The smart of the knife...

I mention the Crimean war (1853-1856) in this class a couple of times and I've posted on it here a couple of times previously (eg Crimean War Photographs and Minié balls and infection before penicillin) but like most of you, I suspect, I don't really know much about it. So when I was in Goleta library last week and noticed Orlando Figes new history of the Crimean War I thought I'd pick up a little holiday weekend reading.

Interesting stuff, I had no idea the extent to which this was a religious war. But most shocking was the passage on the armies response to the new anaesthetic gases such as chloroform which were just becoming available. The use of such anaesthetic gases was embraced by the Russians, who used them to increase their surgical survival rates, but rejected by the British who favored a stiff upper lip. The Principal medical officer of the British Army, Dr John Hall, issued a memorandum cautioning:

'against the use of chloroform in the severe shock of serious gunshot wounds... for however barbarous it may appear, the smart of the knife is a powerful stimulant; and it is much better to hear a man bawl lustily than to see him sink silently into the grave.'

All this surgical amputation was, of course necessary because of the threat of infection - mainly by gram positive bacteria. For upper leg amputations, the most dangerous and the most common type of surgery, the Russian army used the new anaesthetics to improve their survival rate to 25%. In the British army it remained at 10%....