Sir James McGrigor, Director General Army Medical Department (1815–1851,) retired on 6 Feb 1851. He was succeeded by Dr Andrew Smith, who was initially given the title of Superintendent General.
In 1853, the Ordnance Medical Department amalgamated with the AMD. Dr Andrew Smith, as head of the combined services, took the title of Director General. The AMD under DG Andrew Smith had to grapple with the medical problems of the Crimean War.
The Lord Commissioners of the Admiralty thanked the medical officers of the Mediterranean Squadron for their services during the Cholera epidemic of 1850. The Malta Mail very much regretted that no other reward was forthcoming, and that the medical officers received only words but no honours. the paper wrote:
A few promotions amongst them who have withstood and borne the brunt of the late visitation would tend more beneficially to the good of the Service, and more encouragingly to the junior members of the profession, than a mere cold official letter of thanks. How can their Lordships affect surprise at men resigning the Service in disgust and refusing to hazard their lives when such worthless and ungrateful returns are made? Young officers see from such precedents no hope of ulterior reward, no matter how dangerous, nor how trying may be their duties. Hence there is so little, as there is no stimulus for volunteering. The battle field of a medical officer is grappling with the terrors of an epidemic. When everyone is disposed to fly, and even the natural ties of affection are shaken, he is to be found anxiously and watchfully at his post struggling amid the sick and dying, relieving and comforting the smitten, and encouraging all around by his good example and moral courage. From such tragic scenes men who have done their duty well, should not be allowed to retire unrewarded. Such has the struggle of our naval and military medical officers here very lately, but as yet, no substantial recompense has been awarded to any of them.