The average strength of the troops, exclusive of the Royal Malta Fencibles, was 5,950 men. There were 5,849 admissions (983/1000 mean strength) into hospital, with 63 deaths (10.59/1000 mean strength) of which 10 were accidental deaths and two suicides. The majority of deaths (29) were attributed to miasmatic diseases of which there were 2,568 admissions.
The average number constantly sick was 282.03 men. The ratio per 1000 mean strength constantly sick was 47.40; the average sick time to each soldier was 17.30 days; the average duration of each case was 17.60 days. 36 invalids were returned to the Invalid Depôt at Fort Pitt, Chatham for a change of climate. They were all recommended for discharge from the service. The majority (7) were invalided because of respiratory problems, six had a cardiac condition and 4 a mental disorder.
14 soldiers were also admitted to hospital after receiving corporal punishment. There were 16 admissions for paroxysmal fevers (2.7/1000 mean strength), 1,241 for continued fevers (208.6/1000 strength) with 23 deaths (1.01/1000 strength), 409 for dysentery and diarrhoea (68.7/1000 strength) with 6 deaths, 451 for ophthalmia (75.8/1000 strength), and 323 for rheumatism (54.3/1000 strength). Continued fevers were common from June to September.
Convalescent Hospital Citta Vecchia
On 12 June 1860, the old palace at Citta Vecchia was converted into a convalescent hospital for officers and soldiers, at a cost of £1000. The building was leased by the military for £60 a year. It accommodated a hundred convalescents. The PMO, Inspector General John Forrest, reported that the building occupied a high location with a fine atmosphere. It had good ventilation and drainage and there was open ground for the patients to exercise.
The PMO believed that the health of the troops would only improve if they were separated from their insanitary barracks. He remarked that the existing sanitary state of the troops is not satisfactory, as there is great difficulty in numerous cases of inducing convalescence. The sick, frequently degenerate into a low state of chronic debility, requiring change of air, and being sent to England.
Mdina provided the opportunity to remove invalid officers and men from the influence of deleterious local conditions, and hopefully reduced the number of troops invalided to England. Forrest estimated that 1,307 were sent home between 1855 and 31 March 1859. The expense incurred, including the necessity of sending out men to relieve them, at the rate of £12 per man, was about £15,684.
During the hot summer season, the sanatorium afforded considerable relief to the regimental hospitals. It proved of special value in fever cases, rendering their speedy convalescence and in many instances saving having to invalid men to England. Ambulance wagons were used to move patients from Valletta to Mdina. These were the old Crimean ambulances with India rubber springs. The India rubber had, however, lost its elasticity, rendering them practically without springs.
On 9 Feb 1860, Gaspard Le Marchant decided to erect barracks for 1000 men at St George's Bay. Building commenced on Pembroke Camp in June 1860. During the year, considerable progress was also made in converting the old palace of Citta Vecchia into a sanatorium for convalescents. It took three months to complete this transformation.
Older barracks, casemates and bastions of the Order of St John's were also modified to improve sanitation. At Lower St Elmo Barracks, ventilation in the rooms was increased by the introduction of upright air shafts opening on to the roof, and of perforated zinc plates in each window. At Upper St Elmo Barracks, additional accommodation was provided through the erection of two large wooden huts for 56 men. Two of the rooms at Floriana Barracks had openings inserted on their north eastern aspect to ameliorate their ventilation.
In the Cottonera District, certain quarters previously used as ordnance stores in casemated rooms within Fort Verdala and the new casemated barracks of St Clement, adjoining Fort Verdala, were adapted to provide accommodation for about 350 men. The casemated St Clement's Barracks occupied a low sunken position surrounded on all sides by high walls.
Married families were often placed together in one room, their only privacy obtained by screening off their respective portions of the apartment. In 1860, some small rooms were used to give each family in that part of the garrison was provided with a separate apartment. These rooms were, however, ill adapted and badly ventilated. In some instances there only form of light and ventilation was through the entrance of the dwelling.
Army Medical School
On 31 Mar 1860, the Army Medical School opened at Fort Pitt, Chatham. The school was intended for the special training of physicians and surgeons about to enter the Medical Services of the Army. It was established following the report of the Royal Commissioners Inquiry into the Sanitary Condition of the Army.
On 2 Oct 1860, twenty nine gentlemen who had passed the competitive examination held in London in July and August for the army, and fourteen gentlemen who had obtained appointments in the Indian Medical Services, attended the school and hospital. The students passed through a course of practical instruction. The first course ended in Feb 1861. Candidates sat for an examination in the subjects taught by four professors: Thomas Longmore, Professor of Surgery, Edmund F. Parkes, Professor of Hygiene, William Aitken, Professor of Pathology, and Alexander Maclean, Professor of Military Medicine.
The second course ran from April to July, with an examination held in August 1861. The third session started on 1 Oct 1861 and ended on 31 Jan 1862. The school remained at Chatham for its first five sessions. It moved to Netley in 1863, when it became part of the Royal Victoria Hospital.
In 1860, Staff Assistant Surgeon Marston Jeffery Allen, who had contracted Malta Fever while serving in the island, wrote the first detailed description of Mediterranean Fever or Brucellosis.
On 1 July 1861, an asylum to replace the Villa Franconi for the insane in Floriana was completed at Wied Incita, Attard, during the administration of Sir Gaspard Le Marchant. 250 patients were moved to the new building from Villa Franconi Floriana.
Under the Order of St John, the insane were kept restrained in the damp dimly lit cellar beneath the Great Hall of the hospital in Valletta. They were then moved to the Ospizio in Floriana, where they remained until 1837, when they were transferred to Villa Franconi at Floriana.
Under the Royal Warrant of 24 Dec 1860, the Purveyor Department was to be superintended and directed by an officer of that department, with the designation of Purveyor in Chief. He acted under orders from the Secretary of State for War, and held the appointment for 7 years. Promotion was by selection for ability, and on the recommendation of the Purveyor in Chief. The grades of the officers and clerks of the department were: Principal Purveyor (Major), Purveyor (Captain), Deputy Purveyor (Lieutenant), Established Clerk (Non commissioned Ensign) and Probationary Clerk (Non commissioned Ensign).
Army Health Reports
Annual Reports on Army Health were instituted from 1860. Prior to this date returns were submitted from 1817, as the McGrigor Returns
Spinola Palace Hospital
Forrest Hospital was opened in Oct 1860. It was named after the PMO and served the sick of the new camp at St George's Bay. The hospital consisted of a building within a large garden, with wards on three floors. It was three miles from Valletta and half a mile from Pembroke Camp. Forrest Hospital also served as a sanatorium during the summer months, as it was found better suited for patients with chest infections than the sanatorium at Citta Vecchia.