Archive for the ‘military’ Category

The crash of the XB70

Wednesday, December 30th, 2015
North American XB-70A Valkyrie just after collision. Note the F-104 is at the forward edge of the fireball and most of both XB-70A vertical stabilizers are gone. (U.S. Air Force photo)

North American XB-70A Valkyrie just after collision. Note the F-104 is at the forward edge of the fireball and most of both XB-70A vertical stabilizers are gone. (U.S. Air Force photo)

This is an interesting article on the crash of the supersonic bomber prototype.

The two test pilots were in the cockpit of a T-38 trainer flying off the left wing of the new XB-70 Valkyrie bomber, aircraft number 62-0207. They just saw the civilian registered NASA F-104N Starfighter of pilot Joe Walker slide upside down across the top of the huge white bomber, shear off both it’s twin tails and skid sideways, then break in two, killing Walker instantly. Behind the XB-70 Walker’s F-104N tumbled end over end, a pinwheel of bright orange flame nearly six hundred feet long tracing its convulsive death spiral.

The flight was a photo shoot for GE which made the jet engines of all the aircraft being photographed.

The fatal error was including an F 104 star fighter which had unreliable handling characteristics in low speed flight.

The poor safety record of the Starfighter brought the aircraft into the public eye, especially in German Air Force service. Fighter ace Erich Hartmann famously was retired from the Luftwaffe because of his protests against having to deploy the unsafe F-104s. The F-104 was also at the center of the Lockheed bribery scandals, in which Lockheed had given bribes to a considerable number of political and military figures in various nations in order to influence their judgment and secure several purchase contracts; this caused considerable political controversy in Europe and Japan.

It was considered a “widowmaker” at low speed especially takeoff and landing.

The F-104 series all had a very high wing loading (made even higher when carrying external stores). The high angle of attack area of flight was protected by a stick shaker system to warn the pilot of an approaching stall, and if this was ignored, a stick pusher system would pitch the aircraft’s nose down to a safer angle of attack; this was often overridden by the pilot despite flight manual warnings against this practice. At extremely high angles of attack the F-104 was known to “pitch-up” and enter a spin, which in most cases was impossible to recover from. Unlike the twin-engined McDonnell Douglas F-4 Phantom II for example, the F-104 with its single engine lacked the safety margin in the case of an engine failure, and had a poor glide ratio without thrust.

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What is going on with Turkey?

Thursday, November 26th, 2015

istanbul

Turkish F 16s shot down a Russian SU 24, a bomber, after it entered Turkish airspace and did not respond to warnings.

A U.S. track of the Russian plane shot down by Turkey shows that the plane was inside Turkish airspace for 17 seconds, CBS News national security correspondent David Martin reports.

After 10 warnings without a response, a Turkish fighter jet shot the plane down Tuesday. U.S. officials said Wednesday that all of the warnings occurred before the plane entered Turkish airspace, Martin reports.

What remains unclear is whether the Russian plane was still in Turkish airspace when the F-16 fired, Martin reports. The explosion that brought the warplane down occurred when it was back in Syrian airspace, the U.S. officials said.

Why did Turkey do this ? One reason may be that the Russians were attacking Turkmen who are opposed to Assad.

Another is that Turkey is involved in oil trade with ISIS.

Foreign Minister Sergey Lavrov, who canceled his planned trip to Turkey after the incident, described the shooting down of the Russian plane as a “planned provocation.”

He said the Turkish action came after Russian planes successfully targeted oil infrastructure used by the Islamic State of Iraq and Syria, or ISIS, alleging that Turkey benefited from the oil trade.

Lavrov also said that Turkish territory was used by “terrorists” to prepare attacks in other countries, but offered no details. He said that Russia “has no intention to go to war with Turkey,” but added that Moscow will re-consider its ties with Ankara.

Turkey has been trending to Islamism since Erdogan took over the government ten years ago.

President Erdogan also attended the summit, proceeding to speak at the event’s closing ceremony: “Muslim sailors reached the American continent 314 years before Columbus, in 1178. In his memoirs, Christopher Columbus mentions the existence of a mosque atop a hill on the coast of Cuba”. In this way, the Turkish President managed to cause a sensation, while ignoring the fact that mere notion of the ‘discovery of America’ is nothing but a linguistic ploy used to consecrate the European domination of the world from the 16th century onwards and to discount the achievements of the continent’s native populations.

Richard Fernandez has a theory about why this is happening.

Charles Krauthaummer argues that since the Turks could not have been spurred into action by such minor Russian intrusion into their airspace, their true motive must have been to signal Moscow to lay off one its proxies, the Turkmen. They were willing to violate the ‘no clash between principals’ rule to emphasize the point.

This I think sort of highlights that, the Turks are the most opposed to Assad of anybody on the ground. It wasn’t only that the Russian airplane went into Turkish air space. It’s that the bombing run was against Turkmen, who a minority in Syria, ethnically Turkish that the Turks have always felt they have to defend.

Remember that Turkey and ISIS are both Sunni Muslim and the entire ISIS movement began as a Sunni reaction to the extreme provocation of the Sunnis by the Pro-Iran government of Iraq.

The challenge has been Russia’s focus on propping up Assad rather than focusing on ISIL. … Until that happens, it’s very difficult. It’s difficult because if their priority is attacking the moderate opposition that might be future members of an inclusive Syrian government, Russia is not going to get the support of us or a range of other members of the coalition.

Putin’s reaction to the incident on the occasion of his meeting with the King of Jordan describes the same strategic picture, albeit viewed from the other side of the lines.

Obama is basically an ally of Iran and that may be why he withdrew US forces that might have imposed discipline on the Iraqi government. In that sense, ISIS was created by Obama as the Sunnis had nowhere else to go. Turkey has little incentive to fight ISIS as they share Sunni religious affiliation and have no love for the Kurds and other anti-Assad forces. They certainly have little love for Shia Islam, of which Alawite is a form.

The differences between Russia and the West are also a a major factor in our dilemma.

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The Democrats seem to be choosing Islam as their theme.

Sunday, November 22nd, 2015

Hillary

The Meet the Press program on November 22 seemed to set a new theme for the Democrats. First, Hillary this week declared, “Let’s be clear: Islam is not our adversary. Muslims are peaceful and tolerant people and have nothing whatsoever to do with terrorism.”

Then, Chuck Todd had a Muslim activist “American international human rights lawyer, Arsalan Iftikhar,” who bemoaned the Republicans “Islamophobia.”

Arsalan has also been an adjunct professor of religious studies at DePaul University and he is also a member of the Asian American Journalists Association –

He seems to be a professional Muslim. A few months ago, they had former basketball player Lew Alcindor, now named “Kareem Abdul Jabbar,” to make the same point about peaceful Muslims.

Abdul-Jabbar told host Chuck Todd that terrorists “do not represent the teachings of Islam” and that this misconception makes it “impossible for real Muslims to be understood.”

He continued by saying that he believes the majority of terrorists are a product of their environment, not their religion:

What is their environment ? What does the Koran say ? Another essay on Islam says something quite different.

The avoidance of analysis of Islam contrasts sharply with the excoriation accorded Christianity, Israel, and Western Civilization. The Catholic Church sex abuse crisis has received saturation coverage. Distinguished history professor Philip Jenkins, in a book published by Oxford University Press, claims that media coverage distorts the crisis and contributes to anti-Catholic bigotry. Israel’s very right to exist is questioned and, in high profile media, at times denied. Western Civilization is depicted as imperialist, racist, and Orientalist. This politically-correct selective outrage that lambastes the Judeo-Christian tradition and Western Civilization while emphasizing positive images of Muslims only serves further to inoculate Islam from critique.

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Where are we bound ?

Sunday, October 11th, 2015

I watched the Sunday Talk Shows this morning and nothing was reassuring. Then I read the column from Richard Fernandez.

It makes sense. I have believed for some time that we are headed for a revolution. Maybe not an old fashioned bloody revolution but something is coming.

The anniversary of the U.S. war against the Islamic State passed with little notice. It was August 7 of last year that President Obama authorized the first airstrikes against ISIS in Iraq, a campaign he expanded a month later to include targets in Syria. So far this month, the president has delivered remarks on the Voting Rights Act, his deal with Iran, the budget, clean energy, and Hurricane Katrina. ISIS? Not a peep.

Obama’s quiet because the war is not going well … One of our most gifted generals predicts the conflict will last “10 to 20 years.” And now comes news that the Pentagon is investigating whether intelligence assessments of ISIS have been manipulated for political reasons.

His column today suggests that the Ship of State is drifting. He quotes Niall Ferguson’s article in the Wall Street Journal.

I have spent much of the past seven years trying to work out what Barack Obama’s strategy for the United States truly is. For much of his presidency, as a distinguished general once remarked to me about the commander in chief’s strategy, “we had to infer it from speeches.”

At first, I assumed that the strategy was simply not to be like his predecessor—an approach that was not altogether unreasonable, given the errors of the Bush administration in Iraq and the resulting public disillusionment. I read Mr. Obama’s 2009 Cairo speech—with its Quran quotes and its promise of “a new beginning between the United States and Muslims around the world”—as simply the manifesto of the Anti-Bush.

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Waterloo

Tuesday, September 22nd, 2015

We spent the day yesterday ( the 16th) at Waterloo. The battle field is largely preserved and reminds me a bit of Gettysburg. There is an excellent museum and we spent an hour or so at Hougoumont Farm where the battle really began.

Napoleon planned to draw Wellington’s reserve to Wellington’s right flank in defence of Hougoumont and then attack through the centre left of the British and allies’ front near La Haye Sainte.

Before the battle started, Hougoumont and its gardens, located on the allies’ right flank, were garrisoned and fortified by the 1st Battalion, 2nd Nassau Regiment, with additional detachments of jägers and landwehr from von Kielmansegge’s 1st (Hanoverian) Brigade. The light company of the 2nd Battalion, Coldstream Guards under the command of Lt-Colonel Henry Wyndham, was also stationed in the farm and chateaux, and the light company of the 2nd Battalion, Third Guards, under Lt-Colonel Charles Dashwood in the garden and grounds

The fighting here lasted all day and ended finally when the defenders were forced out as the buildings burned. It was too late for the French which had been reenforcing failure all day.

The French eventually committed 14,000 troops to Hougoumont Farm, of whom 8,000 were killed. The most famous encounter was The Battle of the Closing of the gate. The French had surrounded the farm which was an enclosed bastion of brick and stone walls with a gate access to the rear. They managed to force open the gate with axes into the yard but a few British soldiers managed to close it again and all the French who had gained the yard were killed. The few who closed the gate, were to be famous after the battle.

Sous-Lieutenant Legro, of the French 1st Light Infantry, broke through the wooden doors with an axe, allowing French soldiers to flood the courtyard. Graham’s commanding officer, Lieutenant-Colonel James Macdonnell, led his men through the melee in the courtyard to the gates, in an attempt to shut them against the pressing French. This was done with the help of three officers (Captain Wyndham, Ensign Hervey, and Ensign Gooch), Corporal Graham, and a few other soldiers including Graham’s brother Joseph. James Graham was the one to slot the bar in place. Flagstones, carts, and debris were then piled against the gates to hold them secure. The Frenchmen trapped within the courtyard were all killed, apart from a young drummer-boy.

hougoumont-doors-560

The crucial mistake made here was by Napoleon’s brother, Prince Jerome, who commanded the first French troops to attack Hougoumont Farm. When they were repulsed, Jerome kept reenforcing the attack and drew the French focus to the strong point which resisted all day.

waterloo-map-1-560

The farm is to the left and in advance of the British lines. La Haye Sainte is in the middle and both were to be crucial strong points for the British. A word about British tactics here.

Wellington was outnumbered and the hard center of his force was his British Peninsula Campaign veterans. He stationed them on the “military crest” of the low hill behind Hougomont and La Haye Sainte. This sheltered them from French cannon fire. Direct fire cannon fired cannon balls which would skip and were devastating for infantry in squares. It was important to disperse these squares when under fire by cannon. Napoleon was a master of artillery and had won many battles with it. Wellington, in Spain, had learned to shelter his infantry. He even had them lie down in the grass behind the crest of the hill to rest and make them invisible to French cannons.

The fact that it had rained hard the night before the battle, a reason often given for the late hour of the French attack, made the ground soft and the cannonballs often dug in rather than skip along the surface.

Infantry squares were almost impervious to cavalry assault so the wise commander attacking such a force would combine artillery and cavalry to weaken and disperse the defenders. Napoleon knew this but his brother drew the center of gravity to the strong point.

The two battalions that defended Hougoumont suffered 500 dead and wounded out of strengths of 2,000.

The French lost 8,000 of 14,000 men. The courage of the men who closed the gate is still celebrated in England.

The same occurred at La Haye Sainte, another fortress in the center. It was well in advance of the infantry lines at the hill crest. The French attacked and the result was the destruction of The King’s German Legion, which had not prepared the farm as well for defense. However, they did hold it until afternoon.

It was the scene of a famous charge by Marshall Ney who led the French cavalry on a futile charge that destroyed the center of Napoleon’s army.

the French could not see the squares until they were almost on top of them.
Here then they came over the ridge at a steady canter, to be decimated by grapeshot from Mercer’s and other batteries, and by musketry from the squares, at an opening range of about 50 paces.

Pressed on by the ranks behind, they charged past between the squares, losing their formation as they did so. Lord Uxbridge came up with the survivors of the Household Brigade, and the infantry watched a bloodthirsty cavalry battle which raged all round them. At least ten times the French cavalry retreated down the hill, or round by the Nivelles road, reformed their ranks and attacked again, until all this ground between the lane and the ridge was so covered with dead men and horses that they could not ride over it.

Uxbridge lost his leg in this battle and it is buried, in the town.

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It is buried here, behind Wellington’s headquarters in Waterloo town. He had a very good prosthesis made which is displayed in the museum at Wellington’s headquarters in Waterloo town.
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The La Haye Sainte farm is still there although it is not open to visitors.

la-haye-after

The farm lies in the center and is at present privately owned. I understand there is a pending sale to add it to the museum.

The Medical History of the American Civil War. VI

Friday, September 4th, 2015

This will be the final installment of the history. It is in parts because WordPress starts to drop text if the pst gets too long.

Slide57

Amputations were the most common procedures for war wounds. Below knee amputations had about a 33% mortality. Most deaths were from infection and wound shock, which was a mystery until World War I.

Slide58

Abdominal wounds were mostly fatal although there were survivors. One of the survivors was Joshua Chamberlain, who was awarded the Medal of Honor for conspicuous bravery at the Battle of Gettysburg.

joshua-lawrence-chamberlain

Chamberlain was a survivor of an abdominal wound and, like many, was left with life-long disability. He had a bladder fistula that continuously drained urine the rest of his life.

Chamberlain offered his services to the governor of Maine who appointed him Lieutenant Colonel of the newly raised 20th Maine regiment. The scholar-turned-soldier would take advantage of his position as second-in-command and studied “every military work I can find” under the close tutelage of his commander, West Point graduate Col. Adelbert Ames.

Though present at Antietam, Chamberlain and his regiment saw their first trial by fire in one of the doomed assaults on Marye’s Heights at Fredericksburg but missed a chance to be involved at the Battle of Chancellorsville due to an outbreak of smallpox. Losses at Chancellorsville elevated Col. Ames to brigade command, leaving Chamberlain to command the regiment in the next major engagement of the war, the Battle of Gettysburg.

On July 2, 1863, Chamberlain was posted on the extreme left of the Federal line at Little Round Top—just in time to face Confederate General John B. Hood’s attack on the Union flank. Exhausted after repulsing repeated assaults, the 20th Maine, out of ammunition, executed a bayonet charge, dislodging their attackers and securing General Meade’s embattled left. Though the exact origin of the charge is still the subject of debate, Congress awarded Chamberlain the Medal of Honor for “conspicuous gallantry.”

He received a bullet wound in the battle of Petersberg that left him with a permanent disability. Even so, he had a successful career. He was wounded six times in all.

After the war, Chamberlain returned to Maine, where he served four terms as the state’s Governor. He later served as president of Bowdoin College alongside former general and Bowdoin alum, Oliver Otis Howard. Prolific and prosaic throughout his life, Chamberlain spent his twilight years writing and speaking about the war. His memoir of the Appomattox Campaign, The Passing of the Armies was published after his death in 1914.

His wound was ultimately fatal.

His old wound became infected in 1914, and on Feb. 24, at age 85, Joshua Chamberlain, the very model of a citizen soldier, died. He was the last Civil War veteran to die of wounds sustained in battle.

He wrote that Army Manual of Leadership, FM -6-22 which is still in use.

Slide59

Another example of a survivor is Major Henry A. Barnum, a Major of Volunteers who ended the war as a Major General.

Slide61

The Western Campaign brought forth General William T Sherman, who is in my opinion the greatest American general since Washington, who was really more of a political leader.

sherman_web_1

Sherman led his army across Georgia after the successful siege of Atlanta which assured Lincoln’s re-election in 1864.

Slide62

The Siege of Atlanta, which was followed by the burning as depicted in “Gone With The Wind.”

Slide63

During the siege, instances of Scurvy rose among Sherman’s soldiers and in the residents under siege, Once the siege ended and trains resumed bringing fresh fruit and vegetables, the scurvy declined.

Slide64

Women played various roles in the war. One captured Confederate officer, while in a prisoner of war camp in Ohio, delivered a child in spite of the fact that she had campaigned and been captured as a male officer. Her husband was also a Confederate officer.

Slide65

Elizabeth Blackwell was the first American female medical school graduate. She was instrumental in the founding of the US Sanitary Commission, which was modeled on a similar British Commission during the Crimean War. Her organization was called, “the Women’s Central Relief Association of New York,” and had Dorothea Dix as its head.

Slide66

Dix was a well known health reformer who had previously worked on the treatment of mental illness. She began to recruit female nurses although most nurses during the war were male.

Slide67

Clara Barton was working in DC when she saw wounded men making their own way into the city after the battle of Bull Run. She organized relief supplies. The Surgeon General, William Hammond, placed her in charge of distributing donated goods to the wounded in 1862.

In 1881, she organized the American Red Cross.

Slide68

Mother Bickerdyke is a little known but hugely important member of Sherman’s army. She began as a volunteer in Illinois, joined his army and marched all the way to Savannah with the army. They insisted she accompany them in the Grand March in Washington City after the war. She organized field kitchens and bakeries to feed the troops. She organized freed slaves to build her kitchens and field hospitals. It was she who discovered that black berries, growing wild in the South, would prevent scurvy.

After the war ended, Bickerdyke was employed in several domains. She worked at the Home for the Friendless in Chicago, Illinois in 1866. With the aid of Colonel Charles Hammond who was president of the Chicago, Burlington, and Quincy Railroad, she helped fifty veterans’ families move to Salina, Kansas as homesteaders. She ran a hotel there with the aid of General Sherman. Originally known as the Salina Dining Hall, it came to be called the Bickerdyke House. Later, she became an attorney, helping Union veterans with legal issues including obtaining pensions.

Congress had made no provision for pensions or the care of wounded veterans. Mary Ann Bickerdyke worked with Sherman to employ veterans on the railroad that was crossing the plains and to provide care of those wounded and the families of the dead. She and Sherman establish what would eventually became the Veterans Administration. Sherman’s friend and associate General Grenville Dodge was the Chief Engineer for the Union Pacific Railroad.

220px-GMDodge

In May 1866, he resigned from the military and, with the endorsement of Generals Grant and Sherman, became the Union Pacific’s chief engineer and thus a leading figure in the construction of the Transcontinental Railroad.[3]

Dodge’s job was to plan the route and devise solutions to any obstacles encountered. Dodge had been hired by Herbert M. “Hub” Hoxie, a former Lincoln appointee and winner of the contract to build the first 250 miles of the Union Pacific Railroad. Hoxie assigned the contract to investor Thomas C. Durant who was later prosecuted for attempts to manipulate the route to suit his land-holdings.[3] This brought him into vicious conflict with Dodge and Hoxie. Eventually Durant imposed a consulting engineer named Silas Seymour to spy and interfere with Dodge’s decisions.

Seeing that Durant was making a fortune, Dodge bought shares in Durant’s company, Crédit Mobilier, which was the main contractor on the project. He made a substantial profit, but when the scandal of Durant’s dealings emerged, Dodge removed himself to Texas to avoid testifying in the inquiry.

The Medical History of the American Civil War V

Friday, September 4th, 2015

This series is a slightly annotated version of a lecture I have given in several places. One of them was at the Royal Army Medical Corps Museum in the Salisbury Plain.

Slide42

Two major diseases at the time of the war were Smallpox and Malaria. Both affected large bodies of men in close quarters. Both were infectious but not water borne. Vaccination had been discovered by Edward Jenner in 1796.

In the years following 1770, at least five investigators in England and Germany (Sevel, Jensen, Jesty 1774, Rendell, Plett 1791) successfully tested a cowpox vaccine in humans against smallpox.[20] For example, Dorset farmer Benjamin Jesty[21] successfully vaccinated and presumably induced immunity with cowpox in his wife and two children during a smallpox epidemic in 1774, but it was not until Jenner’s work some 20 years later that the procedure became widely understood. Indeed, Jenner may have been aware of Jesty’s procedures and success.

By the early years of the Napoleonic Wars, Larrey had vaccinated the French Grand Army. By 1870, the French army had forgotten Larry’s work and they were decimated by smallpox while the Prussian army had been vaccinated by Billroth.

Malaria could be treated with Quinine, an extract of Cinchona bark.

Quinine occurs naturally in the bark of the cinchona tree, though it has also been synthesized in the laboratory. The medicinal properties of the cinchona tree were originally discovered by the Quechua, who are indigenous to Peru and Bolivia; later, the Jesuits were the first to bring cinchona to Europe.

The Union Army used 19 tons of cinchona bark to treat malaria in the troops. The Confederates were blockaded and had little to use. The Germans were blockaded in World War I and used their new organic chemistry industry to find alternatives, chiefly from organic dyes, like Methylene Blue.

Slide43

There obviously was some understanding of the role of mosquitoes in transmission of malaria as we see with the use of mosquito nets in hospitals.

Slide44

Other infectious disease were scourges although nothing was known about the cause. Tonsillitis was seasonal and diphtheria was treated with tracheostomy although I don’t know how many were done. The story of diphtheria is the story of the great triumph of bacteriology in the late 19th century. In the Civil War the only treatment was tracheostomy.

Wounds were always assumed to be infected and treated accordingly.

Slide45

The treatment of extremity wounds was almost always amputation as there was no understanding of infection.

Here is an amputation tent with a pile of amputated limbs nearby. Baron Larrey, Napoleon;s surgeon personally amputated 200 limbs in 24 hours at the battle of Borodino. That was one amputation every seven minutes and was prior to the discovery of anesthesia.

There was little treatment available for wounds of the head or the body.

Slide49

The wounds from a small battle are listed in The History. Head wounds were mostly fatal although a few survived.

Slide50

Early wound care was mostly in the open as the dressing stations were overwhelmed easily.

Slide51

Saber wounds, inflicted by mounted cavalry were survivable if the skull was not penetrated and they did not become infected.

Slide52

The Battle of Chancellorsville was a success for Lee but a great loss resulted as Jackson was lost.

Slide53

Many believe that all chance of success in the war died with Jackson.

Slide54

Jackson was shot by his own men as he reconnoitered the battlefield. His left arm was amputated but he did not survive. His wife was with him when he died.

Slide55

Gunshot wounds of the extremities were most of the survivors. The mortality rate of amputation was 27%. In the Franco-Prussion War, the incompetent French military surgeons had a 50% mortality rate even though antisepsis had been described three years before by Joseph Lister. Lister was treating tuberculosis of the joints, which was a common condition at the time. He found that infection was prevented by carbolic acid.

In August 1865, Lister applied a piece of lint dipped in carbolic acid solution onto the wound of a seven-year-old boy at Glasgow Infirmary, who had sustained a compound fracture after a cart wheel had passed over his leg. After four days, he renewed the pad and discovered that no infection had developed, and after a total of six weeks he was amazed to discover that the boy’s bones had fused back together, without the danger of suppuration. He subsequently published his results in The Lancet[8][9] in a series of 6 articles, running from March through July 1867.

He instructed surgeons under his responsibility to wear clean gloves and wash their hands before and after operations with 5% carbolic acid solutions. Instruments were also washed in the same solution and assistants sprayed the solution in the operating theatre. One of his additional suggestions was to stop using porous natural materials in manufacturing the handles of medical instruments.

The Germans adopted “Listerism” and the French did not. His reports were after the American Civil War although Semmelweis had tried to introduce hand washing in 1846.

Slide56

Vascular injuries were untreatable and would remain so until Vietnam, when new techniques resulted in salvage of most arterial injuries.

To be continued.

The Medical History of the American Civil War IV

Friday, September 4th, 2015

More of the series on my lecture on the Civil War.

Slide30

The Ambulance Corps were organized and the photo shows one group during the war.

Slide31

The next Army Surgeon General was Letterman who changed Tripler’s organization and built larger hospitals and worked on sanitation projects that had been ignored by the early medical services. Disease was a greater risk to soldiers than wounds and had been since Classical Greece. When large numbers often were accumulated without proper sanitation, disease was rampant. Florence Nightingale was one of the first to realize the importance of cleanliness.

Slide32

One of the greatest medical pioneers of the Civil War was John Shaw Billings who designed hospitals, including The Johns Hopkins Medical Center. He was never Surgeon General but he did organize what became the Public Health Service.

Slide33

One of Letterman’s new hospitals was this one which was constructed in time for the battle of Gettysburg.

Slide34

One of the brilliant surgeons who joined up and contributed was this man, John H. Brinton. Typically, he was dismissed by the politicians around Lincoln because McClellan had appointed him.

Slide35

The most common medical problem was chronic diarrhea.

27,558 Union soldiers died of chronic diarrhea. Without bacteriology, still unknown in 1865, it is impossible to trace the causes.

Typhoid fever killed another 27,056 soldiers.

In the Boer War, in 1899 to 1902, typhoid fever killed thousands of British troops.

of the British Force of 556 653 men who served in the Anglo-Boer War, 57 684 contracted typhoid, 8 225 of whom died, while 7 582 were killed in action.(11) As had been the experience in America, the disease was found to be one which occurred in static camps.

This occurred years after infectious diseases had been identified and the cause of illnesses had been described.

The First Word War was the first war in which more men died of wounds than of disease.

Slide36

This slide, from the “Medical and Surgical History of the War of the Rebellion, shows the seasonal nature of the disease. The nutritional aspects are seen in the incidence during the siege of Atlanta.

Slide37

One example of another page of the History. There were over a million cases of acute diarrhea during the war. “Colored Troops” only appeared after 1863.

Slide38

Diseases were classified according to the medical knowledge of the time. “Miasma” were those which we now know to be infectious. Malaria, for example, mean “Bad Air” in Latin.

Slide39

Tuberculosis was a severe chronic disease which would not be curable until Streptomycin came along in 1946. There were two forms, “consumption” which was the pulmonary form, was not known to be contagious. “Scrofula” is the cervical lymph node form and is associated with milk from infected cows. This was the form studied by Louis Pasteur who recognized that it was transmissible and that heating milk prevented it.

Slide40

Treatment of disease was as primitive as one might expect although quinine was known and used by the Union Army. The blockade of the South prevented its use there. Vaccination was widely practiced and opium was used for pain. There was anesthesia since 1846 and chloroform was more common than ether.

Slide41

Malaria was widespread in the US at the time. Mosquitoes were vaguely known to be associated. Mosquito nets were used although the mechanism was not well understood.

The Medical History of the American Civil War II

Friday, September 4th, 2015

This continues the story of medicine in the Civil War. Samuel Gross, a Professor of Surgery at Pennsylvania Hospital in 1860, realized that no textbook of military medicine and surgery existed so he wrote his own in 60 days. It is shown in this exhibit at the Warren Collection at Harvard’s medical library.

manaual of mil surg

The Confederate Army also had no manual so the Gross manual was used by both sides in the war. It was quickly copied for Confederate Military surgeons. A copy of the manual, which was identical to the Union Army manual is preserved at Jefferson Medical College in digital form.

Slide16

The first battle, famously, was at Fort Sumpter where the commanding office during the battle was actually the medical officer, Samuel Crawford.

Slide17

The woeful state of the army medical department was recognized immediately and a volunteer organization quickly organized. The first was the US Sanitary Commission. It was rebuffed by the Army but quickly became very powerful. This was a people’s war and the Army was incompetent, as everyone knew.

Slide18

Here is the cover of Gross’s book. It was used throughout the war, which had enormous influence on American and world Medicine. The book from which this lecture is taken was used by Theodore von Billroth to design the Prussian Army medical corps for the Franco-Prussian War in 1870. The French had forgotten Baron Larrey’s lessons and suffered terribly.

Slide19

The cover of the Confederate version of Gross’s textbook.

Slide20

Joseph Woodward was an academic surgeon, such as it was known at the time.

“Woodward was the first scientist to establish photomicrography as a tool for both scientific and medical investigations.” According to an article in the Archives of Pathology and Laboratory Medicine:[2] “In addition to collecting specimens for the museum’s archive, he co-authored the definitive medical history of the Civil War in the 6-volume 1870 publication of the MSHWR.4 Woodward’s technique using aniline dyes for staining thin sections of tissue, along with his pioneering work in photomicroscopy, helped prepare the groundwork for modern surgical pathology.”

The “History” is “The Medical and Surgery History of the War of the Rebellion” of which there are six existing full copies. I found one copy in the USC Medical Library and asked the library staff, who had no idea of its value, to place it in a locked collection room. It would be like finding a copy of “De Revolutionibus” on the shelves of an open university library.

Slide21

The design of Union Army Hospitals was entrusted to Frederick Olmsted, who had designed New York City’s Central Park. He was, after the war, very involved in establishing The National Park Service.

Slide22

The first battle of the war illustrated the appalling condition of the medical services of both sides. There were no ambulances and the wounded and to walk back to Washington City, as DC was known then.

A famous American surgeon, who would write one of the world’s great medical textbooks, William W Keen acted as a young army surgeon at the battle.

He studied at Brown University, where he graduated in 1859. He graduated in medicine from Jefferson Medical College in 1862. During the American Civil War, he worked for the U.S. Army as a surgeon. After the war, he spent two years studying in Paris and Berlin.

His “An American Textbook of Surgery” was a hugely influential text and the 1905 edition had a chapter on brain surgery by Harvey Cushing and a chapter on “Appendicitis,” the first use of the term in medical literature, written by John B Murphy, who was the first advocate of early appendectomy for appendicitis.

To be continued.

Is this 1789 ?

Sunday, August 30th, 2015

ruling

In 1789, the French Revolution began. How ?

On May 5, 1789, Louis XVI convened the Estates-General. Almost immediately, it became apparent that this archaic arrangement—the group had last been assembled in 1614—would not sit well with its present members. Although Louis XVI granted the Third Estate greater numerical representation, the Parlement of Paris stepped in and invoked an old rule mandating that each estate receive one vote, regardless of size. As a result, though the Third Estate was vastly larger than the clergy and nobility, each estate had the same representation—one vote. Inevitably, the Third Estate’s vote was overridden by the combined votes of the clergy and nobility.

The essay of Angelo Codevilla in American Spectator in 2014 described a similar phenomenon in 21st century America. American citizens begged for control of illegal immigration and crony capitalism.

As over-leveraged investment houses began to fail in September 2008, the leaders of the Republican and Democratic parties, of major corporations, and opinion leaders stretching from the National Review magazine (and the Wall Street Journal) on the right to the Nation magazine on the left, agreed that spending some $700 billion to buy the investors’ “toxic assets” was the only alternative to the U.S. economy’s “systemic collapse.” In this, President George W. Bush and his would-be Republican successor John McCain agreed with the Democratic candidate, Barack Obama. Many, if not most, people around them also agreed upon the eventual commitment of some 10 trillion nonexistent dollars in ways unprecedented in America. They explained neither the difference between the assets’ nominal and real values, nor precisely why letting the market find the latter would collapse America. The public objected immediately, by margins of three or four to one.

Today, we have a situation in which the Muslim world of the middle east is being overrun by a radical faction of Muslims who call themselves ISIS.

Richard Fernandez, whose writing I read every day, has another good discussion of what is happening and likely to happen in the future.

The anniversary of the U.S. war against the Islamic State passed with little notice. It was August 7 of last year that President Obama authorized the first airstrikes against ISIS in Iraq, a campaign he expanded a month later to include targets in Syria. So far this month, the president has delivered remarks on the Voting Rights Act, his deal with Iran, the budget, clean energy, and Hurricane Katrina. ISIS? Not a peep.

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