1871. 8vo, pp. [2], 152; with colour title-page vignette of the red cross; browned throughout due to paper quality, with some foxing and spotting, and occasional light marginal dampstaining, and faint white paint mark affecting upper margin of p. 1; uncut in the original printed drab wrappers, with red cross vignette on upper cover, head and tail of spine cracked and chipped with some loss, with further minor tears to spine, covers darkened and soiled, with white paint on upper margin of front cover, extremities all somewhat furled and nicked, and overall slightly dog-eared, but still a good copy of a scarce work. Scarce first and only edition of this less well-known work by Pirogov, considered the greatest Russian surgeon and one of the greatest military surgeons of all time. ‘At the invitation of the International Committee of the Red Cross (ICRC), Pirogov inspected military hospitals during the Franco-Prussian War of 1870 and the Russian-Turkish War of 1877–1878. During these trips, Pirogov noted that many of the provisions previously expressed by him regarding the organization of assistance and treatment of the wounded were implemented. The result of the inspections was the publication of two more major works devoted to the issues of military field surgery: A report on a visit to military medical institutions in Germany, Lorraine and Alsace in 1870 (1871) and Military medicine and private assistance in the theater of war in Bulgaria and in the rear of the active army in 1877-1878 (1879). With regard to these works, the outstanding surgeon Ernst von Bergmann, who worked at the universities of Russia and Germany, wrote: ‘We will never forget that our German surgery... rests on the works of the Russian Nikolai Ivanovich Pirogov’ (Samohvalov & Reva, Military Field Surgeon, in the Anniversary Issue, Bulletin of Pirogov National Medical & Surgical Centre p. 22). Pirigov was particularly pleased to see that his recommendations on the use of plaster casts to had by this time been widely adopted. He had been the first to use plaster of paris dressings in the treatment of mass casualties during the Crimean war, developing his own technique, independently of Mathijsen (whose work he knew). His methods and application consisted of using coarse cloth, either in large pieces or in strips, that were immersed in a liquid mixture of plaster of paris immediately before applying them to the limbs which were protected by stockings and cotton pads. Large dressings were reinforced by pieces of wood. On the basis of his wartime experiences, Pirogov believed that all patients with fractures due to missile wounds should not be evacuated from the forward dressing stations until the limb had been immobilized in a proper dressing of plaster of paris. As a result of his and Mathijsen’s work, plaster of paris casts had been generally adopted by military and civilian surgeons throughout Europe by 1870.
It was also during the Crimean crisis, that Pirogov, with the help of his patron, the Grand Duchess Helene Pavlovna, became instrumental in establishing a female nurse corps to improve the care of the Russian sick and wounded, at the same time that Florence Nightingale was beginning a similar program in British military hospitals. Pirigov is credited with having conceived the idea of the Russian Red Cross Society, through the formation in 1854 of the Exaltation of the Holy Cross Community of Sisters of Mercy for the help of wounded soldiers of Crimean War. The first group of nurses gathered 35 women, with the numbers soon rising to 250. As surgeon general during the Crimea, he introduced the mass use of anaesthesia in surgical operations at the front, during the Sebastopol siege, and developed triage on the battlefield, sorting patients according to the severity of their wounds, and was an early advocate of the importance of hygiene, which he emphasized in his later classic work on military surgery based upon his military experiences, Grundzüge der allgemeinen Kriegschirurgie in 1864. An ardent medical educator and reformer, having witnessed the terrible conditions during the siege of Sebastopol, he came once again into conflict with military administration, and after his sharp criticism of the campaign, was forced to resign his surgical professorship at St. Petersburg’s Academy of Military Medicine in 1856. He then entered the Ministry of Education where he held several key positions before his retirement, becoming an active social reformer, as well as an outspoken advocate of the freedom and higher education of women.