Organising The Medical Services
The medical services in the Crimea reflected the knowledge at the time and shows how this knowledge was used to benefit the sick and wounded soldiers.
The Army Medical Department and the Ordnance Medical Department were combined into one unit in February 1853 under Dr Andrew Smith. This would have been done earlier had it not been for the Duke of Wellington who opposed any army medical reforms. When it was clear the war was going to go ahead Dr Andrew Smith had very little time and very little to work with to create a functioning war-ready medical department.
At the outbreak of war Dr Smith had no wagons, no stretcher-bearers and no doctors. He was told he'd need to prepare for 10,000 soldiers. The gap in stretcher-bearers was filled by Captain Tulloch who provided army pensioners to take on the job. However the men were slow and weak in their old age and so this wasn't a very good plan.
Lord Raglan believed that the space on the ships would be of better use to the troops than to the medical department. The 2 designated medical ships were used as troop transporters and were not properly used as hospital ships until 1855. Raglan also believed that only 4 medical assistants was needed for every 100 men were needed and doctors were recruited voluntarily. The same mismanagement and negligence seen in supplying the troops also made its way into the medical supplies. Medical supplies that were offloaded were put into stores, only to be discovered months later when they were unusable.
There were 4 base hospitals established in the Crimean, besides the main one at Scutari:
The General Hospital - opened as soon as troops arrived.
The Castle Hospital - Had 2,500 beds
The Land Transport Corps Hospital
Convalescent Hospital at St Georges Monastery.
The main treatment in these hospitals was amputation. There was at 25% chance that if you survied the amputation you'd then die from shock or infection. Anaesthesia was used when the supplies were available but the mismanagement limited it's impact. Shot was gouged out of flesh and wounds were stitched but infection was still ever present.
The main problem at any hospital or battlefield was the sanitation and clean water. The lack of washing available caused a lice infestation and the risk of Typhus and Typhoid increased. The lack of sanitation caused dysentery and Cholera.
In the Winter of 1854/55 one third of the British army died fro disease, mostly in the hospitals. Out of the 18,000 casualties only 1,761 were caused by enemy action. However Cholera was an evident problem back in Britain and diseases were the main killer in the UK. The developments of antiseptics, John Snows Cholera study and the Germ Theory were yet to happen.