Crimean War, 1854-5
The Crimean War of 1854-5 marks a major turning point in war technology, practice techniques, preventive techniques, and medicine. Prior to the Crimean war, the design of militia and the actions taken in the field and in the encampment setting when it came to health seemed to undergo minimal changes between the late 17th century and 1850. Of course there were important changes, such as the conversion of medicines from basic herbal form to mineral form between 1680s and 1720 during the Dutch Wars, and the Revolutionary War years in the colonies, for better storage, reduction in space requirements, and maintenance of supplies with a greater shelflife, but the overall picture of medicine at war consisted of the same basic elements: dealing with typical life-related illnesses and injuries, dealing with infectious diseases, dealing with the need for surgery due to battle-related injuries and related losses in body parts and functionality.
The 1854-5 Crimean War had large buildings useful as hospitals already established relatively close to the battlefields and encampments. The battlefield was far enough away to have a limited impact on these medical service locations. Prior to the Crimean War, medical philosophy about disease was transitioning from primarily environmentally-focused and pertaining to miasma and such, to people-focused and focused on hygiene and sanitation concerns.
Women finally began to play an important role in the military setting, not just as wives but also as nurses, replacing the male nurses and comforters thereby enabling them to serve as surgeon’s assistants, apothecarians, field assistants, and additional sources for manpower for meeting the ambulatory needs.
We can use the medical geography maps for the time to help us understand some of the thought that preceded the decision to go into battle and remove large numbers of people to a new place, to serve as soldiers.
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Alexander Keith Johnston’s map was designed specifically for use by the Royal Military. This we can tell due to his emphasis on the ability of the military to move through regions and remain healthy. Several routes depicted on his map illustrate this.
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Aitken’s map, which adds a little more detail to Johnston’s map about areal or regional disease patterns, provides insights into the possible medical problems at stake regarding the establishment of a militia in certain regions. Soldiers removing to a new area they, in theory, were not well adapted to biologically, could have a tremendous impact on their value and functionality as soldiers.
Aitken’s map (from other page)
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Ibid. Note lesser focus on endemic diseases.
Whereas seventy-five years earlier, when the French made use of maps to depict health and unhealthy places to be, mostly for fever and diarrhea related illnesses, these maps were developed to serve a broader purpose. The ability to reside in an area and work in that area as a soldier were the added roles these maps played by the mid-19th century, and with time, they also came to serve as important tools for determining where diseases of certain types tend to prevail, and how to prevent these and other new diseases from setting in. We see the value of these lessons with the practice of medicine during the next major war, the Civil War of the United States.
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The following are important examples of these impacts war had on medicine, public health, population control, mapping, and statistical analysis.
Heathcare providers
The classic example in medical history education focuses on Florence Nightingale, who initiated the practice of nursing by women. This added a certain touch of domestication to the hospital and encampment settings by adding insights into the values of sanitation practices and monitoring health and disease statistics.
Ambulation
The idea of carrying soldiers injured off the battlefield and over to the hospital began as a practice of common courtesy following a small skirmish. As the size of batallions increase, the amount of available services increase, and so too did the technology and techniques attached to these provisions.
Ambulances
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Transportation
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Field Hospitals
Military Hospitals
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Hospital Wards
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Prisons
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Prisoners
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Battlefields
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Hand-to-Hand Combat
Cannons
Wives and Nurses
Medicine
Health Statistics
Encampments
Open space versus crowding was a major issue in battles. In a forested setting, tight quarters could become a problem. In an open fields setting, too much space made it easy for too much exposure to the environment to ensue. Wind, precipitation, solar heating and rays, humidity, and ocean spray were all major stresses upon the camp and its people.
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Uniforms
Tactical clothing had to meet the needs of the soldier in terms of utility, personal and military belongings, mobility when put to use, and adaptability to the local climate and terrain. Hygiene had to be promoted and personal biological needs had to be met with these materials and their designs.
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Sources for the above include:
Pictorial History of the Russian War 1854-5-6: With Maps, Plans, and Wood Engravings by George Dodd
Brian Altonen, MPH, MS 