“Napoleon said of him, ‘if an army were to build a monument to just one man, it would be Larrey. All the wounded are his family.’”
By John Danielski
DOCTORS MAKING house calls is sadly a thing of the past. However, Dominique-Jean Larrey was a Napoleonic-era army physician who did indeed make house calls, but his were on the battlefield.
On several occasions Larrey rescued wounded soldiers menaced by skirmishers, driving the enemy off in the process with nothing more than his sword, a horse, and his own determination. Then he conveyed those soldiers to safety in the ambulances that he had designed himself. He then treated their wounds, as skilled with a scalpel as he was with a sword.
During the disastrous retreat from Russia in the winter of 1812, Napoleon’s army was trapped with its back to the ice-choked River Berezina and enemy forces advancing. The only bridge across was jammed with fugitives. Seeing Larrey alone, his arms filled with medical supplies, soldiers spontaneously hurried him through the throngs to safety. “Let us save him who has saved us,” many reportedly cried.
Larrey, who marched in 25 campaigns, was present for 60 battles, and witnessed 400 skirmishes, became Napoleon’s de facto surgeon general. His formal title was Surgeon General of the Imperial Guard. A healer in the finest tradition of Hippocrates, Larrey saved more than just the soldiers of Bonaparte. Indeed, he would become one of the fathers of modern military medicine, with his innovations helping to save wounded soldiers in all armies for centuries to come.
Larrey designed the first practical battlefield ambulance service and instituted the practice of battlefield first aid. He formulated the prioritizing of injuries by severity, a system known as triage, and devised the prototype of the modern mobile army surgical hospital, popularly known as a MASH unit.
Larrey was nicknamed “the providence of soldiers” by the men themselves. Napoleon said of him, “if an army were to build a monument to just one man, it would be Larrey. All the wounded are his family.” Napoleon even left him 100,000 francs in his will, a considerable sum in the 19th century.
Born the son of a shoemaker in a small village at the edge of the Pyrenees in 1766, Dominique Jean Larry was orphaned at age three but taken under the care of a local priest who recognized his precocity.
At age 13, he was sent to Toulouse to study with his uncle, Alexis Larrey, who was surgeon-major and professor of the Hospital of Grave. Young Dominque learned quickly and at age 21 was appointed the youngest surgeon in the French navy.
After six months of duty off Newfoundland, Larry’s naval career ended; chronic seasickness rendered him unfit for duty. During his short time on that station however, he dabbled as a naturalist, finding time to go ashore in both Newfoundland and Labrador to study and note the local flora and fauna.
Returning to Paris, he enrolled in a surgery course at the Hotel Dieu and later worked at Les Invalides. He developed a life-long fascination with anatomy. He attended hundreds of dissections and concluded that surgical techniques of the era needed to be improved.
An ardent supporter of the French Revolution, he was present at the storming of the Bastille on July 14, 1789. But rather than tearing down anything, he set up an improvised treatment center for the injured.
Larrey’s revolutionary zeal led him to enlist in the army and he soon found himself posted as a surgeon to the Army of the Rhine near Strasbourg in 1792. After witnessing his first battle, he was struck by the inefficiency of the French medical establishment. By regulation, the nearest military hospitals were supposed to be no closer to the front lines than three miles. Surgeons and corpsmen were kept safe distance from actual battle, far from the wounded. He noted that there was no organized system to collect casualties so often the injured lay in agony for many days before they received medical attention. If this wasn’t bad enough, France’s revolutionary regime, in an outburst of misguided zeal, abolished all medical schools; a situation that was not remedied for a full year.
Larrey was impressed by the speed and agility of French horse artillery and wondered if there might be a way to use horses and light carts to remove the wounded from the battlefield as quickly as it was to deploy light artillery. Over the next several years, he developed experimental horse drawn carts he dubbed “flying ambulances.” The carriage frames were light, had special springs to cushion the ride, and was enclosed with a top shaped like an inverted U. It had a padded floor, platforms for four stretchers and featured a large rear door for easy access.
Larrey organized his ambulances in groups of 12. The units were accompanied by 15 surgeons and 100 men. Gradually the men of the flying ambulances became so skilled they could clear a group of wounded in as little as 15 minutes. Critical surgery could be performed on the spot or at a dressing station just out of the line-of-fire. Once out of the dressing station, the wounded were sent to the regimental field hospital where more complicated surgeries could take place. Regimental hospitals contained teams of surgeons operating in shifts, as well as pharmacists and specially trained nurses – a far cry from the ad hoc methods of simply using regimental musicians as stretcher bearers found in other armies of the day.
Larrey was a strong advocate of immediate surgery, feeling the first hour after a solider was wounded was critical to his survival. This ran counter to the prevailing medical theories of the day, which prescribed waiting hours before performing an amputation. Larrey’s belief that a body was more resistant to such trauma when surgery was performed immediately after a wound was inflicted rather than later would be proven right; under his direction, French battlefield casualties enjoyed a far higher rate of survival than those of other armies.
Larrey had a deep humanitarian streak that caused him to care just as much about the fate of enemy soldiers as his own. According to the custom of the time, the wounded were divided into three categories. Wounded friendly officers were treated first, wounded friendly private soldiers treated second, and wounded enemy soldiers treated last. Larrey revised this system of triage, making it about the severity of the wound, regardless of nationality. The most gravely wounded who might recover were treated first, those wounded who were not in immediate danger were treated second, and those whose wounds were likely fatal were treated last. It was a revolutionary concept and met with strong resistance at first, but Larrey was nothing if not strong minded and his system gradually prevailed.
He was known to intervene personally when the lives of wounded enemy soldiers were in danger. During Napoleon’s Egyptian Campaign, French soldiers were on the verge of executing a captured Mameluke officer. Larrey’s reputation was such that a few words from him saved the officer’s life. The grateful enemy gave him a ring with a large ruby that he wore until it was stolen from him after the Battle of Waterloo.
His humanity extended to animals as well. While dressing a soldier’s wound after the Battle of the Pyramids, he noticed the soldier’s pet monkey was also injured. Without saying a word, he gently attended to the animal’s wounds. When the soldier returned for a check-up, the monkey reportedly clambered up Larrey’s chest and embraced him.
Though he was eventually made a Baron and a Commandant of the Legion of Honour, Larrey never became a headquarters doctor. He preferred to work with surgical teams in the field where he performed thousands of surgeries.
A keen observer, he also found that many of the medical theories of the day were misguided or just plain wrong, particularly in matters of hygiene. He anticipated the germ theory of Pasteur by always trying to keep a wound clean. He promoted the use of maggots to clean out necrotic flesh and used lint dipped in hot wine and camphor to pack and irrigate wounds. He pioneered the technique of removing a bullet by making a counter opening instead of trying to extract it via the torn path it had left. He also developed the technique of making incisions near bayonet wounds to drain off accumulated pus.
Larrey was the first surgeon to devise a technique to remove the arm at the shoulder joint, the first to make a systematic study of the effects of cold on trauma, and the first to successfully drain accumulated fluid around the heart.
He devised a method of leg amputation that greatly eased the suffering of amputees. Instead of cutting the bone spur flat as surgeons did in other armies, he shaped the bone end into a cone. A cone fitted much more comfortably and securely into a prosthetic leg cup.
He also treated numerous cases of intracranial trauma, so he has been called one of the fathers of modern neurosurgery.
During his lifetime, Larrey published 28 books and scientific papers. Those publications covered subjects as diverse as bubonic plague, typhus, ophthalmia, scurvy, leprosy, aneurysms, hernias and rheumatism. His Memoirs of Military Surgery became a minor classic that was translated into English in 1814. It contained not only descriptions of surgery under fire but much useful medical reference material on a wide variety of topics.
His humanity saved his life during and after the Battle of Waterloo. In the course of the battle, he was out with one of his teams operating in full view of the enemy. In an era prior to the Geneva Conventions or even the Red Cross, an army surgeon treating the injured would have been given no special consideration by enemy gunners. One of Wellington’s officers asked the duke for permission to open fire. Such was Larey’s fame, that Wellington knew exactly who he must be. Wellington replied, “No, I salute the devotion and courage of an age that is no longer ours.”
In the chaos after the defeat of the French army at Waterloo, Larrey was captured by Prussians who planned on executing their prisoner. Fortunately, a Prussian surgeon recognized Larrey and freed him. He was quickly escorted to the Prussian commander, Marshal Blücher himself, who embraced Larrey, gave him new clothes and money and sent word to his wife that he was alive. A year before, Larrey had saved the life of Blucher’s son, who was then a prisoner of war. Before returning to France, Larrey found the time to inspect the hospitals set up in Brussels to care for the wounded of Waterloo.
Larrey’s often forceful crusading for the wounded made him many enemies among the army brass. After the Battle of Eylau in 1807, he had designated a farmhouse as a field hospital. A cavalry general demanded the building, saying he had already planned to use it as his headquarters. The mounted officer dared Larrey to take up the matter with Napoleon. The surgeon did just that; Bonaparte ruled in his favor. “I always give Larrey what he wants.”
Larrey was an astute natural psychologist when dealing with the wounded. After that same battle, a French cavalry colonel was brought in whose leg needed amputation. To the colonel’s chagrin, the leg was shaking so badly that Larrey could not operate. Larrey understood the man’s sense of honor and slapped him. The angry colonel shouted that such an action was a dueling offense and unleashed a long string of invectives. His anger caused him to forget his fear and so his leg stopped shaking long enough for Larrey to remove it. The colonel later became a lifelong friend.
Larrey possessed a sardonic sense of humor and though never boastful, was keen that all should know of his considerable achievements. He wore his hair unnaturally long, and worried, like Samson, that cutting it would somehow diminish his powers.
When Napoleon went into exile on St. Helena, Larrey offered to go with him, but the deposed emperor refused, saying the doctor had many patients left to cure.
After the peace of 1815, Larrey was appointed to a variety of posts, including the Council of Health of French Armies and Surgeon in Chief of the Hotel d’Invalides. He made a triumphal tour of English hospitals, and he organized the ambulance system of the new Belgian Army.
Despite his years on campaign, Larrey enjoyed a long and happy marriage to Marie Elizabeth Laville-Leroux, a talented portrait painter who had studied under Napoleon’s favorite artist, Jacques Louis David. They had a daughter, Isaure, and a son, Felix Hippolyte; the son becoming a famous military surgeon in his own right.
After the bloody battle of Solferino in 1859, Felix Larrey had extensive conversations with a Henry Dunnat, a Swiss businessman and humanitarian. Inspired by those conversations, Dunnat founded the International Red Cross in 1863 and established the Geneva Conventions in 1864.
Larrey and his wife died within 48 hours of each other in 1842, though they were separated by many miles. Larrey died at Lyons in the arms of his son, exhausted after a tour of French military hospitals in Algiers.
In 1992, his remains were reburied at Les Invalides close to the tomb of the man he served for so long, Napoleon.
Larrey’s legacy lives on in the battlefield hospitals of many nations. Several surgical procedures are named for him as is one of the top medical awards of NATO. He was a great humanitarian with a combative side, closer to Hawkeye Pearce than Mr. Rogers. And it is safe to say that the origins of M*A*S*H units lay not in the mountains of Korea, but in the smoke-shrouded plains of the Napoleonic Wars.
John Danielski is the author of eight books chronicling the adventures of Royal Marine Thomas Pennywhistle during the Napoleonic Wars. The newest title in the series is Destination Waterloo. It is available from Amazon.com. He is a frequent contributor to MilitaryHistoryNow.com.
