Star.
London, England, 1808-03-30 00:00:00

FIFTH REPORT,
SIONERS APPOINTED TO ENQUIRE AIIP
EXAMINE INTO THE PUBLIC EXPENDITURE.

ET THE

ARMY MEDICAL. DEPARTMENT.

( Continued front Friday': Paper.)
The Army General Hoepital System, to which we
shall now advert, either as it has been adopted in our
military service abroad, or in that at home, is to be
estimated in respect of its utility in the care of the sick,
and of its seconomy. In both these points of view,
and in both services, it will be found, we believe, that
the system has been carried to too great an extent,
and has been very disadvantageous.

In pursuing this part of our enquiry, we have col-
lected information from Gentlemen of great experi-
ence in every branch of army medical practice, and
have endeavoured, by an examination and compari-
son of the accounts of General and Regimental Hos-
pitals, and of the medical system observed in the
Navy, Ordnance, and East India Company's ser-
vices, to judge ofthe merits ofthe army medical system.
When troops are engaged on active service abroad,
it must, we presume, sometimes happen that the sick
and wounded cannot be accommodated with the re-
giments to which they belong : in such cases, hospi-
tals to which the sick might be generally sent, and
medical aid beyond that which the Regimental Sur-
geons could supply, must become necessary. Accor-
dingly, we find that there were General Hospitals
with our army in Flanders in 1793. The sick were
nevertheless mostly kept with their regiments, and the
Medical Staff of the army was composed of persons
who had had experience in regimental practice. But
in 1794, after the formation of the Army Medical
Board, a new system seems to have been adopted.—
Medical men, stated to be inexperienced in military
habits, and the conduct of army medical practice,
were placed at the head of the Staff ; and the sick
were taken from the Regimental Surgeons, and were
almost solely accommodated in the newly-established
General Hospitals. The consequences, as we learn
from Doctor Borland, then Surgeon to a regiment on
that service, and the concurring testimony of 'other
medical persons serving in the same army, were very
unfortunate : the mortality which, whilst the sick re
mained with their regiments in the former year, had
been trifling, and even in those regiments which still
kept their sick under the eye of their Surgeons in
1794, was comparatively small, became very great
in the General Hospitals : and the expenditure also,
owing to bad superintendence and the want of a due
system, was very considerable. It was another con-
sequence of the change, that the Regimental Sur-
geons, whom Doctor Borland considered as at that time
equal to their situation, not being permitted to take
care of their own sick, became less active in the ser-
vice. Doctor M'Grigor, who also served as a Regi-
mental Surgeon on the Continent in 1794 and 1795,
speaks of the greater mortality in the General than in
the Regimental Hospitals. and of the great expendi-
ture of wine and spirits in the first, whilst the expences
of the second were very moderate ; and of the dis-
gust which was created in the Regimental Surgeons,
because their sick were taken from them and sent to

the General Hospitals, where they were placed under
the care of others not acquainted with army practice,
but selected from civil life.
The concurring testimony of these Gentlemen jus-
tifies us, we think, is alluding to two publications of
Doctor Jackson, who was also a Regimental Surgeon
serving at the same period on the Continent, and
which state the same facts. •
Doctor M'Grigor has noticed in the West Indies,
as well as in Flanders, the superiority of the Regi-
mental over the General Hospitals, in respect of the
treatment of the sick ; for, whilst he served as a Re-
gimental Surgeon in Grenada in 1796, the mortality
under the Regimental treatment was trifling ;—but
when, on the return of the army to Martinique, the
sick were sent to the General Hospitals, the mor-
tality became very considerable. The same observa-
tion of the superior advantages of the Regimental
management of the sick was made by Doctor Bor-
land whilst he served in the West Indies, and whilst
he acted as Deputy Inspector of Hospitals with the
Russian auxiliary army in Guernsey and Jersey, in 1800.
The explanation which is given, to account for the
superiority of the Regimental treatment of the sick
is, that the Regimental Surgeons, and the officers
whose duty it is constantly to inspect the hospitals,
are previously acquainted with the habits and charac-
ters of the patients, and have a superior interest in
keeping up the effective strength of their corps ' • and
that the patients have a greater attention shewn them
by those belonging to the same regiment than they
probably receive in a General Hospital, and that
their cure is promoted by it : and it is also said, that
diseases are often acquired in the General Hospitals,
in addition to those which the sick carry in with them.
It appears to be Doctor Jackson's opinion, as stated
in his publications, (to which we the more willingly
allude, because we have had frequent opportunities
of ascertaining the correctness of the facts stated in
them, and also because many of the improvements
which have lately been made in the army medical
system appear to us to have been suggested by
him), that two-thirds of the Medical Staff abroad,
during the last war were useless : 'Wherever the
Hospital Staff acted," he says, " the Regimental
had little to do ; and where the last did its duty, the
Hospital • Staff had nothing to do." In other parts
too, of the service abroad, it seems that there was an
unneccessary appointment of Medical Staff Officers,
even on the General Hospital System of practice.—
For Mr. Young, a Gentleman of almost universal
experience in the medical service of the army, states,
that while he acted as Inspector of Hospitals to the
army under General Sir Ralph Abercromby, in the
Mediterranean, he has applied to the Surgeon Gene-
OA for some additions of Hospital Mates ; but instead
of Mates, commissioned Medical Officers were some-
times sent out, who being superabundant, were, on
his report to the Connnander in Chief; ordered back
6o England. Nor does it seem a sufficient answer to
this objection of sending officers of a description not
wanted, that officers of the description_required could
with difficulty be obtained.
In respect of the controul and rank established in
the General Hospitals abroad, Mr. Young thinks that
the system was founded on good principles, but that
it would be more convenient to employ Inspecttsrs and
' The distance of Dr. Jackson's residence from London did cwt
conveniently admit of a personal communication with hi*.