Combat Surgeons (review)

John Laffin. Combat Surgeons. 2d ed. Stroud, U.K.: Sutton, 1999. vii + 249 pp. Ill. $42.95.

This volume is by a prolific author of popular military histories, with forty-nine such books plus seventeen other nonmilitary titles published so far. Combat Surgeons is a reprinted and expanded version of Surgeons in the Field (1970). Chapters 1-24 (pp. 1-196) are reprinted from the earlier edition; chapters 25-29 (pp. 197-238) are new. John Laffin writes for the nonspecialist with a captivating and breezy style and an emphasis on the dramatic or gory event, as described by both surgeons and patients. The overall emphasis is British.

In an introductory chapter Laffin points out that the "glorious dead" and "gallant wounded" are in fact people who have been killed or damaged in battle. He writes to show the reader the history of their surgical and medical care. Wound care is briefly described, starting in Egypt and progressing to Greece, Rome, Byzantium, and medieval Europe. Gunpowder complicated wound care by the fifteenth century, and Paré is presented as the surgeon exemplar. John Pringle is given his due for his eighteenth-century book on disease in armies. The American Revolution is the vehicle for discussing disease, diet, and the nonmedical care of soldiers. The Napoleonic campaigns introduce Guthrie's hospital statistics, McGrigor's organizational competence, and Larrey's great surgical skills. Scurvy; the contributions of Lind, Trotter, and Blane; and the medical reforms of Britain's sailing navy are succinctly described.

The Crimean War earns two chapters, but with surprisingly little said about Florence Nightingale. Henri Dunant's Red Cross gets established in 1864; the U.S. Civil War and the Franco-Prussian War introduce the problems of mass casualties, anesthesia, and structured casualty-evacuation systems. The following chapters describe the developing organization of the British Army medical service and the typhoid disasters of the Boer War. World War I is addressed in detail, including chemical warfare, nursing, changes in wound care, and a useful collection of statistics. The discussion of World War II concentrates on the British in North Africa and Europe, the use of blood, better-organized forward surgery, and penicillin, but jungle warfare and the support of guerillas are also considered.

Chapter 25 introduces the "shellshock" of World War I and new material on the "exhaustion" of World War II: their management, and the useful contributions of psychiatrists to combat medical care. With Vietnam came the development of helicopter evacuation and modern burn management, but this is a weak chapter because Laffin relies on Ronald Glasser's 365 Days (1971): Glasser served only in Japan and never in Vietnam. Better, and more vivid and realistic, is 12, 20 and 5: A Doctor's Year in Vietnam (1972) by John Parrish, a young Navy surgeon serving in support of Marines. The Falklands campaign, a bit of U.S. diarrheal disease data in the Gulf War, and comments on the Gulf War Syndrome close the book.

Since the first twenty-four chapters are simply reprinted, the author has not had the benefit of the last thirty years of scholarship on those topics. This lack also contributes to a modest sprinkling of small errors that may cause the specialist to flinch--for example, in regard to chloroform (p. 93), nitrous oxide (p. 111), Letterman's rank (p. 113), Sydenham (p. 133), Beaumont (p. 135), and Hanson (p. 202).

There are seventy-seven footnotes from the sixty-seven references plus a twenty-two-item bibliography--all identical to the 1970 text. Only Glasser's 1971 book and Albert Cowdrey's Fighting for Life (1994) are new for this edition. Heavily salted with fascinating snippets of anecdote and excerpts from texts and memoirs, a number of tables and graphs, and a liberal collection of excellent photographs and drawings, the book--a selection of the Military Book Club--will be enjoyed by the educated laypersons for whom it is intended. Some of these readers might be impelled...