By:  Anzel Veldman- Curator, DITSONG: National Museum of Military History


A watercolour sketch of a wounded man at the Battle of Waterloo by Sir Charles Bell, a military surgeon who recorded wounded men on the warfront between 1809–1815.


During the 17th and 18th centuries armies and their commanders spent most of their time in sieges as they were more prevalent than open field battles. Whilst equally important, field battles at that point did not end a war, but merely led to another campaign the following year. That is also why the armies of the day consisted predominantly of highly trained mercenaries who were difficult to replace, and the uncertain outcome of battle considered too costly by commanders. The French Revolution (1787-1799) and following Napoleonic Wars led to a decline of small professional armies and gave way to large national armies composed of conscripts. This same period saw artillery transformed from a specialised profession overseen by mechanics into a major service branch capable of dominating battlefields (Bowden 1983; Liaropoulos 2006).


The French Revolution and the subsequent Napoleonic Wars were period of intense imperial rivalry between France and Britain due to empire-building and subsequent colonial conquests that served as economic boosts for Europe. Napoleon Bonaparte (1769-1821) after building on his military successes was able to seize control of the government in 1799 and end the Revolution, bringing into being the Consulate and by 1803, he became Emperor Napoleon. However, after a disastrous campaign in Russia, resulting in a European alliance against him, Napoleon was forced to abdicate in 1814 and was sent into exile. Meanwhile, the exiled aristocrats returning to France were rejecting the social transformation of the revolution as well as Napoleon’s “careers are open to talent” and not your birthright or social status, thereby aggravating former revolutionaries. Louis XVII worsened the already tense situation by appointing many of these nobles with questionable skills to their choice of government and/or military positions. To further infuriate the army, the king distributed the Legion of Honour to his followers, who fought against Napoleon. Ultimately, Louis XVII alienated the army when he discharged thousands of men who wished to remain in service. Peasants were also angered when the former aristocracy wanted to revoke the land reforms decided upon by the Republic. News of the discontented population reached Napoleon, and upon his return from exile, he overthrew the monarchy, and restored the empire. Allied nations Austria, Russia, Prussia, and Great Britain declared Napoleon an international outlaw during the Congress of Vienna, and the allied forces immediately started to prepare to invade France.  Endless conflict culminated into the Battle of Waterloo on 18 June 1815. A total of 185 000 men fought in the Waterloo campaign, which ended 23 years of warfare with the defeat of Napoleon by the Duke of Wellington and Gebhard Leberecht von Blücher (Bowden 1983; Fisher 2001; Fremont-Barnes 2006; Lansford 2006; Waskey 2006).


However, victory came at a brutal price. The Waterloo campaign resulted in 63 000 wounded who were to be treated. The masses of wounded men lying on the ground severely hampered the efficiency of stretcher bearers. To put it into perspective, at the Battle of the Somme in 1916, the mean density was 234 injured men per 1.6 km of front, while at Waterloo the equivalent figure was 2291 men. The most common types of wounds were due to musket balls, grape shots, and cannon balls. Incised wounds were also frequent due to the use of lances, sabres, and bayonets. Treatment at the time was straightforward; most frequently amputation was the method to save a soldier’s life thereby avoiding gangrene and septic shock (Bowden 1983; Howard 1988; Crumplin 2015; Kennaway 2020).


The diluted spirits and opiates gave scant relief from the agonising pain of amputation, as in 1815 anaesthesia did not yet exist. What generally happened is that when the surgeon was satisfied there is no chance of saving the limb, the operation is to be performed as soon the patient has recovered from the shock of the injury and will be able to bear the additional one of the operations. There is no denying that having a limb amputated without any anaesthesia must have been excruciatingly painful, and surgeons dreamt of the day when anaesthesia was possible. Contrary to popular belief men were not subdued with alcohol to lessen the pain, instead they had to be sober. Alcohol interferes with the blood’s ability to clot, which could make incisions and controlling blood loss during surgery very difficult. Alcohol use additionally increases the frequency of postoperative bleeding, simultaneously the chances of infection of the surgical site is higher, which may then lead to septic shock and death. Surgeons at the time regarded amputation as advantageous to wounded men, because field hospitals were not antiseptic areas, antibiotics did not yet exist, infections resulting in gangrene and often leading to sepsis were a worse fate than having a limb amputated. Limbs most amputated are legs and arms as these were frequently wounded by musket balls, grape shots, and cannon balls (Guthrie 1815).


The very fact that the battle was so bloody, in terms of both deaths and surgical operations, gave Waterloo more symbolic potency than a tactical victory of manoeuvre could ever have had.  The Waterloo medal was issued in 1816-1817 to about 39 000 men who were present at the battles of Ligny, Quatre Bras and Waterloo. This was the first medal issued by the British Government to all soldiers present during military action. The emotional world of the Napoleonic-era surgery and its memory included intense ideas of blood sacrifice, one that reinforced British collective identity and that justified British power. Therefore, this medal not only represents an end to the Napoleonic era, but also reflects the carnage and suffering men endured in the mid-19th century.




Bowden, S. 1983. Armies at Waterloo: A Detailed Analysis of the Armies that fought History’s Greatest Battles. Empire Press: Arlington.

Crumplin, M. 2015. Medical aspects of the Battle of Waterloo. BMJ Military Health 161:135-139.

Fisher, T. 2001. The Napoleonic Wars: The rise of the Emperor 1805-1807. Osprey Publishing: Great Britain.

Fremont-Barnes, G. 2006. Military Operations of the French Revolutionary Wars (1792–1802). In: Fremont-Barnes, G. (ed), The Encyclopaedia of the French Revolutionary and Napoleonic Wars:  A Political, Social, And Military History pp: 16-23. ABC-CLIO: California.

Guthrie, G. J. 1815. On gun-shot wounds of the extremities, requiring the different operations of amputation, with their after-treatment: Establishing the advantages of amputation on the field of battle. Printed for Longman, Hurst, Rees, Orme, and Brown: London.

Howard, M.R. 1988. British medical services at the Battle of Waterloo. British Military Journal 297: 24-31.

Kennaway, J. 2020. Military surgery as national romance: The memory of British heroic fortitude at Waterloo. War & Society 39: 77-92

Lansford, T. 2006. Empire-Building within Europe and Abroad. In: Fremont-Barnes, G. (ed), The Encyclopaedia of the French Revolutionary and Napoleonic Wars:  A Political, Social, And Military History pp: 36-40. ABC-CLIO: California.

Liaropoulos, A.N. 2006. Revolutions in warfare: Theoretical paradigms and historical evidence–the Napoleonic and First World War Revolutions in Military Affairs. The Journal of Military History 70: 363-384.

Waskey, A.J. 2006. French Revolutionary Political Thought and Ideology. In: Fremont-Barnes, G. (ed), The Encyclopaedia of the French Revolutionary and Napoleonic Wars:  A Political, Social, And Military History pp: 29-32. ABC-CLIO: California.

Ditsong Logo