The Emotional World of Military Surgery, 1815-1914

February 2018
'Cared for': recuperating soldiers being nursed during the Crimean War. Wood engraving by L. Huard. (Wellcome Collection)
'Cared for': recuperating soldiers being nursed during the Crimean War. Wood engraving by L. Huard. (Wellcome Collection)

Note: This article contains references to nineteenth-century racial terms that readers may find upsetting.

The emotional experience of military surgery in the British Empire from the Napoleonic Wars until 1914 was, for obvious reasons, often grisly and agonising. Before the introduction of anaesthesia in the middle years of the century (and often after that), little was available in terms of pain relief. While mortality rates gradually improved, wounded soldiers attended by surgeons faced the prospect of mutilation or an early and painful death.

These facts make it all the more striking that the period saw a veritable cult of heroic stoicism in the face of military surgery. The history of the period is replete with examples of men enduring surgery, especially amputation, without complaint. Many in the Victorian era took the conduct of the Earl of Uxbridge at Waterloo as a model. The well-known (if slightly misleading) anecdote reported that when a cannon ball hit him, he said ‘By God, Sir, I’ve lost my leg’, to which the Duke of Wellington replied, ‘By God, Sir, so you have’. Uxbridge then underwent amputation without a murmur. As the century wore on, there were countless similar anecdotes of soldiers and sailors calmly smoking cigars or singing patriotic songs while they underwent the most dreadful operations. My project investigates the widespread notion that some groups, whether ‘officer class’ or members of ‘martial races’, were better able to withstand the agonies of surgery than others, based on a range of moral, psychological or physiological theories.

Often such stories were understood in a complex class context. On the one hand, gentlemen officers were widely believed to have literally more sensitive nerves than the 'hoi polloi'. Indeed, being a civilised person was sometimes understood to be essentially a matter of being more sensitive to impressions and to pain. Influential observers such as Theodule Ribot argued that peasants were less sensitive to pain on physiological grounds than more sophisticated urbanites. As late as the 1930s, George Orwell recorded a widespread view that working-class people did not feel pain in the same way as their ‘betters’. At the same time, however, those officers were inculcated with a potent ideology of service, Stoicism and restraint that led to the pose and sometimes, it seems, the reality of composure in surgery. The military victories, and especially the ‘glorious’ defeats so beloved of the British (from the Charge of the Light Brigade to the Siege of Lucknow) provided many instances of senior officers displaying remarkable courage while suffering wounds and amputation.

The idea of fortitude in the face of military surgery was also understood in terms of nationality and race. Factors such as ‘scientific’ racism, religious prejudice and colonialism played a central role in assumptions about the emotional character and the ability to withstand pain of specific groups such as English, ‘Celtic fringe’, continental and colonial military surgery patients. The Scottish pioneer of anesthesia James Young Simpson, in his Clinical Lectures on the Diseases of Women (1872), suggested that Irish and Scottish peasants, ‘rice-eating Hindoos’ and ‘black races’ were emotionally tougher and more likely to recover from surgery than other groups. Likewise, Rawdon Macnamara’s Neligan’s Medicines (1867) argued that while Turks and Russians responded to chloroform with calmness, ‘French and Irish specimens of the great Celtic brotherhood’ reacted with ‘violent demonstrations’ and ‘infinite trouble to the operator’.

In the Crimean War such thinking was commonplace, with theories about the natural resilience and emotional powers of endurance among Scottish, English, French, Russian and Turkish troops being discussed in medical journals, newspapers and in lay correspondence and diaries. The aftermath of the war saw an agonised controversy among French physicians such as Velpeau, Le Fort and Malgaigne about whether the apparent low rate of survival of French amputees compared to their British counterparts was the result of French racial degeneration. Similarly, the fact that Russian doctors suggested that French prisoners of war needed twice as much anaesthetic as their own men was widely reported.

Beyond Europe, colonial rule was often justified by allusions to the supposedly superior willpower and Stoicism of the British compared to allegedly ‘soft’ and ‘effeminate’ races such as Bengalis. Other colonial groups (Pashtuns, Gurkhas, Sikhs, etc) were understood to be naturally martial, capable of standing up to pain, and were often incorporated in British imperial forces.

The Indian ‘Mutiny’ that followed quickly after the Crimean War provided an even larger canvas for the projection of ideas about the heroic fortitude of particular ethnic groups undergoing military surgery. In his 1865 The Domestic Life, Character and Customs of the Natives of India, James Kerr argued that Indians ‘bear pain with a firmness truly stoical. Such is their patience under a surgical operation, that some have imagined their nerves are less sensitive than those of Europeans. A degree of pain which would make a strong European cry out or faint away, a weak Bengalee will bear easily’.

The American Civil War and the European colonial wars associated with the Scramble for Africa gave an apparent direct relevance to this medical debate about the fortitude of ‘negro’ soldiers under the surgeon’s knife. Moseley’s Treatise on Tropical Diseases from the 1760s was endlessly cited as evidence that ‘negros… bear chirurgical operations much better than white people: and what would be the cause of in supportable pain to a white man, a Negro would almost disregard’. ‘Orientals’ such as the Chinese and Japanese were also understood to feel little pain. After the Opium Wars, it was widely reported that Chinese wounded exhibited ‘unflinching and calm behaviour’ while experiencing amputation.

My project also involves looking at the broader cultural impact of such thinking, for instance in the novels and pictures of the period. The imperial adventure story In the Grip of the Mullah: A Tale of Adventure in Somaliland (1903) by Captain Frederick Sadleir Brereton is in some ways typical in its depictions of British stoicism in the face of wounds and medical treatment. When the character of Jim has his wounds dressed, his friend Tom says, ‘There, you bore it like a Briton, and will soon be well. Luckily it is only a flesh-wound’. Brereton (also the author of the perhaps less exciting Hemel Hempstead through the Ages) continued with this theme in his novel of the Ashanti War, With Wolseley to Kumasi (1907). In it, a character responds to surgical treatment with the lines, ‘Hah! A mere flesh wound, barely an inch deep. Not even that. I'm lucky! … A schoolboy would laugh at it’.

The whole discourse of how different groups were expected to respond to the agony of military surgery is thus heavily laden with ideology and replete with paradoxes. ‘Superior’ white men, especially their officers, were portrayed as capable of withstanding the pain of battlefield surgery, while if non-white troops did the same it was often ascribed not to high moral character but to mere physiological crudity.

Partly because of its internal inconsistencies, this ideology was itself constantly shifting and was never without its critics. Henry Lawrence, hero of the Siege of Lucknow and a shrewd observer of military matters, was surely near the mark when he suggested that, ‘Courage goes much by opinion; and many a man behaves as a hero or a coward, according as he considers he is expected to behave’. Examining archival medical and lay testimony, my project considers the ambiguities and paradoxes involved in the collision between the reality of surgery and contradictory ideologies of manliness and race, in order to achieve a more nuanced understanding of the emotional world of military surgery in the nineteenth century.

Using the prism of surgery in a century when surgery often remained brutal, the project provides a new perspective on the history of emotions, class, masculinity, race and empire. While martial race ideology and its impact on surgery may seem archaic, it continues to have considerable resonance, playing a key role in divisions between Punjabi West Pakistanis and Bengali East Pakistanis between 1948 and 1971, for instance. Even today ideas of the virile military virtues of toughness and stoical indifference to pain are a commonplace in popular culture and government policy in both Britain and the United States.