Book Review: Sir James McGrigor: The Scalpel and the Sword the Autobiography of the Father of Army Medicine
Authors: Martin R Howard
Journal: Journal of the Royal Society of Medicine (2001)

James McGrigor is rightly referred to as the father of British army medicine. Purchasing his commission in the Connaught Rangers as an unqualified regimental surgeon in 1793, he then extensively campaigned in the Low Countries, Egypt, India, the West Indies, and the Iberian Peninsula. His outstanding qualities as a doctor and administrator enabled him to rise rapidly through the army hierarchy and to eventually become director general of the medical department, a post he held until 1851. His best-known duty was as the head of the medical department in Portugal and Spain during the latter years of the Peninsular War. Here he formed a close working relationship with Wellington, who both liked and respected his senior doctor. McGrigor's achievements were many but above all he raised the status of the ordinary army doctor and introduced the routine collection of disease statistics. Under McGrigor's guidance British army doctors received their first ever mention in dispatches, after the action at Badajoz in 1812. His carefully maintained disease records were later used by statisticians to disprove many of the traditional ‘miasmatic’ theories of disease and to justify the introduction of crucial preventive measures such as better diet, clothing and sanitation.

Despite his eminence and honours, McGrigor was a modest and self-effacing individual. When he first submitted his article on the medicine of the 1801 Egyptian campaign for publication, he expressed reservations about his writing skills. His later autobiography, published in 1861, is the work of an accomplished author. He emphasizes his medical duties but we also have much detail of the war itself. The enormous breadth of McGrigor's campaigning makes this a unique account of the military medicine of the era. Except at Waterloo, he appears always to have been in the midst of the action. He is more reticent about his personal life and we learn less about the private man. Mary McGrigor, the wife of a McGrigor descendent, has edited his autobiography with a light touch. Sir James is allowed to speak for himself, which is as it should be. She has contributed an introduction, explanatory notes and references, some extracts from McGrigor's campaign journal, and a few appendices. The introduction focuses on his formative years in Aberdeen. It is helpful, although a little strong on Scottish local history and genealogy for the average reader. No doubt this reflects the interests of the editor and her publisher. The explanatory notes are appropriate but there are occasional errors—for instance, the arch critic of the army medical board, Dr Robert Jackson, hit the Surgeon General Thomas Keate with his cane, not the Physician General Lucas Pepys as stated. The insertion of McGrigor's journal extracts into the text works admirably, both improving the continuity of the autobiography and adding the sharper perspective of contemporary comments. The appendices are well chosen, the abridged version of McGrigor's account of the plague and ophthalmia-afflicted Egyptian campaign being especially welcome. The book is nicely produced in softback format with a few pertinent black and white illustrations and maps. There are a handful of typographical errors.

I can personally vouch that, even in these days of internet search engines, finding a copy of the original 1861 version is extremely difficult. Mary McGrigor and her publisher are to be applauded for making this seminal work of British military medicine again easily available after an interval of 140 years. Those who enjoy McGrigor's own account of his life might wish to read Richard Blanco's excellent biography (James McGrigor: Wellington's Surgeon General, Duke University Press, 1974) which contains an unparalleled bibliography of the army medicine of the period.