A leading proponent of neurological surgery at the onset of World War
I, Victor Horsley's uncompromising liberalism was unpopular among the
medical hierarchy. Assigned to the Mediterranean Expeditionary Force (
MEF) his political activism proved more valuable than his surgical tal
ent. This report will outline his military career and death in 1916. A
s a member of the local Territorial Force at the outbreak of the war,
Horsley requested active duty on the Western Front. He was eventually
posted as Director of Surgery of the 21 st General Hospital and sent t
o Egypt for the Dardanelles Campaign in May 1915. Several months later
he was promoted to colonel and appointed surgical consultant of the A
rmy Medical Service. Although he operated electively and lectured to m
edical officers on Gallipoli, the chaotic medical conditions prompted
him (and others) to push for re-organization of the medical services;
public outcry succeeded in effecting a change. At the end of this camp
aign, Horsley volunteered for duty in Mesopotamia. The appalling medic
al conditions prevented adequate surgery and for the next 4 months he
devoted his attention to transport, equipment and ancillary care for t
he diseased troops. His death was sudden and controversial. A vehement
opponent of alcohol and the 'rum ration', he publicly testified to hi
s own good health in the tropics as an example of the benefit of absti
nence. In mid-July, 1916, he developed severe hyperpyrexia and died wi
thin 36 h. Detractors pointed to the uselessness of abstinence while p
roponents described his death as the unavoidable result of epidemic pa
ratyphoid. In summary, Horsley's political activism was partially succ
essful in medical reorganization, but his surgical abilities could not
be used appropriately in a theatre of operations where infectious dis
ease played a major role. His early death mirrored the waste and trage
dy of the Great War.