“The weather was intensely hot, the flies were in myriads, depositing their eggs, so that maggots were bred in a few hours, producing dreadful irritation.”

By Martin Howard

THE War of 1812 is one of the strangest conflicts of the modern era.

The ostensible cause of the struggle — the British policy of restricting U.S. trade with Napoleonic France — was resolved before hostilities had erupted. The fighting, which raged along the frontier between the United States and Britain’s Canadian colonies, ultimately changed nothing; all captured territory was returned. And finally, there was no clear winner; both sides simply agreed to terminate hostilities after two-and-a-half years.

By European standards, the battles of the War of 1812 were miniscule. For example, one of the war’s opening engagements — Queenston Heights — involved fewer than 5,000 combatants in total. By comparison, just weeks earlier and half a world away, Napoleon’s 135,000-man Grande Armée met a similarly sized Russian force at Borodino with both sides suffering tens of thousands of casualties in a single day. Yet despite the small scope of the Anglo-American war, the wounded suffered just as greatly as those on European battlefields, indeed perhaps more, particularly when considering the backwoods locations of the clashes and the minimal preparations made for care of the wounded by the competing armies.

At the outset of the conflict, British medical resources were focussed on Europe and there had been no replenishment of the army medical department in Canada since the American Revolution 30 years earlier. Deputy Inspector Gabriel Rice Redmond was given the unenviable role of principal medical officer to the forces in Canada. In the autumn of 1812, he made a tour of the medical department. Extracts from his diary reveal a meagre and poorly maintained service.

The British were poorly prepared but at least there was a recognisable medical department and there is evidence of improving standards during the conflict. By contrast, America’s soldiers and doctors were caught cold by the war.

The post of Physician and Surgeon General was given to Dr. James Tilton. He had gained much experience in the Revolutionary War, but he was an awkward and eccentric individual, more of an innovator than a leader. Despite a steady flow of new regulations, the service suffered from basic organisational problems. There was confusion as to the whereabouts of many of the army’s doctors. Tilton’s poor health limited his efficacy, and he was overshadowed by Surgeon James Mann who was in overall charge of the medical services of the Northern Army.

The state of battlefield medicine in the War of 1812 can best be explored by considering two of the major clashes of arms, the battles of Lundy’s Lane, and New Orleans.

Lundy’s Lane was fought on 25 July 1814. The bloody inconclusive affair cost the Americans some 45 per cent of those engaged. British losses amounted to around 30 per cent of combatants. The American wounded faced the prospect of a near 29-mile journey in carts or wagons over rough and bumpy dirt paths to Fort Erie. Once at the outpost, many of the casualties would end up in the tented general hospital across the river at Williamsville near Buffalo. The British casualties had an equally painful transfer to the hospital at Fort George at the opposite end of the Niagara River.

Lundy’s Lane gives us some of the most vivid recollections of Napoleonic battlefield surgery by young surgeons on and around the field. William “Tiger” Dunlop, a 21-year-old assistant surgeon to the British 89th Regiment of Foot, had sole responsibility for 220 wounded men as his regiment’s two other surgeons were sick.

I never underwent such fatigue as I did for the first week at Butler’s Barracks [a makeshift military hospital at Fort George, crudely constructed from logs]. The weather was intensely hot, the flies were in myriads, and lighting on the wounds, depositing their eggs, so that maggots were bred in a few hours, producing dreadful irritation, so that long before I could go round dressing the patients, it was necessary to begin again; and as I had no assistant but my sergeant, our toil was incessant. For two days and two nights, I never sat down; when fatigued I sent my servant down to the river for a change of linen, and having dined and dressed, went back to work much refreshed. On the morning of the third day, however, I fell asleep on my feet, with my arm embracing the post of one of the berths.

American surgeon William Beaumont, 29 years of age, was at Williamsville.

The Groans of the Wounded & agonies of the Dying are to be heard. The Surgeons, wading in blood, cutting of[f] arms, legs & trepanning heads to rescue their fellow creatures from untimely deaths — to hear the poor creatures crying — Oh Dear! Oh Dear! Oh My God! Do Doctor, Doctor! Do cut of[f] my leg! My arm! My head! To relieve me from misery! I can’t live! I can’t live!

Also, at the hospital at Williamsville, 21-year-old American Hospital Mate William Horner had a similar workload to Dunlop.

My fingers became so sore, from incessant dabbling in water and in pus, that I could seize nothing without pain, and was constantly liable to let articles fall, from the sudden twinges of agony in touching them.

Horner was later to become a professor of surgery, and he tackles the oft ignored subject of surgical pain experienced in an era before anaesthetics.

Soldiers are much disposed to repress the expression of pain, considering it unmanly. When this natural mode of easing the circulation of the lungs by groaning and expiration was withheld, which can only be done by holding the breath, I came to the conclusion that it was highly disadvantageous to the individual. Chewing a bullet is a resort which should also be discouraged. The amount of pain excited in different persons varies very much. I assisted at an amputation of the leg of a soldier who was smoking tranquilly during the whole operation.

The Battle of New Orleans, fought on January 8, 1815, was a crushing defeat for the British. While the American victors suffered only 71 casualties, the vanquished army lost 2,000 men, around 1,200 of them wounded. Surgeon William Lawrence of the Tennessee Militia commented that he “could have walked on the dead bodies of the British for one quarter of a mile without stepping on the ground.”

Details of the management of the few American wounded are sparse. They were mostly evacuated to the New Orleans hospitals. That their care was judged satisfactory is apparent from Andrew Jackson’s approbation. The American general believed that ‘The medical staff has merited well of the country’.

The British medical department was faced with a much greater task. Conditions in the temporary field hospitals were little different from the battlefields of Europe. Lieutenant George Gleig of the 85th Regiment of Foot wandered into one where “every room was crowded with mangled wretches, and apparently in the most excruciating agonies.” The British held their ground for nine days after the action, whilst casualties were transferred to the shore nine miles distant. Senior doctors were mentioned in dispatches suggesting that the British medical department had also coped well in adversity.

The Battle of New Orleans is a good example of the generosity of local citizens to injured soldiers, irrespective of their nationality. Many locals took vulnerable British soldiers into their homes and civilian physicians cared for the enemy’s wounded. This mutual care of the enemy wounded after a major battle was commonplace in the American Revolution and this spirit of cooperation had survived in the War of 1812.

Martin Howard is the author of The Napoleonic Wars: A Medical History from Pen & Sword. A hospital consultant and an honorary visiting professor at the University of York. He has a longstanding interest in the Napoleonic Wars with a particular focus on the human dimension of the conflict and the lesser-known campaigns. His most recent books in the field are Walcheren 1809: The Scandalous Destruction of a British Army and Death Before Glory! The British Soldier in the West Indies in the French Revolutionary and Napoleonic Wars 1793-1815.