Napoleon’s wrong foot: Military doctors in the 19th century

May 25
Culture

The French invasion of Russia, known in Russia as the Patriotic War of 1812, has long been enveloped in a romantic flair created by literature, art and cinema. Because of that, it often escapes notice that it was also the most bloody armed conflict of the 19th century.

It was a time when only the first steps were being taken to provide medical care on the battlefield. Most gunshot wounds resulted in infection, and one of the main treatments was amputation. The widespread introduction of antiseptics in international medical practice did not happen for another half a century, and armies suffered far more losses from sanitary problems than from military casualties. Battlefield doctors, whose names generally remain unfamiliar to most people, had to make great efforts to save lives.

Shortly before being temporary closed, the Battle of Borodino Panorama Museum prepared an exhibition on Military Medicine at the Beginning of the 19th Century. You can visit it after the coronavirus restrictions are lifted. In the meantime, the main exhibits can be viewed online – courtesy of mos.ru and the Mosgortur tour agency.

The father of the ambulance

A major innovation in battlefield medicine, the army ambulance corps system, is credited to France. Dominique Jean Larrey, chief surgeon at Napoleon's Grande Armée (1766-1842), proposed the idea of ‘flying ambulances’ for rapid evacuation of the wounded in light two-wheeled carriages. Before that, they were not picked up until after the battle was over, and they were taken to an infirmary in heavy vans after 24 hours at best. Larrey’s invention helped save many lives, and he was proclaimed the father of the ambulance.

Dominique Jean Larrey. From an album of drawings of uniforms in the Napoleonic army. Early 20th century

An outstanding doctor, he also introduced the concept of triage (French for sorting) whereby the injured are treated based on the severity of their wounds. This prioritisation method is still used today – patients who need emergency care; urgent patients; and non-urgent cases. Prior to that, officers and lightly wounded soldiers enjoyed priority – to be able to return to the fighting sooner.

In addition to military medical system reform, Larrey was also a practicing surgeon. In the Battle of Borodino, he reportedly performed 200 amputations in 24 hours, meaning he spent on average a little more than seven minutes on each.

Faithful to the Hippocratic Oath, he treated others besides the French. Once, after Napoleon’s army entered Vitebsk, Larrey reportedly found about 350 wounded Russian soldiers and helped them without bias.

A Scotsman in Russian service

The foundations of battlefield medicine in Russia were laid by Yakov Willie (1768–1854), or James Willie, which was his name in his native Scotland. He joined the Russian service in 1790 and quickly made a great career for himself, which became prominent after he removed a bullet from one of Suvorov’s Aide-de-Camps’ lumbar vertebra during the Polish campaign of 1794.

Yakov Willie. Lithography. Mid-19th century

Willie reached heights that most doctors in Russia could only have dreamed of: he was Court Surgeon for three Russian Emperors (Paul I, Alexander I and Nicholas I), President of the Imperial Medical and Surgical Academy, director of the Medical Department of the War Ministry and Main Medical Inspector of the Russian Army. As president of the Academy for three decades, Willie made a huge contribution to creating the Russian school of military surgery. As the chief physician at the War Ministry, he developed the concept of medical army service and implemented it.

Willie established the required kits of surgical tools all Russian army units were subsequently supplied with. The battalion kit included nine of the most necessary items: needles of various configurations, forceps, a lancet, a catheter, and large and small saws and knives for amputation. The regimental kit contained as many as 24 tools, and the corps kit, 106.

Amputation toolkit. Early 20th century

It is impossible to estimate how many lives were saved thanks to Willie’s pocket handbook, as its scope went beyond battlefield medicine. The compact book provided guidelines on 33 of the most common surgical operations at that time, including obstetric care. It included sections on the treatment of firearms or cold steel wounds, and was considered the first Russian guide on battlefield surgery. Willie was also the publisher of medical periodicals; the Military Medical Journal he founded in 1823 is still active.

The military hospital system invented by Willie deserves special mention because there was nothing comparable in the world during the Patriotic War of 1812. First aid was provided to the wounded at dressing stations located in shelters around the perimeter of a battlefield. Then orderlies, mostly local militias, delivered those who couldn’t move to three distribution hospitals (one at the centre and two on the flanks). Here urgent operations were carried out and patients were sorted – they were distributed among mobile hospitals located 10-15 kilometres away from the battlefield. In addition, there were hospitals in larger towns.

French and Russian military hospital in Marienburg. Engraving. 1838-1841

As many as 70 mobile hospitals were deployed during the war; over the three days of the Battle of Borodino, 19,500 wounded Russian soldiers and officers were evacuated from the battlefield. The system comprised three lines of hospitals. The first line included infirmaries where the wounded were kept for no more than a day; second line hospitals provided care for up to a month, and the most severe cases went to the third level.

Willie was more than an organiser and a theorist. Like his French counterpart Larrey, the head of the Russian medical service personally performed about 200 surgeries at Borodino. He examined the wounded General Bagration in the middle of a battle. Willie operated on many military leaders: the Marquess of Londonderry and Marshal Vendome in the Battle of Kulm, Field Marshal Radetzky near Leipzig, Field Marshal von Wrede near Tanau, and General Moreau near Dresden.

A staunch advocate of Latin

Another Russified foreigner, the Prussian physician Justus Christian Loder, known in Russia as Khristian Ivanovich, who greatly contributed to the development of medicine, also made a contribution to the Russian language – the Russian word for loiterer is associated with him.

Christian Loder. Engraving on copper. 1801

In 1828, Dr Loder, with a partner, opened an  artifitial mineral waters institution on Ostozhenka. One of the therapies prescribed to his wealthy clients was therapeutic walking. To poorer people, this pastime looked like empty fun, and when cabmen waiting outside were asked what their patrons were doing, walking back and forth in the park for hours, they said they were “chasing Lodyr,” distorting the foreign doctor’s name. So to this day, people in Russia call a lounging idler lodyr, not knowing anything about its etymology or the person related to the term.

A friend of the poet Goethe and the geographer Humboldt, Loder came to Russia as a medical luminary. Before the war, he had a private practice and the title, Court Physician. When the war broke out, the prominent foreign physician was entrusted with a Moscow hospital with 6,000 officer beds and 30,000 beds for enlisted men. As the enemy approached, he also had to manage the evacuation of the infirmary and the deployment of new hospitals in Kasimov, Melenki and Elatma – in the Ryazan direction along which Kutuzov’s army was retreating.

After the war, Loder’s renown continued to grow. He created an anatomical theatre in Moscow, where operations on corpses were performed for medical students. Loder’s anatomical theatre was considered the best in Europe. An honorary member of Moscow University, the court physician held a special position and did not have to report to the university board about his teaching methods. For example, he lectured exclusively in Latin, ignoring the requirements of the dean of the department of medicine to use Russian – a language more familiar to Moscow students in the 19th century. In 1826, the rebellious Loder developed a project for restructuring the department and managed to have it implemented. He quit teaching in 1831 due to poor health, donating his collection of drugs and tools to the university.

The wounds of Napoleon and Bagration

The wounds of military leaders were often reflected in art. One example is Claude Gautherot's Napoleon Wounded before Ratisbonne, a painting that later became widely known from the many lithographs. Ratisbonne is the French name for the Bavarian Regensburg, the city it took Napoleon’s army five days to capture in April 1809. At the same time, Bonaparte suffered a minor wound when a bullet hit his left foot.

Napoleon Wounded before Ratisbonne on April 23, 1809. Claude Gautherot. 1809

His boot was cut open, and the wound was examined and bandaged; the boot was laced back up, and the Emperor immediately mounted his horse. Before the battle, the Emperor always said that if he was wounded, that this should be kept secret. “It would be impossible to calculate the confusion and disorder that might ensue from the slightest report or smallest doubt as to my existence,” Bonaparte said, as quoted in the Memoirs of his private secretary, Claude-Francois de Meneval.

Gautherot actually depicted the moment that Napoleon’s wound was being dressed, but he made a mistake in painting the bandages on his right foot instead of his left.

One of the crucial moments in the Battle of Borodino was the injury of Prince Pyotr Bagration whose soldiers had been keeping the enemy off the fleches of Semyonovskoye (military berms) for a long time. That moment is depicted in Peter von Hess’s famous The Battle of Borodino.

The Battle of Borodino on August 26, 1812. Reproduction of painting by Peter von Hess. Second half of the 19th century

Historians continue to question why a serious yet non-lethal shrapnel wound in the leg would lead to the commander’s death. The prevailing opinion is that Bagration could have been saved by an amputation performed within 48 hours of the injury. However, the surgery was impossible to perform because the Russian army was retreating to avoid capture, and invaluable time was lost.

Prince Pyotr Bagration died of gangrene 17 days after being wounded. He refused amputation twice, and he had his reasons. While French surgeons relied on amputation, Russian doctors sometimes managed to avoid it. Bagration knew doctors had been able to keep Barclay de Tolly’s right arm after he was seriously wounded at Preussisch-Eylau in 1807. He rested for 15 months after that, and over 40 bone fragments of various sizes were removed from his wounded arm over that time.

Cripples with general’s regalia

Conservative treatment for injuries to the extremities was rare. Each major battle, especially involving artillery, left a lot of people crippled regardless of rank and title. Two exhibits are reminders that amputees were not uncommon even among Russian generals.

The painting by an unknown 19th century artist depicts one of the heroes of that time, horse artillery commander Ivan Arnoldi, who lost his leg in the battle of Leipzig in 1813. The description of his feat in the Military Encyclopaedia of the beginning of the 20th century will cause even the most jaded reader to become emotional. Sensitive readers may wish to stop here.

Portrait of Ivan Arnoldi. Unknown artist. Mid-19th century

“Wounded around noon by a bullet in the calf of his left leg, he didn’t leave the frontline for treatment. He continued to command with the bullet in his leg... drove the enemy all the way to Leipzig, where Arnoldi’s wounded leg was blown off, but he remained on his mount for another quarter hour, after which he crawled down and continued to command as he laid near a right-flank gun.”

After the critical medical treatment, he remained in active duty for another 40 years and was eventually promoted to General of the Artillery.

The founder of the famous military dynasty Ivan Skobelev had an incredible military career, promoted from a simple soldier to General of the Infantry. He lost his left arm fighting the Poles in the Battle of Minsk Mazowiecki in 1831. This injury was depicted on chromolithography: Lieutenant General Skobelev sitting on a drum during the amputation of a limb crushed by a cannon ball. One can see on the print that the general’s right hand was also maimed – in 1809, two of his fingers were torn off and a third crushed in the Battle of Kuortane against the Swedes.

Lieutenant General Ivan Skobelev. Chromolithograph. 1851

Images provided by the Battle of Borodino Panorama Museum

Source: mos.ru

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