The Scalpel and the Sword: The Autobiography of the Father of Army Medicine (review)

Mary McGrigor and the Scottish Cultural Press are to be congratulated for making available the autobiography of her husband's ancestor, Sir James McGrigor. An administrative innovator of the first order, McGrigor is best known as the director-general of the British Army Medical Department from 1815 until 1851 who shaped army medicine after the Napoleonic Wars, raising its status both inside and outside the army. Unlike most of his predecessors at the top of army medicine he had extensive field experience abroad as a regimental surgeon, having joined the Connaught Rangers in 1793. His autobiography, originally published in 1861 (three years after his death in 1858), begins with his birth in 1771 and ends abruptly in 1815—but his organizational ability was already evident, and the autobiography reveals the roots of the ideas he advocated and implemented later in his career. Particularly important, in McGrigor's view, were the collection of medical statistics, the education of army surgeons, and the development of systems to facilitate the health and rapid convalescence of soldiers.

This engaging account also vividly reveals the nature of the career and life of a regimental surgeon during the Napoleonic Wars: first in Flanders and the West Indies, then in India, the Middle East, and finally Europe—particularly the Peninsula campaign. Son of a general merchant who migrated to Aberdeen from the Highlands, McGrigor was well educated, having a successful career at Aberdeen Grammar School and at Marischal College in Aberdeen University where he earned an M.A. degree. Deciding against following his father's occupation, he joined friends who were studying medicine, and decided to pursue a medical career. He studied under a prominent Aberdeen practitioner; he also attended the Aberdeen Royal Infirmary for three years, and the lectures available in Aberdeen, before studying in Edinburgh for a year at the University under Munro, Gregory, and Hope. Returning to Aberdeen, in 1789 he and fellow students founded the Aberdeen Medico-Chirurgical Society (which still exists).

Encouraged by his Aberdeen mentor, McGrigor went to London in 1793 armed with letters of introduction: these gave him hospitality, but not the place he hoped for in a lucrative practice; instead, he worked as an assistant to an elderly surgeon in a village a mile and a half outside London. Feeling overworked and underpaid, with only mundane prospects, he was soon caught up in the excitement of the war with France, which had just broken out; with friends in London, many from Aberdeen, he decided to join the army as a medical officer—convincing his father to purchase a surgeon's commission, and taking the advice of the agent to join an Irish rather than a Scottish regiment for more rapid career advancement. But career advancement depended on survival, and the autobiography graphically illuminates the precariousness of survival for the doctors as McGrigor repeatedly succumbed to attacks of fever and to injuries while treating those of the soldiers. Patronage was also crucial to advancement, and the autobiography reveals the myriad networks, many Scottish-based, and the importance of McGrigor's relationships with the Duke of Wellington and members of the royal family.

However, contrary to the publisher's claim, this work on McGrigor should not be taken as definitive. The editor, while drawing on McGrigor's papers in other collections for her introduction and linking passages, does not discuss the provenance of the manuscript, nor when McGrigor wrote it (the Wellcome Library catalogue suggests 1835). Further, she has a tendency to quote uncritically chunks of primary or secondary works rather than give her own clear account of the background informed by recent historiography. Finally, a minor point, but indicative: the year of birth on the title page of the autobiography is...