In this work of inventing a field ambulance of a greatly improved pattern Larrey revealed an exceptionally fine trait of character, viz., a strong desire to utilize his talents and the opportunities afforded by his official position for the benefit of his fellow men, both the wounded of the French army and those of the enemy forces. He revealed the same trait in many other ways—as, for instance, when he took infinite pains, after a battle, to provide proper shelter, food and care for the wounded in the town or village nearest to the site of the conflict, and that too in a part of the country which belonged to the enemy. He revealed it again in the fighting which took place in Eastern Prussia and in the course of the numerous retreats which Napoleon’s army was forced to make in the Russian campaign.
Among the incidents which occurred during that long and disastrous retreat of the remnants of Napoleon’s army from Moscow there was one which reveals in a very clear light the high sense of duty that characterized Larrey’s actions as Surgeon-in-Chief of the French Army and the complete faith which the individual soldiers composing that army—or at least the better disposed among them—placed in his disinterested and loyal service in their behalf. The incident to which I have reference occurred while the disorganized French troops were crossing the Beresina River and is thus described by Larrey’s biographer:—
The Russian general arrived at the head of 50,000 men and began the fire among the division of General Partonneaux, the soldiers of which division immediately wished to cross the Bridge all at once. The conveyances collided with one another, and some of the unfortunate men were crushed, while others, losing all spirit, threw themselves into the stream.... There was throughout a frightful mixture of imprecations, of clashings, and of strugglings, whence arose indescribable disorder and a breaking of the overloaded bridge. The Russian Army approached, and with its formidable artillery tore the ranks of the French mob of soldiers.... In this immense disaster what had become of the distinguished Surgeon-in-Chief of the Grand Army? After having crossed over the Beresina with the Imperial Guard, he discovered that requisites for the sick and wounded of his countrymen had been left on the opposite bank. With equal humanity and heroism, he recrossed the river, and hardly had he done so when he was surrounded by a wildly excited crowd. He was almost suffocated in the midst of it.... No sooner was he recognized than he was carried back with great rapidity in the arms of the soldiers across the river. On all parts was heard the cry, in nearly these words, “Let us save him who saved us!” The soldiers almost forgot their own safety in their desire to preserve an officer whose tender kindness they had so often experienced.
I believe that I have now shown with sufficient fulness of detail what were the prominent characteristics of Larrey as a man and as an executive army medical officer. It still remains for me to furnish some evidence of the excellent judgment which he displayed in his work as a practical surgeon.
In one of the French hospitals, during the war, Larrey’s attention was called to a Russian soldier who had been shot in the forehead by an iron ball weighing 217 grammes. This projectile had pierced the frontal bone above and a little to the outside of the right eyebrow, and had penetrated into the interior of the skull. Despite the bulk of this iron ball, the opening which was perceptible in the bone did not exceed six or eight millimeters in diameter, and, by introducing a small probe, one might feel the ball. The smallness of the opening in the bone, says Larrey, may be explained by the elasticity of the osseous fibres, some of which the ball would have to push aside in order completely to penetrate the outer table of the frontal bone, and which consequently would yield instead of fracturing. In the present case the bony angles at the edge of the circular opening were cut away by the surgeon and the opening itself was made large enough to permit the removal of the ball by means of an elevator and pincers. A great quantity of coagulated blood and some small fragments of bone were then evacuated. The brain itself presented at this spot a depression of about seven millimeters in depth. In a short period of time the wound healed, and apparently complete recovery followed.
In order to judge correctly of the credit which rightfully belongs to Larrey for his successful treatment of this case of gunshot wound of the skull and underlying brain, one must remember that in the early part of the nineteenth century it was considered a very bold surgical act to operate upon the injured brain, and particularly so in the almost complete absence of adequate surgical equipment.
As an instance of Larrey’s quickness in meeting an emergency I will narrate here very briefly an experience which he had at Smolensk, Russia. When the French troops entered that city, after a severe battle, they found that the inhabitants had already fled, owing in part to the fact that many of their dwellings had been destroyed by fire. Larrey, as soon as was practicable, converted fifteen of the largest buildings which had not been devastated by the flames, into hospitals for the wounded. Unfortunately, all supplies or stores of any kind had either been destroyed by the enemy or removed by them in their orderly and premeditated retreat. For the large number of wounded there was a deficiency of linen and splints; but Larrey discovered a store of archives in one of the buildings which had escaped the fire, and he promptly substituted sheets of paper for linen and utilized the thick parchment covers for splints. He toiled with little intermission night and day, and the French surgeons generally, in imitation of their chief, were indefatigable in their attention to the wounded, who were about 10,000 in number.
Las Cases, in his “Memorial of St. Helena,” published after he had returned to Europe, reports Napoleon as having uttered the following words on October 23, 1816: “What a man, what a brave and worthy man is Larrey! What care was given by him to the army in Egypt and everywhere! I have conceived for him the highest esteem. If the army were to raise a column to the memory of any one, it should be to the memory of Larrey. He has left in my mind the idea of a truly honest man.” In his will Napoleon wrote: “I bequeath to the Surgeon-in-Chief of the French Army, Larrey, 100,000 francs. He is the most virtuous man I have ever known.”
The reader will pardon me, I am sure, if I furnish here additional proof of Larrey’s sound judgment in questions of a purely surgical nature. He insisted, for example, on the importance of promptly resorting to amputation in cases where the gunshot wound had caused a complicated fracture of the bone or had inflicted serious destruction of the soft parts; and he particularly recommended this course of action in the case of individuals who were cachectic or below par. He expressed himself in favor of the circular incision in preference to that which was intended to furnish flaps. (From “Mémoire sur les Amputations, etc.,” Paris, 1797.)
In another place Larrey mentions, somewhat in detail, the reasons why primary amputations are to be given the preference in military surgery. They are the following:—