Chapter Three : The Army Hospital and Medical Research

Dr James McGrigor, was a Scottish physician, military surgeon and botanist and considered to be the person largely responsible for the creation of the Royal Army Medical Corps. He had served Wellington’s Chief of the Medical Staff in the wars against Napoleon in the Peninsular War in Spain and the Duke had written : ‘I consider him one of the most industrious, able, and successful public servants I have ever met with.’ In 1815 he became Director-General of the Army Medical Department and in his 34 years in the post, proceeded to carry out reforms involved in keeping accurate medical records to advance both medical science and inform medical officers in the Army.   

Despite the fact that the Hospital was set up on a purely temporary basis, its first Director, Dr.D.Macloughlin, who qualified at the University of Edinburg and took over in December 1814, was the first of a succession of Scots physicians who played a vital role in the history of Army Medicine at Fort Pitt. He was determined to set high medical standards and insisted, for example, that a mortuary be built and a full autopsy be carried out on all deceased patients. 

A museum of morbid anatomical specimens had been started by McGrigor at Hilsea Barracks in Portsmouth in 1810 and after being transferred to York Hospital, Chelsea, where additions were made. It was now transferred to Fort Pitt where Macloughlin employed a civilian, James Miller, to collect ‘morbid specimens’ which were housed in ‘The Anatomical Museum’, now installed on the site. Without knowing it, MacLouhghlin was setting the hospital on a research path which would have important results over fifty years later when Fort Pitt became the site of the creation of first Army Medical School.   

The Hunterian Museum in London with its Anatomical and Pathological Specimens gives some idea of the contents of the museum at Fort Pitt.

McGrigor was keen to promote collaboration between the Army Medical Department and University College London which was essential in replacing battleground 'saw-bones' of the Peninsular War with science-based doctors able to cope with and even prevent sickness, as well as dealing with the horrors of war. The changes McGrigor implemented led to an enormous improvement in the quality of the Army Medical services by the time of the Crimean War in 1854. He went to great pains to keep his collaboration with the University secret. Although it is not known for certain, it is quite probable that he feared that if his bosses at the War Office had known what he was doing, they would have stopped it.

Meanwhile McGrigor, vigorously promoted, what was now, the ‘Museum of Anatomy and Natural History’ at Fort Pitt, which became a notable feature of the teaching facilities there. In 1822 he attached a library to it based on his own considerable collection of books and made repeated personal gifts of books, on one occasion bestowing no less than fifteen hundred volumes and reached a final total of 2,500 volumes. In fact, both library and museum existed on gifts of money and books and bequests for other Army medical officers.

In 1829 the decision was made to separate the natural history collection from the anatomical specimens. The Museum had been given its own building to the northwest of the central tower which Dr Forbes, working in the Hospital, continued to expand and it was recorded in 1833 : ‘But for his zeal, ability and study perseverance, the Museum must have fallen to the ground’. The main problem was the fact that medical research at that time received no funding from the Government. 

It was noted that : ‘The locality of Chatham for the Museum and Library has some advantages, as being the General Hospital of the Invalid Depôt, it is fed with sick from among the most confirmed cases occurring in the various climates over which the Empire extends’. In other words it was to be a rich source of the anatomical specimens gained in post mortems. 

Forbes was appointed Principal Medical Officer in Ceylon in 1829 and returned to Britain in 1836 with his health broken by the climate. He was promoted to 'Inspector General of Army Hospitals' and died at the age of 59 in 1837 and was buried in Rochester Cathedral with a memorial dedicated to him on one of the walls. He doubtless presided over the Museum’s 1833 ‘Catalogue of Preparations in Morbid, Natural and Comparative Anatomy’, which can be accessed online at the Wellcome Library website. (link)  

In addition to its collection of specimens, the Museum also contained the medical sketches of John Alexander Shetky who was one of the surgeons working at the Hospital in 1819 who had already proved himself in civilian life to be a skilled painter of human anatomy. He had served in the Peninsular War in Spain 1808-14 and after the War had retired to his native Edinburgh to pursue and develop his artistic talents, before he re-entered the Army as a surgeon at Fort Pitt. It was here that he produced a large collection of paintings and drawings of natural and morbid anatomy which were stored in the Museum.(link)

The Catalogue of Preparations' provides a fascinating if not sobering insight into the men who were once nursed and died at Fort Pitt and whose organs were donated to the medical collection, like, for example, the recorded case of : ‘Thomas Probert. Age 22. 38th Regiment. A young man of scrofulous habit. He lingered in hospital 12 months before he died’. The whole document provides evidence of the poor physical state that many rank and file soldiers were in while serving in the British Army. 

The anatomical specimens were divided into those relating to Respiration, Digestion, Secretion, Excretion, Sensation and Locomotion. The Respiratory Science Collection of specimens alone, contained over 70 examples, taken mostly from the bodies of soldiers in their twenties and thirties, with a handful in their forties and two in their fifties and two in their teens. Even in their jars, the body parts from officers were treated in a different manner to those of the men. Unlike the men. the officer’s name, rank and regiment was not revealed, as in the case of the label which read : ‘From an officer, age 31, a maniac with well-marked, suicidal propensity – thyroid cartilage, throat’. 

As well as, specimens from serving soldiers, there were also some from the local Chatham and Rochester communities : ‘The patient, a boy age 12, was attacked by acute carditis with final termination in 14 days’ and ‘Lung, abandoned female age 17, who died of a very rapid phthisis’ and ‘A kidney bean impacted in the trachea of a child, whereby suffocation occurred’. 

A second catalogue dated 1845, was presented to Sydney Herbert, the Secretary at War with the preface : ‘This volume is respectfully inscribed by the Medical officers of the Army, in proof of what they by zeal and discreet application of the very limited allowance placed at their command had acquired, calculated to afford important professional information, and in consequence to promote the welfare of the British soldier’.  It contained descriptions of over 3,000 specimens. The last section of this catalogue, titled ‘Experimental Physiology’, related to specimens of mostly dogs and rabbits, but also pigs and fowl with complications relating to broken bones and injured tendons and muscles.  

This documentation indicated that Fort Pitt was building a reputation for medical research alongside its development of medical care. Incidentally, it is also recorded that the Museum contained a collection of 485 skulls, 7 dried heads and 2 mummies donated by soldiers who had collected them from parts of the British Empire where they had been stationed. 

In 1857 Surgeon-Major Williamson published his ‘Catalogue of Crania’ housed at the Hospital, which was well-received in medical circles with the Natural History Review in 1862 paying tribute to his ‘very valuable and interesting account of the collection of crania at Fort Pitt’. The catalogue of crania, the first to be composed and published in Britain, formed  an early anthropological study with Williamson’s comparisons and observations of the Hottentot, Bushman, Ashanti, Negro and Malay skulls in his collection. 

Perhaps the most extraordinary document is the ‘Catalogue of Reptiles in the Museum' at Fort Pitt dated 1843 which begins with a grumble on its frontispiece, that the collection contained too few species of turtle and tortoise and frogs and toads. (link) It expressed surprise ‘considering that India, Australia and Canada are so abundantly supplied with these species’ and made a plea to medical officers in those parts of the Empire to fill the gap. The fact that the catalogue did contain descriptions of specimens donated from 23 countries and regions around the globe, acts a reminder that Fort Pitt at this time was operating when Britain was at the zenith of its global imperial power. 

McGrigor's protege in the Army Medical Department was Andrew Smith, who after service in Cape Province in South Africa and on his return to London was given special responsibility at Fort Pitt and 1845-46. He was an extraordinary man who was an explorer, ethnologist and zoologist. He is considered the 'father of zoology' in South Africa having described many species across a wide range of groups in his major work, 'Illustrations of the Zoology' of South Africa.

Smith had started life as the son of a sheep farmer in Dumfriesshire on the Scottish side of the border. who went on to train to be a doctor and when he was still an eighteen year old student he was interviewed by the Army Medical Board in 1815 for a place in the Army and so impressed McGrigor in his interview that he appointed him Temporary Hospital Mate. As part of his training before his interview in 1818 to enroll at the University of Edinburgh to study for a medical degree to become an Army surgeon, he went for training at Fort Pitt. This was a time when Fort Pitt was transitioning from a fully operational Napoleonic fort into a Army hospital and while there, he lived in quarters associated with the Officer's Mess. After three years at Fort Pitt he made the journey north the Edinburgh which in the days for rail, cost the princely sum of £1.13s. 6d in pre-decimal money.

In 1841 Smith was raised to the rank of Staff Surgeon of the First Class and became the Principal Medical Officer in charge of Fort Pitt which meant he was in charge of the museum, library and hospital. He was also in charge of training of recruits selected by the Army Medical Board and once their training was completed, was responsible for their placement either in Britain or in the Empire. William Munro, one of Smith's contemporaries at Fort Pitt later recalled that at this time the hospital suffered from crowded buildings, an inadequate design, which is not surprising given it's past as a fort and was also much in need of repair. Smith dropped a hint of the defects in a letter that McGrigor saw and as a result Smith managed to set up a joint committee to specify the defects, but little came of it. In fact improvements were only made thirteen years later at the outbreak of the Crimean War when Smith himself was Director-General.

While at Fort Pitt Smith occupied a house which required the services of a house-keeper. He met Ellen Henderson, the widow of a medical officer who had died in India who offered to help him and later became his wife. They were said to have been introduces by W.J.Burchell, who had spent time travelling in Africa who Smith had met when he'd been stationed in South Africa. The role of Andrew Smith and McGrigor in relation to Fort Pitt was highlighted in Professor A,E.W. Miles 2009 book, 'The Accidental Birth of Military Medicine'.(link)

Smith's career took of when he was then was appointed Professional Assistant to McGrigor at the heart of things in Whitehall. He was relieved of his medical duties at Fort Pitt but the training of recruits and management of the medical school, museum and library remained under his supervision. He also set to work on the preparation of his major work in two volumes. It was published in 1848, 'Illustrations of the Zoology of South Africa' and was aided by a Government grant of £1,800.

On McGrigor's retirement in 1851, Smith was chosen by Wellington to be his successor as Inspector-General of the Army Medical Department in 1853. He went on to become a controversial figure. He was responsible for the organizing of medical services during the Crimean War, amidst serious charges of inefficiency and incompetence from 'The Times' and Florence Nightingale. Although he successfully vindicated himself before committees of enquiry, he must be held to account for medical maladministration.

Between the end of the Napoleonic Wars and the outbreak of the Crimean War in 1854, Britain was not involved in a European war. Nevertheless, wounded and sick and soldiers continued to arrive at the Hospital, either casualties from minor engagements and skirmishes in the Empire, or tropical diseases such as ‘rheumatics’ brought on by service in bad climates. In the 1840s many were shipped from India where Britain was engaged in the First and Second Sikh Wars and beyond the frontier, in the Afghan War. From 1847, patients with mental disorders were treated at Fort Pitt after the asylum at Fort Clarence was closed and it opened its doors instead to military convicts. 

These new patients, with their possessions, brought back mementos from distant parts and housed in a building which stood in front of the central tower. The 1847 ‘Pictorial Guide to Chatham’ recorded that : ‘The curiosities by these men form an interesting museum, to which the public were formally admitted, without introduction, on two days in the week’. Even as late as the 1890s and mentioned in the ‘Handbook for Travelers in Kent’, the Hospital still housed an old ambulance which had been used in Wellington’s Spanish Peninsular Campaign which was designed to be taken to pieces and carried on mule back. 

The important role that Fort Pitt played in the Crimean War, underlined by Queen Victoria’s three visits in 1855, will be dealt with in 'Chapter Four : The Army Hospital in the Crimean War’.

John Cooper

Linked later or earlier chapters :                                                                                                 

Chapter One : Construction and function as a Napoleonic Fort

Chapter Two : The Army Hospital

Chapter Three : The Army Hospital and Medical Research  

Chapter Four : The Army Hospital in the Crimean War and Queen Victoria's three visits

Chapter Five : Florence Nightingale and the Army Medical School

Chapter Six : The New Hospital Wing and the First World War and the visit of the King and Queen

Chapter Seven : Conversion of the Fort into the Medway Technical High School for Girls

Chapter Eight : The School in the Second World War and the second half of the Twentieth Century

Chapter Nine : The Site of Fort Pitt in the 21st century.