SANITARY ASSOCIATIONS DURING THE
FRANCO-GERMAN WAR
OF 1870-1871.
VOL. I

GENERAL APPEARANCE OF THE AMERICAN AMBULANCE

HISTORY
OF
THE AMERICAN.
AMBULANCE

ESTABLISHED IN
PARIS DURING
THE
SIEGE
OF
1870-71,
TOGETHER
WITH THE
DETAILS OF
ITS METHODS
AND ITS WORK

BY

THOMAS W. EVANS,
M.D., D.D.S., Ph.D.
PRESIDENT OF THE AMERICAN
INTERNATIONAL SANITARY
COMMITTEE, COMMANDER
OF THE LEGION OF HONOUR, GRAND -
CROIX OF THE ORDER OF
ST. STANISLAS OF RUSSIA, AND
COMMANDER, OFFICER,
AND MEMBER OF VARIOUS ORDERS

Author of "La Commission Sanitaire des États Unis---son Origine, son Organisation, et ses Résultats,"
"Les Institutions Sanitaires pendant le Conflit Austro-Prussien-Italien,"
"The History and Description of an Ambulance Waggon,"
&c., c., c

LONDON:
PRINTED FOR THE AUTHOR AT
THE CHISWICK PRESS,
AND
PUBLISHED
BY
SAMPSON LOW,
MARSTON, LOW.
AND SEARLE,
CROWN
BUILDINGS,
FLEET
STREET

1873

[All rights reserved.]

Entered according to Act of Congress in the year 1873, in the Clerk's Office of the District Court of New York

 

AMERICAN INTERNATIONAL SANITARY
COMMITTEE OF PARIS.

THOMAS W. EVANS, M.D.---President.
EDWARD A. CRANE, M.D.---Secretary.
COL. JAMES MCKAYE.
ALBERT LEE WARD.
JAMES W. TUCKER.

 

PREFACE

RANCE and Prussia had signed the Treaty of Geneva in 1864. During the two years that followed, this treaty, for the amelioration of the condition of wounded soldiers, had been accepted by nearly all the Governments of Europe, and national relief societies had been organized in each State in accordance with its terms

The Austro-Prussian War of 1866 afforded to several of these societies the first opportunity for active work. The character and value of the services rendered to sick and wounded soldiers by voluntary associations during that war, I have myself endeavoured to show in a work entitled "Sanitary Institutions during the Austro-Prussian Conflict." The experience gained during the war of 1866 was moreover of great service to the voluntary societies. The field within which their action might be beneficial was more clearly marked out, and their position as institutions of public utility definitively established. In certain States the organization of the societies was modified and improved---in all it was invigorated and strengthened

The great war of 1870-71 was a fearful contest between the two wealthy and powerful nations which had first given in their adhesion to the Treaty of Geneva, and in which the principle of creating popular aid for the wounded in war had been most generally accepted, and the organization of the relief societies was most complete. The circumstances under which the action of these societies was then tested were not only rich in opportunities of usefulness, but seemed to offer the most favourable conditions for the practice of voluntary relief in behalf of the victims of battle-fields. During the war the popular sympathy for the wounded was intense, and the liveliest interest was taken in the movements and operations of the French and German societies. Since the close of the war the friends of charity and beneficence in every quarter of the world have been anxious to learn, to the fullest extent, the character of their services and the practical results of their labours

Conscious, therefore, of the desirableness as well as the utility of assembling the facts concerning the action of the volunteer relief societies during this war, so classified that they might be easily compared, and so presented that they might clearly teach the lessons to be derived from them, I proposed before the close of the war to prepare a full and complete history of the labours of these societies. Such a work, however, could not be written until data covering a very wide field of operations had been collected, nor before the reports of the principal associations had been made public. The difficulties in the way of obtaining from official sources the necessary information have made it impossible for me to finish this work within the time originally proposed

While, however, the relief societies founded upon the Treaty of Geneva were national in their organization, as also in their more immediate and specific purposes, they were the representatives of a common cause, and were closely affiliated in action as well as in sympathy

The Franco-German War of 1870-71, in opening out a vast and comparatively new field for organized patriotic benevolence, offered also the first great occasion for the exercise of international sympathy and assistance. The occasion was not unheeded. If armies were never before more abundantly supplied by national voluntary effort---never before in human history have belligerents received from foreign and neutral States such generous aid. The action of the French and German societies for battle-field relief was largely sustained by foreign contributions, and the sufferings incident to the war assuaged by the liberalities of aliens. Foreign charities, however, were generally distributed through local organizations, and lost their national character in the process of distribution

The American International Sanitary Committee of Paris was formed almost immediately after the declaration of war in 1870, for the purpose of being a direct agent of American charity in behalf of the victims of the war. It was, moreover, the only foreign association created for the general succour of the wounded that succeeded in preserving throughout the war, on belligerent territory, a complete independence in the direction of its operations and in the immediate distribution of its assistance. The committee began its labours by organizing an ambulance, or field hospital, at Paris

Few organizations for the relief of the wounded during the late war, acquired a more noble celebrity than the American ambulance. As an expression of international goodwill, it at the time secured for itself the gratitude of the French people. As an expression of earnest personal effort, of the courage and generous devotion of compatriots, it cannot soon be forgotten by Americans. As an expression of modern sanitary science, however, it has been chiefly valued, and probably will be longest remembered, by all.(1) Its mission was significant-its work was one of usefulness. To commemorate, therefore, the services of those who laboured in the American ambulance, or contributed to its success, and to preserve a record of its acts and methods, are duties equally imposed

This volume contains the history of that ambulance

It was my original intention to publish it together with, and as a part of, my general history of voluntary effort in behalf of the sick and wounded during the late war. The causes mentioned have held in abeyance the publication of that work. But as most of the material which appears in this volume has been a long time ready for the press, it has not seemed to me expedient to retain it any longer. I accordingly now issue the "History of the American Ambulance," complete, in a single volume, which will form also the first volume of my general history of "Sanitary Associations during the Franco-German War of 1870-1871."

I have endeavoured to present in it a clear statement of the purposes of the American International Sanitary Committee, of the difficulties they encountered, of the labours they accomplished, and of the successes which finally crowned their undertaking. The admirable reports of the gentlemen who were especially entrusted with the administrative and executive work of the Committee---treating upon those subjects which are more particularly scientific and technical---complete the history of the ambulance

The report prepared by Dr. Edward A. Crane is an exhaustive essay in which the writer has not only stated the essential facts connected with the material organization of the American ambulance, but has discussed at length the principles in accordance with which army hospitals have been, and should be, established, and the general character and qualities of temporary and portable shelter

The surgical and medical histories of the ambulance will be read, I believe, with great interest by that portion of the public to which they are now more particularly addressed. Dr. Swinburne's cases are fully and concisely stated, as are also the peculiar difficulties under which he contended while treating them. Dr. Johnson's report, if brief, is nevertheless instructive

In presenting this volume to the world I shall solicit a generous criticism not only in my own behalf, but in behalf of those who have laboured with me in its preparation. Verbal errors, and mistakes even in fact, may doubtless be found. These, as every one knows, are more or less unavoidable, especially in a work, parts of which have been edited for absent writers, and all of which has been hurried through the press in the midst of numerous personal pre-occupations. I believe, however, that while the special subject of the volume may commend it to the favour of many, the facts it presents in connection with the general history of army hospitals will render it a valuable contribution to the medico-military literature of the day

THOMAS W. EVANS.

PARIS,
Avenue de l'Impératrice, No. 41.
July 11th, 1873.

 

GENERAL SUBJECT HEADINGS

I.       AN ACCOUNT OF THE FORMATION OF THE AMERICAN INTERNATIONAL SANITARY COMMITTEE OF PARIS, TOGETHER WITH THE HISTORY OF THE AMERICAN AMBULANCE

II.      ON THE ESTABLISHMENT OF ARMY HOSPITALS

III.     ON TENTS AND TENT-BARRACKS

IV.     ON THE SPECIAL ORGANIZATION OF THE AMERICAN AMBULANCE

V.      ON THE SURGICAL HISTORY OF THE AMERICAN AMBULANCE

VI.     ON THE MEDICAL HISTORY OF THE AMERICAN AMBULANCE

VII.   APPENDIX

 

CONTENTS

AN ACCOUNT OF THE FORMATION OF THE AMERICAN INTERNATIONAL SANITARY COMMITTEE OF PARIS
TOGETHER WITH THE HISTORY OF THE AMERICAN AMBULANCE

MOTIVE for issuing a call for a meeting of American citizens resident in Paris on the 18th of July, 1870
A statement of the object of the meeting
Resolution passed, committee appointed, appeal to citizens of the United States
Letters of the secretary to the president of the "American Association for the Relief of the Misery of Battlefields"
Letter received in reply by the secretary
Purport of this letter---remarkable for certain misconceptions
Reply of Dr. Elisha Harris to a letter addressed to him by the committee
Prompt and generous action of the United States Government contrasted with the indifference of the American Association
Efforts of the committee to obtain funds and carry, out its programme
Attempt made to organize a "Ladies' Branch Committee"
The work undertaken by the committee gradually assumes a definite form
Faults of the French ambulance system
The committee determines to retain its independence and to find a suitable locality for the establishment of its hospital
Not easy to find such a locality
Discussion of the question, "Shall we go or shall we stay?"
The question put to a vote
Opinion thereon of Col. James McKaye
The divergence of opinion how settled
The committee proceed to the organization of an ambulance in Paris
The 4th of September
The Empress finds a temporary refuge in the house of the president of the committee, who subsequently conducts Her Majesty to England
Effect upon the committee of the sudden and unexplained absence of both president and secretary
Scandalous imputations as to the motives of the president's mysterious departure
Action of the committee restored to its former vigour
A long absence from Paris not anticipated by the president
Causes which rendered such an absence finally necessary
Unavailing efforts made by the president to guarantee the Paris ambulance against any crippling of its energies through lack of funds
Resolutions passed by the Paris committee in the attempt to enlist the sympathy of their countrymen in their work
Letter from the secretary to Dr. Elisha Harris
Straitened pecuniary circumstances of the committee
Letter addressed by Dr. Elisha Harris to the president
Appeal prepared for publication in the American press
Pecuniary history of the American ambulance
Certain characteristics of the ambulance
Gratuitous character of the services rendered
Visitors at the ambulance
One of the most eminently popular of the properties of the American ambulance
Patients treated with a success which rendered evident the superiority of the system pursued
Aim which the organizers of the ambulance had mainly in view completely attained
What was said of the ambulance corps by the " Electeur Libre"
What was said of the ambulance corps by "Le Réveil"
What was said of the ambulance corps by " L'Univers"
The ambulance the subject of a special notice
The ambulance gives the best results in the curing of wounds
The ambulance the object of numerous official visits
The Archbishop of Paris visits the ambulance
The ambulance as described by the "Constitutionnel"
"A Visit to the American Ambulance," from the "Official Journal" of the French Republic
"Le National" gives its opinion of the American ambulance
"La Liberté" pronounces everything to have been in the most perfect order
M. Gustave Lafarge writes about "L'Ambulance américaine"
Fifty or one hundred encampments after the manner of the American ambulance advised by "La Défense Nationale"
"That ambulance where the fewest wounded die."---"La Patrie"
The general value of medical and scientific notices in popular French journals
The opinions of the physicians and surgeons of Paris
What M. Francisque Sarcey writes about the American ambulance
What Dr. Dusart says about the ambulance
What the "Gazette Médicale" reports of the prompt and efficient services of the corps of aids-volunteer
What Dr. de Ranse thought of the ambulance
How the "Union Médicale" speaks of the ambulance
The opinion of M. Gustave Monsnereau
Why the American ambulance merits the special attention of the public and of the press, as stated by the "Gazette Hebdomadaire de Médecine et de Chirurgie"
Opinions of M. Nélaton and Baron Larrey
The committee greatly indebted to the medical gentlemen of Paris for constant kindly encouragement
The system employed for heating the tents attracts great attention
Paper prepared by M. Charles Joly upon the subjet
Communication thereon addressed to the secretary by M. Delpierre
Plans and sketches of all the details prepared by General Morin for the "Conservatoire des Arts et Métiers "
An account of the waggons used by the transport corps of the ambulance
The model subsequently adopted by the French Société de Secours aux Blessés
The French Government adopts the stretcher used by the transport corps of the ambulance
The American ambulance largely instrumental in popularizing the use of oakum as a substitute for charpie
General Wolf, the Intendant-General of the Army of the Defence, recognizes the services rendered by the American ambulance
The letter addressed to the committee by Alfred Doucet
An article which appeared in "La Vérité"
Honours conferred by the French Government upon persons for services rendered at the American ambulance
The committee under great obligations to the Government for the uniform kindness and courtesy of all its agents
The success of the ambulance largely owing to the personal interest taken in the work by each member of the corps
The services rendered by the members of the committee
Dr. Swinburne and his surgical staff
Of the captains of the squads for the transport service---Mr. Joseph K. Riggs
M. Ranzi
M. Rillet, Messrs. Gunther and Dreyer, and Majors Hutton and O'Flinn
Of the ladies who served in the ambulance
Miss Bewick, Mrs. McFarlane, Mrs. Koch, Miss Chandon, the Marquise de Bethisy, Mrs. Conklin and the Misses Castri
A remarkable fact concerning all these ladies
Letter addressed to the Queen of Prussia
Letter received in reply from Her Majesty
Communication from the Central Committee for the care of the wounded of the German Army
Visit of the president to the seat of military operations in Eastern France
Organization of the "Society for Clothing the French Prisoners"
The labours of the president in this special field only a part of the general work upon which the American International Sanitary- Committee originally proposed to enter

 

REPORT ON THE ORGANIZATION OF THE AMERICAN AMBULANCE

PART I

ON THE ESTABLISHMENT OF ARMY HOSPITALS

LETTER to Dr. Thomas W. Evans
Silence of the most ancient records with regard to the care extended to the sick and wounded of armies
The earliest allusions to army surgeons in Greek writings
Statement of Herodotus (note)
Silence of Greek writers concerning measures to succour the wounded. Statement of Diodorus Siculus (note)
Equal silence of Latin writers upon the same subject
Subjects which have usually not interested historical writers, modern as well as ancient (note)
Passages cited to show that care was sometimes given to the sick and wounded in Roman armies
Official position of the Medici in the military hierarchy (note)
Popular charity among the Romans in behalf of the victims of war; instances in which it is said to have been exhibited
A remarkable example of voluntary effort in behalf of the wounded
Claims of sick and wounded soldiers upon the State practically unrecognized
Hospitals of all kinds unknown to the Romans
A passage in Velleius Paterculus (note)
Sickness rates in Greek and Roman armies; reasons why they may have been low
An ingenious suggestion (note)
The slaughter on ancient battle-fields. Character of the wounds received in battle
Reasons why an ambulance service was less needed in ancient than in modern times
Physicians and surgeons under the Byzantine Empire
No mention made of hospitals before the eleventh century
Care of the sick among the ancient Hindoos (note)
Xenodochia
Primary object of the establishment of hospitals in Europe
Hospitals for the sick
Special hospitals for the sick and wounded during the crusades
Care taken of the sick poor in the middle ages (note)
Hospitals without physicians---maintained by the clergy as a source of revenue and profit
Scandals arising from the mismanagement of these institutions
Le droit d'oblat
The beneficence of the middle ages
Measures adopted during the middle ages to secure immediate assistance for those wounded in battle
The armies of the crusaders unattended by physicians and surgeons
The practice of surgery held in general disrepute
Care taken of the sick soldiers in camp during the fifteenth and sixteenth centuries
Army surgeons in France until the reign of Louis XIII
Army surgeons in Germany in the time of Charles V
English army medical and surgical service in the fifteenth century
The expedition to St. Quintin
Instructions to Sir Thomas Leighton
Medical and surgical science during the middle ages
One of the causes which retarded the efficient organization of the health service in European armies (note)
The medical department---a result of the establishment of permanent armies
The first military hospitals established in Europe
Le siège de velours (note)
Ordonnance authorizing these hospitals
Hospital service during the reign of Louis XIV
Royal edict of 1662
The Hôtels-Dieu and communal hospital establishments of France
The Hôtel des Invalides
French military hospitals during the early part of the eighteenth century
Permanent military hospitals in the middle of the eighteenth century
Defective management of these hospitals
The Hôtels-Dieu at Paris during the eighteenth century (note)
Suppression of the permanent military hospitals in France in 1788
Re-organization of French military hospitals in 1793
Establishment of permanent military hospitals in England
How the sick in English armies had been taken care of previously to the creation of these hospitals
Evelyn's project for the establishment of an "infermerie"
English permanent military hospitals during the eighteenth century
Cost of constructing permanent military hospitals in France in the eighteenth century
Character of the buildings
The hospital at Lille
General plan of these establishments
The material organization of the civil hospitals or Hôtels-Dieu
Their limited capacity
Ecclesiastical character of the foundations
The monastic infirmary (note)
Light and ventilation little regarded in the construction of monastic hospitals
Administration of permanent military hospitals in France
Administration of civil hospitals in France
Radical vice in the administration of French hospitals
Surgeons-major of camps and armies first recognized in the French service in the reign of Louis XIII
Regimental surgeons in the Swedish army
Regimental surgeons in the English army
Qualifications and duties of a military surgeon in the reign of Queen Elizabeth
Clowes' opinion of his professional contemporaries
Provisions made for an army of 30,000 men in 1620
Number of surgeons attached to armies during the sixteenth and seventeenth centuries (note)
First reference to the ambulance or field temporary hospital
Article in the "Ordonnance" of January, 1629
Establishment of 1638
The field hospital service during the reign of Louis XIV
Personnel of the field service according to the royal edict of January, 1708
Military hospitals first established by the French Service de Santé during the reign of Louis XV
"Instruction" prepared by D'Argenson in 1746
"Order" issued by Marshal de Belle-Isle in 1759
Former organization of corps for field service
Organization of the Service de Santé since 1792 (note)
French ambulance system scarcely improved since the beginning of the century
Personal composition of an ambulance organized by the French Société de Secours aux Blessés in 1870
Impracticability of the organization
Re-organization adopted in October, 1870
Its defects
Field service of the British army from 1750 to 1815
More importance attached to the duties of the army medical officer
Over-sensitiveness of the medical profession in matters relating to military rank (note)
Medical officer better educated
Medical and surgical stores more abundantly furnished
Control of the army medical service
Personal composition of the British army medical service before the Crimean War
Influence of more enlightened views upon sanitary subjects
The regimental hospital
The general hospital
Special hospitals for the wounded
Dispositions for the field service now observed in the British army
Principal defect of the English organization
The convalescent hospital
Medical field service in the United States army
Act of Congress passed in March, 1804
English, French, and American organizations compared
Decree of the French Minister of War of January 4th, 1871
The initiation of a much-needed reform
Radical difference between the French and the English and American organizations
Dependence of the medical service upon the quarter-master's department
Functions of the officier de santé and of the intendant officially defined
Ordonnance issued May 3rd, 1832
The diet list and medicines limited to certain formulæ
Personal independence of the surgeon subject to the assumptions of the intendant
Result of these restrictions and assumptions
Rôle of the French sanitary associations
Poverty of the Service de Santé with regard to the material means for hospitalizing the sick
Qualifications of the Société de Secours aux Blessés for the direction of the ambulance service of an army
Offers of the society
Consequences of the false position it occupied
History of the eighth ambulance
History of the first ambulance
History of the second ambulance
History of other ambulances
Results of the assumption of this society to direct the field ambulance service
Selfish motives which prompted the opening of ambulances
Little popular interest shown for the sick
The rôle of the doctor
The name Société de Secours aux Blessés unfortunate
Evidence of the inefficiency of the volunteer system as applied in France
Inferences from the facts stated
How the offer of the Société de Secours aux Blessés came to be accepted
Who was responsible for the confusion in the administration of the health service
Basis on which the French army hospital service was established during the late war
Necessity of official and personal responsibility
The true province of voluntary effort misconceived by the French society
Causes which led to the formation of the United States Sanitary Commission
One of the glories of the United States Sanitary Commission
Purpose for which the army medical service has been created
If inefficient, the cause should be ascertained and removed
The mission of volunteer associations for the relief of the misery of battlefields

 

MOST remarkable facts in the history of the hospitalization of sick and wounded soldiers
Reforms in army sanitation to be obtained only by the united efforts of many inquirers
Question whose solution appeared to the American International Sanitary Committee most important

 

MILITARY hospitals
Sedentary hospitals
Ambulant hospitals
Hospitals established from reasons of convenience
The primary idea to be attached to the word hospital
The object to be accomplished in building a hospital
An accepted fact of sanitary science
Mortality rates in the first hospitals for the sick
The suppression of hospitals advocated
A curious fact
State of things in the early military hospitals
Causes to which the mortality existing in hospitals was attributed
A fact which could not escape notice
That air once respired was unfit for respiration---a fact not generally known
Earliest recognitions of the importance of pure air
History of ventilation in France
Different plans for obtaining a fresh air supply suggested during the eighteenth century
Too much importance ascribed to cubic space
Ventilation---its principal object
Why crowded habitations are unhealthy
The salubrity of all hospitals to be estimated by the degree of atmospheric purity maintained within them

 

PLANS adopted in the construction of permanent military hospitals
Military hospital at Vincennes
Military hospital at Bayonne
The chief faults of nearly all permanent hospitals
Objects to be kept in view in constructing a hospital
Hospitals not to be erected as monuments of architectural skill
Temporary hospitals indispensable in time of war
Principal reason for the construction of temporary establishments for the sick of armies
The idea of barrack hospitals a modern one (note)
The earliest wise conclusions concerning the relative fitness of buildings to serve as hospitals
The Crimean experience and its results
General character of the sedentary hospitals recently especially constructed to receive the sick of armies
The American ward-pavilion
A ridiculous statement (note)
The English model hospital-barrack
Crimean huts
Experimental barrack erected by Dr. Esse in 1867 at Berlin
German barrack hospitals during the Franco-German War
Prussian ward-barrack for thirty patients
Süvern's mixture (note)
Minden barracks
French barrack hospitals
Barracks of the Luxembourg and of the Garden of Plants
Barrack hospital at Passy
Barrack hospital constructed by the Société de Secours aux Blessés
Barrack hospital at Metz
Characteristics of the German barrack hospitals
One of the chief faults of the typical American pavilion
The use of paper in converting summer barracks into winter hospitals

 

MIXED hospitals respond only partially to the necessities of an active army
Means should exist for creating hospital accommodation within the army itself
Defective condition of the ambulance service in European armies
A want especially felt in each army
Sick and wounded soldiers crowded together in such buildings as chance offers
Consequences of the practice
Proof that no systematic effort has been made to procure suitable shelter for the sick and wounded of active armies
Why we find no accounts of the kind of shelter employed for the ambulances.
The employment of public and private buildings for ambulance purposes possesses certain advantages
Its disadvantages
Larrey's account of the condition of the wounded after the battle of Eylau
Gama's account
Gama's account of the character of the hospitals during the Russian campaign
Evacuation of the wounded, and its consequences
Vaidy's proposition
Suffering in the Crimean War from a want of shelter
Forced evacuations of the wounded
Hospitals at Solferino
Hospitals at Langensalza
Field hospitals during the late war
Hospitals at Sedan
Hospitals at Metz
Hospitals in the army of the Loire
Object of the citations
Is it not possible to improve the hospitalization of active armies?
Objections to the employment of portable shelter
Economic motive to the employment of such shelter
Claims of the soldiers to profit by our science
Want often wastes an army more than fighting
A certain number of tent-hospitals should be established in each army
Advantages which they possess
Pure air of more consequence than shelter itself
Illustrations of the influence of the open air upon the sick
Tents afford all the shelter necessary
A great evil for which a remedy must be found
Dr. Sutherland's opinion
Baron Larrey's opinion
The transportation of the sick and wounded
Its advantages
Its disadvantages
Classes of sick and wounded not transportable
German system of evacuating battle-fields
Disastrous consequences of hurried evacuations
Opinion of Dr. John A. Lidell
The remedy

 

PART II

ON TENTS AND TENT-BARRACKS

MOTIVES which induced the writer to treat these subjects at length in his report

TENTS used in the earliest ages
Tents now used among primitive and nomadic tribes
Tents used by the English during the Peninsular campaign
First real improvements in the construction of temporary shelter
Tents of the Israelites
Arab tents
Tents used within the walls of cities
The use of tents in the East, in the summer
Tents upon wheels
An Oriental story (note)
Atkinson's description of a Kirgis yourt

   
TENTS at the siege of Troy
Tents in Persian camps
The word σκηνὴ (note)
Xenophon's allusions to the use of tents in the Greek armies
Splendid tents---their origin
A description from Athenæus
Time when tents were adopted in the Roman army
Qualities of early Roman tents
Allusions to Roman tents by Livy
Tabernaculum and tentorium (note)
Cæsar's account of the shelter used by his troops
Allusion to Roman tents by other writers
Camp shelter among the Germans and Gauls
Carthaginian encampments
The use of cabins in Roman armies
Roman winter quarters
The bas-reliefs on the column of Trajan
Tabernacula---huts
Difference between the tabernaculum and the tentorium
The tentorium---tent
The papilio---pavilion
The prœtorium (note)
Why certain tents were called papiliones
Difference between papilio and tentorium (note)
Covering employed for the papilio
Woven stuff not mentioned as a covering for Roman tents before the second century
The conopeum (note)
Weaving an Eastern art
Roman commerce with the East---a probable result
Form of the papilio
A mistake explained (note)
Splendid tents not used by the Romans
Interior arrangement of the Roman soldier's tent

 

THE use of tents in the armies of the Eastern Empire
The use of tents among the Goths and Huns
Tents in the armies of the Merovingian and Carlovingian kings
Tents among the Anglo-Saxons
Tents in the armies of the Crusaders
Camp of King Edward II
Froissart's allusions to the use of tents
Statements of French chroniclers
Huts preferred in sieges
Troops occasionally encamped in tents
Tents used by the Hungarians and Tartars
Remarkable accounts of Spanish camps and camp life
Tent-making a special service in armies
Ostentatious rivalry among the knights of the middle ages
Camp before Grenada
The splendid camp equipage of Charles the Bold
Magnificence of Philip the Hardy
The splendid tent of Conradine
The "Field of Cloth of Gold"
The tent of Nadir Shah
An encampment in the time of the Sultan Mahomet IV
Love of display during the middle ages
Brilliant effects of colour in mediaeval encampments
Tent of a French knight of the fourteenth century
Means existing in the middle ages for magnificent displays
Existing customs derived from the usages of mediæeval camp life

 

AMBROISE PARE'S sketch of the imperial encampment before Metz
Disposition of a German camp according to Fronsperger
Hungarian encampment at the close of the sixteenth century
Camps of Maurice of Nassau
Use of tents at Oppenheim
Camps regularly laid out before the use of tents became general
Use of tents in the Imperial armies
Tents in the Levant
Old Turkish conical tent
The Turkish marquee
Turkish camping material
Tents first issued to the troops of modern armies
Use of "baraques and hutts " in English armies
Lodgings provided for the household of Henry VIII. (note)
Soldiers' quarters in the time of Elizabeth
Soldiers' quarters in 1649
What Orrery says of the hutting of troops
What Evelyn says of the camp at Hounslow
Soldiers' tents in the Prussian service
The cannonière
The tente d'ancien modèle
German tents anterior to the reign of Frederick the Great
Wedge-tents
Chinese tents
The cortine
The marquee
Origin of the word marquee (note)
Tents rarely employed during the winter months
Colombier's observations concerning encampments
Use of tents under the First Empire
Use of tents in the English army
Use of tents in the United States army
Use of tents during the Franco-German War
Interior of tents, how furnished
Floor-cloth
Criticisms
Observations of Jourdan Le Comte and Colombier
Instructions of Frederick the Great (note)

 

TENTS as a means of hospitalizing the sick
Sick treated in their quarters by the Greeks
Sick treated in their quarters by the Romans
The valetudinarium
Contubernales (note)
Reported establishment of a tent-hospital in the sixteenth century
Fray Antonio Agapida (note)
Subject of hospitalizing the sick of armies little thought about in the sixteenth and seventeenth centuries
A passage from Bombelles
Infrequent references to tents by medico-military writers
Munro one of the earliest writers who refer to the use of tents for hospital purposes
M. Bégue de Presle's allusion to tents
Tents first recommended in the organization of hospitals
Decree of the French Government
Terms of the decree seldom acted upon
Larrey's allusions to tents
Tent-hospitals in the British service

 

CAUSES for differences in the construction of tents
Why the roof of the Western tent has a sharp pitch
Why Turkish tents are flat-roofed
Material of which modern tent coverings have been made
Classification of tents proposed by MM. Lévy and Boisseau
The classification of tents difficult

 

THE British "marquee"
The British "bell-tent"
Edgington's "three-poled tent"
Major Rhodes' tents
Turner's tent
Shelter-tents in the British army
Shelter-tents used in ancient times
Account of the use of shelter-tents by the Scots in 1547
French account of the origin of the tente-abri
The French tente-abri
Tentes-abri of MM. Waldéjo and Barbe
The shelter-tent cannot be dispensed with
The French tente nouveau modèle
The French tente elliptique
The French tente conique
The French marquise
The French tente de conseil du nouveau modèle
"Surgeons' tent" of the Société de Secours aux Blessés
Model tent of M. de Moulnier
Model tent of M. Couette
The manteau d'armes (note)
Tents now in use in the Turkish army
The Prussian "troop-tent "
The Prussian " hospital tent "
A model Prussian "hospital tent"
Prussian "field hospital tent for twelve beds"
Prussian "tent for the treatment of contagious diseases"
Austrian and Italian "long tent"
Capt. Theurekauf's tent
Austrian "marching-tent"
Italian "shelter-teat"
Italian "conical tent"
Russian tents
United States " wedge-tent"
United States "shelter-tent"
The "half-faced camp"
A Comanche "lodge"
The "Sibley tent "
United States "hospital tent"
Certain advantages of the "fly"
The American "hospital tent " a component part of a large tent or pavilion
Some of the defects of this tent
Le Fort's tent
Le Fort's modified field hospital tent
Le Fort's tent as modified by the Sociéte de Secours aux Blessés

 

THE coverings of modern tents
French Government tent canvas
English Government tent canvas
Austrian Government tent canvas
Certain characteristics of flax tissues
United States Government tent canvas
Italian Government tent canvas
Certain characteristics of cotton tissues
The respective merits of cotton and linen tissues
How tents are destroyed
Wear from ordinary use and handling
Damage from exposure to the weather
Damage from mildew
Preservative preparations
Process of the house Husson
Of the greater strength of linen tissues
The question of cost
Cost of raw flax and of raw cotton in the French market
Waste in the manufacture of flax
Waste in the conversion of cotton into tent-duck
Prices of linen and cotton tent tissues in different countries
A conclusion
Relative merits and demerits of tissues of cotton and flax as tent coverings
Greater permeability of linen tissues
Linen tents hotter in the summer and colder in the winter than those of cotton
Results of the hygrometricity of linen
Relative capacity of tissues to hold water by interposition
Linen canvas easily saturated
Shrinkage of linen tissues
An objection made to the use of cotton canvas
Conclusion

 

THE qualities a hospital tent should possess
Importance of using the best materials in the construction of hospital tents
On the choice of a location for a tent
A location under trees objectionable
Points to be observed in pitching a tent

 

TENT-barracks
Their principal advantage;
Their principal disadvantages
An opinion of competent judges
Tent-barracks used during the Austro-Prussian War of 1866
The tent-barracks of the ambulance at St. Cloud
The tent-barrack of the Hospital Cochin
The tent-barrack of the Charity Hospital at Berlin
Tent-barracks of two kinds or types
The expedient plan
Points to be observed in constructing a tent for a special service
Defects of the tent-barrack of the Hospital Cochin
Tent designed by Dr. Thomas W. Evans

 

PART III

ON THE SPECIAL ORGANIZATION OF THE AMERICAN AMBULANCE

A LAW of sanitary science
Opinions entertained by the American International Sanitary Committee
Resolutions passed
Development of the original plan

 

THE first impression of the visitor
The tents
Furniture
Tent-barracks
Pavilion No. 7
Pavilion No. 8
Pavilion No. 10
Other constructions
The American ambulance, how composed
Essentially a sedentary ambulance

 

THE American ambulance represented a new system
The tent-hospital at Varna
The use of tent-hospitals limited to the summer months
The opinion in France upon this subject
Recent European opinion upon this subject
English opinion upon this subject
Conclusions derived from the use of tents as hospitals during the late war
Conclusions of MM. Demoget and Brossard
Opinion of M. Grellois
Report of M. Leplat
Conclusions of M. Grellois
Tent ambulances of the Société de Secours aux Blessés
The practice among the Germans during the late war
Statement of Captain Galton
Statement of Miss Lees
The "Woolwich ambulance"
Hospital tents in the United States army
Attempts to treat the wounded under tents in the winter
American opinion concerning tent-hospitals

 

THE use of tent-hospitals not limited to the summer months
The results of our experiment
Results obtained at Varna
Opinions of Quesnay and Pirogoff
Statement of Kraus
Statement of Dr. Hammond
Results obtained by Boerwindt
Remarks of Chantreuil
Facts to be considered in comparing results
Statistics vitiated by evacuations from one hospital to another
Statistics of the ambulance at the "Corps Législatif"
Statistics of the American ambulance
Results obtained at the ambulance "Rothschild"
Results obtained at the ambulance in the École des Ponts et Chaussées
Results obtained in other ambulances at Paris
Results obtained by the "first ambulance" at Metz
Results obtained in the civil hospital at Strasbourg
Results obtained in the ambulance of the "Petit Séminaire " at Strasbourg
Statement of Dr. Gordon
Recoveries most frequent in the American ambulance

 

WHY tent-hospitals furnish the most satisfactory results
The sanitary influence of light
Conditions under which the wounded were treated at the American ambulance

 

SANITARY state of Paris
Causes of the great mortality existing during the siege
Quality of the bread issued
Suffering from want of food less than generally supposed
How Paris was able to feed its population for five months or more (note)
A tabular statement of the deaths in Paris
Remarkable exemption of certain classes from disease
The mortality from small-pox
The influence of cold weather upon the mortality rates
Incident mentioned by Dr. Gordon (note)
Diseases of the respiratory organs
Typhoid fever
Diarrhoea and dysentery
Influence of the sanitary state of Paris upon the wounded
Mortuary statistics of the siege (note)
Mortality table
Temperature table
Location---character of the grounds
The tents---how arranged
Tent-barracks
Lighting
Furniture. iron bedsteads
System for warming and ventilating the tents
The general practice in camps
Custom prevalent during the eighteenth century
Difficulties of heating tents
Methods of warming tents at different times suggested
The fireplace and chimney
How to warm tents---a difficult problem
A solution suggested
A practice in the English army before Sebastopol
The "California stove"
A method of applying the system
A second method of applying the system
The arrangement adopted at the American ambulance
Statement of M. Bréhan
Statement of M. Joly
Report of M. Cottard
A difficulty---its cause and its remedies
How uniformity of temperature was obtained
How the rate of the heat supply was regulated
Another advantage of the system
The relation between heating and ventilation
Natural ventilation
Artificial ventilation
Inefficiency of mechanical devices
The evil of draughts
The cheminée d 'appel
The tents at the American ambulance ventilated by natural forces
Canvas full of natural openings
Why the air in tents becomes close
How the air escapes from a tent
Outlets and inlets should be numerous
Important condition in the ventilation of tents
"How do you know your tents are well ventilated?
Conclusion
Cost of the apparatus
Water supply
Amount of water distributed in Paris in August and December, 1870
The composition of Seine water
Quality of Seine water
Kitchen
Wine room.
Provision store
Linen room
Store room
Knapsack room
Operating room
Dormitory
Transport service
Baths
Sinks
Latrines
Trenches
Fresh earth as a deodorant and disinfectant
Cabinets
Urinals
Importance of separating the urinal from the cabinet
A grave abuse
How it can be prevented
Cabinets d'aisance a source of specific disease
Latrines how policed
Dead-house

 

TRANSPORTABILITY an important point in constructing an ambulance
Special advantage possessed by an ambulant hospital
Our tents subjected to an unusual test
The question of cost
Cost of a tent-hospital containing fifty beds
Cost of permanent constructions
Conclusion

 

ON THE SURGICAL HISTORY OF THE AMERICAN AMBULANCE

INTRODUCTION

 

RÉSUMÉ of the general treatment of wounds in the ambulance
General surgical treatment of compound fractures
Injuries which necessitate amputation
Fractures of the shaft or joints which are to be treated by conservation
The transportation of the wounded
The treatment of fractures by extension and counter-extension

 

GENERAL facts in the surgical history of the ambulance
Table of fractures
Fractures of the thigh

Case 3
Case 4
Case 134
Report of the Surgeon-General of the United States
Report of Professor Legouest
Conclusions

Amputations of the thigh

Case 5
Case 9
Case 23

Excisions, amputations, and conservations of the shoulder-joint

Case 32
Case 56
Case 166

Shoulder-joint operations
Fractures of the tibia and fibula

Case 36
Case 244

Fractures of the arm

Case 130
Case 225
Case 31
Case 18
Case 115
Case 14

Fractures of the tarsus and ankle-joint

Case 41
Case 45

Fractures of the scapula

Case 43
Case 6

Fractures of the carpus

Case 191
Case 29

Fractures of the maxillaries

Case 62
Case 65
Case 73
Case 129
Case 145
Case 179
Case 200

Wounds of the abdomen

Case 239

Penetrating wounds of the chest

Case 13
Case 55
Case 64
Case 68

Wounds of the nerves

Case 108
Case 128

 

HISTORY of each surgical case which terminated fatally

Case 7
Case 8
Case 10
Case 53
Case 54
Case 58
Case 59
Case 63
Case 72
Case 82
Case 83
Case 85
Case 96
Case 105
Case 106
Case 109
Case 116
Case 117
Case 120
Case 122
Case 126
Case 127
Case 131
Case 132
Case 133
Case 135
Case 147
Case 148
Case 150
Case 153
Case 155
Case 156
Case 162
Case 164
Case 168
Case 169
Case 178
Case 184
Case 188
Case 189
Case 204
Case 205
Case 222
Case 223
Case 229
Case 240

 

SPECIAL points
Causes influencing the surgical results
Cause of erysipelas, &e
Conditions existing at the American ambulance
Case 106
Opinion of Mr. Erichsen upon blood-poisoning
Did anyone treated at the ambulance suffer from blood- or pus-poisoning?
Origin and character of the conditions observed

 

THE medical and surgical staff
Conclusion

 

TABLE of surgical cases admitted to the American ambulance

 

ON THE MEDICAL HISTORY OF THE AMERICAN AMBULANCE

CONDITIONS influencing the public health
Temporary immunity from disease
Later history of the ambulance
Conclusions

 

TABLE of medical cases admitted to the American ambulance

 

APPENDIX

LIST of the persons who served in the American ambulance

 

PLATES

I. Ground-plan of the ambulance

II. A pavilion, showing the system of heating, &c

III. A pavilion viewed in section, and without the fly

IV. Supplement to Plate III

V. A pavilion viewed from above

VI. Supplement to Plate V

VII. Front view of a pavilion.

VIII. Sectional front view

IX. Sectional view of the trench tent-cords and keys

X. Dr. Evans' hospital-tent


History of the American Ambulance