On 18 Aug 1848, the Governor appointed Gavino P. Portelli of the Civil Hospital to a Sanitary Committee to watch over the public health. The Sanitary Committee was to
adopt such measures as they deemed most useful to promote cleanliness and ventilation, with the view of averting predisposing causes to disease.
The cities were divided into the following districts: Valletta (10 districts), Floriana (4 Districts), and the Three Cities (8 Districts). Inspectors were appointed to the districts with instructions to report weekly to the committee. There were no military officers on the committee.
A letter from the Sanitary Committee dated 12 Sept 1848, and jointly signed by Dr Gavino Patrizio Portelli, Mr Sant Arrowsmith, and Dr Frederick Sedley to Mr Henry Lushington, Chief Secretary to Government, warned of the dangers of infected linen.
It having become known to us that 3 of the washerwomen employed by the contractors to wash the linen of the Civil Hospital have been attacked and died of cholera, in consequence of the excrementitious and filthy state of such clothing. We feel it our duty to recommend that instructions be given immediately to the Purveyor, that all such linen be immersed immediately on its removal from beds or persons, in a weak solution of chloride of lime, and that Harness Casks be employed for conveying the linen to the contractor's premises in order to prevent as much as possible evaporation and propagation of disease.
In Aug 1848, Asiatic cholera made its appearance among pilgrims in Egypt. The first case of cholera among the civil population in Malta was reported on 6 Sept 1848, when Benedetto Tonna, aged 64 years, from Valletta fell ill and died on 9 September.
On 22 Sept cholera spread to the 1st/69th Foot stationed at lower St Elmo Barracks. On 10 Oct the 69th was removed to Floriana where three more cases occurred. Cholera also appeared in the Royal Artillery at Fort Upper St Elmo. The men of the Royal Artillery were removed to a corn store within 100 yards of the fort, with some beneficial affect. As soon as Lower St Elmo was abandoned the rooms were fumigated and whitewashed. The Reserve Battalion/69th was then brought over from the Cottonera Lines and occupied them, with the exception of the infected rooms.
Cholera broke out in the Reserve Battalion where fear and drunkenness prevailed. There were 28 attacks with 21 deaths but the PMO remarked that 639 cases of diarrhoea were admitted into hospital; 20 died showing all the signs of cholera and proving fatal within a few hours of admission.
The conflicting medical opinions as to whether the outbreak was cholera or simple diarrhoea, caused problems for the Governor. On 28 Sept 1848, Moore O'Ferrall urged his Board of Health to settle the question one way or another. The Board of Health was composed of:
- James Barry PMO
- Andrew Millar RN Acting Deputy Medical Inspector
- Daniel Armstrong Surgeon Reserve Bn/44th Foot
- Edward Caldwell Surgeon HMS Ceylon
- Edward Robertson Surgeon 1st/44th Foot
- Dr Gavino Patrizio Portelli
- Tommaso Chetcuti Acting Police Physician
The Board saw no reason why Clean Bills of Health should not be granted to vessels leaving the island as, up to 27 Sept 1848, no cases of Asiatic Cholera had been brought to their attention. However, the medical officers present at the post mortem on the soldier of the Royal Artillery, held at the General Military Hospital on 6 Oct 1848, had voted 9 to 5 in favour of the death being due to Asiatic Cholera. Surgeon Richardson William RA, Staff Surgeon Edward William Burton, Surgeon Henry James Schooles 1st/69th, and Assistant Surgeon Pratt Egerton James 1st/44th had voted in favour of the death being due to Asiatic Cholera.
In addition, the medical officers of the Civil Government Acting Police Physician Tommaso Chetcuti, and Dr Gavino Patrizio Portelli, as well as the officers of the Royal Navy, W. Lindsay (Deputy Medical Inspector), Edward Caldwell, and Assistant Surgeon J. W. Martin RN, had all agreed that death was caused by Cholera.
On 13 Oct 1848, The Malta Mail reported:
the existence of the epidemic is positive. That it is not cholera we have the written pledge of Dr James Barry PMO, Surgeon Armstrong Daniel, Surgeon Robertson Edward, Assistant Surgeon Willocks Arthur Stewart 69th, and Dr Sankey RN, all of whom have had much professional experience of the disease in India, France, or Malta, and in whose opinion we are free to confess we have quite as much faith as will preserve us from the chance of becoming unnecessarily alarmists.
Up to 3 Nov, the doctors had still not agreed as to whether or not Cholera had broken out in Malta. On 20 Oct, the Malta Mail stated that:
the opinion of the PMO Dr James Barry and the medical gentlemen who opposed the idea that cholera has appeared, turn out to be perfectly correct. Stagnant water was found under Fort St Elmo and this was attributed as the cause of the outbreak in the 1st/69th.
The average strength of the garrison was 2,534 men, with an average daily sick in hospital of 108. The total treated in hospital was 3,125. There were 25 deaths in hospital and four deaths out of hospital. The proportion of deaths to the number treated was 1 in 125. The proportion of deaths to strength was 1 in 101. Only 1,550 men were fit and available for garrison duty.
From 31 Mar 1847 to 31 Mar 1848, there were 602 cases of Common Continued Fever.
Morbidity and Mortality (1 Apr 1847 – 31 Mar 1848)
|Morbidity and mortality 1 Apr 1847 to 31 Mar 1848. (TNA:WO 334/16). |
Between 1 Apr 1847 and 31 Mar 1848, the garrison had 713 women and 1,232 children. The women suffered mainly from diarrhoea, catarrh, and ophthalmia. Three women died during the year, one from fever, one from hepatitis and one from apoplexia. There were 220 sick children with 34 deaths. Children fell ill with rubeola, bronchitis and atrophia.