Category Archives: disease

Pirogov’s Surgery Innovations in Crimea, 1855

From The Crimean War: A History, by Orlando Figes (Metropolitan, 2011), Kindle Loc. 5191-5224:

Born in Moscow in 1810, Pirogov began his medical studies at Moscow University at the age of just 14, and became a professor at the German University of Dorpat at the age of 25, before taking up the appointment of Professor of Surgery at the Academy of Military Medicine in St Petersburg. In 1847 he was with the Russian army in the Caucasus, where he pioneered the use of ether, becoming the first surgeon to employ anaesthesia in a field operation. Pirogov reported on the benefits of ether in several Russian-language publications between 1847 and 1852, though few doctors outside Russia were aware of his articles. Apart from the relief of pain and shock through anaesthesia, Pirogov emphasized that giving ether to the wounded on arrival at the hospital kept them calm and stopped them from collapsing so that the surgeon could make a better choice in selecting between those cases requiring urgent operation and those that could wait. It was this system of triage pioneered by Pirogov during the Crimean War that marked his greatest achievement.

Pirogov arrived in the Crimea in December 1854. He was outraged by the chaos and inhuman treatment of the sick and wounded. Thousands of injured soldiers had been evacuated to Perekop on open carts in freezing temperatures, many of them arriving frozen to death or with limbs so frostbitten that they had to be cut off. Others were abandoned in dirty barns or left by the roadside for lack of transport. There were chronic shortages of medical supplies, not least because of corruption. Doctors sold off medicines and gave their patients cheaper surrogates, exacting bribes for proper treatment. The hospitals struggled to cope with the enormous numbers of wounded. At the time of the allied landings, the Russians had hospital places for 2,000 soldiers in the Crimea, but after Alma they were overwhelmed by 6,000 wounded men, and twice that number after Inkerman.

Conditions in the Sevastopol hospitals were truly appalling. Two weeks after the battle of the Alma, the surgeon from Chodasiewicz’s regiment visited the naval hospital:

He found the place full of wounded men who had never had their wounds dressed from the day of the Alma, except such dressings as they could make themselves by tearing up their own shirts. The moment he entered the room he was surrounded by a crowd of these miserable creatures, who had recognized him as a doctor, some of whom held out mutilated stumps of arms wrapped up in dirty rags, and crying out to him for assistance. The stench of the place was dreadful.

Most of the surgeons in these hospitals were poorly trained, more like ‘village craftsmen’ than doctors, in the estimation of one Russian officer. Practising a rough-and-ready surgery with dirty butcher’s knives, they had little understanding of the need for hygiene or the perils of infection. Pirogov discovered amputees who had been lying in their blood for weeks.

As soon as he arrived in Sevastopol, Pirogov began to impose order on the hospitals, gradually implementing his system of triage. In his memoirs he recounts how he came to it. When he took charge of the main hospital in the Assembly of Nobles, the situation was chaotic. After a heavy bombardment, the wounded were brought in without any order, those who were dying mixed with those who needed urgent treatment and those with light wounds. At first, Pirogov dealt with the most seriously wounded as they came in, telling the nurses to transport them to the operating table directly; but even as he concentrated on one case, more and more seriously wounded men would arrive; he could not keep up. Too many people were dying needlessly before they could be treated, while he was operating on those patients too seriously wounded to be saved. ‘I came to see that this was senseless and decided to be more decisive and rational,’ he recalled. ‘Simple organization at the dressing station was far more important than medical activity in saving lives.’ His solution was a simple form of triage which he first put into practice during the bombardment of Sevastopol on 20 January. Brought into the Great Hall of the Assembly, the wounded were first sorted into groups to determine the order and priority of emergency treatment. There were three main groups: the seriously wounded who needed help and could be saved were operated on in a separate room as soon as possible; the lightly wounded were given a number and told to wait in the nearby barracks until the surgeons could treat them; and those who could not be saved were taken to a resting home, where they were cared for by medical attendants, nurses and priests until they died.

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Crimea: The 19th Century’s ‘Great War’

From The Crimean War: A History, by Orlando Figes (Metropolitan, 2011), Kindle Loc. 47-82:

Two world wars have obscured the huge scale and enormous human cost of the Crimean War. Today it seems to us a relatively minor war …. Even in the countries that took part in it (Russia, Britain, France, Piedmont-Sardinia in Italy and the Ottoman Empire, including those territories that would later make up Romania and Bulgaria) there are not many people today who could say what the Crimean War was all about. But for our ancestors before the First World War the Crimea was the major conflict of the nineteenth century, the most important war of their lifetimes, just as the world wars of the twentieth century are the dominant historical landmarks of our lives. The losses were immense – at least three-quarters of a million soldiers killed in battle or lost through illness and disease, two-thirds of them Russian. The French lost around 100,000 men, the British a small fraction of that number, about 20,000, because they sent far fewer troops (98,000 British soldiers and sailors were involved in the Crimea compared to 310,000 French).

Nobody has counted the civilian casualties: victims of the shelling; people starved to death in besieged towns; populations devastated by disease spread by the armies; entire communities wiped out in the massacres and organized campaigns of ethnic cleansing that accompanied the fighting in the Caucasus, the Balkans and the Crimea. This was the first ‘total war’, a nineteenth-century version of the wars of our own age, involving civilians and humanitarian crises.

It was also the earliest example of a truly modern war – fought with new industrial technologies, modern rifles, steamships and railways, novel forms of logistics and communication like the telegraph, important innovations in military medicine, and war reporters and photographers directly on the scene. Yet at the same time it was the last war to be conducted by the old codes of chivalry, with ‘parliamentaries’ and truces in the fighting to clear the dead and wounded from the killing fields. The early battles in the Crimea, on the River Alma and at Balaklava, where the famous Charge of the Light Brigade took place, were not so very different from the sort of fighting that went on during the Napoleonic Wars. Yet the siege of Sevastopol, the longest and most crucial phase of the Crimean War, was a precursor of the industrialized trench warfare of 1914–18. During the eleven and a half months of the siege, 120 kilometres of trenches were dug by the Russians, the British and the French; 150 million gunshots and 5 million bombs and shells of various calibre were exchanged between the two sides.

The name of the Crimean War does not reflect its global scale and huge significance for Europe, Russia and that area of the world – stretching from the Balkans to Jerusalem, from Constantinople to the Caucasus – that came to be defined by the Eastern Question, the great international problem posed by the disintegration of the Ottoman Empire. Perhaps it would be better to adopt the Russian name for the Crimean War, the ‘Eastern War’ (Vostochnaia voina), which at least has the merit of connecting it to the Eastern Question, or even the ‘Turco-Russian War’, the name for it in many Turkish sources, which places it in the longer-term historical context of centuries of warfare between the Russians and the Ottomans, although this omits the crucial factor of Western intervention in the war.

The war began in 1853 between Ottoman and Russian forces in the Danubian principalities of Moldavia and Wallachia, the territory of today’s Romania, and spread to the Caucasus, where the Turks and the British encouraged and supported the struggle of the Muslim tribes against Russia, and from there to other areas of the Black Sea. By 1854, with the intervention of the British and the French on Turkey’s side and the Austrians threatening to join this anti-Russian alliance, the Tsar withdrew his forces from the principalities, and the fighting shifted to the Crimea. But there were several other theatres of the war in 1854–5: in the Baltic Sea, where the Royal Navy planned to attack St Petersburg, the Russian capital; on the White Sea, where it bombarded the Solovetsky Monastery in July 1854; and even on the Pacific coastline of Siberia.

The global scale of the fighting was matched by the diversity of people it involved.

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Malaria Killed More than Combat in PNG

From Hell’s Battlefield: The Australians in New Guinea in World War II, by Phillip Bradley (Allen & Unwin, 2012), Kindle Loc. 4885-4905:

From the moment the Australians flew into Nadzab, they were under insidious assault. Carried by the fragile mosquito, malaria could fell and even kill the strongest of men, and the Ramu Valley, the valley of death in the local dialect, had one of the highest incidences in the country.

The traditional treatment was with quinine, but 90 per cent of the world’s supply came from cinchona-tree plantations in Java, which was now under Japanese occupation. After the 252 Lark Force escapees ran out of quinine on New Britain in early 1942, fifty died within five weeks and most of the remainder needed hospitalisation. An alternative malaria suppressant had to be found or it would be impossible to maintain troops in northern Australia, let alone New Guinea. Atebrin, a synthetic version of quinine that had been developed in Germany before the war, became the Australian Army’s official antimalarial drug, and what quinine remained was reserved for treatment. Australian scientists helped develop practical methods of synthesising Atebrin and pinpointed the dosage that most effectively suppressed malaria among deployed troops. In New Guinea, wearing protective clothing, using mosquito nets, spraying, improving drainage and of course taking the bittertasting Atebrin pills became as important as any combat discipline.

Malaria is not found above elevations of about 1000 metres, but most of the fighting in New Guinea took place along the coast or in the lowlands of the Markham and Ramu Valleys. High rainfall increased the opportunities for mosquitoes to breed, so the relatively dry area around Port Moresby was less dangerous than Milne Bay and the Papuan beachheads, where malaria was rampant. From October 1942 to April 1943, malaria caused almost five times more casualties than combat did. Even that was not the full story, as most affected men had recurrences of the disease after returning to Australia. The highly malarial environment of the Ramu Valley almost crippled the Australian campaign. Almost 1 in 10 of the operational troops were falling ill with malaria each week, meaning that within eleven weeks almost all would be infected. There were other diseases, some—such as scrub typhus—much deadlier, but malaria accounted for 90 per cent of losses due to disease. As a result of the scientists’ studies, the daily Atebrin dose was doubled, and the infection rate fell by about two-thirds. For Japanese troops in New Guinea, malaria was also a serious problem. Though they had stocks of quinine, the progressive breakdown of their supply system meant that almost all frontline troops were infected with malaria, and deaths from it increased as the war went on.

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The Japanese Retreat from Lae, PNG

From Hell’s Battlefield: The Australians in New Guinea in World War II, by Phillip Bradley (Allen & Unwin, 2012), Kindle Loc. 4518-4577:

After the loss of the Bismarck Sea convoy the previous March, the Japanese command in Lae had seen the writing on the wall and made contingency plans for evacuation. As part of those preparations, the engineering unit of Lieutenant Masamichi Kitamoto had orders to blaze a land route across the Huon Peninsula to Lae. At the 1932 Olympic Games in Los Angeles, Kitamoto had run for Japan. Now he would again be asked to use his legs for his country. A week after the loss of the Lae convoy, his fifty-man detachment from the 30th Regiment Independent Engineers crossed the Vitiaz Strait from Tuluvu, on the western tip of New Britain, and landed on the New Guinea mainland. With a native guide, the heavily burdened engineers set out to cross the Saruwaged Range to Lae. ‘It was just like climbing a slide from the bottom to the top,’ Kitamoto wrote later. ‘You had to bend forward deeply to bring the centre of gravity before you. It was as if someone had put a heavy weight on our heads and [was] pulling our legs at the same time.’ It only got worse: ‘The incline kept going up and up into the skies. Our legs grew stiff and we gasped for breath . . . Gazing at the clouds below us, we continued the march up the sharp incline . . . It was so cold that it seemed that our hands which grasped the rocks to pull us up would become frozen.’ At 4500 metres, Kitamoto’s engineers crossed a summit higher than Mount Fuji in Japan. Almost as testing was the descent down the other side. The expedition to Lae took three weeks, but when Kitamoto reported to Lieutenant General Hidemitsu Nakano’s headquarters on 3 April, just a month after the Bismarck Sea debacle, Nakano had his escape route.

Now it was mid-September, and the Japanese situation in Lae was desperate as Kitamoto again reported to Nakano’s headquarters. When the young lieutenant entered, Nakano was in conference with his key officers, poring over a map spread across the table. Kitamoto soon learned that Nakano had ordered a retreat: there would be no final battle for Lae. Civilian employees had already left, beginning their trek on 4 September. For the troops who remained, there were two potential routes: across the Saruwaged Range to the north coast, or through the foothills of the Finisterre Range, parallel to the Markham Valley. Having traversed both, Kitamoto was asked for his opinion. ‘The second plan is impossible,’ he told Nakano, knowing that Allied aircraft could easily interdict a route through the kunai grass that covered the foothills. Kitamoto continued: ‘The first plan is difficult, but there is still some chance of success. If I had to make the final decision I would choose Plan 1. However, the sacrifice will be great.’ The die was cast: the order was issued.

The first group of Japanese soldiers, about 2000 naval troops including Kitamoto’s men, set off from Lae on 12 September, making their way inland along the west bank of the Busu River. They formed one of four groups, totalling 8650 men, headed for the high mountains with enough rations to last ten days. Intermediate supply dumps were established north of Gawan and at Iloko. The first and third groups went into the mountains via Gawan, the second and fourth groups via Kemen. Kitamoto’s engineers led the way, setting up signposts and repairing the track as they went. They crossed the Busu about 3 kilometres upstream from the now fallen kunda bridge. General Nakano travelled with the second group, which halted at the Busu for three days while a new bridge was constructed. The final organised group left Lae on 15 September.

Shigeru Horiuchi, a twenty-two-year-old private with III/238th Battalion, had arrived in Lae only a week before the Australian invasion. Since then, his unit had gone through ‘two weeks of hell,’ under constant attack from Allied bombers; ‘even the officers were trembling in funk holes and had no taste for fighting.’ Horiuchi’s company did not leave Lae until 17 September, but Horiuchi was soon forced to drop out because of a leg wound. He was captured a few days later sheltering in a native village 25 kilometres north of Lae.

In the first days of the trek, 200 men had died, mostly wounded and sick. ‘The mountains were only 500 metres high and this much casualties,’ Kitamoto observed with dismay. ‘How many will die before we clear Mt. Sarawaket, which is 4500 metres high? The sharp precipices rising before us will take many victims.’ Once the track began to rise, ‘the soldiers helped each other along, the strong carrying the rifles of weak men. However, as they grow tired, even the strong began to discard their rifles.’ Kitamoto ordered that any discarded weapons should have the chrysanthemum insignia filed off because ‘it was humiliating to throw away the arms that belong to the emperor.’

As the men weakened, the incidence of malaria increased and more men dropped out. In the first 1500 metres of the climb after leaving Kemen, 500 men died. Steep precipices dropped away on both sides of the track. ‘After we escaped the clutches of the enemy we were confronted by nature,’ Kitamoto wrote. Those who lived also confronted the corpses of those who died. ‘Using the dead bodies as stepping stones and clinging to the slippery lichen-covered rocks, the men made their way up the mountain. Fresh red blood ran from the mouths of the dead when they were stepped on and their glassy eyes stared us in the face.’ Approaching 4000 metres, the cold bit hard into lightweight tropical uniforms; though exhausted, the men were afraid to fall asleep lest they freeze to death. Another 800 men died crossing the top of the range. ‘The screaming voices of the men who slipped from the log bridges to their death in the canyons below, the wailing cries of the men who could move no more and were asking for help . . . it was a sense of hell, something quite out of this world.’

By now the rations had gone. Starving, some men ate human flesh. As he approached the summit of Mount Saruwaged, Kitamoto saw that ‘in the shadow of the rocks, three soldiers had pinned a trooper to the ground while one of them stabbed him in the heart with his bayonet. There were no signs that the dead man had asked the others to kill him. The remaining three soldiers cut slices of the dead trooper’s thigh and began to devour the human flesh.’ After Kitamoto shouted at them, ‘the men looked in my direction, flies that gathered about dead meat swarmed about their faces but they had no strength to drive them away. They had become mad with hunger and fatigue.’ Kitamoto covered the corpse and moved on.

In the end even Kitamoto’s strength gave out, and he was carried to the coast on a stretcher. He reached Kiari, some 20 kilometres west of Sio, twenty days after leaving Lae. Staff Officer Sugiyama told him: ‘I wish to bow my head in gratitude for your strong legs. Your legs saved the whole division.’ Once he recovered, Kitamoto headed back to the top of the range to help the stragglers reach the coast. The last stretcher case was brought in on 15 November. An 18th Army report showed that of the 8650 who had left Lae, 6417 survived—a loss of over 25 percent. Most of the survivors staggered into Kiari suffering from malnutrition and malaria. Although only 1271 of them were officially classified as ‘sick,’ Kitamoto wrote that all the men ‘were a group of invalids . . . in no condition to fight.’

Even on the coast, safety was not assured: three men died as they rested on the beach, crushed by a falling coconut tree. ‘At second look, I discovered that they were the men who became mad and ate their comrade during the march,’ Kitamoto wrote. His right-hand man, the native guide Rabo, also knew what these men had done. ‘Those soldiers no good,’ he told Kitamoto as he stared at the three dead men. ‘They eat friend. God punish them.’ As Rabo turned away, Kitamoto felt a shiver run down his spine.

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New Britain Jungle as Great Equalizer, 1942

From Darkest Hour: The True Story of Lark Force at Rabaul – Australia’s Worst Military Disaster of World War II, by Bruce Gamble (Zenith, 2006), Kindle Loc. 2150-2169:

The jungle, it turned out, was a great equalizer. Lieutenant Colonel Tsukamoto’s battalion encountered several impediments as they pursued the Australians, not the least of which was the heavy rain that blanketed the Gazelle Peninsula. Similarly, Lieutenant Colonel Sakigawa’s mechanized unit slowed to a crawl as they advanced around Ataliklikun Bay on January 27. “The butai could not advance as hoped,” he reported. “The mountain roads went up and down and in some places [soldiers] walked in mud and water up to the knees. And also there were obstructions on the roads [such] as fallen bamboo and rotted trees.”

Other units experienced even greater difficulty. One detachment of mountain artillery tried to drag their wheeled guns through the heavy jungle. They reached the Vudal River on January 25 only to find it impossible to ford, so the soldiers hacked out a road to a different crossing. They even labored to build a temporary bridge, but their progress was so slow that they were forced to leave the field guns in the jungle. By the time the detachment finally reached the western shores of Ataliklikun Bay, they had lost contact with the fleeing Australians.

As a result of such setbacks, the battalion commanders requested naval support. General Horii arranged for a destroyer and three transports to conduct a “sea pursuit,” resulting in the aforementioned landings at Lassul Bay and Massawa Bay, but these proved to be only a minor threat to the Australians. The Japanese did not venture inland, mainly because the jungle quickly conspired against them. As the writer of an operational report later explained: “Practically every man of the 1st Infantry Battalion suffered from malaria owing to an eruptive outbreak of the disease at the time of mopping up … in particular, the pursuit action in the Ataliklikun Bay area.”

The heavy rains and high humidity of the past several days had created ideal conditions for mosquitoes. Many of the men in Tsukamoto’s battalion, poised to capture hundreds of Australians, were themselves laid low by malaria. That so many became infected was the result of “nothing but negligence,” according to the report, which placed blame squarely on the “leaders, medical staffs and epidemic prevention staffs in particular.” Days passed before the Japanese realized what had caused the outbreak. At least ten men died, and several others were “affected in the brain and became mad.” Within days, the combat strength of the South Seas Detachment was reduced by half.

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1918: How the Great War Ended

From Hundred Days: The Campaign That Ended World War I, by Nick Lloyd (Basic Books, 2014), Kindle Loc. 305-326:

The campaign of 1918 remains one of the most important, yet least understood, periods of the war. Writing in 2011, the historian David Stevenson claimed that ‘whereas modern comprehensive investigations now exist into the outcomes of other modern conflicts, the First World War still lacks one’. It had begun on 21 March, when the thunderous opening of the German Spring Offensive shattered the trench deadlock that had gripped the opposing armies for the best part of three years. Having been able to redeploy large numbers of troops to France after the collapse of Russia, Germany’s leaders vowed to strike before the Allies, buttressed by powerful American support, became invincible. The aim was to conduct a massive attack in France, separate the British and French Armies, and win the war before Germany’s perilous strategic situation worsened even further. But this great masterstroke failed. Although manoeuvre returned to the Western Front and the German armies advanced deep into northern France, the Allies evaded this knock-out blow and held on. And it was in July, when Germany’s strength began to fade, that the Allies hit back, thus beginning the final campaign of the Great War: the Hundred Days.

When I began researching this period, the lack of a really satisfactory account of these final battles, particularly one that analysed the situation from the point of view of all the main warring sides, became immediately apparent. Although there have been many good books on 1918 – a personal favourite being Gregor Dallas’s epic 1918: War and Peace (2000) – their coverage remains patchy, selective and frequently drawn from a few well-worn sources. Anglophone historians have understandably focused on the battles fought by the British Expeditionary Force and have relatively little to say about the important roles played by the French or the Americans. Other writers have claimed that the war was effectively over by the summer of 1918 – meaning that the Hundred Days was not especially important – but this remains a narrow and selective approach dependent upon hindsight. The Germans may have lost the war by July, but the Allies had certainly not won it and there was much still to do, as the staggering toll of losses reveals all too clearly. Between 18 July and 11 November the Allies sustained upwards of 700,000 casualties while the Germans lost at least another 760,000 men. Indeed, casualty rates among British units were some of the worst of the war, leading many commentators to assume that nothing had been learnt from previous offensives; that it was the same old story of fruitless slaughter and sacrifice in 1918 as it had been in earlier years. This may not have been the case, but the death toll of those final days – increased tragically by the so-called ‘Spanish flu’ – remains remarkable and deserves greater examination than it has hitherto received.

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Russian Economic Success before 1914

From Catastrophe 1914: Europe Goes to War, by Max Hastings (Knopf, 2013), Kindle Loc. 757-815:

Russia boomed in the last years before Armageddon, to the dismay of its German and Austrian enemies. After 1917, its new Bolshevik rulers forged a myth of Tsarist industrial failure. In reality, the Russian economy had become the fourth largest in the world, growing at almost 10 per cent annually. The country’s 1913 national income was almost as large as that of Britain, 171 per cent of France’s, 83.5 per cent of Germany’s, albeit distributed among a much larger population – the Tsar ruled two hundred million people to the Kaiser’s sixty-five million.Russia had the largest agricultural production in Europe, growing as much grain as Britain, France and Germany combined. After several good harvests, the state’s revenues were soaring. In 1910, European Russia had only one-tenth the railway density of Britain or Germany, but thereafter this increased rapidly, funded by French loans. Russian production of iron, steel, coal and cotton goods matched that of France, though still lagging far behind Germany’s and Britain’s.

Most Russians were conspicuously better off than they had been at the end of the previous century: per-capita incomes rose 56 per cent between 1898 and 1913. With an expansion of schools, literacy doubled in the same period, to something near 40 per cent, while infant mortality and the overall death rate fell steeply. There was a growing business class, though this had little influence on government, still dominated by the landowning aristocracy. Russian high life exercised a fascination for Western Europeans. That genteel British magazine The Lady portrayed Nicholas II’s empire in romantic and even gushing terms: ‘this vast country with its great cities and arid steppes and extremes of riches and poverty, captures the imagination. Not a few Englishmen and Englishwomen have succumbed to its fascinations and made it their home, and English people, generally speaking, are liked and welcomed by Russians. One learns that the girls of the richer classes are brought up very carefully. They are kept under strict control in the nursery and the schoolroom, live a simple, healthy life, are well taught several languages including English and French … with the result that they are well-educated, interesting, graceful, and have a pleasing, reposeful manner.’

It was certainly true that Europe’s other royal and noble fraternities mingled on easy terms with their Russian counterparts, who were as much at home in Paris, Biarritz and London as in St Petersburg. But the Tsarist regime, and the supremely hedonistic aristocracy behind it, faced acute domestic tensions. Whatever the Hapsburg Empire’s difficulties in managing its ethnic minorities, the Romanov Empire’s were worse: enforced Russification, especially of language, was bitterly resisted in Finland, Poland, the Baltic states and Muslim regions of the Caucasus. Moreover Russia faced massive turmoil created by disaffected industrial workers. In 1910 the country suffered just 222 stoppages, all attributed by the police to economic rather than political factors. By 1913 this tally had swelled to 2,404 strikes, 1,034 of them branded as political; in the following year there were 3,534, of which 2,565 were deemed political. Baron Nikolai Wrangel observed presciently: ‘We are on the verge of events, the like of which the world has not seen since the time of the barbarian invasions. Soon everything that constitutes our lives will strike the world as useless. A period of barbarism is about to begin and it will last for decades.’

Nicholas II was a sensitive man, more rational than the Kaiser if no more intelligent. Having seen the 1905 Russo-Japanese war – which Wilhelm incited him to fight – provoke a revolution at home, the Tsar understood that a general European conflict would be disastrous for most, if not all, of the participants. But he cherished a naïve faith in the common interests of the emperors’ trade union, supposing that he and Wilhelm enjoyed a personal understanding, and were alike committed to peace. He was contradictorily influenced, however, by Russia’s recent humiliations – in 1905 by Japan’s forces, in 1908 by Austrian diplomacy when the Hapsburgs summarily annexed Bosnia-Herzegovina. The latter especially rankled. In January 1914 the Tsar sternly declared to former French foreign minister Théophile Delcassé: ‘We shall not let ourselves be trampled upon.’

A conscientious ruler, Nicholas saw all foreign dispatches and telegrams; many military intelligence reports bear his personal mark. But his imagination was limited: he existed in an almost divine seclusion from his people, served by ministers of varying degrees of incompetence, committed to sustaining authoritarian rule. An assured paternalist, on rural visits he was deluded about the monarchy’s popularity by glimpses of cheering peasantry, with whom he never seriously engaged. He believed that revolutionary and even reformist sentiment was confined to Jews, students, landless peasants and some industrial workers. The Kaiser would not have dared to act as arbitrarily as did the tsar in scorning the will of the people: when the Duma voted against funding four battleships for the Baltic Fleet, Nicholas shrugged and ordered that they should be built anyway. Even the views of the 215-member State Council, dominated by the nobility and landowners, carried limited weight.

If no European government displayed much cohesion in 1914, Nicholas II’s administration was conspicuously ramshackle. Lord Lansdowne observed caustically of the ruler’s weak character: ‘the only way to deal with the Tsar is to be the last to leave his room’. Nicholas’s most important political counsellor was Sergei Sazonov, the foreign minister. Fifty-three years old and a member of the minor nobility, he had travelled widely in Europe, serving in Russia’s London embassy, where he developed a morbid suspiciousness about British designs. He had now led the foreign ministry for four years. His department – known for its location as the Choristers’ Bridge, just as its French counterpart was the Quai d’Orsay – spoke scarcely at all to the Ministry of War or to its chief, Vladimir Sukhomlinov; meanwhile the latter knew almost nothing about international affairs.

Russian statesmen were divided between easterners and westerners. Some favoured a new emphasis on Russian Asia and exploitation of its mineral resources. The diplomat Baron Rosen urged the Tsar that his empire had no interests in Europe save its borders, and certainly none worth a war. But Rosen was mocked by other royal advisers as ‘not a proper Russian’. Nicholas’s personal respect and even sympathy for Germany caused him to direct most of his emotional hostility towards Austria-Hungary. Though not committed to pan-Slavism, he was determined to assert the legitimacy of Russian influence in the Balkans. It remains a focus of keen dispute how far such an assumption was morally or politically justifiable.

Russia’s intelligentsia as a matter of course detested and despised the imperial regime. Captain Langlois, a French expert on the Tsarist Empire, wrote in 1913 that ‘Russian youth, unfortunately supported or even incited by its teachers, adopted anti-military and even anti-patriotic sentiments which we can scarcely imagine.’ When war came, the cynicism of the educated class was evidenced by its many sons who evaded military service. Russian literature produced no Kipling to sing the praises of empire. Lack of self-belief, coupled to nationalistic aggressiveness, has always been a prominent contradiction in the Russian character. Nicholas’s thoughtful subjects were conscious of their country’s repeated failures in wars – against the British, French, Turks, Japanese. The last represented the first occasion in modern history when a European nation was defeated by an Asiatic one, which worsened the humiliation. In 1876 the foreign minister Prince Gorchakov told a colleague gloomily: ‘we are a great, powerless country’.

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