OSBORNE'S SCUTARI AND ITS HOSPITALS. *

As an exposition of the wretched state of things at Scutari, or of the suffering and death caused by the sluggish incapacity of the medical authorities, this volume is too late in the field ; the evi- dence of the author himself, as well as of other witnesses, had sub- stantially forestalled its information. Unless our memory de- ceives us, we bad also read some of the remarks in the form of letters "to the editor." But the continuous personal narrative gives completeness to the facts and remarks of Mr. Osborne which they miss in the shape of question and answer or in fugitive let- ters. The pictorial illustrations, though not apparently drawn expressly to accompany the text, exhibit places or incidents it de- scribes, and serve to realize the accounts. The most valuable is the view of the burial-ground at Scutari with parts of the two great hospitals.

There are things in the volume of a fresher kind than the details of needless suffering patiently borne, or the really incomprehen- sible apathy of the principal Doctor and Purveyor. Mr. Osborne carries his reader to the bed-side of the declining or expiring sol- dier with the thoughts and memory of home upon his lips and in his heart. The writer has studied medicine and surgery not in theory only but practically. He looked at the terrible scenes- around him with an eye in which compassion and other emotions did not overpower judgment. He notes some curious contrasts between the wounded, and men stricken down by dysentery,. diarrhoea, or Varna fever • though he does not enter into the. character of the disease. The account of the " war with nature" which the malaria of all those regions induces, from about Kalafat oil the Danube to the Caspian Sea, has yet to be written. Let us hope there are men competent to give the world such an expo- sition of these diseases as the medical officers attached to Buxton's ill-fited expedition gave of the Niger fever. The symptoms appear • Scutari and its Hospitals. By the Honourable and Reverend Sidney Godolphin Osborne. Published by Dickinson; Brotbere.

different, but the general charaoter—death from vital depression, often painless—is similar.

" I made friends of some of the orderlies, (every ward has one,) and got them, and also the Sisters in charge of my district, to give me when I met them intimation of such cases : this brought me a good deal into these wretched dysentery and fever wards, and many a sad scene did I witness there.

" This dysentery—diarrho3a—Varna fever—the men called it by all these names, was most fatal. I visited very few who recovered; indeed, there. was an appearance in by far the greater part of them that seemed to exclude all hope of recovery. It appeared to have a most depressing effect: there was not much active pain, except in the cases which now and then a few hours before death took a form very similar to if not identical with cholera.

• •

" There is a very marked difference between these diarrhcea patients and the simply wounded : the latter live in hope ; even those most wounded with difficulty gave it up. The attendance necessarily given to their wounds by the surgeons kept up this feeling,until, if the wound was fatal, the very moment the last struggle came. I do not say that the old Varna fever cases could have profited from medicine and medical attendance; I certainly never saw much bestowed .upon them. I do firmly believe, however, that much might have been done for many of the diarrheea cases ; but I know at one time the medical men had not at their disposal the commonest drugs proper for their treatment. With the exception of the priests in attendance on the Catholic patients, and ' the Sisters ministering to all, .I seldom met any one in these wards while I continued to visit them.

" In this cruel scene of filthy neglect, I can with truth say I was never called to one dying man who uttered a single murmur against those who thus treated him and his comrades. They were fond of being read to, joined earnestly in prayer, were apparently very truthful in their answers as to their past lives, (very many had run away from home and enlisted under false names); few bad I occasion to attend when dying who did not show the truest penitence, and gladly seek to cling to these hopes most of them bad been taught in their youth, but which, alas I in many of their cases had now first to be realized. • • •

" They dictated calmly the plain unheeding tale they wished written to the parent, wife, or other relative at home : it told of suffering, without any complaint of it ; it expressed the still strong affection they bore for those— this was the realpang—who they wished to know that they never could see them again. There was just the fact of the cause of their sickness, and then the homely expressed message of remembrance to all at home, all in- quiring friends.' " There was little else I could ever do for them : they said so, and gave a gratefulpressure to the extended hand, (in one instance a fine dying fellow kissed it,) then—the God bless you, sir.' There was in some cases one means of calling up a look of earnest pleasure ; it was when they were en- abled from private funds at my disposal to send home small sums to their relatives : this seemed to come home to their very hearts, and gave more pleasure than any of the other means by which I endeavoured to lighten the sad portion of this particular class of the sick. • • •

" The effect of this disease [dysentery] upon the patient was very painful ; it seemed to weigh down every energy of the mind as it day by day weak- ened every physical power. The poor fellows lay in their beds mere spec- tres; except to dictate a letter home, it was difficult to rouse them to any thing. They were grateful for the nice messes the Sisters' cooked for them, took what little medicine was ever offered them ; but all was done in a state of apathy which showed life had become a very weariness. When the newspapers arrived and were distributed, it was distressing to watch the interest with which all the wounded listened to and read ' Alma' again and again ; whilst the diarrhcea patients seemed scarcely willing to turn in their. beds, to listen to a word of that which so interested their wounded comrades."

Here is a singular instance of the effect of habit and discipline.

"Chloroform was always used, and it appeared to use with the greatest success; which I attribute a good deal to the practice of using it on a hand- kerchief held lightly to the face, instead of the plan I. have seen elsewhere of using some instrument, which, whilst it secured the inhalation of the anaes- thetic, excluded too much of the atmospheric air. I assisted at one very painful case, in which a branch of the femoral artery had to be taken up : there were great difficulties about it ; so much so, that one of the best sur- geons there did not seem to me to like to attempt it : it was, however, done by Dr. M'Ilray, assisted by some others. I am afraid to say the length of time the patient was under the influence of chloroform; his head was on my own knee the greater part of the time, and I had to keep up the administra- tion of this inestimable agent : at last they succeeded in getting a ligature round the vessel. I was then left with one of the surgeons to try and re- cover him from the torpor, under which he had without pain borne a moat severe application of the knife, &c. Oar only hope, from the quantity of blood he had lost, was to get some stimulant taken as soon as we could: in vain we tried every means of rousing him ; the pulsation of the heart was so weak, his whole appearance such, I had begun to despair. As a last re- sort, I found out his name, and had him sharply spoken to by it: so strong was the force of habit, that he made just sufficient effort to waken to enable us to order him to drink the wine we gave him : keeping up the same sharp military tone of voice, we got more and more swallowed, and he soon re- covered : I saw him some days after doing well."

Mr. Osborne speaks in the highest terms of the assistance ren- dered by Miss Nightingale and her coadjutors, and has some ju- dicious observations on lady nurses and the more extensive em- ployment of paid nurses. He draws a touching picture of the kindness showA by the officers to each other, and advises strongly against female relations going out to them.

" I may be wrong, but it is my honest opinion that, except where they have expressed a wish for their presence, the wounded officer in the hospi- tal is in reality happier in the absence of female relatives: if they arrive in time to be of use, there is much in the way of their power to give all the aid and comfort they would desire ; their presence, I know well, often causes the greatest anxiety to times they come to nurse. If an officer is dying in the ward of an hospital, his relatives may rest assured all he expects of com- fort, all he can desire of sympathy, is shown him by those about him. Where the wound has been severe, he has contemplated its probable end; so, too, have those who share the ward with him ; they give him the soldier's true earthly comfort, the friendly sympathy of men who shared the danger with him, and now bear in their own persons proofs of what it cost them. Is he to die ? it is amongst his brother officers, still in one of war's scenes: he left home to dare this fate ; faces from home, alas ! too often recall the sacrifice he made for the service he then undertook; they cannot alter the fact—he is an officer dying with the army on service ; their presence brings the painful revival of so many a home feeling, adds so much to make that death still more trying, that I do sincerely doubt whether any joy from the greetang of the parent or the wife makes up in the pleasure it may afford' for that calm. which it certainly disturbs. In spiritual matters the chaplains are kind and attentive to him ; in all other matters his brother officers in their manly sympathy offer sdl he requires. The dying officer does• notforget home, or undervalue its call upon his heart ; he is the son, the husband, or the brother ; but as the soldier in service, he knows that living or dying service must separate him from his relatives.

"I was at the funeral of an officer of high rank whose wife we knew was expected every hour from England. I was present with others—one a very young wife—when we consulted how we should break to a lady in the next ward the death of her husband ; within two hours, that young wife knew herself also to be a widow. Other circumstances of an equally distressing nature came to my notice : it is true there were plenty to sympathise with the mourners; but amidst such scenes, in that country, where at the best of times a lady finds daily life to be daily trial, I ever felt how well it would have been if the love that hurried these relatives to nurse their wounded or their sick could have at any cost been restrained, and they had awaited the issue at home."

It is a thing worth noting that the severest sufferings have taken plaoe in the " Army "proper—that branch of the service under the control of the Horse Guards. We learn from casual notices in the newspaper correspondence, and from evidence before the Parliamentary Committee, that the Artillery was well cared for in food and clothes, and their horses better provided for than the horses of the Cavalry. Two successive despatches from Captain Lushington, not very long since, described the Naval Brigade as having respectively about 5 per cent and 2 per cent sick, and not a serious case among them ! Care and foresight were displayed in the Naval Hospital at Constantinople. The Navy was not indeed exposed to such an influx of patients as was the case in the Army; but where means, provision, and power of combination exist, num- ber is merely a multiplication of the same processes. "At Therapia, about twelve miles up the Bosphorus, is the Naval Hospi- tal : I paid it a hasty visit. It is small, but as yet quite large enough for its purpose. Nothing could exceed the cleanliness, comfort, and order which appeared to prevail. The naval authorities had taken care to commence pre- parations here as early, I believe, as April. The patients were as happy as sailors ever are when sick and in bed : one poor fellow was in the act of dying ; he was closely watched, and had every kind attention. An officer who had lately had a limb amputated, although he was in much pain and some danger, had every comfort the best hospital in England could have afforded. The ventilation seemed good, and there were ample means of se- curing warmth. I saw here none of that confusion and resort to temporary expedients which so prevailed at Scutari. I satisfied myself that the rela- tives of those who are employed in the Navy in the East need the under no apprehension that in the event of sickness or wounds they will not be well cared for in every respect. There were plenty of books and newspapers ; in- deed, I could not find from the medical officer that there had been any diffi- culty in obtaining everything desirable for the proper treatment and comfort of the patients. He expressed to me a wish that one or two nurses should be appointed to the establishment; and I have reason to believe that this was done within a few days of my visit."