had until then 
 remained in doubt. The army profited by these new 
 discoveries, which lightened the pains of the sick and 
 wounded, and its ills were relieved or altogether re- 
 moved by its surgeons, whose ceaseless devotion, and 
 unwearied zeal, have many times deserved the warm 
 encomiums bestowed by the Commander in Chief, and 
 the Minister of War. Their labors resolved themselves 
 into three classes, viz, prophylactic measures, or those 
 employed to prevent diseases ; the care of those wounded 
 in war ; and the treatment of diseases, which, as we 
 know, made terrible ravages. This threefold duty 
 points out three great centres of experience the camps, 
 the field hospitals, and the regular hospitals of the army. 
 On the 25th of July, 1855, 1 was appointed Inspector 
 of the Health Service of Corsica, Italy, and the Army 
 of the East. Having inspected Italy and Corsica, I 
 departed for the Crimea towards the end of September, 
 and thus found myself, after the taking of Sebastopol, 
 upon the theatre of w T ar. This war presents to the 
 mind two impressions : the one glorious in brilliant feats 
 
 2 
 
10 THE CRIMEAN WAR. 
 
 of arms, the other mournful from passive sufferings. 
 Of the one, the world knows the fullest details ; while of 
 the other, it has but vague ideas. Let us enlighten this 
 subject, and we shall learn, that it is not alone in the 
 assaults of battle, that our soldiers always display the 
 greatest courage. 
 
 i CHAPTER I. 
 
 MEDICAL TOPOGRAPHY OF THE CRIMEA. 
 
 THE steamer upon which I embarked, had on board a 
 battalion of the llth legion, and when we reached Malta, 
 thirty men had already been attacked by cholera. They 
 were placed in charge of the Sister^ of Charity, and 
 sent to the Lazaretto, where a small hospital had been 
 arranged for soldiers taken severely ill on the passage, 
 and unable to continue their voyage, without endanger- 
 ing themselves or their comrades. It would have been 
 desirable to form a great hospital establishment at Malta, 
 for the army of the East, but the resources were wanting, 
 even to the English. Still, the few beds which the 
 Lazaretto contained, were, as a sanitary measure, of great 
 value ; and at the end of the war, when typhus, imported 
 from the Crimea, threatened to spread in the south of 
 France, and through the fleets, we were able to escape 
 the dangers of infection, by leaving at Malta a certain 
 number of typhic patients. The governor of the island, 
 as well as the consul of France, Mr. Henry Fourcade, 
 left nothing undone. The governor not only received 
 foreign soldiers upon the island, contrary to traditional 
 usages and positive instruction, but even raised the 
 quarantine for our benefit ; nor did they have cause to 
 repent of this, for neither cholera nor typhus gained a 
 hold in Malta, although its hospital received many 
 times, both choleric and typhic patients. 
 
 Malta is two days' sail from Smyrna, and the cholera 
 continuing, four dead bodies were thrown into the sea. 
 
THE CRIMEAN WAK. 11 
 
 Uneasiness and alarm began to prevail. The young 
 soldiers who encumbered the decks, had no other cover- 
 ing but the sky, and their clothing was saturated with 
 the dews of the chilly nights, succeeding the tropical 
 heat of the days. I caused to be distributed warm wine 
 at nine o'clock in the evening, and an infusion of tea at 
 four in the morning. A salutary reaction checked the 
 progress of the malady, and restored gaiety and songs. 
 Some cholera patients, already cold and purple, were 
 recalled to life by these stimulants, and twelve who 
 remained, were placed in the small French Naval Hos- 
 pital at Smyrna. 
 
 We found at Smyrna a magnificent barrack, sufficient 
 to accommodate six thousand men, which the Marshal 
 St. Arnaud had thought of changing into a hospital for 
 our troops. A noted locality of thermal waters, called 
 the Baths of Agamemnon, occurs a few miles from 
 Smyrna, and the road thither .leads past the site of an 
 ancient temple of Esculapius, whose vast ruins indicate 
 a gigantic edifice, now replaced by a Jews' cemetery, 
 destitute of shade or monuments. The road is excellent, 
 and affords easy communication between the city and 
 the baths. The marshal's project would therefore have 
 been excellent, had it been at once adopted ; but he was 
 delayed by groundless apprehensions of the salubrity of 
 the country, and the English meanwhile, more resolute, 
 established a very large hospital at Smyrna.* In the 
 
 * The English Civil Hospital at Smyrna, consisted of a large Turkish 
 barrack, situated close to the sea, and almost on a level with it, at 
 the south-west angle of the city. The building formed three sides of 
 a square, open to the bay, so as to be freely exposed to the sea breeze 
 and the summer wind, the "Imbat," which blew directly from the sea 
 to the hospital from 9 A.M. to 6 P.M. The general sanitary condition 
 of the locality was decidedly bad, and the wonder was that pesti- 
 lence, in some form, was ever absent from the coast. By careful 
 cleanliness, the hospital was kept measurably free from malarious 
 influences. Sanitary regulations were ordered by Dr. Sutherland, 
 March 28, 1855, requiring the streets adjacent to be cleansed daily, 
 and nuisances to be abated; the street drains to be cleansed and 
 covered; the drains close to the hospital to be cleaned by flushing, 
 and, if necessary, to be relaid; the privies to be disinfected, and 
 water-closets substituted ; ventilation to be thoroughly extended, and 
 all excreta to be thoroughly removed. TB. 
 
12 THE CRIMEAN WAR. 
 
 winter of 1856, having no more sick at that place, they 
 stationed there a brigade of infantry. 
 
 In leaving Smyrna, we passed near Tenedos, not far 
 from the tombs of Ajax, Hector, and Achilles, and 
 within sight of Mount Ida, and the plain where Troy 
 was. The name of every village and locality recalled a 
 classic memory. We entered the Dardanelles, passed 
 Abydos, on the Asiatic side, and four miles further the 
 quiet of this region was replaced by great activity, the 
 English being there constructing a hospital for three 
 thousand sick. The site was well chosen to meet, at 
 the same time, the demands of health, and capacity for 
 defence. Further on we found two hospitals, one 
 belonging to the English, intended for three hundred 
 sick, and the other French, with four hundred and 
 twenty beds. The latter had been established in a 
 Turkish Lazaretto, and they had unfortunately built four 
 large rooms in the middle of the central court, instead 
 of placing them without, upon a little hill, which sloped 
 gently towards the place. This error prevented the cir- 
 culation of air, and was the more to be lamented when 
 they were afterwards required to receive patients 
 infected with Hospital Gangrene. 
 
 Upon landing at Gallipolis, I visited the French Hos- 
 pital, and found another fault in the arrangement. To 
 turn to use a considerable stretch of wall, they had 
 begun by building sheds against it, at the foot of a hill, 
 without noticing the drainage of the soil; but were 
 shown their error, when cholera appeared on the pre- 
 mises. These blunders, unfortunately not rare, might 
 have been avoided by consulting physicians, -who, know- 
 ing the efficacy of air constantly renewed, especially in 
 warm climates, where the rigors of winter are not felt, 
 select elevated and not sheltered sites ; but the quarter- 
 masters for barracks were not always occupied with 
 these views, and, as in France, might be said to under- 
 stand everything but hygiene. If the pupils of Saint Cyr* 
 were to devote only a dozen hours to hearing a dozen 
 
 * Saint Cyr is the great military school specially devoted to the 
 French cavalry service. TR. 
 
THE CRIMEAN WAR. 13 
 
 lectures upon health, they would carry into the army 
 certain principles of science, from which the soldiers 
 would derive substantial benefits ; the advice of physi- 
 cians would be oftener heard ; and the perils of epidemic 
 diseases, to which our armies are constantly liable, 
 would often be avoided. The organization of these hos- 
 pitals was at least blameless ; the furniture, beds, food, 
 and fixtures left nothing to be desired ; and the medical 
 service was perfectly well directed. Everything bore evi- 
 dence of an active zeal and an enlightened solicitude. 
 
 We crossed the Sea of Marmora during the night, and 
 at the dawn of day, the splendid panorama of Constanti- 
 nople, and of Seraglio Point, opened to our view. The 
 slender shafts of the minarets, piercing the azure sky, 
 were ranged like a guard of honor around the grand 
 mosques which commanded St. Sophia; the air was 
 filled with a thin vapor, and the landscape, dotted with 
 pavilions and crowned with a cypress grove, seemed 
 like a realization of the reveries of the Thousand and 
 One Nights. It is a pity that the charm should vanish 
 as soon as one steps into the labyrinth of its narrow 
 muddy streets, full of quagmires, and overrun with street 
 porters of Herculean strength (a race of biped camels 
 that they call hamals), with dogs, and with asses- laden 
 with boards. The houses are of wood, of miserable 
 aspect, and without architectural style or character. 
 
 I at once visited the hospitals, where the sick, who 
 had come from the Crimea, were chiefly tainted with 
 intestinal diseases, intermittent and remittent fevers, 
 and especially with scurvy. In the wounded, the taint 
 of scurvy impoverished the blood, which became more 
 fluid, and oozed from the wounds in abundance, so that 
 the most energetic appliances of science could not con- 
 trol these haemorrhages, and they very often proved 
 fatal. A still more terrible disease, the Hospital Gan- 
 grene, made fearful havoc. Many of the wounded from 
 the Crimea, and those who had until now escaped, were 
 tainted after a brief residence in the hospitals, and 
 wounds almost closed, and considered as healed, were' 
 invaded by the gangrene. This scourge, which had but 
 rarely been seen in Algeria, had, before I left for the 
 
14 THE CRIMEAN WAR. 
 
 east, already appeared in our hospitals at Marseilles 
 and in the south, which received the wounded from the 
 Crimea. It is contagious, and is transmitted by the air 
 from one wounded person to another, so that in a ward 
 impregnated with its miasm, it is very difficult to 
 exterminate it. 
 
 On the 5th of October, 1855, I left Constantinople 
 for the Crimea, on board the steam frigate Descartes, 
 Captain Darricau, and left it with regret at Kamiesch. 
 Reporting myself at the General's quarters and to Mar- 
 shal Pelissier, I at once set to work, in studying the 
 great questions of hygiene, necessary to be settled upon 
 the approach of winter. I visited, upon horseback, the 
 various positions occupied by our army, the camps, and 
 the field hospitals, at the same time taking note of the 
 medical topography of the country. 
 
 The part occupied by the Russians was almost entirely 
 uncultivated, covered by immense plains, and without 
 water ; while that on which the Allies had encamped at 
 the time of our arrival, was dotted with cultivated spots, 
 and vineyards of considerable note. The soil was a 
 dark vegetable mould, easily washed by the rains, and 
 the mud of the Crimea defies all description. This 
 layer of mould varies from one to several yards in thick- 
 ness, and the subsoil is a porous limestone, easily torn 
 up by the pick.* The regiments that were encamped 
 in places where this subsoil appeared, dug circular pits 
 about four or five feet deep, to place their tents, thus 
 
 * The geological features of the Crimea are concisely as follows : 
 The western portion, extending as far east as a meridian passing 
 through the head of SebasLopol harbor, consists of the Upper Ter- 
 tiary or Steppe limestone, so often mentioned in this volume, and of 
 a light porous structure. Along the shore, from Sebastopol to the 
 western third of the southern coast, is a belt of volcanic sand and 
 ashes ; and from the monastery of San Georgeo westward, is a belt of 
 erupted volcanic rocks, forming vast picturesque masses along the 
 coast. The British and Sardinian camps, and the forests of Bai'dar, 
 were underlaid by Jurassic limestone ; the borders of the Tchernaia, 
 from the Russian camps on the north, to the French camps and battle- 
 fields of Balaclava on the south, by chalk and green sand formations. 
 A tract along the southern border from Col, eastward, is underlaid 
 by schist and conglomerate. Tn. 
 
THE CRIMEAN WAR. 15 
 
 avoiding the cold, and especially the winds, which are 
 continual, and sometimes terrible, in the Crimea. 
 
 On the 14th of November, 1854, the winds unloosed, 
 and, attended with torrents of rain, threatened the 
 allied armies with a great disaster. The tents, sheds, 
 and shelters for provisions were overturned and swept 
 level, in the camps, while the ships at anchor were 
 beaten and shattered, and the Henri IV. and Pluton 
 of our imperial marine, sustained irreparable damages 
 in the Bay of Eupatoria. At Kamiesch and at Bala- 
 clava, the transports suffered great injury; and at the 
 entrance of the latter port, eight large vessels, laden 
 with munitions, provisions, and clothing for the English, 
 were sunk, with part of their crews. 
 
 We ought not, however, to complain of the violence 
 of the winds in the Crimea, for without them the soil 
 would be constantly muddy, notwithstanding its surface 
 drainage. The wind renewed the air of our camps, 
 and swept off the mephitic gases with which the cloth- 
 ing was filled ; it bore off the miasms of dead men and 
 animals, buried by thousands, but which, although 
 buried, could not decay harmlessly; and if the wind 
 did not keep us from the typhus, it at least lessened 
 its effect; and perhaps to it, we may have owed our 
 exemption from the plague. 
 
 The district occupied by the Allies, measured five 
 miles in breadth, by about fifteen in length. It was the 
 ' ancient Tauric Chersonesus, of which Herodotus and 
 Strabo have left descriptions, and like the Troad, it 
 called up the memories of heroic ages. It was hither 
 that Diana transported Iphigenia, snatched from the 
 sacrificial fire, and here she made her a priestess ; upon 
 this inhospitable shore the tempests threw Orestes and 
 Pylades, and where Iphigenia failed to sacrifice her 
 brother. Henceforth other recollections will efface 
 these ancient traditions, and the names of our victories 
 will eclipse those of Orestes and his sister. 
 
 The roadstead of Sebastopol is striking from its extent, 
 and its majestic appearance. It was, so to speak, staked 
 out by the masts of sunken vessels, which reared their 
 points as if to mark the place of a great ruin. Upon 
 
16 THE CRIMEAN WAR. 
 
 entering the roadstead, we meet the little Bay of Care- 
 nage, from the head of which the Russian vessels, during 
 the siege, threw volleys of iron shot ; and two and a half 
 miles beyond, is the mouth of the Tchernaia, which 
 flows among the reeds through a marshy country, and 
 whose waters are in part diverted to feed the docks of 
 Sebastopol. The fine road to Sympheropol, crossing 
 the Tchernai'a upon a wooden bridge, winds up the 
 hills, behind which was encamped the army of Gene- 
 ral Bosquet. It passes the spot where the English were 
 encamped, when the Russians attacked them, and the 
 battle of Inkermann was fought, November 5, 1854. 
 
 Prince Menchikof, whose army, elated by the pre- 
 sence of the grand-dukes Michael and Nicholas, had re- 
 ceived large reinforcements, attacked the allied troops 
 at three points simultaneously. While General Liprandi 
 made a vigorous attack on Balaclava, the corps of 
 General Dannenberg sought to gain the heights of 
 Inkermann, taking in the rear the besieging army, 
 which was being attacked from the other side by the 
 battalions of General Timofeif that issued from Sebas- 
 topol, hoping thus to cut off* our communications with 
 Balaclava and Kamiesch. 
 
 We know of the heroic defence made by the English, 
 as they were attacked about daybreak, in their camps, 
 without any works of consequence to protect them. 
 These valiant troops, commanded by the Duke of Cam- 
 bridge, fought with valor the compact masses pressed * 
 against them. The corps of General Bosquet coming 
 up in haste, turned the Russian columns by bayonet 
 charges, while General De Lourmel vigorously repulsed 
 the Russians under the walls of the city, and met a 
 glorious death. General Canrobert, who planned by 
 wise arrangements all the movements, was wounded 
 in the elbow, but fortunately not dangerously. Our 
 ambulances collected about 500 of the enemy's wounded, 
 and it is estimated that 6,000 dead bodies of the 
 Russians were left upon the battle-field. The English 
 lost three generals, a hundred officers, and a multitude 
 of soldiers ; and our loss, though much less, included 
 about 500 wounded. After this great battle, we out up 
 
THE CRIMEAN WAR. 17 
 
 the road, here and there, with enormous trenches, to 
 render another surprise more difficult. On their part, 
 the Russians destroyed the bridge, to cover their retreat. 
 At the foot of the mountain, from the top of which 
 the Russian battalions were thrust by our soldiers, 
 was a true ossuary, the bodies having been devoured by 
 vultures, leaving the skeletons only of the men to await 
 burial. These skeletons had belonged to men whose 
 stature was not great, but whose frames were remarka- 
 bly firm ; and the femur or tibia of a Russian, very 
 easily distinguished him from a Frenchman or an Eng- 
 lishman. 
 
 The valley of the Tchernaia ascends towards the east, 
 to the forest of Baidar, with an average breadth of 
 about four hundred and fifty yards. Its air is sickly, 
 and it was impossible to improve it in the whole course 
 of the war.* 
 
 From the tops of the hills which bordered the valley, 
 the hostile camps were in view of each other, and after 
 the taking of Sebastopol, some of the soldiers of the 
 advanced posts established communications with one 
 another, by means of white handkerchiefs fixed to the 
 
 * The valley of the Tchernaia is thus described by Dr. Sutherland, 
 in the Report of the Sanitary Commission dispatched by the British 
 Government to the seat of war in the East. 
 
 " To the north of tke ridge, forming the northern margin of the 
 basin [of Balaclava], lies the valley of Tchernaia. From the crest of 
 the ridge the ground falls gradually to the foot of a chain of hills 
 called 'Fedoukine Heights,' which rise rapidly to an elevation of 
 500 feet above the sea level. From their summits there is a rapid 
 descent to the level of the Tchernaia. The valley through which the 
 river flows is broad and tolerably flat. The bottom is chiefly of marl 
 mixed with pebbles and chalky debris, and the bed of the river, which 
 is only a few yards wide, and is scooped out of the debris to a depth of 
 four to six feet. Most of the ground is perfectly firm in ordinary 
 states of the weather, but as the. river approaches the head of Sebas- 
 topol harbor, the ground becomes a marsh. . * * * The greatest 
 breath of the valley, measured from its southern boundary ridge to 
 the foot of Mackenzie's Heights, is about six miles, and the length of 
 the wider part below Tchorgoun is about five and a quarter miles to 
 Inkermann Castle, where the precipices of the plateau approach 
 those of Inkermann, and between them lies the marsh at the mouth 
 of the river. The whole of the valley is covered with grass and 
 flowers, and there are no trees except in the marsh." TR. 
 
 2* 
 
18 THE CRIMEAN WAE. 
 
 points of their bayonets. To these visits succeeded 
 exchanges, the Russians having brandy, and the French 
 bread and tobacco ; they became very fraternal, and this 
 kind of amicable warfare extended so far, that General 
 Camou, of the 2d Corps, found it necessary to cool off 
 the heat of these eifusions by punishments. 
 
 On entering the valley, we noticed on the left, the 
 Mackenzie's Heights, veritable walls, straight and inac- 
 cessible, with a central depression, as if to invite assault, 
 but protected in the rear by three stages of command- 
 ing banks.* The Russians had thickly planted these 
 escarpments with cannon, and from thence thundered 
 the batteries named by our soldiers Btiboguet and 
 G-ringalet, which, after the battle of Traktir, made such 
 sad havoc by firing upon our physicians and their ser- 
 vants, while busy in dressing and attending the wounded 
 Russians. A similar occurrence happened after the 
 battle of Inkermann, but the Russian government 
 hastened to disapprove of these barbarous acts, and 
 General Liiders did much to atone for them, in his cor- 
 respondence with Generals Canrobert and Pelissier. 
 These mistakes would be rendered impossible, if, by the 
 common consent of nations, physicians and their hospital 
 attendants were to bear a distinctive badge, alike in the 
 armies of all countries, and such as would be easily 
 recognised by both parties. 
 
 Further on we find the bridge of Traktir, by which 
 the Russian columns sallied out the 16th of August, 1855. 
 It is commanded by the Fedoukine Heights,f held by 
 General MacMahon's corps. The valley is at this 
 place some two or three hundred yards wide, and is 
 traversed by two streams, the Tchernai'a, and a canal of 
 supply, separated by a space of about a hundred yards. 
 Its banks on either side were high, steep, and furrowed 
 by ravines. In these positions, rendered still more 
 
 * These Heights form a long almost horizontal ridge of precipices 
 of chalk, rising to the height of about 1000 feet above the level of the 
 sea, and resting- on a steep talus, extending from one end of the ridge 
 to the other. TR. 
 
 \ These hills rise rapidly to an elevation of five hundred feet above - 
 the sea. They consist of loose chalk with layers of Hint. TR. 
 
THE CRIMEAN WAR. 19 
 
 formidable by entrenchments covered with cannon, the 
 French and Russian armies lay encamped face to face, 
 and the disadvantages that would attend either of the 
 two armies that should go to attack the other, were so 
 great, that it would not be difficult to foresee the result 
 of the combat of August 16th, while, moreover, the 
 precautions taken by General Pelissier placed us beyond 
 peril from surprise. At four o'clock in the morning, six 
 divisions of Russian infantry, supported by 160 cannon, 
 and three divisions of cavalry, under the command of 
 Prince Gortschakof, passed the streams, upon several 
 bridges, screened by fog, and attacked with fury our 
 lines and advanced posts of Piedmontese. The conflict 
 became general ; the Russian columns, when turned 
 back, were quickly rallied, and advanced repeatedly to 
 the charge, but were again hurled back by the French 
 bayonets, and crowded upon the bridges, across which 
 they were beaten and driven by nine o'clock in the 
 morning. General Pelissier reported 3,329 Russians 
 killed, of whom 2,129 were buried by us, and there 
 remained upon the field 1,669 wounded Russians, 38 ot 
 whom were officers, which were collected by our ambu- 
 lances. Our loss was as follows: 19 officers killed, 
 and 61 wounded; 172 non-commissioned officers and 
 privates killed, 146 missing, and 1,163 wounded. 
 
 The whole of the left side of the valley was guarded 
 by the French army, and even after the taking 01 
 Sebastopol, the divisions of the first corps, under Gene- 
 ral Salles, extended as far up as into the forest of Bai'dar. 
 A change of bivouac, and location in the woods, proved 
 favorable to the health of the soldiers. The forest has 
 a rich vegetation and frowning aspect it has for its 
 outline majestic mountains,, furrowed by valleys, and 
 picturesque hamlets dot the slopes. Here and there 
 we notice elegant hunting lodges, such as the Chateau 
 of Perouski ; and the springs of fresh and clear water 
 in this region form the sources of the Tchernai'a. No 
 better bivouac could be found than in this forest, where 
 the division of Autemarre remained in the best condition 
 throughout the severe winter of 1856, although one 
 night in three was passed on guard. 
 
20 THE CRIMEAN WAE. 
 
 If from the forest of Baidar we turn our steps to the 
 east and south, we come by a series of mountains, where 
 the Sardinian army was encamped with its field hospitals, 
 to the little port of Balaclava, hidden in a sinuous open- 
 ing between immense rocks.* It was formerly a secure 
 retreat for pirates, and we may still trace the ruins of a 
 fort built in the thirteenth century by the Genoese. 
 This place contained only a few families of fishermen 
 when the English arrived, bringing with them their 
 industry. They built a railroad, and a hundred ships 
 discharged continually the products of civilization. 
 The camps of our allies were largely supplied with 
 every article of need, by which they escaped the scurvy 
 and typhus in 1856. When we compare the destitute 
 condition of the English army at the opening -of the 
 war, with its state in 1856, we cannot but admit the 
 vigor of the British government. 
 
 The general's quarters in the Sardinian army were 
 fixed at the Greek village of Kadikeui, which was 
 invaded for the time being by a population of cosmo- 
 polite merchants ; and General Marmora invited me to 
 visit the field hospitals of the Piedniontese army, whose 
 management and attendance deserved nothing but 
 praise. 
 
 Between Kadikeui and the valley of the Tchernai'a, 
 extends an undulating field, where, on the 25th of Octo- 
 ber, 1854, was fought the battle of Balaclava. In the 
 morning, the troops under General Liprandi, sustained 
 by powerful artillery, and numerous squadrons, took 
 four unfinished redoubts, which the Turks had aban- 
 
 * Dr. Sutherland thus describes the topography and geology of the 
 port of Balaklava : 
 
 " The coast line of mountain-ridge, is at this point broken across by 
 a deep sigmoid fissure, forming the entrance of the harbor of Bala- 
 clava. On the west side of the entrance, the rock sinks almost per- 
 pendicularly into the water, and on the east side the entrance is 
 bounded by a singular conical hill 469 feet high, on the summit and 
 side of which, are the ruins of the old Genoese castle of Balaklava. 
 The western slope of this hill consists of masses of the same compact 
 reddish limestone, arid the bulk of the hill itself is formed of detached 
 fragments of the same rock, or rather of a brecciated form of it, resting 
 on highly inclined beds of conglomerate." Report of Special Sanitary 
 Commission, p. 220. TR. 
 
THE CRIMEAN WAK. 21 
 
 doned after a vigorous defence, and began a series of 
 cavalry combats, in which the advantage remained with 
 the English, when an ill-timed or badly-interpreted order 
 saddened the events of the day. The Russians having 
 taken some cannon near the redoubts, the light horse 
 under General Cardigan received orders to re-capture 
 them, a thing next to impossible. These splendid 
 squadrons rushed forward, sabred the cannoniers of the 
 Russians at their pieces, and swept through compact 
 columns, but assailed on every side by overpowering 
 numbers and a storm of shot, they turned upon their 
 course, and opened again a passage through the ranks 
 of the enemy, until, with the aid'of the African Chas- 
 seurs of General Morris, they regained our lines with 
 only half their numbers, the rest being left upon the 
 battle-field. It is known, that the order to charge, 
 emanating from Lord Raglan, was taken to General 
 Lucan by Captain Nolan, who was killed in the charge, 
 and it is altogether probable that it was not imperative. 
 In passing south, over the high plateaux which extend 
 along the sea near Balaclava, we come to the Cape Fior- 
 ente of the Genoese, the ancient Cape Parthenion, where 
 are found some traces of the temple of the Tauripolitan 
 Diana, in which king Thoas sacrificed strangers. Near 
 these ruins, in a recess among the rocks, and sheltered 
 from the north wind, is the beautiful monastery of Saint 
 George, the asylum of pensioners retired from the 
 Russian fleet. Although a fine hospital might have 
 been established here, the allied armies respected with 
 care this monastery ; its religious ceremonies were never 
 molested, but were performed daily in the presence of a 
 heterodox crowd, attracted thither by the beauty of the 
 scenery, and the chime of its bells, which recalled the 
 memories of distant lands. The elevation of the ground, 
 with its gentle slopes, and the purity of the air, always 
 freshened by the sea breeze, indicated this place as an 
 excellent location for an encampment. Between Saint 
 George and Kamiesch, the French cavalry were can- 
 toned, and. suffered much less from disease than the 
 infantry, because the place ,of habitation was more 
 healthy; the personal habits of the cavalier are more 
 
22 THE CRIMEAN WAR. 
 
 careful than those of the foot soldier ; and they are more 
 in open air, instead of being squat in their tents a large 
 part of the day. 
 
 The plain of Kamiesch extends to Cape Chersonesus, 
 and is bordered by two bays, called Kazak and 
 Kamiesch, of whose existence our navy were at first 
 but imperfectly informed, and whose discovery was 
 truly fortunate. They were constantly filled with 
 vessels coming with provisions for the French army, 
 and upon these naked shores of easy access, enormous 
 store-houses for provisions were erected, while the 
 shanties of merchants, more or less respectable, were 
 grouped each day more thickly around our military 
 establishments. In a few months, the whole city had 
 been as it were extemporised, with its broad and regular 
 streets, its coffee-houses, its theatre, its police, its Catholic 
 church, and even its Protestant temple. I have not 
 spoken of its hospital, but this was well arranged and 
 provided for, and its medical service was skilfully con- 
 ducted. In it we found a great variety of diseases, 
 because the men who were placed here, were found too 
 ill for the time being, to leave for the hospitals at Con- 
 stantinople. 
 
 Kamiesch is almost five miles from Sebastopol; and 
 as we approach it, the ground is found thrown up by 
 the works of approach, and strewn with great quantities 
 of projectiles. These lay literally in piles, in the 
 ravines of Carabelna'ia, and the little valley where the 
 cemetery of Sebastopol is situated, and which was so 
 often taken and retaken during the war. Its marble 
 shafts were broken, its funereal urns dashed to pieces, its 
 wooden crosses mutilated, and its tumulary monuments 
 overturned : everything was devastated, but by cannon 
 alone, for, notwithstanding the intensity of the cold, 
 our soldiers respected the oaken crosses which stood over 
 the graves. 
 
 N othing is more affecting than to pass around a city 
 taken after a long and bloody siege. Before Sebastopol, 
 there were seen here and there, immense funnel-shaped 
 pits, which had been made by the fire of mines, counter- 
 mines, and camouflets, and everywhere we met trenches 
 
THE CRIMEAN WAR. 23 
 
 for ambuscade, where the French sharpshooters lay in 
 wait from the dawn of clay till night, watching the 
 soldiers and officers, and the artillerists who appeared 
 on the fortifications, or showed themselves before the 
 cannon embrasures. At length the latter were closed 
 by mats, made of ropes skilfully braided so as to be 
 bullet-proof. At times, the French sharpshooters, only 
 fifty yards from their enemies, would draw them into 
 conversation. The Russians were provided with ex- 
 cellent half-boots, of which they knew our soldiers 
 were very fond, and showing the point of their feet they 
 would call out in good French, " Venez les pi'endre."* 
 It may be certain that our soldiers were not slow to 
 reply, nor were they wanting with civil words. At 
 another time, they would hold up over the battlements 
 on one side or the other, a bottle or a flask, and the 
 first who hit the object, was warmly applauded by all 
 the marksmen. There was no hatred between the 
 Russians and the French ; if they did not kill, they 
 embraced. 
 
 In entering Sebastopol by the Mat bastion, I paid a 
 silent homage to the skill of General Todtleben. Be- 
 fore me arose the tower of Malakof, and the Mamelon- 
 Vert, taken on the 7th of June, 1855. The formidable 
 ramparts of the latter, were raised before the former, 
 and arrested our labors of approach, until after a 
 bloody struggle of some hours, when having been taken 
 and retaken several times, it remained finally in our pos- 
 session. As the French assailed the White w r orks, the 
 English gloriously took the position called the Quarries ; 
 but notwithstanding the skilful arrangements of Gene- 
 ral Pelissier, we approached Sebastopol but about four 
 hundred yards. The day was unhappily saddened by 
 the imprudent ardor of the regiments, who ran up to 
 the Malakof, and whose heroic courage was punished by 
 many and much regretted losses. 
 
 I visited the fortifications of Malakof, a true laby- 
 rinth of Italic S's formed in relief by the earth 
 brought up from the subterranean blinds, and the arti- 
 
 * Come and take them. 
 
24 THE CRIMEAN WAK. 
 
 ficial mounds rising each day, at length exceeded the 
 height of the tower itself. During the last days that pre- 
 ceded the assault, the besiegers hurled against the bastion 
 6,000 bombs every twenty-four hours. The Russians 
 were unable to come out ; in burying a corpse, they 
 sacrificed two lives, the dead were therefore oft with- 
 out sepulture. Meanwhile their casemates sustained 
 by enormous masts taken from the fleet, and covered 
 with many yards of earth, could not be injured by 
 this terrible hail of projectiles ; the bastion stood out 
 like an aerial island in front of the Mamelon-Vert. On 
 the 8th of September, our soldiers entered it by an irre- 
 sistible rush. Nothing could stop them; neither the 
 broad ditches surrounding it, nor the high parapets, 
 bristling with bayonets and cannon, nor the firm hero- 
 ism of the defenders. Without waiting for ladders, 
 they sprang into the ditches, and climbed the parapets, 
 by mounting upon the shoulders of their comrades. 
 These positions once gained, they for five hours de- 
 fended them against the vigorous eiforts of the Russian 
 masses, who struggled to regain their lost ground. In the 
 absence of General Todtleben, detained by a wound, at a 
 distance from the defensive works, the Russians had 
 committed the very serious mistake of closing the gorge 
 of the Malakof, on the side towards the city, and of leav- 
 ing only a narrow passage, through which their columns 
 could not deploy, and these thrust themselves fruitlessly 
 upon the bayonets of our soldiers, now become steady 
 in proportion as they had just before been ardent and 
 enthusiastic. The enemy had depended upon an electric 
 wire, leading to some seventy tons of powder, to bury in 
 the ruins of the bastion the besieging army, but by a 
 happy accident the blow of a pick exposed the wire, and 
 it was cut. A few moments after, it demolished forts 
 Paul and Alexander, to cover the retreat of the Russians. 
 Upon this day, which decided the war, we had 5 gene- 
 rals killed, 4 wounded, and 6 missing ; 24 superior offi- 
 cers killed; 20 wounded, and 2 missing; 116 subaltern 
 officers killed, 224 wounded, and 8 missing; and 1,489 
 non-commissioned officers and soldiers killed, 4259 
 wounded, and 1,400 missing. Total loss, 7,551. 
 
THE CRIMEAN WAR. 25 
 
 The district occupied by the allied armies was about 
 sixteen leagues in circuit, the surface mostly uneven, 
 and cut in various places by deep ravines, affording 
 water of good quality, and presenting everywhere 
 places favorable for camp and military operations. 
 Upon the sides of the mountains, the tents of the allied 
 armies were traced in rising and picturesque outlines, 
 and iine macadamized roads, built and kept up by our 
 troops, afforded facilities for transporting provisions and 
 ammunition. The sheds of the merchants formed small 
 villages, which the soldiers, in recognition of the pro- 
 bity of these industriels, named Pickpocketville, Rogue- 
 ville, &G. A thoroughly organized police inspected the 
 wines and brandies, and we rarely heard complaints of 
 their being adulterated. 
 
 The climate of the Crimea, excepting certain marshy 
 spots that might be easily made healthy, is remarkably 
 salubrious, and excepting the cantonments, which the 
 necessities of defence exposed to the paludal influences 
 of the Tchernai'a, our troops were in good hygienic con- 
 dition. The heat of summer, tempered by the sea 
 breeze, scarcely exceeded that of the south of France. 
 The winters are severe, the thermometer sinking 20 
 Centigrade ( 5 Fahr.), and lower, while the violence of 
 the wind renders the cold very hard to endure. 
 
 Our armies found but few resources in the country, 
 and the Tartars could only sell some cattle, sheep, chick- 
 ens, and eggs. They were as greedy in a bargain as the 
 merchants we have mentioned, and I have seen them, 
 ask five francs for a hundred walnuts and they found 
 customers too. We carefully respected their villages, dis- 
 turbed nothing, and maintained good relations with 
 them. The wood which covered the hills quickly disap- 
 peared, and in the winter of 1856 the roots of the 
 stumps themselves were dug up. We have read of the 
 passage of locusts in eastern countries, but the presence 
 of an army is a scourge even more sweeping ; for the 
 former devour only what is upon the surface of the earth. 
 The distance of over twelve miles, prevented us from 
 turning to profit the rich forest of Baidar, and the ad- 
 ministration found it easier and quicker to bring its 
 
26 THE CRIMEAN WAR. 
 
 wood from Varna. After the taking of Sebastopol, the 
 wood employed in the defences was largely used in the 
 kitchens of the regiments, while the troops adjacent to 
 Baidar, alone, continued to obtain its wood from the 
 forest, by the aid ofarabas and oxen, which the author- 
 ities placed at their disposal. These arabas are the 
 wagons of the country, clumsy and entirely of wcocl, 
 not a particle of iron being used about them. They 
 encumbered the road to Voronzof, and the creaking of 
 their wheels Avas music to the ears of the Tartars. The 
 Russians brought in their provisions upon arabas, dra\vn 
 by oxen, and upon their arrival, the cattle were slaugh- 
 tered, and the wood of the chariots served to cook 
 them. 
 
 About six miles from Kamiesch, upon a hill, in the 
 midst of the French army, were the general headquar- 
 ters, and there was the modest little tent, in which General 
 Canrobert passed the winter of 1855, having given up, 
 for the use of the hospitals, the temporary barrack 
 destined for the use of the Commander-in-chief. He 
 wished to share with his men the rigors of the season. 
 This example of self-denial in a high station, infused a 
 heroic spirit through every rank ; but not by this alone, 
 but by many other honorable and ingenious devices, 
 did the General-in- chief seek to sustain the spirit of the 
 army, through the rudest vicissitudes of their duties. 
 Upon the highest point of the General's quarters, "there 
 was built a clock tower, of stone, and the clock, with its 
 dials, taken from a belfry in Sebastopol, served to regu- 
 late the time of their watches. Around the quarters of 
 Marshal Pelissier were grouped the offices of the postal 
 service, the treasury, the electric telegraph, the chief 
 chaplain, the little extemporized church, where mass 
 was said, and in short, all the chief departments of the 
 service. 
 
 I soon entered into the details of the camps, regi- 
 ments, regimental infirmaries, and the field and regu- 
 lar hospitals, and consulted the generals, supervisors, 
 chiefs of departments, and physicians, to learn the wants 
 of the soldier, and fix my ideas concerning measures 
 relative to rations, shelter, and clothing. 
 
THE CRIMEAN WAR. 27 
 
 On the 20th of October, I addressed to the Minister 
 of War the following report : 
 
 " To His EXCELLENCY THE MARSHAL. I have devoted 
 the first days after my arrival in the Crimea, to visiting 
 the field hospitals of Divisions, to examining the camps, 
 and to the study collectively of the great questions of 
 hygiene, implied in the very important mission which 
 your Excellency has deigned to intrust to. me. 
 
 "I am now able to express an opinion upon some of 
 these points, and I can with pleasure affirm, that the 
 health of our troops was never better. In the Crimea, 
 as at Constantinople, half of the beds in the hospitals 
 are unoccupied, while the transmission of the sick has 
 nearly ceased. We have neither cholera nor typhic 
 fever dysenteries are rare, and the scurvy is less 
 intense. The hospital gangrene has begun to disappear, 
 wounds assume a better aspect, and every day numbers 
 of the wounded leave the field hospitals, to return to 
 their regiments, or to their families, to await a formal 
 discharge from the service. 
 
 " The beauty and salubrity of climate, the taking of Se- 
 bastopol, the elevated tone of military spirit, the constant 
 watchfulness of the Commander, the wise measures 
 adopted by the military intendants, and the skill and 
 devotion of the medical corps, are praised by all, and 
 have led to these happy results. 
 
 " The field hospitals of Divisions are well adapted to 
 their purpose, and each of them will accommodate 750 
 sick, sheltered by temporary barracks or tents. The 
 rations of food, as a general thing, leave nothing to be 
 desired; and if the bread is sometimes too damp, or a 
 little burnt, it is explained by the difficulty of dealing 
 out fresh bread every day, in a country where every- 
 thing has to be brought, even to the wood; while as an 
 offset, the wine is of superior quality, and is served at 
 the table of the soldier, the same as to that of the gene- 
 ral. The preserved vegetables have done us much ser- 
 vice, and milk concentrated by the method of Lignac 
 has been tried with satisfactory results. This mode of 
 supply is the only one possible at this time, and would 
 be of great use in our hospitals in the Crimea, and even 
 
28 THE CRIMEAN WAK. 
 
 at Constantinople, where milk is scarce, of very poor 
 quality, and of high price. 
 
 " If the whole army should winter in the Crimea, there 
 would be an absolute necessity of changing without 
 delay, the field hospitals of divisions into temporary 
 hospitals. It would be sufficient to increase the number 
 of shanties, to abandon the tents, so precious in sum- 
 mer, and to furnish the shanties with furniture, bedding, 
 and utensils of every kind necessary. Hospitals for 6000 
 sick, together with the regimental infirmaries, would 
 supply the wants of the army ; and the sending of 
 patients to Constantinople, which until now has been 
 so frequent, often so unpleasant to the sick, especially 
 in rough weather, and always so burdensome to the 
 treasury, would be necessary only in exceptional cases. 
 The hospitals at Constantinople, which so greatly need 
 to be purified by rest, would thus become a reserved 
 resource for secondary use, and a part of their attend- 
 ants and furniture might be sent to the Crimea. It 
 would be wise to construct near the monastery of Saint 
 George or at Constantinople, an extensive depot for 
 convalescents ; for it is of first importance to put an end 
 to these emigrant fleets. The best way to restore a 
 moral tone, and put an end to longings for the domestic 
 fireside, natural enough to the men, but enervating to 
 the army, is to cut short this idea of sending oif the 
 sick, which I believe has been greatly abused, since, out 
 of every hundred sick taken to Marseilles, only ten had 
 need to enter the hospital. We might with little 
 expense construct here ample barracks for the sick. The 
 walls might be made of biscuit boxes filled with earth, 
 and laid one upon another, or by the use of casks, or 
 the fascines used in the siege, which might be laid up in 
 a few hours, and covered with a roof of boards. This 
 system of protection against the rain, snow and cold of 
 winter, might be extended to the whole army ; there 
 would be no lack of fascines, and if boards are wanting, 
 they can use their tents for the roofs. 
 
 u The imperious exigencies of the long and glorious 
 siege of Sebastopol have happily ended, and though we 
 still hear the thunder of cannon, the bullets are almost 
 
THE CRIMEAN WAE. 29 
 
 harmless, and the time has come when we should be 
 actively employed with measures for sheltering from the 
 rigors of winter x the soldiers, to whose heroism France, 
 which honors every kind of merit, will hereafter, with- 
 out doubt, raise one day an imperishable monument.'' 
 
 Pursuing my inquiry, I resolved to inform myself 
 correctly on all points, to seek the means for warding 
 off the dangers which the approaching winter threat- 
 ened us with, and to ascertain the truth, from the 
 varied and often contradictory opinions which were 
 expressed upon these important questions. 
 
 CHAPTER II. 
 RATIONS. 
 
 IN my investigations concerning the provisioning of 
 the army of the East, four principal classes were indi- 
 cated by the nature of the alimentary substances them- 
 selves, and I have examined successively, the facts con- 
 cerning bread, meats, vegetables, and drinks. 
 
 Biscuit, which is the bread of mariners, was of great 
 reliance in our Crimean army. It is easily kept, if free 
 from moisture, is easily carried, and weight for weight 
 is much more nourishing than army bread. The water 
 which bread contains, increases its weight a third part, 
 while none of this remains in biscuit. Flour, when made 
 into biscuit, is lightened five per cent. The biscuits from 
 France were good, while those from Constantinople 
 were not always of faultless quality, and sometimes 
 contained traces of moisture. 
 
 The usual ration of biscuit, was 550 grammes (1.21 
 pounds), besides 185 grammes (0.4 pounds) in the soup. 
 
 At the opening of the campaign, the ration was in- 
 creased to 650 grammes (1.43 pounds), and when the 
 troops labored in the trenches, they received daily per 
 man an increase of half a franc in pay, and of 250 
 
30 THE CRIMEAN WAB. 
 
 grammes (0.55 pounds) of biscuit. Still, the soldiers 
 preferred army bread, though heavy and coarse, to the 
 best of biscuit, as the former digests more slowly, lies 
 better on the stomach, and never leads to satiety and 
 disgust. Biscuit, without leaven, is extremely absor- 
 bent, acting in the stomach like a sponge, and after 
 having exhausted the salivary glands in mastication, it 
 absorbs the gastric juice, so that not enough remains 
 fbr proper digestion. For the purpose of softening 
 it, they soak it for a moment in water, and then hold 
 it to the fire, by which it becomes pasty, insipid, and 
 indigestible. Biscuit should therefore not be distri- 
 buted, unless bread is wanting. Very often half rations 
 of bread are given, and during the Crimean campaign 
 four distributions in seven, were of biscuit. It is no 
 easy task to furnish fresh bread to an army of 140,000 
 men, when it is necessary to bring from beyond seas, the 
 flour, the wood, the kneading troughs, and the ovens. 
 
 In Paris, the baker's civil tax is based upon the pro- 
 portion of 130 pounds of bread to 100 pounds of flour, 
 this ratio between the quantity of flour and water which 
 it should absorb, being recognised as necessary for the 
 proper preservation of the bread.* The war depart- 
 ment imposes no limit, and the highest ratio is the best. 
 
 * In the American army, the regulations allow, under ordinary cir- 
 cumstances, the issue of flour at the rate of 22 ounces daily to each 
 man, in place of the same weight of bread. This flour, drawn by the 
 Division, Brigade, Regiment, or Post, is baked by soldiers detailed for 
 the purpose, in ovens made of sheet iron, covered with brick, stone, or 
 earth, or hi ovens of brick alone, and the savings that result go to- 
 wards establishing a fund for the benefit of the posts or regiments 
 concerned. There are probably no regiments in the service, in which 
 a sufficient number of masons and bakers could not be found, to con- 
 struct and operate these bakeries. For purposes of economy, they are 
 often worked day and night, by relays of men. Ttie savings have in 
 some cases exceeded 33 per cent., and will, in most if not all, come up 
 to 30 per cent. The economy of the arrangement appears in the 
 difference of transportation, and in the quality of the bread, as well as 
 in the savings upon weight, and the facility with which negligence 
 and abuses can be corrected, is so great, that they may be checked 
 upon first appearance. In G-en. Kearney's Brigade, of four regiments 
 in Franklin's Division of the army of the Potomac, the savings in two 
 months, in the winter of 1861-2, amounted to $3,436. TE. 
 
THE CRIMEAN WAR. 31 
 
 With tender wheat, 144 pounds, aftid with hard wheat, 
 150 pounds to 100 of flour, can be attained; but bread 
 too much charged with water, bakes badly, the crust 
 burns and blackens, it soon softens, loses its fermenta- 
 tion, and yields a food more or less defective. Perhaps 
 bread made a half or a quarter biscuit, with a little 
 leaven, should be prepared for armies in the field. The 
 ration would be less in weight, but not less nutritious, 
 and it would obviate, to a considerable degree, the incon- 
 veniences of biscuit. 
 
 The bolting of flour for army bread, has for some time 
 been carried as far as 20 per cent, of bran extraction, for 
 tender wheat. It was thought the less bran there was in 
 bread, the more nutritious it would be, and that the 
 whiter it could be made, the more it could be used for 
 soups, instead of bread bought from the civil bakeries, in 
 which the bolting is carried to 40 per cent, of bran. This 
 innovation does not seem to be wise, for it raises the cost 
 without a corresponding advantage. The new kind of 
 bread digests too rapidly, and does not mix well in soups. 
 It is not shown that bran, within certain limits, does not 
 contain elements capable of assimilation, and in times 
 of scarcity or war, it is a thing of no small consequence, 
 to carry the bolting of bran to such an extent for an 
 army of 500,000 men. Besides, our soldiers are chiefly 
 from the rural districts, and would prefer bread of infe- 
 rior quality, such as they have been accustomed to, 
 rather than the whiter bread of our army supplies. 
 Our Russian prisoners, accustomed to a very coarse 
 bread, were not sufficiently nourished by the bread fur- 
 nished to our soldiers, and required increased rations. 
 
 The best fresh meat is beef. Alone it makes a good 
 soup, and according to a saying as true as it is common, 
 soup makes the soldier. Our cattle arrived in the Crimea 
 after such long vicissitudes, that they might be said to be 
 as lean as Pharaoh's kine, and in order that the quantity 
 might make up for the quality, the ration was increased 
 from 250 to 300 grammes (0.55 to 0.66 pounds), but the 
 bones, which were included, were of great relative 
 weight. I recommended that the hard parts, after 
 having been boiled in the pot, should be pounded up 
 
32 THE CRIMEAN WAR. 
 
 and boiled again, to extract the 'gelatine ; and this 
 method, as employed in the hospitals at Constantinople, 
 very sensibly improved the broths of the sick, and we 
 were able to order it as a regular prescription to the 
 regimental and hospital cooks. In France, it is true, 
 bones are -sold, but here, would they be worth what it 
 would cost to take care of them ? 
 
 When fresh meat was wanting, it was replaced by 
 preserved dressed meat, put up in tin cans hermetically 
 sealed, and as it contained no bones, the ration was re- 
 duced to 120 grammes (0.25 pounds). These preserved 
 meats were of excellent quality, but the soldiers disliked 
 the change, for they estimated the weight and bulk more 
 than the quality, and although the quarter of a pound 
 fed them really as much, they declared it insufficient, 
 and preferred fresh meat, even of poor quality. Some- 
 times the ration was sausage and lard, and occasionally 
 packages of powdered meat. The latter was eaten by 
 few, was liable to adulteration, had a suspicious odor, 
 and the men were always in doubt whether animals of 
 all kinds were not used in its manufacture. After a 
 few days' use, the troops manifested a great repugnance 
 and disgust towards it. 
 
 The sheep, which contrived to find a few blades of 
 grass, although insufficient for the sustenance of cattle, 
 were kept in good condition, and were highly prized. 
 A great number of horses died during the winter of 
 1855-6, and following the example of the distinguished 
 savan, M. Isidore Geoffroy Saint Hilaire, I preached the 
 doctrine of eating horse flesh, but made few converts. 
 The horse is herbivorous, like the ox ; no animal is more 
 neat, it is washed and cleaned daily ; its flesh, although 
 more firm, is not less satisfying, and it would make 
 excellent soups. In Germany, horse flesh, cut up, is sold 
 publicly in the butchers' stalls. The two artillery batte- 
 ries of Autemarre's division, encamped at Baidar, fed 
 upon horse flesh ; nor did they have reason to regret it, 
 as they escaped the diseases and mortality which swept 
 so cruelly through the rest of the army. Experiments 
 made by very competent savans have proved, that 
 horse flesh, even tainted, as in the black-tongue, when 
 
THE CRIMEAN WAK. 33 
 
 purified by fire, may be eaten without danger, but still, 
 I would not venture to advise the eating of diseased 
 horses. I know that the meat of oxen, flaccid, colorless, 
 and gluey, which we were sometimes forced to distribute 
 in times of scarcity-, has caused diarrhoeas.* 
 
 Fish, and especially the buckle turbot, are abundant 
 on the coasts of the Crimea ; and while butchers' meat, 
 even of poor quality, sold at Kamiesch at a quarter of 
 a dollar a pound, a turbot of ten pounds cost only 
 seventy-five cents or a dollar. After the taking of Se- 
 bastopoli the officers, with nets found in the city, made 
 wonderful hauls of fish in the bay of Streteska. I regret 
 that we were unable to establish large fisheries, to con- 
 tribute by this precious resource to the support of our 
 army, and aiford variety to its food. We also found 
 excellent game, quails and woodcock, at the time of 
 their migration, and hares, pheasants, and roebucks 
 in the forest of Baidar. The feast of St. Hubert was 
 held in the forest. It is needless to say, that the luxu- 
 ries did not go to the soldiers' tables. Some of the 
 officers kept fowls for their eggs. 
 
 The want of fresh vegetables for our army was a great 
 privation. Preserved vegetables were never wanting; 
 and the mixed kinds, which we distributed very regu- 
 larly, were the most relished of all. At the end of the 
 campaign, these preserves were of poor quality, and 
 were found sometimes so altered by fermentation that 
 the soldiers threw them away. The avidity of the 
 dealers was not checked by the miseries of the army, and 
 tended greatly to increase them. The sacks of potatoes 
 received from time to time, w r ere very acceptable. The 
 government delivered them at the rate of three cents 
 the pound, but in the shops at Kamiesch they were sold 
 
 * Under favorable circumstances, cattle are issued to the American 
 army upon hoof, their weight being determined by the following rule : 
 From the live weight of a steer, there is deducted 45 per cent, when 
 the gross weight exceeds 1300 pounds, and 50 per cent, when it is less 
 than that, and not under 800 pounds. When pasturage or forage are 
 abundant, the post or regiment may often realize a valuable saving, 
 both in quality and quantity, by allowing their cattle to recruit from 
 the exhaustion of a long journey by railroad and to gam, flesh by 
 feeding. TB. 
 
34 THE CRIMEAN WAR. 
 
 at from nine to twenty-five cents. For cabbages, as 
 much as $1.86 were paid. Man has need of vegetables 
 as muck as of meat. Physiologists divide alimentary 
 substances into two classes ; nitrogenous, which, accord- 
 ing to Dumas, supply the demands of assimilation, and 
 non-nitrogenous, which furnish the products consumed 
 by respiration, and are called by Liebig respiratories. 
 The w r ant of vegetables, which belong chiefly to the 
 latter class, impairs the respiratory function, and injures 
 by hematosis. It has been demonstrated, that the ulti- 
 mate effect of this regimen would be death. 
 
 The necessity of a varied nourishment has been esta- 
 blished as a practical fact. The theoretical views by 
 which it has been attempted to account for this neces- 
 sity, do not seem to accord with the facts observed in 
 late years. The need of a varied food is recognised; 
 explanations of the effects of the food, alone, ought 
 to be abandoned. They are based upon very attractive 
 views, w 7 hich, recognising in vegetables the power of 
 supplying the chemical elements, as oxygen, hydrogen, 
 and nitrogen, or the simple compounds, as water and 
 carbonic acid, and of making from these elements, what 
 organic chemists call the proximate principles, as ami- 
 don, sugar, gluten, etc., deny to the animal, the power 
 of fabricating these proximate principles. They seem 
 to think, that animals should become the borrowers of 
 the food ready prepared, and that they should limit 
 their role to its assimilation. It is now proven by the 
 beautiful experiments of M. Claude Bernard, on the for- 
 mation of sugar by the liver, in animals fed exclusively 
 upon meat, that they can manufacture proximate prin- 
 ciples, as well as vegetables can. Furthermore, in show- 
 ing, that instead of the blood's warming in the lungs, 
 it actually becomes cooler, M. Bernard has rendered 
 inadmissible the hypothesis, which w r ould make this 
 organ the seat of combustion, arising from the combus- 
 tion of atmospheric oxygen with the carbon of venous 
 blood. 
 
 Desiccated vegetables, having lost their water of vege- 
 tation, and perhaps other gaseous elements, which analysis 
 has not been able to discover, cannot adequately replace 
 
TUE CRIMEAN WAK. 35 
 
 the fresh articles.* In the army of the East, the imper- 
 fect aeration of the blood could be traced in sanguineous 
 effusions, and in scurvy. As to food and habitation, the 
 Crimean expedition might perhaps be compared to a 
 long voyage ; the army being, as it were, limited to a 
 great ship, and subjected to the influences of navigation 
 on a vast scale. Prolonged habitation in common, gene- 
 rated noxious exhalations, and finally typhus. The 
 invasion of scurvy was delayed by the presence of a 
 plant, as precious as it was abundant, the Terrassa- 
 cum of Linnaeus, commonly known as the dandelion. 
 As the trees and their roots were removed from the soil 
 of the Crimea, this plant became the king of vegetation. 
 The Crimea was the Promised Land of the Terrassacum. 
 It resisted bravely the destructive war which our sol- 
 diers waged upon it ; torn up without stint, it sprang 
 up again in still greater profusion. It made a salad 
 of easy digestion, and with a pleasant and salutary bit- 
 terness. It appeared daily on the table of Marshal Pe- 
 lissier, with whom it was a great dainty. Unfortunately, 
 in the heart of winter, and middle of summer, the ex- 
 tremes of cold and heat checked the growth of this use- 
 ful plant, and its disappearance was followed by the deve- 
 lopment of scurvy. f The Minister of War caused to 
 be purchased in the markets of Constantinople, large 
 quantities of fresh vegetables. One of my reports says, 
 " 100,000 francs, spent in fresh vegetables, is a saving 
 of 500,000 francs in the expense of sending the sick to 
 
 * The desiccated vegetables furnished to the American army, have 
 in many cases fallen into disrepute, from the faulty manner in which 
 they have been cooked. The error has generally consisted in omitting 
 to soak them thoroughly beforehand, in not boiling them for a suffi- 
 cient length of time, and in putting them into soups in too great quan- 
 tities. When thoroughly soaked, sufficiently boiled, and properly 
 seasoned, they are generally relished. The American army in Utah 
 owed their preservation from scurvy largely to the use of these desic- 
 cated vegetables, at a tune when nothing else of an antiscorbutic kind 
 could be obtained. Tn. 
 
 f Among the antiscorbutics used with success by the army of the 
 United States, in western expeditions, have been agave juice, wild 
 artichokes, lamb-lettuce, wild onions, the tender shoots of the Phyto- 
 lacca decandra or pokeweed, nettles, celery, and wild oranges. Kaw 
 potatoes, sliced in vinegar, are highly useful. TE. 
 
36 THE CRIMEAN WAR. 
 
 hospitals.'' Towards the close of our sojourn, we made 
 kitchen gardens, and raised some few things of first 
 necessity. They promise great resources in the future, 
 should we remain in a country so destitute of every- 
 thing. I am surprised that the army was not furnished 
 with sour krout, which is so easy to keep. Lentils were 
 scarce, but kidney beans plenty. 
 
 Vegetable acids, that is apples, lemons, and oranges, 
 were wanting. These, as we know, are antiscorbutic. 
 The English drew rations of lemon juice preserved in 
 casks, and they used it in their grog, with rum and sugar. 
 Our field hospitals and regimental infirmaries were well 
 provided with it towards the close of the campaign, but 
 our experience, although attended with good results, 
 was not sufficiently tried to render it fully conclusive. 
 The English physicians ascribe great antiscorbutic vir- 
 tues to the lemon juice, and say it is in a large degree 
 owing to its use that their army was saved from the 
 scurvy, in the winter of 1856. It has for a long time 
 been valued as an antiscorbutic by their mariners, who 
 take it with them on long voyages. 
 
 Soup is. excellent food for the soldier, but its quality 
 depends much upon the cook.* Every soldier takes his 
 turn in cooking, as he does in mounting guard ; but 
 this is wrong. In the same regiment, some companies 
 eat good soup, and some bad. The army officers do 
 not usually trouble themselves with these details, so 
 important for the first condition of health is that the 
 stomach be satisfied. In the Crimea, the troops that 
 best sustained privations and fatigues, were those com- 
 manded by colonels careful of their men. Let us take 
 an example of two regiments, which left the camp of 
 
 * In the American service, the several companies of a regiment are 
 provided with kettles and fixtures for cooking by companies, a coos. 
 and one or more assistants being detailed or hired for each company. 
 Probably this service is never better performed, than where an expe- 
 rienced cook is steadily employed, and the assistants are changed at 
 short intervals. By this arrangement, nearly every man in the com- 
 pany will have an opportunity of acquiring that culinary experience 
 which would enable him, if detached from the company, and thrown 
 upon his own resources, to prepare his food in a manner consistent 
 with the preservation of health. TE. 
 
THE CRIMEAN WAR. 37 
 
 Saint Omer at the same time, arrived together in the 
 Crimea, in October, 1855, encamped side by side, en- 
 dured the same vicissitudes of weather, and performed 
 the same services ; the one preserved on the 1st of April, 
 1856, 2,224 soldiers of an effective force of 2,676 men, 
 while the other, with an effective force of 2,327 men, 
 had 1,239 only left and these losses did not include those 
 wounded in the war ! In the armed naval service, our 
 commanders of vessels supervise the preparation of meals 
 for the crews, and observe most punctually the hour for 
 breakfast and dinner, which is never delayed, antici- 
 pated, or interrupted. It is earnestly to be wished, that 
 the same scrupulous care might find its way into our 
 land armies, and that these wise hygienic measures 
 should never be infringed upon, except in cases of abso- 
 lute and manifest necessity. We pay rewards to those 
 colonels of cavalry whose squadrons preserve the great- 
 est number of horses, and these rewards excite an excel- 
 lent and profitable emulation. We could have similar, 
 but more important and happy results, were we to grant 
 similar tokens to colonels, whose battalions preserved 
 the most men in the best health. 
 
 Wine does not form a part of the ordinary rations of 
 the soldier in a campaign. That which was distributed 
 to the army of the East was generally good. Each 
 soldier drew half a pint, and officers were allowed to 
 take daily from the stores, besides their rations, a litre 
 (0.264 gallon) of wine, for which he paid fifteen cents, 
 while the private dealers sold wine for three or four 
 times that sum. During the epidemic, Marshal Pelis- 
 sier doubled the rations. For our sick, we had gene- 
 rous wines, which the administration gave liberally. 
 Brandy alternated with the wine, the ration being 
 about a third of a pint. Taken immoderately, brandy 
 is very dangerous in winter, and exposes the drunkard 
 to perish from cold ; but in moderation it excites a salu- 
 tary reaction. M. Laurent, a ship lieutenant, with some 
 marines, had charge clay and night of a battery before 
 Sebastopol ; he preserved the health of his cannoneers 
 through the winter by giving them, at stated intervals 
 during the night, three warm grogs of brandy, through 
 
38 THE CRIMEAN WAE. 
 
 which the system gained great power to resist the cold. 
 Coffee was often given out instead of wine or brandy, 
 the rations consisting of sixteen grammes (about half 
 an ounce) of coffee, and twenty-one grammes (three- 
 fourths of an ounce) of sugar. During the early cam- 
 paign in Algeria, the columns about to be sent out 
 received advance rations of brandy for eight days, 
 which were consumed before starting. The drunken- 
 ness which ensued was a lamentable prelude of the 
 fatigues and privations of the war ; and at the time 
 of the expedition to Mascara, in 1834, it was necessary 
 to send to the field hospitals a host of soldiers attacked 
 with dysentery. Upon setting out upon the expedition 
 of Tlemcen, I advised the substitution of coffee for 
 brandy, and with very decisive results. Coffee has 
 become among our soldiers in campaign a healthful and 
 favorite drink, and is found to prevent the intestinal 
 looseness so frequent in warm climates. The Arabs 
 take daily, several light infusions of coffee, and when in, 
 their country, we ought to be governed by their tradi- 
 tional usages, founded upon reason. The soldier, by 
 steeping some pieces of biscuit in his coffee, makes at 
 will a very nutritious soup, of which he never gets 
 tired. Coffee is especially useful on a halt, or in the 
 trenches, and, in short, anywhere when the soldier has 
 not time to prepare his soup. It refreshes and enlivens, 
 while it does not prevent sleep after a day of fatigue in 
 the open air. It recommends itself to the government, 
 being easily kept and carried. It should not be ground 
 long before use, because it then loses its volatile aromatic 
 principles. It may be roasted and distributed in the 
 grain. In the Crimea, we gave the troops little mills, 
 which readily prepared it for infusion. The ingenuity 
 of the soldiers furnished means often original, and not 
 always prosaic, for preparing it. I have seen in our 
 camps, the coffee ground by a ball rolled about in the 
 half of a bomb shell. The English replaced coffee by tea, 
 which their troops took morning and evening, sea- 
 soned with rum. Pieces of bread soaked in this grog 
 afforded a nourishing and agreeable food. Thus We meet 
 in the bivouac with the home usages of British families. 
 
THE CRIMEAN WAR. 
 
 39 
 
 The following table shows the rations of an English 
 soldier in the Crimea and upon the Bosphorus : 
 
 Bread, 
 or biscuit, 
 Fresh meat, 
 or salt meat, 
 Sugar, 
 Rice, 
 Coflee, 
 
 IN THE CRIMEA. 
 
 14- pou 
 l" ' 
 
 I 4 ' 
 2 our 
 2 
 1 
 
 nds. 
 ces. 
 
 or cocoa, 
 or tea, 
 Wood, 
 or mineral coal, 
 or charcoal, 
 Candles, per man, 
 
 1 
 
 M 
 
 2 
 
 ounce. 
 
 pounds. 
 
 ON THE BOSPHORUS. 
 
 Bread, 
 
 or biscuit, 
 
 Fresh or salt meat, 
 
 Sugar, 
 
 Coflee, 
 
 1 pounds. 
 1 " 
 
 1 " 
 
 2 ounces. 
 1 
 
 Mixed vegetables, 4 ounces, 
 
 or potatoes, 8 " 
 
 Rum, gill. 
 
 Candles, per doz. men, 3 ounces. 
 
 On days when they issue salt meats, they give besides, 
 two-thirds of a pint of peas or kidney beans, or a quar- 
 ter of a pound of mixed vegetables, or half a pound of 
 potatoes. 
 
 As an antiscorbutic, they give thrice a week to the 
 troops, some lemon juice, and four pounds of sugar to 
 every hundred men. 
 
 The French soldier was never for a day without 
 food, the distributions were made as regularly as in a city 
 garrison, and with as great variety as was possible in a 
 country without resources, and eight hundred leagues 
 from France, from whence everything had to be sent. 
 
 I will here offer some brief observations upon the 
 improvements which appear to me practicable to intro- 
 duce in the regimen of the soldier. Without exceeding 
 the strict' limits of -expense, I believe that the number 
 of sick may be diminished, and along with this the 
 expense of hospitals, by giving a third meal, by varying 
 the food, and by increasing its amount. Our soldiers 
 take two meals : one at ten o'clock in the morning, and 
 the other at four in the afternoon. The breakfast is 
 eighteen hours after supper; Now a man may, if occu- 
 pied with intellectual labor, take food perhaps only twice 
 
40 THE CRIMEAN WAK. 
 
 a day ; but the young soldier, who has not yet reached 
 his full growth, and who is exposed to a great expendi- 
 ture of physical strength, ought to eat oftener. Be- 
 fore entering the service, he was a peasant or a me- 
 chanic, and, practising the popular adage, " never go to 
 work hungry," ate before beginning his labors. When 
 he joined the regiment, this morning repast, which lie 
 had taken from infancy, and which to him is a real want, 
 is at once, and without gradation, cut oif. The old sol- 
 dier, whose stomach is less imperious, takes good care to 
 eat a piece of bread and drink a little glass of brandy 
 before going to his drill. The conscript may do so 
 likewise ; but always in a hurry, and compelled to 
 regulate his life by the tap of the drum, will he always 
 find time to take this irregular repast ? If it is useful, 
 why is it not made regular, and a time given to it in 
 the distribution of the daily duties, as, for example, 
 at seven in the morning ? A sup of coffee, a piece of 
 cheese, an onion, a little bread and butter, and some 
 wine, would be sufficient. 
 
 When a man's food is not varied, his health quickly 
 fails, as Magendie has demonstrated. The mariners 
 who in a long voyage are reduced to biscuit and salted 
 meat, readily contract scurvy, typhoid fever, and some- 
 times typhus. The soldier eats invariably twice a day 
 soup, made of boiled beef, and vegetables, whose quantity 
 varies with the price. To break this monotony, the men 
 often sell their bread to buy fruits, or cheese ; the ration 
 of bread is, however, estimated from the wants of the 
 system, and the sale of a part weakens the body, and 
 procures a variety, without adequate nourishment. 
 These two eternal soups are the strongest reasons, and 
 I know this positively, why the soldier will not willingly 
 re-enlist. 
 
 In 1847, a scarcity of provisions doubled the number 
 of the sick; a fifth part of the effective regimental 
 forces were in the hospitals and infirmaries, ninety-two 
 scorbutic patients were entered at Val-de-Grace, and 
 although the furloughs of convalescence were immensely 
 numerous, the number of deaths per one thousand arose 
 from fourteen to twenty-nine. During the same year, 
 
THE CRIMEAN WAR. 41 
 
 the crack regiment, the municipal guards, and the fire- 
 men, who were able on account of their supplementary 
 pay to add to their rations, escaped the diseases which 
 raged among the troops of the line, which depended upon 
 their simple pay. Thus in 1855, the scurvy attacked the 
 troops at Saint Omer in so serious a way, as to call for 
 the presence of M. Maillot, a medical inspector ; nor did 
 it yield, until certain objectionable features in the pro 
 visioning were reformed. We uniformly observed, in 
 Algeria as in France, that the troops employed in 
 manual labor in the open air, in grading or stoning the 
 roads, are in better condition, aside from the marked 
 and conceded influence of physical labor upon the 
 health; and this fact is explained by the extra pay 
 which the soldier receives for these labors, and which in 
 part goes to increase his food. 
 
 It is commonly said, that the soldier is better fed in 
 the army than in his family, but this is not so true as is 
 generally believed. Besides, ought not the amount of 
 food to correspond with the sum of physical forces 
 expended ? The English laborers, who began our rail- 
 roads, and whose unwearying vigor astonished our 
 workmen, ate two pounds of meat daily; flesh nourished 
 flesh. The French soldier receives, bone deducted, at 
 most, one hundred and twenty grammes (a quarter 
 of a pound) of meat in a day. I admit that he would 
 eat less at home, especially if he came from a poor 
 district, but at least he would have an abundance of 
 bread, cabbage, beans, lard, and onions. Butter would 
 vary his food ; and milk, cider, or at least weak wine, are 
 worth more than the water which he would drink in 
 the army. His labor is free, and without disciplinary 
 restraint, and he has no forced marches to make, carry- 
 ing an equipment, which in a campaign weighs at least 
 fifty-five pounds. He rests when he is weary, eats when 
 he is hungry, and at night, instead of standing sentry, 
 he sleeps a sleep that is sound, and breathes full volumes 
 of fresh air, and not such air as is rationed out in the 
 rooms of a barrack. The greater number of diseases, 
 and especially of tubercular phthisis and typhoid fever, 
 so common in the army, have no other cause than a 
 
 3* 
 
42 THE CRIMEAN WAR. 
 
 vitiated air. In Algeria, the regiments which labored 
 on the roads, during the heats of summer, in the open 
 air, never had these diseases ; but on the return of winter 
 and bad weather, when they were driven into the 
 barracks, they presently paid a heavy tribute to disease. 
 The expense of supply for a company of eighty men is 
 one hundred and sixty dollars per month, which is 
 derived as follows: one hundred and fifty-six dollars 
 and twenty-four cents, total of six cents and five mills 
 per day, taken from the wages of each man ; four 
 dollars at least per month, from the sale of grease 
 and slops, besides what is earned by the soldiers who 
 labor in town, and that which is paid by the officers 
 for orderlies, and which go to the soldiers in common. 
 The company consumes daily in bread for soup, one 
 dollar and twenty-one cents, in meat three dollars and 
 thirty-five cents, in vegetables twenty-eight cents, in 
 pepper and salt nine cents. This four dollars and 
 ninety-three cents per diem, amounts to about one 
 hundred and forty-seven dollars and ninety cents in a 
 month ; and allowing nine dollars and ninety-eight cents 
 for washing, lights, and blacking, for brooms, and the 
 barber's fee, there is left two dollars and twelve cents 
 for some contingent expenses. Many commanding 
 captains have a foolish tendency towards economising 
 in the mess expenses, which results finally in large 
 mortality. I have been astonished to see them intrust 
 to a corporal the duty of buying provisions ; as corpo- 
 rals are rarely ^insensible to the seductions of a glass of 
 brandy; the merchants, who know their weakness on 
 this point, turn it to their advantage, to the detriment 
 of the company. It would be better that a special com- 
 mission should have charge of the sustenance of the 
 regiment. They could then deal directly with the 
 producers, and by dispensing with intermediaries, bene- 
 fit the regiment to the whole extent of the profits made 
 by second and .third hands. Bought upon hoof, the 
 meat would be cheaper, and perhaps of better quality, 
 the soldiers might cut it up themselves, and thus initiate 
 themselves into camp life. It may be objected, that the 
 soldier is suspicious, and ought to be left to dispose of 
 
THE CKIMEAN WAK. 43 
 
 the funds destined for his nourishment according to his 
 own fancy ; but the commission might embrace a repre- 
 sentative from each company. Besides, the State, in 
 supplying the funds, reserves to the fullest extent the 
 right of control, and its interests are identical with 
 those of the soldier. 
 
 CHAPTER III. 
 
 CAMPS AND SHELTERS. 
 
 THE three camps of the French army were located 
 upon elevated grounds, with good hygienic conditions. 
 The air circulated freely, and purified them constantly. 
 The inclosure was, however, too scanty, the tents almost 
 touching one another. There should have been left suf- 
 ficient space to allow of their being moved occasionally, 
 to purify the ground as it became infected by use. As 
 for the barracks, the evil was without remedy. It is 
 a fatal custom thus to huddle together the tents and 
 barracks. In the Crimea, safety made this necessary; 
 but at Constantinople, far from the seat of war, the 
 camps, barracks, and the hospitals were altogether too 
 close ; and to the noxious exhalations thus engendered 
 were to be attributed the persistence of cholera and the 
 ravages of hospital gangrene and typhus. To the phy- 
 sician who asks for more space, it is replied that, it is of 
 the first importance to economise the labor of the 
 service, and so, to save a few steps, they violated some 
 of the most simple, yet most important laws for the 
 preservation of health. 
 
 The physicians also found that the location of the 
 camps, even when nothing controlled the liberty of 
 choice, was. not always well selected. At Constantino- 
 ple, a barrack camp was laid out scarcely half a mile 
 from a miry plain, but the invasion of intermittent fever 
 caused it to be abandoned. It is further to be observed, 
 that two camps, or two barracks, or two hospitals, were 
 
44 THE CRIMEAN AVAR. 
 
 never made upon the same model ; and often a real per- 
 fection in arrangement was superseded by an injudicious 
 innovation. It would, however, be sensible enough to 
 prescribe a plan drawn up by a commission composed of 
 officers of engineers and of the medical staff. 
 
 Camps, when stationary, tend rapidly to infection, 
 but they cannot always be changed ; for in winter the 
 softened soil often prevents the work of removal ; and, 
 besides, camps often occupy military positions which 
 may not be abandoned. We must submit to these 
 necessities, with the determination of withdrawing at 
 the first opportunity. The signing of the peace allowed 
 us to remove our camps along the valley of the Tcher- 
 naia, upon new and elevated ground, exposed to the sea 
 breeze. The officers were loth to quit the conveniences 
 they had arranged ; but Marshal Pelissier commanded, 
 and they obeyed. 
 
 When a camp ground cannot be changed, it is neces- 
 sary to double our vigilance, in ' order to expel the 
 organic miasms and purify the air, by sprinkling the soil 
 in the tents with lime water, by placing a dish of hypo- 
 chlorate of soda in a corner, by taking down the tent 
 when the weather allows, or at least tying up the sides 
 80 centimetres (32 inches) from the ground during the 
 most of the day. Soldiers take so little care of their 
 health that they must be made to come out of their tents, 
 or they will remain squat within, even in fine weather ; 
 and should be compelled to dry their clothes and blan- 
 kets in the sun. The cavalry were more attentive than' 
 the foot soldiers (Zouaves excepted), to these simple 
 requirements, which were issued as army orders. But 
 the infantry gave them the most faithful trial. 
 
 The cemeteries were placed far enough from the 
 camps to be free from noxious exhalations, and all the 
 recommendations of the Army Council of Health were 
 always regularly observed concerning them. Large 
 quantities of quicklime and of chloride of lime, of which 
 ;we had an abundance, were used in them and in the 
 slaughter yards. It was said, and published, that the 
 dead carcasses of animals poisoned the air of our camps ; 
 but this was untrue, as they were immediately buried. 
 
THE CRIMEAN WAK. 45 
 
 General Canrobert, at the beginning, encouraged their 
 burial, and this was regularly done. 
 
 The habits of cleanliness which distinguished the Eng- 
 lish army, should have been followed in our camps. They 
 washed their body linen in warm water, and changed 
 twice a week, but our soldiers were not so careful. 
 Filthiness checks the functions of the skin, and engen- 
 ders vermin. When a patient arrived at Constantino- 
 ple, we first washed his garments in boiling water. On 
 a review day, our soldiers presented, by their new and 
 well-brushed uniforms, an irreproachable military aspect ; 
 but these fine battalions left, as they passed, the marked 
 and well-known stench of the barracks. Is neatness 
 inconlpatible with the soldier's profession ? The Turk 
 finds time, in the midst of a campaign, to perform many 
 times in a clay the ablutions required by his religion ; 
 and surely military discipline ought to be as imperative 
 as the law of Mahomet ! If that has achieved so meri- 
 torious a victory, military education should introduce 
 gradually into the families of our laborers and peasants, 
 those cleanly habits which we so envy in the English. 
 This would be a national reform, which would result in 
 profit to the public health. Our quarters for troops shine 
 with the greasy filth of daily neglect. It is forbidden 
 would any one believe it? to scrub the floors, the 
 benches, and the tables, for fear of wearing them out. 
 Why cannot a barrack be kept as neatly as a ship, and 
 why cannot floors, waxed and rubbed by the soldiers, 
 take the place of the imperfect tiling in the rooms? We 
 have introduced, at length, this luxury into our military 
 hospitals, in spite of the opposition of routine ; and', upon 
 entering the barracks, may ask with surprise, why such 
 useful reforms are so slow in finding their place here? 
 
 The shelters of the army of the East were of different 
 kinds, and for want of houses it adopted more primitive 
 habitations. In the Crimea, we had huts, shelter-tents,* 
 
 * The tente-abris is a slight shelter, sufficient to cover a soldier in 
 the bivouac, and so light that it can be packed up like a knapsack, 
 and carried on the march. Its construction and use are described on 
 a subsequent page. They are about being introduced into the Ameri- 
 can army. Tn. 
 
46 THE CRIMEAN WAR. 
 
 and conical tents. The huts, which our soldiers called 
 mole-hills, were dug a yard, at least, below the surface, 
 and were about seven yards long by three wide and 
 two and a half high. The floor and sides were covered 
 with stone when they could be had. The walls were 
 raised above the surface by brush woven together, and 
 covered with a thick coat of clayey earth, and upon 
 these was placed a roof, with double slope, made of the 
 same materials. One or two openings in the roof admit- 
 ted light, but these were closed with a sod when it 
 rained. Whenever fuel was wanting, these huts were 
 always dangerous to health, and the Piedmontese regi- 
 ment, who lived in huts without chimneys or fire, had 
 many sick.* On the other hand, the division cantoned in 
 the forest of Baidar could have had no better habitation, 
 
 * The pernicious habit of sinking the floors of tents below the 
 surface of the ground has almost always been punished by increased 
 sickness and mortality. Upon many occasions, while inspecting the 
 camps in winter quarters, in the army of the Potomac, in the winter 
 of 1861-2, the writer has observed that the sickly companies and 
 squads were those that lived in tents with excavated floors. This 
 disregard of health should be charged to the officers permitting it. 
 The sides and floor of such a tent can never be dry, or the ventilation 
 perfect, unless, perhaps, in cases where an open wood fire with a good 
 draught is maintained. Carbonic acid gas will settle into the bottom of 
 the tents, where the men lie, and typhoid fevers, rheumatism, and 
 catarrh will swell the numbers attending the sick call and filling the 
 hospitals. The practice prevents the frequent removal of tents to new 
 grounds, and renders cleanliness impossible. The floor of a tent, some- 
 what raised above the natural surface, well drained, and previously 
 dried by the burning of brush, presents the opposite conditions for the 
 maintenance of health. 
 
 The army of the Potomac, in the winter quarters of 1861-2, were 
 well supplied with wood, and very few tents were without fires. The 
 fixtures for warming varied infinitely, and embraced a great variety 
 of open fire-places, of brick, stone, mud, or sods, with chimnej's of the 
 same, with or without an additional draught made of boards, barrels, 
 sticks and mud, or hollow logs; sheet-iron stoves, with or without 
 pipes; open fires in the middle of large tents, with ventilation at the 
 top; or, what was still more objectionable, kettles of embers from the 
 kitchen fires. Of these, the open fire-place, with a chimney, was the 
 only kind without its faults; and the chief difficulty in its use, arose 
 from the increased quantity of wood required. , The thousands of acres 
 of oak timber, cut down as a military necessity, allowed no limit to be 
 placed upon this luxury, except that of transportation. Tn. 
 
THE CRIMEAN WAK. 47 
 
 for being well supplied with wood, they kept tip fires day 
 and night. Nothing is so cheering as a large fire in a 
 bivouac, and wood is half the life of a campaign. While 
 warming himself in the open air, the soldier escapes the 
 emanations of the common quarters ; and when the fire is 
 carried into the huts, it renews the air with great advan- 
 tage. A day of reckoning with rheumatism may hereaf- 
 ter come ; but in war we cannot always be so prudent. 
 
 I visited a Russian camp, where the troops live in 
 huts similar to ours, but larger, wider, and deeper, with 
 sheets of oiled paper instead of glass. Wood had become 
 scarce, and the air, not cleansed by the fire, was heavy, 
 damp, nauseating, and scurvy and typhus abounded. 
 
 To Marshal Bugeaud, we owe the ingenious contri- 
 vance of the Shelter Tent, made from the camp sack of 
 the soldier. Its seams are replaced by rows of buttons, 
 so that it can be changed at will into a square piece of 
 cloth ; and when two of these are buttoned together, 
 and drawn over a pole, raised about a yard from the 
 ground, and the corners fastened by pegs, the two owners 
 of the sacks are sheltered under the tent. Thus was 
 resolved the great question, as to how we might escape 
 the double inconvenience of overloading the shoulders 
 of our troops, and of transporting tents in the train of 
 an army, by expensive and often impracticable means. 
 Ouivtroops become movable and nomadic, like the Arabs 
 whom they pursue. This tent did us great service in the 
 Crimea, but was of little service during the rigors of 
 winter; for when placed on the ground it was too cold, 
 and when covered with a bed of snow it was too warm, 
 and the air within was rapidly tainted. 
 
 The conical tent is made for sixteen men. A single 
 pole in the centre supports the top, while around, it is 
 very firmly fastened to the ground by two sets of ropes, 
 one of which is fixed, and the other movable, allowing 
 the walls to be raised some two feet to ventilate the 
 interior.* They resisted bravely the force of the winds, 
 
 * The Crimean tent has been furnished to a few of the regiments 
 in the American army, but not so extensively as the Sibley tent, which 
 is taller, and descends to the ground at a wider angle, covers less 
 ground, and has a large opening for ventilation. The latter, resem- 
 
48 THE CRIMEAN WAE. 
 
 and the Turks prefer them to all others. They make 
 them of a very close woven texture, and the Sultan 
 furnished a large number of very superior quality. Ours 
 were made of cloth of open texture, which allowed the 
 rain to sift through ; but although not so warm, they 
 were more healthy in summer, because they allowed the 
 air to circulate, while in winter their fault was reme- 
 died by placmg one over another. 
 
 Marquees are a more complicated affair than the 
 conical tents, and as they do not well resist the wind 
 they were not used for sheltering troops in the Crimea. 
 Still they are more healthy and agreeable abodes ; their 
 vertical walls inclose a much larger volume of air, they 
 are very easily ventilated, and are as roomy as a common 
 chamber. On these accounts, they were used for the 
 sick.* The English constructed during the summer, for 
 their regimental infirmaries, marquees of -large size, each 
 holding twenty-four iron bedsteads, and as many bedside 
 tables. The planks were movable, and kept with great 
 neatness ; and every patient had a mat by his bedside, 
 and a hospital robe. An army on the march could not 
 unfortunately enjoy a convenience so cumbersome ; as to 
 move one of these tents, with its furniture, would re- 
 quire at least twenty-five mules! In winter they were 
 replaced by barracks. The Russians also employed 
 tents of very large size for their sick, and I saw several 
 erected near the hospital at Balbec ; they served, so 
 
 bling in outline a Sioux lodge, from which it was perhaps modelled, 
 was first supplied to our troops in the expedition to Utah, and pos- 
 sesses advantages over many if not over all other kinds now used. It 
 is often stockaded to a height of three or four feet from the ground, 
 thus affording additional accommodation. Around the central pole 
 is placed the rack for arms, and a conical sheet iron stove with pipe 
 passing through the ventilator, enables the inmates to keep their 
 quarters comfortably warm in winter. In a cavalry camp, they may 
 afford shelter to the saddles, an economical measure impossible in the 
 common wedge tents. TR, 
 
 * The Marquee, or wall tent, covered with a fly or stretch of can- 
 vas, supported at the ridge by the same pole, but descending at a less 
 angle, so as to allow of the free circulation of air between the two, 
 is the variety furnished to officers in the American army. When two 
 of these are united, they present an outer and an inner appartment. 
 and very satisfactory accommodations. TR. 
 
THE CRIMEAN WAR. 49 
 
 I was told, to isolate the soldiers tainted with severe 
 and infectious diseases. 
 
 The choice of ground for a tent is of great impor- 
 tance. It should be exposed to the air, and free from 
 dampness, should be upon elevated but not exposed 
 places, and should have ditches for carrying off the rains. 
 If, in winter, to keep out the cold, the tent is surrounded 
 by a wall of dry stone, it should be taken down as soon 
 as fine weather sets in. It is a great fault to bury tents 
 to a certain depth to make them warm, for they are 
 then damp, and more difficult to cleanse. In the Crimea, 
 some of the tents had their floors muddy through the 
 whole winter. 
 
 For a bed, every soldier should, under the regulations, 
 receive a bundle of straw every fifteen days ; but in a 
 campaign this can seldom be furnished. It might be 
 better to provide every man with a piece of water- 
 proof cloth, which he could use as a shawl when it 
 rained, and as a screen from the dampness of the ground 
 in the bivouac at night. The sheepskin, which was 
 given instead of the bundle of straw, became loaded 
 with humidity, and propagated vermin. The field hos- 
 pitals and regimental infirmaries had movable plank 
 floors, and a kind of mat beds. After the taking of 
 Sebastopol, some of the colonels covered the ground of 
 the tents with wood brought from the city, or with 
 a thin layer of nut tree branches, of which quantities 
 were found in the forest. 
 
 The camp of the 81st regiment was a genuine model 
 of arrangement. Its spacious tents were carefully in 
 line, upon broad paved streets bordered with fir trees, 
 which the regiment had planted. They were opened 
 during the day, and contained a folding bed, which was 
 turned up when not in use, and replaced when the 
 hour for retiring came. The utmost neatness was pre- 
 served. Nothing was wanting. Even scrapers for the 
 feet, made from broken sabres, were provided at the 
 thresholds. In their infirmary, the regiment had, from 
 its own resources, provided fifty beds; well arranged 
 ventilators renovated the air, and an excellent fireplace 
 kept the temperature at from 14 to 16 Centigrade 
 
50 THE CEIMEAN WAK. 
 
 (58 "to 60 Fahrenheit). Upon a visit, unannounced, I 
 found the colonel, M. de Clonard, presiding at a distri- 
 bution of oranges purchased for the scurvy patients ; 
 under a shed, I counted thirty or forty barrels of wine, 
 kept in reserve for days of great fatigue. Fields of 
 barley, wheat, and potatoes had been sowed for the 
 common supply, and they had even constructed, at the 
 camp, a plough of the Dombasle fashion! The regi- 
 mental band daily discoursed cheerful airs upon a 
 beautiful esplanade, planted with trees by the soldiers, 
 and adorned with a fine rustic cafe. Beyond the color- 
 line there was a row of little stone buildings ; the 
 boxes that had contained the preserved vegetables fur- 
 nished materials for the roofs, and even for stovepipes. 
 These were the kitchens of the several companies. 
 M. de Clonard had thus turned to account the thousand 
 pair of hands of his regiment, when war gave them no 
 further employment ; had banished homesickness and 
 diseases, introduced gaiety and health, and preserved 
 his effective strength almost entirely unimpaired. 
 
 The English army passed the whole of the winter of 
 1856 in well closed barracks. Every morning, the 
 boards upon which the soldiers lay, were sprinkled, with 
 fine sand, which was swept off at night ; stoves of mine- 
 ral coal were kept continually burning, which allowed of 
 the ventilators being always open. Two temporary 
 barracks served as reading-rooms, where there were 
 books, benches, a table, pens, ink, and paper. The 
 English soldiers burned the offal of their camps, while 
 the French buried it. In winter, the heap of offal 
 burned with difficulty, and with a black, stinking smoke 
 that spreads through the whole cantonment.* 
 
 The materials for building, taken from the ruins of 
 Sebastopol, having been divided equally between the 
 English and the French, were then apportioned to the 
 regiments. Without these, the army would have suf- 
 fered cruelly during the winter of 1856. It was worth 
 
 * The English reports show that their manure heaps were swept 
 up, and, on the whole, well burned. The most approved manner of 
 burning was in kilns, made somewhat after the fashion of lime 
 kilns. TR. 
 
THE CRIMEAN AVAR. 51 
 
 noticing the zeal with which the soldiers sought wood 
 under the rubbish, and loaded it upon their shoulders or 
 upon .their arabas. Planks, beams, windows, broken 
 doors, bricks, tiles, and, in short, everything was taken 
 that could be turned to use. The Russians, seeing 
 them so busy, sought to annoy them with cannon, 
 but our soldiers allowed no. such little affair to disturb 
 them. I have seen them climb upon the roofs of the 
 highest buildings, to strip off the sheets of zinc. The 
 Russians would shoot at them as at a target, and they 
 would reply by a mocking gesture well known among 
 the blackguards of Paris. 
 
 CHAPTER IV. 
 CLOTHING. 
 
 As, in the Algerine war, we introduced into our military 
 costume, modifications appropriate to the climate, so, in 
 the Crimean war, we borrowed from the native Tartars 
 certain garments which better shielded our soldiers 
 against the rigors of their winter. 
 
 The Crimeenne is a long and ample hooded cloak, 
 with a little cape, and falls to the middle of the leg. 
 The cloth is coarse, but warm, and almost . water-proof. 
 Excepting the general officers, who wore an overcoat 
 trimmed with fur, everybody wore the Crimeenne, and 
 it replaced the African burnous, and the Caban. It 
 proved very useful, and will perhaps l^e regularly 
 adopted, as it guards the soldier from diseases acquired 
 so often by passing suddenly from the high tempera- 
 ture of the guard-room to the cold outside air, in 
 mounting guard at night. The hood shields the head 
 and neck from the cold, the wind, and dampness ; pre- 
 vents the engorgement of the glands of the neck, and 
 the bronchitis, to which they are liable from the chill. 
 A preparation of India-rubber would easily render the 
 little cape which covers the shoulders water-proof. 
 This garment would replace with advantage the blan- 
 
52 THE (TRIMEAN WAR. 
 
 ket, which the soldier carries upon his knapsack, and 
 which gives him so ridiculous an appearance. . The 
 blanket, so awkwardly perched upon the knapsack, 
 when wet, is very heavy, and dries with difficulty. 
 When dry, it weighs about three pounds and a half. 
 Therefore in summer, in order not to load the shoulders 
 of the men too much, they give them only a half blan- 
 ket, the other half being kept for the approach of win- 
 ter. The storage of these half blankets is not easy, and 
 the army runs the risk of being deprived of them if 
 their supplies cannot follow them. But the crimeenne 
 has none of these inconveniences, is not so heavy, and 
 can be made still lighter, and the knapsack is relieved 
 from the difference in weight. 
 
 French taste, which sometimes blunders, has often 
 attempted to rob this garment of its essential qualities. 
 To render it more elegant, the officers have worn it 
 shorter, narrower, and without the cape or hood, 
 but it was no longer the crimeenne, and had lost its 
 peculiar advantages. The only change which appears 
 practicable, would be to place a flap behind, as in the 
 old infantry cloak, with the view of giving them at will 
 more or less breadth, without drawing in those great 
 flowing folds, which draped so nobly our brave sol- 
 diers, and gave them so majestic an appearance. The 
 crimeenne, with the tunic, would form the winter dress. 
 The tunic appears to me scanty, and should be made 
 more pretentious. A loose uniform is at the same time 
 more healthy and more military ; the costume of the 
 Zouave is an example. 
 
 The Russian officers and soldiers wore a grey habit, 
 very coarse, but warm, and shedding the rain very well. 
 It descended almost to the feet; strings to allow of 
 its being drawn in at will gather the 'folds upon the 
 back, and this gathering does not give them a very 
 graceful appearance. I would much prefer the flap 
 which we had, and which the Austrians still use. The 
 habit of the officers, and even of the generals, is like 
 that of the privates, except a little lace upon the 
 shoulder. The lace of the generals is ornamented 
 with two or three stars, according to the rank. 
 
THE CRIMEAN WAR. 53 
 
 The English have not adopted the crimeenne, but 
 have borrowed from us the tunic, and have adopted as 
 an overall, a long spencer, of brown knit stuff, protect- 
 ing effectually the chest and lumbar region, while it 
 leaves a perfect freedom of movement ; but this does 
 not compensate for the qualities of the crimeenne. Our 
 allies have supplied its place with several distinct gar- 
 ments. In place of the hood, they adopted a kind of otter- 
 skin helmet, falling over the ears and cheeks, and leaving 
 none of the face in sight but the eyes and mouth ; and 
 the cloak was replaced by a large piece of india-rubber 
 cloth, upon which they lay at night in the bivouac. Our 
 troops also wore, at the beginning of the war, a kind of 
 spencer, with sleeves made of sheepskin, the wool with- 
 in, and next to the body. This costume was not 
 graceful, but what was worse, it often was too warm, 
 and caused profuse perspiration. When the cold 
 weather was over, there was danger in leaving it off, 
 as the body had been accustomed to the moisture. 
 The wool retained the humidity, and the grease defiled 
 the outer garment, while vermin found ample shelter. 
 It was entirely given up. 
 
 A girdle of flannel is the best preventive against 
 diarrhoea, the precursor of dysentery, so fatal in 
 armies; and the old soldiers, accustomed to it in the 
 African war, took care not to leave it off. The conscripts, 
 who knew not its value, lost it, or left it in their knap- 
 sacks, in which cases the blame ought to rest upon the 
 officers and physicians ; as the measure was prescribed 
 by the minister of war, and they ought to see it carried 
 into effect. 
 
 Each English soldier had two flannel shirts. No- 
 thing is more healthy than woollen, for in winter it 
 gives a genial warmth, and promotes the functions of 
 the skin, while in summer it prevents the arrest of per- 
 spiration. The Arabs scarcely wear any but woollen 
 garments, and our marines use them in all climates. Two 
 woollen shirts are scarcely heavier than a common soldier's 
 shirt, and could take its place in the knapsack. When 
 wet through, the soldier by putting the other on might 
 escape bronchitis, which is so common, or pneumonia, 
 
54 THE CRIMEAN WAE. 
 
 which proves so often fatal. While I await the adoption 
 of the woollen shirt for our soldiers in the field, I ask 
 that it should be given to our sick, in the regular and 
 field hospitals. 
 
 The whole array was provided with long gaiters 
 made of coarse warm cloth, and reaching to the knees, 
 like those of the soldiers under the Empire. They sup- 
 ported the leg sufficiently in marching, and prevented 
 varices. The greaves of leather actually used, hardened 
 by wet and by frost, excoriated the ancles, and were 
 too cold in winter, and too warm in summer. On the 
 other hand, those of cloth, besides wearing out sooner, 
 retained the wet when it rained, and in fact acted upon 
 the leg like a sponge. The soldiers, having but a single 
 pair, could not always be dry. They also had greaves 
 of sheepskin, the wool on the inside, but they also 
 retained the moisture, and, dried before a fire, became 
 horny, rigid, and brittle. It was not an easy thing to 
 recognise the soldier, in a man wearing a spencer, sheep- 
 skin greaves, and wooden shoes. But this outfit was 
 only a temporary one, and was soon put aside. 
 
 Woollen stockings, although excellent when dry and 
 clean, often remained wet when the soldier was depriv- 
 ed of fire in the bivouac ; and many a man has had his 
 feet frozen, by sleeping with wet woollen stockings and 
 shoes. The woollen slippers contained in the wooden 
 shoes, were always dry ; and the latter were often neces- 
 sary, even in very cold weather, when the shoes, long 
 damp, had been so hardened by the cold, that they 
 could not be put on until they had been softened by 
 warmth. The common shoe, covered with a greave of 
 leather, was not sufficient in a country without roads 
 and thoroughly sodden with wet. After the sad ex- 
 perience of the winter of 1855, the English furnished their 
 troops with strong boots of yellow leather, soft, water- 
 proof, and reaching to the knees, such as those used by 
 sportsmen. They were an aggravating luxury, and half 
 boots were even preferable upon the march. 
 
 The Russians, who understood the countrv, had 
 adopted the half-boot. The firmness and closeness of 
 their leather enabled them to travel in underbrush 
 
THE CRIMEAN WAE. 55 
 
 woods without tearing, or in. the water without soaking 
 them. The leg of these half-boots was large enough 
 to admit the pantaloon legs. This kind of shoes ought 
 to be adopted for our soldiers, two pairs being furnished 
 to each man ; one for summer, with greaves of white 
 cloth, and the other, a half-boot, for winter. Remem- 
 bering with what eagerness our soldiers despoiled the 
 Russian dead of their half-boots, we may be assured 
 that this reform would be popular with them ; they know 
 what is good for themselves. 
 
 In times of peace, the knapsack contains articles for 
 the toilet, and four packages of cartridges without balls ; 
 the total weight is fifteen and a half pounds. If we 
 add the blanket, shelter tent, little wooden bowl, little 
 tin can, cross-belt, waistcoat, cartridge box, sabre, gun, 
 and bayonet, and two days' rations, we have about fifty- 
 three and a half pounds weight. In a campaign, this 
 is considerably increased, and sometimes amounts to 
 sixty-six pounds, at the time of departure. In the 
 African Avars, the soldiers carried six packages of car- 
 tridges, and provisions for eight days. Furthermore, 
 the large canteens, large bowls and kettles, must be 
 carried by a detachment of eight men. 
 
 It will be admitted, that opportunities were afforded 
 for studying these details in the Crimea, when it is re- 
 membered that cold weather was just coming on, that 
 the army had suffered greatly during the previous winter, 
 and that endeavors should be made to spare it as much 
 as possible from new exposures, by turning to account 
 past experience and the counsels of hygienic science. 
 
 Having made this research into the best means for 
 preserving the health of our army, I reduced my views 
 into the following report, addressed November 10th, 
 1855, to the Minister of War : 
 
 "To His EXCELLENCY THE MARSHAL. My duties 
 have been actively applied to the threefold question of 
 food, shelter, and clothing. 
 
 " It is true, our army has no longer to endure the 
 miseries of the trenches ; but instead of old soldiers, it 
 consists at this time of one-third if not a-half recruits ; 
 young beardless soldiers, with at most but a year of ser- 
 
56 THE CRIME AX WAK. 
 
 vice. Last winter, they each received daily an extra 
 pay of half a franc on account of siege work. As this 
 resource will be cut off, the daily allowance will suffer 
 to that extent. The army was fed last winter with 
 great care, but still the number of sick, for the first five 
 months of the cold season, was high.* It is highly 
 important to remember, that the army is now much 
 more numerous than then ; it numbers at this time over 
 140,000 men. 
 
 " 1st. Of the Shelters. To the troops encamped in the 
 forest of Baidar, I advise the building of huts buried a 
 yard and a half in the ground, with roofs of double 
 slope made of brush, covered with earth, or better 
 still, sodded. At the bottom of the room there should 
 be a fireplace opposite to the door, which should be 
 constantly fed with wood from the forest, to renew 
 the air, especially in its lower strata, to dry the 
 walls, and to render a habitation that otherwise would 
 generate typhoid fevers and scurvy, a warm and healthy 
 abode. Where wood and water abound, the soldier 
 is happy. Instead of carrying bread to the distant 
 cantonments of Baidar, we sent sacks of flour, which 
 was made into bread on the ground, thus economizing 
 
 * The following statement shows the sanitary condition of the 
 French army in the field hospitals of the ^Crimea, in the winter of 
 1854-5: 
 
 Months. Effective Strength. Sick. 
 
 October 46,000 3,200 
 
 November 55,000 5,000 
 
 December 65,000 6,000 
 
 January 75,000 9,000 
 
 February 88,000 8,000 
 
 These figures do not include the sick in the regimental infirmaries. 
 The hospitals at Constantinople presented during the same period the 
 following conditions on the 25th of each month : 
 
 Months. Sick present. Sick. 
 
 October 3,235 1,447 
 
 November 3,486 2,695 
 
 December 4,414 2,427 
 
 January 7,031 4,084 
 
 February 7,386 4,905 
 
 AUTHOR'S NOTE. 
 
THE CRIMEAN WAR. 57 
 
 the wood which came to Kamiesch from Varna. This 
 forest, in a hygienic point of view, fulfilled expectations. 
 The six weeks which three divisions of the first corps 
 spent there, could not have been more favorable to 
 the health of the troops, and especially that of the 
 recruits. 
 
 "The camps placed upon the undulating plateaux of 
 the Crimea, were also in perfect health. Unfortunately 
 not a single tree was left ; and the subterranean forest, 
 that is, the roots of trees cut down the year before, are 
 nearly exhausted. It is useless to think of building 
 huts, tents must be resorted to. Where the soil was 
 calcareous, they dug a circular pit, some two feet deep, 
 in which the tent was placed, making a gutter around 
 it, for drawing off the rain water. The materials taken 
 out served to build a wall around it, about two feet 
 high, so that the soldier, when in bed, was sheltered 
 entirely from the wind and the rain. The shelter would 
 have been complete had they added a fireplace, as in 
 the officers' tents. Where the soil was not calcareous, 
 the arrangement was sooner made, but not as good, for 
 the circular bank, in form of a parapet made around the 
 tent, was not to be compared with the wall of dry 
 stones, and the ditches had to be paved, to hinder the 
 water from filtering into the inside of the tent. It is 
 necessary to furnish the men with either a sheepskin 
 or a plank (biscuit boxes answer the purpose), to keep 
 them from the ground, and a piece of oiled cloth which 
 they could form into a mantle, by wrapping it around 
 them on rainy days. 
 
 " The shelter-tent is entirely insufficient for winter, and 
 it is so short that it does not cover the feet of the men. 
 It may be advantageously replaced by the conical tent, 
 fashioned after those of the Turks, of all tents the warm- 
 est and strongest to resist a gale of wind. Tents should 
 always be set as far apart as possible, and when the 
 weather permits, should be moved at least every four 
 days. When the sun shines the contents should be 
 exposed to the air, and the tents should themselves be 
 taken down ; but unfortunately this very essential 
 requirement is not attended to, even in the field hospi- 
 
 4 
 
58 THE CRIMEAN AVAR. 
 
 tals. It should be signalled by tap of the drum, which 
 never fails to catch the ear of the soldier. 
 
 " Board barracks would be better than tents, when the 
 joints of the roof boards are tight, but this shelter is 
 exceptional and limited entirely to the sick in the regular 
 and field hospitals, and the regimental infirmaries. 
 
 "If we help the soldier a little, he will help him- 
 self. Stones abound everywhere, and of them the four 
 walls of a house may be easily built, and we have only 
 to furnish boards for the roof, to have quickly con- 
 structed, and at small expense, a range of comfortable 
 houses, to shelter the men from drenching rains, and to 
 dry their clothes when wet. Without a fire, they will 
 wear their wet clothes more than a week, and this causes 
 many diseases, which must be expelled from the army. 
 When stone cannot be had, I would advise that the 
 walls be made of gabions, sand bags from the trenches, 
 butts, and biscuit boxes. 
 
 " For three days, there have been distributing to the 
 army the building materials found in Sebastopol. Thus 
 use is made of the town, which is being gradually wasted 
 by Russian cannon. I examined the materials with care, 
 and found a large quantity of plank, carpenter's wood, 
 and tiles, besides a great number of large iron kettles, 
 which we shall use for making soups for the hospitals. 
 These resources, apportioned discreetly, will be of great 
 benefit ; and within a month, if the fine weather should 
 continue, our camps, which are the scene of wonderful 
 activity, will be completely transformed. 
 
 " 2d. Of the, Clothing. The Crimean cloak has been 
 of great service, and it is urged that it should be fur- 
 nished to all the soldiers. They have nevertheless done 
 wrong by wearing it in summer, instead of keeping it for 
 bad weather in winter. This abuse of it renders them 
 sensitive to the cold, and exposes them to the effects of 
 vicissitudes. The flannel girdle is indispensable, in pre- 
 venting and checking the diarrhoeas that are so common, 
 and that so often run into dysenteries and other very 
 serious maladies. It should be applied in direct contact 
 with the body. Our old soldiers know its usefulness, 
 but it is not easy to make the recruits wear it. I invoke 
 
THE CRIMEAN WAR. 59 
 
 for the enforcement of this regulation, the vigilance of 
 all commanding officers and regimental physicians. 
 
 "In winter, we distribute to the troops another half- 
 blanket, to be used with that given them for summer 
 use. This blanket loads down the soldier on the inarch. 
 When it becomes damp, as it does by the first rain, 
 it can hardly be said to get thoroughly dry the whole 
 winter. I am convinced it could be profitably replaced 
 by a red woollen shirt, like that worn by the English. 
 A woollen shirt keeps up a pleasant and uniform warmth. 
 Every man should have two, which, at 75 cents each, 
 would amount to $1.50, or about the price of a blanket. 
 The men would be less loaded, and they would have 
 next to the skin^a warm, dry, and perfectly healthy 
 garment. Flannel shirts ought to come into general 
 use in our infirmaries and field hospitals, where they 
 would prevent and cure many diseases. 
 
 " The wooden shoes, which our soldiers use as a change 
 for their wet shoes, are indispensable in a country where 
 the ground is trampled up to a considerable depth ; and 
 during the last winter, the men whose shoes were frozen 
 hard for many days, could not have gone out had it not 
 been for these wooden shoes. Socks are very useful, 
 and not only supply an indispensable outfit for walking 
 in wood, but are also of precious use during the night, 
 in keeping the feet from freezing. It might be difficult 
 to supply them for the whole army, but General Bazaine 
 has assured me, that in every company there may be 
 found men who will knit them for their comrades for a 
 very moderate price. Besides, with some of those 
 ingenious machines of which models were shown at the 
 great Paris exhibition of 1855, we might be readily 
 supplied. 
 
 " 3d. Of the Food. We cannot too highly praise the 
 department of subsistence for having so happily solved 
 the difficult problem, of provisioning an army eight hun- 
 dred leagues from France ; and at no other period in 
 our military history, has the daily issue of rations been 
 made with more regularity. It did not fail a single day, 
 and the alternation of fresh bread and biscuit, of coffee, 
 wine, and brandy, and of fresh meat, preserved meat, 
 
60 THE CRIMEAN AVAK. 
 
 and lard, was conducted with facility, breaking the 
 uniformity of food, and resulting in general health. 
 
 " The supplies most needed were fresh vegetables, and 
 to this want, as well as to the cold and damp habita- 
 tions, and to sleepless nights spent in the trenches, was 
 to be ascribed the scurvy, which so seriously embar- 
 rassed the army. To supply the want of fresh vegeta- 
 bles, an abundance of preserved mixed vegetables should 
 be provided, sourkrout, potatoes, and onions ; they are 
 the best for the soldier's use. Seeds for sowing culinary 
 gardens, and especially radish seeds, should be dis- 
 tributed to the companies, and it would be desirable to 
 supply the mess with condiments, such as cloves, long 
 pepper, nutmegs, and laurel leaves. * Thyme abounds 
 here, and I advise its use in seasoning soups. Cargoes of 
 oranges and lemons, sent to the Crimea, will be necessary 
 in treating, and even in preventing, scorbutic affections. 
 Of vegetable acids the army of the East had long been 
 deprived." 
 
 I addressed a copy of this report to Marshal Pelissier, 
 and to M. Blanchot, the intendant-general of the army. 
 In a reply received from the latter, he said : " I observe 
 with pleasure, that most of theliygienic measures advised 
 by you have been executed, and we have gone even 
 farther than you require, in regard to clothing. You 
 seem to regard it as difficult to furnish the whole army 
 with socks, but I am happy to inform you, that in the 
 coming winter every soldier will have not only a pair of 
 socks, but likewise a pair of woollen stockings, and a 
 pair of long gaiters." It will be seen that my hygienic 
 views agreed entirely with the plans of the intendant- 
 general of the army. The result of these studies 
 will show that my medical and surgical suggestions 
 were also uniformly sanctioned by the Minister of War, 
 and by the Marshal commanding in the East. We can 
 never form too high an estimate of the services which 
 medical science can render to an army in the field, 
 and of the influence that it may exert upon the vicissi- 
 tudes of war. Its counsels, which are not always asked 
 or heard until suffering and death make us cruelly feel 
 their value, might have saved many a man who has 
 
THE CRIMEAN WAR. 
 
 61 
 
 lost or imperilled by imprudence, a life of which the 
 nation had need. The preservation of the soldier, 
 sent out at great expense, is the first thing of interest 
 to a people who may be conducting a foreign war, and 
 it is the first pledge of success. Diseases slay more 
 men than steel and powder, and it is often easy to pre- 
 vent them by a few simple hygienic precautions.* 
 
 * The history of the United States has hitherto afforded but slender 
 materials for statistical deductions of the sickness of armies, and of 
 losses by war. In the Mexican war, the standing army was increased 
 by ten new regiments, and a large volunteer force, which was mus- 
 tered out of the service upon the peace. The following summaries 
 show that there occurred most extraordinary percentages of losses 
 from disease, as compared with those by death or disability from 
 battle: 
 
 
 Old Esta- 
 blishment. 
 
 Ten New 
 Regim'ts. 
 
 Volun- 
 teers. 
 
 Total. 
 
 Aggregate officers and men 
 Average length of service (months). 
 Discharged by expiration of service. 
 " for disability. 
 
 15,736 
 26 
 
 1,561 
 1 782 
 
 11,186 
 15 
 12 
 
 767 
 
 73,532 
 10 
 50,573 
 
 7200 
 
 100,454 
 
 52,146 
 9749 
 
 by order of civil authority 
 " total 
 
 373 
 3716 
 
 114 
 893 
 
 2.016 
 9216 
 
 2.503 
 13825 
 
 Deaths, killed in battle, officers 
 " men 
 died of wounds, officers 
 " " " men 
 
 ' 41 
 
 422 
 22 
 807 
 
 5 
 62 
 5 
 
 71 
 
 47 
 467 
 
 100 
 
 '93 
 951 
 
 27 
 
 478 
 
 " total killed and died of 
 wounds, officers 
 
 63 
 
 10 
 
 47 
 
 120 
 
 " " " men 
 
 729 
 
 133 
 
 567 
 
 1429 
 
 " ordinary, officers 
 
 49 
 
 36 
 
 
 
 " men 
 accidental 
 
 2,574 
 139 
 
 2,055 
 30 
 
 i 6,256 
 192 
 
 10,885 
 861 
 
 " aggregate 
 
 3554 
 
 2264 
 
 7078 ' 
 
 12 896 
 
 Wounded in battle, officers 
 
 118 
 
 ' 86 
 
 129 
 
 283 
 
 men 
 
 1 685 
 
 236 
 
 1 189 
 
 8110 
 
 Resignations 
 
 87 
 
 92 
 
 827 
 
 456 
 
 Desertions 
 
 2,247 
 
 602 
 
 8,876 
 
 6,725 
 
 TE. 
 
PAKT II. 
 
 THE FIELD HOSPITAL AND MEDICAL SER- 
 VICE. 
 
 OUR army of the East had three kinds of health esta- 
 blishments, corresponding with the three grades of 
 treatment. The infirmaries and ambulances of the 
 trenches, were the first to receive the sick and wounded ; 
 those who were suffering more seriously, went to the 
 field hospitals of Divisions ; and lastly, in addition to 
 these, were the regular hospitals, placed beyond the seat 
 of war, and receiving the sick that required a long 
 and careful treatment. Having begun my inspection in 
 the Crimea, I first had to notice the infirmaries and field 
 hospitals, and my first observations were directed to the 
 Surgical Service. 
 
 CHAPTER I. 
 
 THE INFIRMARIES AND FIELD HOSPITALS. 
 
 WE were unable to establish definitively the regimental 
 infirmaries, until after the taking of Sebastopol. Until 
 then, the temporary nature of the bivouacs prevented 
 their proper arrangement, and only the parks of ar- 
 tillery, and the engineers, were settled and had their 
 infirmaries under barracks. That of the artillery park, 
 at head-quarters, embraced everything that could be 
 desired, and was ably conducted. It had around it a 
 vegetable garden, exclusively reserved for the sick, thus 
 improving and varying their regular allowances. This 
 infirmary sent but few sick to the field hospitals, or to 
 the regular hospitals. 
 
THE CRIMEAN WAE. 63 
 
 The recruits who arrived during the autumn of 1855 
 had to undergo at the same time a change of climate, a 
 new kind of life, and a rigorous winter, and it was to be 
 apprehended that they would furnish many inmates to 
 our hospitals. In view of this unhappy prospect, Mar- 
 shal Pelissier prescribed and allowed to each regiment, 
 two barracks for infirmaries. I would have wished that, 
 to prevent crowding, the important measure had also 
 been adopted of sending to Constantinople fifteen thou- 
 sand of the soldiers, who were ailing, and too accessible 
 by disease, they would have then passed a mild winter in 
 comfortable quarters ; but it was impossible to act upon 
 my suggestion. At least the reorganization under bar- 
 racks of infirmaries forty beds to a corps, served to furnish 
 the army with new shelters for twenty-four hundred sick. 
 
 The internal arrangement varied according to the 
 regiments, and while some of the barracks were chinked 
 up and very close, others were open to the day, the 
 joints between the boards admitted the rain, and although 
 the stoves were always burning the cold was intense. 
 The corps of engineers was blamed, as if it could do 
 everything. It had built the barracks, and closed the 
 joints with battens, and if the dryness had drawn the 
 wood apart, the inmates should have repaired it. In 
 some infirmaries, the sick had beds made of strong cloth 
 stretched upon w r ooden frames, or bundles of boughs 
 covered with little mats, but all the others were reduced 
 to the dirty plank of the camp bed. Most of the bar- 
 racks were whitewashed with lime within, and disinfected 
 with chlorine, but these healthful measures were some- 
 times neglected. The diet presented the same irregu- 
 larities, and while in some a small amount of funds 
 reserved from the wages for labor allowed of improving 
 and varying the food, in others, nothing was changed 
 from the ordinary regimen of the soldier, the modifica- 
 tion being only a diminution of quantity. Cleanliness 
 was everywhere wanting. Such an indifference is truly 
 incomprehensible. In each infirmary there were fifteen 
 or twenty men, limping, listless, and idle, and yet they 
 were not. employed to clean their own room ! And 
 negligence was tolerated which endangered the health of 
 
64 THE CKIMEAX WAR. 
 
 the sick ! Would it not be practicable to inspire more 
 system in the hospital service throughout, by leaving a 
 large part to the watchfulness of the colonels, who 
 might be aided by rules carefully prepared? In a 
 campaign, without doubt, we must do as we can, for 
 our means are often scanty, but still we should see 
 that what is indispensable should never be wholly 
 wanting. 
 
 In two or three infirmaries only, I found a special 
 register giving the names of the men of the corps who 
 had been wounded by the enemy since the beginning of 
 the war, and the date, the place, the severity, and the 
 result of the lesion. It is to be regretted that this ex- 
 ample was not more generally followed, and that it was 
 not prescribed as a regular requirement. The authen- 
 ticity of "these documents would render them very use- 
 ful for statistical and other reports. It would be the 
 golden book of the regiment, its titles of nobility. 
 
 The good arrangement of infirmaries is of great im- 
 portance. Being the first asylum of the sick and 
 wounded, they should send to the field hospitals of 
 divisions, or to the regular hospitals, those who require 
 a long treatment. In those badly arranged the most 
 simple ailment may become severe and degenerate into 
 a long course of disease. In a healthy climate like 
 the Crimea most of the diseases are at first light, and 
 may be checked at the outset by a little repose and 
 careful attention ; but if these hygienic precautions are 
 inadequate, the field hospitals become encumbered. To 
 check an ailment in its early stages by applying imme- 
 diately the first remedies ; such is the use of the infirm- 
 aries. As for the wounded in battle, the first dress- 
 ings are almost always applied in the ambulances of the 
 trenches. 
 
 Some eighteen hundred yards from Sebastopol, we 
 find hidden in a snug little valley, a little farm-house of 
 humble appearance, which I never could look upon 
 without respectful emotion. This place had served as 
 the ambulance of the trenches for the works of the left 
 division. Established when the siege began, at the far 
 renowned house called the Clocheton, the field hospital 
 
THE CRIMEAN WAR. 65 
 
 was forced by the enemy's fire, which was unceasing, 
 to retire into the nook where this little farm-house stood ; 
 the bearers of litters brought in the wounded con- 
 tinually, and on the night of May 1-2, 1855, four hun- 
 dred entered. As the works of the siege advanced, the 
 hospital spread itself; tents and barracks grouped round 
 the original building. A worthy chaplain from the fleet 
 resided with the physician. Religion and science united 
 to solace the pains of the wounded, to inspire a hope of 
 life, or soften the hour of death. A piece of ground 
 inclosed with walls, was used as a burial-place, where 
 each officer had a separate grave, while the soldiers 
 reposed together in great common graves ; companions 
 in arms and in dangers, death itself did not separate 
 them. After the fall of Sebastopol, this field hospital 
 became a shrine of pilgrimage, where each one sought 
 the tomb of a friend. Well might a chapel be erected 
 there in honor of so many courageous men, struck down 
 without distinction in the painful labors of the siege. 
 
 Two caves used as ambuscades by the Russians, in the 
 ravines of Carenage, and of Karabelnaia, served as field 
 hospitals for the trenches of the right. They were shel- 
 tered from balls fired in direct range, but more than 
 one bomb rolled down the ravines, exploding and mak- 
 ing victims at the doors of these sad retreats, the habi- 
 tations of suffering. Only a straggling light penetrated 
 these recesses by day, rendering surgical operations diffi- 
 cult ; and at night, only one small lamp was suspended 
 from the roofs so as not to attract the notice of the 
 enemy. In the midst of the continued and deafening 
 thunders of the cannonade, might be heard at intervals 
 the cries of the birds of prey, as, disturbed in their 
 wonted homes among the cliffs, they plunged down, and 
 bore away the rags of human flesh which were scat- 
 tered around. After the taking of the city, we went 
 with pious reverence to visit these grottoes, peopled 
 with so many gloomy memories. They showed us the 
 litter of straw, still bloody, where the surgeon had knelt 
 to extract a ball, or stop a haemorrhage. Who can 
 ever tell all of the sad and pitiful scenes which these 
 places have witnessed ! 
 
 4* 
 
66 THE CRIMEAN WAR. 
 
 In these ambulances of the trenches, gaping wounds 
 and broken limbs received their first dressings ; the 
 blood which flowed in abundance, was checked by hasty 
 appliances ; many entered only to die, after cruel agonies, 
 with heroic courage, while the remainder were trans- 
 ferred to the field hospitals of Division. 
 
 The fourteen Divisions of the Crimean army were 
 each provided with a field hospital, but they sometimes 
 simplified the labor, by giving one only to two Divisions, 
 and in this case it was always a double size. The Divi- 
 sions were arranged into three corps, to each of which 
 was attached a head physician. Each field hospital 
 had eight doctors, two majors, and six aid-majors. 
 The apothecary service was intrusted to one or two 
 military apothecaries, under one faculty.* The number 
 
 * The medical officers of the French service rank as follows in the 
 descending series, with the total number in the army of each grade. 
 
 7 Medical Inspectors. 
 
 40 Principal Physicians of the first class. 
 
 40 Principal Physicians of the second class. 
 
 330 Major Physicians of the first class. 
 
 260 Major Physicians of the second class. 
 
 400 Aides Major Physicians of the first class. 
 
 400 Aides Major Physicians of the second class. 
 
 300 Sub-aide Physicians. 
 
 The apothecaries are divided into like classes, with corresponding 
 names, but their numbers are less, viz.: 1, 5, 5, 17, 34, 50, 50, and 160 
 respectively. These numbers are alike in peace and war, and they 
 bear no corresponding relation with military grades. Physicians and 
 apothecaries from civil life are commissioned as auxiliaries for special 
 emergencies according to the wants of the service. 
 
 The functions of the several grades of medical officers are defined as 
 follows : 
 
 The Medical Inspectors, designated by the Minister of War, acting 
 collectively, constitute the Council of Health of the army. The 
 Inspector of oldest commission presides, and the Board is charged 
 with overseeing and directing all that pertains to the healing art, in 
 every branch of the health service, and with assisting the Minister of 
 "War upon all subjects to which these questions relate. They 
 maintain a correspondence with the medical officers of hospitals and 
 corps of troops, and with the chief health officers of the armies, in all 
 that concerns the science and art of healing. They advise in the 
 designation of medical officers in the various departments of the 
 sanitary service, upon information derived from the notes or reports 
 of the persons engaged in the two professions, and from the evidences 
 
THE CRIMEAN WAE. 6V 
 
 of infirmaries increased in proportion with the sick, 
 and the medical service was apportioned according to 
 their wants. When a part of the division made a move- 
 ment, it was followed by a part of the field hospital, 
 under the care of the second major physician, and two 
 aids. The stores carried upon ammunition wagons 
 or the backs of mules, were greater or less in quantity, 
 according to the probable wants, and the facilities for 
 transportation. They were often compelled to leave 
 behind the ambulance caissons, and to march with only 
 a few chairs or litters, to bring back the sick and 
 wounded. 
 
 At the opening of the war, the field hospitals of Divi- 
 sions were in tents. The barracks arrived at a later 
 period, and became more and more numerous. At the 
 
 shown by the examinations of the major physician, undertaken with 
 the view of ascertaining special aptitude for the functions of the 
 physician or the surgeon. Individually, the Inspectors are charged 
 with the duty of annual or extraordinary medical inspections, under 
 special instructions. They may be employed in the direction of the 
 medical service of the armies, and upon such special missions as the 
 Minister of War may assign. 
 
 The Principal Physicians are attached to the corps of armies in 
 campaign, and perform for their commanders, duties analogous to those 
 of the Council of Health to the Minister. They are employed as chiefs 
 of the medical service, in hospital establishments whether civil or 
 military, and in this respect their functions are determined by the 
 regulations of the hospital service. 
 
 The Major Physicians, of the first and second class, are employed as 
 practising physicians in hospitals, and as chiefs of the health service 
 in corps of troops. Their fitness for this service is previously 
 ascertained by examinations, of which the programme is arranged by 
 the Council of Health. 
 
 The Aides Major Physicians have their two classes, each divided 
 into two sections, in order to facilitate the rotation of these officers in 
 the hospitals and regiments, so as to prevent them from remaining too 
 long in any one part of the service. They have the immediate charge 
 of the sick, and their duties nearly correspond with those of surgeons 
 in the American service. 
 
 The Sub-aide Physicians, like the Assistant Surgeons of the U. S., 
 render medical assistance in the regiments and hospitals, and are 
 often placed in charge of detached bodies of troops, and small posts. 
 
 The Auxiliary Physicians, commissioned by the Minister of War, or 
 employed by the Military Intendants, are employed in the duties of 
 Aide-Major, and cannot be intrusted with those of Major Physicians, 
 except in default of such officers in the service. M. 
 
68 THE CRIMEAN WAK. 
 
 close of the year 1855, they could lodge from four 
 thousand to five thousand sick. At that time, the 
 Minister of War sent six thousand new mattresses, an 
 immense quantity of blankets, beyond even their wants, 
 and a considerable amount of stores. It was not 
 easy to take care of all this in a campaign ; every 
 moment, unforeseen difficulties arrest the best inten- 
 tions; thus during the most rigorous part of the 
 winter of 1855-6, it was impossible to wash the bed 
 clothing properly. To lessen the great consumption of 
 linen bandages, it was desirable they should be washed, 
 so as to be used again, but there was no laundry. 
 It became necessary to burn them, so as to preserve 
 the hospital from the putrid emanations which they 
 gave out. The surgeons in the field should be econo- 
 mical in the use of lint and linen compresses, the supply 
 becomes more difficult to renew in proportion as cotton 
 is more generally employed as a substitute for linen and 
 hemp. Carded cotton increased our resources, and a 
 compress of wadding maintains a pleasant and uni- 
 form heat ; it is an excellent dressing, and well to recom- 
 mend. It is true, wadding is not an absorbent, but this 
 inconvenience is obviated by placing between it and 
 the wound some tufts of lint. 
 
 The diet in the field hospitals of Divisions was essen- 
 tially the same as that of the hospitals in France, except 
 such accidental modifications as were imposed by unfore- 
 seen events. Broth was never wanting, and besides meat 
 and vegetables, the field hospitals received minced pies, 
 eggs, prunes, sweetmeats, chocolate, and wine. They 
 were even furnished with cans of preserved milk of the 
 consistence of butter, which was diluted with three 
 or four times its volume of water when used. It 
 retained its properties, even after several days' exposure 
 to the open air. The physicians sometimes distributed 
 Bordeaux wine, derived from the national gifts. These 
 field hospitals were of course moved many times during 
 the war, and the following history of the field hospital 
 of the 3d division of the 2d corps will serve as an 
 example of the rest. 
 
 On the 20th of September, this field hospital was divi- 
 
THE CRIMEAN WAE. 69 
 
 ded at Alma into two parts, of which one was established 
 on the battle-field, and the other in the train of the Divi- 
 sion. Four hundred wounded, of whom a hundred were 
 Russians, were attended to during the night, and at once 
 embarked. Fifteen amputations were performed. Ar- 
 riving under the walls of Sebastopol, the field hospital 
 was established in the ruins of a Tartar farm-house, and 
 received the first wounded of the siege. On the 6th of 
 November, the day of the battle of Inkermann, a sec- 
 tion was detached to go to the camp of the Moulin. It 
 received 400 wounded Russians, and as it was easier to 
 bring tents than remove the wounded, they remained for 
 the time on the field of battle, with a brigade of the 
 Division. They had pitched temporarily upon the place 
 of combat, without regard to choice of site, and bad 
 weather subsequently prevented them from removing it 
 elsewhere, or even from enlarging it. It was upon a 
 flat piece of ground, sheltered and hedged in on every 
 side by the French and English camps ; but it was near 
 the siege works, at the entrance of the ravine of 
 Carenage, and near that of Karabelnaia, and into it 
 the ambulances of the trenches emptied the greater 
 part of their wounded. After one of the night combats, 
 which were so murderous and so frequent during the 
 winter of 1855, one hundred and thirty great operations 
 were performed within twenty-four hours. 
 
 Meanwhile, the 3d Division of the 2d corps had sus- 
 tained many cruel losses ; its most valiant chiefs had 
 fallen at its head, and its effective strength was reduced 
 to 3,000 men. It received orders to move upon the 
 Tchernaia, and there replace the 1st division. Each 
 Division left its field hospitals and its sick in their respec- 
 tive positions, the medical staff and hospital staff being 
 only changed, by passing from one field hospital to the 
 other. 
 
 Thus, the field hospital of which we have spoken, 
 changed, so to speak, its Division but not its locality. 
 Scarcely a hundred yards separated it from the reserved 
 artillery parks of the French and English. On the 16th 
 of Nov., 1855, at about four o'clock in the afternoon, 
 three fearful explosions, echoed from the mountains in 
 
70 THE CRIMEAN WAE. 
 
 a prolonged roll, shook suddenly the soil of the Crimea, 
 and announced some terrible accident. A high column 
 of flame and smoke rising in the direction of the 
 mill of Inkermann, marked the spot where three 
 magazines of our grand park of artillery, containing 
 66, 120 pounds of powder, 600,000 cartridges, 300 loaded 
 bombs, and other appliances of war had exploded. The 
 burning materials, thrown to a great distance, set fire to 
 the English park near us, and occasioned partial explo- 
 sions and a great conflagration. We had 100 wounded 
 and 30 killed, while the English lost 24 killed and 112 
 wounded. The misfortune would have been still more 
 serious, had it not been for the vigilance of Marshal 
 Pelissier, who directed in person all the measures for 
 safety. The field hospital barracks were thrown over 
 like a pack of cards upon the poor sick, but happily 
 only a few were bruised. Five physicians in the field 
 hospital were hurt, so as to be incapable of performing 
 their duties, but nevertheless,, during the evening, all 
 the wounded had received the necessary care. The sick 
 in this field hospital which was not rebuilt, were sent to 
 another hospital. The field hospital which the 1st Divi- 
 sion left to the 3d, was in a favorable situation upon 
 the plain of Inkermann. The soil was dry, elevated, 
 gently inclined, and exposed to the constant ventilation 
 of a healthful breeze. It was an elongated quadrilateral, 
 divided into two equal parts by a paved road, the 
 entrance guarded by a sentinel, who occupied, some- 
 what after the manner of Diogenes, a hut made of two 
 butts, set one over the other, and open on the side. The 
 in closure was formed by a trench, and a pile of butts 
 filled with earth, served as a parapet. The shelters con- 
 sisted of marquee tents, single or double, and of Turkish 
 tents or else barracks. Of the twenty-four barracks seven- 
 teen were provided by the English at the beginning of the 
 campaign, but they were not so good as those the army 
 subsequently received. Low, damp, and badly venti- 
 lated, they were used only from necessity. Those applied 
 to the use of the physicians were in the midst of the 
 hospital, where after exposure during the day to mias- 
 matic affections, they remained at night still exposed to 
 
THE CRIMEAN WAR. 71 
 
 danger. We cannot too strongly insist upon the peril 
 and folly of such imprudence. These officers almost 
 always exceed their duties, and remain in the hospi- 
 tals after their service is finished, even refraining in 
 times of epidemics from taking horse exercise, and 
 thus neglecting those preventive measures which they 
 recommended to others. This excess of self-denial de- 
 prives the army of competent men, and endangers the 
 attendance of the sick. There could be nothing to pre- 
 vent the officers of health from lodging at least 200 
 yards from the hospitals, leaving in them only the medi- 
 cal guards during the night. 
 
 It should be remarked that, at times, the medical 
 staff was so much pressed that human endurance and 
 the most zealous activity could not supply the require- 
 ments. However numerous, in time of battle or of an 
 epidemic, they proved very inadequate to our wants. 
 When a half day's battle sends to a hundred physicians 
 in the field hospitals six or seven thousand wounded at 
 a time, could they even place so much as a single com- 
 press and bandage upon each wound ? Much less could 
 they perform upon each the operations indicated by 
 surgery. 
 
 To supply this want there was created, in the Crimea, 
 a class of attendants of subordinate grade, who ren- 
 dered very important services. Our system of recruit- 
 ing makes our army the vivid image of our society, and 
 assembles under the flag its manifold elements. Among 
 the convalescents Avere often found men of education, 
 bachelors of arts, and even lawyers. Some of these 
 returned to their families on sick leave, but we retained 
 those who appeared capable of assisting the physi- 
 cians. These new duties, by employing their minds, 
 hastened their recovery, and some, becoming fully 
 restored, returned to their corps, to be replaced by 
 others. These useful auxiliaries are called soldier- 
 dressers. Scrive, Thomas, and Lustreman, in the Cri- 
 mea and at Constantinople, were warm in their praises 
 of their promptitude and skill. When the typhus 
 decimated our medical corps, we feared, for a time, 
 that we should be left without physicians, and urged. 
 
72 THE CRIMEAN WAR. 
 
 the Minister of War to send some as soon as possi- 
 ble ; but he had none at his disposal, and recruiting 
 failed to supply the want. Thanks to our soldier- 
 dressers, we triumphed over this serious difficulty, but 
 without them, our medical service would have been 
 impeded. These subaltern agents evinced a zeal, apti- 
 tude, and intelligence, rarely witnessed except in the 
 French army. They were intrusted with the care of the 
 visiting pass-books, the distribution of the food and medi- 
 cines prescribed, the application of simple dressings, 
 poultices, blisters, and similar services. They prepared 
 with great skill the splints for fractures, and even applied, 
 in a faultless manner, under the direction of the chiefs 
 of the service, the dressings of amputated limbs.* 
 
 The happy results gained by the use of soldier-dress- 
 ers in the Crimea, should not be lost. It may lead 
 to the total discontinuance of assistant physicians, who 
 discharge negligently duties they think of too little 
 importance. Although they are not doctors, their 
 embroidered collars make them appear like savans, and 
 they are too often intrusted with medical responsibili- 
 
 * The following note upon these soldier-dressers is taken from a 
 report of M. Lustreman, chief physician of the University Hospital, 
 at Constantinople, made January 19, 1856 : " Following the example 
 of M. Thomas, at Gulhane, I have organized in this hospital a little 
 company of soldier- dressers, and can affirm that the services rendered 
 by these men have surpassed my expectations. They have enabled 
 me to insure aid to all the wounded at a time when the energy of 
 our medical force, whatever it may be, could not fully supply the 
 want of numbers. Not only have I met in most of these a 
 .zeal worthy of all praise, but a tact and facility in learning their 
 new duties, that I had not dared to count upon. One of these 
 men, named Verdun, whom I made their chief, has twice, by a skil- 
 fully applied compress, arrested a haemorrhage spouting from the 
 femoral artery, thus giving me time to arrive and tie the vessel. It 
 is obvious that the field of duty of these infirmary dressers should be 
 quite limited, and strictly manual, and that they should never be 
 allowed to meddle in the scientific, or even the artistic departments 
 of the treatment. They are so many hands added to those of the 
 chief of the service, and nothing more. This arrangement, extempo- 
 rized in the army of the East, was of great assistance, and appears to 
 me to have given a practical demonstration of the justice of the 
 views long since expressed by Inspector Baudens, upon the subject of 
 appointing special assistants in charge of the dressings." 
 
THE CRIMEAN WAR. 73 
 
 ties.* Taken from the school-benches to serve in the 
 armies, they lose the best time of life for study ; their 
 youthful years are spent in the camps, and when they 
 return they feel neither the strength nor the courage to 
 recommence their classical studies to acquire the doc- 
 tor's degree. When the medical faculties finished by 
 giving them a diploma, it was oftener on account of 
 former services than their scientific attainments. Thus 
 the health corps of the army has been filled with very 
 inferior assistants. 
 
 The English, besides their regimental infirmaries, pos- 
 sessed four general field hospitals : one at Inkermann, 
 two at Balaclava, and one at the Monastery of Saint 
 George.f Their medical service, directed by the skilful 
 and learned Sir John Hall, left nothing to be desired to 
 
 * The embroidered collars and sleeve-cuffs of the coat distinguish 
 the personnel of the French service. They are crimson with the 
 physicians, and light blue with the apothecaries. There is no dif- 
 ference among the several grades, excepting that the Major Physi- 
 cians of the first class add a wand. The auxiliaries bearing commis- 
 sions from the Minister of War have the uniforms of aides-major, 
 but those employed by military iutendants have no uniforms. TR. 
 
 f The hospitals were known as the General and Castle Hospitals of 
 Balaclava, the General Hospital of the Third Division, and the Gene- 
 ral Hospital at Saint George. 
 
 The first of these was of stone, and had been used as a Russian 
 military school. It consisted of two divisions, the front one contain- 
 ing large, lofty, airy wards, well isolated from the ground, and the 
 other, of smaller apartments, built against the slope of a hill, with 
 windows upon one side only. They formed two sides of a parallelo- 
 gram on the east side of the harbor, the remaining sides being ranges 
 of buildings used as stores and offices. Besides these, there were 
 twelve or thirteen Portland huts in rows on the sloping ground above 
 the harbor, which were used as wards for the sick. It proved to be 
 on the site of an old graveyard, and unhealthy. It was best suited 
 as a transit hospital, and latterly was almost entirely used for that 
 purpose. 
 
 The Castle Hospital had a very fine natural position, occupying the 
 whole of a long narrow ridge running nearly east and west, and join- 
 ing Castle Rock with Marine Heights. It was three hundred and 
 twenty feet above' the level of the sea, and cut off from the adjacent 
 higher ground by a deep ravine. The hospital consisted of a num- 
 ber of Portsmouth huts arranged side by side, with the ends facing 
 the sea. Several other huts, on a model called the "Chester hut," 
 were afterwards erected, until the whole ridge was occupied by thirty- 
 one huts, all, or nearly all, used for hospitals or stores. The faults of 
 
74 THE CRIMEAN WAR. 
 
 the end of the campaign. The attendants discharged 
 their duties with zeal, under the impulse of active and 
 intelligent female hospital assistants, at the head of 
 whom was the celebrated Miss Nightingale. Beautiful, 
 young, and wealthy, she sacrificed everything to the 
 noble mission of alleviating suffering. This delicate 
 young woman, mounted on horseback, might be seen 
 passing from one hospital to another, looking after the 
 sick of the three allied armies with a pious solicitude ; 
 and at the time of the typhus, she sent to the French 
 and Sardinian field hospitals a large present of port 
 wine and preserves of every kind. 
 
 The field hospitals of the English were extremely 
 clean, which cannot be said of ours. The difference 
 was in part due to the higher and more independent 
 position of the English military surgeons, who exercise 
 more authority in the enforcement of hygienic mea- 
 sures. Their allowance of food was better than ours. 
 Tea, roast meat, and puddings held an important place, 
 
 ventilation that early existed were afterwards remedied, and the 
 results showed an exceedingly favorable sanitary condition. 
 
 The General Hospital of the Third Division, in April, 1855, con- 
 sisted of a number of Portsmouth huts, ranged in parallel lines behind 
 the Third Division, and surrounded by the huts and tents of several 
 regiments. The space was considerably raised above the general 
 level of that part of the plateau, and had ample means of drainage. 
 The soil was a tenacious clay, hardly capable of drainage, and liable 
 to become extremely muddy at every rain. The huts were too 
 crowded, their sides were banked with earth, and the ventilation was 
 imperfect. These huts were gradually appropriated to other uses, and 
 very few sick remained at the close of the year. 
 
 The General Hospital at Saint George was formed of a square of 
 huts, similar to the Chester hut, upon a nearly level piece of ground 
 not far from the top of the great ravine, and about five hundred feet 
 above the level of the sea. The sides and roofs of the huts were 
 double, and the ridge-pieces were raised so as to insure ventilation 
 from between the sides. Each hut was fastened down at the angles 
 by timbers, there was a porch at each end, and a row of swing win- 
 dows of rough plate glass on either side. There was one large hut 
 in this hospital made of corrugated iron, which, from its conducting 
 power of heat, was found a bad material for the walls and roofs. In 
 summer it became overheated, and in winter too cold, thus exposing 
 the sick to injurious vicissitudes of temperature. The cases usually 
 sent to this hospital were convalescents and ophthalmias from regiments 
 in the front. TR. 
 
THE CRIMEAN WAE. 75 
 
 and the physicians could order beer, wines of different 
 kinds, rum, cognac, and whatever they judged proper. 
 The extras must, however, be prescribed the night 
 before. In the provision stores of these hospitals, I 
 have even seen champagne, which they used to check 
 vomiting. 
 
 The English soldier eats three meals in the hospitals, 
 the regimen of a sick person being as follows : 
 
 For breakfast, at eight o'clock, he received 192 
 grammes (0.42 pounds) of bread, 500 grammes (a quart) 
 of infusion of tea, made from four grammes (62 'grains) 
 of the leaf, and 24 grammes (three-fourths of an ounce) 
 of sugar. 
 
 Dinner, at noon, was composed of a quart of broth, 
 500 grammes (1.1 pounds) of boiled or roasted meat, 
 128 grammes (four ounces) of bread, and 500 grammes 
 (1.1 pounds) of potatoes, or other vegetables. Of beer, 
 wine, or rum, they gave a'variable quantity, according 
 to the medical prescriptions. 
 
 For supper, at six o'clock, they served the same arti- 
 cles as at breakfast, and in the same quantities. Broth 
 being given but once a day in the English hospitals, 
 they have the advantage of being able to roast a part of 
 the meat intended for the pot, a practice very advan- 
 tageous to the sick. 
 
 The Sardinian field hospitals very much resembled 
 our own, and the greater part, of. our regulations were 
 adopted. The medical service with them is placed, as 
 with us, under the authority of the military intendancy, 
 and is not organized, as with the English, upon an inde- 
 pendent basis. The learned physician-in-chief, M. Co- 
 mizetti, was well seconded by able and experienced 
 practitioners. Their field hospitals were located upon 
 the high plateaux of Kamara, upon the Cape of Bala- 
 clava, and were each composed of 42 tine barracks, 
 of average capacity for 36 beds, planked and well 
 kept. The beds were made of two wooden trestles, 
 supporting three boards, upon which were placed a 
 mattress, a pillow, a pair of sheets, and two blankets. 
 The officers had, in addition, a straw-bed, a bedside table, 
 and a mat spread down by the side of the bed. Their 
 
76 THE CRIMEAN WAR. 
 
 regimental infirmaries were arranged like ours, and 
 altogether they counted 1600 beds, a high number for 
 an army of 15,000 or 18,000 men. Never more than 
 1200 of their beds were occupied at one time. The 
 Piedmontese army was heavily afflicted with scurvy, 
 but the typhus touched them but lightly. In each sec- 
 tion a Sister of Charity presided over the distribution of 
 food and medicines, supervised the attendance of the 
 sick, and directed the attendants. In the kitchen, the 
 dispensary, the apothecary-room, the laundry, and the 
 wash-room, was always found a devoted and intelligent 
 Sister. They went daily to the market at Balaclava, to 
 purchase provisions ; and their thoughtful charity had 
 provided the field hospitals with a poultry-yard of five 
 hundred hens, which were fed from the refuse of the 
 table. The salary of these Sisters was five hundred 
 francs, and they received, besides, two daily rations of 
 camp provisions. They filled very nearly the places of 
 our infirmary-majors. The Sardinian physicians were 
 also aided by soldiers, in bleeding, and they also took 
 charge of the prescriptions and visiting pass-books. 
 To each field hospital was attached a skilful knife- 
 grinder an excellent measure, which might be imitated. 
 I visited the Russian field hospital at Belbec, which 
 was well arranged, and provided with good furniture. 
 They had double beds, with separate mattresses, sheets, 
 and blankets, thus economising space, but not without 
 danger to the sick. More than half a century ago, 
 this unhealthy practice was discontinued in France. 
 The barracks, arranged for 120 places, in four ranges of 
 beds, were well built, but not ventilated. In the finest 
 weather the doors and windows were closely shut, the 
 air was heavy and offensive, and typhus made extensive 
 ravages. My secretary, M. Benjamin Crombez, was 
 attacked by it, after remaining only a single hour in 
 this field hospital. It is remarkable that the memory of 
 past suffering should not prove more instructive, and 
 that the most terrible lessons should be lost. In 1829, 
 their army of the Danube, attacked by typhus and the 
 plague, lost 60,000 men. The number of men that 
 recrossed the Pruth did not exceed 10,000 or 15,000 
 
THE CRIMEAN WAR. 77 
 
 combatants.* Like the English and Sardinians, the 
 Russians employed women for attendants. To their 
 Sisters of Charity, who were much esteemed, were 
 added the lady attendants, for the most part com- 
 posed of officers' widows, who brought voluntarily 
 to the Crimea the tribute of their pious devotion. 
 They were employed in the laundry, the kitchen, and 
 the apothecary-room, took care of the wards, and 
 watched over the fever patients and the wounded, with 
 indefatigable zeal. Upon some of the beds we saw 
 dead soldiers, with their faces uncovered ; little wax 
 candles burned at the head of the bed; doubtless some 
 religious rite ; the adjoining sick took no notice of it. 
 
 Two Russian physicians, taken prisoners with their 
 attendants in the attack on the white works at Sebasto- 
 pol, were brought to the general's quarters. One of them, 
 wounded in the head, was taken care of in the field hos- 
 pital, while the other, who was unhurt, proved a very 
 skilful surgeon, and was placed in special charge over 
 the wounded Russians. Like the rest of his country- 
 men, he practised amputation by the circular method, 
 cut the integuments behind to facilitate the flow of pus, 
 and kept together the lips of the wound by a wick of 
 waxed lint, after the manner of Sedillot, of Strasbourg 
 a practice which gave good results. The Russian 
 physicians spoke French, and lived with our physicians ; 
 they were afterwards exchanged for some of our men. 
 Their assistants were so skilful in ligating arteries and 
 in applying dressings, that not a single secondary 
 haemorrhage occurred. 
 
 Felchers replaced our soldier-dressers in the Russian 
 army. They rank as sergeants, are a permanent class, 
 and are usually recruited from among the orphans of 
 soldiers dying in the service of the empire. The 
 government brings them up, and gives them a crude 
 education in surgery and military hygiene. In the hos- 
 pitals, we found one felcher to every seventy-five sick ; 
 the regiments are composed of four battalions of 1000 
 men each, and they have one to a battalion. The sur- 
 
 * " Campagnes des Russes dans la Turquie d'Europe, en 1828 et 
 1829," by Colonel Baron de Moltke. 
 
78 THE CRIMEAN WAR. 
 
 geons under whose orders the felchers are placed, praised 
 very highly their behavior, intelligence, and subordi- 
 nation. 
 
 As to the physicians of the Russian army, they are 
 either the orphans of officers, brought up and educated 
 at the expense of the government, or physicians taken 
 from the ranks of the profession, and graduated from 
 their great universities. The state requires of the for- 
 mer six years' active service ; the latter can resign. 
 After having served twenty-five years, they may both 
 claim a retiring pension, which equals half their pay 
 according to rank. After thirty years' service the 
 pension is the same as if in active service. Every five 
 years after the first six, they receive an increase of 
 pay. Like the officers of the army, their grades begin 
 with the rank of captain, and rise to that of general, 
 sharing with the other officers all military honors, as 
 well as dangers and privations. The Russian soldiers 
 carry in their knapsacks a compress and roll of bandage 
 precious resources, which allow of the instant and effi- 
 cient application of a first dressing upon the battle-field, 
 where articles for dressings are so often wanting. 
 
 CHAPTER II. 
 SURGICAL OPERATIONS. 
 
 MOST of the surgical operations are made in the field 
 hospitals, and consist of extraction of balls, amputations, 
 and resections. 
 
 In the Crimean campaign, the severity of the wounds 
 was not only due to bullets and shell, so terrible 
 in a siege, but also to the employment of arms of 
 precision, and the substitution of conical balls for 
 round. These improvements were known to the Rus- 
 sians, and were, before the walls of Sebastopol, as mur- 
 derous to the besiegers as to the besieged. But still, 
 thanks to the genius of our nation, to the intelligence, 
 
THE CRIMEAN WAR. 79 
 
 activity, and hardihood of our soldiers these arms 
 "essentially French," as Marshal Bugeaud says, were 
 peculiarly destructive in their hands. 
 
 The arrow had for some time suggested the idea of 
 giving to spherical projectiles an elongated form, in 
 order to diminish the resistance of the air. 
 
 It has been long attempted to substitute for the 
 smooth bore, tubes grooved in spiral form, which should 
 give to the ball a rotary motion ; this idea is the sequel 
 of the preceding one. This rotative motion can only be 
 gained by forcing the ball into the groove, and to 
 remedy the inconvenience of driving it in with the blows 
 of a mallet, the flattening method has been proposed, 
 especially by M. Delvigne. This is done by driving the 
 leaden ball smartly with the ramrod, against a little pro- 
 jection in the chamber of the gun. In the forcing by 
 dilatation afterwards proposed, the cylindro-conical balls 
 are hollowed at their base, and the gases resulting from, 
 the ignition of the powder, act upon this concave sur- 
 face by a violent expansive effort, forcing the lead into 
 the furrows of the barrel. The former system has been 
 in use in France more than twenty years, but the second 
 only a few, and has likewise been adopted in England. 
 Experience having shown, that after passing a certain 
 distance, the longer axis of the projectile tends to incline 
 from the line of flight, this has been remedied by the 
 ingenious and simple use of circular grooves, made 
 around the ball near its base, which perform the office 
 of quills, or plumes, which, in the flight of an arrow, 
 are so important.* 
 
 Arms of precision have received new improvements, 
 known by the names of their inventors, Poncharra, 
 Minie, and Thouvenin, and to the latter belongs the honor, 
 of having produced the carbine called d tige, so much 
 esteemed among the battalions of foot chasseurs. The 
 tige is a little cylinder of steel, screwed into the middle 
 
 * The Russian rifle was little inferior to the minie in range or force, 
 while its conical deep cupped ball was heavier. The severity of the 
 primary action on the part struck, and the aggravated evils which 
 followed their wounds, combined to exercise a most prejudicial influ- 
 ence on the surgery of the war. TR. 
 
80 THE CRIMEAN WAR. 
 
 of the breech, and of less diameter than the barrel. The 
 powder lies around the tige, and the expansion of the 
 ball is effected by flattening it against the top.* The 
 range of these balls is more than 1,400 yards, but beyond 
 800 yards it is not exact. Experiments have shown, that 
 a round ball, at a range of 600 yards, will not pass through 
 two-inch fir planks, while a cylindro-conical ball, thrown 
 from this carbine, will easily perforate eight such planks. 
 
 Wounds present different characters, according to the 
 velocity and shape of the projectile. The hole where a 
 spherical ball has entered, is round, depressed, and smaller 
 than that where it comes out. The path which it traces 
 through the limb, is conical, and goes on enlarging, and 
 if it meets the sheath of a tendon, or a bony surface, it 
 is often much deflected from its course, so that it is not 
 rare to find the place of outlet, which is more irregular 
 and bruised, with the lips raised and jutting not directly 
 opposite the entrance.f 
 
 The place of entrance of a cylindro-conical ball is 
 oval, and sometimes linear, as if made with the point of 
 
 * This arm was furnished to the Chasseurs de Vincennes. The ball 
 weighed 1 ounce 5 drachms and 16 grains. Tr. 
 
 f It is not always easy to distinguish the gunshot wound of en- 
 trance from that of exit. According to Dr. Macleod the former is 
 more regular, and less discolored than the latter. The inversion of the 
 lips of the wound in one case, and their eversion in the other, is not 
 always clearly marked, and if the velocity of the ball has been great, 
 and no bone has been struck, there is very little difference in either 
 the size or discoloration of the wounds. The enlargement of the 
 wound, as the projectile enters, is common when the velocity is nearly 
 spent, or when a bone or aponeurosis has checked the force, and 
 changed the direction of the ball. This is especially true of the coni- 
 cal projectiles. Muscular wounds from gunshot, almost always heal 
 by suppuration and granulation, the exceptions being extremely rare. 
 The opening of a wound may be apparently smaller than the projec- 
 tile. At Scutari, a piece of shell weighing nearly three pounds, was 
 extracted from the hip of a man wounded at Alma, which had been 
 overlooked two months, and entered by a small aperture. Larrey 
 gives a case of a ball weighing five pounds, which was extracted 
 from the thigh of a soldier. It had not been detected by the surgeon 
 making the dressing, and incommoded only from the weight. Frag- 
 ments of nine and twelve pounds weight have been reported as buried 
 in the thigh with no suspicion for a time of their presence. The elas- 
 ticity of the soft parts enables us to explain the smallness of the 
 entrance wounds in these cases. Tr. 
 
THE CRIMEAN WAR. 81 
 
 a sabre; the ball which General Thomas received in 
 the groin at Alma made a wound exactly like that of a 
 sword or bayonet. Their line of passage does not ap- 
 pear to take the form of an elongated cone, which is 
 probably owing to its twisting motion, and deviates 
 much less from its course, than the round ball. Neither 
 the sheaths of muscles, nor tendons, nor bones resist 
 the penetrating points of conical projectiles, the lead is 
 perhaps battered or turned, so as to present its greatest 
 surface, which is about a third of an inch in area. In 
 this case the outlet, which does not usually differ from 
 the entrance wound, except that it is larger, and with 
 its lips more bruised and projecting, presents unusual 
 dimensions with rags of flesh very irregularly torn. 
 
 If a round ball meets at an inclined angle, a curved 
 bone, as the cranium or a rib, or a long round bone as 
 the femur, it often passes around, instead of breaking 
 it, but a conical shot almost always breaks It into splin- 
 ters. We therefore observed in the Crimea a propor- 
 tionally larger number of fractures from balls than in 
 our African wars. It should nevertheless be remem- 
 bered, that a round ball scarcely weighs an ounce, while 
 the others are nearly twice as heavy. When a conical 
 ball strikes, it may perhaps be inclined, so as to enter 
 crosswise. In such cases, which are rare, the entrance 
 and path are very large ; we usually find the lead at no 
 great depth. Its extraction is easy. 
 
 In 1830, when I joined the army sent to Algeria, it 
 was the rule and practice to lay open with a bistoury 
 the holes of entrance and exit made by balls. The 
 most approved teachers advised large incisions of the 
 skin and subjacent tissues, to favor granulations in the 
 injured parts, and prevent their choking up, thus avoid- 
 ing the evils which ensue from such cases, as for exam- 
 ple gangrene. This bloody operation, called unloosen- 
 ing, was much more painful than the wound made by 
 the ball, but no one questioned its efficacy. It had be- 
 come, so to speak, a medical dogma. In the early 
 conflicts in Africa, at Sidi-Ferruck and Staoueli, I 
 saw with astonishment a large number of wounds, 
 which, for want of time, had not been enlarged with a 
 
 5 
 
82 THE CRIMEAN WAK. 
 
 cutting instrument, healed without mishap, and even 
 more quickly than those through which the bistoury 
 had passed. In the Crimea, I observed with satisfaction, 
 that the unloosening of wounds had not a single partisan. 
 Although it still finds academic partisans, it has been 
 styled a useless and barbarous practice. In these terms 
 I spoke of it in a work published in 1836,* and nothing 
 has occurred to lead me to change my opinion. I have 
 even proved, that free openings do not prevent acci- 
 dents, when the wound contains foreign bodies, as 
 wadding, pieces of clothing, or lint, drawn in by the 
 projectile, or when the ball itself, whether entire or 
 broken, has come in contact with bone, breaking it into 
 splinters. 
 
 Sometimes these splinters of bone remain in the 
 flesh, irritating it like thorns, in which case the best 
 remedy is, to extract these foreign bodies. Should 
 we trust to the eliminating agency of suppuration, 
 as is still advised, in getting rid of these splinters ? 
 Failures in this are so common, that it is evidently 
 preferable to take them all out as soon as possible, 
 whether adherent or not, with the view of simplifying 
 the wound. A simple wound heals regularly, without in- 
 ducing a variety of painful complications, which every 
 moment endanger the lives of the wounded. Lisfranc 
 said, we should wage a partisan warfare with these 
 complications, that is that we should combat them bis- 
 toury in hand. It would be better still, to prevent 
 them, by removing the splinters at once. Their reten- 
 tion leads to endless suppurations, with constant suf- 
 fering, which is increased whenever a piece of bone 
 works out, thus wasting away the vital forces, causing 
 marasmus, reabsorption of pus, colliquative diarrhoea, 
 and death. 
 
 On the contrary, when the wound contains not a 
 bony splinter, but a round smooth ball, of which the 
 surgeon cannot readily find the track, it is wiser not 
 to multiply his searches, and to spare sufferings to his 
 
 * Olinique des Plaies tfArmes dfeu, 1 vol. 8vo. Paris. 1836. J. B. 
 Bailliere. 
 
THE CRIMEAN WAK. 83 
 
 patient, as its presence is less irritating than the angles 
 of a splinter, and furthermore, in the course of healing, 
 the ball will work towards the surface, and will be 
 more easy to reach. 
 
 The extraction of balls is often a difficult operation, 
 because they traverse tissues of various density, and 
 therefore of different degrees of resistance, which cause 
 them to deviate from a direct line. A ball striking a rib 
 obliquely, does not always penetrate the chest, but passes 
 along the curve of the bone, upon which it is held by 
 the elasticity of the skin, neutralising its centrifugal 
 force. When a ball penetrates the tissues, it tears 
 them by pushing forward, like a blunt point ; and at the 
 end of its course, it often meets in the skin a resistance 
 which it cannot overcome, and it remains just beneath 
 the surface. In this case, by taking it between the 
 thumb and fore finger of the left hand, and cutting the 
 skin over it, with a little gentle pressure down and 
 behind, it will roll out. If it resists, it is needless to 
 enlarge the incision, and we must ascertain what 
 holds it. The obstacle may be due to a thin and trans- 
 parent layer of cellular tissue, with which the projectile 
 has enveloped itself in its thrusting course at the end of 
 its flight. It forms a little sac, which only needs to be 
 opened to allow the ball to escape. 
 
 I can demonstrate this fact conclusively, and have 
 called this the primitive sac, to distinguish it from 
 the definitive sac, organized around balls when left 
 to themselves, and allowed to remain, thus becoming 
 naturalised in the tissues.* These singular guests may 
 ever after remain quite harmlessly in their sacs, or at 
 times, the pressure caused by the weight of the lead 
 may irritate and soften the sac ; the bull opens for it- 
 self a path step by step, the void behind closes 
 gradually by granulation, a process of cicatrization 
 
 * This observation has not been made by other writers upon 
 Military Surgery, and the cellular envelope, although occasionally 
 found, is rare. 
 
 Muscles wounded by gun-shot are apt to shorten during the cure, 
 unless care is taken to prevent it. The result is always unfortunate. 
 TR. 
 
84 THE CRIMEAN WAR. 
 
 which presses it forward upon its journey. The pro- 
 gress is slow and almost imperceptible, so that only 
 in the course of years will a bail which was in the 
 groin, descend to the heel. 
 
 Wounds made by fire-arms, being essentially contus- 
 ed, cause a strong inflammatory reaction, which, by a 
 variety of accidents, may lead to gangrene, and demand 
 oftentimes an energetic treatment. In these wounds, 
 the best therapeutic agent I have found to be cold, pro- 
 duced by ice. The illustrious Percy used cold water, 
 in treating gunshot wounds. I have followed his 
 example with results so favorable, that I was led to 
 study carefully the action of refrigerants. When the 
 inflammation exceeds certain limits, cold water is not 
 sufficient, and we must then resort to ice, either alone, 
 or mixed with sea-salt, to increase the intensity of the 
 cold, which should be regulated according to the vio- 
 lence of the traumatic inflammation. Ice should never 
 be in direct contact with the surface. We begin 
 by placing upon the inflamed part a simple compress 
 of linen, soaked from time to time in cold water, and 
 then put pieces of ice in the folds. If the refrigera- 
 tion does not procure more than a moderate relief with- 
 out destroying the deep and painful sense of heat, or, as 
 the patients express it, if the ice seem to burn, the 
 cold should be increased, by the addition of salt. No- 
 thing is easier than to avoid the abuse of refrigerants, 
 and the accidents resulting from their use. The con- 
 tact of cold upon an inflamed part causes an agree- 
 able and decided sense of relief, and this is an infallible 
 guide, which should be carefully observed. The refri- 
 gerants should be continued, so long as they produce 
 this sensation, and should be gradually withdrawn 
 when they cause a disagreeable sensation of cold damp- 
 ness. This does not occur until the fire of inflamma- 
 tion is extinct ; and if continued, the ice would cause 
 the most severe pain, from the abstraction of the nor- 
 mal amount of caloric. The patient is therefore the 
 best judge to consult. Before applying ice, the physi- 
 cian should ascertain the general condition of the 
 patient. If the constitution has been enfeebled by 
 
THE CRIMEAN WAE. 85 
 
 fatigues and privations, if he fears that the broken vital 
 energies will fail, and that a salutary reaction Avill not 
 ensue, he will give stimulant drinks instead of refrige- 
 rants, and place over the wound a thick layer of lint, 
 to retain the heat. The use of ice, in such a case, would 
 be a monstrous absurdity. 
 
 The opponents of the refrigerating treatment appre- 
 hend gangrene, or at least the reaction and check of 
 perspirations. It is difficult to understand d priori how 
 a limb can without danger be covered with ice several 
 days at a time, when a single icicle held a few moments 
 in the fingers, leads to a beginning of congelation, 
 keen pain, and a feeling of insupportable constriction. 
 It is because in the one case the ice acts upon an inflamed 
 surface, and in the others upon a healthy part. Inflam- 
 mation imparts to the region of which it is the seat, a 
 remarkable power of resisting cold. Hunter, after 
 having frozen the ear of a rabbit, by immersing it in 
 a dish of pounded ice, could not freeze it again, when 
 inflammation had set in. This was a great discovery. 
 The organic, normal, or physiological heat, existing in 
 health, should be distinguished from the abnormal heat 
 of inflammation. The former is indispensable in regu- 
 lating the animal functions, and cannot be withdrawn 
 without peril ; we know that a simple chill may be 
 dangerous. The caloric produced from inflammation, 
 if it does not exceed a certain degree necessary for 
 healthy action, ought not to be lessened. It is when it 
 appears in excess that it is full of danger, and excites a 
 host of disastrous results. It is better in these cases to 
 resort to refrigerant applications, than to local or general 
 bleeding. Cold is a sedative, calming the pain, and 
 preventing the determination of blood to the affected 
 part, while bleeding, by suction, and the painful prick- 
 ing, attracts the blood, and congests the wound. Cold 
 acts upon the patient as a tonic, while bleeding weakens ; 
 cold is a most energetic agent for arresting inflamma- 
 tion and preventing it from spreading, while bleeding is 
 often powerless ; and cold tends to localize the phlegma- 
 sia, imprison it in the wound, and prevents its sympa- 
 thetic transmission to the great viscera, especially the 
 
86 THE CRIMEAN WAR. 
 
 heart, the reaction on which excites fever. The inflam- 
 mation has sometimes been so intense, that I have had 
 to apply for several days, to complicated wounds that 
 were choked up, a freezing mixture of 14 Centigrade 
 ( 4 Fahrenheit). 
 
 During the insurrection of 1848, I kept ice during 
 forty days upon the leg of a wounded officer. A 
 quarter of the substance of the tibia, ground to pieces 
 by the projectile, had been extracted to simplify the 
 wound ; an amputation was avoided, and fifteen months 
 after, this officer laid aside his crutches, and could walk 
 freely. This was one of the finest triumphs of conserva- 
 tive surgery. 
 
 Treatment by ice may not only be applied to wounds 
 received in war, but also to lesions resulting from acci- 
 dents, as dislocations, contusions, and fractures, and 
 especially to strangulated hernia, which it relieves with- 
 out an operation, with great success.* It is proper to 
 limit its use to lesions caused by violence, because the 
 inflammatory action is then decided, simple, and free 
 from predisposing individual influences. Used on a 
 multitude of patients at Val-de-Grace, where I directed 
 the surgical service during ten years, the treatment by 
 ice has been tested; military surgery has adopted it 
 and finds it answer. 
 
 When a splinter of a shell strikes by one of its angles, 
 it makes a large cut, very clean in appearance, but one 
 which cannot heal until after the adjacent parts, that 
 have been killed by the violence of the shock, are elimi- 
 nated. These wounds had in the Crimea a remarkable 
 tendency to the characteristics of hospital gangrene. 
 
 "When cannon balls nearly spent are rolling upon the 
 ground, they must be carefully avoided, even when the 
 motion is very slow. A grenadier of the guard, lying 
 upon his side on the ground, was suddenly killed by a 
 ball which broke his spinal column. This ball had so 
 little force left, that by a singular coincidence it lodged 
 in the hood of the soldier, and was found there. 
 
 * On the 29th of May, 1854, 1 read before the Academy of Sciences 
 a memoir upon the value of ice in the reduction of strangulated 
 hernias. 
 
THE CRIMEAN WAR. 87 
 
 Bombs always produce very serious wounds, and make 
 in the chest and abdomen such terrible breaches, that 
 art is powerless for relief. When a ball, or a piece of a 
 bomb, has taken off a limb, the wounded man very 
 often evinces the effects of a general shock, and, as soon 
 as the stupor begins to pass off, the hand of the surgeon 
 is necessary, to trim the wound. If left to the un- 
 aided efforts of nature, the violently torn tatters, mixed 
 with tendinous portions of unequal length, and bruised 
 pieces of bone, almost invariably tend to a mortal gan- 
 grene. The rupture of arteries may cause haemorrhages 
 
 that prove quickly fatal. General R died in a 
 
 few moments from a haemorrhage caused by a musket 
 ball, which divided the popliteal artery. His life might 
 have been saved by compressing the vessel until a sur- 
 geon arrived. There are some cases in which the vio- 
 lence of the blow itself brings with it an effectual 
 remedy ; the tearing off of a limb leads to a retrac- 
 tion of the arterial tissues, and the opening of the tube 
 closes upon itself, thus opposing a barrier to the expul- 
 sion of the blood. 
 
 Sometimes the effects of bombs are horribly fantastic. 
 General Pecqueux de Lavarande was literally cut in two 
 by a bomb which exploded between his legs, the head 
 remaining on one side with an arm and a leg. Other 
 effects more singular, but not as horrible, were many 
 times observed during the siege of Sebastopol. We 
 know that bombs, in traversing their parabolic curve, 
 give out a peculiar hissing sound, which enables one to 
 dodge them, and by dropping flat upon the ground, to 
 avoid the explosion. It has so happened, that at the 
 instant when the soldiers are stooping to drop on the 
 ground, the bomb in its path followed the curvature of 
 the spinal column, and crushed it the whole length, caus- 
 ing instant death. At another time, when the shock 
 was less violent, the spinal column resisted, the skin from 
 its elasticity was not broken, and the subcutaneous 
 bloodvessels were alone torn. In this instance, the 
 blood accumulated near the os sacrum, at its lowest part, 
 and the sac was punctured by the subcutaneous method 
 of M. G. Guerin, to avoid danger from the introduction 
 
88 THE CRIMEAN WAR. 
 
 of air into the closed cavities. A black gr unions blood 
 escaped, and the patient recovered. 
 
 At another time, we found on the battle-field a dead 
 body which showed no external marks of wound, and 
 whose death they ascribed to the wind of the ball. 
 This is now acknowledged to be an error, for we have 
 seen a ball take off a knapsack from a soldier's shoulders, 
 his cap, and even his pipe, without leaving any effect of 
 its passage ; and, again, the parts under the skin have 
 often been found bruised to pulp, and the bones broken 
 to atoms. The wind of a ball could not do such 
 damages, but it was the ball itself, especially in some 
 of its last rebounds, towards the end of its flight. 
 The elasticity of the skin explains why it can remain 
 nnkroken, although a ball may come in contact with 
 the body. 
 
 At the battle of the Alma, the splinter of a shell struck 
 General Canrobert on the breast, bruising the pectoral 
 muscle, while it scarcely broke the skin. General Bos- 
 quet received on the after part of his chest just below 
 the shoulder blade, a splinter of a shell. The skin became 
 ecchymosed, but was not broken, although three ribs 
 were fractured on their inner side, in a curved form ; they 
 were replaced with difficulty, and left a very apparent 
 depression, which was quite perceptible to the touch. 
 This fracture, probably complicated with a rupture of the 
 lung, admitted into the chest an effusion of blood which 
 crowded the pulmonary tissue against the spinal column, 
 and hindered the introduction of air into the bronchial 
 cells. The general was very skilfully treated by M. 
 Secourgeon, chief physician of the 3d Corps, and by 
 Dr. Cornbarieu, who had him carried from the trenches 
 to the Lancaster batteries, where he was bled. M. Com- 
 barieu then took him to Pan, to the house of his aged 
 mother. 
 
 The department of our science which treats of ampu- 
 tation is of first importance. When ought w r e to prac- 
 tise it, and when avoid it ? Upon these t\vo questions 
 the Crimean war has shed a flood of precious light. 
 During the wars of the empire, no matter in what part 
 of the leg the wound w r as situated, were it even the 
 
THE CRIMEAN WAE. 89 
 
 heel, they practised amputation at about four or five 
 fingers' breadth below the knee. The stump, disguised 
 by a long pantaloon, was fastened to a wooden leg of the 
 simplest kind and not liable to get out of order. 
 
 There was here an advantage which many surgeons do 
 not like to give up. During the last twenty years however 
 distinguished practitioners have laid down the precept, 
 that the amputation should be made as low as possible, 
 and always just above the ancles, that is, the ankle bones. 
 At this point the leg is smaller than above, the wounded 
 surface is less, there is less inflammation, ulterior acci- 
 dents are reduced, and cases of healing are numerous. 
 This rule involves the general principle, that we should 
 always amputate as far from the trunk as possible. The 
 office of the surgeon is, above all, to save the life of the 
 wounded, and his conscience bids him prefer the safest 
 way. Other reasons operate in favor of the sub-malleolar 
 amputation. The important articulation of the knee is 
 preserved, and by the aid of an artificial limb it is easy 
 to conceal the mutilation. This consideration is not one 
 of indifference to a young man who has his way to make, 
 nor even to a superior officer, commanding on horseback. 
 A lieutenant-colonel upon whom I performed the opera- 
 tion was able to continue in the service, and is now a 
 colonel. It is true that the apparatus furnished to the 
 soldier who has suffered an amputation above the ancle 
 bones costs two or three times as much as the classic 
 peg, but the State will never be run in debt by so small 
 an affair. I demonstrated in 1839,* that we may take 
 off the whole foot without having recourse to amputation 
 of the leg, taking a flap from the soft parts to cover the 
 wound on the instep, or better still, on the heel.f In the 
 Litter case the amputated person walked well without the 
 aid of any apparatus, by bearing the weight of the body 
 upon a short wooden leg fixed to a bootee with a high 
 heel. I have met some amputations performed in the 
 middle of the calf of the leg, and I have blamed them 
 
 * New method of amputations, first memoir, Tibio-Tarsal Amputa- 
 tion. Paris, Germer-Bailliere, 1842. 
 
 f Nouveau precede de I'amputation tibio-tarsienne, with a Plate. 
 Gazette des Hopitaux, Feb. 1850. 
 
90 THE CRIMEAN WAR. 
 
 exceedingly. Soldiers should never be subjected to such 
 experiments, and the army council of health are quite 
 right in maintaining the wise and traditional rule, which 
 prohibits military surgeons from employing modes of 
 treatment and operations not, sanctioned by experience. 
 An amputation in the middle of the calf has serious in- 
 conveniences. The volume of the leg, much greater at 
 this place, gives a large wound and increases the chances 
 of mortality. The stump is left too long, so that a 
 wooden leg cannot be readily applied. 
 
 A truth, which numerous tacts observed in the Crimea 
 now allow me to affirm, is that when it is not possible 
 to amputate the leg, the disarticulation of the knee is 
 to be preferred to the amputation of the thigh. The 
 former succeeds oftener than the latter. The disarticu- 
 lation of the knee should be done immediately ; and it is 
 a point acquired henceforth for science, that we hazard 
 success by delay. In fact the volume of bone, even in a 
 state of health, is not in harmony with that of the soft 
 parts, and the disproportion will become greater as the 
 patient loses flesh by prolonged suffering and profuse 
 suppuration. This amputation preserves to the patient 
 the free use of the hip-joint, and gives a solid point of 
 attachment for an artificial limb. 
 
 For half a century surgeons have discussed the 
 question, whether it is better to perform an amputation 
 as soon as possible, or to wait some days, if not weeks. 
 At the present day the first of these two opinions has 
 decidedly the preference, and the results of observations 
 in the East militate in its favor. We shall observe, for 
 example, in a review of immediate and delayed amputa- 
 tions practised in the hospital at Gulhane,* that three 
 immediate tibio-femoral amputations succeeded, and 
 that five consecutive amputations performed after some 
 delay at Constantinople, failed. 
 
 Before the Crimean war it was a generally received 
 rule, that a femoral fracture by fire-arms rendered an 
 amputation necessary. There is reason to believe that, 
 thanks to my new apparatus for fractures, this rule may 
 
 * 3ee Appendix. 
 
THE CRIMEAN WAR. 91 
 
 be considered too absolute.* These appliances have the 
 advantage of keeping the limb in its normal position with- 
 out compressing or wasting it, and of keeping the fracture 
 in perfect rest by permanent extension, counter-exten- 
 sion, and adjustment, worked by the aid of elastic straps 
 replacing perfectly the contractile action of the fingers. 
 Inflammation is sooner allayed, the thigh almost com- 
 pletely naked is exposed to the salutary influences of 
 the air and light, and the surgeon can constantly follow 
 with the eye the progress of the case, dispense with 
 assistants, and make applications and dressings to the 
 wounds very easily. In the Crimea and at Constanti- 
 nople, in the experience of our most skilful physicians, 
 Lustreman, Thomas, Salleron, Maupin, and Manny, many 
 legs and thighs were saved by using this apparatus for 
 
 * This apparatus is thus described in the Comtes Rendus of the 
 Academy, 1 853, first part, p. 854. 
 
 It consists, first, of a kind of box open on the top ; second, of an 
 inclined plane; third, of three cushions of hair; and fourth, of two 
 graduated compresses with elastic strings for fastening. 
 
 The open box for lodging the affected limb should be about thirty 
 inches long, eight wide at the place for the thigh, and only seven 
 where the leg and foot are placed. It is made of four pieces ; the 
 bottom, two sides, and a foot board, the latter moving upon hinges 
 and capable of being fastened by a hook. The bed piece is horizontal, 
 the sides about nine inches high and pierced with three rows of holes 
 placed one above the other about as large as to admit the finger. The 
 foot-board is of the same height or a little higher. The inclined plane 
 is designed to receive the broken limb, and the cushions of hair to 
 form a bed on the bottom of the box. The two graduated compresses 
 should be of the length and thickness of the fore-finger, and are to 
 be placed across the limbs above the fractured parts to assist the 
 action of the adhesive straps. The limb is placed upon cushions, the 
 parts adjusted and held in position by elastic straps, fastened by adhe- 
 sive straps operating by extension and counter extension in such a 
 manner as to supply a pressure, much like that of the fingers of the 
 surgeon. The numerates holes afford a choice of selection for points 
 of attachment of the elastic straps, and enable the surgeon to apply 
 his tension as he may have occasion. The foot-board has also holes 
 for a like purpose. The heel is supported by a little pad under the 
 tendon of Achilles, and in a later description the sides of the box were 
 fastened by hinges to the bottom so as to adapt their inclination to a 
 given case. 
 
 Descriptions of the apparatus and of cases treated under it, were 
 read by the author before the Academy of Science at Paris, June 30, 
 1851, May 15, 1853, Aug. 7, 1854, and Jan. 15, 1855. Ta. 
 
92 THE CRIMEAN WAR. 
 
 fractures. It is first necessary to extract all splinters of 
 bone ; their presence in the flesh leads to an intermina- 
 ble suppuration and almost always to death. After 
 these are extracted, the wound is given such an inclina- 
 tion as to allow the ready escape of pus, and nature is 
 left to work the cure without hindrance. Many cures 
 have been obtained without leaving noticeable deformi- 
 ties. The unsightly callosity, or place of joining of a 
 badly united fracture, with deformity of limbs, has been 
 successfully reduced by the use of this apparatus, even 
 after several months.* The shortening of the femur 
 corresponding with its loss of bone may generally be dis- 
 guised by using a high-heeled boot. 
 
 Amputations of the thigh are the more serious on 
 account of their proximity to the trunk, it is therefore 
 very important to avoid them. Although disarticulation 
 at the knee ought to be done immediately, that of the 
 hip does not succeed so well, but on the contrary, 
 should be delayed some days after the injury is receiv- 
 ed. This remark is very important, for it allows of 
 attempts being made to save the limb. The upper 
 extremity of the femur is chiefly formed of spongy tis- 
 sue, more easily traversed than solid bone, and the 
 ball finding less resistance, does less injury. We may 
 then apply the apparatus, for we run no risks, as, if it 
 fails, we may still resort to amputation. 
 
 In the upper extremities, we may very often avoid 
 amputations, and preserve the limbs, not only by taking 
 away the splinters, but by resection, a method of ope- 
 rating, which gives most admirable results. These 
 resections I had often practised on the battle-field, 
 or advised and explained in books and lectures. It 
 was with much satisfaction that I saw the surgeons 
 in the Crimea more cautious as to amputation, and 
 performing resections as often as possible, instead of 
 taking oft' the entire arm. Resections apply to the 
 salient angles of fractures, happening in the body of 
 long bones, or at their articular extremities. The perios- 
 teum, or membrane covering the bone, must be prc- 
 
 * See Appendix. 
 
THE CRIMEAN WAR. 93 
 
 served with the greatest care ; as M. Flourens has 
 shown, that it is this membrane that secretes bony 
 tissues, and that it will reproduce them, if left in place. 
 The grand triumph of resection is when it is practised 
 upon the head of the humerus. An officer of high rank, 
 M. Bertier, who submitted to this operation, is now colonel 
 of the 86th regiment, and uses very well the arm that 
 was operated upon, although it is a little shorter than 
 the other. A sergeant-major, M. Plombin, upon whom, 
 at the age of twenty-three, I performed the same opera- 
 tion in Algeria, is now colonel of the 1st regiment.* 
 
 Thanks to resection, an isolated fracture of the 
 radius, or of the ulna, does not necessarily require the 
 loss of the limb, and I have, with success, taken out 
 almost the whole of one of these bones. Even where 
 both bones are fractured, they are not always, unless 
 with grave complications, a subject of amputation. 
 We may say as much of fractures of the body of 
 the humerus. Resections are useful, not only for saving 
 the limb, but for securing a more ready cure. We 
 should observe as well as possible, our rules of conser- 
 vative surgery. Especially in fractures of the hand, 
 it is important that we should be imbued with this 
 precept, and that we should apply it in all its vigor. 
 We should never forget that the misshapen stump of a 
 finger may still be very useful. Eight years ago, in 
 June, 1848, they brought in a captain, to have his right 
 wrist amputated, in consequence of a gunshot wound. 
 I succeeded not only in avoiding amputation, but in 
 saving the little finger, half of the index finger, and the 
 thumb. This officer can still hold a sabre, and has con- 
 
 * The author, in a paper read before the Academy of Sciences, vol. 
 xxvi., 1855, performed fourteen operations for resection of the head of 
 the humerus, all of which, but one, had succeeded. When the head 
 of this bone has been broken by a ball, he regards resection as the 
 rule to be followed, and amputation the exception. By his method, 
 the limb did not necessarily remain suspended from the shoulder, as 
 sometimes happens, but he obtained in most cases a good joint, 
 where the glenoid cavity of the scapula was intact. The end of the 
 amputated bone should be brought in contact with this cavity, and 
 all muscular fibres should be carefully removed, only a simple incision 
 was made and no flap. TR. 
 
94 THE CRIMEAN WAR. 
 
 tinned to serve. I met him in the Crimea, the colonel 
 of a regiment, and to bring himself to my recollection, 
 he showed me his hand. 
 
 We cannot so often practise resection upon the lower 
 extremities, especially in time of war, when the 
 wounded are liable to long and painful removals. Being 
 the means of support, the lower limbs must be more solid 
 than the arms. The very voluminous muscles render 
 less accessible to the hand of the surgeon, the splinters 
 of the femur than those of the humerus. A comminuted 
 fracture of the two bones of the leg, is often a cause of 
 amputation ; but if the wounded can endure the perils 
 of transportation to a well furnished establishment, we 
 should try to save it. When the tibia, or the fibula, is 
 only broken, the resection, or even the simple extrac- 
 tion of the splinters, often suffices to lead to a cure. 
 Perforations of the foot,by bullets, are less grave than were 
 formerly supposed, and by the extraction of the splin- 
 ters, we may almost always avoid amputation. In 
 June, 1848, M. Thayer, now a senator, received a wound 
 of that kind, and the extraction of the splinters with 
 long continued application of refrigerants led to a per- 
 fect cure. 
 
 The most terrible enemy which the surgeons of the 
 army of the East had to encounter, was Hospital 
 Gangrene. This pestilence, like typhus, springs from 
 concentrated and prolonged mephitism, so difficult to 
 avoid in armies stationed for a length of time in crowd- 
 ed tents. It arises spontaneously, is propagated by the 
 air, or by means of direct contagion by the deposit 
 upon a healthy wound, of matter coming from a surface 
 infected with gangrene. The second mode of exten- 
 sion would not be so serious, if care was taken to burn 
 all the linen which had been used in dressing gangre- 
 nous wounds, with the view of preventing its being 
 used again. The air is so obviously the vehicle of 
 infectious miasms, that hospital gangrene always shows 
 a tendency to increase or decline, according as the wards 
 are more or less encumbered. 
 
 Hospital gangrene attacks the wounded, as well as 
 those whose wounds are not entirely cicatrized j and at 
 
THE CRIMEAN WAE. 95 
 
 the time when the poor wounded men have just 
 readied the end of their cure, and are preparing 
 to return to their families, they perish, victims of this 
 horrible disease ! We recognise this terrible malady, 
 when the wound grows dry, and becomes painful and 
 slate-colored, with black patches. A gangrenous dis- 
 organization breaks out, attacking by preference the 
 cellular tissues, of which it eats out deep excavations. 
 At times, instead of a humid gangrene, the skin becomes 
 covered with a dry scab ; and at other times, while the 
 wound is healing on one side, it is increased in size by 
 ulcerations on the other. This is called, "ulcerated hos- 
 pital gangrene." At the beginning, a reddish violet circle 
 from a fifth to a third of an inch wide, is formed around 
 the circumference of the wound. In three or four days, 
 this falls into a gangrene, and another circle succeeds ; 
 it becomes gangrenous in its turn, causing great destruc- 
 tion of the substance, often attended with alarming 
 hemorrhages. This kind of local typhus does not hesi- 
 tate to invade the whole organism, and death presently 
 follows, if art proves powerless, or cannot seasonably 
 intervene. 
 
 The first remedy, and that without which all others 
 are powerless, is to isolate the infected, in non-contami- 
 nated places. This isolation is at the same time de- 
 manded in the interests of the sick, tainted with the 
 pestilence, and in those of the neighboring sick, who 
 may be exposed to contagion. The tent is here an ex- 
 cellent resource, especially if each one of those attacked 
 can have one by himself. The air is then easily renewed, 
 as it is only necessary to fasten up the sides a few inches 
 from the ground, to secure a constant and very salutary 
 ventilation ; the bed being above the openings, the patient 
 does not suffer any inconvenience. When hospital gan- 
 grene is once established in a hospital, it is very difficult 
 to get rid of its contagious miasms ; and it is necessary to 
 abandon it for a time, whitewash the walls, frequently 
 sprinkle the floors with chlorides, and fumigate tho- 
 roughly. In this way alone can it be conquered. 
 
 The local treatment consists in cauterizing with a red 
 hot iron, or with the perchloride of iron, a powerful 
 
90 TUB CRIMEAN WAR. 
 
 caustic, which penetrates easily into all the sinuosities 
 of the wound ; this treatment M. Salleron employed 
 with success. Dressings of lemon juice, pulverized 
 charcoal, and quinquina, with camphor, are secondarily 
 useful with caustics. Continued lotions of cold water, 
 falling drop by drop, are also a disinfectant, an excel- 
 lent modifier of the disease, and a constant sedative of 
 pain. Injections of the tincture of iodine, which M. Yel- 
 peau commonly employed, also give advantageous 
 results. But still, these are only auxiliaries ; caustics 
 and cauteries alone can stop the progress of hospital 
 gangrene, and suppress the sources of the putrid fluids 
 that infect the whole economy. 
 
 There were 5,000 to 6,000 cases of frost-bite, during 
 the two winters of 1855 and 1856 ; and the facts ob- 
 served, presented noticeable peculiarities. In 1855, the 
 cold was not very intense, but there were abundant 
 rains, and the soil remained soaked a long time, especially 
 in the trenches. The feet of the soldiers, immersed in the 
 icy water, suffered from the effects of frost, similar to 
 that in 1836, before the walls of Constantinople. It 
 produced a tumefaction, attended with redness and gan- 
 grenous spots, more or less defined. Freezing repro- 
 duced the six degrees of change, admitted by Dupuy- 
 tren in burns ; we know that cold and heat produce the 
 same effects. The disorganization acts by a humid 
 gangrene. 
 
 On the contrary, in the rigorous winter of 1856, 
 when the thermometer often descended to five degrees 
 below zero of Fahrenheit, we often observed dry and 
 sudden gangrene. The sick, when being transported to 
 the field hospitals upon chairs, and the soldiers sleeping 
 in tents, had their extremities frozen. The extreme 
 cold expelled the liquids, the feet dried up, were reduced 
 in volume, turned, so to speak,to parchment, became a 
 dirty white, and finally, formed a dry, black eschar, like 
 in a mummy. 
 
 In Russia, when they travel in sledges without taking 
 the precaution of covering the nose and ears with furs, 
 it happens that the parts in like manner become sud- 
 denly white, wrinkled, and deprived of life. The ears of 
 
THE CRIMEAN WAR. 97 
 
 our soldiers were preserved by red cloth caps called the 
 chachia^ which were distributed to them. Among the 
 soldiers who conducted the wagon trains, and who 
 were obliged to be out in all kind of weathers, we most 
 frequently observed the effects of rigorous cold ; many 
 of them had one or more fingers of the rein-hand frozen. 
 Frozen feet were very common in all the regiments. The 
 soldiers took care to be always moving, and would call 
 out to those of their comrades whom they saw standing 
 still, careless or indifferent, " you will freeze ;" unfortu- 
 nately, they were not mistaken. When cold acts upon 
 the whole surface of the body, it does not produce very 
 much suffering, but a simple dulness throughout, and 
 an irresistible desire to sleep, which is fatal if indulged in, 
 especially after having drunk alcoholic liquors in excess. 
 
 If limited to the feet or hands, the action of cold is 
 first announced by a painful numbness. A horse-soldier 
 whose right hand had been frozen, said that he had first 
 felt a numbness in the ends of his fingers, but that soon 
 after they seemed to warm, and he felt it no more. The 
 recurrence of cold rendered it difficult for him to hold 
 the reins, and soon his fingers formed a rigid hook around 
 which he fixed them. He was so imprudent as to 
 approach a fire, and lost all his fingers by gangrene. 
 He should have begun by rubbing his hand with snow, 
 and should only have recalled warmth and life by degrees. 
 
 Until the parts struck dead by congelation drop off, 
 the suffering is very slight ; the appetite remains, and 
 there is but a very moderate amount of fever of elimina- 
 tion. They were satisfied, under my advice, to wrap 
 the limb in soft folds of wadding, the light and silky 
 contact of which is agreeable ; the patients enjoyed 
 their food, and often congratulated themselves that the 
 affection was not serious ; but unhappily, when, a little 
 after, the toes, or a half of the foot, or both feet, begin- 
 ning to putrify, separated from the body, leaving exposed 
 a large wound, which contact with the air irritated, the 
 pain became violent, a fever was kindled, the large vis- 
 cera became affected, life was endangered, and often 
 death supervened, mocking the efforts of medical art. 
 
 In proportion as the circular limits of the living and 
 
98 THE CRIMEAN WAR. 
 
 the dead parts enlarged, the suppuration, already fetid, 
 became more abundant, and the softened parts became 
 detached in shreds, bringing with them pieces of the 
 skeleton. The bones remaining in place, deprived of 
 their nourishing ligaments, grew black, and finally fell 
 off of their own accord. This labor of separation by 
 nature, though slow and patient, must be scrupulously 
 respected. If, to hasten it, we seek to shake a single 
 joint of the finger, scarcely held by its eroded ligaments, 
 the wound will not fail to become covered with fleshy 
 granulations of a bad kind, flabby, bloated, bleeding at 
 the least touch, and always threatened with hospital 
 gangrene. Amputations made in the Crimea, on account 
 of freezing, were not successful. M. Boudier, chief phy- 
 sician of one of the field hospital divisions, in one of his 
 reports, attributed this failure to the shattered and 
 wasted condition of the sick, almost all of whom were 
 tainted with chronic diarrhrea.* The cases of conge- 
 lation happening even in the field hospitals, were a mani- 
 fest proof of this debility. The inefficiency of the ope- 
 rations imposed the duty upon the surgeon to abstain 
 from them, and to limit his treatment to cleanliness, 
 disinfecting the wound by dusting on it with chloride of 
 lime, and leaving to nature alone, the effort of separat- 
 ing the dead parts. This forbearance of the surgeon 
 proves the fact, that nature draws the line of demarca- 
 tion between the living and the dead part much better 
 than the hand of the operator, and with much less sacri- 
 fice. Art assigns to amputations certain places, which 
 often oblige the sacrifice of portions of a member that 
 might be saved, while nature, entirely conservative, 
 never takes off any part that can possibly live. In ob- 
 serving the operations of nature, we may be convinced 
 that the indication of places called preferable, is often 
 theoretical, arbitrary, and not sustained by experience, 
 and that we may amputate precisely at the line of der- 
 marcation between the healthy and the diseased parts.f 
 
 * To thig cause we may also ascribe the unfavorable results ob- 
 tained by double amputations, that is, of two limbs at a time. 
 
 f The U. S. Sanitary Commission has issued a tract, prepared by a 
 committee of associate medical members, on the subject of amputations 
 
[THE CRIMEAN WAE. 99 
 
 Upon these principles I have now for several years per- 
 formed a series of partial amputations of the foot. The 
 war of the East has furnished a host of examples which 
 I may use as arguments. Even before I visited the 
 Crimea, I found in the hospital at Marseilles among the 
 wounded sent to France, three hundred soldiers affected 
 with partial freezing of the feet, which were healed, or 
 in process of healing, although art had not intervened, 
 and nature alone incurred the expense of a cure. Nature 
 takes no notice of the decisions of savans in fixing 
 places of preference. If a part of a toe can be saved, 
 even when all the others are dead, she saves it. I 
 have seen upon two patients, the second phalanx of the 
 little toe left, after the spontaneous separation of all the 
 other toes; and in others, only the thumb and little 
 finger remained. Nothing is more diversified or more 
 ingenious than the conservative operation of nature. 
 The surgeon must imitate it only, or let her take her 
 
 through the foot and dt the ankle joint, in which they arrive at the 
 
 following general conclusions : 
 
 " I. In all amputations of the Lower Extremity the surgeon should be 
 
 governed in the selection of the point of operation, and the 
 
 method to be adopted, 
 
 1. By the mortality of the operations in question. 
 
 2. By the adaptability *of the stump to the most serviceable 
 artificial limbs. 
 
 II. In all injuries of the foot, involving parts anterior to the medio- 
 tarsal articulation, the surgeon should sacrif\ce as little as possible 
 of the structures essential to progression. He should preserve 
 
 1. Single phalanges, the importance of which increases from the 
 small to the great toe ; 
 
 2. The metatarsus, by amputation of the phalanges, or by the 
 excision of individual metacarpal bones ; 
 
 3. The tarsus, by amputation at the tarso-metatarsal articula- 
 tion. (Hey's or Lisfranc's method.) 
 
 III. Of the amputations through the tarsus, or at the ankle joint, 
 preference should be given to S} T me's operation as affording a 
 minimum mortality, with a stump best adapted to an artificial 
 limb. 
 
 IV. In the after treatment of the amputations and resections above 
 considered, it is good practice to leave the wounds open to heal by 
 granulation." 
 
 The above tract has been furnished to all surgeons in the present 
 army service, and is designated as G. in the series of monographs upon 
 surgical and medical specialities, published by the Commission. 
 
100 THE CRIMEAN WAK. 
 
 course. Let us see how she proceeds : The portion of 
 bone to be separated dries up, becomes black, and pro- 
 jects. At its base, the living flesh swells out, covered 
 with granulations, and encroaches upon the bone, which 
 finally falls off of itself, leaving a deep hole. The gra- 
 nulations fill this cavity rapidly, and thus the stump be- 
 comes covered with soft parts, in the best possible man- 
 ner. The surgeon should not interfere, unless nature is 
 powerless, and even then he should assist with caution, 
 for he has reason to apprehend hospital gangrene. This 
 was the opinion of M. Thomas, physician-in-chief at 
 Constantinople, who observed that the slightest effort 
 to extract a bone, scarcely held by the ligaments, almost 
 always induced hospital gangrene, and he therefore left 
 to nature entirely, the task of finishing the amputation 
 of parts mortified by freezing. It was not until 1856, 
 that the hygienic condition of the hospitals became 
 such, that Messrs. Thomas and Lustreman could prac- 
 tise amputations with success. In the field, the best 
 treatment is fraught with great danger. Latterly Pro- 
 fessor Chassaignac has amputated the dead parts of a 
 gangrenous limb, thus relieving the patient of the bur- 
 den of the lost member, stopped the source of wasting 
 putrid fluids which infected the whole system, and ev 7 en 
 allayed pain, in relieving by division of the bones, the 
 choking up of the marrow which they contained. This 
 practice is good in common cases, but in the East, it 
 would invariably invite an attack of hospital gangrene. 
 
 We see what cares devolve upon the military sur- 
 geon in times of war. The soldier has only to evince 
 heroism on the battle-field, and a still greater heroism in 
 obscure labors, and fatigues, and privations, bravely 
 endured ; but the surgeon has not only in his own per- 
 son to share a large part of these pains and perils, but 
 also to seek to relieve those of others ; he must also 
 in the midst of active labors, often too severe, work in 
 his mind, to devise the best method for performing one 
 or another operation, and of conducting the treatment, 
 which is ever varying according to the circumstances. 
 Every one knows that the first part of this task was per- 
 formed by the physicians of the army of the East with 
 
THE CRIMEAN WAR. 101 
 
 devotion, and the army itself proclaimed the sincerity of 
 its regrets, when it saw slowly passing to the cemetery, 
 borne by maimed soldiers, and followed by generals, 
 military intendants, and officers of every grade, the coffin 
 of M. Mercier, chief physician of the field-hospital of 
 the right, who was decorated after the taking of the 
 Malakof, and died two months after in the midst of 
 his sick. Day and night he had remained in the field 
 hospital at Carenage, depriving himself of necessary 
 sleep, until he laid himself down to die.* I wish to 
 demonstrate in a few words that in the fulfilment of 
 the second part of their task, that of scientific observa- 
 tions, we found in our surgeons the same attention and 
 activitv. 
 
 CHAPTER III. 
 
 THE PHYSICIANS. CHLOROFORM. EUPATORIA. 
 
 HAVING carried my investigations into all the regi- 
 ments, and taken account of their several organizations, 
 and the causes of sickness and deaths, I often met the 
 surgeons in scientific councils, where we mutually enlight- 
 ened each other on different subjects, and each, accord- 
 ing to his ability, gave his experiences, and profited by 
 those of others. These conferences always ended by a 
 
 * The funeral honors, due to medical officers ill the French service, 
 are as follows : 
 
 Inspectors are followed by three det'achments, when the death 
 occurs in active service, and by two, when in"retirement. 
 
 Principals, by two detachments when the death occurs in active 
 service, and by one when in retirement. 
 
 Majors, by one detachment, whatever may have been their position 
 at the time of death. 
 
 Aides-Major^ by a half detachment, whatever their position ; physi- 
 cians and apothecaries commissioned by the minister of war, receive 
 the same honors as the aides-major of regular rank. 
 
 In the common salutations of the camp, sentinels "present arms," 
 upon the passing of inspectors, and " carry arms, 1 ' when a principal 
 or aide-major passes. 
 
102 THE CRIMEAN WAK. 
 
 session in the amphitheatre. M. Scrive, chief-physician of 
 the army of the Crimea, to which he rendered great ser- 
 vices, usually attended us thither. We caused all kinds of 
 operations to be repeated before us upon the dead body 
 by the army surgeons, with the view of ascertaining 
 the most capable, in order to place them as circumstances 
 required at the head of important trusts. A great num- 
 ber of health officers attended daily at these practical 
 reunions. I was often invited to give them advice 
 and examples, which I cheerfully did, and thus not only 
 acquired great influence, but was able to excite among 
 them a laudable emulation, so that they carried even to 
 the battle-field, an ardent relish for study. These ses- 
 sions proved quite an attraction, and the Sardinian and 
 English physicians, and Sir John Hall among others, 
 honored them sometimes with their attendance. French 
 science was there worthily represented. Under the 
 empire, at least, half of our army physicians had never 
 received their medical degree, and had neither the abi- 
 lity nor the legal right to make prescriptions, and hold 
 the rank of practising physicians. Now, the officers of 
 health are recruited only from doctors of the regular 
 faculty, who are not admitted without being subjected 
 to a new examination. All are educated men, author- 
 ized by law and their diplomas to practise medicine. 
 
 This was a necessary reform. Does not the military 
 surgeon require a large amount of knowledge and expe- 
 rience so that he shall never fall short of his mission, 
 and be able at any moment to practise the most nume- 
 rous and grave operations ? And yet it is not in the 
 operations alone, however important they may be, that 
 he finds the greatest difficulties to overcome. In ampu- 
 tations, the rules for tying arteries are known and esta- 
 blished beforehand ; he has had hundreds of opportuni- 
 ties to practise in the amphitheatre, and acquire a cer- 
 tain sleight-of-hand, in such operations. Upon the bat 
 tie-field the variety and number of the missiles produce 
 at each moment an unforeseen combination of wounds 
 most fearful to manage ; here, in place of previous 
 rules, everything must be extemporized. We must act 
 quickly, to save the life which is gushing from the 
 
THE CRIMEAN WAR. 103 
 
 wound. On this bloody theatre, it is not enough to be 
 learned ; a quick eye, and prompt intelligence always 
 alive to the occasion, are required. It is this instinctive 
 genius, always so precious and necessary, that I would 
 wish to see developed at the school of Val-de-Grace, 
 among the students who are to supply the health service 
 of the army. They should receive more instruction in 
 the difficult problems of military surgery, oftentimes 
 reduced, as they are, to the resource of expedients ; show 
 them how, with the blade of a sabre, the ramrod of a 
 gun, a bayonet, and even some pieces of a cloak, the 
 apparatus ibr a fracture may be had on the field of 
 combat. At least they should take a thorough course 
 upon gunshot wounds, and other wounds of war ; but, 
 singular to remark, a special chair upon the wounds 
 of war has not yet been, established at Val-de-Grace. 
 It is true this department is not neglected, for the 
 professors seize with eagerness all occasions to initiate 
 their pupils into the practice of military medicine, 
 and the treatment of these wounds ; but we may 
 be allowed to hope that the treatment of gunshot 
 wounds, instead of being left to the chance teaching of 
 many chairs, and different professors, will be deemed of 
 sufficient importance to be confided to a special teacher. 
 Already Marshal Vaillant, the minister, with whom the 
 soldier's health is an object of constant care, has endowed 
 Val-de-Grace, since June,, 1857, with a special chair of 
 diseases and epidemics of armies. The department to 
 which I allude, would add a new lustre to the reputa- 
 tion of Val-de-Grace. It is true, that to fully compre- 
 hend the importance of these special lessons, and to 
 illustrate their bearings upon the higher departments of 
 science, a long course of practice is necessary on the 
 field of actual warfare ; but the pupils of Val-de-Grace 
 would find at least in the writings of our illustrious pre- 
 decessors, especially Percy and Larrey, a host of practi- 
 cal illustrations, a rich nomenclature of the incidents of 
 war, and ingenious methods of treatment ; and they 
 will learn how a surgeon may overcome every difficulty, 
 which war continually offers. 
 
 These difficulties are innumerable. Let us remember, 
 
104 THE CRIMEAN WAR. 
 
 however, that in the Crimean war, surgical science was 
 first aided by a recent discovery due to the re- 
 searches of M. Flourens, and which iintil then had not 
 been used on the battle-field. We allude to the anaesthetic 
 action of chloroform, whose wonderful effect in reliev- 
 ing the terrible pains of the wounded, has been often 
 useful in healing their wounds. Its use permits us to 
 trim wounds, mortal in appearance, which the surgeon 
 would not have ventured to treat with so much energy, 
 for fear of exciting new sufferings. These wounds 
 being thus treated, become less painful, and sometimes 
 we are astonished at their unexpected cure. For exam- 
 ple ; a soldier of the 57th regiment received in the 
 upper part of his thigh a piece of a bomb weighing 
 2 kilogrammes, 150 grammes (4.74 Ibs.). This enor- 
 mous piece of iron buried itself so deeply that only a 
 small projecting corner could be seen. Chloroform 
 permitted the extraction of this mass, and afterwards 
 amputation, without the patient suffering the least pain, 
 and he rallied. Without this agent, we should have 
 hesitated to attempt the operation. 
 
 By subduing pain, chloroform gives a calmness and 
 mental tranquillity to the wounded, very favorable to 
 healing. It deprives the traumatic fever of an excess 
 of reaction, often caused by the anxiety of the patient. 
 Before the discovery of this precious agent, some sol- 
 diers, it is true, endured amputations without a groan. 
 I have seen an Arab continue to smoke his pipe, while 
 I took off his arm ; but this paroxysm of courage, gained 
 by a great exaltation, fell some days after into a nervous 
 depression, so much the more dangerous on account of 
 the stoicism which had hitherto sustained him. There- 
 fore, those surgeons who know how dangerous it is to 
 struggle against suffering, tell their patients not to 
 resist it, but to let it express itself in cries. I remember 
 an unfortunate soldier, who, having decided to allow his 
 leg to be cut off, exclaimed : "They told me it was no- 
 thing that some sing under the operation ; I should 
 like to see them !'' 
 
 We know that, in great operations, death ensues 
 oftener from nervous prostration, consequent upon 
 
THE CRIMEAN WAR. 105 
 
 excess of suffering, than from haemorrhage. It is the 
 same with animals. M. Claude Bernard observed, that in 
 laying open the spinal column, in experiments upon rab- 
 bits, they always died at once, unless they had pre- 
 viously been rendered insensible by chloroform. 
 
 But used imprudently, this agent, while it takes 
 away suffering, may also take away life. It shares this 
 sad privilege with the most potent remedies ; taken 
 in large doses, they are for the most part poisonous, 
 and kill instead of curing. The danger may perhaps be 
 certainly avoided, by observing certain rules, and espe- 
 cially by not pressing the inhalation to its extreme 
 limits. This extreme limit is, in my opinion, when in 
 accordance with the precept laid down for several years, 
 we pass the stage of insensibility and reach that of col- 
 lapse^ and a complete muscular prostration. This condi- 
 tion is reached, when a limb is lifted up, and falls like a 
 mass of dead matter, for then, life almost borders upon 
 death, it has retired into the vital centre, placed by 
 M. Flourens in the medulla oblongata, at the origin of 
 the eighth pair of nerves which absolutely control the 
 function of the heart and lungs. To approach this 
 point, is rash temerity : to reach it, is death. This 
 rashness appears to me unjustifiable. We ought always 
 to stop when insensibility is reached ; it is enough for 
 the patient that the pain is alleviated. The surgeon 
 may find it convenient to cause a prostration of the 
 vital powers, but should abstain from affecting it by 
 such dangerous means. The movements of the patient 
 are easily restrained by the assistants, and if not entirely 
 repressed, I would even then abstain from its use.* 
 The physicians of the army of the East were of 
 this opinion, and administered chloroform with great 
 prudence, stopping at the point of insensibility, and 
 never intentionally exceeding it. They had therefore 
 no fatal accidents to deplore, although in the campaign of 
 the East this agent was employed at least thirty thou- 
 sand times. In the Crimea alone, it was administered 
 
 * I have given this precept all the proofs necessary in a memoir 
 read at the Institute, July 19, 1853. 
 
 9 
 
106 THE CRIMEAN WAR. 
 
 to more than twenty thousand wounded, according to 
 the estimate of M. Scrive. The physicians of the Sar- 
 dinian army, at the beginning of the campaign, hesitat- 
 ed to use it, but the success of our surgeons soon 
 gave them confidence in its efficacy. Henceforward we 
 may have a steadfast confidence in chloroform, and 
 thank Providence for having allowed human skill to 
 invent an agent that can suspend pain.* 
 
 Epidemics made such ravages among our physicians, 
 that after the taking of Sebastopol, the field hospital of 
 the left division was converted, upon the requisition of 
 M. Scrive, into a special home for convalescents belong- 
 ing to the personal service of this department. It was 
 located upon the heights of Sebastopol. It had its share 
 of sorrow. A little lamp lighted for use at night, was 
 observed by the Russians, and made a target for their 
 guns. Their bombs crashed through the roof. We 
 hastened to carry away the sick upon mule-litters, and 
 when the danger had passed they were brought back. 
 
 In front of this hospital a magnificent panorama 
 spreads itself. Towards the south, bounded by a 
 horizon of vast extent, the sea was covered with the 
 supply ships of the allied armies ; to the north a 
 splendid road without rocks or sandbars, finely shelter- 
 ed from the winds, and easy of access, was dotted with 
 vessels destroyed by the hand of man ; and at the head 
 of the harbor, the granite docks and marine railways, 
 masterpieces of human skill, which were going to be 
 
 * The English surgeons, in the Crimea, employed chloroform very 
 generally, and McLeod considered their confidence in its efficacy 
 greater than among the French. Only one well established fatal case 
 occurred from its use, while a great number of operations were suc- 
 cessfully performed which would have otherwise not been attempted. 
 The morale of the wounded was better sustained, and the courage 
 and comfort of the surgeons increased. Its moderate use was not 
 found to result in depression, but on the contrary it often supported 
 the strength of the patient under the operation, and it was never 
 more successful than when used immediately after the injury, 
 before the constitution had begun to suffer from the nervous irritation 
 liable to follow a wound. It acts more rapidly upon persons who 
 have lost much blood, and henco more care is necessary in such 
 cases. 
 
THE CRIMEAN WAR. 107 
 
 destroyed, challenge our wonder, and suggest fruitful 
 themes of reflection. Beyond these, arose three for- 
 midable lines of Russian batteries, while still beyond 
 lay the camps of the enemy, spread over a plain of 
 great extent ; to the east irregular mountains, com- 
 manded by the bastion of Malakof. 
 
 As for Sebastopol, this city, lately so proud and so 
 menacing, presented only a spectacle of mingled ruins 
 and tombs, with great heaps of disabled cannon, and 
 broken gun carriages, balls, shells, and bombs. In walk- 
 ing about it was necessary to avoid the channels swept 
 in enfilade by the Russian'artillery, and to thread our way 
 with difficulty, through the encumbered and obstructed 
 streets cut in the steep ridges of this promontory, which 
 could not be attacked in front. The house occupied by 
 General Levaillant, Governor of Sebastopol, was not 
 bomb-proof, as was made evident by large openings in 
 the roof. The general led me to a corner of his little 
 garden, where he had built his observatory, and lent me 
 his spy-glass. We could observe very distinctly, the 
 Russians on the other side of the harbor, loading and 
 pointing their cannon at us ; but their shot passed over 
 our heads. 
 
 These shot often committed ravages, through the 
 carelessness of our soldiers, who exposed themselves 
 rashly and needlessly ; they had seen so many of them, 
 that they took no care to avoid them. This negligence 
 added new wounded to our field hospitals ; but epide- 
 mics were the chief agencies in filling them. Surgical 
 operations diminished and gave place to therapeutic 
 treatment. The sick, coining in by crowds, encumbered 
 our hands, and obliged us to send to the regular hospi- 
 tals all cases of an obstinate character. A field hospital 
 admits readily of expansion, according to its wants ; it 
 is only necessary to bring into use more tents, houses, 
 or barns, as they may be needed from day to day. It 
 is necessary, however, to hasten as much as practicable 
 the distribution of the sick among the various hospitals, 
 in numbers of five, or at most, six hundred men to each. 
 If this number was exceeded to double or treble, as it 
 often happened, we ran great risk of miasmatic infection. 
 
108 THE CRIMEAN WAR. 
 
 This peril is encountered even in times of peace, when 
 we accumulate at a given point a large number of sick ; 
 and in extensive hospital establishments, the relative 
 mortality is much greater than in those of small extent, 
 notwithstanding every hygienic precaution. This truth 
 is not generally admitted, except by medical men, and 
 it is usually held that, by a system of centralization, the 
 service is better attained ; we violate the laws of health, 
 prolong the stay of the sick in the hospitals, increase the 
 number of invalided and of deaths, and generate infec- 
 tious diseases. With the view of emptying the field 
 hospitals of the Crimea, we opened in December, 1855, 
 some new hospitals at Constantinople. I went to visit 
 them, after having continued, by way of Eupatoria, my 
 tour of inspection. 
 
 Eupatoria is a large city, which the Russians would 
 have burned had they found time, but we saved it from 
 ruin. Its houses are mostly one story high, and very 
 spacious, especially those bordering upon the larger 
 streets. The principal thoroughfares are much cut up, 
 and very muddy in winter, but they are bordered by 
 sidewalks about twenty inches above them, which are 
 sheltered by overhanging roofs. At this time the city 
 was occupied by the Allies. Only a poor part of the 
 population remained. The Avealthy had retired, but the 
 poor were increased by the daily arrival of the unfortu- 
 nate villagers from the country around, who said they had 
 been burnt out by the Russians. They were not only 
 received, but fed by the Allies ; I have seen biscuit dis- 
 tributed to more than a thousand children, who in return 
 performed such services as they were able, for the corps 
 of engineers. The sanitary condition of the French 
 troops was very satisfactory, and we counted but 300 
 sick in an effective force of 12,000 men. Such a result 
 could not be attained, even in France ; it is due to the 
 continuance of fine weather, an abundance of provisions 
 of good quality, which were regularly distributed ; and 
 finally, to the military evolutions that were executed, 
 which preserved the soldiers in a high state of morale. 
 The corps of Generals D'Allonville and Failly, which 
 harassed the enemy, showed very few sick upon their 
 
THE CRIMEAN WAR. 109 
 
 rolls; and the pleasure of burning ammunition, combined 
 with their successes, soon transformed the young recruits 
 into veteran soldiers. 
 
 These corps were encamped under shelter-tents, which 
 would become unserviceable as soon as the first rains 
 should soak the ground. Would it not have been better 
 to lodge our troops in the city itself? It was showing 
 too much respect for the property of our enemies ; the 
 inhabitants would have been as'ked neither beds nor 
 blankets, but only a roof to shelter the men against the 
 rains, and the rigors of a winter which we knew would 
 be inclement.* There was an abundance of houses. 
 The diseases, it is true, were not serious, but the dan- 
 gers of an unhealthy camp might increase their number, 
 and enhance their severity. In anticipation of this, the 
 field hospitals were arranged under sheds in an immense 
 area, inclosed with walls, and having for their depen- 
 dencies three fine houses which might afford accommo- 
 dations for two hundred beds. It would be easy to 
 prepare tents in the courts, if needed. The physicians 
 were assembled in conference, various measures were 
 discussed, and attention was called to the Turkish field 
 hospitals, from whence the germs of epidemics might 
 perhaps arise. The 15,000 Turks and Egyptians, assem- 
 bled at Eupatoria, had many thousand sick, chiefly of 
 scurvy, which they sent to Varna. Their field hospitals 
 were well arranged, but unfortunately were attended 
 by few physicians worthy of the name. It was agreed 
 with Achmet-Pacha, General-in-Chief, that certain effec- 
 tive measures should be taken, under the supervision 
 of M. Bourgillon, chief physician of our hospital, and 
 one of the most distinguished of our medical officers, 
 who would thus learn the peculiarities and sanitary con- 
 dition of the sick in the Turkish and Egyptian armies. 
 M. Bourguillon was highly gratified in the relations 
 with M. Cassini, chief physician of the Egyptian army, 
 who conducted a difficult service with much ability. 
 
 * This suggestion, made in my report to the Minister of War, and 
 to Marshal Pelissier, was attended to, and the army took up its winter 
 quarters in a portion of Eupatoria. 
 
110 THE CRIMEAN WAK. 
 
 Our Mahomedan allies, less scrupulous than ourselves, 
 seized for their use all the houses of consequence, even 
 the mosques, and the magnificent Hebrew synagogue, 
 which was one of the finest in the world. They, how- 
 ever, gave up to us, of their own accord, two large 
 houses, well furnished with hospital furniture. 
 
 In the Turkish field hospitals, as in the English, the 
 physicians enjoyed great authority in their administra- 
 tion and control. Their attendants were soldiers of long 
 service, but too young to be pensioned for retirement, 
 who generally evinced much zeal, because the loss of 
 their place would deprive them of all right to a pension. 
 The food was composed largely of mutton and chicory. 
 In the East, mutton is abundant and of good quality, 
 but beef is scarce, lean, and poor. Encouraged by this 
 example, I desired that mutton and chicory should 
 sometimes be distributed to the hospitals instead of 
 broth and boiled beef, deeming it proper that in dis- 
 tant countries w r e should avail ourselves of the resources 
 of the locality, and adopt wise modifications in our regi- 
 mental customs. We borrowed another practice from 
 the Turks : that of frequently fumigating the wards of 
 the sick, by throwing dried sage upon a pan of burning 
 coals. The aroma thus occasioned, is agreeable; it 
 rapidly and completely renovates the air contaminated 
 with miasms, and if we open for a moment the doors 
 and windows, the fumes soon escape. This ancient 
 mode of purification is not to be despised.* 
 
 The want of Medical Science, which the Turks have 
 long felt, will be soon supplied, as the Sultan has founded 
 
 * The English Sanitary Commissions were not favorably impressed 
 with the results of fumigations. The deodorizing substances used, 
 diminished the odor, but not in the same ratio the disease ; and they 
 expressed decidedly the opinion that they should never be trusted to 
 for protecting health, if it be possible to remove the nuisances at once 
 and to a distance. They observe that " burial of putrid refuse to a 
 sufficient depth, when removal is impossible, or when the substance 
 cannot be destroyed by fire, is a safer expedient than removing its 
 smell by charcoal, or by any other deodorizing agent scattered over its 
 surface. Smell is indeed the natural index to danger, and removal or 
 destruction of the offensive matter is the remedy. There is reason to 
 fear that after the smell is removed the danger remaiqs." TB. 
 
THE CRIMEAN WAR. Ill 
 
 at Constantinople, a school of medicine, in which five 
 hundred pupils are collected. The more intelligent are 
 to be sent to Paris to finish their studies, and this 
 nursery for the education of young men will confer 
 great services upon the Ottoman army, and spread 
 among their co-religionists our ideas and our customs. 
 
 Upon leaving the Crimea, I went to inspect not 
 field but general hospitals. The first condition of the 
 latter is their permanence. At Constantinople, these 
 vast establishments increased and multiplied daily. 
 They were far from the enemy, and were sheltered from 
 all danger from abroad. They were near enough to the 
 Crimea for easy communication ; they were on the sea- 
 shore, and the means of transportation were easy. Their 
 organization was excellent. 
 
 Shut out, by the blockade of Sebastopol, from trans- 
 portation by sea, the Russians were compelled to remove 
 ,their sick in four-wheeled waggons, without springs, 
 drawn by three horses, and arranged for four patients, 
 of whom the two that were best able to endure it were 
 seated upon a kind of bench, while the other two lay 
 upon straw. Rude as this conveyance was, it proved 
 very acceptable to the Russian soldiers, and by this 
 means of conveyance they were sent to Baghtchehsarai' 
 and Sympheropol, where 15,000 beds were arranged in 
 various hospital establishments. They underwent great 
 exposures, and often suffered intense cold upon this long 
 journey, and the mortality among these unfortunate 
 men was very great. 
 
 The English waggons, used for moving the sick, were 
 suspended upon good springs. Two beds laid upon, 
 litters were placed in the carriage, after the manner of 
 drawers, and the sides were made of light rails, to 
 insure the circulation of fresh air. Such men as could 
 travel without lying down, sat in a kind of covered seat 
 placed in front, and others even rode upon the top, 
 when the weather permitted. 
 
 Our ambulance waggons were well hung on springs, 
 and proved a great luxury. A covered seat in front 
 received such of the wounded as could sit up, and 
 in the other part, arranged like an omnibus, two sick 
 
112 THE CRIMEAN WAB. 
 
 could lie upon litters placed on the sides. The seats 
 were elastic, well cushioned, and covered with red 
 sheepskin leather. These carriages were heavy, and 
 but little used, as we preferred to use mules, provided 
 with chairs or litters. In a campaign, the simplest 
 measures are always the best. Nevertheless, although 
 these carriages were very comfortable, it was of great 
 advantage that their use was confined to removal to 
 short distances ; to the infirmaries and field hospitals, 
 and from thence to the place of embarkation. The fleet, 
 whose business it was to supply our army with neces- 
 saries of every kind, rendered also great assistance in 
 transporting from the Crimea to Constantinople, many 
 of the sick who could never have recovered their health 
 in the Crimea. 
 
PART III. 
 
 THE HOSPITALS AND THEIR DISEASES. 
 TYPHUS IN THE CRIMEA. 
 
 IT was not against the Russian arms alone that the 
 allied troops of the Crimea were forced to struggle. 
 Those acquainted with the history of long campaigns 
 are aware that accidental or endemic diseases commit 
 greater ravages among soldiers, than gunpowder and 
 the sword. Besides the hygienic precautions necessary 
 to preserve those in health, and the care demanded 
 by the wounded/the wants of the sick and convalescent 
 press incessantly upon the military administration the 
 most painful problems of medical science. If we review 
 the history of our hospital establishments during the 
 war in the East, this fact will be shown ; and I trust that 
 the administration and science will never cease from 
 their exertions until these problems, which are the 
 highest aim of their double task, are solved. 
 
 CHAPTER I. 
 THE CHOLERA. 
 
 IT will be remembered that, at the beginning of the war, 
 Gallipolis was selected as a place for assembling the 
 various contingents arriving from the several ports in 
 the south of France, and from Algeria. This peninsula 
 was to be made the strategic point of the army of the 
 East, and the base of its operations. By the active 
 forethought of General Canrobert, it has been rapidly 
 converted in reality into a military station, devoted 
 
 6* 
 
114 THE CRIMEAN AVAK. 
 
 to camps and provision stores of all kinds, including 
 materials for regular and field hospitals. Each had 
 upon the front of its color line, its particular guidon, 
 and each had its separate cantonment. As new regi- 
 ments debarked, they pitched their tents upon undu- 
 lating but elevated grounds, whose salubrity, recognised 
 in advance, is preserved by the fresh sea breeze. The 
 energies of the medical corps of the army were directed 
 to putting into force certain sanitary measures, which 
 were also applied to the city of Gallipolis itself. They 
 had to struggle against the well known indolence of the 
 Mahommedans, before they could obtain the removal 
 of heaps of rubbish and filth, that endangered the health 
 of the town. In oriental cities, this duty is left to be 
 discharged by the sun and winds, the former having for 
 its share to calcine tha heaps of filth, and reduce them 
 to powder, when the winds are expected to carry them 
 away. The horrible stench of these accumulations of 
 rubbish seems a standing invitation to epidemics. 
 
 While the brigades were being organized, the old 
 athletic and bronzed soldiers, who had served in Algeria, 
 sought to initiate their comrades into martial usages, 
 and as war was something new to them, to accustom 
 them to the habits and life of the camp. They under- 
 took to teach them, according to their picturesque 
 expression, how to handle the tools, that is to say, how 
 to endure hardships like themselves, and how to be pre- 
 pared to practise the art of resisting the inevitable pri- 
 vations of the campaign, and at the same time to retain 
 their health. General Canrobert did not leave the 
 troops inactive, but accustomed them to the fatigues of 
 war, by making them labor upon earth works, and 
 construct immense trenches around their camps, ren- 
 dering them as capable of defence as forts. With 
 the assistance of the English army, they fortified the 
 peninsula of Gallipolis by entrenchments which ex- 
 tended from the gulf of Saros to the sea of Marmora ; 
 these works were to close against the Russians the 
 passage of the Dardanelles, which they had opened in 
 1829. Besides being useful in a military point of view, 
 they served a sanitary purpose, with the most happy 
 
THE CRIMEAN WAR. 115 
 
 results. The number of the sick at Gallipolis was not 
 large, and most of these had only slight indispositions, 
 which kept them but a few days in the field hospitals. 
 A hospital with three hundred beds, established a kilo- 
 metre (0*62 miles) from the city, took the place of some 
 houses in the town which had been temporarily occu- 
 pied by our sick, and abundantly sufficed for the first 
 necessities of the army. This first hospital barracks 
 of the French army was established in May, 1854. 
 Placed near the route of the fleets, upon the shores of 
 the Dardanelles, at a point where lighters could easily 
 land, it was used by us, after the departure of the armies, 
 with the greatest advantage. At this hospital, the sick 
 on their way to France from the Crimea and Constanti- 
 nople were left, when it was found they could not 
 encounter the voyage without danger. It therefore 
 became an appendage to the hospitals at Constantinople. 
 
 We had at first committed the error of constructing 
 the barracks upon low grounds, with the view of util- 
 izing some ruins, and to be near a spring; but this 
 fault was subsequently remedied, when it became neces- 
 sary to extend our hospital resources. At a place but 
 fifty yards distant, we found an elevated and well aired 
 plateau, where we prepared several barracks, with beds 
 sufficient for 300 sick. The hospitals at Gallipolis, when 
 thus completed, had 600 beds, and were always well 
 managed by the intelligent and devoted medical atten- 
 dants under the care of Dr. Molard. I found the litters 
 and furniture in complete condition, and the bread, 
 wine, meat, and broth of good quality. 
 
 But the events of a campaign advance with rapidity ; 
 and when once assembled, our troops did not remain 
 long at Gallipolis. Nearly a hundred thousand Rus- 
 sians, followed by large reinforcements, laid siege to 
 Silistria, which was bravely defended by eighteen 
 thousand Turks. The troops of Omer-Pacha amounted 
 to a hundred thousand combatants, but they were 
 scattered at many points, chiefly at Routschouk, Silis- 
 tria, and Chumla. This barrier might be overthrown 
 at any moment by the invading army, and it appeared 
 urgent that we should hasten to the assistance of the 
 
116 THE CRIMEAN WAR. 
 
 Turks, and place Adrian ople in condition for defence by 
 a prompt movement. Each movement of the army 
 required the creation of new centres for hospital ser- 
 vice. 
 
 On the 7th of May, 1854, the Marshal Saint Arnaud 
 arrived at Gallipolis, reviewed our enthusiastic army, 
 and left bis instructions to embark at once for Constan- 
 tinople, to which place he went himself the next day. 
 He imparted his own activity to all whom he approach- 
 ed, and his lively and animated tones excited life even 
 in the Ottoman authorities. The sultan himself con- 
 fided in the marshal, and ordered all the resources 
 of his empire to be placed at the disposal of the 
 generals of the allied armies. Activity succeeded 
 the slowness and hesitation of the Ottoman administra- 
 tion, so accustomed to leave everything till the mor- 
 row. On the 19th of May the marshal and Lord 
 Raglan went to Varna, held a conference with Omer 
 Pacha, passed in review at Chumla a corps of 45,000 
 soldiers of tried valor, and decided to send forward, not 
 a single division as he had at first proposed, but the 
 whole available forces at his disposal. Varna then be- 
 came a new base of operations, which left Gallipolis a 
 secondary point. Large supplies of provisions, ammuni- 
 tion, materials of war, and hospital supplies were hastily 
 sent forward. On the 1st of June, 6000 troops, com- 
 posing the first brigade of the division of Canrobert, 
 embarked from Gallipolis, and an English detachment 
 of equal force at the same time from Scutari, where 
 Lord Raglan had his head-quarters, and advanced by 
 land to Varna, about twenty-three and a half miles 
 distant. Other French regiments were to arrive by sea 
 and land, at the common rendezvous. 
 
 On the llth of May, a barrack commission, in which 
 Dr. Cazalas represented the medical interests, assembled 
 at Adrianople, the ancient residence of the Turkish 
 sultans, and the capital of Roumelia. This city, by the 
 beauty of its climate, its wealth, its resources of every 
 kind, and especially its location, which commanded the 
 Balkans, and the route which the enemy must neces- 
 sarily take, became a strategic point of the greatest 
 
THE CRIMEAN WAE. 11 7 
 
 importance. They hastened to place at our disposal 
 an immense barrack, built in 1820 by order of the Sul- 
 tan Mahmoud. It formed a parallelogram about 490 
 yards long from north to south, and 300 yards wide 
 from east to west, built with a ground floor and one 
 story. The angles were relieved by square four-story 
 towers, each surmounted by a gallery and terrace, with 
 a staff from which floated the national colors. In the 
 centre of the principal arcade was the entrance to the 
 pavilion of the sultan, quite in oriental style. It was 
 supported by many storied ranges of white marble 
 columns, among which the winds played freely, and had 
 a grand portico of sculptured marble adorned with 
 gilded arabesques. Five large marble basins, each 
 furnished with twenty large copper spouts, and fed by 
 an aqueduct, furnished an abundant supply of good 
 water. There was a wide difference between this 
 monument of taste and our barracks in France, where 
 rigid economy allows no freedom to the inspirations 
 of the architect. The premises we have described 
 could lodge 10,000 soldiers, and contained 2*78 rooms 
 receiving light from 1280 external windows. It was at 
 once decided that a hospital for 1200 sick should be 
 established in a part of this magnificent barrack, and 
 to remedy as much as possible the inconvenience of so 
 great a concentration of sick it became necessary to as- 
 sure each patient at least 45 yards of air. In our 
 hospitals the common measure is from 24 to 26 yards, 
 and in our barracks from 16 to 18 yards. Subsequent 
 events having rendered Adrianople less important as a 
 military point, we reduced the number of beds to 300. 
 
 On the 16th of June, when the division under General 
 Bosquet, amounting to 11,435 men, and the troops of 
 General Morris, composed of about 1200 cavalry, arrived 
 at Adrianople, a hospital was prepared to receive 169 sick 
 and 250 lame. The former division left for Varna on 
 the 25th of June, but the cavalry regiments of General 
 Morris did not follow, and at a later day they left their 
 bivouacs on the plain of Tundja for the barracks where 
 they passed the winter of 1855. 
 
 The first French hospital established at Constantino- 
 
118 THE CRIMEAN WAR. 
 
 pie was that of Maltepe, and the first sick that were 
 received belonged to the third division, commanded by 
 Prince Napoleon. This division, having left Gallipolis 
 May 28th, proceeded by land along the borders of the 
 Sea of Marmora to Constantinople, leaving their sick 
 and lame about half way at Rodosto, in a transient 
 hospital arranged for 250 beds. They would have 
 retained this as well as the barrack accommodations 
 used by the victorious Russians in 1829, had not 
 the siege of Sebastopol been decided upon. On the 
 7th of June, the third division entered Constantinople, 
 and bivouacked on the plain of Daoud Pacha, leaving 
 upon the minds of the Turks a vivid impression of 
 admiration and wonder. They saw with surprise the 
 oriental costume of our Zouaves, which had been 
 abolished among them by a reform, against which the 
 old Ottoman party had protested ; they still wore, by a 
 kind of tolerated disobedience, the ancient national 
 costume. 
 
 Maltepe was a Turkish hospital, one half of which 
 was opened June 7th for a field hospital of the third 
 division, and the remainder some months after. At a 
 distance of some 2000 yards from the chateau of Seven 
 Towers and the strong walls of Stamboul, on the west 
 side, appear in strong profile upon the poetic sky of the 
 East the two great permanent barracks of Daoud Pacha 
 and Ramis-Tchiflik. They were modelled after those of 
 Adrianople, and were distinguished by an architecture 
 in which elegance did not detract from solidity. They 
 were about a mile and a quarter apart, upon an exten- 
 sive plain deprived of trees, but covered in summer with 
 rich harvests. The hospital of Maltepe was built be- 
 tween the two barracks upon a little eminence exposed 
 constantly to the sea breeze, and of sufficient capacity 
 for 450 sick. 
 
 The third division was reviewed on the borders of 
 the rich vale of the tombs of Eyoub, by the Sultan and 
 his brilliant staff; and on the morrow (June 18th) 
 it embarked for Varna. The field-hospitals followed this 
 movement, leaving their sick at Maltepe, where the 
 suffering soldiers sent from Rodosto were received. 
 
THE CRIMEAN WAR. 119 
 
 From this day, a hospital was definitely arranged, at the 
 head of which was the learned chief physician M. Du- 
 rand, who continued in charge during the campaign. 
 
 The sick arriving by sea, were landed at the foot of 
 the Golden Horn, from whence the convalescents 
 walked, while others were transported upon litters, 
 chairs carried by mules, or ambulance waggons. The 
 road was very narrow and steep as far as the Porte-des- 
 Canons; the feeble were often scarcely able to make 
 the journey, and the Turks, a people considered in Eu- 
 rope as wanting in compassion, assisted them or made 
 them sit down. Upon reaching the external walls at the 
 Opening of the Crosses, the route continued to rise by a 
 very gentle slope to Maltepe. It passes through the 
 immense cemetery, planted with resinous trees and the 
 common cypress, which borders the long western line of 
 the ramparts of Stamboul. We soon arrive at a little 
 historical hillock, on which is a small windmill, the only 
 one on the plain. It is here the troops of the Sultan 
 Mahmoud were harangued by their chiefs and ulemas 
 in 1828, when departing for Maslak, where they massa- 
 cred in their camps* the revolted janizaries. The hos- 
 pital is 200 yards beyond, and from its principal front is 
 displayed a beautiful panoramic view of Constantinople, 
 the Sea of Marmora, the Princes Islands, and the Moun- 
 tains of the ancient Bithynia, capped with snow. The 
 sick were never tired of admiring this fine spectacle, 
 which inclined them to a calm and quiet meditation, so 
 salutary in convalescence. 
 
 The establishment at Maltepe formed a great rectan- 
 gle, and the four sides inclosed a court of very large 
 extent planted with trees. The walls were of wood on 
 the side towards the court, but of stone externally, and 
 the side towards Constantinople had only a ground-floor 
 surmounted at the angles by little turrets. Externally it 
 was bordered by an orchard, cooled by refreshing springs 
 received in marble basins, and had in the centre a monu- 
 mental entrance-way of white marble in good Byzantine 
 style. This range of buildings contains several of the 
 hospital accessories, such as the Turkish baths, the laun- 
 dry, the kitchens, the apothecary rooms, the offices and 
 
120 THE CRIMEAN WAE. 
 
 two chambers of honor, one called the Sultan's, and the 
 other the Seraskier's, or Minister of War. The other 
 three sides of the rectangle contained a ground-floor, 
 and one story above it, along which, on the side towards 
 the inner court, ran a corridor to give access to the 
 rooms which looked on the country. Each chamber 
 contained from 30 to 40 Turkish beds, which were made 
 of large fir boxes sustained by iron legs, and contain- 
 ing two mattresses of cotton or wool. An aqueduct, 
 abundantly supplied, distributed excellent 'water through 
 the whole establishment. The artificers of the engineers 
 immediately arranged everything to our wants, so dif- 
 ferent from those of the Turks, and this hospital con- 
 tinued to be used by us constantly until May 31, 1856, . 
 when the Crimean troops began their embarkation for 
 France, which was completed on the 5th of July fol- 
 lowing, under the personal observation of Marshal Pe- 
 lissier. 
 
 Meanwhile the ranks of the army, composed of some 
 15,000 to 20,000 men, increased from day to day, a fourth 
 Division having joined the expedition, and soon after a 
 h'fth. They all proceeded in succession to Varna, whose 
 ramparts are situated at the foot of a marshy valley, be- 
 tween -two spurs of the Balkan range. It was taken by 
 the Russians, in 1828. The city contains 16,000 inhabi- 
 tants, and has on one side an extensive lake, and on the 
 other the sea. ' Its harbor is very difficult of access, and 
 offers but little shelter and very poor anchorage. Upon 
 their arrival the regiments were stationed about five 
 miles beyond, where they pitched their tents upon a 
 high plateau called Franka, approached by paths wind- 
 ing through most beautiful gardens. The elevation 
 of this plain was about 650 feet above the sea, its 
 breadth from east to west was about two miles, it was 
 bordered by forests, and refreshed by many springs of 
 limpid water. The Russians had bivouacked here in 
 1828; it was in all respects most suitable for the 
 encampment of an army. From this point our troops 
 watched the defiles of the Balkan mountains, escaping 
 the noxious miasms to which a sojourn in the low 
 grounds would have exposed them. Unfortunately they 
 
THE CRIMEAN WAR. 121 
 
 committed indiscretions ; eat unripe fruit, and drank 
 immoderate quantities of spirits or cold water. In the 
 evening, when the heat of the day had fallen from 30 
 to 12, and even 10 Centigrade (86% 54o and 50 Fah- 
 renheit), they would often remain in the open air, and 
 sleep without their clothing, being in this respect more 
 careless than the inhabitants of the country, who avoid 
 going out of doors after nightfall, unless protected 
 against the low temperature and humidity by warm and 
 impervious clothing. 
 
 Although the general sanitary condition was satisfac- 
 tory, yet a number of men entered the infirmaries, sick 
 with intermittent fevers, and especially with the intes- 
 tinal fluxes, precursors of cholera. It became necessary 
 to create asylums for the suffering troops. The Ottoman 
 authorities placed at our disposal a very large permanent 
 barrack, which we shared with the English. It receif ed 
 700 beds complete. The" buildings were old and in 
 bad condition. We contented ourselves with making 
 the motet necessary repairs. It continued during the 
 campaign to receive soldiers from the Crimea, and 
 chiefly from Eupatoria. Besides this permanent hospi- 
 tal, there were established upon the elevated grounds 
 several large field-hospitals, two of which were exclu- 
 sively reserved to the Cholera patients from the fatal 
 expedition of the Dobrutcha.* 
 
 * The English suffered from cholera on two occasions during the 
 Crimean war. The first epidemic appeared in April, 1854, increasing 
 for three months, and again declining slowly, and in an irregular man- 
 ner till February, 1855, when it disappeared. The following month 
 marks a clear interval between the two epidemics, for no case occurred 
 in the English army in March, 1855. 
 
 The second outbreak began in April, 1855, culminated in June, and 
 declined slowly and irregularly as in the former. It was less severe 
 than the first, but showed a tendency to remain permanently, and after 
 a month's interval again increased, as if to make a third annual visit. 
 The total number of cases that occurred, was 7,575, and of deaths 
 4,513 or 59-57 per cent, of the deaths 2,902 were in the first, and 
 1,611 in the second period. The cavalry lost 399, the ordnance 460, 
 and the guards and infantry 3,654. Among the prophylactic measures 
 adopted, were the discontinuance of parades and avoidable fatigues, 
 a frequent change of encampment, strict attention to cleanliness in 
 the camps ; suppression of unripe fruits, and unwholesome wine and 
 
122 THE CRIMEAN WAR. 
 
 The whole coast from Varna to the Danube is a deso- 
 late country, covered with steppes and marshes, whose 
 neighborhood is fatal during the heats of summer. In 
 the spring of 1854, Omer Pasha said to Commandant 
 Henry, envoy to his camp at Chumla, " If the Russians 
 remain another month in the Dobrutcha, their army 
 will be annihilated : to me it would be equivalent to 
 winning a great battle.'' The terrible havoc made by 
 malignant epidemics in the Russian army in 1828, could 
 not be entirely forgotten ; and without doubt, the re- 
 membrance of this, in part decided the Russian gene- 
 rals to quit the Dobrutcha and to reascend the Danube 
 to Silistria ; and which made them abruptly quit this 
 place after a futile but not fruitless siege. The city, 
 breached on every side, was on the point of yielding, 
 and the vigor of its defenders was on the point of giving 
 in 4o the numbers and desperate valor of the assailants. 
 The retreat of the Russians on the left bank of the 
 Danube gave to the allied armies, who were impatient 
 to march to the combat, a mingled feeling of -painful 
 surprise and almost of discouragement. Marshal Saint 
 Arnaud felt it was necessary to produce a powerful reac- 
 tion in the morale of the army, employ his soldiers, 
 draw them from fatal inaction, and revive their ardor 
 by some great movement, whose boldness and wisdom 
 should draw the attention of Europe. At that time, the 
 Cabinet of St. James earnestly insisted, that we should 
 proceed to the Crimea, destroy Sebastopol, and annihi- 
 late the Russian fleets in the Black Sea. The instruc- 
 
 spirits ; the furnishing of a spirit-ration, and an increased quantity of 
 fresh meat, and a portion of barley or rice daily on medical represen- 
 tation ; coffee for men returning from guard-duty, and every effort to 
 induce men affected with diarrhoea to report themselves for medical 
 assistance in the early stages of the complaint. 
 
 It was particularly urged to use remedies in the early premonitory 
 stages ; but with their best efforts the influences of climate, vicissi- 
 tudes of temperature, heavy dews, defective diet, impure water, unripe 
 fruits, and sour wines, operated against the best devised measures for 
 relief, and defied the control of the medical staff. 
 
 The greatest mortality occurred at Varna. The period of greatest 
 intensity was in Dec. 1854, when 888 cases in an average strength of 
 29,727 appeared, and 636 died, giving 2 - 9 per cent, of deaths to the 
 whole force, and 7T6 per cent, of admissions. TR. 
 
THE CRIMEAN WAB. 123 
 
 tions to the Marshal Saint Arnaud were less imperative, 
 and left him free upon this point. The exploration of 
 the shores -of the Crimea was therefore commenced, 
 and as soon as the enterprise was considered to be 
 practicable, it was irrevocably decided upon, notwith- 
 standing the opposing advice of the admirals of the 
 fleet, who distrusted the sea at this advanced season of 
 the year. 
 
 In the midst of preparations, occasioned by the pros- 
 pect of early departure, the unmistakable signs of Cho- 
 lera took our army by surprise. On the 9th of July, the 
 pestilence appeared in the hospitals at Varna, although 
 the relative number of all the sick at the time was not 
 over 600, to the 50,000 men already collected ; it was 
 doubtless imported into the East by the successive con- 
 tingents of the fifth division, embarked in the South 
 of France, where the population was a prey to this epi- 
 demic. It first made its appearance at Pirea, and then 
 at Gallipolis, where in a few hours it took oif gene- 
 rals Duke of Elchingen arid Carbuccia. The expedition 
 of the Dobrutcha was not slow in furnishing new vic- 
 tims. Great as was the wish to transport the allied 
 armies at once to the Crimea, it could not be done 
 before fifteen days, this delay being necessary to make 
 the preparations for departure ; it was determined to 
 profit by the opportunity, and make a demonstration 
 that should annoy the enemy, and deceive them as to 
 the plan of attack on Sebastopol. 
 
 According to the official reports of a colonel of the staff, 
 sent upon the ground, the Russians had at 45 leagues 
 from Varna, near Babadagh, 10,000 men, with 35vpieces 
 of cannon. The three first divisions of the .French 
 army were sent to find them, and they were directed 
 to proceed along the sea-shore, for the convenience of 
 provisioning. It was thought that a frequent change 
 of bivouac would lessen the choleraic tendencies of the 
 troops. On the 21st of July, General Espinasse, who 
 commanded for the time being the first division, while 
 General Canrobert was exploring the shores of the 
 Crimea, received orders to move upon Mangalia, at the 
 head of 10,500 men, of whom 328 were officers. There 
 
124 THE CRIMEAN WAR. 
 
 were left in the infirmaries and hospitals at Varna 16 
 officers and 925 soldiers. The 1st Regiment of Zouaves, 
 transported by sea to Kustendje, was to operate at the 
 head of the column under the orders of General Yus- 
 suf, and to support 2,000 or 3,000 Oriental cavalry, orga- 
 nized from the undisciplined bands called the bachi- 
 bozouks. The physician-in-chief of this division was 
 M. Cazalas, an energetic man, who had evinced a tho- 
 rough knowledge of his profession at the school of Val- 
 de-Grace. He was assisted by several chosen physi- 
 cians, Doctors Quesnoy, Bailly who was taken off a 
 few days later w T ith the cholera, and Raoul de Long- 
 champ, who resisted the pestilence as if by a miracle. 
 The means of transportation intended for the sick, con- 
 sisted of 65 pairs of mule-chairs, 5 pairs of litters, some 
 ambulance caissons, and a number of arabas, loaded 
 on starting with provisions for ten days, for the use 
 of the expedition. Each soldier carried besides provi- 
 sions for five days. 
 
 To accomplish the six and three-fourth miles of the 
 first stage from Franka to Kapakli, the soldiers remained 
 ten hours upon foot, exposed throughout the. day to a 
 heat of 30 Centigrade (86 Fahrenheit). In the same 
 evening four cases of cholera appeared. On the 22d, 
 they started at four o'clock in the morning, and the divi- 
 sion did not reach Tchatal-Tchesme until seven in the 
 evening. They travelled about eleven miles, the thermo- 
 meter rose to 35 C. (95 F.), and the march was very 
 difficult, owing to the route passing over steep and gul- 
 lied places ; but beyond this bivouac, the column des- 
 cended into a naked plain, without trees, about 124 
 miles in length, covered with high herbaceous stalks, 
 many of which lay rotting upon the ground, where they 
 formed a tangled mat, through which the troops ad- 
 vanced with great difficulty. This was the Dobrutcha, 
 covered with lakes and marshes which infected the 
 atmosphere, especially in this season of the year. Geo- 
 graphers have placed it as between the Danube, and the 
 walls of the camp of Trajan, about five miles from Kust- 
 endje, but medical topography w r ould place its southern 
 limits as far south as beyond Kavarna, where the troops 
 
THE CRIMEAN WAR. ] 25 
 
 arrived three days after leaving Varna. The encamp- 
 ments which marked the subsequent stages of the expe- 
 dition were all equally insalubrious. At Sattelmuch- 
 Gol, Mangalia, Orgloukoi, and even at Kustendje, as 
 in the ruins of the village of Kergelak, we found no 
 place of encampment other than low marshy grounds, 
 whose waters were poisoned with vegetable substances 
 in process of decomposition. As we approached the 
 Danube, we met some parties of Cossacks, who opposed 
 no serious resistance ; the aspect of the country became 
 more and more desolate, cultivation disappeared, and 
 every trace of human industry was lost. We met only 
 some shafts of broken columns, and tumuli of great anti-' 
 quity, silent witnesses of former civilization against 
 modern barbarism. Since the Russian invasion in 1828, 
 this region, fearfully ravaged, had become almost 
 deserted. Clouds of vultures followed our steps, to 
 devour the dead bodies which might be left behind ; 
 it was not unusual to meet troops of wild horses, who 
 took to flight on seeing us. Some shepherds, whose 
 constitutions present the characteristics of paludal 
 cachexia, are almost the only inhabitants of the Do- 
 brutcha; and they are forced, like the beasts that they 
 tend, to use foul water, dipped from the pools, cisterns, 
 or abandoned wells. 
 
 The army had furthermore to endure tempests of rain, 
 and numerous atmospheric vicissitudes of heat and cold. 
 The cholera, which until this time had remained almost 
 inoffensive, no longer delayed to make a sudden and fear- 
 ful attack. On the night of July 30, 300 Zouaves were 
 violently seized, and the bachi-bozouks were also terribly 
 assailed by the epidemic. General Yussuf prepared to 
 march forward, but the redoubled strokes of the pesti- 
 lence compelled him to fall back. His troops scarcely 
 found time to bury the dead that fell by the way. He, 
 however, in spite of all difficulties, transported upon 
 gun-carriages and upon horses, the sick, whose number 
 increased every moment with frightful rapidity. The 
 column of General Espinasse, hoping to surprise the 
 enemy, had made a night-march on Kargualeck, without 
 knapsacks, and with very few waggons, in order to pro- 
 
126 THE CRIMEAN WAR. 
 
 ceed more rapidly, and arrived at about one o'clock in 
 the morning. It started in a rain-storm which lasted 
 several hours. The following morning witnessed a sor- 
 rowful scene, for instead of the enemy, they saw 300 sol- 
 diers belonging to the 1st regiment of Zouaves, crowded 
 into the mean village ruin, and struck down with the 
 cholera. Means for transportation were wanting. The 
 9th battalion of foot-chasseurs, forming the rearguard, 
 showed a remarkable example of devotion. They took 
 up all the sick upon litters, prepared on the spot with 
 their shelter-tents, and poles found in the village. The 
 column, ravaged by the pestilence, retraced its steps 
 'towards its former bivouac near the great lake of Pallas. 
 It was compelled to leave in a field-hospital, until the 
 morning, a large number of cholera patients, which it 
 could not carry away. On the 31st of July, the sur- 
 viving portion of the division arrived at Kustendje, 
 where it found the houses full of bachi-bozouks. About 
 1800 cholera patients were awaiting their turn to embark 
 upon steam frigates, and 1,200 dead bodies were buried 
 in trenches dug around the place. 
 
 The unexpected arrival of General Canrobert at Kust- 
 endje, gratified the earnest wish of all, and produced a 
 keen and touching emotion. He called a medical council ; 
 impressed new energy into the measures already taken 
 by General Espinasse, who was then suffering from 
 cholera, and revived the courage which the disease had 
 checked. The division, making unheard of efforts to 
 transport the cholera patients which fell from time to 
 time, arrived at Mangalia on the 3d of August, where 
 the forethought of General Canrobert had brought 
 together resources of every kind, and especially fresh 
 provisions, wine, brandy, coffee, and sugar. New deaths 
 were counted by hundreds, and 2,000 sick were embarked 
 for Yarna. The marshy stopping-place of Mangalia was 
 rendered still more dangerous by the putrid decay of 
 many dead bodies, which the bachi-bozouJcs had left 
 lying about without sepulture ; they had thrown a very 
 large number into pits, to avoid digging graves, and a 
 part of the water, which had already become rare, was 
 found to have been thus poisoned. 
 
THE CRIMEAN WAR. 127 
 
 It would have been well to fly from the places thus 
 infected as quickly as possible ; but the care of the sick, 
 the havoc made in the ranks of the medical men 
 who had fallen victims of tried devotion to their 
 duties, the necessity of organizing the service of soldier- 
 attendants from the different regiments, and the time 
 required for embarking the sick and for provisioning 
 the division, did not permit us to leave for Varna before 
 the 7th of August. The pestilence raged up to that 
 time, but on the 9th, as soon as the column arrived upon 
 the high plateaux of Kavarna with its air revived and 
 made wholesome by the forests of the Balkan moun- 
 tains, an amelioration in the sanitary condition was 
 quickly felt, and the epidemic presently lost its intensity. 
 Some days later, the division returned to its camp at 
 Franka, where it prepared large field-hospital tents, 
 and under the most favorable hygienic conditions. There 
 remained but half of its late effective strength, the other 
 half being in the hospitals, or under the soil. The 
 loss of the bachi-bozouks was still more cruel; M.Cazalas 
 estimated, that their deaths amounted to full half of 
 their number. 
 
 The second division entered the Dobrutcha after the 
 1st. Upon arriving at Mangalia it found itself suddenly 
 seized with the cholera, and struck down without mercy ; 
 but General Bosquet, in the course of his operations, 
 observed a steady and firm policy, following faithfully 
 the hygienic measures advised by the physicians, and 
 rigidly enforcing them. The soldiers on the march never 
 neglected to make their soup and coffee, however long 
 the day's journey, or scarce the water, which was drawn 
 from wells, few and very deep. Three hundred arabas, 
 embracing the means of transportation of the 2d divi- 
 sion, had been divided among the different corps in such 
 a way that each had its own provisions with it, and each 
 could watch the peasants, and their oxen, who were 
 always ready to desert. This measure did not prevent 
 some of the former from taking flight, but they at 
 least left their waggons, and the beasts that drew them. 
 The soldiers were made to supply their place as drivers. 
 As the waggons were unloaded of their provisions by 
 
128 THE CRIMEAN WAR. 
 
 the daily consumption of the army, they placed upon 
 them the sick, and thus greatly increased the ordinary 
 transportation of the ambulances. At each bivouac, 
 they dug large trenches to inter the dead. One day, 
 General Bosquet said to an old soldier, who, pipe in 
 mouth, was covering over his comrades with apparent 
 indifference, "Close up this ditch, there are now enough 
 in it." " I am in time, general, and there are more to 
 come," replied the grave-digger, who felt himself mor- 
 tally struck with the cholera. A few moments after he 
 fell into the open ditch, and his body filled the place which 
 he had prepared. The 2d division was not more than 
 five miles from Varna, when the aide-de-camp of the gene- 
 ral-in-chief came to announce that the hospitals were too 
 full already, and that they could receive no more sick. 
 General Bosquet replied, that he was glad of it, as he 
 could do without hospitals, and place the sick in condi- 
 tions more favorable to health. Soon after, all his sick 
 were provided for in tents placed on the high plateaux, 
 in the midst of the woods. The soldiers discharged 
 cheerfully, and with a good will and singular devotion, 
 the duties of infirmary attendants. Many recoveries 
 attested the timely wisdom of the measures taken, and 
 in a short time the cholera, thus treated, became almost 
 harmless. Mother Philippon, who enjoyed great popu- 
 larity among the soldiers, was distinguished among all 
 the cantinieres by her indefatigable zeal. Day and 
 night she was on foot, and in the coarse vocabulary of 
 the camps, in which she excelled, would ask if they were 
 hungry or wanted anything to drink. The jokes of mo- 
 ther Philippon passed from mouth to mouth, and made 
 even those laugh who had the least inclination to do so. 
 
 The second division had comparatively much less 
 cholera than the first ; and the third, not having gone 
 beyond Bojardjik, was attacked with less severity than 
 the second. This circumstance seemed to settle beyond 
 doubt the fact, that the epidemic derived new energy 
 from the fatigues which our soldiers encountered in the 
 midst of a pestilential country. 
 
 Some physicians ascribe to conditions of dryness or 
 humidity in certain soils, an influence upon the murder- 
 
THE CRIMEAN WAR. 129 
 
 ous spread of cholera. They have pushed their in- 
 quiries through the various geological series, from the 
 granite to the tertiary formations inclusive, and have 
 studied the modifications which the epidemic derives 
 from them; but the facts observed almost mutually 
 contradict each other. Some observers attribute an 
 immunity to dry granitic regions, while others declare 
 the same in favor of marshy districts, but the Dobrut- 
 cha has given the cruel lie to this latter theory. It 
 has been asserted, that the cholera prevailed in the 
 plain before we penetrated it, but this statement seems 
 without any foundation. It is certain that the comman- 
 dant of the staff, M. Balliard, who about this time 
 visited the Danube side of Silistria, never heard the 
 cholera spoken of, nor did the army of Omer Pasha or 
 the village populations complain of its presence. It can. 
 no longer be doubted, that the germ of the epidemic 
 was in some way latent in the ranks of our army, and 
 that the slightest causes were only needed to bring it 
 suddenly into operation.*' 
 
 If the essential causes of cholera are unknown, and if 
 they are of a nature to escape our inquiries, the circum- 
 stances which propagate it are more and more manifest. 
 The unhappy experiences of the Dobrutcha clearly 
 prove that the violation of hygienic laws, insalubrity, 
 and misery, are capable of exciting it into murder- 
 ous activity, and constitute its true element. It is 
 enough to know that the revival of this pestilence, 
 which has so often ravaged the army of the East, has 
 
 * This generally received opinion is not entertained by M. Cazalas, 
 according to whom the choleraic influence reigned evidently in the 
 Dobrutcha, before the arrival of our army. " I have myself seen," 
 said he, " cases of cholera among the native population, and the reports 
 which I have received from these places leave no doubt of the fact 
 It is, however, incontestably proved from the fact that the 1st divi- 
 sion, which suffered most, was composed of regiments from Algeria, 
 where cholera did riot prevail at the time they left: and that the bacJii- 
 bozoucks, who had never seen either France or Algeria, and who had 
 had, so to speak, no communications with our troops, were attacked 
 first, and most violently. Thus the choleraic influence was developed 
 spontaneously in Turkey and the Crimea, where our troops have been 
 much exposed to bad hygienic conditions. Such at least appear to be 
 the facts demonstrated." 
 
130 THE CRIMEAN WAR. 
 
 uniformly happened when the army was in a peculiarly 
 critical position, and suffering from the influence of 
 extraordinary depression, want, privations, and fatigues. 
 The specific remedy for cholera is yet to be discovered ; 
 but medical science is not powerless: it gives wise 
 preventive measures, which are but too rarely ob- 
 served, and knows the symptoms indicating the approach 
 of the disease. An indisposition with tendency to chills, 
 a general feeling of illness, and above all, a derange- 
 ment of the bowels, with diarrhoea, are the premonitory 
 symptoms, of which we should take careful note in 
 times when cholera is to be apprehended.* By taking 
 immediate care we are almost sure to escape the disease, 
 or to reduce it to a mild form. Cases of fearful sudden- 
 ness, without premonitions, are so rare, that, in the 
 opinion of many physicians, they do not exist at all. 
 
 * All army surgeons have felt the difficulty of reaching the 
 early stages of disease among the privates of the regiment. Habitu- 
 ally careless of his health, the soldier will disregard the early premo- 
 nitions of an epidemic, and the sanitary precautions necessary to avoid 
 an attack. It is only by a strict enforcement of wholesome regula- 
 tions, and a constant watchfulness of the police of the camp, that men 
 will be prevented from practices injurious to the health, and of immi- 
 nent danger. Diarrhoea, as an accompaniment of cholera, or rather as 
 a premonitory symptom, has been generally remarked. The disease is 
 attended with a depressing effect upon the human system. In the 
 official medical and surgical history of the British army in the Crimea, 
 the following statements were made illustrating these facts. 
 
 " It was noticed by medical officers generally, that from the date 
 cholera first appeared among the troops in Bulgaria, the soldier's effi- 
 ciency was greatly impaired ; he was no longer able to undergo the 
 same exertion, he was fatigued by short marches, and a parade, pro- 
 tracted for a few hours, left him exhausted by the weight of his accou- 
 trements, and exposure to the hot sun ; and when the army arrived 
 in the Crimea, it was evident that the physical capabilities had already 
 been sadly reduced. In short marches though it must be admitted 
 generally marches very protracted the men fell out of the ranks in 
 great numbers ; they were unable, in many instances, to carry their 
 burdens, and their canteens, and even blankets, in some cases, were 
 thrown away. This mysterious poison, so subtle as to traverse immea- 
 surable distances, riding on the air, so gross as to find conveyance in 
 moving battalions, across water, over hills and valleys, and, if neces- 
 sary, through climates of opposite characteristics, was at work ; and 
 the exhausting flux which it determined, drained off the manly ener- 
 gies of the soldier, sapped his strength, and rendered him, in many 
 instances, helpless as a child." TR. 
 
THE CRIMEAN WAK. 131 
 
 The measures to be taken are very simple, such as 
 placing in a bed, so as to facilitate a salutary perspira- 
 tion warm aromatic infusions a girdle of flannel 
 around the bowels, and attention to diet. Light at- 
 tacks of the disease require no other treatment. In 
 the cold stage it is chiefly necessary to restore the 
 heat and circulation, and we must have recourse to 
 warm aromatic drinks, with a few drops of ether. 
 Rough frictions over the body, sinapisms upon the ex- 
 tremities, warm flannel coverings, and bottles of warm 
 water applied to the body, are usually considered useful 
 measures. Shampooing (massages) and friction excite 
 the capillary circulation, and recall the heat to the cold 
 parts, as after submersion ; yet some physicians doubt 
 their efficiency. In fact, it seems doubtful whether 
 purely mechanical agencies can combat successfully a 
 refrigeration caused by a depression of the vital forces. 
 Turkish baths exert a remarkable influence, and M. 
 Cazalas derived excellent results from their use in the 
 hospitals of Constantinople. These remedies could not, 
 of course, be used to any extent in the Dobrutcha. 
 The inadequacy of the stimulant allowed the pulse and 
 animal heat to fall almost to complete depression, and 
 many of the sick died without any reaction. 
 
 These excitants, if pressed too far, have their danger, 
 as they may hasten the reaction of fluxes and visceral 
 congestions, which may prove fatal. We therefore find 
 ourselves placed between two evils too little and too 
 much. The appearance of reaction is an almost infalli- 
 ble indication of returning health, if rightly managed. 
 Bleeding, and acidulous drinks, modify its violence. 
 Convalescence demands the greatest caution, as relapses 
 are always very serious in results. It will be seen that 
 this treatment is easy to apply ; it is rational and simple, 
 and in fact too simple to satisfy the sick, who are not 
 always contented with common remedies. 
 
 Cholera is transmitted by the air, and is not conta- 
 gious in the exact sense of the word; or otherwise, all 
 our physicians would have been attacked. In its journeys 
 it has two different modes of travelling : sometimes 
 from neighborhood to neighborhood, and sometimes it 
 
132 THE CRIMEAN WAR. 
 
 advances by leaping over a district where the inhabitants 
 appeared to be threatened, and invades, on a sudden 
 and without notice, other places where it was least ex- 
 pected. In these latter cases it is probably imported ; 
 but whether imported or not, wherever causes of affini- 
 ty pre-exist, no matter what sanitary precautions are 
 taken, its visit is certain ; in like manner it may disap- 
 pear spontaneously without our knowing why. When 
 circumstances favoring its appearance do not exist, it 
 may be imported without danger ; it will not develop 
 itself. During the war of the East there was not, so 
 to speak, a single week in which choleraic patients were 
 not brought in steamboats to Constantinople, but yet 
 the disease did not attack the Mahomedan population. 
 
 The excellent traditions of the army of Africa were 
 not forgotten. They go back to the time of Marshal 
 Bugeaud, who exhibited an example of rare solicitude 
 for the soldier. When he commanded an expedition, he 
 always took care in the evening to reconnoitre the route 
 of the morrow, and learn the obstacles which were to 
 be encountered, with the view of regulating the times 
 of departure of the regiments, and never let the men 
 remain a needless time with the knapsacks upon their 
 backs. The columns started at daybreak at every sea- 
 son of the year, after taking coffee or eating soup ; 
 every man had a light infusion of coffee in his canteen. 
 After marching three-quarters of an hour, he always 
 called a halt of twenty minutes, and after that they stop- 
 ped to rest only a few minutes at a time, every hour. 
 He presided himself at the passage of the fords, re- 
 quiring the men to take off, or roll up, their pantaloons, 
 and to preserve from wet their shoes and socks. If the 
 water was deep, they passed over single file, with ropes 
 to serve as guards. Sentinels were placed over the 
 springs of fresh water, found upon the road, to prevent 
 the troops from drinking to their injury, and thus 
 many cases of sickness were avoided. When not de- 
 layed by the firing of the enemy, the troops reached 
 their bivouac by ten o'clock in the morning. They had 
 then time enough to get well established, prepare a 
 comfortable soup, wash their linen, and recover from 
 
THE CRIMEAN WAE. 133 
 
 their fatigues. The camping grounds were chosen, as 
 far as practicable, upon elevated grounds, at a distance 
 from swamps, and near wood and water. When wood 
 was not expected in the next bivouac, each soldier car- 
 ried a faggot upon his knapsack, and a piece of wood 
 used as a walking stick. 
 
 The Marshal often tasted the soups of the messes, and 
 assured himself that the flannel girdle was around the 
 loins, and not in the knapsack. At nightfall he posted 
 the pickets and camp guards, and to prevent thieves 
 from stealing into the camp by night, he placed the 
 most distant sentries along the roads, and those near the 
 camp in the bushes, knowing that thieves abandon the 
 regular roads when they approach the bivouac. He was 
 the last to retire to his tent, having a company en- 
 camped close to him, so as always to have some soldiers 
 at hand, in case of an alarm or night attack. He was 
 annoyed whenever he saw needless fatigues imposed upon 
 the men during a campaign, such as parades, manoeu- 
 vres, dressing line, etc. Said the Duke of Isly to a 
 young colonel who, on arriving at the bivouac, had left 
 his men ten minutes under arms, " I see, sir, that you 
 have never carried a knapsack upon your own shoul- 
 ders.'' Although he admitted into his intimacy the 
 chief physician of his field hospitals, he wished to ob- 
 serve for himself the sanitary condition of his men, as 
 to their digestion, and took a glance at their alvine 
 evacuations around the camp. He checked a tendency 
 to disease whenever he saw it, by a day of timely 
 repose, and a supplementary ration of rice, meat, coffee, 
 or wine. Knowing that half of the troops that en- 
 tered the hospitals, or lagged behind, ran the risk of 
 losing their lives, and that often the men were made 
 lame and disabled by a shoe that was too tight, he 
 ordered the colonels never to allow a pair of shoes to 
 be given out, until they had been carefully tried on : 
 and to frequently make themselves sure of the con- 
 dition of the shoes themselves, and see that they were 
 daily softened by a coat of grease. Following the 
 example of Marshal Clausel, he assigned a company of 
 men to the service of the field hospitals, to prepare the 
 
134 THE CRIMEAN WAR. 
 
 tents, and provide wood and water. He often visited 
 the sick and wounded, and his presence restored their 
 morale. For all these cares he was called the father of 
 the soldiers, and he always found his troops, in time of 
 combat, energetic and full of health, enthusiasm, ardor, 
 and warlike courage. He could ask of them the dis- 
 arming of the most ferocious tribes, the only means, in 
 the eyes of the illustrious Marshal, of securing their 
 submission, and the empire to our arms. 
 
 The painful impression made by the expedition of the 
 Dobrutcha, was rapidly effaced. The allied armies em- 
 barked for the Crimea, to enter upon the real campaign, 
 in which battles and new diseases soon rendered the 
 establishment of many new hospitals necessary. From 
 1854 to 1856, nineteen French hospitals were success- 
 ively established at Constantinople, in buildings of four 
 different kinds : permanent barracks, Turkish hospitals, 
 palaces, and wooden barracks. To recall the circum- 
 stances which caused the establishment of these hospi- 
 tals would be to record the most melancholy epochs of 
 the campaign. 
 
 CHAPTER TI. 
 THE HOSPITALS AT CONSTANTINOPLE. 
 
 ON the 14th of September, 1854, the three allied 
 fleets disembarked, without resistance, upon the soil of 
 the Crimea, at Oldfort, 137 cannon and 61,200 men ; of 
 whom 27,000 were French, an equal number English, 
 and 6,000 Turks. The want of good drinking water, 
 which would have to be brought a distance of three miles 
 and a half, compelled the allied armies to use a brack- 
 ish water, obtained by digging pits along the sea shore ; 
 but this became so bitter when it was boiled that they 
 abandoned it in making soups. They were also without 
 wood. The consequences were, derangements in the 
 digestive organs, which brought on some of the symp- 
 toms of cholera, especially in the English army. Our 
 
THE CRIMEAN WAR. 135 
 
 allies, having been unable to bring their large tents, 
 which were inconvenient to carry, were furthermore 
 exposed by night to dampness and the abundant rains, 
 while our African army had with them their little shel- 
 ter-tents. 
 
 On the 19th an order to advance was hailed with a 
 shout of enthusiasm. The divisions were doubly happy 
 in marching upon the enemy, and in leaving these bivou- 
 acs, destitute as they were of wood and water. We 
 know with what vigor and success the Russians were 
 attacked, on the morrow, in their formidable posts at 
 Alma ; upon their left, by the troops under General 
 Bosquet, whom nothing checked, neither canister nor 
 the ruggedness of rocks ; upon their right, by a portion 
 of the valiant English army; and in the centre by the 
 bayonet charges of the troops of Generals Canrobert and 
 Napoleon. 
 
 The transportation of the wounded upon cacolets, and 
 litters borne upon the backs of mules, again demon- 
 strates that this system is better than ambulances upon 
 wheels.* Whenever a man fell wounded in the ranks 
 his comrades carried him a few paces in the rear, where 
 the muleteers took charge of him. The battalion sur- 
 geon, or those who attended the ambulance, applied the 
 first dressings and made him lie down in a litter, or sit 
 in a kind of chair called the cacolet, in which he was 
 then carried to the field hospitals, placed as well as might 
 be out of the reach of the bullets. There each officer 
 and soldier waited his turn to be operated upon, except 
 that those more severely wounded took precedence. 
 
 The victory achieved on the 20th of September, 
 poured into our field hospitals 1,033 wounded French 
 
 * In 1835, in the expedition of Mascara, in the province of Oran, I 
 realized the idea of carrying litters upon camels, one upon each side. 
 This method has since been perfected. The camel, in walking, has a 
 balancing motion, and the wounded were placed rather high. We 
 have exchanged, with advantage, the camel for the mule, an animal 
 more gentle and more easily managed. AUTHOR'S NOTE. 
 
 The Cacokt consists of a pair of chairs with strong side arms and 
 concave backs, which hook together and hang across a mule. The 
 seats are attached to the backs by hinges and straps, so as to be 
 adjusted to the most convenient angle for the patient. TR. . 
 
136 THE CRIMEAN WAR. 
 
 and several hundred Russians. Both were, immediately 
 after the first dressings, carried on board the fleet, and 
 thence to Constantinople, where, on the 24th of Septem- 
 ber, was established the hospital of Dolma-Baktche, 
 located about one hundred rods from the Bosphorus. 
 This hospital, reserved almost entirely for the wounded, 
 embraced two isolated and entirely distinct buildings ; 
 the one more elevated was the artillery hospital of the 
 Ottoman Guard, and the other, about twenty rods below, 
 contained 600 beds. The ships arriving from the Crimea, 
 anchored at the entrance of the Golden Horn near Top- 
 Hana. The wounded, placed upon tenders and landed 
 at Dolma-Baktche, were carried upon litters by attend- 
 ants or Turkish soldiers. From September 24th, 1854, 
 to April 1st, 1856, this hospital received 8,582 invalids, 
 mostly wounded ; and of these 2,318 died. The manage- 
 ment of this important service was intrusted to a skilful 
 director, Dr. Salleron. 
 
 The officers wounded at Alma, caused the establish- 
 ment of the hospital of Canlidje upon the Asiatic side 
 and directly adjacent to the Bosphorus. The viceroy 
 of Egypt had liberally placed at our disposal this domain, 
 which was his country residence. Beautiful undulating 
 gardens, a pure atmosphere, and elegant kiosques, made 
 this an enchanting place of sojourn. Near us was the 
 palace of Fuad-Pacha, minister of foreign affairs. Two 
 young Armenian girls, belonging to his harem, eluded 
 the vigilance of the eunuchs. Their songs and playing 
 upon the piano had attracted the notice of two aides- 
 major, whom they saw through the lattice of their win- 
 dows. They were smitten with their admirers, and one 
 fine day escaped in the costume of one of the pacha's 
 sons. On the next day they were taken back to their 
 prison. This escapade would have assumed the propor- 
 tions of a grave event, had it not been for the prudence 
 of Fuad-Pacha, who contented himself with recovering 
 the fugitives. It was, nevertheless, asserted wrongly, I 
 have no doubt that according to the Turkish custom, 
 these two unfortunates were put into a sack and cast 
 into the Bosphorus. Subsequently the wounded officers 
 exchanged the hospital of Canlidje for the house of the 
 
THE CKIMEAN WAE. 137 
 
 Russian ambassador. Two or three hundred beds, 
 placed in the palace of Mehemmed-Ali, were appro- 
 priated to the soldiers. 
 
 It w T ill be remembered that the allied armies landed in 
 the Crimea with nothing but light artillery, which was 
 quite unable to contend against the heavy marine artil- 
 lery which bombarded them from the roadstead of Sebas- 
 topol. It was necessary to prepare for a regular siege. 
 The w r orks of investment and circumvallation were begun 
 on the 9th of October, and rapidly pushed forward; 
 numerous battalions and companies of sharpshooters 
 protected the laborers. Night and day one half of the 
 army were exposed to the iron storm and the vicissi- 
 tudes of the season, while the other half snatched a short 
 repose in order to take its turn at the work. New 
 troops arriving daily increased the number of the sick, 
 while the failure of the fire, opened October 17th, 1854, 
 against the place, by the vessels of the two combined 
 fleets, and by batteries mounting 126 siege guns, -added 
 new numbers to our wounded, and seemed to indicate 
 that the city of Sebastopol,then defended by a garrison 
 of 32,000 men,* and by the army of reserve under the 
 orders of Prince Menchikoff, could not be taken by a sud- 
 den dash. The remittances of sick and wounded from the 
 Crimea to Constantinople, followed one another rapidly. 
 In October two important hospitals were opened, one 
 ' for 1,200 sick at Ramis-Tchiflik, a fine barrack situated 
 upon the plains of Daoud-Pacha ; and the other upon the 
 heights which command the Bosphorus towards Pera, 
 in the buildings of the preparatory school, which were 
 arranged to receive 400 beds. In the following months 
 new hospitals were opened. In the extensive gardens 
 of the point of the old seraglio, at Gulhane, the military 
 engineers had erected barracks for 1,800 sick ; above 
 that, the University palace, a fine edifice of cut stone, 
 and still unfinished, was prepared as a hospital for 1,400 
 beds. 
 
 These tw r o establishments, opened in the old aristo- 
 cratic Ottoman quarter, in the very heart of Stamboul, 
 
 * Of whom 21,000 were marines, rendered available in the sinking 
 of the vessels to serve as a barrier to the roadstead. 
 
 7* 
 
138 THE CRIMEAN WAR. 
 
 denoted to what degree of tolerance the Turks had 
 attained concerning us. In the suburb of Pera, there 
 were added to the hospitals already established there, 
 that of the Military School, containing one thousand one 
 hundred beds, reduced soon after to five hundred by a 
 fire, and that of the Parade Ground, containing twelve 
 hundred beds under shelters. The barrack of Daoud- 
 Pacha, designed as a place for convalescents, became 
 itself a hospital for one thousand two hundred sick. 
 With such vast resources for hospital accommodation 
 yet barrack-camps for twenty-five thousand men were 
 being constructed at Muslak, on the high plateaux 
 which border the shores of the Bosphorus, and proved 
 of incalculable service in time of the typhus. The 
 central pharmaceutical department, intrusted to supply 
 the medical service of the Crimea, and of Constantinople, 
 was established upon the sea-shore, near Bachisstach, in 
 the palace of a pacha. The Minister of War had sent 
 to the army of the East, new and complete material for 
 thirty-five hospital establishments of five hundred beds 
 each. I have spoken before of the difficulties encoun- 
 tered in the Crimea, in taking care of the materials, and 
 in washing the bed clothing and the linen. We were 
 surprised to find these difficulties at Constantinople. 
 To surmount them, it was only necessary to establish 
 small steam wash-houses, like those which some military 
 hospitals possess, as, for example, that of Nancy. For 
 this purpose, a movable furnace containing a steam 
 generator is necessary. The steam entering at the base 
 of the double-bottomed coppers, acts mechanically upon 
 the linen, impregnated with an alkaline solution, and 
 hastens the formation of soap-suds. Without going into 
 further details of the operation of this economical appa- 
 ratus, easy to set up and transport, I would add, that it 
 only requires four hours to empty a copper of three and 
 a quarter tons, and eight hours by the method of 
 Thiery, to empty four coppers at once. How useful 
 these washing machines would have been, not only in 
 our hospitals, but in our field-hospitals, and even in our 
 stationary camps. 
 
 About two-thirds of the fever patients received into 
 
THE CRIMEAN WAR. 139 
 
 the hospitals of Constantinople, were attacked by 
 diarrhoea or dysentery. The diarrhoea was so common, 
 that we might say that sickness was almost always 
 preceded by a diarrhoea in the acute stage, and termi- 
 nated by a diarrhoea in the chronic stage. This sad 
 complication was not peculiar to the army of the East, 
 but has been observed in all armies in campaign ; it is 
 concomitant with the soldier's life, to the poor rations, 
 home-sickness, and the thousand influences which it is 
 not always possible to foresee. Dysentery has almost 
 always for its first symptom, a more or less active 
 diarrhoea, of which it is, as it were, the second stage. 
 The intestinal changes proceeding even to ulceration, 
 indicate alike the anatomical lesion in the two diseases. 
 Acute diarrhoea, so common among soldiers upon 
 beginning a campaign, is often cured in a few days 
 by rest, regimen, the wearing of a flannel girdle, and if 
 needed a few drops of laudanum.* If it were possible to 
 treat it always by these simple means, and to prevent 
 relapse by hygienic care, we might certainly reduce by 
 more than half the number of cases of disease, and of 
 death. An emetic, or an emetico-cathartic, will almost 
 always drive off in a short the gastric difficulties with 
 which this disease becomes complicated. In the chronic 
 or advanced stage, astringents, which are so much extolled, 
 only give an ephemeral rather than a real relief, and are 
 often more pernicious than useful. The best tonic is 
 good wine, in small doses often repeated, the effect of 
 which should be carefully watched by the physician. 
 
 * Feculent, gummy, arid sweetened drinks, are almost always given 
 in intestinal disorders, as emollients. In a very interesting work upon 
 antiphlogistic and emollient medication, by Prof. S. Delioux de Roche- 
 fort, he has examined the action of these so called emollients. He 
 concludes that, feculent, gummy, and sweetened drinks, being soon 
 decomposed and absorbed upon entering the intestines, their emollient 
 topical application is null, unless we consider them as nutritious 
 drinks, perhaps useful in so far as they make agreeable change in 
 the diet of the sick. In a word, they are aliments, not medicines. 
 These views appear to justify the practice of the English physicians, 
 who are as sparing of diet-drinks as we are prodigal of them in 
 France. It is true that our sick believe they cannot be cured unless 1 
 they take infusions of all kinds, which harm oftener than they 
 benefit. 
 
140 THE CRIMEAN WAK. 
 
 A light dose of opium alone, or better still, given with 
 ipecacuanha, or sulphate of magnesia in small doses, has 
 been more efficacious than all other therapeutic agents. 
 A severe regimen can alone prevent a relapse, which is 
 very often fatal.* 
 
 This disorder would have committed greater ravages, 
 had it not been for the moral energy which through the 
 whole campaign sustained the French troops, and which 
 never showed itself so strongly as in the most critical 
 moments. 
 
 * Diseases of the bowels, the constant scourge of armies, affected the 
 English troops to an alarming extent in the Crimean war. For one- 
 third of the eighteen months embraced, they presented a more fatal 
 aspect than had ever before been recorded. The exciting causes 
 might be divided into two great classes. First, an epidemic or choleraic 
 constitution of the air, with the seasoning agencies of a hot climate, 
 and 2d, the hardships and privations of a winter siege, in an inhospi- 
 table climate. The mortality was chiefly to be ascribed to the latter 
 class of causes. From April, 1854, to June, 1856, inclusive, 55,767 
 cases of diseases of the stomach and bowels were admitted into 
 the English hospitals, of which 7,611 were from the cavalry, 7,014 
 from the ordnance, and 41,140 from the foot guards and infantry. 
 Of these, 5,950 were fatal; 281 from the cavalry, 487 from the 
 ordnance, and 5,182 from the foot guards and infantry. 
 
 The scorbutic taint gave peculiar virulence to this class of diseases, 
 and the prevalence of ulceration of the intestines, especially towards 
 the lower part, was perhaps the most constant pathological condition 
 observed. Surgeon Macleod remarks upon this condition as follows : 
 
 " The immense majority of those who served during the early part 
 of the war were so affected, the ulceration being rather of recent than 
 ancient date : and this remark does not apply to those who died of 
 abdominal affections, but also to those who succumbed from other 
 diseases or from wounds. It is also a fact which I have had many 
 opportunities of verifying, that men killed in action at a time when 
 they were apparently in the possession of health, or rather, as it should 
 be put, men dying shortly after receiving severe wounds when seem- 
 ingly robust, were found to have ulcers in their intestines, sometimes 
 of a very extensive character. To this it was not uncommon to find 
 diseased kidneys and lungs added. The disease, in these cases, 
 might not be active at the period of death, but it was ready to break 
 out whenever any injury or operation made an extra demand on the 
 powers of life. It is of importance to note this extraordinary pre- 
 valence of undeveloped disease this deceptive character in the 
 appearance of the men as bearing on their behavior under acci- 
 dent" TB. 
 
THE CRIMEAN WAE. 141 
 
 The importance of the MalakofF bastion was fully 
 recognised, and preparations for its attack were pressed 
 with vigor. The Russians had executed with rapidity 
 a series of works and counter-approaches, which it 
 was resolved to take on the night of February 23-24, 
 1855. General Bosquet passed through the trenches 
 where the soldiers were half leg deep in mud. He was 
 preparing his troops for the combat, when he met a sen- 
 tinel, who had just before been wounded in the head, and 
 who presented arms. Seeing the blood flowing from 
 the wound, the general asked him why he did not go to 
 the field hospital. " My shoes are full of holes," replied 
 he, alluding to the avidity with which his comrades dis- 
 puted for some of the Russian spoils ; " there is to be a 
 distribution of boots to-night, and I want to be there." 
 
 It was not cholera and dysentery alone that peopled 
 our hospitals of the East, but fevers of various kinds. 
 The miasms exhaled from the putrid decomposition of 
 vegetable matter taint the air, and produce in the 
 economy the same effects as poison, which nature 
 seemed to seek to rid herself of by critical and periodical 
 fevers. This special fever, which we have named inter- 
 mittent, to distinguish it from continued fever deter- 
 mined by other causes, is characterized by three w r ell 
 marked periods ; first the cold stage, then the hot, and 
 lastly the sweating stage. However, it rarely showed 
 itself in the Crimea in this pure and distinct form ; but 
 commonly the accession was incomplete the heat would 
 steal on without the initial chill, and without being fol- 
 lowed by the sweating. This disease appeared to be no 
 other than a modification of continued fever. It was 
 very rare to find diseases, of themselves continuous, run 
 through all their phases, without becoming complicated 
 with intermittent phenomena. The fevers were then 
 generally remittent. They are thus called when they 
 are composed of a continuous febrile element and of an 
 intermittent febrile element.* 
 
 * The tendency of malaria to give a remittent form to all diseases 
 that may appear in a given district where this influence prevails has 
 been often noticed. 
 
142 THE CRIMEAN WAR. 
 
 The Russian physicians regarded remittent fever as 
 endemic in the Crimea, where the Tartars contracted it as 
 readily as strangers. This malady has been considerably 
 developed in their army, and they principally attribute 
 it to the insalubrity of their subterranean huts. Among 
 our soldiers the accessions of remittent fever were rarely 
 complete. The slightest intermittent attack proved 
 rapidly fatal when it appeared in the course of a con- 
 tinued fever, for the economy had then already received 
 serious damage from privations, diarrhoea, scurvy, and 
 other chronic diseases. In these complicated cases, in 
 which the intermittent was only secondary, the first 
 care was to attack the continued febrile element by 
 emetics if there appeared a gastric difficulty, by bleed- 
 ings if symptoms of plethora were noticed, &c. At the 
 same time, upon the first appearance of intermission or 
 remission, it was necessary to hasten or prevent their 
 return by two or three doses of quinine,* of from fifteen 
 to thirty grains. The attacks of pernicious intermittent 
 
 The surgeons of the American army in winter quarters near Wash- 
 ington, in the winter of 1861-2, observed this tendency in nearly all 
 their diseases, and derived a corresponding benefit from the use of 
 quinine. 
 
 The whole of the region occupied by the army of the Potomac was 
 more or less malarious, and autumnal intermittents are familiar to the 
 civil practitioner. In some of the more sickly of the regiments, the 
 low condition of health might fairly be traced to the depressing effects 
 of summer camps in low valleys, which left the men with constitutions 
 impaired, and liable to the invasion of diseases. These usually assumed 
 a typhoid form. The percentage of sickness to the effective strength 
 varied from one-third of one per cent, to eighteen per cent, in a regi- 
 ment, the average being about five and a half. Some of the sicklier 
 regiments were from the Northern border of the Union ; and it was 
 observed that soldiers enlisted in the naval districts, although often a 
 rough and apparently hardy class of men, endured the open winter and 
 humid climate of the Potomac region with less resistance than those 
 from cities. 
 
 The army of the Potomac, abundantly fed and clothed, presented 
 a favorable comparison with the British army in time of peace, in 
 which six and a half per cent, of the force otherwise available are 
 reported " in hospital." In the Peninsular War under the Duke of 
 Wellington, in 1808-14, it was twenty-one per cent., and their sick 
 list varied from nine to thirty-three per cent, at different periods TR. 
 
 * The sulphate of quinine is always to be understood by this term 
 when used in this work. TR. 
 
THE CRIMEAN WAR. 143 
 
 fever are caused by a deep paludal intoxication. In the 
 Dobrutcha a certain number of cases were observed, but 
 it was rare in the Crimea. 
 
 The still increasing numbers of our fever patients ren- 
 dered the hospitals at _ Constantinople insufficient for 
 their accommodation. The Sultan, with an unprompted 
 generosity, offered a palace then scarcely finished, which 
 bore his name, and became thenceforth the hospital of 
 Pera. The architecture of this palace was in the orien- 
 tal style, very handsome, and of great solidity. Each 
 angle had a tower which supported another story, and 
 a central minaret, adorned with many ranges of balco- 
 nies, boldly pierced the clear azure of the heavens, and 
 lent to this monument an aerial appearance, without 
 detracting from its majestic character. The ground 
 floor, elevated about six and a half feet above the earth, 
 and the first story, presented broad and immense galle- 
 ries, lighted on the side of the court by arched openings, 
 the arches resting upon elegant pillars. The openings 
 were closed by large windows. These galleries were 
 intended to serve exclusively for promenades in bad 
 weather, and it is to be regretted that the necessity of 
 lodging 2,000 sick required us to employ this space. 
 We have already noticed the danger of collecting large 
 numbers of men afflicted with severe maladies and forced 
 to remain all the time in bed. It is offering a premium 
 for infection, which is the cause of the greatest number 
 of deaths. Abundant water, of good quality, was drawn 
 from the fine forests of Belgrade, where visitors admire 
 the gigantic aqueducts of Constantine, and the still more 
 wonderful sluices, which are held in place by enormous 
 blocks of marble, brought thither at great cost in the 
 reign of the Sultan Mahmoud. In front of the hospital 
 of Pera rise the shores of Asia, the city of Scutari, and 
 its deeply ravined knoll, which descends to the Bospho- 
 rus and commands the great Field of the Dead, planted 
 with evergreen trees. The sick arriving from the Crimea 
 were debarked at Bachistach, distant about a mile and a 
 quarter from the hospital, but the ascent was so^steep 
 that convalescents themselves could scarcely make the 
 journey on foot. At the head of this great establish- 
 
144 THE CRIMEAN WAR. . 
 
 ment, the renowned physicians, Messrs. Scoutetten, 
 Morgues, and Cambay, were successively placed. Each 
 of them sought to reduce the figure of hospital inmates, 
 but still the beds were always full. The Crimea sent us 
 new sick daily ; every ship brought two or three hun- 
 dred. It may give some idea of the importance of the 
 hospital of Pera by mentioning that it received 27,500 
 sick during the twenty-two months of its existence, of 
 whom 9,460 left entirely cured, 13,000 were sent 
 to France or turned into other hospitals, and 5,040 
 died. 
 
 After the taking of the Malakoff bastion, the hospital 
 received 800 sick in one day, of whom 595 were severely 
 wounded Russian prisoners. The greater part of the 
 latter would not at first consent to the grave opera- 
 tions which their condition demanded ; it was only later, 
 upon seeing their comrades die, that they consented. 
 Unhappily, this delay was fatal ; but, nevertheless, they 
 survived in greater numbers than our own soldiers, 
 because their constitutions were less deeply impaired by 
 fatigue and privations. Moreover, a rough and chiefly 
 manual education, strict sobriety, and a coarse but abun- 
 dant aliment, caused a great preponderance of the mus- 
 cular system* in the physique of the Russian soldier ; the 
 nervous element being much less developed, they suffer 
 less in operations than our own soldiers. The progress 
 of their wounds is more rapid and regular, the febrile 
 reaction less marked ; their power of assimilating food 
 greater, and requiring greater quantities; their blood 
 appeared richer and more plastic, and their arterial sys- 
 tem more fully developed so much so, that after each 
 operation it \vas necessary to tie more arteries than in 
 the wounded of our own army. They evinced strong 
 tokens of gratitude towards the French surgeons, who 
 
 * The experience of the army surgeons of the United States among 
 our "Western Indians has led to a somewhat similar remark. The repa- 
 rative forces of nature appear to be more powerful than with the whites, 
 and they will survive a greater bodily mutilation. This has been 
 ascribed by Dr. Day to the greater simplicity of their diet, and may be 
 in part due to a less delicate susceptibility and the greater develop- 
 ment of the muscular as compared with the nervous system. TR. 
 
THE CRIMEAN WAR. 145 
 
 bestowed the same care upon them as upon our own 
 soldiers, among whom they lodged. None sought to 
 escape. Our rations of white bread, more easy of diges- 
 tion than the Russian army bread, proved insufficient, 
 and had to be increased. These soldiers wore pictures 
 of the saints, or copper crosses, suspended around the 
 neck by a tape ; they recited daily their prayers in their 
 beds, taking no notice of the persons in the room. 
 
 From the 21st of May, 1853, the house of the Russian 
 ambassador at Pera remained closed. On that date 
 Prince Menchikoff hastily took his departure. Whilst 
 the French and Russian officers and soldiers encumbered 
 onr hospitals at Constantinople, the doors of the palace 
 remained inexorably closed, although it was of size suffi- 
 cient to receive 400 sick. A force of 30,000 men, 22,000 
 of whom were of the guard, were assembled in the fields 
 of Maslak, to reinforce the army in the Crimea. They 
 experienced many attacks of cholera, which threw many 
 new sick upon our hospitals. At length, after the nume- 
 rous and bloody conflicts of April and of May 1st, 1855 
 after the grand and terrible artillery duel, which 
 gained us some important works of defence, it was 
 decided to lodge the French and Russian wounded 
 officers in the house of the ambassador. All the furni- 
 ture was carefully carried into rooms reserved for its 
 storage. M. Lelouis, the physician in chief, a man of 
 unquestionable merit, took charge of the wounded, and 
 devoted himself to them, but still this hospital soon 
 showed signs of infection. The wounded became affected 
 with hospital gangrene, and afterwards the typhus, 
 imported from the Crimea, was propagated from bed to 
 bed. When peace was signed, the French government 
 expended large sums in putting this palace in good con- 
 dition, and made it even finer than before, by repairing 
 injuries of older date. 
 
 At the beginning of the campaign, the Sisters of 
 Charity had opened, in the suburb of Pera, a hospital, 
 which soon became highly sought for by the officers. 
 Each invalid received, in a room by himself, the most ten- 
 der and intelligent care, and could enjoy the services of 
 any military surgeon he should choose. This eonveni- 
 
146 THE CRIMEAN WAR. 
 
 ence was very highly appreciated, and the hospital of 
 the Sisters was always full. 
 
 Among the French soldiers received into the hospitals 
 at Pera, there were many who had been wounded in the 
 frequent street quarrels of this suburb, whose mixed 
 population, so different from that of the Musulman 
 quarter of the Stamboul, embraced a great number of 
 renegades from justice, of every nation. At Pera, crimes 
 were committed with impunity in open day ; assassina- 
 tions occurred in the middle of the street, and the 
 passer-by went on his way, as if he had seen nothing. 
 By request of the general of division, Larchey, superior 
 commandant at Constantinople, the JYench ambassador, 
 M. Thouvenel, obtained permission to establish a French 
 police at Pera, and our armed police guards rendered 
 the most essential service. They arrested the malefac- 
 tors; but here a new difficulty was encountered, for 
 these miserable wretches were reclaimed by the consuls 
 of their country, who, under the pretext of trying them, 
 allowed them their liberty. It generally ended by 
 granting them a hearing, and by their giving a sufficient 
 security for good behavior. 
 
 At the time when the house of the Russian ambassa- 
 dor at Pera was turned into a hospital, the most bloody 
 conflicts of the campaign had occurred, and some 
 months after, the taking of Sebastopol seemed to put 
 an end to the Crimean war; but the task of our medical 
 staff was far from being ended, and if the numbers of 
 our wounded were less, those of the sick were largely 
 increased, under the double influence of scurvy and 
 typhus, and in proportions which excited the greatest 
 solicitude. Then, as at the opening of the campaign, 
 the Turkish government showed itself most kindly dis- 
 posed to second the efforts of the French administration. 
 Contrary to all antecedents, the Sultan had attended a 
 sumptuous ball given by the French ambassador. The 
 French and Ottoman troops fraternally formed the 
 double lines upon his passage ; salvos of artillery an- 
 nounced his entrance into the palace of the ambassador. 
 Abdul-Medjid was conducted into an elegant saloon, 
 reserved for his use, where I had the honor of being 
 
THE CRIMEAN WAE. 147 
 
 presented to him. He spoke to me with lively interest, 
 of the body of Turkish troops which I had visited at 
 Eupatoria, of the health of his soldiers and ours, and 
 pressed me to visit the Turkish military hospital at 
 Constantinople, concerning which he desired my opinion. 
 The Sultan understood French, and spoke it in its 
 purity, but with a timid reserve, so that his minister of 
 foreign affairs, Fuad-Pacha, who had made medical 
 studies in Paris, hastened to supply the words to his 
 thought when he hesitated. His countenance, naturally 
 somewhat sad and thoughtful, was animated in conver- 
 sation, and showed at times a remarkable expression 
 of ingenuousness and benevolence. He made his en- 
 trance into the ball, in the midst of all the high func- 
 tionaries of his empire, covered with embroideries in 
 gold, and crosses in brilliants. His costume was of a rich 
 plainness : a cap of red felt without ornament, a little 
 black cloak with upright collar, sparkling with large 
 diamonds, a European coat, and the broad band of the 
 Legion of Honor. The old Turk party was greatly 
 troubled on this occasion ; in their alarm they thought 
 that the Sultan, in accepting the broad band of the 
 Legion of Honor, had been converted to Christianity ; 
 but to quiet them, they were made to understand that 
 the star of the Legion of Honor was composed of five 
 points, and not of four, as in the Christian emblem. 
 
 The Sultan advanced with slow and measured steps 
 into the ball-room, looking to the right and left with a 
 tranquil and easy air, although it was the first time he 
 had been in such an assembly. He took his place upon 
 a reserved seat, where he appeared to follow with some 
 interest the movements of the dance. I know not 
 what impression Abdul-Medjid received from this array 
 of beautiful women and brilliant toilets, but I doubt if 
 it was favorable to female emancipation in Turkey. He 
 retired at an early hour, with the same ceremonial. I 
 remarked that the assistants kept some distance from 
 his person, and I learn that this is not simply from respect, 
 but on account of the aversion which contact with a man 
 inspires, and which is explained by remembering the 
 disastrous epidemic so common in the East. The Sultan 
 
148 THE CRIMEAN WAE. 
 
 lays off, never to resume, the garments which a man has 
 touched. We know that he is served exclusively by the 
 females of his harem. He never addresses a word to 
 any one in public ; but once or twice, to the great 
 astonishment of Musulmans, he laid aside this traditional 
 habit, in favor of General Larchey. He fixes his looks, 
 for a longer or shorter time, upon the person whom he 
 meets, according to the degree of esteem which he 
 wishes to evince. In this mute language of the padishah, 
 are foreshadowed the inner sentiments which words fail 
 to express. I was able to read it perfectly, during the 
 filing of the high functionaries of the empire before the 
 Sultan, on the day of the ceremony of the beiram, or 
 kissing the feet. The filing past continued more than 
 an hour, during which the looks of Abdul-Medjid did 
 not rest upon more than twenty persons. I observed 
 that they made only a feint of kissing the feet, and each 
 time that an indiscreet worshipper touched the Sultan, a 
 slight motion testified to the keen and disagreeable 
 sensation which had troubled the reverie of his sove- 
 reign. 
 
 CHAPTER III. 
 
 THE SCURVY AND TYPHUS. 
 
 THE leisure which marked for us the beginning of 
 winter in 1856, was short. The attention of the medi- 
 cal corps was soon called, as I have said, to two grave 
 epidemics scurvy and the typhus, which came upon us 
 with cruel intensity. 
 
 In the Crimea as elsewhere, the scurvy was induced 
 by debilitating causes, a diet too uniform, composed 
 often of salted meat, and a slender supply of fresh vege- 
 tables, personal filthiness, fatigue, home-sickness, putrid 
 emanations, and above all a cold, damp, and rigorous 
 winter. The first stage of the scurvy is marked by a 
 change in the constitution of the blood, but without any 
 very apparent external or local symptoms. A general 
 
THE CRIMEAN WAR. 149 
 
 tendency to haemorrhages, great muscular lassitude, 
 deep-seated pains, especially towards the feet (pains 
 which physicians have mistaken for a specific disease, 
 calling it acrodynia*), a slackening of the pulse, a loss of 
 appetite, a marked discoloration of the skin, and a 
 remarkable dilatation of the pupils, these are the symp- 
 toms of the first stage of this disease. Soldiers were 
 rarely sent to the hospital during this stage, but almost 
 all of those received for other diseases, had at the same 
 time scurvy in the first stage. In the second stage, 
 the gums swelled, softened, and ulcerated, emitting an 
 infectious and abominable odor. A sister of charity 
 died of gangrenous inflammation of the pharynx, from 
 having inhaled the breath of a scorbutic patient, while 
 touching the ulcerated gums with a pencil wet in hydro- 
 chloric acid. The teeth become loose, and more pro- 
 minent ; the lower extremities infiltrated, present livid 
 spots, extensive bloody effusions, especially in the 
 internal parts, extensive serous engorgement. The 
 muscles, losing their elasticity, become hard, like wood, 
 and the patient can no longer walk. In the third stage, 
 the greyish ulcers of the gums extend to other parts of 
 the mouth, sometimes perforating the cheeks, in the 
 form of gangrenous spots, of which the parotid glands 
 were the principal seat. They entirely consumed the 
 tonsils, and caused caries of the maxillary bones. Hae- 
 morrhages occurred from the mouth, nose, urinary 
 passages, and the intestines, the pulse became extremely 
 feeble, and the falling away and softening of the tissues 
 continued, until the serous scorbutic cachexy usually 
 
 * From the Greek words a K pn$ extremity, and oSwr] pain. This name 
 was applied to an epidemic disease which prevailed in Paris in 1828 
 and 1829, and of which the prominent symptoms were a painful for- 
 mication usually felt in the feet and hands. AUTHOR'S NOTE. 
 
 This affection, like the "burning feet" noticed among the sepoys of 
 India, has been by some writers looked upon as a sequel of rheumatism. 
 The Parisian disease was described as attended with formication of 
 the feet and hands, streaking along the edges, a varying degree of 
 sensibility, an oedema, dark patches on the limbs, desquamation of the 
 epidermis, lancinating pains, and great heat on the parts at night. In 
 severe cases, delirium, inflammation, paralysis, marasmus, and death 
 followed. TR. 
 
150 THE CRIMEAN WAR. 
 
 ended by distinct asphyxia, following the swelling of 
 the glottis and epiglottis, preventing the air from 
 reaching the lungs. Often congestions form in the 
 viscera, which were found after death, infiltrated with 
 discolored and very impoverished blood. 
 
 Scurvy prevails as an epidemic, and is rarely found 
 without being complicated with chronic diarrhoea, inter- 
 mittent or remittent fever, bronchitis, pneumonia, or 
 other diseases, which more directly cause the mortality 
 attributed to scurvy. The treatment throughout, should 
 be hygienic, rather than therapeutic. In leaving the 
 Crimea, the scorbutics escaped the predisposing causes. 
 At Constantinople, and especially in France, a diet of 
 fresh vegetables, timely adopted, almost always sufficed 
 to operate a cure, when the disease was simple, and with- 
 out complications. 
 
 The English army escaped scurvy in 1856, from which 
 it had suffered so greatly the preceding year.* As to 
 the Russians, they were, according to their army sur- 
 geons, but lightly affected by it, and they attribute this 
 almost complete immunity to the daily distribution of 
 cabbage and fresh meat. When the war was declared, 
 Russian families had sent from every point of the em- 
 pire, under the name of a national gift, arabas loaded 
 with wheat, and drawn by oxen. This patriotism 
 relieved and powerfully seconded the efforts of the 
 Czar for provisioning his armies. 
 
 * The English suffered less from the scurvy in well defined forms, 
 than from the scorbutic taint, which was wide-spread and complicated 
 with other diseases, especially fever, and affections of the bowels. 
 For the first six months of the siege, all morbid action in the older 
 residents was more or less distinctly marked by scorbutic symp- 
 toms. It was much more prevalent among the infantry than in the 
 ordnance and cavalry branches of the service. This disproportion was 
 observed chiefly in the winter of 1857, when the privations and suf- 
 ferings of that arm were greater than in the others. All the facts 
 observed, only confirmed the truths previously established, that 
 defective innutritious diet, improper shelter and accommodation, over- 
 crowding and filth, as distinct from excessive labor and fatigue, were 
 the essential causes of this disease. The English, in the Crimea, had 
 1,763 cases of scurvy admitted from the infantry, of whom 172 died. 
 From the Ordnance 105, and from the Cavalry 223 were received, 
 and from each of these, three died. TR. 
 
THE CRIMEAN WAR. 151 
 
 F The Ottoman troops encamped at Eupatoria, sent 
 monthly to Varna a thousand scorbutic patients, mostly 
 those gravely affected. A short sojourn in a place 
 where fresh vegetables abounded, re-established their 
 health. To apply this sovereign remedy to the scorbu- 
 tics of our army, it was only necessary to find some neigh- 
 boring island in the Archipelago, and to obtain per- 
 mission to occupy it. Mytilene appeared to unite the 
 necessary conditions, and on the 1st day of December, 
 1855, 1 went thither with Messrs. DeCourville, a captain 
 of engineers, and Quesnoy, major physician, upon the 
 steamer IlAjaccio, attached solely to the personal 
 service of the French ambassador, and which M. Thou- 
 venel placed at my command. M. Laurent, the captain 
 of the vessel, notwithstanding the foul weather, brought 
 us to the island in thirty-six hours. The French con- 
 sul, M. Didier, procured us horses led by cavas, or 
 couriers. These cavas follow the rider, and are never 
 far from him, whatever may be the pace of the horse. 
 I was pained at seeing my cavas run by my side over 
 the rocky roads, and hoping to leave him behind, 
 rushed on at full speed, but was surprised to see him 
 arrive before me, ready to hold the stirrup, and to 
 assist me in alighting. 
 
 Mytilene, one of the largest islands of the Archipelago, 
 is the ancient Lesbos, so famous for its wines and its 
 courtesans. It is about half way between Smyrna and 
 the Dardanelles, triangular in form, the angles termi- 
 nate by Cape Mativa on the north, Cape Sigri on the 
 west, and Cape St. Mary on the east, and its circum- 
 ference is about one hundred and twenty miles, eighteen 
 miles in length by thirty-six in breadth. The soil is 
 very sloping, and free from marshes. The highest 
 mountains are on the west side of the island. Mount 
 Ordinus may be seen at a distance from forty-five to 
 sixty miles ; and Mount St. Elias, at the eastern end, and 
 south side, forms a high plateau, crowned by Mount 
 Olympus, having a height of three thousand and eighty 
 feet. Besides sundry anchorages, the island has three 
 good harbors on the southern side, of which Port 
 Langan is the largest, Port Sigri, and lastly Port Olivier, 
 
152 THE CRIMEAN WAK. 
 
 one of the most important in the Archipelago. Port 
 Olivier is only five miles from the city of Mytilene, and 
 extends eighteen miles into the land, with a breadth of 
 nearly four miles. It is entirely shut in by high moun- 
 tains, from the violence of the winds. The olive trees 
 with which the heights are crowned, give a magnificent 
 effect, and from these the port derives its name. This 
 port might easily contain a fleet of a hundred vessels. It 
 must be entered by a south wind, and can only be left 
 when the wind is north ; but steam tugs would relieve 
 this difficulty. The mountains on the west are covered 
 with pines and fir-trees of large size, whose timber 
 furnishes materials to the ship-yards for construction of 
 large vessels. A dozen pretty villages are perched on 
 the gentle swell of the mountains. At the head of the 
 bay, there exists an establishment of thermal waters, 
 slightly saline, and of 86 F., called Quindros, having 
 two large marble pools, sufficient to accommodate a 
 hundred bathers. These waters, which enjoy a great 
 celebrity in that region, could be used by our sick ; 
 they would doubtless prove very beneficial in the indu- 
 rations and pains in the limbs left by the scurvy. 
 
 The Sultan collects one tenth the value of all the pro- 
 ducts of the island. Mytilene, in 1850, exported three 
 hundred thousand quintals of olive oil, but the severe 
 winter of 1851 injured the trees, so that the production 
 Avas temporarily reduced to one hundred thousand 
 quintals. The island has numerous mulberry planta- 
 tions, and exports annually about twenty-two thousand 
 pounds of silk. Its production of wheat is insufficient 
 for the islanders ; it has many sheep, and their meat, 
 which is excellent, sells at about five and a half cents 
 the pound, and the wool at five and a quarter cents the 
 pound. Cattle are kept for labor ; and those used for 
 food, are imported from Asia, whose coast is but ten 
 miles distant. The horses are very small, and resemble 
 those of Corsica. Cow's milk is rare, but that of the 
 goat is abundant during ten months of the year, and 
 from this they make excellent cheese. Fresh vegetables 
 are abundant, and of very low price. I have seen 
 cabbages sold for a cent, which in the Crimea would 
 
THE CRIMEAN WAR. 153 
 
 have cost fifty cents. The potatoes are of good qualit^J 
 oranges and lemons abound, and in the fish markets, 
 mullets, dorads, and lobsters were plenty. The wine is 
 warm, generous, and aromatized with mints, but this in 
 my opinion weakens its quality. It is said, that rich 
 mines of antimony are in prospect of being opened ; fine 
 quarries of marble, and even of mineral coal, discovered 
 at Policnity, have not as yet been worked. 
 
 The population is estimated at 70,000 souls, of whom 
 20,000 are Turks, and of these 10,000 to 12,000 live 
 in the city. The remainder of the inhabitants, almost 
 all of Greek origin, are scattered among 74 well- 
 built villages, and appear in easy circumstances. The 
 climate is very healthy, soft, and temperate, and the 
 orange-tree thrives in the open fields. Diseases are 
 rare, and intermittent fever is, so to speak, unknown. 
 The people live* to an advanced age. Water is abun- 
 dant, * and of excellent quality. Mytilene is so cele- 
 brated for its great salubrity, that many sick from other 
 islands in the Archipelago go thither to pass the time 
 of their convalescence. 
 
 A hospital for convalescents would be happily placed 
 in this favored region. The city of Mytilene is com- 
 manded by a large citadel. This citadel, built by the 
 Genoese, of hewn stone, stands out like a promontory, 
 and its ranges of batteries rise to an elevation of about 
 260 feet above the level of the sea, from which it 
 seems to rise as a single mass. This fortress includes 
 numerous magazines, some empty, others containing 
 old cannon frames. It is occupied by only 400 native 
 troops. It would be easy to arrange for the use of 
 the sick, some of the magazines and uninhabited houses 
 which the Turks had built in 1820, as a means of 
 security in the time of the Greek war for indepen- 
 dence so as to accommodate 300 convalescents. There 
 were still other buildings that might be taken. Upon 
 the summit, 110 yards in the rear of the citadel, was a 
 Turkish barrack, which only needed the walls to be 
 whitewashed, and the number of windows increased. 
 West of the city, in the midst of fine culinary gardens, 
 stood the school of the Greek community, with very 
 
154 THE CRIMEAN WAR. 
 
 Spacious and convenient rooms. The conak Moharem- 
 Bey, and the Metaxa house, -were two vast Turkish 
 palaces, immediately available, and in perfect preserva- 
 tion. The Pacha himself offered me the palace of the 
 former governor, but this was falling into ruins, and 
 could not be safely inhabited. He also tendered to me 
 his country residence, situated about six and a quarter 
 miles south of the city, on the sea shore, and adjacent 
 to a small landing. In riding there, along the shore, I 
 passed through a beautiful grove of olives, in the midst 
 of which was a cluster of pretty villas. In short, my 
 visit to the different establishments on the island adapted 
 for hospital use, convinced me that if would be easy at 
 once to lodge 785 convalescents at Mytilene, in five 
 buildings, isolated, it is true, but grouped within a dis- 
 tance of 500 or 600 yards. This subdivision, doubtless, 
 rendered impossible the erection of a hospital of conva- 
 lescents, is such as required by classic traditions, but 
 these traditions do not appear to me imperative when it 
 concerns convalescents, to whom liberty of movement 
 and of walking in the open air, are necessary. It suffices 
 to create depots of convalescents, organized and living 
 like the companies of a regiment. There might also be 
 prepared, at small expense, two establishments under 
 t ents, each to contain 2,000 scorbutic patients, one at the 
 country-house of the Bey, and the other near the ther- 
 mal springs of Quindnos. 
 
 A learned physician settled on this island, M. Bar- 
 gigli, afforded in this examination very marked and 
 valuable assistance. The governor of Mytilene, Ismael 
 Pacha, said to me, "Hasten, for the English have 
 already sent a commission to explore the island, and 
 doubtless they will not delay coming ;" and he kindly 
 added, " I would rather have the French here than the 
 English." M. Thouvenel, on his part, procured permis- 
 sion of the Sultan to put our plans immediately into 
 effect. M. Darricau, the intendant general, Councillor 
 of State, and Director of the War Department, wrote 
 to me on the 29th of December. 1855, as follows : " I 
 have read with lively interest your report upon the 
 island of Mytilene. Your account shows perfectly to 
 
THE CRIMEAN WAR. 155 
 
 what extent we may there form an establishment. The 
 Minister has addressed to General Larchey and Intendant 
 Angot, instructions to decide them on this point. There, 
 our soldiers, under a pure sky, and in the midst of the 
 comforts which you have described, may be able rapidly 
 to recover their wasted strength." Unfortunately, 
 delays and difficulties after the peace was signed, pre- 
 vented a hospital and the encampments from being 
 formed at Mytilene, where thousands of our scorbutic 
 patients might have rapidly recovered their health, and 
 not have furnished at a later period so large a contin- 
 gent to the typhus. 
 
 I come now to speak of the second and most terrible 
 of the epidemics, with which we contended in 1856. 
 There has long been known a disease which develops 
 itself specially among people crowded together into 
 close quarters, and subjected to miasmatic influences. 
 It is called the fever of camps, jails, ships, and hospi- 
 tals, Hungary fever, Naples fever, and the contagious 
 typhus of Mayence. Its principal features are stupor, 
 with delirium, an' eruption upon the surface, and the 
 power of transmission from the sick to a person in 
 sound and perfect health. The appearances, during 
 thirty years, of this disease, in the duchy of Posen, at 
 Reims, at Philadelphia, at Edinburgh, at the convict 
 quarters at Toulon, and in the prisons at Strasbourg, 
 have happily been too short and too confined to allow 
 us to observe the differences which distinguish it from 
 the typhoid fever, so attentively studied in our day. 
 The typhus of the Crimea has solved the question of 
 identity or of non-identity between the two diseases, 
 and it is no longer possible to confound them, although 
 they have more than one bond of relationship, and an 
 apparently common cause.* It is generally agreed that 
 typhus originates in an animal miasmatic intoxication, 
 resulting as well from too great a number of human 
 
 " * See the Memoir published June 2. 1856, in the Comptes Rendus 
 of the Academy of Sciences. The observations which I collected in 
 that Memoir have been since reproduced by writers who have forgot- 
 ten to mention where they found them. I do not complain, since 
 they have aided me in spreading the truth. 
 
150 THE CRIMEAN WAR. 
 
 beings closely shut up, as from the putrid decomposition 
 of animal matter. Consequently this disease appears in 
 vessels, barracks, camps, prisons, and field hospitals, 
 crowded with the wounded, whose sores are a source of 
 abundant suppuration. It shows itself in besieged cities, 
 and in certain localities infected by dead animals, or men 
 left without burial. There is this distinction between 
 the two diseases : Want is the essential cause of typhus, 
 while it is scarcely an accidental cause of typhoid fever. 
 Authors agree on the non-relapse of typhoid fever. 
 Two physicians, Messrs. Lardy and Laval, were attacked 
 with typhus, although they had four or five years before 
 had the typhoid fever. There were found traces of the 
 latter in the cicatrices of intestinal ulcers in M. Lardy, 
 who, less fortunate than M. Laval, died. This is another 
 proof of the non-identity of typhus and of typhoid 
 fever. 
 
 Contagion, still very much doubted in the latter, is 
 not in the former. We have seen, especially in the 
 service of M. Lallemant, major physician, the typhus 
 propagated from bed to bed in the wards, spreading 
 itself by contact, and killing those sick of some light 
 affection. At another time, as in the field hospital of 
 the first division of the third corps, the typhus attacked 
 almost every hospital employe ; fifteen physicians in 
 sixteen were attacked, and there did not remain a single 
 healthy attendant. The word contagion, as applied to 
 typhus, ought to be explained. The typhus, generated 
 spontaneously by certain definite causes, does not trans- 
 mit itself by the contact of a sick person with one in 
 health, but rather by infection ; that is to say, by the 
 air charged with the elements of typhus. The morbific 
 miasm exhaled from the surface of the sick, or from 
 animal detritus, infects the man who breathes it ; and 
 once absorbed, during a longer or shorter time, called 
 the period of incubation, it prepares the organism for 
 sickness. 
 
 Typhus differs on one point from most epidemic dis- 
 eases, such as small-pox, scarlatina, measles, sweating 
 sickness, cholera, etc. These are brought on by a pre- 
 disposing condition of the atmosphere, and the physician 
 
THE CRIMEAN WAR. 157 
 
 has no means of preventing their invasion. On the 
 contrary, the causes of typhus are known, to such a 
 degree, that we can produce or terminate at will the 
 typhic influence. Another remarkable difference between 
 typhus and common epidemic maladies, is that the latter 
 have a regular course of duration, while typhus holds 
 on and extends its ravages indefinitely, so that by any 
 well directed measures we cannot master it. 
 
 Typhus breaks out more or less quickly, according to 
 the intensity of the affection, and the resistance of the 
 organism. Every sick person sends out noxious emana- 
 tions. When the wards are full, when the cases of pri- 
 mary or contracted typhus increase, the epidemic fur- 
 nace acquires a greater energy, and its manifestations 
 radiate through the entire personnel of the hospital. It 
 was in this way that the sisters, the chaplains, the phy- 
 sicians, and the attendants were so cruelly struck down 
 during the war of the East. We have seen some physi- 
 cians, less predisposed, endowed with a greater power 
 of reaction, or. of elimination of the absorbed miasm, 
 overcome the epidemic influence in a manner little 
 apparent, but still real. Each time that the fire of infec- 
 tion increased in the hospital by swelling the numbers 
 of the typhic, they were seized with headache and 
 sleeplessness, the tongue was dry, and the countenance 
 assumed a typhic aspect. These symptoms held on 
 three or four days, when the typhic veil was torn, and 
 they returned to their usual health. Sometimes, how- 
 ever, the morbid state continued, and then the issue 
 was almost always fatal. 
 
 The progress of the typhus in the Crimea was less 
 uniform and regular than that so well described by Hil- 
 denbrand, one of the most eminent physicians of the 
 Vienna school.* The irregularity of typhus in the Cri- 
 mea was due to various complications, chiefly of scurvy, 
 dysentery, and intermittent fevers. It was on the 1st of 
 January, 1856, that the typhus, which the year previous 
 had commenced to show itself, was greatly developed. 
 
 * In a treatise upon contagious typhus, published in Vienna in 
 1810, and translated into French the next year by M. Gasc, health 
 inspector in the army. 
 
158 THE CRIMEAN WAR. 
 
 During the last days of the siege of Sebastopol, the hos- 
 pital gangrene, that typhus of wounds, committed great 
 ravages. The scurvy, already remarked by Franck as 
 the precursor of typhus, had assumed immense propor- 
 tions. The contagious typhus waited only for the con- 
 centration and accumulation consequent upon the rigors 
 of winter, to break forth. The soldiers packed into 
 their tents, hermetically closed, in which the ground 
 was damp and impregnated with impurities, were 
 fatally poisoned by the organic miasm. Moreover the 
 energetic excitement, so powerful in resisting typhus, 
 fell with Sebastopol, and they saw themselves delivered 
 over to the epidemic without relief from these powerful 
 moral reactions. 
 
 The typhus described by Hildenbrand should have 
 shown the regular character assigned by that writer, if 
 not among our soldiers, broken down and already a 
 prey to other maladies, at least among the physicians, 
 the chaplains, and the other attendants of the hospitals 
 at Constantinople, whose constitutions were not broken ; 
 but even here irregularity was the rule, and the eight 
 stages describe* by Hildenbrand were not perhaps 
 observed in a single case. The premonitory state (lassi- 
 tude, unrefreshing sleep, lumbar pains, shudderings, 
 painful tension in the head, and vertigo), so common in 
 typhoid fever, were often wanting. The typhus almost 
 always began with a chill and an inflammatory period, 
 which foreshadowed besides the more or less distinct 
 catarrhal state of the eyes, nasal passages, and bronchia 
 an intense frontal headache, dizziness as in intoxication, 
 stupor, great prostration of strength, intense thirst, 
 often a saburral condition of the digestive passages, and 
 a calm or furious delirium. The skin became burning, 
 and after two or three days was covered with a kind of 
 eruption which was never absent except in subjects too 
 much broken down, and which differed essentially from 
 that of typhoid fever. This eruption appeared upon the 
 trunk and limbs, in irregular groups of rounded spots, 
 of deep red, not in relief, smaller in size than a bean, not 
 disappearing upon pressure, and not of such a character 
 as to be confounded with the spots of typhoid fever. 
 
THE CRIMEAN WAR. 159 
 
 The continuity of the fever with 100 to 130 pulsations 
 to the minute, was often broken by one, or more rarely 
 two regular paroxysms, in twenty-four hours, which 
 much resembled the accession of remittent fever, and 
 gave to the typhus of the Crimea a peculiar character. 
 The belly was soft, without pain, or flatulence, or the 
 rumbling in the right iliac fossa, which is the proper 
 symptom of typhoid fever. Constipation has almost 
 always occurred, in place of the intestinal flux of 
 typhoid fever, when dysentery did not exist upon the 
 invasion of typhus. After an inflammatory period last- 
 ing five or six days, there supervened a nervous period 
 marked by ataxic or adynamic symptoms, and often by 
 a mixture of both. The nervous period lasted four or 
 five days, and was but little observed when convales- 
 cence began. 
 
 The typhus sometimes ran through these three periods 
 with a fearful rapidity, and death often supervened the 
 third day, and even the second or the first. The typhus 
 was then terrible. It rarely lasted beyond fifteen days, 
 unless complicated with organic congestions of one of 
 the three splanchnic cavities (the brain, the chest, and 
 the abdomen), and a return to health almost always 
 occurred, if at all, within twelve days. The sick passed 
 suddenly from death to life, and the typhic veil of the 
 face fell off, the eye became clear and intelligent, the 
 appetite ravenous, and strength returned with great 
 rapidity. Still the intellect retained the stigma of 
 typhus, as shown by disturbing dreams by night, or 
 delirium upon some points by day, although the reason 
 was clear on the others. A weakness of hearing and 
 sight, a more or less complete loss of memory remained 
 for a considerable time, nevertheless the hair did not 
 fall out as in typhoid fever. These favorable changes 
 were often preceded by bleeding at the nose, sweats, 
 and morbid condition of the urine, and sometimes 
 inflammation of the parotid glands. It will be noticed 
 that convalescence, which is so slow and so difficult to 
 manage in typhoid fever, proceeds rapidly in typhus. 
 The departures from a strict diet are little to be feared, 
 which is explained by the absence of the lesions of the intes- 
 
160 THE CRIMEAN WAE. 
 
 tinal follicles, and of the engorgement of the mese'nteric 
 glands which form so constant and important a feature 
 in typhoid fever, and which hundreds of post-mortem 
 examinations have never discovered in our hospitals of 
 the East. 
 
 To cure typhus, it is necessary, above all, to have 
 pure air constantly renewed ; to withdraw the sick from 
 the causes of the infection, to ventilate the room, and 
 order frequent aromatic and chlorine fumigations ; to 
 respect the inflammatory period as the greatest effort of 
 nature ; to drive out the miasmatic poison by an exan- 
 thematous pressure. Not to bleed unless the subject is 
 very strong; if threatened with cerebral apoplexy, pre- 
 fer generally leeches behind the ears, or cups between 
 the shoulders to a general bleeding, a remedy of which 
 we should be extremely cautious. Adopt the same 
 means when the smallness of the pulse denotes an 
 oppression of the vital forces, which are relieved by 
 moderate sanguineous depletion. When from the 
 beginning, as in the typhus of the Crimea, there were 
 remittent paroxysms, it was weU to attack the disease 
 with a few doses of quinine. By this means, the con- 
 tinuity of the fever was secured, and it fell of itself after 
 a few days, unless maintained by an organic congestion 
 produced by its first attack. This complication fre- 
 quently occurred when we did not take care to anni- 
 hilate entirely the paroxysms, that is, the recurrences 
 of the fever. On an attack of typhus an emeto- 
 cathartic was useful, especially if there existed some 
 gastro-intestinal difficulty; we give mucilaginous or aci- 
 dulated drinks, and sometimes wine in water. In the 
 nervous period we have recourse to the remedies 
 employed in ataxy and adynamia. In the latter, tonics, 
 such as Malaga or port wine, much hastened recovery. 
 
 Such is a brief statement of the treatment which 
 gave the best results in the army of the East, and upon 
 which the most experienced physicians relied, such as 
 M. Cazalas, who from the first conceived the idea of 
 regulating the inflammatory action by quinine, by ex- 
 pelling the paludal element, which had so marked an 
 influence upon the sickness of the Crimea. To sum up ; 
 
THE CRIMEAN WAR. 161 
 
 the typhus reveals its true nature by its infectious cha- 
 racter, its easy communication, the rapidity of its pro- 
 gress, the whole train of its symptoms, and the absence 
 of anatomical lesions. 
 
 We may derive still further light concerning the 
 typhic affection, by comparing the typhus of the Crimea 
 with epidemics of the same kind that have afflicted 
 populations and armies, at other periods. Doubtless 
 there is no absolute resemblance, because, as we know, 
 epidemic manifestations vary in the same disease, ac- 
 cording to the season, the locality, and the people, but we 
 find in the typhus of the Crimea, the same putridity and 
 rapid destruction of the vital forces, that distinguish the 
 typhus of Mayence, the delirium, stupor, and rosy 
 exanthem described by Hildenbrand, etc. If the typhus 
 of the Crimea was not very grave, as compared with 
 the dreadful epidemics of Mayence and Torgau, we 
 may explain this by the different conditions in which 
 we found our army ; a better hygiene, the prompt care 
 bestowed upon the sick, the facility and abundance of 
 means of transportation, the multiplication of hospitals, 
 and lastly to the moral conditions and material resources 
 which did not exist in the campaigns of 1812 and 1814. 
 
 The appearance of contagious typhus was the most 
 terrible event that happened to the army of the East. 
 The blow struck first in the Crimea. In November, 
 1855, the reports made to me by M. Scrive, noticed in 
 that month 11 cases of typhus, of which 6 were fatal. 
 December showed the following increase: from the 1st 
 to the 10th, 4 new cases, 1 death ; from the 10th to the 
 20th, 46 new cases, 21 deaths ; and from the 20th to 
 the 31st, 92 new cases, 41 deaths. During the month, 
 the field hospitals of the Crimea had emptied upon the 
 hospitals of Constantinople 3,206 sick. All of these 
 had, in the field hospitals of the Crimea, been in con- 
 tact with the typhus, had lain in the same wards 
 side by side. Some were even lightly tainted with 
 typhus, so that the hospitals of Constantinople began 
 to show from the 10th to the 20th of December, 13 
 cases and 2 deaths, and from the 20th to the 31st, 
 28 new cases and 7 deaths. 
 
162 THE CRIMEAN WAE. 
 
 From that moment, I sought to restrain from the 
 start, by an extensive plan, the first menaces of this 
 new disease, and submitted to Marshal Pelissier a 
 project having for its end the maintenance until spring, 
 in good quarters in the camps of Constantinople, of all 
 the sick who came from the hospitals of the Crimea ; 
 and likewise of sending thither several thousand men 
 from the regiments, who were drooping, or already in 
 the regimental infirmaries. 
 
 " I, myself, consider the first project,'' the Marshal 
 replied on the 4th of January, " as one of easy applica- 
 tion, and as capable of giving good results by allowing 
 the complete recovery of men still weak and subject to 
 relapse. Yet I do not think we ought to adopt it unless 
 with men whom the health officers recognise as out of 
 condition of rendering service, and whom they judge 
 necessary to send to Constantinople for the winter. 
 When these shall have gained sufficient strength to 
 return to the ranks, they should rejoin their corps, as here- 
 tofore. I have therefore the honor of informing you, 
 that I have issued orders to General Larchey, to put 
 this measure into execution, in this qualified sense. I 
 have likewise examined the proposition which formed 
 the subject of your second note, dated on the 1st inst., 
 relative to our sending to Constantinople the drooping 
 men now in the Crimea. As to these, its adoption ap- 
 pears to me less opportune, on account of the great 
 numbers already sent off. Those thus sent away, are 
 already a too active cause of the diminution of our 
 effectives, and they realize indirectly the end that you 
 propose. I, however, am perfectly conscious that a soli- 
 citude for the well-being of our soldiers alone prompts 
 you to make the proposition, and I thank you for having 
 done so." 
 
 The 4th January, 1856, M. Scrive informed me that 
 the health of the Crimean troops continued compara- 
 tively satisfactory. " Your prescriptions, sir," he said, 
 "are being executed, and you shall have, as soon as 
 possible, the information concerning the ambulances, 
 which you require to be supplied from the heads of the 
 department," 
 
THE CRIMEAN WAR. 163 
 
 " From information received from the intendant-gene- 
 ral, I learn that we have now in service 5,000 complete 
 beds in barracks, and 5,000 places for men in tents. 
 There are no troops in shelter tents; all have either 
 camp tents or huts. The Zouaves' huts answer their 
 purpose well ; the rain enters very little, and the inge- 
 nious soldier immediately places a sod over the holes. 
 The large heating apparatus for Aurelle's and Herbillon's 
 divisions do not answer ; they have been inundated by 
 the deluging rains. The partially underground tents 
 are healthy ; those of the flying ambulances at the 
 Tchernaya are perfect models. The regimental infir- 
 mary barracks are being constructed, but not without 
 great difficulty. I hope, however, to have two ready 
 for each regiment in a few days. In fact, we shall soon 
 be well provided in every way." 
 
 "It snows and rains continually. The sun has not 
 shown itself for a fortnight. In the face of such a severe 
 winter, the health of the troops is better than could 
 have been anticipated." 
 
 A few days later, M. Scrive, in a report addressed to 
 the Council General of the Health of the Army, said : 
 " The causes which have produced this healthy condition 
 of the army were foreseen, and the result was certain. 
 Several months ago, Inspector Baudens wrote to the 
 Minister of War, that the hygienic condition in which 
 the army would be placed during the winter would ren- 
 der sickness more general and severe. This prophecy 
 was unfortunately substantiated. Although the troops 
 have not had to experience the fatigues of a siege, yet 
 they suifered from the condition of continued warfare 
 which followed the fall of Sebastopol. It was no longer 
 a circumscribed circle of trenches, but a line of defences, 
 thirty-six miles in length, from the valley of Baidar to 
 Sebastopol, which had to be defended. Continual alarms 
 obliged three-fourths of the troops to remain under arms. 
 This extended line of defence rendered numerous pickets 
 and advance-guards necessary; it made the furnishing 
 of provisions difficult and irksome ; and it was spreafl 
 over ground in many instances unfavorable for winter 
 camping, but rendered necessary by war. t , , ." 
 
164 THE CRIMEAN WAR. 
 
 The hygienic conditions of our hospitals at Constanti- 
 nople and the appearance of the new epidemic, however, 
 actively engaged the attention of our head physicians. 
 I had frequent conferences with them, and visited them 
 almost daily during their rounds, so that I might per- 
 fectly understand the situation. They also represented 
 to me, in writing, the cases where an ameliorated con- 
 dition was urgently required. 
 
 The suggestions I had made to the Commander-in- 
 Chief brought me, on the 9th January, 1856, the follow- 
 ing despatch from M. Angot, military superintendant at 
 Constantinople, relative to the establishment of a depot 
 for convalescents : 
 
 " SIR The General of Division commanding, orders 
 me in a letter, dated 8th January, to confer with you, 
 in accordance with the orders of the Marshal command- 
 ing, respecting the immediate establishment at Constan- 
 tinople of a sort of depot for convalescents, destined for 
 the use of the soldiers now in the Crimea who are too 
 weak to withstand the severities of the winter. 
 
 " This measure being adopted on your suggestion, I 
 have the honor to request you to inform me what con- 
 ditions of location you deem most applicable for the 
 immediate establishment of this depot, as much with 
 regard to the medical attendance as for the adoption of 
 particular regulations, if such are required. 
 
 "It is indispensable for me to know your opinion on 
 these questions, before indicating to General Larchey 
 the system to be followed in realizing to the utmost the 
 intentions of the Marshal commanding. You will, per- 
 haps, with me, recognise the advantage of a conference, 
 in which Dr. Thomas and the military sub-intendants 
 shall be asked to take part. In this case, I shall be 
 obliged by your informing me the day and hour which 
 would be most convenient." 
 
 The llth of January, a committee, composed of Gene- 
 ral Larchey (President), of General Pariset, of Military 
 Intendant Augot, and inspector Baudens; De Missy, 
 sub-intendant ; Lieut.-Col. Cadart, Chief of Engineers ; 
 M. Thomas, Physician-in-Chief ; and having for its Secre- 
 tary, Lieut. Col. Gravillon, Major of the Staff, was as- 
 
THE CRIMEAN WAE. 165 
 
 sembled in conference, and made many arrangements 
 of recognised utility. These formed the basis of detailed 11 
 instructions, to be found in the appendix. 
 
 Notwithstanding the precautions taken, the typhus 
 made, both in the Crimea and at Constantinople, rapid 
 and alarming progress. In the Crimea, there were 
 counted from the 1st to the 10th of January, 34 new 
 cases, and 49 deaths ; from the 10th to the 20th, 164 
 cases, and 70 deaths. In the same period at Constanti- 
 nople, there occurred, from the 1st to the 10th, 95 new 
 cases, and 15 deaths; from the 10th to the 20th, 162 
 cases, and 32 deaths ; and from the 20th to the 31st, 
 205 cases, and 18 deaths. 
 
 The epidemic was sadly confirmed. There can be no 
 doubt as to the cause which propagated it in our hospi- 
 tals at Constantinople. It was the impossibility of iso- 
 lating the men tainted with typhus, and the crowding.* 
 In a report made to me January 29, 1856, by Doctor 
 Garreau, the Physician-in-Chief of the hospital of 
 Daoud-Pacha, he thus relates how the accumulation 
 of the sick in that hospital kindled suddenly the 
 typhus : 
 
 " At Daoud-Pacha we enjoyed very satisfactory sani- 
 tary conditions up to December 21st, but diseases of bad 
 type were not slow in appearing, in proportion as the 
 sick sent from the Crimea became more numerous, espe- 
 cially when this number passed certain limits. A care- 
 
 * Physicians and Directors do not agree upon the word crowding. 
 The latter apply the definition literally ; so that, in a hospital pre- 
 pared, for instance, for 1500 sick, they would not, in reaching that 
 number, especially if each patient had 70 cubic feet of air to breathe, 
 be crowded. But with the physician, a crowding exists, when an 
 increasing mortality reveals the presence of contamination from a 
 collection of sick. From that moment he should advise a reduction 
 in number of patients, and the disinfection of the wards. In a cam- 
 paign, when a soldier is convalescent, he leaves his place for another 
 more sick than himself, and the beds are never empty day nor night. 
 As each sick man is a furnace of mephitic emanations, we may see 
 how an encumbrance may be rapidly gained. In times of peace, a 
 hospital for 1500 sick has scarcely 1000 beds in use at any one time, 
 and a third of the convalescents walk out into the courts and gardens 
 during the day, thus benefiting the remaining sick, by giving them 
 the 70 cubic feet of air allowed them in the wards. 
 
166 THE CRIMEAN WAR. 
 
 fill observation of facts demonstrates satisfactorily, that 
 1 crowding, in badly ventilated and poorly lighted wards, 
 without lires, was the cause, I do not say the only but 
 the principal cause, of our actual condition. 
 
 "On the 21st of December, we reckoned 525 sick, all 
 doing well. We had 729 beds occupied on the 1st of 
 January, and the sanitary condition was passable, be- 
 cause the defective wards were not as yet crowded. 
 From the 1st to the 10th of January, our number 
 increased to 877, and from the 10th to the 20th it 
 amounted to 1,140 scorbutic or diarrho3a patients, 
 almost all of them quite debilitated. It was at exactly 
 this time, when it was necessary to crowd the beds 
 together, and exceed the normal number, that the 
 typhus fever began to rage in the hospital, beginning, as 
 you know, in the upper story. Within fifteen days more 
 than 125 cases of continued fever were disclosed, the 
 persons attacked being almost all of them convalescents. 
 About eight in ten came from the Crimea. The sick 
 were few on the llth, more numerous on the 21st of 
 January, and increased rapidly from the 21st to the 
 29th ; following step by step the progress of the crowd- 
 ing in the wards, for the sick placed in the vast gal- 
 leries, where the air was constantly renewed, did well." 
 
 The instructions which the Minister of War had 
 given me in writing had anticipated the terrible and 
 exceptional periods. He said : 
 
 " Independently of your duty as inspector, which in- 
 vests you with the right of direct correspondence with 
 me, I desire that the authority of your rank as well as 
 your surgical skill, may be employed for the benefit of 
 the army, and I hope that you will not remain uncon- 
 scious of the impetus which might be given to the me- 
 dical service by your presence during your sojourn 
 either at Constantinople or in the Crimea. 
 
 "To this end, when you think it expedient, or w r hen 
 the circumstances may require it, you are to take tem- 
 porarily the direction of the service, and to practise as 
 well on the battle-field, as in the field and the regular 
 hospitals, and both by your example and your counsels to 
 support our military physicians in the heavy task rest- 
 
THE CRIMEAN WAR. 167 
 
 ing upon them, and sustain them in the way of zeal and 
 devotion for the cause in which they are engaged. 
 
 " If any grave diseases should break out at one or many 
 points in the country occupied by our army, you will 
 search for the causes, and study their character, symp- 
 toms, and progress, suggest the preventive measures 
 which circumstances seem to you to require, and give to 
 the health-officers such instructions for their guidance 
 as may be proper in the treatment of these diseases. 
 
 "You will give to the general commanding-in-chief, 
 and to the intendaut general as well as to General Larch ey, 
 and the intendant of the station at Constantinople, all 
 the information which they may ask, and such advice as 
 you may think fit to submit to them, relative to the 
 health of the army, upon the salubrity of grounds and 
 localities, upon the establishment and organization of 
 hospitals, field-hospitals, etc. 
 
 " For the rest, my dear sir, I leave it to your solicitude 
 for the welfare of our soldiers, and to your experience 
 in campaign service, to supply what the foregoing in- 
 structions have left incomplete, and I feel assured that 
 you will find in the command and administration, that 
 cordial concurrence, which will render your mission as 
 fruitful of results as possible." 
 
 During the whole course of the epidemic I took the 
 official direction of the health service in the army, and 
 was thus able to impart to it greater unity and strength. 
 I entered then upon my duties of Inspector, which placed 
 me in a more elevated sphere, as the delegate of the 
 minister. 
 
 It was necessary to employ energetic measures, with- 
 out which the mortality would have been unlimited. 
 The principal remedies were the isolation and ventilation 
 of the sick. I earnestly pressed the military intendant 
 to place the typhic patients in special wards, where the 
 air might be freely admitted, and thus at the same time 
 guard the other sick against the risk of infection. It 
 became necessary to open new hospitals in temporary 
 barracks, to prevent encumbrance, to find places for 
 5,000 sick, and to be able to lodge four typhic patients 
 only in each barrack in the camps of Maslak, instead of 
 
168 THE CRIMEAN WAR. 
 
 eight, as in common sickness. Our English allies ten- 
 dered us every kind of assistance, both personal and 
 material. 
 
 General Storks offered to go, and prepare in one of 
 our camps a hospital complete for 1000 sick, and to fur- 
 nish and attend them, it' we desired it. "Whatever 
 we do," said he, " we can never repay the French, for 
 what they did for us last year." Happily we were 
 plentifully supplied with materials, and the military in- 
 tendant at once introduced a salutary change in the 
 rations. The things most needed, were room and pure 
 air, and I urged the adoption of temporary barracks. 
 This was made the subject of several consultations under 
 the presidency of General Larchey, and it was decided 
 to separate the sick, and to increase the number and 
 extent of the hospitals. 
 
 At the same time I was occupied with devising measures 
 for preventing the spread of the pestilence in the Crimea, 
 and on the llth of February, 1856, I wrote to Marshal 
 Pelissier and to the Minister of War as follows : 
 
 " Reports from the Crimea show a great increase in 
 the numbers of soldiers entering the hospitals, while at 
 the same time diseases are reducing our number of phy- 
 sicians. I pray your Excellency to permit me to sub- 
 mit, on this occasion, some reflections inspired by an 
 interest for the service. 
 
 " An increase of the sick was foreseen. An army whose 
 effective strength is doubled within a year, and which 
 includes a great number of young soldiers, w r ould, as I 
 have said in former reports, send during the rigors of 
 winter large numbers to the field hospitals. In view of 
 this probable event, each regimental infirmary received 
 two barracks, and 6,000 mattresses have been sent to 
 the Crimea to replace the mats upon which the sick have 
 lain. These prudent measures have nevertheless not 
 allowed us to completely dispense with putting the sick 
 in tents, where they have no other bed than a mat, and 
 one or two blankets ; many have had their feet frozen, 
 and have reached us from the Crimea in the most piti- 
 able condition. 
 
 " I presume that recourse was only had to the tents in 
 
THE CRIMEAN WAR. 169 
 
 cases of absolute necessity, and it is well to remember 
 that this shelter, so excellent in summer, may become 
 very pernicious in winter, when they are hermetically 
 closed to exclude the cold, and the air not being renewed, 
 becomes loaded with noxious miasms, that develop 
 typhoid fever, if not the typhus. When these are 
 opened, the frost seizes upon the anemic men within.* 
 
 " The fault of arrangement of these tents has been 
 their nearness to each other. They should not occupy 
 more than a third of the ground, so that they may be 
 moved daily when the weather permits, and keep at a 
 distance from each other the hotbeds of infection of 
 which they so soon become the seat. 
 
 "The field-hospital barracks, encumbered with soldiers 
 dangerously sick, are rapidly infected. They are unfor- 
 tunately much too near together, so that they mutually 
 radiate upon each other their infection. To render 
 
 * Living in common in tents, carefully closed, is extremely perni- 
 cious to the health. 
 
 In this confined atmosphere, vitiated by the vapors thrown off 
 from the breath and skin, and.by the emanations of the infected soil, 
 the soldier yields to the effects of poison by putrid intoxication. "We 
 know that confined air may contain, besides its constituent elements 
 (oxygen and nitrogen), traces of the oxyde of carbon, sulphuretted 
 hydrogen and ammonia, and that it is besides altered by an excess of 
 carbonic acid, and other principles called miasms, not as yet appreci- 
 able by chemical reagents, but whose presence is revealed by their 
 disastrous effects upon human health. From the experiments of the 
 savan M. Dumas, it appears, that an adult changes into carbonic acid 
 gas, by respiration, in one hour, all the oxygen in 3 - 2 cubic feet, and 
 that to supply this loss, twelve cubic feet of fresh air are required per 
 hour by each individual. 
 
 Carbonic acid gas being less respirable and heavier than the ele- 
 ments of air, we learn the danger in soldiers passing the night toge- 
 ther, under an air-tight tent, and lying upon the ground. If asphyxia 
 does not occur, as in the Grotto del Cane, near Naples, the aerrzation 
 of the blood is impaired, and it becomes impoverished. As to the 
 mephitism caused by organic emanations, it carries into the circu- 
 lation a special poison of more or less active character, of which the 
 prolonged effects appears as typhus in campaigns, and in times of peace, 
 when the air is not well renewed in the hospitals these influences 
 result in other diseases, such as typhoid fever, scrofula, and consump- 
 tion. According to some hygienists, the indispensable ration of pure 
 air to each man is at least 18 cubic feet per hour. (See Appen- 
 dix.) 
 
170 THE CRIMEAN WAR. 
 
 them healthy, they should, besides the measures already 
 advised, be fumigated five times daily ; twice with chlo- 
 rine, at six o'clock in the morning and at seven in the 
 evening ; and three times with dry sage, after the cus- 
 tom of the Turks, who in their hospitals take effectual 
 precautions against contagious diseases. The aromatic 
 fumigations should be made, one at noon, and the two 
 others half an hour after the fumigations with chlorine. 
 These precautions had been entirely neglected, even in 
 our hospitals at Constantinople, and I was obliged to 
 enforce them with vigor, but not without difficulty. The 
 regimental infirmaries, and if possible the tents of the 
 soldiers, where the trampled ground will not allow of a 
 change of place, should also be purified by these fumiga- 
 tions. While the liberated chlorine decomposes and 
 neutralizes the miasms, air charged with aromatic vapors, 
 searches into the corners and recesses, and escapes, bear- 
 ing with it the sickly odors. They are, so to speak, an 
 atmospheric broom. 
 
 " Dried aromatic plants abound in the markets of Con- 
 stantinople, and a supply might easily be sent from 
 there to the Crimea. 
 
 "Your Excellency is aware that the typhoid fever, 
 and especially the typhus, makes some progress before 
 Sebastopol. Thanks to the measures in operation, the 
 latter does not threaten us with the fierce ravages which 
 it displayed in 1812 and 1814, but nothing should be 
 omitted in watching and preventing the spread of this 
 powerful epidemic. 
 
 "The accumulation of the sick from the Crimea, in 
 our hospitals at Constantinople, operated unfavorably 
 upon their hygienic condition, in consequence of the 
 severity of the diseases. Commonly, among a hundred 
 sick, only ten are in danger ; but here the proportions 
 are reversed, and in a hundred tainted men, ninety are 
 in a perilous condition. There are scorbutic patients, 
 with infected breath, and dysenteric patients with con- 
 tagious typhic emanations. The miasmatic intoxication 
 of our hospitals has developed numerous unlooked-for 
 troubles. To arrest them, I have proposed the reopen- 
 ing of the discontinued hospitals, and the creation of 
 
THE CKIMEAN WAK. 1^1 
 
 others, sufficient for about five thousand beds, in the 
 camps at Maslak, and between the hospitals of Ramis- 
 Tchifflick and Maltepe, where the sick may be free, and 
 in a salubrious and well-ventilated situation. 
 
 " To prove that to check typhus it is only necessary 
 to place the sick in a non-infected place, we may refer 
 to the depot of convalescents prepared in a portion of 
 the camps of Maslak. . In one thousand men, not one 
 showed any traces of typhus ; they recovered rapidly, 
 and only fifteen soldiers were sent back to the hospitals, 
 and nineteen to the infirmary. 
 
 " Mytilene would have been a providential resource 
 for the scorbutic, on account of its fine climate, thermal 
 waters, and abundance of fresh vegetables. 
 
 " Your Excellency knows that at Constantinople there 
 are barracks for lodging about twenty-five thousand 
 men, that might be easily converted in twenty-four 
 hours, into good hospitals. These resources would allow 
 of the arrangement providing for the sick sent from 
 the army in the Crimea, according to the views that I 
 proposed. The ailing fill the regimental infirmaries ; but 
 it would be better to send them directly to the quarters 
 prepared fo their reception, without their passing 
 through the field hospitals, where their condition is 
 aggravated. 
 
 "The medical employees in the places devoted to 
 contagious diseases have paid a large tribute to the 
 typhus ; many physicians are dead, and twenty-five, not 
 including those actually sick in the Crimea, are under 
 treatment in the hospital at the Russian embassy. 
 
 * Your Excellency will observe with satisfaction, that 
 not a single army officer has shown any traces of the 
 typhus, which proves that it is, as it were, imprisoned in 
 the hospitals, and is not propagated in the camps by 
 contagion, although it is generated spontaneously in 
 the tents." 
 
 M. Larchey, General of Division and Superior Com- 
 mandant at Constantinople, to whom I had imparted 
 my plan of converting into hospitals the camps of which 
 I have spoken, directed me to prepare some instructions 
 to lay before a commission, which met February 13, 
 
2 THE CRIMEAN WAR. 
 
 1856. The minutes which follow repeat very nearly 
 what I have already stated. 
 
 Upon the call of the General of Division, the military 
 commandant Messrs. Pariset, brigadier-general, at- 
 tached to the general of division ; Angot, military 
 intendant, upon special service ; Baudens, inspector of 
 the health service of the army of the East ; De Missy, 
 military sub-intendant of the 1st class ; Cadart, lieu- 
 tenant-colonel commandant of engineers ; Wilson, mili- 
 tary sub-intendant of the 2d class ; Thomas, principal 
 physician of the 1st class; Demortain, principal apothe- 
 cary of the 2d class assembled in council February 13, 
 1856, at the general head-quarters, for the purpose of 
 inquiring into the measures to be taken to prevent the 
 development and spread of typhic diseases in the mili- 
 tary hospitals of Constantinople. 
 
 After full discussion and inquiry at this session, the 
 following arrangements were adopted, namely : 
 
 1st. The numbers of sick in the hospitals are to be 
 reduced, until the miasmatic infection shall have dis- 
 appeared. 
 
 2d. An examination is to be made by the command- 
 ant of engineers relative to the labors jiecessary to 
 convert into hospitals the barracks not occupied by 
 troops. 
 
 3d. The vigorous measures recommended in the order 
 of April 13, 1855, and reiterated in the order of Febru- 
 ary 11, 1856, relative to the ventilation and fumigation 
 of wards, are to be put into effect. 
 
 4th. In addition to the chlorine fumigations, which 
 should be made morning and evening, as prescribed in 
 the formulary of medical hospitals, it is recommended to 
 make three others daily, with aromatic plants, such as 
 dried sage, after the manner of the Turks. These aro- 
 matic fumigations should be made morning and evening, 
 a little while after the chlorine fumigations, and also at 
 noon. 
 
 5th. Typhoid fever, typhus, and dysentery, being fur- 
 naces of infectious emanation, it is necessary to fumigate 
 with chlorine all the clothing and bedding of persons 
 dying from these diseases, and also to subject to fumi- 
 
THE CRIMEAN WAR. 173 
 
 gation (if the sick can change their beds) all the bed 
 clothing used during the course of the disease. 
 
 6th. When the weather is so mild that the patients 
 can go out, it is ordered to fumigate the empty bar- 
 rack throughout with extra quantities of chlorine, taking 
 care to hang out the mattresses and blankets ; to keep 
 the ward empty as long as possible, that it may be puri- 
 fied and cleansed : and to do this in rotation through 
 every ward of the hospitals. 
 
 7th. The doors and windows are to be opened when 
 the weather will permit. 
 
 8th. Redoubled care should be taken with regard to 
 cleanliness 1st, of the sick, by washing their feet when 
 they are brought in, rubbing with warm water and soap 
 their thighs, legs, and arms, when it is not possible to 
 give them a bath, or when the bath should not be used ; 
 but to do nothing without the previous advice of a phy- 
 sician; and 2d, in the wards, corridors, and privies. 
 Disinfectants are to be placed permanently in places for 
 evacuations, and a pinch of sulphate of iron is always 
 to be left in the night vessels, after being thoroughly 
 cleansed. 
 
 9th. A wash-house should be built at Gulhane, and 
 another at Pera ; the former to be devoted to washing 
 the linen of the hospital at Gulhane and at the Univer- 
 sity, the other that of the hospital at Pera and the Parade 
 ground. 
 
 10th. Smoking or spitting in the wards to be prohi- 
 bited. There shall be assigned a place for smoking in 
 each hospital, and wooden spit-boxes shall be placed at 
 regular distances. The attendants of the infirmaries 
 must not spill any drinks, broth, or other liquids. . 
 
 11 th. On account of the increase in the number of the 
 sick, and the diminution in the numbers of employees 
 in consequence of death or sickness, and in view of the 
 good results already attained from the employment of 
 infirmary-dressers, there shall be designated to each hos- 
 pital a certain number of intelligent assistant attendants, 
 to keep the visiting pass-books and perform the minor 
 dressings. 
 
 12th. A commission, consisting of General Pariset,. of 
 
174 THE CRIMEAN WAR. 
 
 the sub-intendant charged with the hospital service, and 
 Lieutenant-Colonel Cadart, commander of engineers, 
 shall visit in succession all the hospitals at Constantino- 
 ple, and propose such improvements as circumstances 
 may require, and which are not above indicated. 
 
 During the month of February, the number of sick in 
 the Crimea amounted to 19,648, of whom 2,400 died, 
 1,993 recovered, and 8,738 were sent to Constantinople ; 
 and during the same month, in the hospitals of Constan- 
 tinople, the sick amounted to 20,088, of whom 2,527 
 died, 3,617 recovered, 649 were sent to Gallipolis and 
 Nagara, and 3,717 to France. 
 
 The plague in Egypt, in 1792, is spoken of with terror. 
 Said the illustrious Desgenettes, in his Medical History 
 of the Army of the JEast, " from the most accurate and 
 careful reports, the army in Syria lost by this epidemic 
 about seven hundred men." Our typhus committed 
 much more dreadful ravages. 
 
 Notwithstanding my urgent representations, a suffi- 
 cient number of places for the increasing numbers of 
 typhic patients were not provided ; and on the 28th of 
 February I addressed the following letter to the Minister 
 of War: 
 
 " To HIS EXCELLENCY THE MARSHAL. The progress 
 of typhus continues upon the increase, and 150 new 
 cases have occurred in the hospitals at Constantinople 
 within twenty-four hours. At Maslak No. 1, among 420 
 sick, 180 have the typhus, and at Ramis-Tchifflick, among 
 700 sick, there are 250 cases of this disease. 
 
 "Your Excellency will observe that there exists in 
 certain hospitals a serious tendency to the disease, and 
 that it demands a prompt remedy. The remedy is sim- 
 ple ; air, pure air, constantly renewed ; and to secure 
 this, we should, as quickly as possible, remove one half 
 of our hospital population to the unoccupied barracks of. 
 Maslak, and there construct a great encampment and 
 bivouac. This has been my request, morning and even- 
 ing, daily. 
 
 u On the 1st of March they promise me 2,000 places 
 in barracks ; but these will be inadequate ; the more so, 
 on account of the great number arriving from the Crimea. 
 
THE CRIMEAN WAR. 175 
 
 Yesterday, 650 sick arrived from Eupatoria. I have 
 visited them, and they are properly placed on litters 
 and furnished with blankets. The passage only occu- 
 pied thirty-six hours; four died at sea, and only ten 
 men, one of whom was of the medical staff, had the 
 typhus. 
 
 " An error has spread among the authorities, which I 
 have endeavored to counteract, because it might be 
 attended with pernicious consequences. This is, the 
 comparison of typhus with cholera, and the belief that 
 the disease will disappear of its own accord. The cho- 
 lera, whose cause is unknown, sweeps forward with a 
 force that nothing can check, arrives at its maximum, 
 and then declines and spontaneously disappears. Typhus, 
 on the contrary, which we know is brought on by priva- 
 tions, continues until the cause is removed. Its element 
 is human miasm, rendered contagious and virulent, in 
 proportion to the number of typhic patients assembled 
 in one spot. 
 
 " It was because the great measures of prevention 
 were neglected, or could not be employed, that typhus, 
 during the wars of the empire, was seen to take such an 
 extension, and strike terror into the hearts of cities. So 
 it was during the siege of Mayence. The wise foresight 
 of the government, and the great solicitude of your 
 Excellency, has happily not left us disarmed in face of 
 the epidemic. We have barracks for 25,000 soldiers 
 awaiting inmates. Let us hasten to use them. But 
 opening barracks to satisfy new wants, on the gradual 
 arrival of our sick from the Crimea, will not meet the 
 end required ; it is simply waiting till the approaching 
 tide swallows us up. And yet I should say, that the 
 brave and worthy General Larchey has the best disposi- 
 tion to aid in any measures, as also has the Intendant 
 Angot, and I have only to approve my excellent rela- 
 tions with them. Why don't we act more rapidly ? 
 There are, apparently, difficulties in the execution, of 
 which I am not cognisant. Thus, I have heard the 
 Intendant object, in one of our general conferences, 
 against my plan of substituting field hospitals for the 
 large general hospitals, that the Minister would not 
 
176 THE CRIMEAN WAR. 
 
 allow the establishment of them out of the Crimea. I 
 admit that the instructions are plain, to one who has no 
 responsibility; so I dare not complain, and can only 
 deplore the situation in which I am placed. 
 
 " I have already informed your Excellency that Gene- 
 ral Larchey has permitted us to select, from among the 
 soldiers about to be sent to France on sick leave, 
 two hundred auxiliaries for the hospital service, to 
 whom we will entrust the visiting pass books and the 
 charge of the minor dressings. This measure assures 
 the perfect fulfilment of the service ; and as soon as the 
 auxiliaries recover their health, we will send them back 
 to the Crimea, and supply their places with others. The 
 following are the last daily reports of the progress of the 
 typhus in our hospitals at Constantinople : 
 
 New Cases 
 Remaining. Recovered. Died, within 24 hours. 
 
 February 25, 1,706 15 40 166 
 
 " 26, 1,826 7 46 188 
 
 " 27, 1,846 50 56 137 
 
 " Three military physicians fell victims to the typhus 
 on the 26th ; and it pains me to inform you that one of 
 them, M. Sagne, Aide-Major Physician, in a moment of 
 delirium, inflicted upon himself several cuts with a razor, 
 which opened the arteries of both arms, and he died of 
 the hemorrhage that followed. 
 
 "M. Gerard, Major-Physician, died at the hospital, 
 at the Russian embassy; and the principal physician, 
 Volage, has been poisoned by the breath of the 
 sick, upon whom he lavished the treasures of his 
 science and self-denial. His death has caused the keen- 
 est regrets. 
 
 " Within three days six new cases of typhus have ap- 
 peared in the medical corps at Constantinople, and yet 
 no one hesitates, and each will discharge his duty till 
 the end. 
 
 " P.S. General Larchey, to whom I have communi- 
 cated tfcis report, has brought to my knowledge a minis- 
 terial dispatch, this moment received, in which your 
 Excellency has ordered the ailing soldiers of the Crimean 
 regiments to be sent to Constantinople. This measure 
 
THE CRIMEAN WAR. 177 
 
 would have been well when I advised it ; but the ailing 
 are to-day the sick. We are going to open wide to them, 
 the doors of the camps of Maslak, which soon, I trust, 
 will be converted into hospital establishments." 
 
 The courier, on the morrow, bore another dispatch, 
 which I addressed to his Excellency the Marshal Pe- 
 lissier. 
 
 " CONSTANTINOPLE, February 29, 1856. - 
 
 "To HIS EXCELLENCY THE MARSHAL. I have the 
 honor to address to your Excellency a report upon the 
 progress of the typhus in our hospitals at Constantinople, 
 which will enable you, with the documents transmitted 
 directly from the Crimea, to understand the sanitary 
 condition of the army. I cause a report to be made to 
 me daily of the number of men tainted with the typhus, 
 of the new cases appearing during the last twenty-four 
 hours, the number of recoveries, and the mortality. 
 
 "These reports are instructive, and the following 
 table gives their returns since the 20th of the present 
 month : 
 
 New Cases 
 
 Number of Ty- within 24 
 February phus patients. kur.j Eocovered. Died. 
 
 20 1,450 62 4 36 
 
 21 1,517 111 10 44 
 
 22 1,586 168 9 62 
 
 23 1,556 105 27 41 
 
 24 1,615 128 8 43 
 
 25 1,706 166 15 40 
 
 26 1,826 188 7 46 
 
 27 1/848 137 50 56 
 
 28 1,927 168 39 50 
 
 29 1,969 178 79 60 
 
 *' The epidemic wave is rising, and we can only escape 
 it by watching its conditions, and raising against it an 
 effectual barrier. It is only necessary for you to cast 
 your eyes over the tables showing the new eases occur- 
 ring within twenty-four hours to convince yourself of 
 the contagion of typhus, and of the necessity of adopt- 
 ing measures for limiting its spread as quickly as possi- 
 ble. It would be well to advise means to retain all the 
 men tainted with typhus in the Crimea, if it could be 
 done without exposing the army to too great risks. But 
 
 9 
 
178 THE CRIMEAN WAE. 
 
 in the mean time, it is easy to arrest the typhus at Con- 
 stantinople, and to prevent it from spreading. We have 
 providentially in our camps empty barracks for 25,000 
 men. They, are arranged upon elevated grounds, and 
 are in good hygienic condition. Let ns remove thither 
 half of our hospital population, some 5,000 sick, and I 
 will answer for it that we will check the progress of the 
 mortality from typhus almost immediately ; for what, 
 sir, is necessary to cure this disease ? Only an abundance 
 of pure air, constantly renewed, in place of air charged 
 with contagious miasms. Every form of medical treat- 
 ment, whatever may be its virtues, will prove a striking 
 failure, if the first essential condition, that of disencum- 
 berment, is not fulfilled. For this end, I ask only some 
 field hospitals and beds. Straw beds, even, would suffice 
 for probable wants, and the necessity for them would, 
 I trust, disappear with the return of fine weather. This 
 measure ought not to present great difficulties in exe- 
 cution. We shall have, in a short time, 5,000 places 
 under barracks to satisfy the new wants as they shall 
 arise ; but in so doing, we allow ourselves to be pressed 
 upon by necessity, we do not meet it. We shall find 
 ourselves some day invaded by the sick, in place of hav- 
 ing prevented the sickness. 
 
 "Pardon me, Marshal, for expressing myself to the 
 point. I must tell your Excellency the truth. Myself a 
 man of action, field hospital surgeon, I would wish to 
 move off with some supplies, and with my sick to esta- 
 blish a great bivouac in the unoccupied camps. The 
 administration, on which all responsibility rests, cannot, 
 I am aware, act so quickly. They encounter, besides, 
 great difficulties in recruiting auxiliary infirmary at- 
 tendants. 
 
 " As for the personnel of the health service, although 
 reduced by mortality and sickness, it can yet face pro- 
 bable events, if the commander, whose solicitude has 
 never been dormant, still continues to second our efforts. 
 We have here upon our hands 10,000 sick soldiers, 
 who, in place of being sent to France on sick leave, 
 would like nothing better than to become our infirmary 
 attendants. They would otherwise be lost, so far as 
 
THE CRIMEAN WAE. 179 
 
 being of any service in the Crimea, during the next 
 four months. By placing them in charge of the visit- 
 ing passbooks and minor dressings, we may hold 
 them in reserve, and as soon as they become fit to 
 resume active service, we might send them away and 
 replace them by others. 
 
 " I visited the sick on -board the ships arriving from 
 the Crimea, and presided over the arrangements for 
 placing them upon steamers to be sent to France. I can 
 affirm that every measure possible, suggested by human- 
 ity and affection, has been adopted. I have taken espe- 
 cial pains not to allow any sick to embark that were 
 tainted with typhus; but it is not within the power 
 of man to prevent the malady from breaking out upon 
 the voyage. We have had for a year 2,500 places pre- 
 pared for the sick in the lazaretto of Marseilles, 500 in 
 that of Port-Vendres, and 1,500 in that of Toulon. 
 Thus, in this way, everything has been foreseen by his 
 Excellency the Minister of War. 
 
 " My relations with M. Scrive have brought to my 
 knowledge the excellent arrangements adopted in the 
 Crimea. It is of the highest importance that the site of 
 the camps should be changed as soon as the weather will 
 permit ; but, in the mean time, it is necessary to empty 
 and cleanse the field hospitals. 
 
 " Thus far the epidemic has happily been limited to 
 the hospitals, without entering the camps. On the 26th, 
 three physicians died of typhus, others are now in great 
 danger, and twenty-four are under treatment. Everyone 
 does his duty with self-denial and with redoubled efforts. 
 We have already lost eight military physicians killed, 
 and thirty wounded on this battle-field. I class among 
 the wounded the physicians who have contracted the 
 typhus among the sick whom they have attended. 
 When the proper moment shall have arrived, I will 
 with confidence appeal to your high benevolence con- 
 cerning this class of officials, who since the beginning of 
 the campaign have enjoyed the honorable privilege of 
 conciliating more and more the earnest sympathies of 
 the army." 
 
 Unfortunately, the weather became unfavorable. On 
 
180 THE CRIMEA;* WAR. 
 
 the 3d of March, 1856, the Intendant-general addressed 
 me as follows from the general head-quarters : 
 
 "I have read very carefully your report upon the 
 sanitary condition at Constantinople. We are passing 
 through a terrible crisis, and most of all need pleasant 
 weather to enable us to pass through it in the Crimea ; 
 for a short continuance of fine weather would enable us 
 to complete the purification of our ambulance hospitals. 
 Already the old field hospitals of the 1st corps have been 
 rearranged throughout, and are now perfectly healthy. 
 We need to do the same thing everywhere ; but the 
 weather still continues so bad that we meet with the 
 greatest obstacles. Meanwhile, we observe a marked 
 improvement in the general health, and the number of 
 daily entries has sensibly diminished during the last ten 
 or twelve days. This may be due, in a great degree, to 
 the oil, vinegar, potatoes, and mixed vegetables which I 
 have caused to be distributed among the troops, so that 
 there are but very few scorbutic patients now in the 
 
 field hospitals I think 'that the Marshal will give 
 
 orders for the employment, to the greatest extent possi- 
 ble, of the barrack camp at Maslak for the use that you 
 suggest. I am entirely of your opinion, that when 
 possible, a seat of infectious disease should be aban- 
 doned without delay. I weh 1 remember that during 
 the cholera, at Varna I had to fight it in like man- 
 ner ; I required that the choleraic patients should 
 be taken out of the hospitals, and placed in tents ; I 
 demanded pure air, and was answered that heat was 
 needed. The number of sick increased, and they were at 
 length forced to have recourse to the tents, and then 
 learned that this was not so bad a plan after all. It 
 appears to me that it is the same thing with typhus, 
 except that large well-ventilated barracks, and only a 
 few sick placed in them, would prove better than 
 tents." 
 
 On the same day, a telegraphic dispatch from Marshal 
 Pelissier, sent to Constantinople the orders necessary for 
 the immediate establishment of field hospitals for 5,000 
 sick, and on that day I wrote as follows to the Minister 
 of War: 
 
THE CRIMEAN WAR. 181 
 
 "The contagion continues its ravages. It will con- 
 tinue thus, so long as we cannot carry into the barracks 
 of the unoccupied camps a third or a half of the sick in 
 the hospitals. Of the 5,000 places that I have requested, 
 1,000 have been furnished, and we have thus been able 
 to create a little space in our hospitals. This at once 
 produced a diminution in the number of new cases. In 
 fact, on the 1st of. March, this number had fallen to 93 ; 
 but, unhappily, this respite was enjoyed but for a mo- 
 ment, and new additions of sick, sent from the army 
 before Sebastopol, have encumbered our hospitals, and 
 have obliged us to encroach upon the rooms reserved 
 for the sick who are dangerously ill. The number 
 of new cases has thus been increased beyond any 
 former period, amounting to 257 within twenty-four 
 hours. 
 
 " By constant airing and ventilation of the wards ; by 
 five fumigations daily, two with chlorine, and three with 
 aromatic herbs ; by placing under the bed of each typhic 
 patient a cup of chloride of lime; by scouring the floors 
 and whitewashing the walls of the wards, one after ano- 
 ther ; by keeping always in the chamber vessels some 
 sulphate of iron ; by making large openings in the privies, 
 for their thorough ventilation ; by having, if possible, 
 two beds for each man gravely affected by the typhus, 
 and fumigating each bed for twenty-four hours after it 
 is left ; by washing the linen in boiling water ; by an 
 improvement in the regulations for the diet, and a more 
 substantial broth, and Bordeaux wine for the sick all 
 of which measures we have regularly enforced are we 
 able to resist the pestilence, which nevertheless is gain- 
 ing ground upon us daily. We shall be able to conquer 
 it only when we shall have taken possession of the new 
 hospital establishments prepared in the camps at Maslak. 
 It is not without trouble that I can destroy in the mind 
 of the command and the administration their feeling of 
 security in the midst of so much danger : they believe 
 that the typhus brought from Sebastopol will disappear 
 at Constantinople, when it ceases to be imported from 
 the Crimea. It would result from this, that we need 
 not trouble ourselves here on account of the epidemic. 
 
182 THE CRIMEAN WAR. 
 
 In the meantime, the epidemic spreads rapidly among 
 our hospitals at Constantinople. The only way to stop 
 it is to remove half of the sick to empty barracks. Let 
 this be done, and I will answer for it that the march 
 and fatality of the typhus will be almost immediately 
 checked. I ask only for field hospitals. The measure 
 appears to present great difficulties in the execution. 
 More places in barracks are promised, in proportion as 
 new wants arise. By so doing, we wait till necessity 
 compels us to act we shah 1 find ourselves some day 
 invaded and powerless. I would wish to go with some 
 supplies, and with my sick establish a great bivouac in 
 the unoccupied camps." 
 
 At the close of a new report, written on the 6th of 
 March, the minister addressed to General Larchey, at 
 Constantinople, a telegraphic dispatch, in the following 
 word's : 
 
 " The last report of M. Baudens makes me fear that 
 the order for placing the sick in barracks, or under well- 
 aired tents, has not been sufficiently carried out. Do 
 everything that M. Baudens desires." 
 
 Night and day the health officers remained among 
 their typhic patients, and scarcely left them, except to 
 follow in the funeral procession and attend the burial 
 of one of their number. Forty-six have perished, struck 
 by typhus,* while bravely contesting its ravages, and 
 eighty-two have died during the campaign. Never has 
 the medical staff found a finer occasion for proving their 
 traditional devotion to France, and to the army which 
 has always regarded them with affection, and in the 
 
 * The names of the physicians and surgeons dying of the typhus 
 were as follows : Principal Physicians, Volage and Barby. Majors, 
 Felix, Goutt, Bonnet-Masimbert, Frette-Damicourt, Moulinier, Braun- 
 wald, Girard, Rampont, Leclere, Pegat, Fuel, Berthemot, and Fey- 
 russet. Aides-Majors, Le Clere, Cordeau, Dulac, Savaete, Gillin, Mil- 
 tenberger, Perrin, Molinard, Gueury, Lasserie, Lemarque, Perry, 
 Desblancs, and Masson. Aides-Major Physicians, Leker, Bouquerot, 
 Servy, Demanet, Dartigaux, Ragu, Lardy, Forget, Sagne, and Fournier. 
 Sub-aide Physicians, Jacob, Godquin, Sautier, and Labretaigne. Aide- 
 Major Apothecaries, Boussard, Carron, and Granat. 
 
THE CRIMEAN WAB. 183 
 
 ranks of which they have always been so eager to be 
 classed.* 
 
 On the 2d of March, the population of Pera was 
 saddened by the spectacle of three hearses, bearing in 
 the same train the bodies of three physicians, who had 
 fallen together, the victims of their own selfdenial. 
 These gloomy processions to the field of the dead break 
 the spirit ; for each one may truly ask himself: "Who 
 of us to-morrow will receive this last sad adieu ?" It 
 fell to the share of the Medical Inspector to perform the 
 painful duty of pronouncing the last words over the 
 tomb of his unfortunate comrades. 
 
 The pious sisterhood of Saint-Vin cent-de-Paul paid 
 also a large tribute to disease, and thirty-one perished 
 near their grateful sick, upon whose attendance they 
 were unwearied; never showing signs of fatigue, nor 
 disgust, nor anxiety about themselves in their delicate 
 and assiduous attentions. Of those who died, twenty- 
 four were struck by the typhus. The first one of them 
 who took the disease was Sister Walbin, whose last 
 words were: " The only favor I ask, is to be buried with 
 the soldiers they will be lonesome without me." 
 
 Meanwhile, instead of opening field hospitals, and 
 ample quarters in barracks, they continued to send the 
 sick to France. Within a month, 6,000 were sent thither 
 in transports, and half the vessels, instead of returning 
 to the Crimea, were despatched to Marseilles and Tou- 
 lon. For the want of ships, the Crimea could not send 
 us so many sick ; and so the system continued as it was 
 the Crimea relieving itself upon us, and we upon 
 France. Two hundred soldiers a day died between the 
 Crimea and Constantinople ; and the sailors, falling vic- 
 tims to the contagion, entered the hospitals along with 
 the sick whom they brought. From Constantinople, 
 the disease which infected the vessels was carried to 
 Marseilles ; and it would seern that we were indefinitely 
 threatened with this real and terrible disaster. It was 
 
 * France knows how to appreciate every kind of heroism, and yet 
 the widows of medical officers are deprived, by a decree that doubles 
 the pensions of retreat for the officers of the army, of the advantages 
 conceded to the widows of the latter. AUTHOR'S NOTE. 
 
184 TIIE CRIMEAN WAE. 
 
 a time for prompt action, under penalty of soon being 
 rendered powerless it implied the very existence of the 
 army. 
 
 Two great measures were to be taken ; the first was 
 to send no more sick from Constantinople to France ; 
 and the second, to keep all the typhic patients in the 
 Crimea, to the exclusion of the other sick, who might 
 be sent to Constantinople. 
 
 I left for Sebastopol on the 9th of March, 1856, and 
 at the moment of embarkation received a visit from 
 M. Girette, the Director of the Imperial Mail Boat 
 Company. He said : " The typhus is making such 
 ravages in the ships of the company, infected by 
 the constant transmission of the sick, that the mail 
 service will be forced, in a few days, to be discon- 
 tinued on the route from Sebastopol to Marseilles.'* 
 Many of the sailors, firemen, and commanding offi- 
 cers of these vessels have died of the disease, and others 
 are sick. M. Girette had not been able to replace 
 these by others. 
 
 Immediately upon arriving in the Crimea, I visited a 
 part of the camps and field hospitals ; and on the 15th 
 of March, without further delay, informed Marshal 
 Pelissier upon the sanitary state of the army. The first 
 question that I proposed to investigate was whether 
 the typhus raged only in the field hospitals, or w r hether 
 it had also spread in the regiments. I became satisfied 
 that the latter was but too truly the case, and gave direc- 
 tions that they should watch with the most scrupulous- 
 care, so as not to leave, either in the regimental infirm- 
 aries or the tents, any men tainted with the typhus ; 
 on the first premonitory symptoms, they should be 
 placed in the field hospitals. The human miasm of this 
 disease does not become contagious until after the 
 disease has continued several days, and especially during 
 the period of the critical sweats ;* and for this reason, 
 the recommendation here given becomes of the highest 
 importance. I also demanded that they should change 
 
 * Tke correctness of this point of theory is confirmed by the views 
 of Hildebrand, and was in conformity with the facts observed in all 
 the regiments hi the Crimea. 
 
THE CRIMEAN WAR. 185 
 
 the sites of all the camps from a soil that had become 
 deeply impregnated with impurities ; and that as often 
 as the weather permitted, they should take down their 
 tents, or at least raise the curtain that extended around 
 the bottom to the height of a few inches from the 
 ground. They might thus prevent the soldiers from 
 remaining a great part of the day in their tents, which 
 they kept hermetically closed, even in the finest weather. 
 The floor of the tents, once dry, ought to receive a 
 coat of w T hite-wash, renewed from time to time, which 
 would cleanse and harden the surface. The bed-clothing 
 and garments of the sick should be hung up in the sun, 
 as long a time each day as possible. Those which had 
 been used by patients infected with the typhus ought to 
 be exposed for several hours to chlorine fumigation be- 
 fore being again used. 
 
 A considerable number of regimental infirmaries had 
 a defective arrangement, and, in place of two barracks, 
 several had but one. The ground was not always pro- 
 tected against humidity, and camp bedsteads, or at least 
 boards, were not always furnished to keep the sick from 
 the ground. The interior of the barracks should be 
 whitewashed with quicklime, and the floor and walls 
 exposed to fumigations at frequent intervals. The 
 rations should be increased a sixth part in the article of 
 preserved meats, and a supplementary ration of wine 
 should be issued daily, to give the army a greater power 
 of resistance against the attacks of the malady. 
 
 I also recommended, as an excellent auxiliary to good 
 hygienic condition, that exercise should be taken, to a 
 judicious extent, when the weather was fine ; for nothing 
 is so pernicious as perfect repose, and idleness enervates 
 both body and mind. The six thousand mattresses dis- 
 tributed four months previously, tinder the direction of 
 the Intendant-general, were, in part, out of condition for 
 service. There remained of them about 2,500, more or 
 less. There was scarcely barrack room for more than 
 4,500 sick. The blankets were sufficiently numerous, 
 but almost all of them were tainted ; sheets and hospital 
 clothes were wanting, as were also proper means for 
 washing. 
 
 9* 
 
186 THE CRIMEAN WAR. 
 
 To supply these resources, which are so quickly ex- 
 pended in a campaign, AVC were obliged to overcome 
 very great difficulties, in a country stripped of every- 
 thing. The last ten days of February, the 20th to 29th, 
 showed 519 sick discharged from the field hospitals 
 cured, and 873 had died. In continuing the compara- 
 tive inquiry, so as to include only those tainted with 
 typhus, we shall observe a still more terrible result ; for 
 we have had in this disease only 27 recoveries to 385 
 deaths, while typhus, under ordinary conditions, does 
 not carry off more than a sixth part of the number sick. 
 Thus, at Constantinople, of 422 hospital attendants 
 attacked with this disease in our hospitals, only 42 died. 
 
 In consequence of these facts, I proposed that we 
 should retain in the Crimea only those sick with typhus, 
 and that we should send all the others to Constantino- 
 ple ; and as the latter were the most numerous, their 
 departure would produce an immediate disencum- 
 brance, and allow us to use all our resources for the bene- 
 fit of our unfortunate typhic patients. The latter, being 
 retained in the Crimea, could no longer spread contagion 
 in the ships and among the hospitals at Constantinople.* 
 
 Two hours after my sending in this report, Marshal 
 Pelissier replied : " I have ordered that all your direc- 
 tions shall be carried immediately into effect in the regi- 
 ments and field hospitals." 
 
 At the same time, strong encouragement came to me 
 from France. On the 15th of March, the Minister of 
 War wrote : " I await with much anxiety the news of 
 your sanitary condition. Tell your associates in the 
 liealth service, that I thank them. This word expresses 
 the whole. The Emperor is informed of the new proofs 
 they have shown of their zeal, their courage, and their 
 self-denial. He has always relied upon these officers; 
 but his faith in their devotion has been increased by a 
 knowledge of the energy they have shown upon this 
 occasion. I send to your assistance some sisters of cha- 
 rity, 200 infirmary attendants, and 20 aides. Can such 
 a supply relieve you ? At Marseilles and Toulon, there 
 
 * See in the Appendix the original report. 
 
THE CRIMEAN WAR. 187 
 
 is much excitement, but nothing serious has occurred, 
 although there is great apprehension. We are turning 
 to account the good and prudent arrangements taken 
 by you in your tour in Provence. The Emperor wrote 
 to me this morning, and speaking of the sanitary condi- 
 tion of the army, he added : * It is necessary to establish 
 as soon as possible the field hospitals in barracks, which 
 M. Baudens has advised, and let pressing orders be 
 given accordingly.' I cannot do better than report the 
 very words of the Emperor. I have addressed General 
 Larchey by telegraph and letter, and have ordered that 
 as many as possible of the sick shall be placed at Maslak. 
 I have told him to arrange with the physicians, outside 
 of all the pre-existing regulations, relative to the diet of 
 the sick. He has full powers, and I will approve every- 
 thing he may do. The Russian prisoners on the island 
 of Prinkipo are in perfect health. I think that after 
 their departure from Russia, if that event has not 
 already occurred, a fine field-hospital might be esta- 
 blished there. I have given orders to allow an addi- 
 tional pay to the physicians of one hundred francs per 
 month.* I conclude by renewing the recommendation 
 to retain at Constantinople all the sick whose removal is 
 not demanded by want of space or by the absence of 
 sanitary necessities." The Director of the War Depart- 
 ment, M. Darrican, wrote to me: "Your position is 
 terrible. We will do everything possible to relieve it." 
 On the same day, the President of the Council of 
 Health in the Army addressed to me the following 
 letter : f 
 
 " MY VERY DEAR AND HONORED COLLEAGUE The 
 
 Council of Health has, with the greatest interest, taken 
 into consideration the dispatches which you have suc- 
 
 * The radical decree of 1852 having abolished the extra war 
 allowances to the medical staff of the army, privations that endan- 
 gered their health were the result. The Minister of War, whose atten- 
 tion I had called to this pernicious condition of affairs, readily modified 
 the evil growing out of the decree, by ordering a supplementary allow- 
 ance. AUTHOR'S NOTE. 
 
 f The Council of Health consists of three or five Inspectors, desig- 
 nated annually by the Minister of War. TK. 
 
188 THE CRIMEAN WAR. 
 
 cessively addressed to it, as also your last reports to the 
 Minister upon the general aspect of the medical service 
 at Constantinople. 
 
 "The Council hopes that the hygienic and prophy- 
 lactic measures which you have proposed, and whose 
 execution you have yourself superintended, will be fol- 
 lowed by the favorable results that you anticipate, and 
 that they will contribute, together with the reforms 
 which you announce in the hospital rations, to the pre- 
 vention of the development of infectious diseases, and 
 to the arrest of their progress. The Council follows 
 you in your labors with very great interest, and ear- 
 nestly prays that the insufficiency in the number of the 
 medical officers may not prevent the sick from receiving 
 those assiduous attentions that may be so necessary for 
 them. 
 
 "The Council, deeply touched by the death of so- 
 great a number of its courageous fellow laborers, returns 
 you its thanks for having expressed over their graves in 
 its behalf the just regrets which their loss has inspired, 
 and desires you to be the medium for expressing to all 
 the health officers of the army of the East the sentiments 
 which are impressed upon it by their zeal, devotion, and 
 self-denial in the midst of great dangers." 
 
 On the 16th of March, Marshal Pelissier decided that 
 two field hospitals, which had become thoroughly in- 
 fected, and which I advised to be abandoned, should be 
 at once closed. The engineers immediately constructed 
 two others, upon sites selected by me, upon high pla- 
 teaux, placing the barracks twenty yards from one 
 another, and the quarters of the physicians over two 
 hundred yards from the hospitals. These two establish- 
 ments have remained healthy, and have proved emi- 
 nently useful. On the same day Marshal Pelissier 
 ordered all the sick in the Crimea to be sent to Constan- 
 tinople, except those sick with the typhus. I passed 
 through the regiments, one after another ; I conversed 
 with the colonels, and imparted to them my observa- 
 tions. My counsels w^ere everywhere listened to with 
 eagerness, although not always followed with religious 
 care. I could show that the mortality and sickness of 
 
THE CRIMEAN WAE. 189 
 
 the several regiments always bore an exact relation to 
 the degree of solicitude which the colonels bestowed 
 upon their soldiers.* 
 
 By the 28th of March, the good effects of these mea- 
 sures were easily observed, notwithstanding the pro- 
 tracted and severe winter. I informed Marshal Pelissier 
 of this, drawing his attention also to some much regret- 
 ted neglects, in the following report : 
 
 " The measures which I recommended in my report 
 of the 15th instant, for arresting the progress of typhus, 
 and which your Excellency directed to be immediately 
 carried into effect in the regiments and field hospitals, 
 have borne their fruits. 
 
 "During the last ten days, the number of those enter- 
 ing the field hospitals shows a reduction of 500, as com- 
 pared with those of the te# days previous, and the 
 diseases are much less severe. The mortality in the 
 Crimea has been reduced one-tenth. The cases of scurvy, 
 on the 20th of March, in our field hospitals, amounted 
 to only 649, in consequence of many being sent away ; 
 but at Constantinople we have in our hospitals, among 
 10,000 sick, 4,000 scorbutic cases. This disease, how- 
 ever, still fills, to a great degree, our regimental infirma- 
 ries ; but is sensibly ameliorated since the distribution 
 of fresh vegetables and the return of the sun. Some 
 anti-scorbutic lemon juice, prepared according to the 
 English method, has been placed at the disposal of the 
 physicians in the army, and I look for good results 
 from it. 
 
 * A general in the army of the Potomac, noted for the care which 
 he bestows upon the welfare of his command, made a somewhat simi- 
 lar remark to the editor of this volume, upon the occasion of a visit for 
 purposes of sanitary inspection, in March, 1862. He stated that his 
 observations and inquiries had convinced him that the sickness of a 
 regiment bore an inverse ratio to the efficiency of its discipline ; and 
 produced the records of his surgeons to prove, that for months the 
 sickness had been greatest in those regiments which he ranked as the 
 worst officered. All experience tends to prove, that without strict 
 rules, well enforced, soldiers will not attend to those details of neat- 
 ness of the person, the quarters, and the camp, so essential to health, 
 In no way does the energetic disciplinarian appear to greater advan- 
 tage than in this. TR. 
 
190 THE CEIMEAN WAR. 
 
 "So much for the general conditions. Let us now 
 examine the state of the typhus. 
 
 " This disease has always one foot in the camp and 
 the other in the field hospital. It has not gained ground ; 
 but still it must be acknowledged that it retains its hold, 
 and menaces the army. We can safely assert that there 
 are now a greater number of cures ; medicine is, with- 
 out doubt, favorable in some conditions, and its impo- 
 tency less marked. Thus, during the last eleven days, 
 we have counted 283 recoveries, to 699 deaths. The 
 sum total is not much increased, as it was 1,457 on the 
 16th of March, and 1,606 on the 26th. It should be 
 remarked, that since the 17th of this month, we have 
 not sent to Constantinople a single person tainted with 
 typhus. 
 
 u Two hundred and eighty-three cures in eleven days 
 is evidently a very good comparative result, when we 
 remember, that since the 1st of January, each period of 
 ten days showed that the number of soldiers cured was 
 7, 14, 25, 36, 27, 62, and 45 respectively ; but still this 
 figure of 283, placed opposite to a mortality of 699 
 deaths, is very distressing. It shows conclusively that 
 we should redouble our efforts to obtain a vigorous exe- 
 cution of every prophylactic measure recommended to 
 the regiments and field hospitals. But permit me to 
 inform your Excellency, that in passing among the regi- 
 ments, I daily observe that many of the tents are not 
 ventilated, that the clothing is rarely spread in the sun, 
 and that the ground has not yet received the sprinkling 
 of lime ordered. I either find the men absent, and the 
 tents carefully closed, with large stoves, so as to be 
 air-tight, or they are squat smoking within them, like 
 Laplanders, exposed, without their knowing it, to the 
 danger of reciprocal miasmatic poisoning ; and yet, dur- 
 ing the last fifteen days, the sun has not failed to vivify 
 the earth daily with his presence. 
 
 " In the field hospitals, the measures directed are not 
 executed as rapidly as I could wish, but still progress is 
 made. The isolation of typhic patients has become 
 almost complete, the bedsteads have arrived, and disin- 
 fection by chlorine fumigation is becoming general. Two 
 
THE CRIMEAN WAR. 191 
 
 field hospitals will be abandoned, according to your 
 orders, on account of infection, as soon as those which 
 your Excellency ordered are finished. 
 
 " I regard it as a most urgent measure, that the non- 
 typhic patients should be immediately sent off. At least 
 fifty cases of typhus show themselves daily in our field 
 hospitals, among those entered for other diseases. This 
 amounts to 1,500 cases per month, of whom it is shown, 
 by actual results, that 1,000 prove fatal. It would there- 
 fore be 1,500 per month to strike out, if in our own 
 field hospitals there were only sick belonging to this 
 category. We should establish small hospitals in tents, 
 at least three hundred yards from the actual field hospi- 
 tals, for the temporary reception of new non-typhic 
 cases which ought to be sent away. The result of this 
 measure would be to keep up the morale of the sol- 
 diers, who have a horror of field hospitals and the con- 
 tagion of typhus. 
 
 " Whenever the day arrives in which we shall have to 
 treat only typhic cases coming from the corps, our situa- 
 tion will be materially alleviated. At the lowest esti- 
 mate, the corps furnishes us daily seventy men infected 
 with the epidemic ; the recoveries and the deaths would 
 very nearly balance this number, even in the present 
 conditions. 
 
 " I have already had the honor of showing your Excel- 
 lency that by retaining in the Crimea all those men 
 infected with the typhus, we should relieve the fleet and 
 the hospitals at Constantinople from the dangers of infec- 
 tion. I advised regimental physicians to redouble their 
 vigilance to prevent any typhic patient from remaining 
 in the regimental infirmaries. The only danger which 
 threatens us is, the spread of the epidemic among 
 the masses. It may be prevented by two different 
 methods. 
 
 " 1st. By continuing to remove from the corps, and 
 sending to the field hospitals, those that show the first 
 symptoms of the epidemic, with the object of arresting 
 its propagation by infection. 
 
 u 2d. In removing from the regiments the causes 
 which spontaneously generate typhus. This may be 
 
192 THE CRIMEAN WAR. 
 
 done by causing to be put into effect the prophylactic 
 measures laid down in the army orders, and remember- 
 ing that the most important of these measures is the 
 change of site of the camps from those places where the 
 disease has been engendered. 
 
 "The urgency of this latter rule will appear more 
 especially towards the time when the troops are to em- 
 bark on their return to France. It will be necessary, 
 at least fifteen days before that time, to make short 
 marches with their shelter-tents, and change their 
 encampments every two or three days. The country 
 all along the ridge of the heights, which border upon 
 the sea between Balaclava and Kamiesch, presents, in a 
 hygienic point of view, favorable bivouacs for this pur- 
 pose. I am well aware that these frequent movements 
 must be irksome, and even vexatious, to those who do 
 not see their importance ; but the soldier, who alone 
 with the physicians bears all the burdens of typhus, will, 
 with them, heartily approve of it. 
 
 " If this advice is not followed, typhus will propagate 
 itself on board ship ; and as there will be no means of 
 isolating the infected, and the epidemic might assume 
 gigantic proportions, a heavy responsibility would rest 
 on the physician who has not warned, and on the com- 
 mander who heeds not the counsels given. 
 
 " The typhus will continue, so long as the causes that 
 generate it remain ; and the danger of not crushing it in 
 the bud, and of letting it increase, is that when once 
 started, it develops itself rapidly by infection, and 
 extends to the masses. Who does not remember the 
 lamentable narratives of misfortunes occasioned by con- 
 tagious typhus in armies ? 
 
 " It is because I am thoroughly convinced that these 
 misfortunes will not occur, if we seek to avoid them, 
 that I insist so much not so much to enlighten your 
 Excellency, whose great wisdom and experience are 
 known throughout the army, as to convince these men, 
 whom I see ignorant of the most elementary principles 
 of hygiene, living careless of the present, and, as it 
 were, wrapping themselves up in a kind of Mahomedan 
 fatalism. 
 
THE CRIMEAN WAE. 193 
 
 "Are we to be frightened by it? Certainly not. 
 Fear is a bad counsellor ; but we must watch and fore- 
 see. By so doing, we are certain never to be unpre- 
 pared, and we command the situation, whatever it may 
 be. Supposing the typhus did not exist, there would 
 still be advantage in religiously observing the hygienic 
 rules which insure the health of armies. 
 
 " As for myself, I am reassured ; because I have con- 
 fidence in the enlightened and active concurrence of the 
 commanders, and in the wisdom of the measures already 
 adopted by the Minister of War. The personal service 
 of the medical department continues to sustain losses 
 daily, but its courage and self-denial increase with the 
 emergency. I have taken, with the Intendant-general, 
 certain measures, of a tendency to modify this state of 
 things, which grieves me seriously. I intend to return 
 with the mail of the 5th of April to Constantinople, 
 where my presence may be of more use than in the Cri- 
 mea ; but before my departure, I respectfully beg your 
 Excellency to give your advice, which, shall be my 
 command." 
 
 On the 30th of March, the Marshal replied : 
 
 " Since the measures recommended to be put into 
 execution, in your report of the 15th instant, have not 
 been performed with all the care that was desirable in 
 the several corps, I will again call the attention of the 
 general officers to them. I will also carry into execu- 
 tion, as soon as the weather permits, your suggestions 
 relative to encamping the troops for some time upon 
 new grounds, and under the shelter-tents. As for your 
 departure for Constantinople, you are a better judge 
 than myself of its expediency ; and I leave you entirely 
 free to embark by the mail of April 5th, if you deem 
 your presence more useful at Constantinople than in the 
 Crimea." 
 
 An improved condition of aifairs appeared, and on 
 the 5th of April the Minister of War wrote to me as 
 follows : 
 
 " MY DEAR DOCTOR I do not thank you again for 
 the care which you have taken, for the zeal which you 
 display in the interests of our poor sick ; it would only 
 
194 THE CRIMEAN WAR. 
 
 be repetition. I agree with you that we should hasten 
 to remove our unhealthy camps, placed upon grounds 
 infected with miasms, and go as soon as possible to the 
 heights that you have mentioned. I count upon the 
 solicitude of Marshal Pelissier to give at once orders to 
 this effect.* We are much engaged with matters relat- 
 ing to the return of the army to France. The numerous 
 cases of typhus which have appeared at Marseilles, at 
 Toulon, and on board our ships, are of a nature to cause 
 us serious reflections. I have pointed out to General 
 Rostolan that w r e have at the Island of St. Marguerite 
 a hospital for four or five hundred sick, and also, under 
 barracks or tents, beds for four or five thousand men. 
 At Frioul, where we have already a hospital, I shall 
 establish a camp for four or five thousand men. Lastly, 
 in one of the islands of Hyeres, on the peninsula of Gyen, 
 I am establishing a third hospital and three camps, for 
 ten or twelve thousand. 
 
 "Our ships will disembark their sick or healthy at one 
 or another of these establishments. 
 
 " The healthy will remain eight or ten days, longer if 
 necessary, in camp ; they will walk about, bathe, will be 
 well fed, will see the coasts of France ; and, finally, all 
 the conditions for restoration to health will be, as far as 
 possible, combined. After undergoing this kind of qua- 
 rantine, those who have sustained the test may be taken 
 to Marseilles or Toulon, and sent to their proper garri- 
 sons. These are the measures which are being studied 
 at this time. The results of the inspection you have 
 made, in the localities that I have indicated, are very 
 useful to us." 
 
 * "We know that the Marshal only awaited the return of fine 
 weather, which would dry the ground deeply soaked by the winter 
 
THE CRIMEAN WAR. 195 
 
 CHAPTER IV. 
 THE RETURN OF THE ARMY. 
 
 PEACE at length came, putting an end to our miseries. 
 The relations between the allied armies and the Rus- 
 sians were soon established upon a very cordial footing, 
 and on each side they celebrated, with fraternal liba- 
 tions, the termination of their long-continued sufferings. 
 The Russians, French, English, and Sardinians, were to 
 be seen walking arm in arm, singing and dancing, assist- 
 ing each other to walk when they had taken a glass too 
 much, as often happened, and giving them a hospitable 
 couch for the night, whenever unsteady limbs rendered 
 it impossible for their visitors to depart. The Russian 
 General, Commander-in-Chief of the division encamped 
 near Belbec, in speaking of this, said to me : "We have 
 had some Zouaves for several days in our camps, who 
 agree perfectly with our soldiers ; by the aid of a very 
 simple pantomime, they understand one another won- 
 derfully, and drink together gaily. These Zouaves 
 expect to be punished upon their return to camp, and 
 have asked me for a certificate, showing that they were 
 so well received that it was impossible for them to return 
 to their regiment." 
 
 Steeple chases and military fetes were held in the val- 
 ley of the Tchernai'a, and the Arabian horses sustained 
 their ancient reputation. In 1856, as in 1855, they 
 resisted the rigors of winter and the hardships of the 
 bivouac much better than horses of other breeds, thus 
 justifying the assertions of General Dumas.* The races 
 attracted large crowds, the soldiers attended without 
 arms, and these reunions created a happy diversion of 
 the spirits, which were depressed with apprehensions of 
 the typhus. Moreover, dramatic artists from France 
 
 * It will be remembered, that in different essays printed in the 
 Revue des Deux Mondes (numbers for December 1, 1851, and May 15, 
 1855), General Dumas first advocated the advantages of Arabian 
 horses for the purposes of war. 
 
196 THE CRIMEAN WAR. 
 
 gave very well attended exhibitions, every evening, in 
 the theatre at Karaiesch, which prompted the formation 
 of rival companies among the soldiers themselves. They 
 compared the merits of the young chief actress at Ka- 
 rniesch with those of a young Zouave bugler, and the 
 opinions of critics were much divided. Had not most 
 of the lyric heroes of the latter been slain in the storm- 
 ing of the Malakoff, it was thought that the theatre at 
 Kamiesch could never have competed with that of the 
 Zouaves. 
 
 In the bivouacs established upon the plains of Fedou- 
 chine, an immense ball-room was made, where figured 
 the grand dames lately made wealthy in the villages of 
 Pickpocketville and Rogueville. 
 
 Before leaving the Crimea, I visited once more, in 
 company with Sir John Hall, the hospitals of our allies, 
 and learned with certainty that the typhus had not reap- 
 peared since 1855. In the port of Balaclava, I visited 
 an English steam frigate, fitted up as a hospital ; it was 
 arranged like a large ward, with 300 beds. They had 
 carried attention to the wants of their sick so far as to 
 place three or four cows on board, so as to have fresh 
 milk during the passage. I inquired of the commandant 
 how many troops a vessel of this size could transport, 
 and he replied, " 700 English, or 1,500 French, because 
 the latter w r ill quarter themselves anywhere, either on 
 the deck, or between decks." The care which the 
 English take of their soldiers, reminds me of the expres- 
 sion often used " the English soldier is capital." This 
 does not exclude from them far from it sentiments of 
 humanity^ but it attaches an idea of value, which 
 should be preserved. On another occasion, when they 
 captured at Balaclava a Russian officer and his family, 
 an English general said, " Here is a good Bank Note." 
 The French navy had also some steam frigates trans- 
 formed into hospitals ; but the transportation of the 
 sick was done by comm'on merchant steamers or sailing 
 vessels. The ships of the imperial postal service were 
 particularly useful in this capacity. The sick had each 
 of them a little mattress and a blanket. 
 
 From a general statistical account, published in 
 
THE CRIMEAN WAR. 197 
 
 England by the Minister of War, Lord Panmure, it 
 appears that from the 19th of September, 1854, to the 
 28th of September, 1855, the English army had 188 
 officers "and 1,775 soldiers killed. There died of wounds, 
 during the same period, 51 officers, and 1,548 soldiers; 
 of cholera, 35 officers, and 4,244 soldiers; and of other 
 diseases, up to the end of December, 1855, 26 officers, 
 and 11,425 men.* These severe trials did not recur, 
 and during the year 1856, the sanitary condition of the 
 English army was in a very satisfactory state, even in 
 the depth of winter.f To be convinced of this, it is only 
 
 * Since the above period, and up to March 31, 1856, 322 soldiers 
 have died of wounds and diseases, making a total of 270 officers and 
 19,314 men. In addition to these, 2,873 soldiers were frozen, making 
 a total of 22,457 deaths. 
 
 During the winter of 1854-5 (from the 1st of October to the 30th of 
 April, a period of seven months), the mortality in the English army 
 was distributed as follows: 
 
 Infantry, 39 deaths per 100 men in seven months. 
 
 Artillery, 18 " " 4i 
 
 Cavalry, 15 " " " 
 
 Naval brigade, 4 " 
 
 Officers of all arms, 6 " 
 
 AUTHOR'S NOTE. 
 
 f At an early period in the war, the English army had suffered con- 
 siderably from disease ; but this was remedied by a vigorous adminis- 
 tration towards its close. During its occupation of Bulgaria, in the 
 early part of 1854, cholera, diarrhoea, and dysentery made great havoc. 
 The troops arrived before Sebastopol, debilitated by these diseases and 
 the influences that had caused them, and were for weeks without tents 
 or changes of clothing. The supplies arriving at a later period, left 
 few causes of disease beyond those incident to the climate and the 
 labors and exposures of the men. 
 
 Of fevers (not typhus), 30,376 cases and 3,161 deaths occurred. Their 
 greatest prevalence was in March, 1855, when they gave 21 per cent, 
 of the mortality of that month. The kind of fever that most prevailed 
 in the English army partook of the character of typhoid fever, as seen 
 in large cities, and showed an absence of great febrile action a rapid 
 prostration, slow convalescence, and tendency to relapse. It was often 
 followed by dysentery, and the intestinal lesions which attended it 
 occasioned secondary diseases that often proved fatal, especially if the 
 patient exposed himself to irregularities of diet, or the. use of intoxi- 
 cating drinks, during the period of apparent convalescence. It was 
 not imcommon for the febrile symptoms to disappear entirely, and 
 prospects of health to gradually return, so as to admit of discharge 
 from the hospital. But at a period more or less remote, a fresh inva- 
 
198 THE CRIMEAN WAK. 
 
 necessary to read the weekly bulletin given to me by Sir 
 John Hall, upon the day that I paid him a visit, March 
 25th, 1856. 
 
 Weekly Report, from the 16th to the 22d of March. 
 
 Effective strength of the English army in the Crimea and at 
 
 Constantinople 70,042 
 
 Entered the hospitals and regimental infirmaries 1,883 
 
 Sent oft', or discharged cured 1,641 
 
 Died 25 
 
 Keinaining in the general and field hospitals 4,267 
 
 Proportion of sick to effective strength 6.09 per cent. 
 
 Proportion of deaths to effective strength. . . .0.03 per cent. 
 
 The return of fine weather dried the soil of the 
 Crimea, and permitted us at length to remove the 
 location of the camps to new and non-infected ground. 
 The necessities of the war did not require, after the 
 treaty of March 30th, any of the regiments to re- 
 main and hold the military positions of the left 
 bank of the Tchernaia, with its miasmatic emanations ; 
 Marshal Pelissier issued orders to abandon the old 
 bivouacs, and remove three leagues to the south, upon 
 the high plateaux, ventilated by the sea breeze, and 
 inclining from the monastery of St. George towards 
 Kamiesch. All of the barracks and large tents, conta- 
 minated by prolonged habitation, were replaced by 
 Marshal Bugeaud's little shelter-tents. The sites of the 
 camps were frequently changed, and these migrations 
 every time effected an improvement in the health of the 
 troops. Such removals often excited remonstrances on 
 the part of officers, who were continually disturbed in 
 
 sion of the disease was very apt to occur ; and after an uncertain con- 
 tinuance, with favorable remissions, death would in three or four 
 months, if not sooner, close the scene. This fever was known as the 
 "Crimean fever," and was never absent from the English army during 
 the campaign. 
 
 Typhus fever proper, which made such frightful havoc hi the French 
 army, occurred among the English troops in 828 cases, of which 285 
 were fatal. It prevailed chiefly in the spring of 1855, and presented 
 the usual appearances of the disease in England. The Russians suf- 
 fered from the typhus even more terribly than the French Tu. 
 
THE CRIMEAN WAR. 199 
 
 their arrangements. The Marshal, however, took no 
 notice of them ; he cared .only for the health of the sol- 
 diers. He presided at the embarkation of the troops, 
 watching that no regiments should be embarked but 
 those in which traces of typhus had not appeared for 
 some weeks ; and did not himself leave the soil of the 
 Crimea until the last regiment had departed. 
 
 On the 8th of April, 1856, 1 left the Crimea. M. Scrive, 
 the physician-in-chief, with an enlightened solicitude, 
 superintended and put into vigorous execution the 
 hygienic measures which I had advised. Twice a week 
 he sent me a bulletin of the sanitary state of the army 
 before Sebastopol. Upon my arrival at Constantinople, 
 on the llth of April, I found still in the hospital three 
 or four thousand cases of scurvy, and of 8,315 sick, there 
 were 1,379 typhic patients. The mortality during the 
 last ten days had only been 620, showing a reduction 
 of more than a third upon the numbers for the pre- 
 ceding period of ten days. The Russian prisoners hav- 
 ing just left the island of Prinkipo, I visited it on the 
 day after my arrival, and found a perfectly salubrious 
 site, which the Russians had not occupied. It was easy 
 to establish there three hundred tents upon the border 
 of a pine wood, and I designed sending thither a part of 
 the scorbutic inmates of our hospitals. At the rate of 
 six men to a tent, this would accommodate 1,800 patients, 
 and I laid the plan before Marshal Pelissier. " The ar- 
 rangement," said I, " would be simple ; some boards laid 
 together a few inches from the ground would serve as a 
 floor and camp bed, and some mattresses, or, if these 
 are wanting, some straw beds, with pillows, bed cloth- 
 ing, and blankets, will complete the furniture of this 
 temporary establishment. The country air, now fresh- 
 ened with vegetation; the liberty of running in the 
 woods, and of fishing on the sea-shore; and a diet 
 largely vegetable, would yield results which we must 
 never expect in our hospitals. I estimate that we could 
 send monthly to Prinkipo 1,800 new scorbutic cases. 
 We will not send the convalescents to France until they 
 have undergone a month of this salutary quarantine ; 
 thus easily and certainly escaping the invasion of typhus 
 
200 THE CRIMEAN WAR. 
 
 upon the voyage. Thanks to this increase ol our 
 resources, we may insure, without further interruption, 
 the indispensable separation of typhic and non-typhic 
 patients. We might intrust the attendance of these 
 1,800 scorbutic cases to the eight Crimean physicians 
 who are at this time recovering from typhus at the con- 
 valescent hospital prepared for them at Sebastopol. If 
 we persist in the salutary measure of sending to Con- 
 stantinople all the sick not infected with the typhus, the 
 personal attendance of the medical service of the Crimea, 
 although so reduced by the epidemic, will nevertheless 
 be more thar sufficient, and a portion can be spared to 
 return to Constantinople. As for the eight convalescent 
 physicians, they will not, for a long time to come, be 
 exposed to new dangers from the infection of typhus. 
 At Prinkipo, in making the tour of visitation, they 
 would regain their health at the same time as they were 
 restoring it to their scorbutic patients." 
 
 On the 14th of April, the Marshal replied: "I ap- 
 prove the putting into execution of this project, and by 
 this mail give the necessary instructions." I at once 
 went to Prinkipo, to prepare a large field hospital for 
 1,800 scurvy patients ; and, thanks to the energy of 
 General Pariset, who succeeded General Larchey in the 
 command of the post at Constantinople, I completed 
 this task in two or three days. Prinkipo took the place 
 of Mytilene. Scarcely had the sick arrived, than they 
 recovered their health, and were soon wandering over 
 the island, elated and joyous. 
 
 On my way to Prinkipo, I stopped at Calchi, a neigh- 
 boring island, where there was one of the two hospitals 
 assigned to the naval service, the other being on the 
 Bosphorus. Both were very admirably conducted by 
 clever physicians. In front of Calchi there lay at anchor 
 four or five large ships of war, which bore the yellow 
 flag of the quarantine. They had been infected by the 
 typhus in consequence of having transported the sick 
 from the Crimea. A part of their crews, affected with 
 this disease, had been landed, and were very well pro- 
 vided for, in immense rooms converted into hospitals, or 
 in double tents. Immediately on my return to Constan- 
 
THE CRIMEAN WAR. 201 
 
 tinople, I effected the isolation of all the sick infected 
 with the typhus, and a daily renewal of the bed cloth- 
 ing; the number of new cases appearing within the 
 twenty-four hours fell at once to half the former num- 
 ber. Thanks to the mildness of the temperature, we 
 were able to put in tents the typhic patients belong- 
 ing to the hospitals extra-muros, thus securing a com- 
 plete isolation and constant ventilation. The ships had 
 still among their crews a number of typhic cases ; and 
 on the 14th of April, fourteen sailors, who belonged to 
 a ship that had been selected to transport 300 conva- 
 lescent sick, were sent to the hospital. The order for its 
 departure was at once countermanded. I directed, in 
 all the ships freighted by the government, an active sur- 
 veillance to be instituted, and thorough hygienic and 
 disinfecting measures to be adopted. I conferred with 
 Dr. Fauvel, quarantine physician, who stated, that he 
 had no directions to add to those which I had advised 
 and caused to be put into effect. If the measures begun 
 were thoroughly carried out, the typhus would speedily 
 disappear. During the whole course of the epidemic, 
 the population of Constantinople escaped the disease ; 
 nor did they evince any disquietude, being in this respect 
 wiser than the inhabitants of the South of France, who 
 were alarmed beyond measure at the importation of the 
 pestilence through the arrival of typhic cases at Mar- 
 seilles and Toulon. The Turkish government placed at 
 our disposal, as auxiliaries, the most proficient students 
 in their medical school, and the aid thus rendered gave 
 us a very satisfactory idea of the organization of the 
 medical corps of the Ottoman government. The direc- 
 tor of the health service of the Turkish army was Tho- 
 mal-Bey, a very important personage, and grand judge 
 of Anatolia. This dignity corresponds with the rank of 
 Muchir, or pacha of three tails. The generals of division 
 are only pachas of two tails. 
 
 This high functionary is also Director of the School 
 of Military Medicine, into which they admit students 
 from civil life. He presides twice a week at the council, 
 composed of the professors, and labors directly with the 
 Minister of War. The sub-director of the school, Arif- 
 
 10 
 
 I 
 
202 THE CRIMEAN WAR 
 
 Bey, superintends the health service, and daily addresses 
 a written report to the director. These health officers 
 of the Turkish service, like the military staff of almost 
 all other nations, have a line of grade and promotion 
 corresponding with the officers of the army. In the 
 Turkish army, all the chief physicians of the great hos- 
 pitals have the rank of colonel, and their pay is even 
 higher than that of those officers. The other physicians 
 have the ranks of lieutenant-colonel, chief of battalion, 
 and captain. The latter grade is borne only by a small 
 number of the military medical officers. 
 
 In the last days of February, at the close of a con- 
 ference upon the subject of typhus, at w r hich the medical 
 personnel of the hospitals of the military school attended, 
 an English physician, Mr. Pinkoffs, who has distin- 
 guished himself by his great zeal for science, proposed 
 to me an early convention of the English and Sardinian 
 physicians. The idea at that time occurred to me to 
 found a Medical Society, which should continu^ after 
 our departure, by interesting in it the more eminent 
 physicians of Constantinople and the professors of the 
 Turkish Medical School, among whom was our learned 
 countryman, M. Fauvel, quarantine surgeon. Mr. Pin- 
 koffs seconded me willingly, and took all the necessary 
 steps, which resulted, soon after our departure, in the 
 foundation of a society, with an annual stipend from the 
 Sultan, and called the Imperial Medical Society. I 
 recur with pleasure to the time when, during my sojourn 
 at Constantinople, I presided at this assembly of distin- 
 guished savans. The sessions of the new society were 
 taken up by lectures and important discussions, and the 
 medical press at Paris still continue to publish its trans- 
 actions. As early as 1 830, I had had the good fortune 
 to revive in Algeria the course of studies of the Avi- 
 cenne, the Razes, the Albucasis, &c., which had been 
 interrupted for centuries ; and it was with this idea that 
 I co-operated in the formation of the first learned society 
 in Stamboul. 
 
 Upon becoming assured of the good effect of the 
 measures adopted to counteract the epidemic, happily 
 on the decline, I was desirous of completing my investi- 
 
THE CRIMEAN WAF. 203 
 
 gallons of the medical institutions of Turkey by a visit 
 to their hospitals at Constantinople. The Ottoman go- 
 vernment had reserved for its own use four military 
 hospitals, located at the Seraskierat, at Jeni Batche 
 (new garden), at Gulhane, and at the Navy Office ; the 
 remainder having been generously placed at the disposal 
 of the allied armies. The French occupied those on the 
 European shore, and the English the fine military 
 edifices at Scutari, on the Asiatic side. All of these 
 hospital establishments, built upon elevated and salu- 
 brious sites, and as much isolated from other habitations 
 as a ship in quarantine, are a perfect acknowledgment 
 of sanitary laws. A great number of openings ad- 
 mitted the air and light ; the windows were double, to 
 prevent the sick near them from being incommoded by 
 currents of air through the joints, and to allow a genial 
 temperature to be easily maintained in winter. Green 
 curtains tempered the light, often too strong in this 
 oriental region. On a level with the ground, openings 
 made through the external walls ventilate the lower 
 part of the rooms. The floors were painted in oil, or so 
 thoroughly washed, that not a speck of dirt could be 
 seen. Narrow strips of carpet, placed along the foot of 
 the bed and the spaces between them, deadened the 
 footsteps of the attendants. Smoking was strictly for- 
 bidden ; convalescents could only smoke in the rooms 
 specially reserved for this purpose. Excepting in some 
 of the minor details, there was everything to praise. 
 The beds appeared to me to be rather too near each 
 other the sick do not get air enough to breathe. This 
 fault is in part obviated by the unexpected extreme 
 cleanliness, and by the custom of keeping the doors and 
 windows open. The mildness of the climate prevented 
 those dangers which would have attended such a mea- 
 sure in France. The rooms are warmed in winter, and 
 most of the windows open on to great inclosed galleries, 
 where the temperature is never very low. Fumigations 
 of chlorine, and especially of aromatic herbs, are repeated 
 several times a day in all the rooms, carrying away the 
 loathsome miasms generated by the sick a practice 
 which I w r ould wish to see introduced into the hospitals 
 
204 THE CRIMEAN WAR. 
 
 in France, as it already has been into our general and 
 field hospitals in the East. 
 
 The privies, placed in isolated sheds, communicate 
 with the rooms by covered passages, and are paved with 
 large blocks of marble kept always clean. A great num- 
 ber of small swinging windows, opening at the top, 
 secured constant ventilation. Most of the bedsteads 
 were of iron, and the mattresses, the clothing, and the 
 blankets were of irreproachable cleanliness. Upon the 
 night stand of each patient is placed a tray of tinned 
 copper, holding a dish of drink, a plate, and a spit-box, 
 so as not to soil the floors. These articles, which were 
 of zinc, were kept very bright. A little board, fixed to 
 the table, bore the number of the bed, the name of the 
 patient, his disease, and the prescription of diet for the 
 day. The apothecary wrote upon a separate memoran- 
 dum book, at the dictation of the physician, the medi- 
 cines which he was to administer. The hospital costume 
 consisted of pantaloons, cap, slippers, <fcc. 
 
 The arrangements for washing would be an object of 
 envy to our good Flemish housewives. Basins of white 
 marble, attached to the walls, were, like our bathing 
 tubs, furnished with pipes for supplying the water and 
 letting it out after it had been used. The articles to be 
 washed are soaked in large coppers, in which wood 
 ashes* are macerated. In rainy weather, in winter, 
 they exposed the linen upon driers, placed over large 
 braziers. These prudent measures, so essential in a 
 country frequently devastated by malignant epidemics, 
 prevented the bad results of incumbrance and infection, 
 so frequent in the hospitals of other countries. 
 
 The diet, appropriate to the w r ants of the East, is 
 
 * The custom of wringing clothing to deprive it of water is liable to 
 tear it The English, in their hospitals at Scutari, replaced wringing 
 by drying in a turbine. The wet clothes were placed in a kind of 
 circular metallic basin, pierced with many small holes, and this was 
 made to revolve very swiftly upon its axis by means of a crank. The 
 linen, obeying the centrifugal law, pressed strongly against the sides 
 of the basin, where the openings gave exit to all the water contained. 
 It would be an improvement to introduce it into our hospitals. The 
 English call this ingenious device the "wringing machine/' AU- 
 THOR'S NOTE. 
 
THE CRIMEAN WAR. 205 
 
 healthy and simple. In Constantinople, beef not being 
 much esteemed, mutton roasted, or served with vegeta- 
 bles, cabbage, chicory, or rice, forms the basis of hospi- 
 tal diet. The lighter form of diet most in use, is a cream 
 of sweetened rice, of which the Turks prepare the na- 
 tional dish called Malibi. The sick take t\vo repasts a 
 day one at eight in the morning, and the other at three 
 or four o'clock in the afternoon. The first is composed 
 of a simple porridge, thickened with rice, and the second 
 includes, for a convalescent man, 300 grammes (0.57 Ibs.) 
 of cooked meat, some vegetables,^ and 600 grammes 
 (1.14 Ibs.) of bread. This allotment of food, too small 
 for the first meal, and too abundant for the second, 
 requires a better distribution. 
 
 The hospital at the Turkish Navy office presents a 
 great luxury of arrangement, and, as a model, has no 
 rival in any of the hospitals of Europe. In the little 
 hospital of the palace of Bachistach, everything is in 
 princely style, rich carpets, beds and curtains of silk, 
 choice supplies of food, and perfect attention to every 
 
 want. Dr. Z , one of the Sultan's physicians, who 
 
 conducted me through the establishment, could not show 
 me the apartments of the women of the harem, but in- 
 formed me their principal disease was an ungovernable 
 jealousy, continually aroused about things which to us 
 would seem quite unimportant. They receive, from 
 time to time, little gifts for example, a box of sugar- 
 plums. The three or four hundred boxes must be ex- 
 actly alike, or there ensue scenes of violence that en- 
 danger their health. Almost all of them die of pulmon- 
 ary consumption at an early age. M. Z sent secretly 
 
 to the more feeble of them some bottles of Bordeaux 
 wine, to prolong their existence. 
 
 Henceforth, the grand and only object was the return 
 of the army to France. The cases of typhus, already 
 imported by our ships into Marseilles and Toulon, spread 
 alarm among the inhabitants, and rendered great precau- 
 tions necessary. The minister of war had, fortunately, 
 taken the wise sanitary measures which were stated in a 
 foregoing letter. On arriving in France, the army of the 
 East had to undergo a kind of quarantine, in the hos- 
 
206 THE CRIMEAN WAR. 
 
 pitals and camps, established at the Island of Saint Mar- 
 guerite, at Frioul, in the islands of Hyeres, and in the 
 peninsula of Gyen, under the skilful medical direction 
 of M. Maillot, inspector of the health service of the 
 army. To establish the series of hospitals as stages on 
 the route of the fleet, it was desirable that there should 
 be a field hospital at Pirea, and another at Messina. The 
 objections raised by the Neapolitan government pre- 
 vented us from placing a hospital for typhic patients in 
 Sicily. The ships, laden with troops, had orders to leave 
 the infected cases at Gallipolis, Nazara, Malta, and Cor- 
 sica, before their arrival in France. By debarking the 
 sick men at each of these stations, it prevented conta- 
 gion from spreading on board the transport vessels. 
 
 Two other sanitary stations were necessary, one be- 
 tween Nagara and Malta, and the other between Malta 
 and Corsica. I went to Pirea and had an interview 
 with Admiral Bouet Willaumez, and with M. Mercier, 
 the French Minister. The Grecian Minister of Foreign 
 Affairs, M. Rangabe, gave us immediately authority to 
 establish a hospital, for typhic patients, in the island of 
 Milo, which we went to examine. This island resembles, 
 in form, a horseshoe, and only at the head of the har- 
 bor are there any low and marshy uninhabited grounds. 
 The population, numbering about three thousand, live 
 in villages perched upon the mountains. On the west- 
 ern side is Castro, where M. Brest, our Consul, a fine 
 old man, to whom we are indebted for the Venus of 
 Milo, resides. I selected a monastery, which had been 
 abandoned since 1837, at the time when monastic pro- 
 perty was reconstituted the domain of the Greek govern- 
 ment. Knowing, by tradition, that the monks always 
 selected for themselves the most salubrious and pleasant 
 places, I made an ascent to this establishment by a wind- 
 ing but very practicable road for mules. I there found 
 some large buildings, half in ruins, but which could be 
 made serviceable three or four fine kitchen gardens, and 
 some beautiful level spots, shaded and perfectly adapted 
 for pitching tents. An old centenarian and his family 
 lived here, but occupied only one or two rooms. Water 
 was abundant and of good quality. It was, however, 
 
THE CRIMEAN WAK. 207 
 
 difficult to install three hundred sick at Milo, and if in- 
 fection had spread in the fleet during the voyage, this 
 hospital would have soon proved insufficient. This fact 
 decided us to sail for Candia, where the Sultan had given 
 us permission to arrange a hospital establishment. We 
 found in that island a fine well-aired plateau, which was 
 reached by an easy mule road, which the Pacha promised 
 should be immediately put in repair. Yely Pacha, for- 
 merly ambassador to Paris, placed at our disposal, one 
 hundred officers' tents, for the formation of a hospital, 
 which, fortunately, was not wanted. 
 
 The number of sick diminished rapidly in the Crimea 
 and at Constantinople, the hospitals were emptied and 
 closed, and, on the 6th of June, Marshal Pelissier wrote 
 to me as follows : 
 
 " You will doubtless be recalled to France in a few 
 days, and your mission to the army will then end. I 
 will not let you leave Constantinople, without express- 
 ing to you my satisfaction at the manner in which you 
 have discharged your duties, and without informing you 
 that I have made a statement to the minister, of the use- 
 ful and enlightened services which you have rendered to 
 the army." 
 
 I left the East with the consciousness of having con- 
 tributed, to the extent of my ability, to the alleviation 
 of so many evils, and I may also say, of having witnessed 
 the most appalling spectacles which have been seen for 
 many a day. To the active instruments of death, which 
 human genius had rendered so murderous, and which 
 were never before collected in so great a number, with- 
 in so small a space, were added the cholera, the scurvy, 
 the dysentery, and the typhus. The constant and active 
 solicitude of the government, the persevering efforts of 
 the military administration, and the devotion of the 
 medical staff, had ended, it is true, by conquering the 
 epidemics, but at the cost of what sacrifices ! If we con- 
 sult the medical statistics of the hospital establishments, 
 which should alone occupy our attention in this view, 
 we would find that the number of deaths occurring in 
 the field and general hospitals in the East, during the 
 campaign, would amount to about 63,000, of which 
 
208 THE CRIMEAN WAR. 
 
 31,000 occurred in the Crimea, and 32,000 at Constanti- 
 nople. 
 
 An army needs moral excitement, to prevent home- 
 sickness and prostration. Religion exalted the troops 
 of Godfrey of Bouillon ; a spirit of chivalry animated 
 the French officers at Fontenoy ; the certainty of victory, 
 maintained by a rapid succession of victories, sustained 
 the armies of the Empire. It was a noble motive also 
 which inspired our troops during the severe campaign 
 of the Crimea ; it was the sentiment of duty which ani- 
 mated our soldiers, without failing for a single day, in 
 this struggle equally glorious against the enemy, and 
 against privations and sufferings of every kind. Although 
 other armies may have shown as .much heroic ardor, im- 
 petuosity, and bravery, as the army of the East, none 
 have surpassed it in stoicism, courage^ and contempt of 
 death. 
 
APPENDIX. 
 
 Economy in the Use of Linen for Dressings. 
 
 THE Minister of War sent me, on the 30th of August, 
 1855, the following instructions: 
 
 " At this time, when you are intrusted with the im- 
 portant service of Medical Inspector of the general and 
 tield hospitals of the Army of the East, I think it pro- 
 per to send you some instructions relative to a thorough 
 examination of the use and consumption of linen for 
 dressings. 
 
 " The high price of this kind of linen, the scarcity of 
 materials needed in its preparation, and the delays in its 
 manufacture, render its adequate supply very difficult. 
 It is therefore highly important, that the consumption 
 of linen for dressings should be economized, in order 
 that the surgeons may always be able to meet the more 
 pressing demands of their profession. To enable you to 
 render an exact account in this regard, I herewith send 
 twenty copies of the instructions of May 12, 1845, and 
 of the circular of January 15, 1853, relative to the use 
 of these articles. These documents will give you full 
 instructions as to the preparation of the linen and the 
 means employed in supplying deficiencies. You will 
 make such distribution of the papers as you may judge 
 to be for the interest of your inspection. 
 
 " You are directed to satisfy yourself that the physi- 
 cians in charge, in the establishments you may visit, use 
 no more linen for dressings than may be absolutely ne- 
 
 10* 
 
210 APPENDIX. 
 
 cessary ; and will request them to favor this end, as far as 
 may be, by causing it to be washed and used again until 
 completely worn out. You will be able to concert mea- 
 sures with the military intendants, Blanchot and Angot, 
 for adopting the most effectual measures to attain this 
 desirable result, through the concurrence of physicians 
 and other accountable persons. In permanent establish- 
 ments there should be no difficulty; those in charge can 
 take advantage of the conveniences offered for wash- 
 ing. Experience has demonstrated that a pound of new 
 linen may, by repeated washings, be made to go as far 
 as six pounds. I cannot demand that this proportion 
 shall be exactly attained ; but an active supervision, and 
 method, ought to yield results not hitherto reached. 
 
 " Your arrival in the Crimea will coincide with a 
 measure which I think will be profitable to the treasury 
 and facilitate the surgical service, without the sick hav- 
 ing to suffer thereby. I will order, through the Military 
 Journal, the employment of cotton, along with linen, for 
 dressing, under such rules as may be furnished by the 
 Council of Health. Large supplies of this linen will 
 speedily be sent to the regular and field hospitals of the 
 army, along with the compresses of carded cotton, of the 
 use of which you are directed to explain the advantages. 
 I charge you to use your influence among the acting 
 surgeons to induce them to employ willingly these arti- 
 cles, with the view of reducing the demand for dressings 
 w r ithin the limits of our means of supply. The impor- 
 tant subjects brought to your notice by the present dis- 
 patch should be made the occasion of a detailed report 
 in your labors of inspection. The military intendants, 
 Blanchot and Angot, are informed of these instructions, 
 and are directed to furnish all the means you ma/ deem 
 necessary to insure the execution of my orders." 
 
APPENDIX. 211 
 
 n. 
 
 Alimentary Regulations of the Sick in the Sardinian 
 Army. 
 
 \ 
 
 THE following table shows the common rations of each 
 meal (at ten in the morning and four in the afternoon), 
 in the Sardinian army, and was furnished to me by 
 M. Comizetti, chief physician of the Piedmontese army 
 corps : it is here inserted as a document worthy of 
 examination : 
 
 ounces ounces ounces ounces ounces pints pints 
 
 bread, baked pie or rice. bread broth, wine, 
 
 meat, vermicel. for soup. 
 
 Diet 1.32 1.76 3.52 0.48 
 
 Quarter ration .. 2.20 0.70 1.32 1.76 3.52 0.48 1.18 
 
 Half ration 4.40 1.40 1.32 1.76 3.52 048 0.36 
 
 Three-quar. ration 6.60 2.10 1.32 1.76 3.52 0.48 0.36 
 
 Ration* 8.80 2.80 1.32 1.76 3.52 0.48 0.36 
 
 The ration of meat for a day is only 0.55 Ibs., while 
 in the French hospitals it is double that quantity. It 
 would not be enough to make a good broth ; but they 
 add, like the English, the juice of preserved meats, called 
 " essence of beef." The distribution of food commonly 
 takes place twice a day, at ten in the morning and at 
 four in the afternoon. Besides these rations, the patients 
 receive, at eight o'clock in the morning, if prescribed by 
 the physician, some soup, coffee, with or without milk, 
 a milk soup, or some chocolate ; but this distribution is 
 not general ; it extends only to those of the sick who 
 appear to need it. 
 
 The rigid diet includes only broths and jelly broths. 
 The common diet is composed of soups in the following 
 order of gradation : a half soup, morning and evening, 
 two, three, and even four soups, if the physicians pre- 
 scribe them, or rather two soups, and coffee, alone or 
 with milk, a milk soup, or chocolate. The soups of the 
 
 * The entire ration, after being ordered three days in succession, is, 
 in exceptional cases, reduced to three-quarters, when they then return 
 to the full ration. 
 
212 APPENDIX. 
 
 diet are made at the option of the physicians, either 
 with farinaceous ingredients, like vermicelli and semoulia, 
 or of broken bread. 
 
 Besides the articles above enumerated, they have a 
 number of kinds that they term extra-ordinary, which 
 enter into the daily distribution, and will be mentioned 
 when we come to notice the other elements of their 
 rations. 
 
 The common quarter ration is composed of two or 
 three soups, and the quantity of bread, meat, and wine 
 stated in the table. With the quarter ration they may 
 allow the patient the eight o'clock morning meal, with 
 all the varieties above stated. With the quarter of the 
 ration, the boiled meat may be replaced by chicken, 
 veal, or mutton, or by vegetables, such as potatoes, 
 spinach, carrots, cabbages, turnips, &c., according to 
 tne season. They may also add two poached eggs, and 
 0.44 Ibs. of cooked fruits or marmalade. 
 
 The two gills of vin ordinaire, usually added to the 
 quarter ration, may be replaced by the same quantity of 
 some generous wine, such as Bordeaux, Malaga, <fcc. 
 
 The half ration is composed of two soups, to which 
 may be added for breakfast, at eight o'clock, another 
 soup, coffee with milk, or chocolate, besides the quantity 
 of bread, meat, and wine given in the table. The half 
 ration of boiled meat may be also replaced by a half 
 ration of ragout, fowl, gelatine, veal, or roast mutton, 
 or by half a ration of vegetables ; but it excludes dried 
 fruits and marmalade, whose distribution here forms an 
 exception, and is only allowed in certain particular cases. 
 Wine may be substituted in the same manner as in the 
 quarter ration. The half ration of meat may be divided 
 into two quarters, as, for example, a quarter of ragout 
 and a quarter of vegetables. 
 
 The three-quarter ration usually remains as in the 
 table, but in exceptional cases, a soup, coffee, alone or 
 with milk, chocolate, and the quantities of bread, meat, 
 and wine, given in, the table, may be added as breakfast. 
 The three-quarter ration of boiled meat may be replaced 
 only by a three-quarter ration of veal, mutton, ragout, 
 vegetables, or salad, fowl and gelatine being excluded. 
 
APPENDIX. 
 
 213 
 
 It may also be subdivided into a half ration of ragout, 
 and a quarter of vegetables, or the converse. 
 
 The entire ration consists of the quantities of bread, 
 meat, and wine, mentioned in the table. In the Crimea, 
 in consequence of the inferior quality of the meat, and 
 the special wants of the sick, it was permitted to add an 
 extra ration of vegetables to that given in the table. 
 Potato and fresh lettuce salads were, in consequence, 
 often ordered for the scorbutic patients. 
 
 III. 
 
 Summary of immediate "amputations performed in the 
 Crimea / received and treated in the hospital of Gul- 
 hane, at Constantinople ; and of delayed operations 
 performed at the latter place, between the 1st of May 
 and 31st of December, 1855. 
 
 IMMEDIATE OPERATIONS PERFORMED IN THE CRIMEA. 
 
 Died 
 40 
 13 
 44 
 23 
 2 
 9 
 1 
 3 
 
 Kind of Operations. Number. Recovered. 
 
 f A rm . ... 
 
 91 
 
 51 
 
 AMPUTATIONS IN 
 THE BONE, 
 
 
 38 
 
 74 
 89 
 
 25 
 30 
 66 
 
 Thiffh. 
 
 Leg, place of preference, 
 
 
 Submalleolar, . . . 
 
 4 
 
 2 
 
 
 ' Scapulo-lmmeral, . . . 
 
 25 
 
 16 
 
 
 Radio-carpal, .... 
 
 5 
 
 4 
 
 AMPUTATIONS AT 
 
 Carpo-metacarpal, . . . 
 
 9 
 
 6 
 
 THE JOINTS, 
 
 Femoro-tibial, process of 
 
 
 
 
 M. Baudens, .... 
 
 3 
 
 3 
 
 
 Tarso-metatarsal, . . . 
 
 7 
 
 5 
 
 ( Head of the humerus, pro- 
 
 
 
 RESECTIONS, . -< cess of M. Baudens, . 
 
 3 
 
 2 
 
 ( Body of the humerus, 
 
 3 
 
 1 
 
 Total, 351 
 
 211 
 
 140 
 
 CAUSES o: 
 
 Purulent Infection, ... 4 1 
 Hospital Gangrene, ... 27 
 Gangrene, 20 
 
 B 1 DEATH. 
 Typhus. . 
 
 6 
 
 Pleuritic Effusion, . . . 
 " Abdominal, . . 
 
 Total, 
 
 2 
 . 2 
 
 140 
 
 Haemorrhage, .... 
 Chronic Diarrhrea, . . 
 Scurvy, 
 
 . 2 
 . 36 
 
 4 
 
214 
 
 APPENDIX. 
 
 DELAYED OPERATIONS PERFORMED IN THE HOSPITAL OF 
 GULHANJS. 
 
 Kind of Operations. Number. Recovered. Died. 
 
 fArm, ....... 44 
 
 AMPUTATIONS IN) Forearm, ...... 14 
 
 
 LLeg, 
 
 47 
 
 AMPUTATIONS AT 
 THE JOINTS, 
 
 EESECTIONS, . 
 LIGATURE OF 
 
 Scapulo-humeral, . . 
 Coxo-femoral, . 
 Femoro-tibial, . . . 
 Body of the humerus, 
 " " radius, . 
 " " femur, . 
 Primitive carotid, . . 
 Brachial .... 
 
 3 
 2 
 5 
 1 
 5 
 1 
 3 
 g 
 
 ARTERIES, . 
 
 
 11 
 
 
 Anterior tibial, . ? . 
 
 1 
 
 Total, 177 
 
 25 
 9 
 
 27 
 2 
 
 4 
 4 
 1 
 
 87 
 
 90 
 
 CAUSES OF DEATH. 
 
 Purulent Infection, ... 29 
 
 Hospital Gangrene, ... 16 
 
 Gangrene, 14 
 
 Haemorrhage, 1 
 
 Typhoid Fever, .... 5 
 
 Scurvy, ... 
 Pleuritic Effusion, 
 Chronic Diarrhoea, 
 
 ... 3 
 
 ... 22 
 
 Total,, 90 
 
 These tables show at once the great advantages in 
 favor of amputations performed immediately after the 
 wound, over those in which a considerable length of 
 time has elapsed ; and the results obtained at this hos- 
 pital are similar to those at the other French hospitals 
 at Constantinople.* 
 
 * The experience of the English army in the Crimea fully confirmed 
 that of the French, in favor of early amputations from severe injuries 
 by gunshot wounds, and showed that every hour of delay lessened 
 the chance of a favorable issue. Dr. Macleod, in his " Notes on the 
 Surgery of the Crimean War," has collected facts, showing that 1288 
 cases of the greater amputations, in various wars, from gunshot wounds, 
 were followed by death in 396 instances, while 902 secondary ampu- 
 tations were followed by death in 586 cases. The per centage of 
 30*7 in the former, and 67-9 in the latter, nearly agrees with the ex- 
 perience of the Russians in the Crimean War. They lost one-third of 
 the primary, and two thirds of the secondary amputations of this class. 
 TR. 
 
APPENDIX. 215 
 
 The total of 140 deaths following immediate amputa- 
 tions, and 90 deaths to 87 recoveries in delayed opera- 
 tions, are excessively abnormal, and can only be ex- 
 plained by the striking deterioration of the health of 
 the men at the time when they were wounded, and by 
 the infection which prevailed in the general and field 
 hospitals. When I had charge of the field hospitals of 
 the expeditionary columns in Algeria, it often happened 
 with me, as with my colleagues, that we did not lose a 
 single patient from amputation. This was especially 
 the case after the campaign of Mascara, when I obtained 
 fifteen recoveries in succession. In one of the later ex- 
 peditions in Kabyiie, M. Bertherand, chief physician, 
 met with results equally satisfactory in twenty amputa- 
 tions. A comparison of amputations with resections, 
 shows also that the advantage rests, as I have often ob- 
 served, in favor of the latter, thus proving that the do- 
 main of conservative surgery will" be constantly enlarged. 
 M. Thomas, the skilful surgeon whose practice I have 
 above stated, coincides with my views, and I was much 
 pleased, in examining his patients, to find the successful 
 results obtained, in many cases, of wounds that appear- 
 ed to demand an amputation of the thigh, through the 
 use of my fracture box. Some of these cases will be 
 given in the following memoir. : 
 
 IV. 
 
 Observations upon several comminuted fractures of the 
 thigh by bullets, resulting in cure when treated with 
 Mr. IBaudens 1 fracture box, reported by Mr. Thomas, 
 Physician-in-chief. 
 
 BICHET, a sergeant of the 4th marines, of good consti- 
 tution and sanguine temperament, was struck on the 
 7th of June, 1855, before Sebastopol, in his right thigh 
 by a ball of large size. On his arrival at the hospital of 
 Gulhane on the 18th, there were two openings, one on 
 
216 APPENDIX. 
 
 the outside and the other on the inside of the limb, at 
 its lower third. The bone was broken with many 
 splinters, and two of these 1.18 inches Jong, and of the 
 size of a goose quill, with many of less size, were ex- 
 tracted from the place of entry of the ball, somewhat 
 enlarged for the purpose. This reduced the case to 
 one of much simplicity, and the limb was placed in a 
 box, and subjected to extension and counter extension. 
 In ninety-two days, the limb was consolidated without 
 deformity or shortening, and without local or general 
 accident. This subaltern officer rejoined his corps early 
 in October. 
 
 DEMAIN, a fusilier of the 86th infantry, a young soldier 
 of good constitution, was wounded June 9, in the right 
 thigh, by the bursting of a shell, and arrived on the 18th 
 at the hospital of Gulhane. He had a long wound in 
 the upper and external part of his limb, with a com- 
 minuted fracture of the femur, about three quarters of 
 an inch below the great trochanter. Many splinters 
 were extracted, and the limb was placed upon cushions 
 in the box, from whence it was taken three months after 
 completely set, and with a shortening of only three 
 quarters of an inch. The recovery, retarded by nume- 
 rous abscesses, occasioned by splinters of bone and pieces 
 of clothing left in the wound, was not complete before 
 the beginning of October, when he was sent to France. 
 
 JUSEF-TESTANIEF, a Russian prisoner, received on the 
 7th of June, a fracture of the left femur below the great 
 trochanter, and two wounds opposite that point, on the 
 inner and upper part of the thigh, indicated the path 
 of the ball which committed the injury. The finger 
 reached a considerable number of large fragments, the 
 removal of which, on the 20th of June, resulted in a loss 
 of substance in the bone, estimated at an inch and a half. 
 The limb was placed in a box, where it remains at the 
 time of writing, having acquired so much firmness, that 
 the patient can move it perfectly. The first wounds 
 have closed, and pus flows only from two fistulous open- 
 ings caused by abscesses from little splinters of bone, 
 bits of clothing, and parts of the ball, of which the 
 wound was never entirely freed. He was still in our 
 
APPENDIX. 217 
 
 wards, when, upon signing the peace, he returned to 
 Russia, perfectly cured. 
 
 SAMOCHENKO, a Russian prisoner, received, June 7, 
 a ball which passed from without inward, through the 
 middle part of his left thigh, causing a comminuted 
 fracture of the femur at that point. On the 19th, 
 he was admitted into our hospital, where, after the 
 extraction of four large fragments of bone and many 
 pieces of clothing, his limb was placed in a box, and 
 kept till October 20. The consolidation was then com- 
 plete, but there existed a shortening of one and a half 
 inches. Notwithstanding the restlessness of the patient, 
 his cure was not delayed by any accident, either local 
 or general. He is waiting in our wards, to be sent to 
 Odessa. 
 
 ZEKEPA (Simon), a Russian prisoner, on the 7th of 
 June, was struck by a cylindro-conical ball, which passed 
 through the right thigh, from front to rear, on the level 
 of the great trochanter, fracturing the femur into 
 splinters. On the 19th, when admitted at Gulhane, we 
 extracted many splinters, and applied the fracture box. 
 After a treatment of four and a half months, frequently 
 embarrassed by abscesses of intermittent recurrence, 
 and relapses of diarrhoea, this patient was sent to Odessa 
 with a limb entirely solid, and shortened only three- 
 fourths of an inch. 
 
 FERNET (Felix), sergeant-major in the 85th infantry, 
 received September 8th, a baD, which entered the ex- 
 terior and upper part of the right thigh, and fractured 
 the middle of the femur. A few hours after, a field 
 hospital surgeon extracted many splinters, and applied 
 Scultet's bandage. On taking off this apparatus for the 
 fourth time, on the 27th, upon entering the hospital at 
 Gulhane, the limb was badly swollen, painful, and covered 
 with a thick layer of bloody and putrid pus. It was at 
 once placed in a fracture box, and covered with an 
 emollient and narcotic decoction. On the 2d of October, 
 the swelling having quite disappeared, we found that 
 the ball had only made one opening, and that a cylin- 
 drical piece of bone four or five inches long, formed by 
 the whole size of the femur, was detached and crowded 
 
218 APPENDIX. 
 
 towards the inner part of the thigh. The finger passed 
 into the wound detected no other foreign substance. 
 This condition being known and examined, we brought 
 the fragments into position, and kept them in place by 
 extension and counter extension, by the aid of adhesive 
 straps, fastened upon different parts of the limb. Up to 
 the 21st of October, several abscesses had opened, and 
 the last one gave exit to the ball. Since the escape of 
 this substance every day has witnessed an improvement 
 in the condition of the limb, and the general health of 
 the patient; and now (Jan. 4, 1856), the consolidation 
 of fragments is far advanced, the limb preserves its form 
 and proper length, the suppuration is slight and of good 
 quality ; the health of the patient is excellent, so that 
 we may look forward to an early and complete recovery. 
 Two months after Fernet returned to France perfectly 
 cured. 
 
 These cases, I doubt not, will be studied with a lively 
 interest by surgeons worthy of the name. They prove, 
 contrary to received opinion, that comminuted fractures 
 of the femur with wounds are not necessarily subjects 
 for amputation, if we take care to extract the splinters 
 and foreign bodies, so as to render a complicated wound 
 simple, and then, by the aid of a proper apparatus, place 
 the limb in a state of complete rest without shaking it, 
 even during the dressings, and giving to the purulent 
 fluids an easy outlet. I might have borrowed similar 
 facts, from other surgeons in our hospitals at Constan- 
 tinople, and thus increase the number, but they would 
 have afforded nothing further of special interest. I 
 cannot meanwhile pass in silence the observations 
 recorded in the following chapter, and which attest the 
 wonderful power of surgical art in skillful hands. 
 
 V. 
 
 Fractures of the femur, caused by projectiles. Cases 
 of distorted bony union in broken thighs, remedied at 
 long periods after the accident, by the use of thefrac- 
 
APPENDIX. 219 
 
 ture apparatus of M. Baudens. Report of M. Mau- 
 pin, Chief Physician of the hospital at the Parade- 
 grounds at Constantinople. 
 
 AMAK, a fusilier of the 21st regiment of the line, was 
 shot in the left thigh, September 20, 1855. The ball, 
 which was of large size, entered on the front exterior 
 part, at the upper third of the limb, and lodged under 
 the integuments, having passed through the great tro- 
 chanter. The femur received a comminuted fracture, and 
 considerable haemorrhage occurred. The patient would 
 not submit to the disarticulation of the limb at the hip. 
 The wound was enlarged, the splinters of bone removed, 
 and simple dressings applied twenty days. The limb, 
 placed in a half bent position, rested upon a blanket, 
 rolled up, so as to form a hollow trough. Some strips 
 of bandage completed this rude apparatus, for which, in 
 eight days, that of Scultet was substituted, and the 
 patient was sent from the Crimea to Constantinople. 
 Upon arriving at our hospital (October 14th), the wound 
 was tainted with spots of hospital gangrene. The thigh, 
 shortened at least five fingers' breadth, formed from 
 without inward the arc of a circle, the heel touching the 
 right calf, when the patient allowed his two thighs to 
 take their own position. Amaris a man full of courage, 
 and has faith that he will recover without an amputa- 
 tion. The limb was placed in an inclined plane, the foot 
 being fastened to the foot of the bed. A cloth folded 
 in many thicknesses, and placed between his thighs, 
 effected counter-extension, but at the end of thirty days, 
 no change in the deformity or shortening of the limb 
 being apparent, the apparatus of M. Baudens was ap- 
 plied. On the 15th of March, when Amar was sent to 
 France, the wounds, whose dressings were easily applied 
 by aid of this apparatus, had been cicatrized for some 
 time, the limb was slowly coming back, without torture, 
 or even appreciable pain, and in an almost perfect man- 
 ner, to its normal position, and the shortening was re- 
 duced, at the most, to three-fourths of an inch. The place 
 of consolidation, very voluminous at first, was notably 
 diminished, and its irregularities were lost in the gene- 
 
220 APPENDIX. 
 
 ral ossification. The thigh, which was much shrunk in 
 November, had increased in volume, and its movements 
 were in every way easy and free. 
 
 ALBARIC (JOHN), fusilier, of the 80th regiment of the 
 line, September 8, 1855, received a musket shot on the 
 outer side of the right thigh, at the point of junction of 
 the upper external and middle third. There was but 
 one opening. An examination at the field hospital of the 
 second division, found fracture of the thigh, extracted 
 several fragments of bone and the projectile, and applied 
 a simple apparatus, consisting of compresses, bandages, 
 and four splints. 
 
 On the 19th of October, Albaric was sent from the 
 Crimea to the hospital at the parade-ground. The bony 
 union had already become so firm, that it allowed of the 
 limb being raised, but the natural curve of the thigh was 
 much increased, and, moreover, at the place where the 
 entry of the projectile was hidden by the cicatrix, there 
 was a lump caused by the angle at meeting of the two 
 pieces of the femur, and the limb was shortened full four 
 fingers'-breadth. While the leg was slightly bent upon the 
 thigh, the foot was very much twned outward. The limb 
 was subjected to a very simple kind of continued exten- 
 sion, by being stretched between the head and foot of an 
 iron bedstead, that is to say, it was mal-treated. The 
 hospital gangrene devoured the cicatrix, and spread 
 deep and wide. 
 
 On the 2d of January, 1856, the shortening and de- 
 formity of the limb were very nearly as they were on 
 the 19th of October, and yet the solid appearance of the 
 bony soldering had not suffered from the proximity to 
 the hospital gangrene. The limb was placed in the per- 
 manent extension apparatus of M. Baudens, by the aid 
 of which dressings maybe daily applied to the gangrene 
 with great- facility. By the 15th of March, the limb had 
 been gradually brought back in length, direction, and 
 form, to correspond very nearly with the other, and the 
 patient could move it as easily. Still the hospital gan- 
 grene, although carefully treated, remained. Twenty 
 times it came to some kind of healing, and it would then 
 relapse, showing, by its oscillations, the effects of the 
 
APPENDIX. 221 
 
 sick man's surroundings. At the place of the fracture, 
 the thigh is now but slightly swollen. 
 
 SALARD, a grenadier, of the 18th regiment of the line, 
 August 13th, 1855, met with a violent contusion of the 
 right thigh by a musket ball, at a point three fingers' - 
 breadth above the knee-pan ; the integuments were only 
 excoriated, but the femur was fractured, and an ecchy- 
 mosis continued for several days. It will be proper to 
 note that, four days before his wound, Salard left the 
 infirmary of his corps, where he had been under treat- 
 ment for arthritic rheumatism of the right knee, which 
 had left a soreness and pain upon moving the joint. At 
 the field hospital in the Crimea, the limb had been en- 
 veloped in three splints, resting upon three small cush- 
 ions. In this condition, the patient arrived, on the 20th 
 of August, at the hospital of the Parade ground. There 
 was much swelling of the thigh and knee, which were 
 extensively ecchymosed. The femur was fractured at 
 its lower extremity, but the swelling did not allow of 
 any examination into the condition of the bone. The 
 limb was placed in a half flexed position, kept so by 
 pieces of linen folded around it, and enveloped in com- 
 presses kept constantly wet with bran and water. The 
 swelling being reduced, a fracture of the femur, just 
 above the condyles, was found. The lower fragment 
 was considerably raised, and the upper one made a lump 
 very appreciable to the touch in the bend of the knee. 
 The member was at once placed in the modified appara- 
 tus of the Hotel-Dieu, and retained nearly two months 
 in it, with but little pain at first, but a great deal of in- 
 convenience towards the end. From time to time the 
 extension was increased, as much as an apparatus of this 
 kind would allow of. The apparatus was removed in 
 the early part of November. The bony union was then 
 so far advanced, that the patient could raise the member 
 at will, but the joining. was very voluminous, and the 
 limb was noticeably shortened. The knee was, besides, 
 considerably swollen, and presented evidence of incipient 
 hydrarthrosis. 
 
 Being impatient of further restraint, the patient 
 rejected every measure proposed in view of relieving 
 
222 APPENDIX. 
 
 the difficulty, and attempted to walk. The swelling of 
 the knee enlarged, it became painful, and the effusion 
 increased. Salard was compelled to take to his bed 
 again; but his constitution, which had hitherto been 
 quite vigorous, became impaired in a very marked 
 degree, and symptoms of a scorbutic character ap- 
 peared. It became difficult, and then impossible, to 
 raise the thigh without assistance, and it appeared pro- 
 bable that the bony union was disposed to yield to 
 methodical and continued traction. The limb was 
 placed in the apparatus of M. Baudens, where it 
 remained about three months. By varied means, and 
 especially by the aid of vesicatories repeatedly applied, 
 the swelling of the knee was reduced to the proportions 
 inseparable from a grave fracture. The shortening of 
 the limb, which was more than three fingers' breadth, 
 when taken from the Hotel Dieu apparatus, had been 
 extended to about a third of an inch of its proper 
 length. The general projection of the soldered part 
 was still perceptible in the bend of the knee, but deeper 
 and better hi the axis of the femur. Walking, though 
 still difficult, was no longer painful. It grew stronger 
 every day, and the knee, instead of swelling, became 
 reduced to its proper volume. He left the hospital on 
 the 15th of March, happy at having escaped by his 
 second recovery, as far as was possible, the incon- 
 veniences that would have followed the first. 
 
 MEUNIER, a fusilier of the 21st of the line, September 
 8, 1855, was shot by a musket in the left thigh, the ball 
 striking the superior external part of the limb, a little 
 below the great trochanter, fracturing the femur at that 
 point into splinters. There was no opening of exit, and 
 no resulting circumstances occurred to indicate whether 
 the projectile was buried in the limb or not. Eight 
 hours after the accident, the patient was removed to 
 the field hospital of the Second Division. The limb was 
 then considerably swollen. Simple dressings were ap- 
 plied. The shortening amounted to nearly two inches. 
 On the 20th of September, the apparatus of Scultet was 
 applied. The wound, freed from splinters, tended 
 
APPENDIX. 223 
 
 rapidly towards cicatrization. Although hospital gan- 
 grene prevailed, he was not attacked with that disease. 
 At the Hospital of the Parade Ground, where Meunier 
 arrived on the 30th of September, the apparatus of 
 Scultet was renewed, and the cicatrization of the wound 
 was completed under this treatment. On the 28th of 
 November, when the patient passed from the fourth to 
 the first division of the wounded, the soldering of the 
 bone was complete, although very voluminous and irre- 
 gular, and had so far progressed, that he could move his 
 thigh without appreciable pain. The shortening of the 
 limb was three full fingers' breadth. The apparatus box 
 of M. Baudens was adapted to the limb, and extension 
 applied, both to the thigh and lower leg, and maintained 
 till the end of February. On the 10th of March, the 
 patient was sent to France. There was then scarcely 
 any shortening perceptible upon measurement, and the 
 bony knob at the point of union had well nigh dis- 
 appeared. 
 
 This case proves anew, that when there is a faulty 
 consolidation of recent occurrence, we may, notwith- 
 standing the defective relation of the bony parts to one 
 another, so far correct the misfortune, that in the least 
 successful cases there will remain but a simple shorten- 
 ing compatible with the free use of the limb. 
 
 Up to what period may a faulty soldering of the bone 
 be remedied ? I am not, at present, able to show pre- 
 cisely, although my experience embraces nine successful 
 cases. Still, I certainly would not accept the narrow 
 limits which dogmatic teaching has prescribed in the 
 application of trial methods ; and I would observe, that 
 several of my cases have been taken in hand within four 
 months of the lesion, when the soldering presented such 
 solidity that the patient could raise the limb. In these 
 same cases, the most faulty union of bone yielded very 
 readily to continued and graduated extension, and, two 
 months later, had taken a proper direction, and showed 
 an elongation that I had scarcely hoped to effect. 
 
 Of all the means or apparatus which I have used to 
 correct, as much as possible, the deformities of the sol- 
 dering, there has been none more convenient in applica- 
 
224 APPENDIX. 
 
 tion, or more sure of success, than that which I used in 
 the cases here described. It combines all the modifica- 
 tions of traction and extension deemed necessary, and, 
 at the same time, is as inflexible as we could desire in an 
 apparatus of this kind. This action may be gradually 
 increased without appreciable pain to the patient, con- 
 ditionally, and here lies the whole secret of the success 
 of all apparatus, that the different parts be carefully 
 fitted, and the effects closely watched. As it does not 
 cover up the limb, the proper dressings can be applied 
 to the wound, without in any way interfering with its 
 efficacy. 
 
 VI. 
 
 Observations collected by M. Beaufils, Aide-Major 
 Physician. 
 
 I. SPONTANEOUS LOSS OF BOTH FEET FROM CONGELA- 
 TION. CUBE. 
 
 MANGIN, aged twenty-three, of feeble constitution and 
 nervous temperament, belonging to the 62d regiment of 
 the line, after five months' residence in the Crimea, had 
 both feet frozen, while sleeping in his tent, on the night 
 of March 19. He was sent to the hospital at Gulhane, 
 where he arrived April 11, 1856. Both feet were cold 
 and insensible, and the tissues had a black and lifeless 
 aspect, with a line of separation around them at the 
 ankles. The patient appeared weak and broken down. 
 There was no fever. By the 30th of April, the circle of 
 elimination had made progress, the tissues were deeply 
 ulcerated, the tendons exposed, and fleshy granulations 
 appeared along the edge of the wound towards the leg. 
 
 By the 5th of May, the bones of the legs were entire- 
 ly denuded as far as the ankles, the left foot was only 
 held by some tendons, and by the ligaments of the joint, 
 which were completely dissected. A few clips of the 
 scissors detached the foot from the leg, without a drop 
 of blood following, and without its loss being felt by the 
 
APPENDIX. 225 
 
 patient. On the next day, May 6th, the same operation 
 was performed upon the right foot. The patient was 
 much pleased at being relieved from the annoying weight 
 at the extremities, which had prevented him from turn- 
 ing in bed. On the 8th of May, he was placed under 
 the influence of chloroform, and the operation of resec- 
 tion of the ankles was performed, as indicated by M. 
 Baudens in his method of tibio-tarsal amputation. The 
 borders of the wound were soon covered with fleshy 
 granulations that completely enveloped the extremity of 
 the bone, and now, May 30th, the wounds are almost 
 entirely closed, the cicatrices are regular, and the patient, 
 being considered as cured, is about to return to France. 
 
 II. PARTIAL AMPUTATION OF BOTH FEET, IN CONSE- 
 QUENCE OF FREEZING, ONE COMPLETED SPONTANEOUSLY, 
 AND THE OTHER BY SURGICAL AID. 
 
 MANAVELLA, of Piedmontese origin, a soldier of the 
 second foreign legion, aged twenty years, of good consti- 
 tution and nervous temperament, after fourteen months' 
 residence in the Crimea, entered the field hospital of the 
 fourth division on the 1st day of January, 1856, attack- 
 ed by typhus. Being placed under a tent both his feet 
 were frozen. Upon recovering from the typhus, he was 
 sent to the hospital at Gulhane, where he arrived on the 
 14th of February. 
 
 The extremities of both feet, and as far up as the tar- 
 so-metatarsal articulation, were completely mummified ; 
 black, hard, resonant like a piece of wood, insensible, 
 dry, and horny. The toes, being dried together, could 
 not be moved. The general health was satisfactory, 
 and the patient ate with relish the quarter, and after 
 some days the half ration. The pain, which had been 
 but slight, on the 20th of March became more acute. 
 A circle of elimination was formed upon the right foot, 
 and the affected part soon ulcerated. The suppuration 
 became abundant, the pain very acute, and the slightest 
 dressings could not be applied without exciting cries of 
 distress. The extremity of the foot drew heavily upon 
 the ligaments, causing great torture to the patient, who, 
 nevertheless, could not bring himself to consent to an 
 
 11 
 
226 APPENDIX. 
 
 operation. On the 5th of April the medio-tarsal articu- 
 lation opened, the ligaments were in part destroyed, 
 and the skin held only to the bottom of the foot. A few 
 clips of the scissors completed the amputation that had 
 been begun and partly finished by nature. The scaphoid 
 bone remained in place ; the three cuneiform bones and 
 the cuboid bone were removed, and but little blood fol- 
 lowed the operation. The borders of the wound were 
 covered with bright florid granulations, of healthy cha- 
 racter. 
 
 On the 20th of April, the flesh covered the scaphoid 
 bone. The granulations were of a vermillion red color, 
 the wound was diminished in extent, the suppuration 
 was of good quality and less abundant, and the pain had 
 ceased. On the 30th of April the wound presented a 
 very good appearance, and was much reduced, and now, 
 May 30th, it has entirely closed. 
 
 The left foot took much longer time to eliminate itself 
 than the right. Although the toes and lower parts of the 
 foot were equally mummified, black, shrivelled, hard as 
 wood, glued together, and completely insensible, yet the 
 circle of separation had not begun to appear by the 20th 
 of April. Thinking that, the gangrene being only super- 
 ficial, vitality might be restored to the toes, the foot was 
 subjected to a continued irrigation of cold water. On 
 the 20th ^of April, the skin of the great toe appeared 
 macerated and white in places. On the 24th, the extre- 
 mity of the foot had passed from black to white. The 
 heel and lower part of the leg were warm. The patient 
 feels well ; there is no pain or chills ; the irrigation of 
 the limb was continued. On the 26th a line of elimina- 
 tion appeared at the level of the tarso-metatarsal articu- 
 lation ; the tissues over the tarsal bones, which were 
 slightly swollen, became white, and almost insensible to 
 pressure. The toes were still mummified, hard, and cover- 
 ed with a thick layer of white epidermis, that could be 
 removed like a blister by the aid of a spatula. On the 
 27th, the tissues appeared to take new life, and the great 
 toe, particularly, showed a slight tinge of redness. The 
 patient felt a little life in it. On the 30th, the foot present- 
 ed the same favorable aspect, and the irrigation was con- 
 
APPENDIX. 227 
 
 stantly continued. On the 2d of May, the mummification 
 of the tissues had almost entirely disappeared, the toes 
 showed a fleshy color, especially the great toe and the 
 third. They were less stiff, less glued together, and 
 there was neither pain nor offensive odor. On the 3d of 
 May the patient could stir the toes, and effect some 
 slight movements. On the 4th of May, a line of demar- 
 cation appeared on the back of the foot, without inflam- 
 mation, pain, or redness, and worms were continually 
 multiplying in the wound. On the 6th of May it was 
 deeper, and continued to extend, the patient, meanwhile, 
 showing no signs of suffering or of reaction. The irri- 
 gation, which was continued, prevented pain and sup- 
 pressed all bad odors. At length, on the 13th of May, 
 the alteration having continued to extend in depth, a 
 considerable change in the osseous tissue could be de- 
 tected. Mr. Thomas, Chief Physician, performed a 
 medio-tarsal amputation, preserving as much as possible 
 of the soft parts. A haemorrhage occurred, which was 
 arrested by the perchloride of iron. The patient, at the 
 time of operation, was under the influence of chloroform. 
 At this time, May 30th, the wound has completely 
 closed, and the patient may be considered cured. 
 
 These two cases show very conclusively the appear- 
 ance and progress of injuries caused by frost-bite. They 
 indicate the prudent course to be followed- by the sur- 
 geon, whose only object should be to second the efforts 
 of nature, and to come to her aid only when she cannot 
 effect her object alone. The aid of the surgeon should 
 be particularly withheld when the constitution of the 
 patient is broken down, or when he is infected with 
 miasmatic poison. We have, in the foregoing pages, 
 shown that operations, apparently the most innocent, 
 were sufficient at times to excite hospital gangrene in 
 the hospitals of the Crimea and at Constantinople. It 
 was not till later, when the hospitals had been purified 
 from this terrible scourge, that surgical operations were 
 relieved from the saddening occurrence of reverses, and 
 that amputations could be performed with fair chances 
 of success. 
 
228 APPENDIX. 
 
 Report of Mr. Thomas, Physician-in-cJdef, upon the 
 Sanitary Condition of Constantinople, during the 
 month of January, 1856, addressed to the Medical 
 Inspector of the Army of the East. 
 
 " From the 1st to the 31st of January, inclusive, 13,520 
 patients were treated in our hospitals, of whom 895 
 were wounded by the fire of the enemy ; 504 by other 
 causes; 1,075 were frost-bitten, and 11,048 were fever 
 patients received from the Crimea, from troops in 
 passage, and from the garrisons. Since the first of 
 January, the arrivals of troops sent for medical treat- 
 ment from the Crimea, have been more frequent and 
 numerous than in the preceding months, and the increas- 
 ing numbers of sick under care, have rapidly consumed 
 the means provided by the administration, who, count- 
 ing upon the continuance of the sanitary condition of 
 November, had discontinued the hospitals at the Pre- 
 paratory School, at Maslak, No, 1, and reduced by a 
 third, the number of beds in the other establishments.* 
 
 " Excepting some cases of old wounds, kept in the 
 hospitals since the taking of Sebastopol, and a few 
 hundred men frost-bitten, we find that those sent to the 
 hospitals during the month, consisted entirely of febrile 
 patients tainted with scurvy, diarrhoea or chronic 
 dysentery, and typhus. Scurvy is, so to speak, the 
 exclusive disease of the febrile patients arriving from 
 the Crimea during the month, and exists with them all, 
 either alone or complicated with other affections. Many 
 of them present symptoms of advanced cachexy, great 
 anemia, general swelling, fungous ulceration of the 
 gums, sanguineous and painful infiltrations of the 
 limbs, serous effusions in the cellular tissues, peritonitis, 
 pleuritis, pulmonary oedema, diarrhea almost always 
 accompanied by hemorrhages, etc. 
 
 " Cases of diarrhoea and chronic dysentery are very 
 common, stubborn, and destructive. I have already, in 
 several of my preceding reports, had the honor of stat- 
 
 * This latter measure had been adopted at my request, in view of 
 disencumbering and purifying the hospitals. 
 
APPENDIX. 229 
 
 ing to yon, facts concerning a special complication 
 which has for some months changed completely the 
 appearance of our wards. It prevailed in our hospitals 
 during the winter of 1855, and has been commonly 
 denominated the typhic condition. During the present 
 year, it has also prevailed, at the same epoch, and 
 attended with almost identical symptoms. HoAvever, 
 our physicians are far from agreeing as to its nature, 
 and while some regard it as a variety of typhoid fever, 
 others consider it a severe form of remittent fever ; the 
 majority regard it as the typhus of camps, hospitals, etc. 
 
 " This typhus threatens to assume the dimensions of a 
 great epidemic, and is observed chiefly among the sick 
 arriving from the Crimea, where our soldiers live under 
 conditions most favorable for its development. They 
 are there deprived of hygienic attentions, are over- 
 crowded and exposed to the deleterious emanations of 
 a soil profusely charged with organic matter of every 
 kind, and impregnated with the effluvia of more than 
 twenty thousand decaying men and animals. The resi- 
 dence in our wards of a certain number of men infected 
 with this pernicious disease, has developed a true epi- 
 demic typhus, whose malign influence is reflected upon 
 those sick of other and chronic diseases, and upon the 
 attendants, sisters of charity, and physicians upon 
 duty. 
 
 "This disease, notwithstanding its many points of 
 resemblance to typhoid fever, appears to me to differ 
 from it essentially, in the manner of its attack, the pro- 
 gress of its symptoms, the duration of the various atten- 
 dant conditions, and the pathological changes that result 
 from its action. Thus, contrary to what takes place 
 among the greater number of cases of typhoid fever, 
 we rarely have a premonitory period ; and the greater 
 number of cases of typhus which we have observed, 
 attacked convalescents from other diseases, or persons 
 in health. 
 
 " We have seen it almost always appear suddenly, with 
 an initial chill, followed by a burning fever, and severe 
 pain in the forehead, which was soon followed by a 
 furious or tranquil delirium, according to the degree of 
 
230 APPENDIX. 
 
 nervous susceptibility, or perhaps the paludal intoxica- 
 tion of the patient. These first symptoms were followed 
 closely by stupor and general prostration, and often 
 this lethargy showed itself the first day in debilitated 
 patients. These showed an extreme depression of 
 vitality in the expression of the countenance, and an 
 indescribably death-like cast of features, which constitute 
 one of the pathological symptoms of typhus. Loss of 
 hearing existed in a great majority of cases. 
 
 " During the whole course of the fever, the skin re- 
 mained dry and burning. It was often covered with 
 petechial spots, but rarely among the sick whose con- 
 stitutions, impaired by previous diseases, had not 
 strength to bring on reaction, and suscitate the stage 
 of elimination. This eruption, either separate or con- 
 fluent, and red, purple, or brown, appearing from the 
 first to the third day, differed from the lenticular rosy 
 spots of typhoid fever in their form, which resembled 
 the eruption of measles, by their early appearance and 
 by their duration, which was rarely more than four 
 days. 
 
 " The thirst of the patients was proportioned to the 
 intensity of the fever. Frequently the tongue remained 
 clean and moist, and only in very prolonged and severe 
 cases, or with those having a scorbutic taint, was it 
 covered with a yellow or brown coat. We have at 
 times seen it of a blood-red color, attended with ex- 
 treme dryness, and a remarkable uncertainty in its 
 motions. 
 
 "The bowels usually preserved their pliability and nor- 
 mal susceptibility; and if they were the seat of pain, it 
 was transient, light, and spread over the whole surface 
 of the abdomen, or fixed under the sub-umbilical region. 
 It was rarely felt exclusively in the right iliac fossa, and 
 crepitation existed in this region only in patients suffer- 
 ing from diarrhoea. Constipation is the more common 
 condition with typhic patients, while meteorism, so com- 
 mon in typhoid fever, was very rarely observed. 
 
 " The lungs of scorbutic patients tainted with typhus 
 often became the seat of congestions, which were an- 
 nounced by dyspnoea, a sense of oppression, and rales of 
 
APPENDIX. 231 
 
 various kinds. This pectoral complication of typhus 
 was generally more grave and deadly in its effects than 
 the abdominal and encephalic. Sometimes the pulse 
 was full, hard, and frequent, especially at first ; and at 
 other times it was small, sharp, quick (a hundred and 
 thirty to the minute), and often maintained itself in this 
 condition till the end of the disease. In most instances 
 it was weak and languid, and in grave cases, towards 
 the close, it was thread-like, and scarcely perceptible. 
 It however varied considerably, according to the con- 
 stitution of the individual. 
 
 "Nasal haemorrhages were common in cases of typhus, 
 rarely appearing before the fourth day, and still more 
 rarely showing themselves in the premonitory stage, 
 when such occurred, or at the beginning of the disease, 
 as in typhoid fever. The mean duration of this malady 
 might perhaps be estimated at eight days ; frequently it 
 terminated at the end of the first week, and rarely went 
 beyond the second. Grave cases of typhus, which were 
 prolonged beyond this period, oftentimes relapsed into 
 conditions very similar to those of typhoid fever. The 
 mouth became dry, the tongue and gums were covered 
 with sordes, the bowels were inflated, the right iliac 
 fossa was painful and the seat of a manifest crepitation, 
 and at length a diarrhoea appeared. At a still later 
 period, coma supervened, with a general loss of sensi- 
 bility and the functions of the senses, thus completing a 
 striking resemblance between the two diseases. Fre- 
 quently the typhus ended as suddenly as it began ; in 
 fact, it is not a rare thing to find the Eisease all at once 
 become aggravated, and terminate in death in a few 
 hours, while very severe cases would as suddenly amend, 
 and return quickly to health. In a considerable number 
 of cases of typhus, we have seen the malady attended 
 with fetid sweats having an odor of rotten straw, and 
 with intestinal fluxes and parotitis. These abscesses in 
 the parotid glands have more than once modified the 
 progress of the disease in a favorable manner, especially 
 in the case of a young aide-major, M. Garny, whose 
 recovery from a severe attack of typhus was not really 
 determined until the appearance of an abscess of this kind. 
 
232 APPENDIX. 
 
 " No matter what cause induced a favorable termina- 
 tion of this disease, the convalescent returned rapidly and 
 steadily to health, thus presenting a contrast with the 
 slow and almost fatal irregularity of typhoid fever. 
 This difference in the progress of convalescence may be 
 explained by the diversity of the intestinal lesions exist- 
 ing in the two diseases. Thus, in cases of typhus end- 
 ing fatally, after an attack of a person in full health, we 
 simply find along the intestinal canal some red! and yel- 
 low discolorations in patches or bands, and numerous 
 arborescent injections of the mucous membrane, a few 
 
 Eimples, and some of Peyer's glands, pointed or retieu- 
 ited ; a condition which we constantly find in a multi- 
 tude of different diseases, and which cannot be regarded 
 as a constant pathological character. We have never 
 observed the glands honey-combed, fungous, pustulous, 
 ulcerated, or gangrenous, nor the mesenteric ganglia 
 engorged, nor any of the other special lesions of 
 typhoid feVer. 
 
 " This disease, of which we have enumerated the prin- 
 cipal symptoms, has a strong tendency to spread from 
 one patient to the next. Thus we have seen it, in our 
 wards, communicate from the first patient to his nearest 
 neighbors, and so on from them to the attendants, the 
 sisters of charity, and the physicians. We have met it 
 in persons whose age would be considered as a protec- 
 tion against an attack of typhoid fever, and with young 
 men who are well known to have been attacked and 
 to have been cured (Messrs. Lardy and Laval, Aides- 
 Major). 
 
 "These facts should be considered sufficient to establish 
 the nature of typhus, and prevent it from being con- 
 founded with typhoid fever. If, furthermore, it did not 
 differ essentially from it 
 
 " 1st. In the manner of attack and progress, the 
 absence of premonitory symptoms in almost all cases, 
 and the sudden appearance 01 nervous symptoms, which 
 rapidly reach their state of greatest intensity. 
 
 " 2d. In the form, period, and duration of the exan- 
 thematous eruption. 
 
 " 3d. In the period of the appearance of epistaxis. 
 
APPENDIX. 233 
 
 " 4th. In the frequent absence of disturbances in the 
 region of the bowels. 
 
 " 5th. In the shortness of duration. 
 
 " 6th. In the rapidity of convalescence. 
 
 " 7th. In the frequent occurrence of parotitis. 
 
 " 8th. In the difference of the pathological changes 
 observed in the two diseases. 
 
 " This epidemic typhus, after being a long time sta- 
 tionary^ has suddenly assumed very considerable pro- 
 portions. During the first fifteen days of January, the 
 number of patients tainted with the disease was not over 
 a hundred, but now it has arisen to sixteen hundred. It 
 has thus far spared the officers of the army; but, on the 
 other hand, it has raged cruelly among the surgeons, 
 the sisters of charity, the chaplains, and the attendants 
 belonging to the field and general hospitals. Of the 
 physicians treated for this disease in the hospital at the 
 Russian embassy, eight are in a most serious and alarm- 
 ing condition. They are Messrs. Girard, de Santi ; Mil- 
 4emberger, Arondel, Rioublanc, majors and aides-majors 
 of the field hospitals ; and Volage, principal, Cornac, 
 major, and Bauchet, aide-major of the general hospitals. 
 Since the last of January, we have had Messrs. Dulac, 
 Savaete, and Lardy. Several, whose names I do not 
 know, succumbed to the disease at Eupatoria and 
 Sebastopol. 
 
 " Your hygienic prescriptions to insure the salubrity 
 of our hospitals have been carried into effect. At your 
 instance, a depot of convalescents has been opened, and 
 the new localities have been prepared for the accom- 
 modation of five thousand sick, with the view of scatter- 
 ing them, and thus prevent encumbrance in the existing 
 hospitals. The food of the sick has been modified and 
 adapted to the wants of the patients whom we treat ; 
 and there is reason to hope that these wise measures 
 will eradicate the disease, and that we shall soon be able 
 to announce an amelioration in our general condition of 
 health." 
 
 11* 
 
234 APPENDIX. 
 
 VIII. 
 
 Instructions relative to the establishment of a Dtpot of 
 Convalescents, in apart of the Camps at Maslak. 
 
 1. ORGANIZATION. The convalescents shall be di- 
 vided by sections and arms, as much as possible, the 
 effective maximum being 200." 
 
 2. The sections shall be commanded and managed by 
 lieutenants, or sub-lieutenants, having under them sub- 
 officers and corporals. They shall each be taken from 
 among the convalescents, or in default of these, from 
 the 84th line, which regiment shall always furnish for 
 each section, the sub-officer and corporal who shall 
 perform the duties of sergeant-major and quarter- 
 master. 
 
 3. A captain, selected from the 84th, shall exercise 
 supervision over the officers of the section in all that 
 relates to discipline, internal police, orderlies, etc., and 
 shall sign for the various sections, such papers as orders 
 for purchase, bills, etc. He shall be responsible to the 
 council of the administration of the corps, with whom 
 he is to confer directly, with regard to administrative 
 affairs. 
 
 4. ADMINISTRATION. The sections shall be placed 
 under the general supervision of a superior officer, 
 taken from the 84th, who shall direct the general service, 
 secure a proper discipline, and employ the captain as 
 his intermediary for transmission of his orders. 
 
 5. INTERIOR REGULATIONS. Each section shall form 
 an administrative unity, in the same manner as the com- 
 panies of a corps. 
 
 6. The sections shall mess separately. 
 
 7. The mess expenses shall be the same as in the 
 regular army corps. There shall be added a supple- 
 mentary sum of five centimes (a cent) a day, which shall 
 be devoted exclusively to the purchase of fresh or pre- 
 served vegetables. 
 
 8. There shall be allowed to each sub-officer and 
 soldier present, including those charged with the com- 
 
APPENDIX. 235 
 
 mand, a ration of wine daily, in addition to the regular 
 ration of sugar and coffee. 
 
 9. The rations of provisions shall consist exclusively 
 of bread, fresh meat, rice or dried vegetables, salt, sugar 
 and coffee, at fixed prices, and the lixed allowance of 
 fuel. 
 
 10. The additional ration of wine shall be distributed 
 one half at each meal. 
 
 11. The ration of sugar and coffee shall be issued at 
 about eight o'clock in the morning. 
 
 12. BARRACKS AND ENCAMPMENTS. The convalescents 
 shall be placed in barracks instead of tents, and these 
 shall be furnished with stoves. 
 
 13. To each man there shall be allowed a mattress and 
 a bolster, which shall be placed upon the camp beds. 
 
 14. In the absence of camp beds, trestle bedsteads of 
 wood shall be furnished. 
 
 15. The men shall be provided with camp-blankets. 
 
 16. The utensils and other furniture for this service, 
 will be furnished from the public stores upon the order 
 and responsibility of the corps to which the men belong. 
 
 17. SANITARY SERVICE. The sanitary service shall 
 be intrusted to a physician of the grade of major, who 
 shall be designated by the chief physician of the service 
 of the hospitals at Constantinople. He will be assisted 
 by one or more aides-major, according to the wants of 
 the establishment. 
 
 18. The men shall be taken out to walk, according to 
 the direction of the chief physician, who shall limit the 
 time, and if need be, shall cause the feebler ones to be 
 attended by an aide-major. 
 
 19. A sanitary visit shall be made weekly, and those 
 who are deemed able to rejoin the service, will be sent 
 to their corps. Pleasant days are to be selected, as far 
 as practicable, for sending them off. 
 
 20. Such men as prove tp be incapable of complete 
 recovery at the depot of convalescents, may, according 
 to circumstances, be sent to the hospital, or be allowed 
 sick leave, or be sent to the depot of their corps. Jn 
 these two latter cases, the major-physician charged with 
 the duty, shall furnish certificates of visit, which visit 
 
236 APPENDIX. 
 
 shall be made by the chief physician of the health ser- 
 vice, in the presence of the Brigadier General. 
 
 21. The barracks shall be warmed only when the 
 major-physician may deem it necessary. 
 
 22. One or more barracks shall be placed at the 
 service of the major-physician, to be used as a regi- 
 mental infirmary. 
 
 23. The medicines and dressings necessary for use in 
 the infirmary, shall be supplied from the public stores, 
 to be charged against the funds of the corps that may 
 
 -require them. 
 
 24. FOEMATION or THE DEPOT Sending to the Hos- 
 pitals. The depot for convalescents shall be opened on 
 the first of February next, and instructions shall be 
 issued in time to enable the chief physicians of the 
 hospital service, and other accountable officers, to select 
 and send to Maslak such men as they may deem proper 
 to be admitted. Those whose duty it is to report lists 
 of names, shall indicate the number of the regiment, the 
 Christian and family name, and the rank, and they shall 
 be classified as infantry, cavalry, artillery and engineers, 
 and other arms. These lists shall be addressed to the 
 military intendant, on the 28th instant, and shall be at 
 once sent to the general commanding the military 
 division. 
 
 25. The hospitals shall send their men upon the first 
 fprmation of the depot, in the following order : 
 
 February 1st, Pera, Dolma-Batche, Military School, 
 and Parade-ground Hospitals. 
 
 February 2d. Gulhane and the University Hospitals. 
 
 February 3rd. Daoud-Pacha, Maltepe, and Kamis 
 TchhTlick Hospitals. 
 
 26. The first formation shall embrace a section for 
 each arm and, if need be, two from the Infantry, 
 
 27. The sections shall form a single series of numbers, 
 and the designation of the arm shall be added to the 
 number of each section. 
 
 28. After the first formation, the hospitals shall send 
 only upon certain days of the week, viz : 
 
 Monday Gulhan6 and the University Hospitals. 
 Wednesday Pera and Dolma-Batche Hospitals. 
 
APPENDIX. 237 
 
 Thursday Military School and Parade-ground Hos- 
 pitals. 
 
 Saturday-*-Daoud-Pacha, Maltepe, and Kamis-Tchiff- 
 lick Hospitals. 
 
 In case of bad weather, the sending may be delayed 
 till the next day, or to the day named in the week 
 following. 
 
 29. The selections shall be made by the chief physi- 
 cians, at least forty-eight hours before sending. Lists, 
 including details mentioned in Article 24, and arranged 
 according to the arms, shall be sent to the chief of the 
 staif, on the day before the day designated for the 
 removal, in order that the commander of the depot 
 may be prepared in time. 
 
 30. Such men as are known by the major-physician 
 to be unable to walk the distance, may be sent in chairs 
 or arabas, according as may be most convenient. 
 
 31. In all cases the Administration will take charge 
 of the transportation of all property belonging to the 
 men, sent to the depot. 
 
 32. Each man sent by the hospitals to the depot shall 
 be furnished with a ticket of discharge, which shall be 
 at once sent to the major-physician, and by him re- 
 turned to the men when they are sent to the stations 
 of their corps. The tickets of the men entered at the 
 hospital or sent to France, shall be lodged with the 
 captain performing the duties of military sub-intendant, 
 who shall forward them to the smaller depots of the 
 corps, at the same time notifying the depots of the 
 present location of the men. 
 
 IX. 
 
 Report to Marshal Pelissier. 
 
 CRIMEA, GENERAL QUARTERS, March 15, 185G. 
 
 " To HIS EXCELLENCY, THE MARSHAL : 
 
 " I have hastily passed through a part of the camps 
 and field hospitals, and without further delay, consider 
 
238 APPENDIX. 
 
 it my. duty to inform your Excellency of my opinion, as 
 to the sanitary condition of the army. 
 
 "The first point which I wish to determine, was, 
 whether typhus prevailed in the field hospitals only, or 
 whether it was also prevalent in the regiments. To be 
 convinced of the latter, it was only necessary to attend 
 the morning visit when the men presented themselves 
 at the regimental infirmaries. To the inexperienced 
 eye, the premonitory symptoms of typhus may be con- 
 founded with those of other diseases, and some of our 
 physicians did so mistake them at first, but in the 
 hospital all doubt quickly vanishes. To the initial 
 chills, with headache, succeeds a dulness and stupor, 
 which distinguishes typhus as plainly as the symptoms 
 of cholera, which can no longer be mistaken. The pro- 
 duction of typhus in the midst of regiments, is a serious 
 fact, and unhappily as well established as the fact of its 
 propagation by infection. Two great indications pre- 
 sent themselves here : first, prevent its spread among 
 the masses ; and second, remove the causes. The mea- 
 sures to prevent the spread of typhus among the troops, 
 are simple, and easy to put in execution. 
 
 "It is only necessary to carefully watch that no patient 
 infected with the disease shall be allowed to remain 
 either in the tents or in the regimental infirmaries, and 
 to send the soldiers, on the first appearance of the 
 symptoms, to the field hospitals. 
 
 " The importance of this counsel will be appreciated 
 when it Is remembered that human miasm does not 
 appear to be contagious until the expiration of several 
 days of sickness, and above all, at the period of the 
 critical sweats. 
 
 " The preventive measures to be applied in the regi- 
 ments, are as follows, and observe, Marshal, that I shall 
 only recommend such as are within our resources, and 
 those which your Excellency, with wise forethought, has 
 given to the army. 
 
 "Awaiting the return of fine and settled weather, to 
 allow of changing the site of all the camps, the soil of 
 which is deeply impregnated with impurities, it would 
 be well, as often as the weather permits, to take down 
 
APPENDIX. 239 
 
 the tents, or at least to draw up the circular curtain as 
 high as the safety cords will permit. This operation, 
 which 'I have often witnessed, can be easily accomplished 
 if the tent-pins are four or five inches above the ground. 
 Six men occupied five or six minutes in completing it. 
 Furthermore, recourse should be had to this hygienic 
 measure, which serves to ventilate and dry the ground, 
 always damp, if not actually muddy, whenever 'it does 
 not rain or snow ; and for a stronger reason, when the 
 sun shines, and when a fine breeze is blowing. 
 
 " In order to secure the punctual execution of this 
 prescription in the 15,000 to 20,000 tents, it should be 
 indicated by drum-roll in the morning, when the men 
 get up, and in the evening at the time of retiring.. It 
 would have the effect of preventing the soldiers from 
 remaining the greater part of the day in their tents, 
 which they keep hermetically closed, even in the finest 
 weather such as we have had for the last three days. 
 It is quite enough to have them closed at night, and to 
 be obliged to breathe a contaminated air during sleep. 
 
 " The ground of the tents, once dry, should receive a 
 coat of lime, which would harden and purify it. 
 
 "The blankets and articles of clothing should be 
 hung out in the sun, as soon as it appears, so as to dry 
 out the dampness and purify them. Those which have 
 been used by typhic patients should be subjected to 
 several chlorine fumigations, before being again put to 
 use. 
 
 " As soon as the weather permits, the shelter tents 
 should be removed to another location. These tents 
 have not only the advantage of affording to the inmates 
 a sufficient protection from rain and atmospheric 
 changes, but allow the air inside to be renewed by 
 the passage of fresh air through the interstices of the 
 fabric. 
 
 "A great number of the regimental infirmaries are 
 badly arranged. Instead of two barracks, many have 
 only one. The men are not always protected from con- 
 tact with the damp ground by camp-bedsteads, or even 
 planks. The barracks ought to be whitewashed inside 
 and out, and often fumigated. Why not supply all of 
 
240 APPENDIX. 
 
 them with the little wooden frames, like those in the 
 infirmary of the 81st of the line, which is a model of 
 good arrangement, and those which are supplied to the 
 sub-officers and to the soldiers of the guard? The air 
 circulates freely underneath these little sort of litters, and 
 when possible, they might be covered with a sack of hay 
 or straw, as in the barrack of the 81st of the line, which 
 provides a good bed. Since I have spoken of the 81st 
 of the line, I will further say that I experienced great 
 satisfaction at witnessing the fine hygienic arrange- 
 ments in the tents of this regiment. Each soldier has a 
 separate camp-bedstead and a mattress ; cleanliness per- 
 vades everywhere, and we may ask why the care be- 
 stowed by the officers on the men in this instance, 
 should not be emulated by all the others. The results 
 of such a system are that the 81st haye an effective 
 strength of 2,400 men, ready at a moment's notice to 
 encounter the fatigues of war. 
 
 "Food. All the food, with the exception of the fresh 
 beef, is good. The beef is flaccid and gluey ; the ani- 
 mals are reduced to a state of marasmus when killed, 
 and their flesh affords but slight nourishment; but this 
 eventually has been anticipated by the solicitude of the 
 government. In the absence of fresh meat we have 
 excellent preserved beef of the first quality. If the sup- 
 plies permit of it, I think, sir, that the ration of preserved 
 meat might be augmented one-sixth. This measure, as 
 well as that already taken, of supplying a daily supple- 
 mentary ration of wine, seems to me useful, as long as we 
 are subject to typhus, to strengthen the systems of the 
 men against the attack of the epidemic. 
 
 " I do not speak of the powdered meat, which is con- 
 sidered very inferior to the preserved beef. 
 
 " I am surprised that no effort is made to use the flesh 
 of the horses that are condemned to be killed. To over- 
 come prejudice the example should be set by those in 
 authority. A commencement might be made by distri- 
 buting horse flesh to the officers. The generals might 
 set the example by inviting the colonels to a dinner of 
 horse flesh. This flesh is far preferable to the beef 
 which we have here. If I did not fear that the use of it 
 
APPENDIX. 241 
 
 would affect the spirits of the patients, I would recom- 
 mend it in the field hospitals. 
 
 " The spring will bring with it the invaluable dande- 
 lion. Meanwhile it would be well to encourage the 
 excellent measures of the Minister of War for the ship- 
 ment of large quantities of the fresh vegetables which 
 abound at Constantinople. 
 
 " Work and moderate exercise are excellent aids to 
 health. Nothing is more pernicious than absolute rest ; 
 idleness enervates the body and soul. 
 
 " Collections of rubbish have been allowed to accu- 
 mulate around some of the camps ; they should be cart- 
 ed away, as soon as possible, by well directed fatigue par- 
 ties. The moment for redoubling care and cleanliness 
 has arrived ; the slightest violation of hygienic laws will 
 increase the number of sick and deaths. 
 
 " For the time being, I confine my counsels to the 
 regiments, to these few and simple measures. 
 
 "Ambulances. You are aware, sir, that notwithstand- 
 ing our united efforts, we have been unable to give our 
 ambulances a good hospital status. 
 
 " Of the 6,000 mattresses put in use four months ago, 
 there are hardly 2,500 which are serviceable, and it is 
 with difficulty that the repairs are made in time to 
 maintain this number. 
 
 " The barracks are only sufficient for 4,500 inmates. 
 
 " Blankets are numerous, but almost all of them con- 
 taminated; sheets are wanting, as well as means for 
 thorough washing. Many of the sick are obliged to 
 sleep in their trowsers. There are not sufficient camp 
 beds for the tent hospitals, and many utensils are want- 
 ing, such as chambers, broth bowls, spittoons, etc., and 
 above all the slippers and hospital clothing. 
 
 " I am not criticising ; far from it. I am the first to 
 acknowledge the great difficulties which have been 
 overcome, before arriving at the present result. Be- 
 sides, it must not be forgotten that we are carrying on 
 a campaign in a country destitute of everything ; I have 
 only wished to prove the facts, and show that it is 
 urgently required that the greatest number possible of 
 our sick should be sent to Constantinople, in order to 
 
242 APPEXDIX. 
 
 disencumber our field hospitals here. If it were neces- 
 sary to demonstrate it by figures, I could find it in the 
 afflicting results furnished by the sick treated in the 
 Crimea, during the last few weeks. 
 
 " During the last ten days, from the 20th to the 29th 
 of February, which is a good sample of the same period 
 for a long time back, 519 left the ambulances cured, and 
 873 died ! ! A comparison in the cases of typhus gives 
 a still more terrible result. For every 27 cures we have 
 383 deaths, and yet, sir, typhus in its ordinary condi- 
 tion^ although a serious disease, does not carry off more 
 than a sixth of the sick. For example, of 442 infirmary 
 attendants attacked with typhus at Constantinople, only 
 42 died. 
 
 " These figures do not require comment ; they loudly 
 testify to the impotency of medicine, in the conditions 
 found in the Crimea. 
 
 " Ought all the sick to be sent to Constantinople, or 
 only a certain class ? My advice is, to ship off all the 
 non-typhic patients, if their condition allows of it ; they 
 are the most numerous. Their departure will effect an 
 immediate disencumbrance of the hospitals and allow all 
 the energies and care of the surgeons to be devoted to 
 the unfortunate typhic patients, who, retained in the 
 Crimea, will no longer risk the fleet and the hospitals of 
 Constantinople with the dangers of infection. 
 
 " If the weather continues favorable, it would be ad- 
 visable to place the typhic patients in tents, pitched at 
 distances of 15 yards apart, and, if our resources will 
 permit of it, to instal only two patients in each tent ; 
 they should not be allowed to lie on the ground, but be 
 provided with camp beds, by this means they would be 
 protected from the unhealthy influence of the lower 
 stratum of the air ; the bed clothing should be changed 
 daily, and exposed to fumigating agents ; whitewash the 
 ground, fumigate, constant change of air, for I again 
 repeat, contagious typhus must have pure air, constantly 
 renewed, without which cure is impossible. 
 
 " You see, sir, military medicine is not very exacting, 
 it can bend itself to the necessities of war ; but the little 
 we ask should be given without grudging. 
 
APPENDIX. 
 
 243 
 
 " One of the grave considerations occupying M. Scrive 
 and M: Mery, Xledical Director of the 3d corps, is the 
 sanitary condition of the two field hospitals, that of the 
 2d division of the 2d corps, in which the mortality at 
 the present moment is very great, and that of the two 
 first divisions of the reserve. I visited the last. Among 
 the 600 sick, I found 319 cases of typhus in very deplo- 
 rable conditions, so deplorable that, in my opinion, the 
 immediate abandoning of the hospital can alone bring 
 any remedy. 
 
 " Your Excellency can judge for yourself from the 
 statement given below, handed to me by M. Goutt, 
 Medical Director of this ambulance. 
 
 '-'Field hospital of the first division of the reserre 
 corps (3d corps). 
 
 "Return of cases of typhus, from the 10th of January 
 to the 10th of March, 1856. 
 
 Period. 
 
 
 Entered. 
 
 Left. 
 
 Sent away. 
 
 Died. 
 
 January 10 to 20. 
 
 
 65 
 
 
 
 4 
 
 10 
 
 20 to 30. 
 
 . 
 
 18 
 
 
 
 30 
 
 30 
 
 February 1 to 10. 
 
 
 184 
 
 4 
 
 149 
 
 61 
 
 " 10 to 20. 
 
 t 
 
 313 
 
 
 
 6 
 
 133 
 
 " 20 to 29. 
 
 
 137 
 
 
 
 52 
 
 93 
 
 March 1 to 10. 
 
 , 
 
 120 
 
 
 
 
 
 101 
 
 Total. 
 
 837 
 
 241 
 
 428 
 
 " Of these 837 cases of typhus, 531 were sent directly 
 from the regiments, and 306 were developed in the field 
 hospital in the following proportion : 
 
 Chaplains 1 
 
 Administrative officers 
 
 Attendants 85 
 
 Laborers . . 25 
 
 Sick who entered from other 
 
 diseases. 185 
 
 Physicians 10 
 
 " The return of pleasant weather will, doubtless, mo- 
 dify in a favorable degree, this unfortunate condition, 
 but the sun alone cannot accomplish all. We must come 
 to its aid, and second its influence with our own efforts, 
 if we wish to make sure of enjoying its benefits. 
 
 " The typhus of last year never presented the grave 
 characters of the present attack. In the opinion of some 
 
244 
 
 APPENDIX. 
 
 Effective 
 Strength. 
 78 000 
 
 April 
 
 Deaths. 
 615 
 
 Effective 
 Strength. 
 91,000 
 
 89000 
 
 Mav 
 
 . . 1 075 
 
 107,000 
 
 96,000 
 
 jM.*y 
 
 June . . 
 
 . 3.106 
 
 121,000 
 
 physicians, it did not then even exist, but now, no one 
 doubts its presence. The following total of deaths dur- 
 ing the first six months of 1855, in the field hospitals of 
 the Crimea, is highly instructive. It will be seen that 
 the sun gave more activity to the emanations of organic 
 miasms, and did not reduce the number of deaths, as we 
 hoped it would. 
 
 Deaths. 
 
 January 971 
 
 February 543 
 
 March 500 
 
 " The last figures embrace, it is true, a large number 
 of deaths from cholera. In the above table, the deaths 
 from wounds received in action, form but an insignifi- 
 cant part. In disclosing the sanitary condition of the 
 army, loyally and as it actually exists, I feel that I have 
 only done my duty. The situation is serious, but we 
 can still control it, and your Excellency will surely tri- 
 umph, if the simple measures proposed are adopted. 
 The mortality is very considerable, amounting to five or 
 six thousand men a month, in the Crimea and at Con- 
 stantinople. It has hitherto mocked the wisest precau- 
 tions ; the burden of blame must be borne by the evils 
 which war entails. The powerful assistance which your 
 Excellency has rendered to the medical officers of the 
 army, of whom nineteen have already died of typhus, 
 and the high degree of confidence with which the pro- 
 fession has been honored and encouraged, have ever 
 elevated its devotion and self-denial, and impressed me 
 personally with the deepest gratitude." 
 
 X. 
 
 Report of Dr. Marcet, Chief of the Medical /Service 
 at Calchi. 
 
 NAVAL HOSPITAL AT CALCHI, April 10, 1856. 
 
 " INSPECTOR BAUDENS : SIR I have the honor, in 
 addressing you, to respond to your wish, that I would 
 
APPENDIX. 245 
 
 submit some notes upon the typhic affections that pre- 
 vailed in the hospital at Calchi, from the latter part of 
 December, 1855, to the 12th of April, 1856. You will 
 please pardon the brevity of my statements, in view of 
 the numerous engagements of the present time. 
 
 "I have had under treatment sailors attacked with 
 the typhus in the following order : 
 
 From the ship Wagram 2*7 *j 
 
 " " " Vauban 13 [January 
 
 Sick attacked in the hospitals, particularly scorbutic (and Feb. 
 patients 32 J 
 
 From the ship Orenoque 119 ] 
 
 " " " Algeria 129 
 
 *' " " Magellan, for the most part convales- I ,.- , 
 
 cent 60 H rch> 
 
 " " " Lucifer 13 
 
 Sick attacked in the hospital 58 
 
 Total (of whom 64 died) . . . .446, or one 
 death in seven. 
 
 " I attribute the very large proportion of sick from 
 the Algeria and the Orenoque to the fact, that these 
 ships were obliged to keep their sick ten or twelve days 
 on board, during a cold and rainy period, which com- 
 pelled all the passages for ventilation to be closed. It 
 is worthy of remark, that the Algeria alone had any of 
 its officers sick (five, one of whom was the comman- 
 dant). The berths of the officers of sailing frigates are 
 between decks, and have no air but what comes from, 
 the gun-deck, where the sick passengers lie. The com- 
 mandant, whose berth was in the after part of the gun- 
 deck, owed his sickness to his humanity. He had given 
 up a part of his cabin to the passengers, and lived in the 
 midst of the most severe cases. The masters of all the 
 ships pay a large tribute to the disease being lodged in 
 the lower parts of the vessel. 
 
 " The period of incubation of typhus appears to me 
 to be from twelve to fifteen days. With few exceptions, 
 typhus has presented three periods premonitory, catar- 
 rhal, and that which I shall call the actual condition, 
 during which the ataxic or the adynamic symptoms 
 prevailed, sometimes both. 
 
246 APPENDIX. 
 
 "The most general symptom was the petechial erup- 
 tion, which was often of remarkable intensity. It 
 showed itself during the first day, rarely after the fifth 
 or seventh. Once it appeared on the ninth the patient 
 died two days afterwards. 
 
 " Pains in the head and epistaxis were the rule. The 
 latter recurred five or six times in twenty-four hours ; in 
 three cases the excessive haemorrhage necessitated plug- 
 ging ; they appeared to relieve the pains in the head. I 
 observed bloody stools in only one case, and one case of 
 ha3maturia, followed by very sedimentary urine and 
 rapid improvement. 
 
 "Abdominal symptoms were slightly marked and 
 rare (a distinctive character of typhoid fever) ; consti- 
 pation very frequent, particularly at the commencement. 
 The condition of the lungs deserves great attention in 
 the catarrhal period; but, especially in the more ad- 
 vanced stages, I have noticed a hypostatic condition. 
 
 "As regards nervous symptoms, I have found them 
 all, from the simple spasm to the most perfect form of 
 epilepsy. I have seen one case of chorea, three or four 
 contractions of the limbs, several of trismus, of convul- 
 sions of the muscles of the eye, and, finally, tonic con- 
 vulsions of tetanus, or clonic action of eclampsia. Deaf- 
 ness has been frequently noticed. Delirium has always 
 existed, four or five times of a furious kind ; eight men 
 were required to restrain the patient, in one case ; the 
 access lasted two hours, and appeared to succumb to 
 inhalations of chloroform, and later to leeching behind 
 the ears, and counter-irritants to the lower extremities. 
 
 "The progress of the disease is incomparably more 
 serious, when strongly marked nervous phenomena 
 exist, than in the worst stages of the adynamic 
 condition. 
 
 " I have observed, as critical stages, abundant sweats ; 
 they did not appear to me to exercise a favorable influ- 
 ence ; parotitis (once double) almost always suppu- 
 rated, good symptom, except in two cases, where the 
 fever seemed to redouble in intensity, and caused death 
 in twenty-four, hours ; abundance of sedimentary urine, 
 good symptom ; numerous abscesses on the body, boils, 
 
APPENDIX. 247 
 
 pustules of ecthyma, etc. ; but of all these symptoms the 
 sudamina have been the most favorable their appear- 
 ance has always presaged convalescence. 
 
 "More than fifty patients have had sores on the 
 sacrum, or gangrenous spots on the limbs; in two cases 
 these appeared on the scrotum. One of the patients, 
 who seemed to be convalescent, was affected with 
 sphacelated ulcers of the scrotum, of the upper part of 
 the thigh, and of the perineum, which eat through into 
 the rectum in two places ; he died. Once I observed 
 rapid ulceration of the two corneas. 
 
 " Treatment. At the beginning, an emetic or emeto- 
 cathartic, with an infusion of flax-seed. During the 
 catarrhal period, diet, sudorific and diluent drinks, a few 
 leeches to the mastoid process ; saline or oily purgatives. 
 When the adynamic stage is reached, broth, drink of 
 wine, tisane, with melissa or acetate of ammonia, eight 
 to thirty grammes in twenty-four hours ; frictions with 
 camphorated vinegar; to stop involuntary stools, enemas 
 of hypochlorate of soda, or ratanhia, which is preferable ; 
 if there is distension of the stomach, I employ campho- 
 rated embrocations. When nervous symptoms predo- 
 minate, I have employed camphor, musk, ether, but not 
 often with any good result. 
 
 "At the commencement, I bled twelve or thirteen 
 men only one died. In three cases the blood was 
 covered with a thick buffy coat." 
 
 This report is particularly worthy of attention, be- 
 cause the sailors who were attacked by the disease were 
 in perfect health, and of unimpaired constitution. Like- 
 wise, the progress of typhus has been more distinct and 
 regular in the crews of the navy than in the worn-out 
 soldiers ; and the blood-letting, which would have been 
 fatal to the latter, was employed with benefit to the for- 
 mer. Bleeding at the nose has been more frequent than 
 with the soldiers. We have likewise observed gangre- 
 nous eschar, following typhus, in the hospitals of the 
 land forces. As to the furious delirium which M. Mar- 
 cet had such trouble in suppressing, we have seen 
 Medical-director Garrat, at Daoud-Pacha, constantly 
 
248 APPENDIX. 
 
 overcome it with ease by a combination of opium and 
 sulphate of quinine, administered as a drink. 
 
 XL 
 
 Report to the Minister of War. 
 
 CONSTANTINOPLE, April 28, 1856. 
 " MARSHAL : 
 
 " The excellent manner in which our hospital service is 
 carried on, reveals itself in results more and more satis- 
 factory. The mortality decreases notably, and at the 
 same time the cures are on the increase. Medicine is 
 not alone in congratulating itself upon a condition so 
 advantageous to the success of its therapeutics. Sur- 
 gery also is benefited thereby. Amputations, especially 
 those practised for frost-bite, were almost always fol- 
 lowed by hospital gangrene, and ended in death ; now 
 they almost all succeed. 
 
 " Some unfortunate fellows whose feet had fallen off 
 from the effects of frost-bite, have suffered amputation 
 of both legs, with perfect success. Our hospital esta- 
 blishments, to which considerable additions have been 
 made, feel no longer the influence, so to speak, of epi- 
 demics or miasms ; the new hospitals are nevertheless 
 the most favored in this respect. Thus, in the large 
 barrack hospital of Ramis-Tchifflick there is compara- 
 tively no mortality, and no cases of typhus. 
 
 " The large field hospital in tents, established in a few 
 days at Prinkipo, is already full of scorbutic patients, 
 whose faces gleam with joy at finding themselves in 
 such healthy quarters. 
 
 " Scurvy has been the precursor of typhus : it was 
 urgent to withdraw from the influence of this disease 
 the scorbutic patients on whom it throve. 
 
 " Four cases of typhus appeared among the scorbutic 
 patients; the seeds of the disease were sown in our 
 hospitals, and the incubation of the infectious miasms 
 
APPENDIX. 249 
 
 took place after their arrival. I caused a few tents to 
 be pitched at a distance of a quarter of a mile, and there 
 placed the typhic patients. By these means we shall 
 certainly escape its propagation to the other sick. 
 
 "I estimate that in twenty or thirty days the 1,800 
 scorbutic patients now at Prinkipo will be sent off, and 
 their places occupied by others. When the fresh arri- 
 vals of scorbutic patients cease, we can begin to receive 
 convalescents. 
 
 " I intend to subject the convalescents to a quarantine 
 of fifteen days in another part of the island, and shall 
 only embark them for France, when I am convinced 
 after this lapse of time, they are insured against an 
 attack of the reigning epidemic. 
 
 "Our last report, up to the 27th instant, of the 
 typhus at Constantinople, which is just handed to me, 
 presents the following figures : 
 
 In Hospital. Entered. Cored. Dead, 
 April 27 919 29 113 11 
 
 " This result is very satisfactory ; the comparison of 
 the number of cures with the deaths fully confirms the 
 value of the precautionary measures before mentioned. 
 
 "I think, Sir, that the subject which should occupy 
 our attention at the present time, is the manner of 
 transporting the troops from the Crimea to France. 
 
 "In a conference with General Espinasse* it was 
 decided, in order to equalize the distances between the 
 Hospitals on the route followed by the fleet, that field 
 hospitals in tents should be established at the Pirea and 
 at Messina. Difficulties are placed in the way by the 
 authorities at the latter place, who are opposed to a 
 depot for typhic patients being established there. We 
 shall report on the Pirea and on some island as near 
 as possible to Messina. 
 
 "I may be obliged to visit Greece, to find a con- 
 venient depot. The space assigned to the present 
 quarantine ^it the Pirea is altogether insufficient forty 
 
 * The Emperor had charged General Espiuasse, on his leaving the 
 Crimea to return to France, with the mission to inspect the Hospitals 
 at Constantinople. 
 
 12 
 
250 APPENDIX. 
 
 typhic patients would certainly engender infection. Dr. 
 Artigues, who has resided for some time in this country, 
 has given me valuable information, which I shall make 
 use of. And although I hold a sea voyage in great 
 horror, I should not hesitate to make it, in the hopes 
 that some service might result from it. 
 
 " I am at this moment much distressed. My private 
 secretary, M. Benjamin Crombez, a young man full of 
 courage and self-denial, whose help is so valuable to me, 
 is suffering from a severe attack of typhus, caught dur- 
 ing our visits to the hospitals. I pray heaven to take 
 pity on him and spare me the pain of seeing him die a 
 victim to his devotion ! 
 
 " I have this moment received from Marshal Pelissier 
 an answer to my letter of the 22d ; he tells me that the 
 reports received from all quarters agree in showing that 
 the sanitary conditions are considerably improved. He 
 continues to use all efforts to advance this improvement, 
 for which happily the w y eather is favorable. 
 
 " I have always found the Marshal ready to listen to 
 the counsels of the physicians ; he gives them full justice 
 and honors them with his fullest confidence. I owe to 
 his assistance the prompt execution of the prescriptions 
 which I deem indispensable. 
 
 "I learn from M. Scrive that all the prophylactic 
 measures applied to the troops before their departure 
 for France, are faithfully executed. He is strongly 
 impressed wdth the danger of propagation of typhus on 
 board of the transports on their passage to France. 
 
 " In one of his letters, he says : ' I yesterday received 
 a report from Mr. Molard, director of the hospital at 
 Gallipolis; sixty-two cases of typhus have been landed 
 from the ships le N^avarin and le Jupiter, and yet the 
 soldiers left Kamiesch and Eupatoria in good health. 
 It is impossible that it should be otherwise. What 
 would have been the result if these vessels had remained 
 fifteen days at sea without touching land ?' 
 
 " From General de Martimprey, chief of the staff, I 
 received a letter on the 2d of May, 1856, as follows: 
 
 " ' You know, sir, that we are improving here, al- 
 though slowly. Those remaining of the 2d corps, which 
 
APPENDIX. 251 
 
 is now embarking, are in little shelter tents, on ground 
 which has not before been occupied, and remote from 
 the other encampments. The guard and the 1st corps, 
 which are to embark after, are subjected to the same 
 precautionary measures. On receipt of your letter of 
 the 22d of April, the most stringent orders were again 
 given for the punctual enforcement of the hygienic mea- 
 sures which you advise. You would find that the divi- 
 sion of the reserve corps, at this moment suffering from 
 typhic infection, is encamped on the sides of the high 
 mountain which overlooks the plain of Balaclava.' 
 
 " In conclusion, I am happy to be able to assure your 
 Excellency, that the epidemic is on the decrease, and 
 that the army has nearly reached the end of its terrible 
 trials." 
 
 XII. 
 
 The necessity of breathing a pure and continually re- 
 newed air. 
 
 To prove how necessary pure air is to man, as well as 
 to all organized beings, we shall confine ourselves to a 
 few facts borrowed from some articles by M. Boudin, in 
 the "Annales d'Hygiene publique et de Medicine legale" : 
 " In 1834 a spacious and handsome house was construct- 
 ed in the Zoological Gardens, London, intended for the 
 monkeys, about 30 in number, who for several years 
 past had lived in pretty good health, in the open air. 
 The principal object in constructing this new building 
 was to provide them in winter with an artificial warmth 
 similar to that of their native clime. A few weeks after 
 their establishment in the warmed building two-thirds 
 of them died by the disease which kills the majority of 
 our soldiers, pulmonary phthisis ; the survivors were at 
 the point of death. It had been omitted to renew the 
 air by ventilation. Fresh air was liberally supplied, and 
 the monkeys which had not yet succumbed, soon reco- 
 vered." 
 
252 APPENDIX. 
 
 The same author cites the following extraordinary 
 occurrence: "The Hospital Beaujon in Paris is com- 
 posed of four separate buildings, of exactly the same 
 size, and each containing the same number of patients, 
 suffering from analogous complaints. During several 
 years hospital gangrene, erysipelas, and pleurisy were 
 rampant in three of the buildings; one building only 
 was exempt, it was the one ventilated by the Leon 
 Duvoir system." 
 
 The Council of Health of the Army was consulted 
 fifteen years ago, on account of a murderous attack of 
 typhoid fever, which occurred yearly at the St. Cloud 
 barracks, as soon as King Louis Philippe took up his 
 residence at that place. None of the inhabitants of the 
 town or the officers were affected, and as soon as the 
 king left the place the epidemic ceased. It was account- 
 ed for in this manner : while the king was away the 
 barracks contained 400 men only; but when he arrived, 
 the number in the same badly ventilated barracks was 
 increased to 1,200. 
 
 We hasten to add that the War Department, profiting 
 by the severe lessons of the past, has given strict atten- 
 tion to the ventilation of hospitals. In the splendid 
 military hospital which has just been built at Vincennes, 
 the apparatus for heating and ventilation are so arranged 
 that each patient is assured a minimum of sixty ctibic 
 yards of air per Jiour, and a uniform temperature, day 
 and night, of 60 Fahr. 
 
 These improvements, so creditable to the Minister who 
 has thus taken the initiative, cannot fail to secure the 
 best results, and we sincerely hope that the same princi- 
 ples will, before long, be applied to all the barracks. 
 
 THE END. 
 
INDEX. 
 
 Acclimatization, 63. 
 Acids, vegetable, 36. 
 Acrodynia, 149. 
 Air, poisoned in tents, 169. 
 " in closed cavities, 88. 
 Algeria, surgery in, 215. 
 
 " hospital gangrene, land, 13. 
 ship, 245. 
 Ambulances, 241. 
 " English, 111. 
 " French, 112. 
 " Russian, 111. 
 " not as good as chairs, 135. 
 " of the trenches, 62, 64, 
 
 66. 
 
 American bread rations, 30. 
 " beef, 33. 
 " desiccated veg., 35. 
 Amputations at joints, 90. 
 
 " experiments deprecated, 
 
 89. 
 
 faulty, 89, 248. 
 former practices, 89. 
 immediate or delayed, 90, 
 
 92. 
 
 low as possible, 89. 
 partial, 99. 
 rules for, 88, 99. 
 spontaneous, 98, 100, 224, 
 
 225, 226, 227-. . 
 statistics of, 213,214, 215. 
 sub-malleolar, 89. 
 thigh, 92. 
 Antiscorbutics, 35, 36, 39, 60, 180, 
 
 189. 
 
 Apothecaries, French army, 66. 
 Arabas, 26, 51, 124, 127, 150. 
 Arms of precision, 78. 
 
 Army of Potomac, sickness in, 142. 
 Aromatic fumigations, 170, 172. 
 Attendants from convalescents, 
 176. 
 
 Baidar, 14, 17, 19, 20, 25, 26, 32, 
 
 33, 46, 56, 163. 
 Bailly, Dr., 124. 
 Bakeries, camp, 30, 56. 
 Balaclava, 14, 15, 16, 17. 20, 21, 
 
 35, 73, 76, 192, 196, 251. 
 Balls, conical, 78, 79. 
 
 " in wounds, 82. 
 
 " (see Gunshot Wounds,) 
 Bandages, 68, 78. 
 Barracks, 28, 50, 58, 169. 
 Baths of Agamemnon, 11. 
 Battle, Alma, 135. 
 
 " Balaclava. 20. 
 
 <l Inkermann, 16, 18, 19. 
 
 " Traktir, 18, 19. 
 Baudens', M., fracture box, 91, 92, 
 
 215-223. 
 
 " report to Minister, 248. 
 Beaujon hospital, 252. 
 Beds and bedding, 49, 50, 59, 68, 
 
 172, 185, 241. 
 Beef, 31, 33, 41, 110, 205. 
 Beer, 75. 
 
 Birds of prey, 65, 125. 
 Biscuit, 29, 30, 59. 
 Bivouac before voyage, 192. 
 Blankets, 52, 59, 68, 185, 241. 
 Bolting of flour, 81. 
 Bombs, wounds by, 87. 
 Bones, use of, 31, 32. 
 Boots, 23, 54, 55, 141. 
 Bowel complaints, English, 140, 
 12* 
 
254 
 
 INDEX. 
 
 Brandy, 37, 38, 59, 75. 
 
 Bread, '27, 30, 31, 40, 59. 75, 
 
 115. 
 
 Breakfast for troops, 40. 
 Bronchitis, 51, 53, 151. 
 Building materials, 50, 51, 58. 
 Burden of a soldier, 55. 
 
 Cabbage, 34, 205. 
 
 Cacolets, 135. 
 
 Calchi, hosp. island, 200, 244, 
 
 247. 
 
 Callosity of fractures, 92. 
 Camels for carrying wounded, 135. 
 Camp, 25, 43. 
 
 " of 8 1st Line, 49. 
 
 " change of, 44, 57, 185. 192, 
 198. 
 
 " fires, 46, 47. 
 
 " Russian, 47, 107. 
 Castle hospital, 73. 
 Catarrh. 47. 
 Cautery in hospital gangrene, 95, 
 
 96. 
 
 Cavalry cantonment, 21. 
 Cemetery, army, 44, 65. 
 
 " Sebastopol, 22. 
 
 " Turkish. 119. 
 Champaigne, 75. 
 Chapel, head-quarters, 26. 
 
 " hospital, proposed, 65. 
 Chicory, 110, 205. 
 Chlorine, 44, 63, 170, 172, 173, 
 
 181, 185.. 190, 203. 
 Chloroform, 104, 105, 106. 
 Chocolate, 68. 
 
 Cholera. 10, 11, 27, 43, 121, 123. 
 124, 125, 126, 127, 128, 
 129, 145, 180, 244. 
 
 " English loss by, 197. 
 
 u propagation of, 131. 
 
 " symptoms, 134. 
 
 " theories, 129. 
 
 " treatment, 130, 131. 
 
 " unlike typhus in attack, 175. 
 Cleanliness, 123. 
 
 " English, 45. 
 Climate of Crimea. 25. 
 CJocheton hosp., 64. 
 Clothing, 51, 58. 
 
 Coffee, 38, 59. 
 
 Cold, action of. in inflammation, 
 
 84, 85. 
 Communications, friendly, 17, 18, 
 
 23, 195. 
 
 Compresses, 68, 78. 
 Condiments, 60. 
 
 Conservative work of nature, 99. 
 Constantinople camps, 43, 162. 
 " citizens escape typhus, 
 
 201. 
 
 " convalescent depot, 164. 
 
 ' hospitals, 28, 32, 43, 45, 
 
 71, 72, 107, 118, 119, 
 
 131,134, 138, 170, 174, 
 
 203, 204, 205. 213. 214, 
 
 218, 227, 22a 235^ 249. 
 
 " resources at, 28, 29, 35, 
 
 171. 
 " sanitary condition, 56, 
 
 164, 180, 188, 228. 
 " school of medicine, 111, 
 
 202. 
 
 " scurvy in, 199. 
 " sick sent to, 28, 63, 112, 
 115, 119, 132. 137, 144, 
 161, 162, 241, 242. 
 " surgery, 90, 91, 100. 
 " typhus, 165. 166. 167, 168, 
 172, 176, 178.' 181, 182, 
 183, 184, 188,189, 190, 
 191, 199, 201, 242, 243, 
 244. 
 Contusions, treated with ice, 
 
 86. 
 
 Convalescent depot, 28, 164. 
 " attendants, 176, 178. 
 " camps, 234, 237. 
 Cooking, 35, 36, 37. 
 Cotton for dressings, 68, 210. 
 Council of health, 187, 210, 252. 
 
 " on typhus, 172. 
 Councils, medical, 101, 102. 
 Crimeenne, garment, 51, 52, 53, 
 
 58. 
 
 Crowding, how understood, 165, 
 166. 
 
 Danube, 124, 125, 129. 
 
 " army of the. in 1829, 76. 
 
INDEX. 
 
 255 
 
 Daoud-Pacha, 118, 137, 138, 236, 
 
 237, 248. 
 
 Depot. Maslak, rules, 137, 234. 
 Descartes, steamer, 14. 
 Desiccated vegetables, 34, 35. 
 Diarrhoea, 33, 53, 58, 82, 121, ISO, 
 
 138, 139, 140, 150, 228, 231. 
 Diet drinks, 139. 
 
 " hospital, 205, 211. 
 Digestion, theory of, 34. 
 Dilatation of conical balls, 79, 
 
 80. 
 
 Disarticulation, 90, 92. 
 Discipline promotes health, 189. 
 Disinfectants, 44, 63, 173, 181. 
 Dislocations treated with ice, 86. 
 Distortions cured by use of appa- 
 ratus, 218, 219, 220, 221, 222, 
 
 223. 
 Dobrutcha, 121, 122, 123, 124, 
 
 125/127, 129, 131, 143. 
 Dolma Batche, 136, 236. 
 Drainage of camps, 49. 
 Dramatic entertainments, 195, 196. 
 Dumas on digestion, 34. 
 Duvoir, Leon, ventilation, 252. 
 Dysentery, 27, 38, 53, 139, 172, 
 
 197, 228. 
 
 Economy often pernicious, 42. 
 Edinburgh, typhus at, 155. 
 Egyptian troops. 109. 
 Electric wires, 24, 26. 
 Embarkation of troops. 134, 199. 
 English careful of soldiers, 196. 
 
 " losses by war, 197. 
 
 " sickness, bulletin of, 198. 
 Epidemics of the Crimea, 113. 
 Erysipelas, 252. 
 Eupatoria, 15, 108, 109, 121, 147, 
 
 151, 175, 233, 250. 
 Expenses of a company, monthly, 
 
 42. 
 
 Explosion of magazines, 69. 
 Extemporised dressings, 103. 
 Extraction of balls, 83. 
 
 Fatalism concerning typhus, 192. 
 Felchers, 77, 78. 
 Fetes, military, 195. 
 
 Fevers, 228. 
 
 Crimean, 141, 198. 
 intermittent, 13. 121, 141, 
 
 150. 
 
 remittent, 13, 141, 142, 150. 
 typhoid, 40, 41, 46, 56, 170, 
 
 172. 197, 229, 252.' 
 " typhus (see Typhus). 
 Field of the dead, 143. 
 Firemen, 41. 
 Fish, 33, 1531 
 Flannel girdle, 53, 58, 131, 133. 
 
 139. 
 
 Food, 29. 
 
 Fortifications built, 114. 
 Fowls, 33, 76. 
 
 Fractures, apparatus for, 90, 91, 
 92, 216, 217, 218, 219, 
 220, 221, 222, 223. 
 " ice, in treatment of, 86. 
 Franka, 120, 124, 127. 
 Freezing, 96, 97, 98, 224, 225, 226, 
 
 227, 228. 
 Fuel, 25, 26, 27, 30, 46, 56, 57, 
 
 133. 
 
 Fumigations, 110, 160, 170, 172, 
 181, 203, 239. 
 
 Gaiters, 59, 60. 
 
 Gallipolis, 12, 113, 114, 115, 116, 
 
 118, 123, l'74, 206, 250. 
 Game, 33. 
 
 Gardens, culinary, 36, 60, 62. 
 ^Gelatine of bones, 32. 
 Geology of Crimea, 14, 18, 20. 
 Grain raised by troops, 50. 
 Greaves, 54. 
 
 Grottoes as hospitals, 65. 
 Gulhane, 172, 173, 2U3, 215, 216, 
 
 217, 224, 225, 236. 
 
 Gunshot wounds, 80, 81, 82, 83, 
 84, 85, 93, 94, 215, 216, 217, 
 
 218, 219, 220, 221, 222. 
 
 Habit, Russian, 52. 
 
 Harem, hospital of, 205. 
 
 Helmet, fur, 53. 
 
 Haemorrhage checked in disrup- 
 
 ture, 87. 
 Hernias treated with ice, 86. 
 
256 
 
 INDEX. 
 
 Hildebrand on typhus, 157, 158, 
 
 161, 184. 
 
 Horses, Arabian, 195. 
 Horse-flesh, 32, 33, 240. 
 Hospital, Adrianople, 116. 
 
 " artillery park, 62. 
 
 " arrangement, 63, 64. 
 
 " attendants, 186. 
 
 " Bachistach, 205. 
 
 " Balaclava, 73. 
 
 " Balbec, 48. 
 
 " barracks for, 67, 70. 
 
 " Beaujon, 252. 
 
 " Caulidje, 136. 
 
 " Castle, 73. 
 
 " Calchi, 200. 
 
 " Constantinople (see Constan- 
 tinople). 
 
 " convalescent, 106. 
 
 " Daoud-Pacha, 118, 137, 138, 
 168, 236, 237, 247. 
 
 " Dardanelles, 12. 
 
 " diet, 68, 74, 110. 
 
 " Sardinian, 211. 
 
 " Doltna Baktche, 136, 236. 
 
 " division, 65, 66, 68. 
 
 " English, 11, 12, 70, 73, 74, 
 75, 196. 
 
 " Eupatoria, 109, 110. 
 
 11 field, 27, 28, 62, 63, 64, 65, 
 66, 67, 69, 126, 127, 135. 
 
 " frigate, 196. 
 
 " Gallipolis, 12, 115, 174, 250. 
 
 " Gulhane, 90, 137, 203, 215, 
 216, 224, 225, 236. 
 
 " Guyer, 194, 206. 
 
 " harem, 205. 
 
 ** head-quarters, 26. 
 
 " Hyeres, 194, 206. 
 
 " injured by explosion, 70 
 
 11 Jeni-Batche, 203. 
 
 " Kamiesch, 22. 
 
 " Malta, 10. 
 
 " Maltepe, 118, 119, 236, 237. 
 
 " Marseilles, 14. 
 
 " Maslak, 177, 180, 181, 187. 
 
 " military school, 138, 236, 
 237. 
 
 " movements of, 68, 69, 70. 
 
 " Navy office, 203, 205. 
 
 j Hospital, overcrowding perilous, 
 108. 
 " Parade-ground, 138, 219, 
 
 220, 221, 222, 223, 236, 
 
 237. 
 
 " Pera, 143, 144, 236. 
 " Piedmontese, 76. 
 " Pirea, 206. 
 " Prinkipo, 199, 200, 248. 
 " purification of, 177, 180. 
 " Ramis-Tchefflick, 137, 236, 
 
 237, 248. 
 " register, 64. 
 " Rodosto, 118. 
 " Russian embassy, 76, 111, 
 
 137, 145. 
 
 " Saint George, 74. 
 " St. Marguerite. 199. 
 tt Sardinian, 74, 75. 
 " Seraskierat, 203. 
 " Sisters of Charity, 145. 
 " series of, to France, 206, 
 
 249. 
 
 " Smyrna, 11. 
 " supplies to, 68. 
 j " tents for, 48, 67, 70, 127, 
 
 128. 
 " trenches, of the, 64, 65, 66, 
 
 69. 
 " Turkish, 109, 110, 147, 203, 
 
 204, 205. 
 
 " University, 137, 236. 
 " Val-de-Grace, 40. 
 " Varna, 121. 
 " Vincennes, 252. 
 " Visited, 174. 
 " washing for, 68. 
 " gangrene, 12, 13, 27, 43, 86, 
 
 94, 100, 145, 158, 248, 
 
 252. 
 
 " described, 94, 95. 
 " isolation required, 95. 
 " treatment, of, 95, 96. 
 Hungary fever, 155. 
 Hunter's experiments, 85. 
 Huts, 46, 56, 58, 73, 74. 
 Hygiene, ignorance of, 12, 43. 
 " precautions in, 60, 61, 64, 
 
 193. 
 " statistics of, U. S., 61. 
 
INDEX. 
 
 257 
 
 Ice on gunshot wounds, 84, 85, 86. 
 
 " theory of action of, 85. 
 Imperial Medical Society. 202. 
 Indians, survive greater injuries. 
 
 144. 
 
 Infirmaries, 62, 63, 64, 67. 
 Inflammation after wounds, 89. 
 Infusions, medical, 139. 
 Inkermann, 16, 17, 61, 73. 
 Inspection, 14, 26, 66, 111. 
 Instructions in case of epidemics, 
 
 167. 
 Jupiter, ship, 250. 
 
 Kamiesch, 14, 15, 16, 21, 22, 23, 
 
 33, 57, 192, 196, 198, 250. 
 Kearney's brigade bakery, 30. 
 Kidney beans, 36. 
 Knapsacks, 55. 
 Kustendje, 124, 125, 126. 
 
 Labor promotes health, 41, 42. 
 Laborers, English, 41. 
 
 " French, habits of, 41. 
 
 " in Algeria, 42. 
 Land, 32, 59. 
 Larrey, writings of, 103. 
 Lazarettos as hospitals, 10, 12. 
 Lemons, 60, 153. 
 
 " juice, 36, 39, 189. 
 Lentils, 36. 
 
 Letters, M. Angot to Baudens, 
 164. 
 
 " Baudens to Marshal Pelis- 
 sier, 168, 177. 189, 207. 
 
 41 to Minister of War, 27, 55, 
 174, 181, 193. 
 
 " Council of Health to Bau- 
 dens, 187. 
 
 " Intendant to Baudens, 186. 
 Liebig on digestion, 34. 
 Ligature of arteries, statistics, 
 
 214. 
 
 Lime water, 44, 62, 185. 
 Linen for dressings, 68, 209, 210. 
 Lisfranc on wounds, 82. 
 Macadamized roads, 25. 
 Macleod, Dr., 90, 106, 140, 214. 
 Magendie on varied food, 40. 
 Mahommedan indolence, 114. 
 
 Malarious influences, 142, 143. 
 Maltepe, 119, 171, 236, 237. 
 Mangalia, 123, 125, 126, 127. 
 Marcet, Dr., report, 244, 247. 
 Marching orders, Gen. Bugeaud, 
 
 132. 
 Marseilles, 14, 28, 99, 179, 183, 
 
 184, 186, 194, 201, 205. 
 Mascara expedition, 38, 135, 215. 
 Maslak, 119, 138, 145, 161, 171, 
 
 180, 181, 187, 228, 229, 235, 
 
 236, 237. 
 Mayence, fever, 155, 161 ; siege, 
 
 175. 
 
 Meals, number should be in- 
 creased, 39. 
 Meat, horse, 32, 33, 240. 
 
 " powdered, 32, 240. 
 
 " preserved, 32, 59, 240. 
 Medical education, Turkish, 201. 
 " " Russian, 77. 
 
 " society founded, 202. 
 Messina, 206, 249. 
 Mexican war statistics, 61. 
 Miasms, 15, 43, 44. 
 
 " fevers from, 141. 
 Military school hospital, 138, 236, 
 
 237. 
 Milk concentrated, 27, 68. 
 
 " fresh, on ship board, 196. 
 Mines and minerals, 153. 
 Minie balls, 78. 
 Morale of troops, 208. 
 Mutton, 32, 110, 205. 
 Mytilene, 151, 152, 153, 154, 171, 
 
 200. 
 
 Naples fever, 155. 
 Navarin, ship, 250. 
 Negligence, French soldiers, 45, 
 
 63. 
 
 Nervous prostration, 104. 
 Nightingale. Miss, 74. 
 Nitrogenous foods, 34. 
 Nostalgia, 28. 
 Nurses, female, 76, 77. 
 
 Offal, disposal of, 60. 
 Onions, 60. 
 Ortinoque, ship, 245. 
 
258 
 
 INDEX. 
 
 Parade ground, hosps., 138, 173, 
 219, 220, 221, 222, 223, 236, 
 237. 
 
 Paris, bakeries, 30. 
 
 " medical schools, 111, 147. 
 
 Patriotism, Russian, 150. 
 
 Pera, 137, 138, 143, 145, 146, 173, 
 183, 236. 
 
 Percy, quoted, 103, 184. 
 
 Perforations of foot, by balls, 94. 
 
 Periosteum generates bone, 93. 
 
 Peritonitis, 228. 
 
 Peyer's glands, diseased in ty- 
 phoid, 232. 
 
 Pharmaceutical department, 138. 
 
 Philadelphia, typhus at, 155. 
 
 Phthisis pulmonalis, 41, 205. 
 
 Physicians (see Surgeons). 
 
 Piedmontese, 19, "20, 46, 76, 21]. 
 
 Pirates, haunts of, 20. 
 
 Pits for huts, 14, 15, 46, 47, 56, 
 57. 
 
 Plague, 1792, 174. 
 1829, 76. 
 
 Pleurisy, 262. 
 
 Pneumonia, 53, 150. 
 
 Police, 25, 146. 
 
 Policnity, 153. 
 
 Poucharra arms, 79. 
 
 Port-Vendres, sick at, 179. 
 
 Posen, typhus at, 155. 
 
 Potatoes, 33, 50, 60 75, 153. 
 
 Preparations for sickness, 1 68. 
 
 Preserved vegetables, 27, 33, 34. 
 
 Prinkipo, Island, 187, 199, 200, 
 248, 249. 
 
 Proximate principles, 34. 
 
 Puddings, 74. 
 
 Quarantine, 194, 200, 205, 249. 
 Quarries, 23. 
 
 Quindros thermal spring, 152, 153. 
 Quinine, use of, 142. 
 
 Radishes, 60. 
 
 Ramis-Tchifflick, 118, 171, 174, 
 
 236, 237, 248. 
 Rations, hospital, 211. 
 
 " English, 39. 
 
 " French, 29, 39, 41, 145. 
 
 Records, statistical, 164. 
 
 Regimental fund, 30. 
 
 Resection, 92, 93, 94, 213, 214, 
 
 215. 
 
 Resources of the Crimea, 25. 
 Return of army, 195, 205, 249. 
 Rewards for preserving horses, 37, 
 
 50, 59, 68. 
 Rheumatism, 46, 47. 
 Rice, 205. 
 Rifled arms, 79, 80. 
 Rifles, Russian, 79. 
 Rum, 75. 
 Russian embassy, 145. 
 
 " prisoners, vitality of, 144. 
 
 Sac formed around balls, 83. 
 
 St. Cloud barracks, 252. 
 
 St. George, monastery, 14, 21, 28, 
 
 73, 198Y 
 
 St. Omer, sickness at, 37, 41. 
 Sanitary condition, 56, 189. 
 Sardinian hospitals, 75, 211. 
 
 " troops, 20, 195. 
 Sausage, 32. 
 
 Scarcity produces sickness, 40. 
 Scenery, Sebastopol, 106. 
 School of Medicine, Turkish, 201. 
 Scorbutic taint, 140, 150, 170. 
 Scrive, M., 71, 102, 106, 161, 162, 
 
 163, 179, 199, 242. 
 Scultet, apparatus of, 222, 223. 
 Scurvy, 13, 20, 27, 35, 40, 41, 47, 
 50, 56, 60, 76, 109, 146, 
 148, 149, 158, 180, 199, 
 200, 228, 248. 
 causes, 148. 
 epidemic, 150, 
 English army, 150. 
 Russian army exempt, 150. 
 symptoms, 148. 
 " treatment, 150, 151. 
 " Turkish army, 151. 
 Scutari, 80, 116, 143, 203, 204. 
 Sheepskin garments, 53, 54. 
 Shells, wounds by, 86, 88. 
 Shelters, 56. 
 Shelter-tents, 45, 47, 59, 135, 198, 
 
 239, 251. 
 Shirts, woollen, 53, 54, 59. 
 
INDEX. 
 
 259 
 
 Shoes, 54, 133. 
 
 Sicily, hospital prohibited, 206. 
 
 Sickness, aggregate French, 207. 
 
 Sidi-Ferruck, wounds at, 81. 
 
 Silistria, 115, 122, 129. 
 
 Sisters of Charity, 10, 76, 145, 149, 
 
 186, 229. 
 Sisterhood of St. Vincent de Paul, 
 
 183. 
 
 Skeletons of the slain, 17. 
 Soil of Crimea, 14, 15. 
 Soldier-dressers, 71, 72, 76. 
 Soldiers, careless of health, 121. 
 Soup, 40, 58, 60. 
 Sour-krout, 36, 60. 
 Spencer, English, 53. 
 Splinters of bone, 82, 92, 316, 217. 
 
 218, 219, 222. 
 
 Staoueli, gunshot wounds at, 81. 
 Stockings, woollen, 54, 59, 60. 
 Strasbourg, typhus at. 155. 
 Students, Turkish, 201. 
 Surgeons, allowances to, 187. 
 " assistants, 72, 73, 76, 77, 
 
 110, 186. 
 
 " badges of, 18, 73. 
 " devotion of, 9, -71, 100, 
 
 101, 171, 176, 207. 
 1 died of typhus, 182, 233. 
 " discussions among, 101, 
 
 102. 
 " division hospitals, 66, 69, 
 
 70. 
 " duties of various grades, 
 
 67. 
 
 " English, 73, 74, 106 
 " funerals of, 183. 
 " grades, French, 71, 72, 77. 
 " losses of, 179, 182, 188, 
 
 193. 
 
 " military, 66, 67, 186. 
 " pensions not allowed, 183. 
 " promptness necessary, 
 
 103. 
 
 " qualifications of, 102, 103. 
 " quartered in hospitals, 70, 
 
 71. 
 
 " Russian, 77, 78. 
 " Sardinian, 106. 
 " Turkish, 201, 202. 
 
 Surgeons, wounded, 18. 
 
 Sultan, 116, 118, 143, 146, 147, 
 
 148. 
 
 " attends a ball, 146. 
 " endows a medical society, 
 
 202. 
 Surgical operations, 78. 
 
 Tchernala, 14, 16, 17, 18, 19, 20, 
 
 25, 44, 69, 163, 195, 198. 
 Tea, 11, 38, 74. 
 Tenedos, associations of, 12. 
 Tents, conical, 59, 147. 
 
 " Crimean, 47. 
 
 " hospital, 48. 
 
 " marquee, or wall, 48. 
 
 " shelter, or " Tente-abris." 
 (see Shelter-Tent.) 
 
 " ventilation of, 44. 
 
 " winter use bad, 169. 
 Terrassacum, plant, 35. 
 Thiery, method of washing, 136. 
 Thouvenin arms, 79. 
 Tige rifle, 79, 80. 
 Tlemcen, expedition of, 38. 
 Tolerance of Turks, 138. 
 Topography of Crimea, 10, 14, 20. 
 Torgau, typhus of, 161. 
 Tornado, 15. 
 Toulon, sick at, 155, 179, 183, 186, 
 
 193, 201, 205. 
 Trajan, camp of, 124. 
 Tunic, 52, 53. 
 Turbot, buckle. 83. 
 Turks, ablutions of, 45. 
 Typhic condition, 229. 
 Typhus, 15, 20, 27, 35, 40, 43, 47, 
 71, 74, 76, 138, 140, 
 145, 155, 174, 248, 249. 
 " alarm in south of France, 
 
 205. 
 
 " Calchi, 245. 
 ' Constantinople, 229, 230, 
 
 231, 232, 233. 
 
 " compared with cholera, 175. 
 " convalescence, 159, 232. 
 " course indefinite, 157. 
 " decline of, 207. 
 " differs from typhoid fever, 
 
 232, 233. 
 
260 
 
 INDEX. 
 
 Typhus, disencumberment, 177, 
 
 180, 181, 187, 190, 201. 
 " English', 196, 198. 
 " history and origin, 155, 156, 
 
 238. 
 
 " limited to hospitals, 179. 
 " Marseilles, 194. 
 " not to be sent off, 184, 242. 
 " nurses die of, 183. 
 " officers escape, 171. 
 " premonitions of, 158, 238, 
 
 246. 
 " prevention, 167, 172, 174, 
 
 238. 
 " progress of, 157, 158, 159, 
 
 165, 166, 168, 171, 177, 
 
 181, 184, 186, 189, 190, 
 
 191, 199, 242. 
 " removal of causes, 192. 
 " reports on, 177, 237, 243, 
 
 244, 245. 
 
 " should be kept in the Cri- 
 mea. 177, 186, 188. 
 " sent to' France, 183, 
 " sent to camp, 182. 
 11 ship-board, 184, 192, 194, 
 
 200, 201, 246, 247, 250. 
 " surgeons die of, 171, 182, 
 
 183. 
 " symptoms, 155-158, 230, 
 
 231, 238, 246, 247. 
 " synonyms, 155. 
 " treatment of, 160, 191, 
 
 247. 
 
 Undeveloped disease, 140. 
 University hospital, 236. 
 Utah, troops in, 35, 48. 
 
 Val-de-Grace, 86, 103, 124. 
 Varna, 26, 57, 109, 116, 117, 118, 
 
 120, 122, 124, 125, 126, 127, 
 
 128, 151, 180. 
 Vegetables, fresh, 35, 50, 60, 
 
 241. 
 
 Ventilation, necessity proved, 251. 
 " of camps, 44, 47, 49, 56, 
 57, 160, 185, 190, 239. 
 Vincennes mil. hosp., 252. 
 
 Washing, 68, 138, 173, 204, 209, 
 
 210. 
 Wind of Crimea, 15, 25, 44. 
 
 " of a ball (so called), 88. 
 Wine, 11, 37, 74, 115, 139, 153, 
 
 181, 212. 
 
 Winter quarters, 26, 29. 
 Wooden shoes, 54, 59. 
 Woollen under clothing, 53, 54, 
 
 59. 
 Wounds, battle of Alma, 135. 
 
 " Inkermann, 16. 
 " Traktir, 19. 
 siege, 24, 65, 66, 68, 69. 
 shell, 80, 81, 86. 
 gunshot, 80. 
 Wr nging machine, 204. 
 
 Zouaves, costume of, 52, 118. 
 
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