Nikolay Ivanovich Pirogov, depicted outside his “FST”in this painting in the Panorama Museum at Sevastopol, is regarded as the father of Russian military surgery.
He instituted a five stage system of triage, he used novel amputation methods whilst using ether as an anaesthetic and used plaster casts to stabilised fractured limbs.
He was ahead of his British professional contemporaries on the other side during the Crimean War (1854-56) having already used anaesthesia in the field in the Caucasus campaign in 1854.
The British Principal Medical Officer had issued a warning that chloroform was too dangerous to be used on injured soldiers and that applying ice to an injured limb to numb it was a preferred method.
His advice seems to have been largely ignored by the medics on the front line and after the first few months of the war chloroform was widely used. During the course of the war 3/4 of a ton was intended to be issued to the army in the Crimea and used right down to RMO level.
There were some difficulties in the supply chain however (nothing new in that) which meant that all of the chloroform did not reach its destination; damaged in transit or perhaps put to other uses.
The principal problem in the use of chloroform seems to have been a failure to regulate the amount of chloroform given and as a consequence overdosing the patient. This rendered them almost moribund and as they needed an excessively long time to regain consciousness. Chloroform was administered either with a Snow’s Inhaler or simply onto a bit of lint held over the patients mouth and nose. Clover’s Inhaler, with which it became possible to regulate the amount of inhaled anaesthetic, did not come into use until 1877.
In addition to an EMO ether inhaler there was a Snow’s Inhaler amongst the issued kit at 55FST