Hospital Care and the British Standing Army, 1660-1714 (review)

This is a sequel to Dr. von Arni's Justice to the Maimed Soldier (Ashgate, 2001), which described the medical care provided for wounded and sick soldiers during the English Civil Wars and Interregnum. After acknowledging that the two standard general histories of the British Army Medical Services, Gore (1879) and Cantlie (1974), devote only a few pages to the seventeenth and early eighteenth centuries, the author states his intention of filling "this void whilst, additionally, enquiring into the broader aspects of the welfare facilities provided for soldiers and their families" (p. 2). Unfortunately the book falls short of these objectives and potential readers should note the actual title placing the word "care" in parentheses: it is almost exclusively concerned with the establishment and administration of British Army hospitals. The most glaring lacunae are the Royal Hospitals at Kilmainham and Chelsea, which appear only in passing, but such topics as the social origins, training, remuneration, abilities and competence of physicians, apothecaries, and surgeons; treatments and medicines; nursing practices and techniques; the success rate of hospitals; the return of the wounded and sick to duty; public attitudes to military casualties; pensions and welfare, etc.; are either absent or mentioned briefly. It is a pity to be negative but so many opportunities have been missed and questions not raised, let alone answered, that it is difficult to be more generous. Also, there are a number of factual errors and an annoyingly large batch of typographical mistakes.

The book actually comprises a survey of the administration of army hospitals in Tangier; England between 1660 and 1688, including the semipermanent institution erected on Hounslow Heath; Ireland during the War of the Two Kings, 1688–91; the Nine Years' War in the Low Countries; Marlborough's campaigns; and Iberia during the War of the Spanish Succession. There are some useful maps and appendices. Von Arni argues that, following the disbandment of the New Model Army and its medical facilities, the new Restoration Army was too small to possess hospitals of its own and was dependent upon London civilian hospitals. As the army grew under James II, a semipermanent hospital, complete with an establishment of staff, was built upon Hounslow Heath. After the corollary of the Glorious Revolution pitched England into the Nine Years' War, the initial experiences in Ireland in 1689 caused a revision of medical facilities in both Ireland and Flanders. The result was the adoption of the Dutch model of privately contracted hospitals, an experiment that that was carried forward into the War of the Spanish Succession. Generally, it was a story of modest improvement and committed individuals doing their best in trying circumstances. Although limited in scope and coverage, von Arni has produced a detailed and valuable study of medical administration, but the history of the British Army Medical Services in this period remains to be written.