During the war some colonial regiments even came into camp without any surgeon, or the slightest provision for disease or injury. In 1776 Congress ordered that there should be one surgeon and five assistants to each 5,000 enlisted men, the former being paid $1.66 per day, the latter $1 a day. Imagine the attention that could be bestowed upon 5,000 soldiers by six men whose services were thus compensated. Camp hygiene, hospital corps, and ambulance service were undreamed of; nevertheless John Warren, then only twenty-three years of age, accomplished a great deal in building up a medical corps, while as much more was done by Benjamin Church, of Boston, who was styled Director General and Chief Physician, and who was paid $4 a day. Unfortunately Church was detected in traitorous correspondence with the enemy, was court-martialed, imprisoned for a year, then allowed to leave the country, and was probably lost at sea. He was succeeded by John Morgan, of Philadelphia, who had to fight the politicians as well as the foreign enemy and, failing to satisfy them, was dismissed from the service, though acquitted from all blame. Thus you see that even in those days the politicians made it hard to secure adequate and proper care for our sick and wounded soldiers. Everywhere at that time were unrest, excitement, and suspicion, and their demoralizing effects showed in every department of military as of civil government. After Morgan came Shippen, who held office from 1777 to 1781, under whose guidance affairs in the medical department improved very much. Smallpox had been perhaps the greatest scourge of the soldiers, as well as of the people in general, but this was kept in subjection by the practice of inoculation, which had been generally accepted in this country by nearly all men from Washington down.
A word or two must also be said about that remarkable man, Benjamin Rush, with his many-sided, versatile, erratic, obstinate and querulous character, who nevertheless constituted in his day the most prominent figure in the profession; who served two years in Congress; who signed the Declaration of Independence; and who, in the same year, got his first army medical experience. It was perhaps not strange that, with his peculiar temperament, he failed to come under the influence of Washington's peculiar personal magnetism, and that their personal relations were not at all to Rush's credit, since he endeavored in many ways to belittle his Commander-in-Chief, and suffered therefor a rather ignominious exposure.
The temptation is always to place most stress upon accounts of heroism which happens to be most publicly performed. While this is not unnatural it is often an injustice, since an act of courage may be performed in the lime-light of publicity, with a regard for notoriety, that would be lost were it done in private. It perhaps is not kind to think that anyone would ever be more courageous in public than in private, and yet it is to be feared that human nature is not always free from temptation of this kind. But the real silent heroes of military or civil medical life are those who engage in duties which nevertheless have even more of danger about them than spectacular performances upon the battle field. Take for instance, the work done by Major Reed and Dr. Carroll, who devoted themselves for months to the study of yellow fever. Many a man will stand upon the field of battle permitting himself to be fired upon, but how many will deliberately submit to being bitten by insects believed to be carriers of the germs of yellow fever. Dr. Carroll had this quiet kind of bravery, and allowed himself to be bitten by a mosquito that twelve days previously had filled himself with the blood of a yellow fever patient, and in consequence suffered from a severe attack, barely escaping with his life. Dr. Lazear permitted the same experiment upon himself, but was not at that time infected; but some days later while in the yellow fever ward he was bitten by a mosquito, made careful note of the fact, acquired the disease in its most hideous form, and died a martyr to science, as true a hero as ever died upon fortress or man-of-war. Others, too, willingly exposed themselves, but there was at that time no other fatality to record. But realizing the value of the service rendered, the indisputable proof of the nature of the disease, and the method by which it is carried, the value of the demonstration becomes inestimable, since a true prophylaxis was demonstrated, and a means furnished of ridding the community of this fearful pestilence. Moreover, it was shown how unnecessary it is to destroy valuable property, it being only necessary to kill the mosquitoes, and do away with their breeding places. Major Reed died a few years after he had led in this fight against the dread disease, but no monument, or other testimonial which can be erected to the memory of Reed, Carroll and Lazear can adequately express the value of the service which they have rendered to the world.
"Peace hath her victories no less than war." This epigram is as true of the conflicts in which the medical profession engage as of any other. This same sentiment has been put in other words. It is said, "That peace hath higher tests of manhood than battle ever knew." For instance, in New York there is a simple tablet commemorating, in loving remembrance, the death of eighteen young physicians who, one after another, attended a ship load of emigrants sick of typhus fever on Quarantine Island. They fought their good fight and were buried without martial music, adding eighteen names to the innumerable list of victims who have fought the silent battle of dealing with disease, public gainers only in this, that someone has been thoughtful enough to record their names in this semi-public fashion.
Taken again the case of Dr. Franz Muller, of Vienna, who contracted the bubonic plague while working in the laboratory with its germs. Just so soon as he realized that he himself was infected he locked himself in an isolated room, and pasted upon the window pane a sheet of paper containing this message, "I am suffering from plague. Do not send a doctor to me, as in any event my end will come in four or five days." He refused to admit those who were anxious to do for him, wrote a letter to his parents which he placed against the window, so that it could be copied from the outside, then burned the original, fearing that if sent through the mail it might carry the elusive germ. Was not this equal to any instance of valor under the excitement or the stress of battle and cannonade? Could anyone more worthily win a Victorian Cross, or any other emblem of courage and heroism?
Many of you have been in, or will go to Havana. It will be worth your while to make a pilgrimage to the cemetery there, where were buried sixteen young medical students who lost their lives under peculiar circumstances, which afford as well an illustration of Spanish tyranny and injustice. In 1871 one of the professors in the medical school died, and was followed to his grave by the students whom he had taught, and who loved him. Unfortunately they committed an indiscretion by scribbling with a pencil in a public place some criticism on the government; in consequence they were reported, arrested and court-martialed. The written paragraphs were evidence sufficient, and the Governor General ordered the ranks of students to be decimated. There were 160 students all told, and in accordance with this sentence sixteen of them were next day shot without any further ceremony. Of these the youngest was not quite sixteen years old, and his father offered his entire fortune for his life, but without avail. Later the citizens of Havana erected a monument of white marble, at no small cost, to commemorate this sacrifice.
There comes over me, as I prepare these words to read to you, a feeling of their inadequacy, and of lack of personal justice to many of my auditors. Brought up in civil life, with but a smattering of military training, I am rehearsing incidents of which you may read as easily as I, while at the same time I do not forget that from the lives of many of my auditors there might be drawn just as many illustrations of courage, fortitude, endurance and personal valor as any that the Surgeon General's library records. Unfortunately I am not familiar with them. They are, happily in one respect, too numerous to mention, and again are not yet public property, because modesty is ever the accompaniment of these other traits which we all admire so much. Hence, gentlemen, if I seem to you to disregard or forget many an incident in your lives or the careers of your friends, ascribe it to my ignorance rather than to my intent, and to the fact that I have never seen a battle, and that my fights with disease have not been fought in camps, but within the walls of the quiet sick room or hospital ward. Nevertheless I am never happier than when I can try to compel a wider public recognition of what you are constantly doing and of your valorous deeds.
Next to those general improvements in the service which have come about through natural causes, and as results of a better appreciation of its needs, and of a generally improved state of the profession, nothing has come from outside during the past fifty years which has been so helpful and advantageous as the support afforded by the Red Cross, and the introduction of skilled nurses; in fact the greatest help which the medical service of the army and navy can enjoy is that which comes from this volunteer and outside source. By the way, I wonder how many of you recall, or are familiar with, the beginnings of the Red Cross movement? So important has it become that its history should be well known to all. In June, 1859, was fought the bloody battle of Solferino, at the conclusion of which some 36,000 French, Sardinian and Austrian soldiers lay dead or dying on the field. The medical corps was, of course, absolutely inadequate to the work thrown upon them, and as usual thousands of wounded men had to care for themselves as best they could. A Swiss traveler, Henri Dunant, viewing the scenes, and being profoundly impressed by them, not only assisted in the work of relief, but wrote a book entitled, "A Souvenir of Solferino," in which he urged more humane, widespread and speedy aid to the wounded. M. Moynier, president of the Society of Public Utility, of Geneva, a man of independent means; Dr. Appia, a wise physician, and M. Ador, an eminent lawyer of Geneva, also became interested in the movement. The attention of the General of the Swiss Army was called to it and his co-operation enlisted. In this way came about, in 1863, the formation of a permanent society for the relief of wounded soldiers. At a meeting held in October in the same year men from many countries joined in discussing the subject, and an international conference was held, which resulted in calling an international convention, to be held at Geneva in the autumn of 1864.
Such was the beginning of the Red Cross movement, which has now extended all over the world, and has afforded an opportunity for all races, creeds and nationalities to care for those who are made victims of war or pestilence, or who suffer from any other great disaster with which private charity is unable to cope. It marks a step in the evolution of mankind, and has now achieved such universal recognition that national governments and individual potentates are glad to join hands in the great work.
A more concrete application of the same idea has been the comparatively recent formation of ambulance corps and later of nursing bureaus, within our own service, and the employment of trained nurses. This has not been in all respects an easy matter to bring about, nevertheless it has redounded to the credit and to the welfare of all concerned. Never at any time were the sick and injured, either in private or in military practice, so well cared for as now, and America should lead the world to-day, as ever, in the adequacy of its provisions and the perfection of its methods. In private this is notably the case in ordinary hospital work, as seen by all travelers, upon the continent and in Great Britain, who take pains to make comparisons with the way in which things are done there and in our own country. Although Florence Nightingale immortalized herself by showing what woman could do on the battle field and in military camps, it has remained for Americans to improve upon the lessons which she taught, while at the same time revering her for her wonderful devotion to her self-imposed duty and her enthusiasm. In its performance the lessons of the Crimean and the Civil War, for instance, have left their impressions upon history in such a way as may never be erased, and certainly no one was ever more entitled to the designation of "angel of the sick room" than was Miss Nightingale.