The Tsar's Doctor (15 page)

The tsar had intended to travel on to Scotland and to sail back to Russia from Leith. This would have fitted in well with Wylie’s plans, allowing him to visit Kincardine, where many of his family still lived. Janet is known to have made the long journey to St Petersburg, departing back to Scotland with several much treasured shawls.

His eldest brother William, however, now Master of the Public English School in Dundee, came down to London with his family to visit their now famous relation. The sight of the esteemed doctor, a tall, imposing man in his late forties, with decorations of foreign countries emblazoned on his uniform, both impressed and intimidated his relations. Long gone and near forgotten was the thin, rebellious young man who had sailed away to Russia at the age of only twenty-two. So long in fact had he been absent that they probably found it hard to comprehend some of his words, the Scottish accent of his youth being imbued with inflection of the Russian tongue. Lodged as he would seem to have been with the rest of the tsar’s entourage in the Pulteney Hotel, he may even have found it difficult to get used to the food and customs of a country that now seemed foreign to him.

Reunited with his relations, he is known to have given valuable presents, in addition to a hundred pounds, to each of his five nieces. More importantly, he tried to persuade his nephew, the Reverend Doctor John Wylie, respected Church of Scotland minister at Carluke, to return with him to Russia as his secretary. But the young man refused, probably for family reasons, or else intimidated both by his uncle and the thought of going so far from home. Wylie bore him no grudge; years later, when his nephew did finally go to visit him in Russia, he was to receive yet more expensive gifts.

Also included in the present-giving was Madame Escudier, wife of the proprietor of the Pulteney Hotel, to whom Alexander presented a valuable brooch on his departure from the hotel. The tsar and his entourage left London on 22 June. Travelling to Portsmouth, both he and his sister were entertained by the prince regent, for the last time, on the royal yacht. At Spithead they saw the strength of Britain’s navy as they watched a review of the fleet. Then moving on to Petworth, they said farewell to the prince regent before sailing to Ostend on 27 June.

CHAPTER TWENTY-ONE

‘The First Medical Person in the Russian Empire’

Tsar Alexander, with his personal doctor and Surgeon in Ordinary, now Sir James Wylie, returned to St Petersburg on 24 July 1814. That Wylie had committed himself to his adopted country is proved by the fact that his engagement to an English woman, who lived in St Petersburg, although sanctioned by Alexander, was nonetheless broken off because she wanted to go back to England. Nothing would make him resign his high position in the country he now considered his own. If not a misogynist, he seems to have preferred the company of men to the point where a group of Russian military surgeons became his ‘family’ in whose undemanding company he liked to spend his time.
⁵³

While in England, the tsar and his doctor had visited hospitals in London where Wylie, thanks to his reputation, had found himself warmly received. The main hospitals were the Westminster, with ninety-eight beds, the London Hospital on the south side of White-chapel Road, and St Thomas’s in Southwark, which had been much endowed by the wealthy merchant Sir Thomas Guy, founder of the infirmary on the opposite side of the road which to this day bears his name.

Also in London was Bethlem Hospital at Moorfields, the lunatic asylum famously featured in many of Hogarth’s cartoons. Commonly known as Bedlam, it was a great tourist attraction, the visitors being allowed to peer at the antics of the ‘unfortunates’ as they were then termed. They were even permitted to bring long sticks with which to poke at them through the bars to enrage them into performing the antics thought amusing by their tormentors, to whom madness was a form of sport.

In the absence of records of their visit it seems unlikely that the tsar and Wylie were among the 96,000 visitors to the Bethlem Hospital that year. It is known, however, that they did visit several of the hospitals named above. Touring the wards they had found that, contagion now being recognized as a cause of disease, the beds were placed further apart. This was just one example of the advancement of medical science, thanks to the chance for experiment offered by the carnage of the recent war.

The war had also produced a more humane outlook towards the suffering of the men, who had hitherto been regarded as being as dispensable as the bullets they fired. Wellington, who had so caustically referred to his soldiers as ‘the scum of the earth’, had added that he would ‘never fight a battle without them’.

Ironically, however, it was the French who had led the way in reforming conditions for the fighting men. Foremost among them was Baron Larrey, Napoleon’s Surgeon General, who had invented the well-sprung ambulances, the
ambulances volantes
, by which wounded men were spared the agony of jolting carts. He had also perfected the art of surgery, famously amputating limbs in two minutes as his opposite number in Wellington’s Peninsular army, Doctor James McGrigor, could vouch for, having witnessed him operating in Paris following the armistice with France. McGrigor, who kept a journal throughout the Peninsular War, describes how he, like Wylie, influenced his commander-in-chief – in his case the cantankerous Iron Duke – to establish the field hospitals which saved so many men’s lives.

Unfortunately his diary ended with the armistice and, as we know, Wylie’s own memoirs were destroyed. Nonetheless it is more than likely that the two men, both Scotsmen, and with so much experience to share, should have met, either in Paris or in London, to which, at the time of Wylie’s visit, McGrigor had just returned. Appointed Chief of the Army Medical College (later the RAMC) at Millbank, he then held a position in British army circles similar to that of Wylie in Russia.

Wylie’s importance in Russia is emphasized by a contemporary physician, Doctor Lyall, who, possibly jealous of his predominance in Russian medical circles, and of his influence with the tsar, described him as:

One of the most notorious and powerful individuals in Russia . . . with not very brilliant medical talent, with very moderate scientific acquirements, and with much singularity and little refinement of manners. Sir James Wylie has risen from the most obscure parentage to be the first medical person in the Russian Empire.
⁵⁴

Wylie was obviously outspoken, a characteristic inherited from his mother, but Lyall’s envy shines through when he criticizes his work.

Prior to the reign of Alexander the care of the sick in the peasant population had been left almost entirely to parish priests. Likewise even the prestigious Guards regiments had only a few surgeons to deal with the accidents and diseases inevitable among hundreds of men. The Russian soldier was considered expendable, but it seems as though it must have been Wylie who opened the eyes of the emperor to the suffering and waste of life that was draining his army’s strength. Certain it is that, deeply concerned over the great losses among his soldiers in the Crimea, the tsar asked him to produce a treatise on considering ‘preventive and curative instructions for the Russian troops’, and that subsequently, with typical efficiency, came the medical papers on yellow fever and plague, written in his neat, small hand in both Russian and French.

Already Wylie’s
Handbook of Operations
, again much sneered at by Lyall, had now been in print for nearly ten years, and reprinted several times. Likewise his magnum opus,
The Pharmacopoeia Castrensis Ruthiena
, again many times reprinted, remained the authorized text-book on the subject for over half a century. Of still more lasting importance are the scientific
Journal of the Royal Medico-Chirurgical Academy
and
The Military Medical Journal
, established initially by Wylie and which continue to the present day.

Amazing as it now may seem, during the first quarter of the nineteenth century the three chief public offices in Russia were held by men with Edinburgh degrees. While Wylie headed the medical branch of the army department, James Leighton held a similar position for the Navy and Alexander Crichton for the civil department. All three found themselves struggling against corruption, endemic in all government offices throughout the land.

Lyall’s obviously jaundiced view of Wylie may have sprung from the fact that, before being able to practise in Russia, Lyall was forced to pass the examination of the Medico-Chirurgical Academy as dictated by law. Although advised to bribe the professors he refused to do so and, to his own and everyone else’s surprise, he passed successfully nonetheless.

Sir Alexander Crichton, on the other hand, was already distinguished as an expert on mental disorders before going to Russia as physician to Alexander I in 1804. On becoming head of the civil medical department he found his office to be infested with corruption which he struggled to remove. Most notably he wrestled with a bad outbreak of cholera in 1809 which, thanks largely to his competence, was eventually subdued. He also succeeded in organizing universal vaccination against smallpox, one of the most dreaded diseases of the time. Crichton, reportedly a very likeable man, was one of the many emigrants in Russia who made his fortune within a few years. Popular at court, he collected pictures, some of which remain in the Hermitage to this day.

Sir James Leighton, head of the medical department of the navy, was another of Wylie’s compatriots against whom Robert Lyall vented his spleen. Lyall claimed in his autobiography that ‘although the medical services of the Navy needed reorganizing, Doctor Leighton probably thought it better to take the salary and let the Russians get on with things themselves’.
⁵⁵

Despite Lyall’s scathing assertion, Leighton’s reputation is vindicated by a fellow physician, Doctor Robert Lee who, himself working in Russia at a later date, was taken round the Marine Hospital in St Petersburg. Noting in his own journal that ‘Leighton had taken great trouble to set up an excellent surgical theatre and that the whole hospital was in very good order,’ he added that he had found Leighton’s medical views to be ‘quite up to those of the most scientific doctors in London’.

Lee, having shortly left England, should at that point have known what he was talking about. Observant and literate, he left in his journal a vivid picture of life in Russia at that time. It is largely thanks to him that a clear picture emerges of the illness which was to affect Alexander in the final months of his life. A fellow Scot, Lee had much in common with Wylie, whom he held in great respect although, with twenty-four years between them, he was young enough to have been Wylie’s son. Wylie had already been in Russia for three years when Lee was born in the Scottish Border town of Galashiels in 1793. Following in the footsteps of the man who was to become his mentor, he had taken his degree in medicine at Edinburgh University, aged only nineteen, in 1814.

While there, because it was a common topic, even if he did not buy a newssheet, he must have heard of the tsar’s visit to London, widely reported as it was. The identity of the doctor who travelled with him, tall and distinguished as the emperor himself, probably escaped his notice for, unlike in Russia, Wylie’s name in Scotland was known only to a few. Little could Lee, at that time just emerging on his career, have guessed at his own future involvement with the Tsar of Russia and with the man of his own profession who would fight such a desperate battle to save his life.

CHAPTER TWENTY-TWO

The Prophetess

On returning from England, Tsar Alexander remained in St Petersburg for only two months. Then he was off again, this time with his wife, the Empress Elizabeth, their horses as usual driven at a frantic speed, over the many miles to Austria, the most central empire in Europe, chosen as the venue for the great debate that would become known as the Congress of Vienna, aimed at settling the future of the continent.

On 25 September, together with Frederick William, King of Prussia, the tsar made a ceremonial entry into the Austrian capital. The Emperor Francis, having made over a whole wing of his Hofburg Palace to the Russian delegation, then spent the modern equivalent of £5,000,000 in entertaining his guests.

Alexander and Elizabeth borrowed Count Razumovsky’s enormous Neoclassical palace to hold a banquet for a great number of guests – from 400 to 700 according to various writers of the time. The count’s protégé Beethoven, although invited, was one of the few who did not attend, perhaps due to his deafness. The scene was remembered as magnificent. Fifty tables within the enormous panelled hall were set with porcelain and silver brought from Russia, as were the cucumbers, lettuces and cherries which came from the hothouses of the tsar’s summer palace of Tsarskoe Selo. The room glowed with the light of thousands of candles, burning in the vast chandeliers. Guests were dazzled by the sheer ostentation of the spectacle but the sight that drew most eyes was that of the Russian empress, a slight, almost fairy-like figure, in a dress of shimmering silk and gauze enhanced with tiny pink roses. Declared by those who were present to be unsurpassable both for her beauty and graciousness, it was also to be remembered afterwards how, whenever they fell on his wife, Alexander’s eyes shone with pride.

Later some chroniclers were to accuse the tsar of spending too much time in gaiety but, although he enjoyed the many entertainments, he came to the Conference of Vienna with a clear purpose in mind. Foremost among the problems which faced the assembled delegates were the position of Poland and the fate of Saxony. Alexander intended to restore Poland as a kingdom and to cede Saxony to Prussia, but both Britain, as represented by Castlereagh, and the Austrian Foreign Minister Metternich, spoke forcefully against this plan. A secret agreement signed by both men, together with the French Foreign Minister Talleyrand, who had cunningly exploited the jealousy between the delegates, resulted in Castlereagh’s announcement that George III’s government, under Lord Liverpool, would not agree to any reconstruction of Poland except that it be independent of Russia.