Commentaries on the Surgery of the War in Portugal, Spain, France, and the Netherlands / from the battle of Roliça, in 1808, to that of Waterloo, in 1815; with additions relating to those in the Crimea in 1854-55, showing the improvements made during and since that period in the great art and science of surgery on all the subjects to which they relate.

by G. J. Guthrie

PREFACE TO THE FIFTH EDITION.

Twenty months have elapsed since the Introductory Lecture was published in The Lancet; fifteen others succeeded at intervals, and fifteen have been printed separately to complete the number of which the present work is composed. Divested of the historical and argumentative, as well as of much of the illustrative part, contained in the records whence it is derived, it nevertheless occupies 585 pages—the essential points therein being numbered from 1 to 423.

Sir De Lacy Evans, in some observations lately made in the House of Commons on the subject of a Professorship of Military Surgery in London, alluded to these Lectures in the most gratifying manner; he could not, however, state their origin, scope, or object, being unacquainted with them.

On the termination of the war in 1814, I expressed in print my regret that we had not had another battle in the south of France, to enable me to decide two or three points in surgery which were doubtful. I was called an enthusiast, and laughed at accordingly. The battle of Waterloo afforded the desired opportunity. Sir James M’Grigor, then first appointed Director-General, offered to place me on full pay for six months. This would have been destructive to my prospects in London; I therefore offered to serve for three, which he was afraid would be called a job, although the difference between half-pay and full was under sixty pounds; and our amicable discussion ended by my going to Brussels and Antwerp for five weeks as an amateur. The officers in both places received me in a manner to which I cannot do justice. They placed themselves and their patients at my entire disposal, and carried into effect every suggestion. The doubts on the points alluded to were dissipated, and the principles wanting were established. Three of the most important cases, which had never before been seen in London nor in Paris, were sent to the York Military Hospital, then at Chelsea. The rank I held as a Deputy Inspector-General precluded my being employed. It was again a matter of money. I offered to do the duty of a staff-surgeon without pay, provided two wards were assigned to me in which the worst cases from Brussels and Antwerp might be collected. The offer was accepted; and for two years I did this duty, until the hospital was broken up, and the men transferred to Chatham. In the first year a Course of Lectures on Military Surgery was given. The inefficiency of such a Course alone was soon seen, for Surgery admits of no such distinctions. Injuries of the head, for instance, in warfare, usually take place on the sides and vertex; in civil life, more frequently at the base. They implicate each other so inseparably, although all the symptoms are not alike or always present, that they cannot be disconnected with propriety. This equally obtains in other parts; and my second and extended Course was recognized by the Council of the Royal College of Surgeons as one of General Surgery.

When the Court of Examiners of the Royal College of Surgeons of England—of which body I have been for more than twenty years a humble member—confer their diploma after examination on a student, they do not consider him to have done more than laid the foundation for that knowledge which is to be afterward acquired by long and patient observation. When a student in law is called to the bar, he is not supposed to be therefore qualified to be a Queen’s counsel, much less a judge or a chancellor. The young theologian, admitted into deacon’s orders, is not supposed to be fitted for a bishopric. When the young surgeon is sent, in the execution of his duties, to distant climes, where he has few and sometimes no opportunities of adding to the knowledge he had previously acquired, it is apt to be impaired; and he may return to England, after an absence of several years, less qualified, perhaps, than when he left it. To such persons a course of instruction is invaluable. It should be open to them as public servants gratuitously, and should be conveyed by a person appointed and paid by the Crown. He should be styled, in my opinion, the Military Professor of Surgery, and be capable, from his previous experience and his civil opportunities, of teaching all things in the principles and practice of surgery connected with his office, although he may and should annually select his subjects. Leave of absence for three months might be advantageously granted to officers in turn for the purpose of attending these lectures, and the Professor should certify as to their time having been well employed. For thirty years I endeavored to render this service to the Army, the Navy, and the East India Company, from the knowledge I had acquired of its importance. To the Officers of these services my two hospitals, together with Lectures and Demonstrations, were always open gratuitously, as a mark of the estimation in which I held them. By the end of that period the enthusiasm of the enthusiast who wished for another battle in 1814 had oozed out, like the courage of Bob Acres in “The Rivals,” at the ends of his fingers. The course of instruction was discontinued, but not until such parts were printed, under the title of “Records of the Surgery of the War,” as were not before the public, in order that teachers of civil or systematic surgery should be acquainted with them.

4 Berkeley Street, Berkeley Square,
June 21, 1853.