Eric Gruber von Arni. Justice to the Maimed Soldiers: Nursing, Medical Care and Welfare for Sick and Wounded Soldiers and their Families during the English Civil Wars and Interregnum, 1642-1660. Aldershot and Burlington: Ashgate, 2002. xv + 283 pp. $74.95 (cloth), ISBN 978-0-7546-0476-1.
Reviewed by Stephen K. Roberts (History of Parliament Trust, London)
Published on H-Albion (February, 2003)
A book dealing with the period when the modern British standing army was in gestation is bound to provoke comparisons with later medical and nursing experience. Much can be learned from how modern states have treated the casualties of war. At first glance it might seem that only with the rise of mass democracies in western society came any degree of serious interest in the welfare of those injured in the service of the state. In 1916, 20,000 British servicemen died on the first day of the battle of the Somme. Today, World War One mortality levels would jeopardize the survival of western democratically-elected governments, which rightly become jittery about the "body bag count" when it reaches double figures. But it is easy to assume that governments willing to accept huge casualties will be indifferent to the fate of sick and injured military personnel. In fact, during the 1914-18 conflict, unprecedented progress in army medical treatment and nursing of survivors was made, to parallel much else that was unprecedented about that war. There were significant innovations in medical science, but also administrative and organizational responses to the treatment of mass casualties. Moreover as combatant mortality levels fall, political interest in the survivors of war rises. The politics of modern military welfare is very much a live issue, as continuing debate over "Gulf War syndrome" illustrates.
Eric Gruber von Arni has written a book that challenges mythology and explores the relationship between the state and those damaged in its service during wars which, as he reminds us, have some parallels with modern conflict, not least in mortality rates compared with population levels. Quoting calculations by Charles Carlton, he accepts that while 3 percent of the population of the British Isles perished of "war-attributable" causes in World War One, over 11 percent did so during the civil wars.[1] He throws down a challenge to the accepted orthodoxy that "modern nursing" was a product of nineteenth-century reforms. The period he deals with has long been considered a "dark age" in nursing history, not least as a result of the Victorian reformers' castigations of it, largely based on ignorance. The available secondary literature on soldiers' welfare in the civil war period is slight, but the author has provided an account which illuminates contemporary practice and rectifies whiggish notions of medical progress. In nine substantial chapters and a conclusion, the author explores the evidence for nursing practice, hospital provision, treatment regimes, and the administration of the various expedients devised to cope with the human fall-out from war, both on land and at sea.
The introduction shows how on the eve of civil war all assumptions about the welfare of soldiers and sailors, notoriously feared for their potential for disorder, drew on the parish-based system of poor relief. The first chapter, on the king's army at Oxford, paints a vivid picture of the university town's transformation into a military camp, with Oxford college quadrangles turned into animal pens and the churches into military prisons. Gruber von Arni reaches pessimistic conclusions about the standards of care in the royalist army; the splendid architectural surroundings and rarified intellectual atmosphere at the king's headquarters were but a backdrop to scenes of squalor and indifference. Nursing provision thus joins a list of things in which royalist army war effort logistics were inferior to those of Parliament. Chapter 4 examines how Parliament's structure--never a "system"--of military welfare evolved in a ramshackle way. It is the history of the Sick and Maimed Soldiers' Committee, which began as a body supervising London hospitals and which accumulated, in classic Interregnum fashion, more and more responsibility beyond hospitals and beyond the metropolis. This is the core chapter of the book, and does much to explain how the administrative response to this welfare problem was conditioned by political change and financial crisis: National Health Service administrators will recognise the dynamics. Here we are on turf made familiar by the late Gerald Aylmer, who would have approved of the way the diagrams and tables illuminate the issues. Two illustrations are most striking: the reproduced seal of the Committee for Sick and Maimed Soldiers, and a soldier's printed certificate of discharge from hospital. Both are memorable reminders that we are here in the foothills of a modern, bureaucratic approach to welfare. The author demonstrates how the administrative apparatus of the Sick and Maimed Soldiers Committee thickened with each reorganization, but also traces the exposure and resolution in Parliament of more than one financial scandal to assail its treasurers: a form of public accountability did exist.
There are chapters on naval welfare, colonial military campaigns, and the casualties of "War in the Celtic Nations" (nothing on Wales here, however), where an account of the military and nursing response is interwoven with a narrative of the military events themselves. This is achieved effectively, although the material is presented as a new slant on conventional enough military history. The chapters on "Contemporary Treatments" and "Nursing Personalities of the Civil Wars and Interregnum" cover fresher territory, even if the chapter titles seem lifted from a Health Service Yearbook. One of the important dimensions of this book, which the author does not highlight in his choice of chapter titles or dust jacket blurb, centers on what is revealed of women's history. The careers of a number of prominent women nurses are explored, even though the twenty-four notables selected for mini-biographies in Appendix IX are all male physicians and surgeons. Among the women thus rescued from historical oblivion is the colorful Elizabeth Alkin (d. 1655), secret agent, military nurse, informer against the Commonwealth's enemies, and newsbook seller. Every such defiant and resilient life story is worth a dozen potted biographies of medical worthies.
This is a book based firmly on empirical historical research. The standard of accuracy seems very high (an unusual slip is the misdating of Oliver Cromwell's death as occurring in November 1658, p. 84) and the volume deserves to become a standard work on its subject. Where, perhaps, it leaves more to be said is in the area of welfare politics and in motivating ideology. It is hard to assess, on the evidence Gruber von Arni presents, to what extent military nursing and welfare became a factor in political struggles at Westminster. We are served up one story of royalist military healthcare and another, parliamentarian one, but given the various metamorphoses of the Sick and Maimed Soldiers' Committee over nearly twenty years I would be confident that an internal political dynamic, rooted in parliamentary factions, is in there somewhere waiting to be flushed out. Whether the members of the Sick and Maimed Soldiers' Committee drew on a Puritan world view, on pragmatic fear of social disorder, or on simple humanitarianism to sustain their deliberations remains a question for further consideration.
Note
[1]. C. Carlton, Going to the Wars: The Experience of the British Civil Wars, 1638-1651 (London and New York: Routledge, 1992), pp. 214-9.
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Citation:
Stephen K. Roberts. Review of von Arni, Eric Gruber, Justice to the Maimed Soldiers: Nursing, Medical Care and Welfare for Sick and Wounded Soldiers and their Families during the English Civil Wars and Interregnum, 1642-1660.
H-Albion, H-Net Reviews.
February, 2003.
URL: http://www.h-net.org/reviews/showrev.php?id=7218
Copyright © 2003 by H-Net, all rights reserved. H-Net permits the redistribution and reprinting of this work for nonprofit, educational purposes, with full and accurate attribution to the author, web location, date of publication, originating list, and H-Net: Humanities & Social Sciences Online. For any other proposed use, contact the Reviews editorial staff at hbooks@mail.h-net.org.