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Original paper
Medical aspects of the Battle of Waterloo: the battle Mick Crumplin Correspondence to Mr Mick Crumplin, [email protected] Accepted 24 November 2014 Published Online First 18 December 2014
ABSTRACT The Duke of Wellington's polyglot army assembled for the Waterloo campaign was hastily aggregated and the Army Medical Department was somewhat short of staff and not entirely of the calibre of the department serving latterly in the Peninsular campaigns. The casualty rates during the battles of this campaign were high and the regimental and hospital staff struggled with the large number of casualties. Lack of stretcher bearers and transport were significant problems, which were compounded by the high density of the casualties. Three quarters of the surviving wounded rejoined their units.
Key message The eventual successful evolution of the Army Medical Department in the Peninsular War was not mirrored in the Waterloo Campaigns of 15–18 June 1815.
would be required of the surgeons over the 15–18 June.
THE MEDICAL STAFF INTRODUCTION
To cite: Crumplin M. J R Army Med Corps 2015;161:135–139.
In 1814, the British Government had sent the fourth and last unsuccessful expedition to the Low Countries, to secure the port of Antwerp. Five thousand soldiers under Lieutenant General Thomas Graham landed with their medical staff in March. The expedition failed, with at least 1500 casualties. There were 28 medical staff personnel, serving under a Deputy Inspector Robert Grant. Garrisons and hospitals remained here until July. Bonaparte had escaped his captors on Elba and landed with around 1000 of his Imperial Guard between Frejus and Antibes on 1 March 1815. Eventually, he reached the Tuilleries on the 21 March, with the deposed Bourbon monarch Louis XVIII fleeing to Ghent. News of Bonaparte’s escape reached the Congress of Vienna on 7 March. There were four armies, Anglo-Dutch-German (ADG), Prussian, Russian and Austrian arrayed against the emperor’s anticipated manoeuvres. The nearest two Allied forces would partake in the Waterloo campaign. The polyglot ADG force—around 100 000 men—was commanded by the Duke of Wellington and the Prussian army was headed up by Field Marshal Gebhard Leberecht von Blücher with approximately 120 000 effectives. Bonaparte’s Armée du Nord was 125 000 strong and rapidly approached the Belgian/French border, outwitting Wellington with the speed and direction of his movement. He planned to drive a wedge between the Prussians and the Duke’s army, push the Prussians back east then defeat Wellington, subsequently suing for peace on his terms, from Brussels.1 The campaign consisted of the battles of Ligny (French vvs Prussians) and Quatre Bras (ADG vvs. French) fought on the 16 June, the action at Wavre (French vvs. Prussians) and then at Waterloo (ADG and Prussians vvs. the French) on Sunday 18 June. Around 40 000 casualties of both armies evolved from Waterloo and Quatre Bras (ref 2, page 28); added to these would be around 20 000 from the other two actions, at Ligny and Wavre, so much
Mustering sufficient medical staff for the Waterloo campaign was a significant challenge for the Allies and the French, since both nations’ forces were worn out and many medical staff had resigned, were sick, on half-pay or just unwilling to rejoin the colours. A new Director General of the Army Medical Department (AMD), Sir James McGrigor was appointed on 13 June 1815—merely 5 days before Waterloo!3 He had had a monumental task, rapidly trying to build up adequate staff and supplies. McGrigor’s brother-in-law, the experienced Inspector James Grant (Principle Medical Officer (PMO) of the campaign—Figure 1) would have to shoulder the burden of the hospital staffing, principally in Brussels, but also in Antwerp, Ostend, Ghent and Bruges. Grant’s duties included riding with the Duke’s staff during the battle. Credit must be given to Professor S. Brugmans, inspector general of the Low Countries Medical Department, who along with redoubtable surgeons such as Medical Officer 1st Class J Kluyskens and many other Dutch/ Belgian colleagues gave significant support to the Allied Army and its medical staff (ref 2, page 12). Of the two ADG army corps, we know that the 1st Corps dressing station was in the farm and environs of Mont St Jean Farm, 500 m or so behind Wellington’s line (ref 2, page 12); the whereabouts of the 2nd Corps station remains obscure. Two experienced corps PMOs had been appointed: Deputy Inspector John Gunning, (1st Corps), based at Mont St Jean Farm, where there is now a plaque dedicated to him and his staff, placed there by the Royal Army Medical Corps, and Staff Surgeon Henry Gresley Emery (2nd Corps) who had served in many difficult campaigns (Corunna, Walcheren and Burgos). The cavalry medical services were supported by a deputy inspector and two staff surgeons. Each division was allocated one or two senior staff and an assistant. Some of Grant’s men had served in the disastrous expedition to Bergen-op-Zoom and had moved south to Brussels as part of an occupation
Crumplin M. J R Army Med Corps 2015;161:135–139. doi:10.1136/jramc-2014-000391
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Figure 2
Figure 1 Sir James Grant. force. There were 43 medical staff appointed to serve in the campaign, including six deputy inspectors, one of whom, John Hume, was Wellington’s personal physician, two physicians, one of these was George Denecke (one of two medical men wounded during the campaign), nine staff surgeons, three apothecaries, a deputy purveyor and a collection of 22 junior staff. One of the staff surgeons, J. Gideon Van Millingen was notable for his (failed) attempts, after the war, to implement some important and sensible developments such as dedicated bearers and front-line support, based on excellent systems proven by the French.4 The 23-man Ordnance Medical Department had its own battery hospitals and was commanded by Deputy Inspector Wittman; finally, a company of 107 veterans, with four officers were embarked to help with transport of the wounded. The provision of hospital staff was to prove inadequate, with 62 other staff and several civilians coming out to help, after the battle. Significantly, of the medical men at Waterloo, only 49% had seen Peninsular service (63% of the non-regimental staff and 45% of battalion surgeons) (ref 2, page 9). The regimental medical staff numbered 57 Regimental Medical Officers (RMOs) and 107 assistant RMOs. Some battalions, such as the hard-hit 27th (Inniskillings), had only two assistants for a 698-strong battalion. They suffered 478 casualties in the battle (68%). No longer was the surgeon placed seven paces behind the colours5; this was too risky and many battalion men worked in or near Mont St Jean or other local buildings. There they could operate with colleagues or staff surgeons. Many of the few camp followers aggregated around these farm buildings. The senior of the two assistant surgeons would be at the front line. Regimental staff wore a single breasted, short-tailed red coat, 136
A field amputation.
grey overalls (trousers), black boots or shoes and the new 1812 pattern faux-fronted felt shako. Buttons, facings and other tunic decorations were of that particular battalion. The black-feathered plume on the shako was peculiar to only the Judge Advocates Department and the AMD. Surgeons were armed, since there was yet neither the Red Cross nor a Geneva Convention. The regimental surgeon had an orderly, a mule or cart, with equipment to care for around 250 patients, a horse, a capital instrument set contained in a felt-lined box and a pocket set of small instruments—also his dressings and drugs. Junior staff right at the front carried linen roller bandages, water, a few instruments, lint and sutures; although there was a limited amount they could do in combat. Their duty was to get casualties back to a regimental, brigade or divisional field hospital. Although there were occasional capital procedures performed in the field, most were carried out in the field or base hospital by experienced staff surgeons (Figure 2). Transport, as in the Peninsular War proved a problem, not only getting the patients off the field, but getting them away to the general hospitals 10–20 miles distant. Although expressly forbidden, there were over a thousand men absent for some of the battles, helping to evacuate injured comrades. Regimental bandsmen were employed as bearers. After the battle, around 50 spring wagons (two lying or eight sitting cases in each) were ordered down from Brussels. Delay in evacuation meant many early fatalities on the battlefield, which accounted for a low in-hospital mortality rate.6 The French system was patchily efficient. Early in the war, it was recognised for its revolutionary fervour, conscription of civilian doctors, training schedules and, most particularly, its forward ambulance service. However over the long Napoleonic War, bureaucracy and inefficiency had eroded earlier successes. Each regiment with two, three or four battalions had, as in our own army, a regimental and several battalion surgeons and assistants. Each division and corps had its own ambulance, which was usually stationed directly to the rear of that unit.
MEDICAL ASPECTS OF THE ACTION ON 18 JUNE Two days before Waterloo, the French Army split into two forces. The left hand French force provoked an action at Quatre Bras, around 12 miles south of Waterloo (Figure 3). Marshal Ney, a somewhat unstable but brave officer exhibited considerable lacklustre in his assaults on the burgeoning Allied forces at Quatre Bras. A large farm building acted as a field hospital there and the Crumplin M. J R Army Med Corps 2015;161:135–139. doi:10.1136/jramc-2014-000391
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Original paper
Figure 3 Square of the 28th Foot at Quatre Bras.
Allied casualties (amounting to around 4500) were cleared to the north, to some extent hampering the subsequent Allied retirement to Waterloo on the sodden night of the 17 June. Further east, at Ligny, the Prussians were engaged in a furious duel with 3rd, 4th, 6th French Army Corps and the Imperial Guard with Bonaparte and Marshal Grouchy in command. While the relatively modest number of injured men at Quatre Bras would weaken several units on the 18 June, the casualty rate at Ligny was impressive enough: 11 000 Prussian dead and wounded and around 8000 French. No quarter was given during this latter engagement. After Blücher’s defeat, the main Prussian force loyally retired north, not east, so that they might later support Wellington.7 Marshal Grouchy was dispatched with 30 000 men to prevent Blücher’s forces joining up with Wellington later. This manoeuvre was to fail—at great cost to Bonaparte. The terrain of the now very damp battlefield was open rolling countryside with hedges, copses and woods. Of the latter, the large Fôret de Soignes was at Wellington’s back. Three defended farms on or forward of Wellington’s line (a ridge around 3 miles long) were temporary havens for casualties but we know little about the Allied medical staffing of them. Chateau Hougoumont projected well out from the Duke’s right centre, la Haye Sainte farm was several hundred metres in front of the line and Ferme Papelotte was on the Allied left flank. Thus, apart from these somewhat isolated forward positions, a large temporary field hospital at Mont St Jean Farm, 500– 1000 m behind the ridge, some isolated hovels and barns served
as unit dressing stations. Mont St Jean probably housed about 6000 casualties during the day. Many wounded had to traverse a hazardous 500–1500 m or more, of exposed battle ground to reach this farm where the few camp followers played a role in the care of the injured. In this field hospital, many of the battalion surgeons would coalesce, assisting each other and sharing equipment as necessary (Figure 4). During close fighting, with infantry in line or column, the assistant surgeon’s position was made known. In square formation, he dressed and tidied wounds, splinted fractures, controlled haemorrhage and gave water to victims. (ref 8, page 108) Casualty clearance for the cavalry arm was tricky, since so many of the dismounted and damaged troopers were isolated or lay in disputed or enemy territory. The battle commenced at around 11:30 h, with an artillery bombardment and an infantry attack on the south face of Chateau Hougoumont and its adjacent woodland. Fierce skirmishing in these woods was followed by an intense assault on the farm. Over the day, German soldiers and light company Foot Guards inflicted around 4500 casualties on the French, receiving themselves about 850 killed and wounded. We are unsure of the medical support in the farm, but the surgeon of the Coldstream Guards (William Whymper) and/or one of his assistants were probably in attendance in this forward position. We know some walking wounded exited the north gate of the farm back up to the security of the Allied ridge. Many of these eventually converged on the farm of Mont St Jean.
Figure 4 Mont St Jean Farm.
Figure 5
Crumplin M. J R Army Med Corps 2015;161:135–139. doi:10.1136/jramc-2014-000391
Limb avulsed by a round shot. 137
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Original paper Around 12:30 h, there was a break in at Hougoumont through the north gate. One other break-in and almost another were aborted and the attackers soon shifted their assault from the open killing ground at the south and west aspects of the farm to the gardens and orchard to the east. Around 14:30 h the chateau building was set alight and as the building burned, casualties were evacuated to nearby barns. The French assaults continued, with both sides being reinforced. Far from drawing Allied troops away from Wellington’s centre, more and more French of Count Reille’s 2nd Corps were sucked into the assault on Hougoumont. Around 12:45 h, a great barrage commenced from Bonaparte’s 64-gun battery, approximately a kilometre from Wellington’s ridge. Bonaparte wished to pulverise the Duke’s left centre and then send in Count Drouet d’Erlon’s fresh 17 000 strong 1st Corps. The heavy bombardment lasted around three-quarters of an hour and probably caused only about 500 casualties, because of damp ground, a thinly dispersed target line and over/undershooting.8 Round shot injuries, if central were fatal and the commonest reason for survival from these injuries was limb avulsion (Figure 5). As the guns fell silent, dark columns of French infantry were seen moving through the gun lines. D’Erlon’s four divisions advanced en echelon, left in front and two of them formed in an unusually wide column (145 files long) formation to bring maximum firepower on the Allies. As the French skirmishers dropped away, the leading divisions topped the ridge and pushed back the Allied infantry, recently depleted at Quatre Bras. This was a dire moment for the Duke. Henry Paget, Lord Uxbridge sent in around 2500 sabres of the Household and Union heavy cavalry brigades. Although the main French infantry thrust was shattered by this unexpected manoeuvre and around 1500 French were captured, the British heavy cavalry had gone too far and was effectively destroyed by frontal and flanking enemy cavalry. Lance wounds, musketry, capture and horse falls accounted for losses of half the attacking force. In a small study of 77 wounds in 29 Union Brigade troopers, 48 were lance wounds, with surprisingly, only 13 torso strikes (Mr Stuart Mellor, personal communication). Some other troopers suffered up to 20 lance injuries. From 15:30 to 17:00 h, repeated attempts to capture La Haye Sainte Farm failed and three Allied infantry battalions were helplessly cut down sooner or later by French cavalry, lurking behind the farm. The French heavy cavalry sabres were used in a thrusting manner, often inflicting fatal penetrating injuries, while the British equivalents and light 1796 pattern cavalry sabres caused fearful slashing injuries. (ref 8, page 66)
Around 14:00–15:00 h, the French 6th Corps and later, units of the Imperial Guard were drawn off to parry a mounting Prussian assault on Bonaparte’s right rear at the village of Plancenoit. As to the main assault, Bonaparte’s options were now limited and he decided to commit his two magnificent 3rd and 4th cavalry corps (Generals Kellerman and Milhaud) to move against Wellington’s right centre. The Allied infantry formed square to resist the massed cavalry advances. Trotting up the muddy slopes, thousands of horsemen received, first round shot then case from Allied ordnance, cutting down cuirassiers and horses in swathes (Figure 6). Lapping around the impenetrable squares, the killing continued. Only when the horsemen retired did the infantry take terrible retribution from French artillery. Wounded were pulled back into squares and the dead were thrown out. Before 2 h were up the sweaty bleeding horsemen stood off from the exhausted, smoking squares, gesturing futilely at the Allies, while the infantry conserved their cartridges and waited for another charge. So many casualties must have exsanguinated here, unable to move on to Mont St Jean or travel back to the French ambulances. At around 18:00 h, La Haye Sainte was taken, poorly shored up the previous night and the little garrison had run short of ammunition. As the French poured in, furious soldiers dispatched the Allied casualties lying in the farmhouse. Meanwhile, at Plancenoit, Bonaparte’s men were hard pressed and units of the Young and Old Imperial Guard barely held on. Casualties of both sides lying around in the cellars of the village houses were butchered mercilessly. Once again, no quarter was given. As dusk arrived, General Ziethen’s 1st Prussian Corps arrived to shore up the Allied left, unimpeded by Grouchy’s force, which was still engaged at Wavre, east of the main battle. Bonaparte’s game was up. In a last desperate attempt to break Wellington’s line, units of the French Middle Imperial Guard, supported by some units of the Old Guard and by horse artillery, moved up in three waves, to assault Wellington’s right centre en echelon, mainly in square formation. Accompanied by battalion surgeons, with the Guard ambulances to the rear, around 3000 veterans trudged up the slope, where they wreaked havoc on some exhausted Allied units, until flung back by Dutch troops—Detmer’s brigade and a battery of artillery.10 On the right Peregrine Maitland’s 1st Guard’s Brigade smartly volleyed the leading Chasseurs of the Guard, bringing down the leading ranks. The British Guards impetuously rushed down on
Figure 6 A French cavalry assault.
Figure 7
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An above-knee amputation.
Crumplin M. J R Army Med Corps 2015;161:135–139. doi:10.1136/jramc-2014-000391
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Original paper
Figure 8 A British field surgical instrument set used at Waterloo. their broken quarries, until coming under immense fire from a strong French assault. They retired and Sir John Colborne’s veteran 52nd regiment, 1000 strong, and two other units wheeled left and saw off the last brave French advances. This battle had claimed around 50 000 killed, wounded and missing. In all, from the four battles of the campaign, there were about 63 000 wounded men to be treated. At Waterloo, there had been 17 000 Allied casualties and of around 24 000 British soldiers participating, 7016 (29%) were killed or wounded with 28% officer casualties. Many men lay on the field for a day or more. The main problem was the density of the wounded, hindering efficient retrieval by adequate cadres of bearers. (ref 2, page 26–30) At the battle of the Somme in 1916, the mean density of injured was 234 per mile of front— at Waterloo the equivalent figure was 2291. An impressively low in-hospital mortality of 9% merely reflected the inability of so many casualties to reach hospital. About 40 spring wagons were requisitioned from Brussels, where five main hospitals had been set up. Small detachments of men from each battalion searched the field for comrades and remained back to assist with the wounded. The battalion surgeons all left with their units, thus committing thousands of French and Allied casualties to the hospital staff, French Prisoners of War surgeons and Belgian civilian staff. One of the latter, 18-year-old Dr Seutin,
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amputated 23 men during 1 day. There were around 500 Allied amputations on the 18th and roughly 2000 over the whole campaign (Figures 7 and 8). Surviving casualties were shipped by barge to Ostend and sent home. A year later, of 6831 casualties, 506 were discharged, 854 remained in hospital, 236 survived amputation and 167 had joined veteran battalions. The remainder, 5068 (74%) rejoined the army. (ref 2, page 34) Most of Wellington’s staff had been injured and he was joined by a single officer at supper on the night after Waterloo. His military secretary, the future Lord Raglan of Crimean fame had lost an arm, his close friend and an aide-de-camp, Alexander Gordon had had a leg amputated and subsequently bled to death. His cavalry commander Lord Uxbridge also lost a leg. His Quartermaster General, Howe de Lancey tangentially struck in the flank by a round-shot had succumbed from severe internal bleeding. After the war, Britain was later flooded with discharged soldiers and unemployed surgeons, some of whom became wellknown characters, such as John Hennen, George Guthrie, Samuel Cooper, John Knox who was associated with the Burke and Hare murders and John Hall (of the ill-fated Crimean campaigns). James McGrigor continued to serve as director general until 1851. Two generations of soldiers and surgeons later, many valuable lessons of these long wars were to be forgotten in the shambles of the Crimean War (1854–1856). Competing interests None. Provenance and peer review Commissioned; internally peer reviewed.
REFERENCES 1 2 3 4 5 6 7 8 9 10
Glover G. Waterloo, myths and reality. Pen and Sword Ltd, 2014:36. Crumplin MKH. The bloody fields of Waterloo. Ken Trotman Publishing, 2013. Blanco RL. Wellington’s surgeon general: Sir James McGrigor. Duke University Press, 1974:146. Howard M. Wellington’s doctors. Spellmount Publishing 2002:64. Crumplin MKH. Guthrie’s war. Pen and Sword Publishing, 2010:21. Adkin M. The Waterloo companion. Aurum Press, 2001:312. Clayton T. Waterloo, four days that changed Europe’s destiny. Little, Brown Publishing, 2014:235. Crumplin MKH. Men of steel. Quiller Publishing, 2007. Adkin M. The Waterloo companion. Aurum Press, 2001:301. Field AW. Waterloo—the French perspective. Pen and Sword Military, 2012:198–9.
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Medical aspects of the Battle of Waterloo: the battle Mick Crumplin J R Army Med Corps 2015 161: 135-139 originally published online December 18, 2014
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Original paper
Medical aspects of the Battle of Waterloo: the battle Mick Crumplin Correspondence to Mr Mick Crumplin, [email protected] Accepted 24 November 2014 Published Online First 18 December 2014
ABSTRACT The Duke of Wellington's polyglot army assembled for the Waterloo campaign was hastily aggregated and the Army Medical Department was somewhat short of staff and not entirely of the calibre of the department serving latterly in the Peninsular campaigns. The casualty rates during the battles of this campaign were high and the regimental and hospital staff struggled with the large number of casualties. Lack of stretcher bearers and transport were significant problems, which were compounded by the high density of the casualties. Three quarters of the surviving wounded rejoined their units.
Key message The eventual successful evolution of the Army Medical Department in the Peninsular War was not mirrored in the Waterloo Campaigns of 15–18 June 1815.
would be required of the surgeons over the 15–18 June.
THE MEDICAL STAFF INTRODUCTION
To cite: Crumplin M. J R Army Med Corps 2015;161:135–139.
In 1814, the British Government had sent the fourth and last unsuccessful expedition to the Low Countries, to secure the port of Antwerp. Five thousand soldiers under Lieutenant General Thomas Graham landed with their medical staff in March. The expedition failed, with at least 1500 casualties. There were 28 medical staff personnel, serving under a Deputy Inspector Robert Grant. Garrisons and hospitals remained here until July. Bonaparte had escaped his captors on Elba and landed with around 1000 of his Imperial Guard between Frejus and Antibes on 1 March 1815. Eventually, he reached the Tuilleries on the 21 March, with the deposed Bourbon monarch Louis XVIII fleeing to Ghent. News of Bonaparte’s escape reached the Congress of Vienna on 7 March. There were four armies, Anglo-Dutch-German (ADG), Prussian, Russian and Austrian arrayed against the emperor’s anticipated manoeuvres. The nearest two Allied forces would partake in the Waterloo campaign. The polyglot ADG force—around 100 000 men—was commanded by the Duke of Wellington and the Prussian army was headed up by Field Marshal Gebhard Leberecht von Blücher with approximately 120 000 effectives. Bonaparte’s Armée du Nord was 125 000 strong and rapidly approached the Belgian/French border, outwitting Wellington with the speed and direction of his movement. He planned to drive a wedge between the Prussians and the Duke’s army, push the Prussians back east then defeat Wellington, subsequently suing for peace on his terms, from Brussels.1 The campaign consisted of the battles of Ligny (French vvs Prussians) and Quatre Bras (ADG vvs. French) fought on the 16 June, the action at Wavre (French vvs. Prussians) and then at Waterloo (ADG and Prussians vvs. the French) on Sunday 18 June. Around 40 000 casualties of both armies evolved from Waterloo and Quatre Bras (ref 2, page 28); added to these would be around 20 000 from the other two actions, at Ligny and Wavre, so much
Mustering sufficient medical staff for the Waterloo campaign was a significant challenge for the Allies and the French, since both nations’ forces were worn out and many medical staff had resigned, were sick, on half-pay or just unwilling to rejoin the colours. A new Director General of the Army Medical Department (AMD), Sir James McGrigor was appointed on 13 June 1815—merely 5 days before Waterloo!3 He had had a monumental task, rapidly trying to build up adequate staff and supplies. McGrigor’s brother-in-law, the experienced Inspector James Grant (Principle Medical Officer (PMO) of the campaign—Figure 1) would have to shoulder the burden of the hospital staffing, principally in Brussels, but also in Antwerp, Ostend, Ghent and Bruges. Grant’s duties included riding with the Duke’s staff during the battle. Credit must be given to Professor S. Brugmans, inspector general of the Low Countries Medical Department, who along with redoubtable surgeons such as Medical Officer 1st Class J Kluyskens and many other Dutch/ Belgian colleagues gave significant support to the Allied Army and its medical staff (ref 2, page 12). Of the two ADG army corps, we know that the 1st Corps dressing station was in the farm and environs of Mont St Jean Farm, 500 m or so behind Wellington’s line (ref 2, page 12); the whereabouts of the 2nd Corps station remains obscure. Two experienced corps PMOs had been appointed: Deputy Inspector John Gunning, (1st Corps), based at Mont St Jean Farm, where there is now a plaque dedicated to him and his staff, placed there by the Royal Army Medical Corps, and Staff Surgeon Henry Gresley Emery (2nd Corps) who had served in many difficult campaigns (Corunna, Walcheren and Burgos). The cavalry medical services were supported by a deputy inspector and two staff surgeons. Each division was allocated one or two senior staff and an assistant. Some of Grant’s men had served in the disastrous expedition to Bergen-op-Zoom and had moved south to Brussels as part of an occupation
Crumplin M. J R Army Med Corps 2015;161:135–139. doi:10.1136/jramc-2014-000391
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Figure 2
Figure 1 Sir James Grant. force. There were 43 medical staff appointed to serve in the campaign, including six deputy inspectors, one of whom, John Hume, was Wellington’s personal physician, two physicians, one of these was George Denecke (one of two medical men wounded during the campaign), nine staff surgeons, three apothecaries, a deputy purveyor and a collection of 22 junior staff. One of the staff surgeons, J. Gideon Van Millingen was notable for his (failed) attempts, after the war, to implement some important and sensible developments such as dedicated bearers and front-line support, based on excellent systems proven by the French.4 The 23-man Ordnance Medical Department had its own battery hospitals and was commanded by Deputy Inspector Wittman; finally, a company of 107 veterans, with four officers were embarked to help with transport of the wounded. The provision of hospital staff was to prove inadequate, with 62 other staff and several civilians coming out to help, after the battle. Significantly, of the medical men at Waterloo, only 49% had seen Peninsular service (63% of the non-regimental staff and 45% of battalion surgeons) (ref 2, page 9). The regimental medical staff numbered 57 Regimental Medical Officers (RMOs) and 107 assistant RMOs. Some battalions, such as the hard-hit 27th (Inniskillings), had only two assistants for a 698-strong battalion. They suffered 478 casualties in the battle (68%). No longer was the surgeon placed seven paces behind the colours5; this was too risky and many battalion men worked in or near Mont St Jean or other local buildings. There they could operate with colleagues or staff surgeons. Many of the few camp followers aggregated around these farm buildings. The senior of the two assistant surgeons would be at the front line. Regimental staff wore a single breasted, short-tailed red coat, 136
A field amputation.
grey overalls (trousers), black boots or shoes and the new 1812 pattern faux-fronted felt shako. Buttons, facings and other tunic decorations were of that particular battalion. The black-feathered plume on the shako was peculiar to only the Judge Advocates Department and the AMD. Surgeons were armed, since there was yet neither the Red Cross nor a Geneva Convention. The regimental surgeon had an orderly, a mule or cart, with equipment to care for around 250 patients, a horse, a capital instrument set contained in a felt-lined box and a pocket set of small instruments—also his dressings and drugs. Junior staff right at the front carried linen roller bandages, water, a few instruments, lint and sutures; although there was a limited amount they could do in combat. Their duty was to get casualties back to a regimental, brigade or divisional field hospital. Although there were occasional capital procedures performed in the field, most were carried out in the field or base hospital by experienced staff surgeons (Figure 2). Transport, as in the Peninsular War proved a problem, not only getting the patients off the field, but getting them away to the general hospitals 10–20 miles distant. Although expressly forbidden, there were over a thousand men absent for some of the battles, helping to evacuate injured comrades. Regimental bandsmen were employed as bearers. After the battle, around 50 spring wagons (two lying or eight sitting cases in each) were ordered down from Brussels. Delay in evacuation meant many early fatalities on the battlefield, which accounted for a low in-hospital mortality rate.6 The French system was patchily efficient. Early in the war, it was recognised for its revolutionary fervour, conscription of civilian doctors, training schedules and, most particularly, its forward ambulance service. However over the long Napoleonic War, bureaucracy and inefficiency had eroded earlier successes. Each regiment with two, three or four battalions had, as in our own army, a regimental and several battalion surgeons and assistants. Each division and corps had its own ambulance, which was usually stationed directly to the rear of that unit.
MEDICAL ASPECTS OF THE ACTION ON 18 JUNE Two days before Waterloo, the French Army split into two forces. The left hand French force provoked an action at Quatre Bras, around 12 miles south of Waterloo (Figure 3). Marshal Ney, a somewhat unstable but brave officer exhibited considerable lacklustre in his assaults on the burgeoning Allied forces at Quatre Bras. A large farm building acted as a field hospital there and the Crumplin M. J R Army Med Corps 2015;161:135–139. doi:10.1136/jramc-2014-000391
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Original paper
Figure 3 Square of the 28th Foot at Quatre Bras.
Allied casualties (amounting to around 4500) were cleared to the north, to some extent hampering the subsequent Allied retirement to Waterloo on the sodden night of the 17 June. Further east, at Ligny, the Prussians were engaged in a furious duel with 3rd, 4th, 6th French Army Corps and the Imperial Guard with Bonaparte and Marshal Grouchy in command. While the relatively modest number of injured men at Quatre Bras would weaken several units on the 18 June, the casualty rate at Ligny was impressive enough: 11 000 Prussian dead and wounded and around 8000 French. No quarter was given during this latter engagement. After Blücher’s defeat, the main Prussian force loyally retired north, not east, so that they might later support Wellington.7 Marshal Grouchy was dispatched with 30 000 men to prevent Blücher’s forces joining up with Wellington later. This manoeuvre was to fail—at great cost to Bonaparte. The terrain of the now very damp battlefield was open rolling countryside with hedges, copses and woods. Of the latter, the large Fôret de Soignes was at Wellington’s back. Three defended farms on or forward of Wellington’s line (a ridge around 3 miles long) were temporary havens for casualties but we know little about the Allied medical staffing of them. Chateau Hougoumont projected well out from the Duke’s right centre, la Haye Sainte farm was several hundred metres in front of the line and Ferme Papelotte was on the Allied left flank. Thus, apart from these somewhat isolated forward positions, a large temporary field hospital at Mont St Jean Farm, 500– 1000 m behind the ridge, some isolated hovels and barns served
as unit dressing stations. Mont St Jean probably housed about 6000 casualties during the day. Many wounded had to traverse a hazardous 500–1500 m or more, of exposed battle ground to reach this farm where the few camp followers played a role in the care of the injured. In this field hospital, many of the battalion surgeons would coalesce, assisting each other and sharing equipment as necessary (Figure 4). During close fighting, with infantry in line or column, the assistant surgeon’s position was made known. In square formation, he dressed and tidied wounds, splinted fractures, controlled haemorrhage and gave water to victims. (ref 8, page 108) Casualty clearance for the cavalry arm was tricky, since so many of the dismounted and damaged troopers were isolated or lay in disputed or enemy territory. The battle commenced at around 11:30 h, with an artillery bombardment and an infantry attack on the south face of Chateau Hougoumont and its adjacent woodland. Fierce skirmishing in these woods was followed by an intense assault on the farm. Over the day, German soldiers and light company Foot Guards inflicted around 4500 casualties on the French, receiving themselves about 850 killed and wounded. We are unsure of the medical support in the farm, but the surgeon of the Coldstream Guards (William Whymper) and/or one of his assistants were probably in attendance in this forward position. We know some walking wounded exited the north gate of the farm back up to the security of the Allied ridge. Many of these eventually converged on the farm of Mont St Jean.
Figure 4 Mont St Jean Farm.
Figure 5
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Limb avulsed by a round shot. 137
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Original paper Around 12:30 h, there was a break in at Hougoumont through the north gate. One other break-in and almost another were aborted and the attackers soon shifted their assault from the open killing ground at the south and west aspects of the farm to the gardens and orchard to the east. Around 14:30 h the chateau building was set alight and as the building burned, casualties were evacuated to nearby barns. The French assaults continued, with both sides being reinforced. Far from drawing Allied troops away from Wellington’s centre, more and more French of Count Reille’s 2nd Corps were sucked into the assault on Hougoumont. Around 12:45 h, a great barrage commenced from Bonaparte’s 64-gun battery, approximately a kilometre from Wellington’s ridge. Bonaparte wished to pulverise the Duke’s left centre and then send in Count Drouet d’Erlon’s fresh 17 000 strong 1st Corps. The heavy bombardment lasted around three-quarters of an hour and probably caused only about 500 casualties, because of damp ground, a thinly dispersed target line and over/undershooting.8 Round shot injuries, if central were fatal and the commonest reason for survival from these injuries was limb avulsion (Figure 5). As the guns fell silent, dark columns of French infantry were seen moving through the gun lines. D’Erlon’s four divisions advanced en echelon, left in front and two of them formed in an unusually wide column (145 files long) formation to bring maximum firepower on the Allies. As the French skirmishers dropped away, the leading divisions topped the ridge and pushed back the Allied infantry, recently depleted at Quatre Bras. This was a dire moment for the Duke. Henry Paget, Lord Uxbridge sent in around 2500 sabres of the Household and Union heavy cavalry brigades. Although the main French infantry thrust was shattered by this unexpected manoeuvre and around 1500 French were captured, the British heavy cavalry had gone too far and was effectively destroyed by frontal and flanking enemy cavalry. Lance wounds, musketry, capture and horse falls accounted for losses of half the attacking force. In a small study of 77 wounds in 29 Union Brigade troopers, 48 were lance wounds, with surprisingly, only 13 torso strikes (Mr Stuart Mellor, personal communication). Some other troopers suffered up to 20 lance injuries. From 15:30 to 17:00 h, repeated attempts to capture La Haye Sainte Farm failed and three Allied infantry battalions were helplessly cut down sooner or later by French cavalry, lurking behind the farm. The French heavy cavalry sabres were used in a thrusting manner, often inflicting fatal penetrating injuries, while the British equivalents and light 1796 pattern cavalry sabres caused fearful slashing injuries. (ref 8, page 66)
Around 14:00–15:00 h, the French 6th Corps and later, units of the Imperial Guard were drawn off to parry a mounting Prussian assault on Bonaparte’s right rear at the village of Plancenoit. As to the main assault, Bonaparte’s options were now limited and he decided to commit his two magnificent 3rd and 4th cavalry corps (Generals Kellerman and Milhaud) to move against Wellington’s right centre. The Allied infantry formed square to resist the massed cavalry advances. Trotting up the muddy slopes, thousands of horsemen received, first round shot then case from Allied ordnance, cutting down cuirassiers and horses in swathes (Figure 6). Lapping around the impenetrable squares, the killing continued. Only when the horsemen retired did the infantry take terrible retribution from French artillery. Wounded were pulled back into squares and the dead were thrown out. Before 2 h were up the sweaty bleeding horsemen stood off from the exhausted, smoking squares, gesturing futilely at the Allies, while the infantry conserved their cartridges and waited for another charge. So many casualties must have exsanguinated here, unable to move on to Mont St Jean or travel back to the French ambulances. At around 18:00 h, La Haye Sainte was taken, poorly shored up the previous night and the little garrison had run short of ammunition. As the French poured in, furious soldiers dispatched the Allied casualties lying in the farmhouse. Meanwhile, at Plancenoit, Bonaparte’s men were hard pressed and units of the Young and Old Imperial Guard barely held on. Casualties of both sides lying around in the cellars of the village houses were butchered mercilessly. Once again, no quarter was given. As dusk arrived, General Ziethen’s 1st Prussian Corps arrived to shore up the Allied left, unimpeded by Grouchy’s force, which was still engaged at Wavre, east of the main battle. Bonaparte’s game was up. In a last desperate attempt to break Wellington’s line, units of the French Middle Imperial Guard, supported by some units of the Old Guard and by horse artillery, moved up in three waves, to assault Wellington’s right centre en echelon, mainly in square formation. Accompanied by battalion surgeons, with the Guard ambulances to the rear, around 3000 veterans trudged up the slope, where they wreaked havoc on some exhausted Allied units, until flung back by Dutch troops—Detmer’s brigade and a battery of artillery.10 On the right Peregrine Maitland’s 1st Guard’s Brigade smartly volleyed the leading Chasseurs of the Guard, bringing down the leading ranks. The British Guards impetuously rushed down on
Figure 6 A French cavalry assault.
Figure 7
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An above-knee amputation.
Crumplin M. J R Army Med Corps 2015;161:135–139. doi:10.1136/jramc-2014-000391
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Original paper
Figure 8 A British field surgical instrument set used at Waterloo. their broken quarries, until coming under immense fire from a strong French assault. They retired and Sir John Colborne’s veteran 52nd regiment, 1000 strong, and two other units wheeled left and saw off the last brave French advances. This battle had claimed around 50 000 killed, wounded and missing. In all, from the four battles of the campaign, there were about 63 000 wounded men to be treated. At Waterloo, there had been 17 000 Allied casualties and of around 24 000 British soldiers participating, 7016 (29%) were killed or wounded with 28% officer casualties. Many men lay on the field for a day or more. The main problem was the density of the wounded, hindering efficient retrieval by adequate cadres of bearers. (ref 2, page 26–30) At the battle of the Somme in 1916, the mean density of injured was 234 per mile of front— at Waterloo the equivalent figure was 2291. An impressively low in-hospital mortality of 9% merely reflected the inability of so many casualties to reach hospital. About 40 spring wagons were requisitioned from Brussels, where five main hospitals had been set up. Small detachments of men from each battalion searched the field for comrades and remained back to assist with the wounded. The battalion surgeons all left with their units, thus committing thousands of French and Allied casualties to the hospital staff, French Prisoners of War surgeons and Belgian civilian staff. One of the latter, 18-year-old Dr Seutin,
Crumplin M. J R Army Med Corps 2015;161:135–139. doi:10.1136/jramc-2014-000391
amputated 23 men during 1 day. There were around 500 Allied amputations on the 18th and roughly 2000 over the whole campaign (Figures 7 and 8). Surviving casualties were shipped by barge to Ostend and sent home. A year later, of 6831 casualties, 506 were discharged, 854 remained in hospital, 236 survived amputation and 167 had joined veteran battalions. The remainder, 5068 (74%) rejoined the army. (ref 2, page 34) Most of Wellington’s staff had been injured and he was joined by a single officer at supper on the night after Waterloo. His military secretary, the future Lord Raglan of Crimean fame had lost an arm, his close friend and an aide-de-camp, Alexander Gordon had had a leg amputated and subsequently bled to death. His cavalry commander Lord Uxbridge also lost a leg. His Quartermaster General, Howe de Lancey tangentially struck in the flank by a round-shot had succumbed from severe internal bleeding. After the war, Britain was later flooded with discharged soldiers and unemployed surgeons, some of whom became wellknown characters, such as John Hennen, George Guthrie, Samuel Cooper, John Knox who was associated with the Burke and Hare murders and John Hall (of the ill-fated Crimean campaigns). James McGrigor continued to serve as director general until 1851. Two generations of soldiers and surgeons later, many valuable lessons of these long wars were to be forgotten in the shambles of the Crimean War (1854–1856). Competing interests None. Provenance and peer review Commissioned; internally peer reviewed.
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Glover G. Waterloo, myths and reality. Pen and Sword Ltd, 2014:36. Crumplin MKH. The bloody fields of Waterloo. Ken Trotman Publishing, 2013. Blanco RL. Wellington’s surgeon general: Sir James McGrigor. Duke University Press, 1974:146. Howard M. Wellington’s doctors. Spellmount Publishing 2002:64. Crumplin MKH. Guthrie’s war. Pen and Sword Publishing, 2010:21. Adkin M. The Waterloo companion. Aurum Press, 2001:312. Clayton T. Waterloo, four days that changed Europe’s destiny. Little, Brown Publishing, 2014:235. Crumplin MKH. Men of steel. Quiller Publishing, 2007. Adkin M. The Waterloo companion. Aurum Press, 2001:301. Field AW. Waterloo—the French perspective. Pen and Sword Military, 2012:198–9.
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Medical aspects of the Battle of Waterloo: the battle Mick Crumplin J R Army Med Corps 2015 161: 135-139 originally published online December 18, 2014
doi: 10.1136/jramc-2014-000391 Updated information and services can be found at: http://jramc.bmj.com/content/161/2/135
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