The medical services often do not draw much attention from military historians except when they fail to perform adequately. However, there is great potential for an examination of an army through its medical services because it gives a clear indication of how officers and men react to scientific innovation. Unlike debates over tactics or strategy, debates over medical provision are empirically based and have definite right and wrong answers, with very clear benefits and consequences.
This piece will set out a brief background of the scientific and organisational changes that the British army medical services underwent between 1854 and 1914, before addressing some of the reasons for the slow and sporadic reform. While military conservatism and organisational inertia did inhibit reform, the essay argues that officer’s notions of proper military conduct and suitable gentlemanly behaviour played a role in the army’s lack of interest in medical innovation. The most notable change in the army in the two decades prior to 1914, from a medical perspective, was not the significant organisational reform of the army or the foundation of the RAMC, but rather a cultural shift among officers, whereby illness—becoming a casualty off the battlefield—became dishonourable rather than simply a risk to be accepted bravely and without complaint. The essay will also explore some differences in medical provision and preparation between small colonial campaigns and larger wars.
This essay tackles issues of scientific innovation, and organisational and cultural transformation through the prism of the British army’s medical services, and explores why the army often had reform forced on it from outside, rather than seeking it out. It attempts to explain the marked dichotomy between innovations and the army’s failure to make the transformations necessary to benefit from them.
By Andrew Duncan, Centre for War Studies, University of Birmingham