British Naval Hospitals
Malta
1799 – 1970

A Naval Medical Department, with Sir William Burnett as its first head, did not appear until 1832. Previously, Commissioners of the Sick and Wounded Seamen and Prisoners of War, commonly called The Sick and Hurt Board, administered the provision of care for injured sailors. The Commissioners were subordinate to the Admiralty, to which they referred all matters of financial expenditure for approval.

In the 1790s, the promotion of physicians as Commissioners of Sick and Wounded Seamen, enabled medical reforms to be brought to the fore. Thus, in 1795, Sir Gilbert Blane, a Commissioner from 1795 to 1802, was able to adopt James Lind's measures against scurvy. Through his intervention, the Lords of the Admiralty laid down that lemon juice was to be issued after six weeks on salt provisions.

The Sick and Hurt Board was abolished in 1806, when its functions were transferred to the Transport Board. In 1817, this was in turn merged with the Victualling Board.⁹

The first set of regulations for the conduct of His Majesty's Service at Sea was published in 1731. Those articles pertaining to the surgeon specified that whenever possible the ill and injured were to be treated in the Sick Berth or transferred to a hospital ship which accompanied the fleet. The sick were attended to by Sick Berth attendants or lob–lolly boys as they were referred to in the service.¹⁰

The surgeon was to inform the captain every day of the condition of his patients, especially if any of the distempers were infectious, that they may be sent out of the ship, or if that cannot be done separated from the rest. Table I, shows that the total number of sick seamen of the Mediterranean Squadron sent ashore was very small as compared with those admitted to the Sick Berth.

Medical men entered the navy as surgeon's mates or hospital mates. They held the rank of warrant officer and messed in the cockpit with the mates and midshipmen, not with the officers in the ward room. The boatswain, carpenter, gunner and purser all had separate cabins. Not so the surgeon's mate who slept in the cable tier in a battle ship of the line. The assistant surgeon, as the mate later became known, had to serve a minimum of three years afloat and certified as qualified for every department by undergoing the different necessary examinations, before becoming eligible for promotion to surgeon. In the army, the surgeon being paid by a scale of service, was allowed to reckon all the time he passed as an assistant surgeon, in calculating his pay as surgeon. In the navy, only the first three years were allowed in calculating his pay, irrespective of the numbers of years served in the junior rank.¹¹

The difficulty in enticing medical men to join the navy as surgeons and surgeon's mates during the French Revolutionary Wars, led to the Order in Council of 23 January 1805. This went some way towards addressing the grievances of the mates, but still confined them to the cockpit.

The Order in Council set the full pay for hospital mates at 6 shillings 6 pence a day at home, and 7 shillings 6 pence a day on foreign stations. Their reduced half pay was 2 shillings a day, provided they had served two years on full pay. Lodging money of 10 shillings 6 pence per week was also granted to those not accommodated within the hospital.

Hospital Dispensers and ship surgeons received a full pay of 10 shillings a day, with a daily half pay rate when unemployed of 5 shillings. Their lodging allowance, when a residence was not provided for them, was 12 shillings a week. Surgeons appointed to hospital ships and hospitals received a full pay of 15 shillings a day, with a lodging allowance of 15 shillings a week when not provided with a quarter within the hospital. Surgeons had a right to retire after thirty years service on full pay, including not more than three years as hospital mate or assistant surgeon, on a half pay of 15 shillings a day. Those, who because of ill health contracted in the service were no longer able to perform their duties, were allowed to retire after twenty years' service on half pay at ten shillings a day.¹²

The prospect of an assistant surgeon being promoted to surgeon was slim as the navy list was so congested with surgeons on half pay carrying on their private practice, that promotion in peacetime was exceedingly slow. On 9 August 1838, Admiral Sir Edward Codrington (1770–1851), in his evidence to the Commissioners inquiring into Naval and Military Promotion and Retirement, stated that since 1815, a hundred medical officers in the army have been promoted to ranks higher than regimental surgeons, while only one surgeon of the navy has, during the same period, been promoted to any higher rank.¹²

On 21 June 1824, Hospital Mate Robert J Dallas, petitioned the Victualling Board for promotion. Unfortunately for him, the Board had no authority to promote him. This was wholly vested in the First Lord Commissioner of the Admiralty.

In January 1817, having then served about four years in the Mediterranean, two and a half years of that time in the Naval Hospital at Malta, and from 15 April 1815 until 14 July 1816 in HMS Clorinde, Mr Thomas Marryat Surgeon, the Transport Board appointed me to the Albion, then in the Mediterranean, from which ship I was reappointed to the Naval Hospital Malta on 13 October 1818, where I have served until now (June 1824). Having completed upwards of eleven years on this station, more than eight of that time in the hospital, and my health being much lately impaired, I beg leave to submit my survey to your consideration and to request that you may be pleased to promote me.¹³

The next stage of promotion for a naval surgeon, who had served for at least five years, was that of Physician to the Fleet.

In Roderick Random, Tobias Smollett painted a very bleak picture of the conditions under which naval surgeons in the eighteenth century had to work. Their plight was repeatedly highlighted in the correspondence of the Lancet and the Provincial Medical Journal. Although in 1805, the status of senior surgeons had improved, the battle for elevated status, pay and promotion for the assistant surgeon continued for the next half century.¹⁴ It was not until 1881, that the pay and conditions of service of the naval surgeon matched those of the army surgeons.

The naval surgeon's personal status, in a way relied very much on his relationship with his captain, on whose support he depended upon for promotion. It was through Nelson's patronage that Michael Jefferson, surgeon of the Vanguard, and John Allen surgeon of the Royal Sovereign became surgeons of the naval hospital at Malta. Surgeon George Magrath of the Victory, had been recommended by the Physician to the Fleet John Snipe, as a suitable replacement for John Gray surgeon at the naval hospital at Malta. On 14 December 1804, Nelson appointed G Magrath, surgeon to the naval hospital at Gibraltar following the death of surgeon William Burd from fever on 20 November 1804.

In 1799, a number of Sick Quarters were opened on shore for the sick and wounded of the blockading naval squadron. Putrid Fever or Epidemic Typhus, caused by Rickettsia prowazekii, frequently broke out among the ship's company. R. prowazekii is passed on from human to human by the body louse, Pediculus humanus. After a blood meal from an infected patient, the Rickettsia multiply in the gut of the louse, and are excreted in its droppings. Dried faeces retain their ability to transmit the disease for many months, thus rendering the dust in a dwelling sheltering louse riddled seamen a potential source of infection.

On 31 March 1799, Alexander Ball reported to Nelson that the:

The miseries and wretched poverty of the Maltese have caused a malignant fever to break out, which has swept off a number of the troops as well as inhabitants. The infection got into my ship, from having frequent communications with the inhabitants, and the sick list suddenly increased from five to twenty-seven, of which two only died, all the rest recovered and the ship is now as healthy as ever, by taking precautions and fitting up a house in an airy situation on shore, where I sent every man who had the slightest symptom of the fever.¹⁵

One can only speculate as to the exact location of this house in an airy location on shore. The Master's log of the Alexander records that on Wednesday 16 January 1799, the ship was at anchor in Marsaxlokk Bay with the Audacious and Incendiary. All the boats were employed in watering and a number of marines, 40 seamen and three lieutenants went ashore. She was back in Marsaxlokk Bay on 19 February, when she anchored in 15 fathoms of water and positioned herself North West West of Marsaxlokk Castle, West South West of Benghajsa Tower and East South East of Delimara Tower. The Alexander hoisted out all the boats, sending them on shore for the men who had been quartered in Marsaxlokk Castle.¹⁶

On 20 February 1799, the Alexander came to anchor in 13 fathoms of water with the Goliath, Audacious and Minerva on St Paul's Bank with St Paul's Castle to its South West.¹⁷

On Monday 25 March, while still at anchor on St Paul's Bank, she landed two of the lower deck guns, 100 shot and 20 cartridges for the use of the Maltese. On Saturday 13 April, she received six men from the hospital and sent three sick men there. Another two sick men were sent to the hospital on Monday 15 April. On 20 May, two final entries in the Master's log record hoisted out all the boats and sent them for the sick, received the sick from the hospital.¹⁶

The Goliath was in frequent contact with the Alexander. On Sunday 5 May, she joined her on St Paul's Bank, when the malignant fever spread to its ship's company. William Burnett, surgeon of the Goliath, however, declared that a boat party which had been sent into Marsascala to water had became infected and passed on the contagion to about forty of the ship's company. The most prominent symptoms were nausea with vomiting, succeeded by headache, flushed face, full and frequent pulse, thirst, and white tongue. Most had delirium with three patients exhibiting suppuration of the parotids, a recognised complication of typhus fever.¹⁸

Burnett says that he landed and placed the sick under his care in a large castle near St Paul's Bay, where they were purged, blistered and bled repeatedly. This soon produced a cessation of pyrexia, when tonics and a well regulated diet completed the cure. All were said to have recovered from their ordeal.¹⁸

The large Castle near St Paul's Bay is most likely to have been Wignacourt Tower, although the Castle at Selmun is also a possibility, as this could have been reached from the landing area at Mistra Bay.

The entry in the Master's log of the Goliath, dated Thursday 9 May 1799, records sent a midshipman and nine men to the hospital.¹⁹ The Captain's log for the same day states sent the sick to the hospital on shore, received slops from the Alexander, and one dated Sunday 19 May notes hoisted the Pinnace out and sent her into Saint Paul's for the sick, supplied the Audacious with wood.²⁰

The fever failed to abate. On 31 August 1799, Captain Alexander Ball was forced to open a Temporary British Naval Hospital for all the sick of the squadron and appointed Thomas Alldridge, Purser of HMS Lion, Superintendent of the hospital on a salary of five shillings a day.

Whereas there are on board His Majesty's ships under my orders, many sick persons principally of contagious fevers, it becomes absolutely necessary to establish a hospital on shore at this place. And in order that the sick at the said hospital may be regularly and properly victualled, you are hereby appointed to superintend the said hospital, supplying the same with such provisions and necessaries, as may be demanded by the surgeon, keeping a true and exact account of all expenses attending the same, paying for house rent, and all contingent expenses, drawing bills upon the Commissioners of the Sick and Hurt London.²¹

Thomas Burke was surgeon to the hospital on five shillings a day as extra pay, assisted by an unnamed surgeon's mate at the rate of two shillings six pence a day. Alldridge entered into contracts with the Maltese merchants Lorenzo Diacono and Antonio Parnis, who not only supplied the hospital with beef, fish, lemons, sugar, bread, macaroni, eggs, mutton, sheep's heads, vegetables, wood and chamber pots but also employed a maid to do the laundry and mules to carry the provisions.

The Temporary British Naval Hospital admitted its first sick seamen on 30 August 1799 and closed on 16 November 1799. It admitted a total of 149 sick or wounded seamen from the following ships: Alexander (30 August–24 October) 91 men, Lion (3 September–20 October) 15 men, Success (8 September–28 October) 15 men, El Corso (9 September–15 September) 15 men, Audacious (11 September–2 November) 13 men (2 deaths), Stombolo (14 September–2 November) 7 men, and La Bonne Citoyenne (17 September–7 October) 5 men.

The exact whereabouts of this hospital is unknown. From Thursday 29 August to 7 September 1799, the Alexander was anchored in 13 fathoms of water in Marsaxlokk Bay. Her log for Saturday 31 August records sent 30 men to the hospital. On Sunday 1 September 1799, she landed two main deck guns and 100 shot and supplied the Maltese with ten barrels of powder; on 5 September she sent two men to the hospital and landed four cannonades for use of the Maltese.¹⁶

The captain's log of the Alexander of Friday 18 October, while still anchored off Marsaxlokk, records received the sick on board, landed for the use of the Maltese, six lower deck guns 32 pounders and six main deck guns 18 pounders. However, the Alexander was back at St Paul's Bank in 16 fathoms of water from 21 October to 19 November, where her log for Tuesday 22 October, states made a moderate run into St Paul's Harbour, employed in landing the sick. HMS Bomb Vessel Strombolo was also moored in St Paul's where her log recorded anchored here HMS Alexander with the sick of the squadron. Boats employed landing ditto to the hospital. On Friday 1 November, while still in St Pauls' Bay, the Stombolo sent Richard Gibson sick to the hospital and on Thursday 7 November, she supplied the hospital with 43 gallons of wine and took discharged 9 men belonging to HMS Success.²²

The cost to the Sick and Hurt Board of maintaining the hospital from 31 August to 16 November 1799, amounted to £301 14s 11d for provisions, and £48 2s 6d for salaries of the superintendant at 5s a day for 77 days (£19 5s), surgeon 5s a day for 77 days (£19 5s), and (£9 12s 6d) for the surgeon's mate at 2s 6d a day for 77 days, making a grand total of £349 17s 5d. Three months' rent was paid at the rate of £30 pounds sterling per annum, the house being totally evacuated on 16 November 1799.

On 10 December 1799, two British infantry regiments under the command of Brigadier General Thomas Graham disembarked in Malta to reinforce the land blockade. The men of the 30th and 89th Regiment of Foot soon fell ill, making it imperative to open a hospital for them in Zejtun, in the country house of Count Agostino and Paola Formosa de Fremeaux. On 3 April 1800, Mr Edward Tegart was appointed surgeon to it while Dr Alexander Jamieson served as its physician.

The log of the Alexander, while at anchor off St Julians, has an entry dated Tuesday 25 March 1800, which simply states carpenters employed fitting a hospital on shore for the sick. Their work must have soon been completed for on Friday 28 March, the Alexander sent twenty six men sick to the hospital, and on Friday 2 May 1800, while still off St Julians, she received the sick from the hospital. It is not clear whether the carpenters were fitting up the military hospital at Zejtun or another naval hospital. It is probably the former, but if the latter, then the Palace of Spinola overlooking St Julian's Bay would have made an obvious choice. On Tuesday 1 April 1800, the log of HMS Northumberland which was moored in Marsaxlokk, documents receiving 32 men from the hospital. It does not give the location of the hospital, but Marsaxlokk Bay is within easy reach of the military hospital at Zejtun.

In the naval engagement of 30 March 1800, which resulted in the capture of Le Guillaume Tell, HMS Foudroyant had 8 killed and 69 wounded, HMS Lion had 7 killed and 41 wounded, and HMS Penelope suffered 2 killed and 2 wounded. Surgeon Nathan Wilson HMS Penelope and Surgeon James Young HMS Lion admitted their worst casualties to the Military Hospital on shore, as no naval hospital was still open. Young lamented:

The marines who had disembarked and were doing duty on shore for some time, had suffered materially from sickness, particularly for want of medicine and a properly regulated hospital – indeed it was disgraceful to see that a squadron frequently consisting of seven and eight sail of the Line with smaller ships, had no proper establishment for their sick on shore, while the moment a couple of regiments arrived a superb hospital with every necessary convenience and luxury was immediately provided and to the humane attention of Dr Jamieson, I am indebted for his reception and care of some of my wounded men after the action with the French Republican ship of war Le Guillaume Tell.²³

On 5 September 1800, the French were starved into capitulating. The naval sick were admitted to the Sacra Infermeria of the Order of St John of Jerusalem, which had become a Military Hospital for British troops. On 11 December 1800, Mr M L Unwin, Purser of the Foudroyant supplied the General Hospital with two hundred and eight gallons of wine, in two pipes.²⁴

On 17 December 1800, a naval hospital was established in Vittoriosa, in the former Armoury of the Order of St John of Jerusalem. It received its first patients on 13 January 1801, when 2nd Master Peter Carrall of HMS Alexander was admitted with rheumatism. The first recorded deaths were those of Able Seaman Mark Christian of HMS Alexander, who was admitted on 13 January 1801 and died on 24 January from debility; Able Seaman Andrew Brannon of the Alexander admitted on 13 January and died on 29 January from rheumatism; Private Marine Richard Martin of the Regulus admitted with the flux on 14 January and died on 31 January and Able Seaman James Webb of the Blonde admitted on 14 January with venereal disease and died on 21 February 1801. Able Seamen John Hagg of the Ulysses and John Hughes of the Wassenaar died of Hectic fever on 22 and 30 April 1801 respectively. On 22 April, Boatswain's Mate Charles Thompson of the Bulldog died from rheumatism.²⁵

In July 1801, surgeon John Roxburgh of the Stately, who had served with Nelson in the Agamemnon from 26 January 1793 to 10 June 1796, was admitted with general debility and rheumatism. He was invalided on 5 September after a stay of sixty seven days in hospital and returned to England on board the Chichester.

On 17 December 1800, Michael Jefferson was installed Surgeon of the hospital by Lord Keith, Commander in Chief of the Mediterranean Fleet. He remained in charge of the hospital until its closure on 14 May 1802. Jefferson had been surgeon of the Vanguard, and had dressed Nelson's head wound during the Battle of the Nile. In 1804, he sought, but failed, to be appointed surgeon to the Victory. Nelson in his letter to Emma Hamilton, dated Victory off Toulon 14 March 1804 wrote:

With respect to Mr Jefferson, I can neither say or do anything. The surgeon of the Victory is very able, excellent man and the ship is kept in the most perfect state of health. I would not do such an unjust act as to remove him for I have every reason to be perfectly content. Mr Jefferson got on by my help, and by his own misconduct, he got out of a good employment, and has seen another person at Malta Hospital put over his head. He must now begin again, and act with much more attention and sobriety, than he had done to ever get forward again.⁵

On 10 January 1801, Pasquale Rancate was appointed Assistant Surgeon to the Armeria Naval Hospital. On 8 May 1801 Gioacchino Pietrofile became Acting Dispenser. Both served until 14 May 1802. Additional assistant surgeons were employed whenever the need arose, such as when patients were confined in quarantine or during an influx of sick prisoners of war.

From 17 May to 31 August 1801, Francesco Borg and Giuseppe Galdes were engaged as additional temporary assistant surgeons. Assistant Surgeon Thomas Rintoll was placed on the hospital roll from 21 September 1801 to 4 March 1802, and Assistant Surgeon James Ferguson from 17 October 1801 to 22 March 1802.²⁵

A matron, (Margaret Hamilton succeeded by Ann Cordell), took charge of the linen. A number of female nurses, (Mary Clair, Isabella Leeson, Mary O'Hara, Mary Murphy, Biddy Moreto, Ann Grace, Elizabeth Hayden, Mary Johnson, Mary Ferguson, Mary Burnett, Elizabeth Bennett, Mary James), probably the wives of soldiers, were employed as nurse attendants. In addition the hospital had a clerk (Jonathan Baillie), steward (Saverio Trigance, James Dowling), cook (Joseph Christian), porter (Salvatore Zammit, Salvatore Zarah) and a number of locally employed labourers.²⁵

The Naval Hospital at the Armeria closed on 14 May 1802, as part of the general drawdown in compliance with the Treaty of Amiens. All the hospital staff ceased to be employed and were discharged to La Vallette.

The start of the Napoleonic Wars in May 1803 saw increased activity of the Royal Navy in the Mediterranean. In the absence of a naval hospital in Malta, sick and injured seamen and marines were admitted to the General Hospital in the former Sacra Infermeria of the Order of Saint John. The medical naval sick were under the supervision of Inspector of Field Hospitals Abraham Bolton; the surgical naval sick were under the care of Surgeon Robert Grieves. Major General William A Villettes, General Officer Commanding Troops Malta said of them that they attended the navy patients with the most conscientious and approved attention.²⁶

Sick Prisoners of War, who were also the responsibility of the Commissioners for Sick and Wounded Seamen, were admitted to Fort Ricasoli under the care of the Apothecary to the Forces Joseph Thomas.

On 18 January 1804, Inspector General of Hospitals William Franklin petitioned Lord Nelson to grant the two military surgeons an allowance for the considerable additional duties they undertook in the care of the naval sick. A precedent had been set during the Egyptian Campaign of 1801, when naval surgeons caring for wounded soldiers had been granted an extra ten shillings a day while the sick were under their care. Table II shows the number of naval patients admitted to the military hospital. The cost for victualling them amounted to £3,252 14 shillings.²⁶

Naval sick in a military hospital were not only an administration nightmare, but had the potential of carrying hospital fever on their return to their ships. In a naval hospital, the sick were victualled by the agent of the Sick and Hurt Board. He was accountable to the Board for every single item of expenditure. The Army Medical Department had an altogether different accounting sytem where by the hospital was supplied by the Purveyor to the Forces and the regimental hospitals, often co-located with the General Hospital, were accounted for by hospital stoppages from the soldier's pay. The army surgeon who victualled sick sailors in his regimental hospital had to reclaim his expenses from the naval authorities.

Tensions often broke out between naval and army surgeons. Thus in July 1803, William Franklin called into question the professional judgement of naval surgeon James Schaw of the Madras, for delaying in sending a febrile sailor to the hospital. Schaw retaliated by attacking him in a private letter, forcing Nelson to order Physician to the Fleet John Snipe to investigate the affair. Nelson also attempted to reconcile the two factions. On 31 August, he wrote to General Villettes:

I have your letter of 8 August enclosing a letter from Dr Franklin complaining of the conduct of Mr Schaw. It appears to me that if Mr Schaw did not send the poor man so soon to the hospital as ought to have done, then he is very blameable, for no man ought to be kept a moment longer than is possible after an inflammatory fever was upon him.
I shall take an early opportunity of sending Dr John Snipe to inquire and make known to me whether the man was kept longer on board than he ought to have been. If Mr Schaw thought his professional judgement was called in question unfairly by Dr Franklin, he should have desired an inquiry to refute Dr Franklin statement and had no right previously to attack in a private letter the conduct of Dr Franklin.
I have heard of Dr Franklin's kindness to our seamen spoken of in the highest terms and I trust that he will continue it.

I shall very soon send Dr Snipe to Malta and I hope he will be able to settle this business amicably. I am my dear General truly sensible of the great care and attention shown by the medical gentlemen of the hospital to our seamen and they have no reward adequate to their trouble. I trust that this little asperity in a professional judgement between two professional men will not prevent the reception of our seamen in future and the former kindness of the gentlemen of the hospital towards them. I suppose the Admiralty if we are to keep Malta will establish a proper naval hospital.⁵

On 7 November 1803, Nelson repeated his conviction to Villettes that the navy ought to have had a regular hospital at Malta, and not to have thrown the trouble of attending seamen on the medical skill of the army. Whenever Sir Richard Bickerton and Dr John Snipe go to Malta, I intend they shall examine the large house on the opposite side to you, which will be very fit place for a marine hospital.⁵

On 6 December 1803, a contract was entered into between Doctor John Snipe Physician to the Fleet and Inspector of Hospitals in the Mediterranean on the part of the Sick and Wounded Board and Mr William Higgens for victualling the sick and wounded seamen and sick prisoners of war in the Naval hospital at Malta from 1 January 1804 at one shilling ten and a half pence sterling per men per day. The contract was approved by Admiral Nelson, but as it contained no provision for any supply of milk, it was subsequently stipulated that each patient should be furnished daily with half a pint of good milk, and that an additional allowance of one penny and a half penny should be made to the terms of the contract, making the total daily victualling to two shillings for each patient. The contract, which expired on 13 October 1805, cost the exchequer £6,050 6 shillings during which time sick seamen spent 36,977 days in hospital and prisoners 54,175 days.²⁵

On 15 September 1803, the Commissioners of the Sick and Wounded seamen appointed Captain Philip Lamb RN their agent for Prisoners of War and Resident Agent for Transports replacing Lieutenant William Pemberton who had occupied the post of agent for Transports. The Commissioners ordered Pemberton to return to England but on 21 December 1803, Nelson appointed him Governor of the Naval Hospital at Malta.²⁶

On 1 January 1804, there were 58 naval sick in the Military Hospital Valletta belonging to the following ships: Kent (6), Victory (2), Canopus (3), Superb (4), Belleisle (6), Donegal (2), Gibraltar (2), Renown (1), Agincourt (3), Stately (1), Madras (4), Amazon (1), Active (8), Phoebe (5), Juno (3), Avion (1), Raven (2), Morgiana (3), William (1), and Childers (1).

On 2 January, all the naval sick were transferred to a naval hospital prepared for them in the Grand Prison of Valletta. In addition, there were in Fort Ricasoli 29 sick and wounded Prisoners of War. These, were relocated to the naval hospital on 8 January 1804.²⁷

A Slave Prison had been set up in Valletta during the time of Grand Master Hugues Loubenx de Verdalle (1582–95). Staff Surgeon William Henry Burrell who inspected the naval hospital during the plague of 1813, described the Grand Prison as:

A lofty quadrangular building, standing on the brow of a hill fronting the Grand harbour. It is isolated, being bounded by Strada Ursula in front, the ramparts behind, Strada St Christoforo and Strada Pozzi on either side. It consists of three stories and occupies a nearly equilateral space about 400 paces in circumference. The large quadrangular court, into which very large windows open from the two upper floors and smaller ones from the basement, is disposed into separate grounds for exercise, and is exceedingly dry and airy. There is thorough ventilation in all the rooms above the basement; large windows open on both sides, and except in two or three of the cells, windows are placed in all the sleeping rooms on the ground floor, opening on a spacious colonnade, the only objection being that they are on the same side as the doors. The prison was common to the whole island, and, except a portion of the upper floor appropriated to the sick of the navy; it was then occupied by French prisoners and the ordinary criminals.²⁸

The hospital was inspected on 9 January 1809 by the Commander-in-Chief of the Mediterranean Fleet Cuthbert Collingwood. The naval wards occupied one side of the square, the other three being crowded with civilian prisoners. He found it to be well run with its wards capable of receiving more than 300 men. However, it was in an unsuitable location in the town, too far away from the shore, and had a prison below it for Frenchmen, with no outlet for convalescent men to take exercise. The sick were disembarked at three landing places. The first was 640 paces from the hospital, another which had the smoothest landing was 686 paces distant, and the third had 126 stone steps and was 430 paces away.²⁹

Mr John Gray was the surgeon of the Grand Prison Naval Hospital. He was born at Dunse, Berwickshire in 1768, and entered the navy in 1790 as a surgeon's mate to the Proserpine Frigate. From November 1798 to the Truce of Amiens in March 1802, the sick of the Mediterranean Squadron had been admitted to the Naval Hospital at Port Mahon, Minorca under the care of John Gray. He went back to England in August 1802, after an absence of eleven years. War having been declared in May 1803, John Gray returned to London and on 1 July 1803, was appointed surgeon to the Naval Hospital at Malta.³⁰

Nelson's letter to Dr J Snipe dated 25 November 1803 from the Victory off Toulon, ordered him to assess the building for its suitability as a hospital.

The Commissioners for taking care of Sick and Wounded Seamen and Marines having acquainted me that they had appointed Mr John Gray to be surgeon of a naval hospital intended to be established at Malta. I therefore desire that you will proceed immediately in HM Ship Narcissus to Malta to examine the situation and necessary accommodation of such hospital previous to its being occupied as such. And as it has been mentioned to me by admirals and captains who have served in the Mediterranean that the situation of the former Naval hospital at Malta was particularly unhealthy, it is my directions that you do not suffer that house to be received as a hospital or any other which from situation you may judge improper, but endeavour to procure a convenient and well appointed house in an airy and healthy situation for a naval hospital pro tempore, until such time as Government shall take the necessary measures for building or otherwise providing a convenient and proper hospital. If such accommodation cannot be had, you will beg Major General Villette to allow Mr Gray the use of the wards in the Military Hospital at present appropriated for the seamen, until the necessary arrangements can be made for their reception in some other place.²⁶

During his last six months in Minorca, Gray had fallen ill with an obstinate tertian ague which had completely destroyed his constitution. While in Malta he suffered repeatedly from bilious attacks which produced great debility and rendered him incapable of performing his duties at the hospital.²⁶ He left Malta in August 1804 for the recovery of his health. On 9 September 1805, Nelson recommended him for the post of Physician of the Mediterranean Fleet and Inspector of Naval Hospitals. He succeeded Doctor Leonard Gillespie who in December 1804 had taken over the reins from John Snipe. Gray inspected the hospital in Malta from 1 April and 30 June 1808. John Gray never married. He succumbed to a stroke on 25 March 1826, and was interred in St John's Wood's burying ground.³⁰

On 30 June 1804, Nelson appointed Mr John Allen Surgeon of the Royal Sovereign and an old follower of Sir Richard Bickerton, Surgeon of the Naval Hospital at Malta. His appointment was confirmed by the Admiralty on 6 August 1804, the day he was discharged from the Sovereign.

John Allen was born in 1762. He received his warrant as Surgeon's First Mate to the Belleisle on 8 May 1782. He was promoted Surgeon to the Culloden on 7 June 1788, but his seniority was antedated to 12 June 1784 as he had been surgeon to the Cyrus from 13 June 1784 to 17 April 1786. He was surgeon to the Royal Sovereign from 1 February 1804 to 6 August 1804 when he was appointed Surgeon to the Naval Hospital at Malta, having served 3 years as a mate and almost eleven years as surgeon.³¹

On 6 October 1827, after having served at the naval hospitals in Malta for just under 16 years, John Allen was superannuated at the rate of £250 per annum by order of the Lord High Admiral and placed on half pay of 6 shillings a day, being the half pay he would have been entitled when appointed to the hospital. John Allen died on 14 January 1849 at his residence in Strada Forni, Valletta. He had been married for 48 years to Lucy, who predeceased him on 23 November 1840, aged 71 years. Both were laid to rest in Msida Bastion Cemetery.

The staff of the naval hospital at the Grand Prison from 1 July 1805 to July 1819 consisted of:

• Governor
  1. William Pemberton. (Post of Governor was abolished in March 1809.)
• Surgeon
  1. John Allen
• Agents
  1. Matthew Welch
  2. John Newton (from 8 January 1813)
  3. Henry Stephens Dyer
• Dispensers
  1. George Saunders
  2. Henry D Morison (from 21 August 1814, late surgeon of the Sloop Partridge.)
  3. Charles O Morris (Acting Dispenser 13 August 1815 – 17 February 1816 during the absence on leave of H D Morison).
• Chaplain
  1. John Thomas Howe Le Mesurier (from 1 January 1814).
• Matrons
  1. Hannah Kirk/Cheale
  2. Lucy Staines (from 1 March 1814).
• Hospital Mates
  1. Henry Donnet (1 July – 20 July 1805)
  2. John William Ellia (1 July 1805 – 18 Sep 1806).
  3. J Pragnell (20 Sep 1806 – ?June 1807)
  4. Lorenzo Sammut (1 July 1807 – 29 March 1809)
  5. David Ross (16 Dec 1807 – 30 June 1809).
     First Assistant Surgeon of HMS Tigre temporarily at the hospital due to an increase number of sick.
  6. Alexander Kindell (22 June – 5 July 1808). Acting Hospital Mate.
  7. Robert C Swann (6 July – 10 July 1808).
     Temporarily at the hospital due to a considerable increase number of wounded and sick prisoners of war.
  8. John McGhie (6 July – 9 September 1808).
     Temporarily at the hospital due to a considerable increase number of wounded and sick prisoners of war.
  9. Barry Omara (12 January – 25 January 1809). Acting Hospital Mate.
  10. Baldassare Sammut (24 January – 28 March 1809)
  11. John McGhie (27 January 1809 – 31 March 1810)
  12. Thomas King (20 February – 31 March 1810)
  13. Charles O Morris (8 October – 11 October 1810)
  14. Joseph Henry Kent (1 January – 8 June 1811)
  15. Charles O Morris (1 January 1811 – 31 March 1817)
  16. Baldassare Sammut (21 February – 30 September 1811)
  17. Lorenzo Sammut (26 April – 27 May 1811) Assistant Hospital Mate.
  18. James Kay (23 April – 31 May 1811)
  19. James Trigge (23 May – 30 September 1811) Assistant Hospital Mate.
  20. Thomas Gallogly (22 July – 12 August 1811)
  21. Joseph Stilon (2 February 1814 – 31 March 1817) Resident Medical Officer at the Dockyard.
  22. John Hunter (1 January – 11 January 1816)
  23. Alexander Gordon (12 January – 19 February 1816)
  24. Robert J Dallas (from July 1818), late assistant surgeon HMS Albion and Acting Hospital Mate.

Table III shows the maximum and minimum number of patients admitted to the hospital in any one day from 1810 to 1817. Rear Admiral Charles V Penrose remarked that except in the years 1811 and 1812, there have seldom been more that 73 patients in the hospital at any one time, but for a few days, and never so many bad cases.³¹

By 1817, Malta had been firmly established as the Headquarters of the Mediterranean Squadron. In January 1818, Rear Admiral Sir Charles V Penrose, Commander-in-Chief of the Mediterranean Fleet, agreed with Sir Thomas Maitland to consolidate the naval property on the Cottonera side of the harbour, and return all the houses in naval occupation in Valletta to the Civil Government. The exchange of properties took a year to complete.

The estimated cost of refurbishing all the buildings, stores and wharves was £19,071 7s 91/2d, of which £2,078 11s 8 1/2d was for essential work to convert the former armoury into a hospital. It was hoped that the new hospital would save money. The surgeon and agent of the hospital were to be housed in naval property saving the lodging allowance that was paid to them for occupying a house in Valletta. It was also envisaged to abolish the post of Resident Assistant Surgeon in the Dockyard, as the surgeon of the new hospital would be nearer to that establishment, and take on that responsibility.

This plan was fine on paper but it failed to take into account the advanced age and failing health of surgeon John Allen, who did not retire until 1827. The new hospital was also no longer to be victualled by contract but through purveryorship, making further savings on the full, half and low diets issued to the sick. In 1820, it was decided to charge the Masters of Transports one shilling and sixpence per day for every man sent to the hospital.³²

By 5 January 1819, the Armeria in Vittoriosa had been refurbished. It was surveyed by the Captains of the HMS Albion, Aid, and Glasgow, Surgeon John Allen, Agent Mr H S Dyer and Master Builder of the Naval Yard John Harvey as to its capacity and fitness as a Naval Hospital. They declared the building complete in every respect for a naval hospital holding many advantages over the present Hospital being in a situation more airy and easier of access particularly in bad weather. It had also the advantage of being close to the ships refitting at the dock yard and the advantage of a large airy space for air and exercice. The house allocated to the surgeon was only 400 paces away from the Armeria Hospital; in Valletta it had been 560 paces away from the Grand Prison Hospital.

On 30 April 1819, stores were packed up ready to be moved to store houses on the Marina Grande. Unserviceable or superfluous items were sold to the general public by auction held on 25 May in the Royal Naval Hospital Strada Christoforo, Valletta. On 30 June 1819, the doors of the naval establishment in the Grand Prison were shut and the keys delivered to Sir Richard Plasket, Chief Secretary to the Government of Malta from 1817 to 1824.³³

On 1 July 1819, Surgeon John Allen moved his staff to the former armoury (Armeria) of the Order of St John in Vittoriosa. This building, despite the praise that had been lavished upon it by the survey of officers, had the same disadvantages as the hospital in Valletta. It lay in a narrow street, cheek by jowl with a very populous neighbourhood, distant from the water edge, and without any means of conveying the sick and wounded to it, other than by steep narrow and tortuous approaches.

The planners had calculated a total bed space for between 169 to 125 patients depending on whether ample space, three feet of space or two feet was allowed between cradles. The ground floor held the hospital stores, dispensary, the matron's quarters, and a large ward with five small wards on either side for between 62 to 52 patients. The upper floor, which was well lit and airy, was fitted out for between 107 and 73 men depending on the bed space allocated between cots. In reality, the wards could hold no more than 77 patients when bed side tables to hold the drink and medicines of bedridden patients, and closed stools were added.

In December 1819, the average number of patients victualled daily was about 40 men. The hospital coped reasonably well when the fleet had only 1,500 men. However, by 1829 it had increased to over 6,787 men. There were then six ships of the line, six frigates, eleven sloops of war, four bomb vessels, one surveying vessel and two cutters. The number of patients in the hospital in the year ending 1 June 1819 was only 184; in the year ending 1 June 1830, it had increased to 372 patients, with no corresponding addition of staff to look after them.

In 1829, the hospital was so crowded that the cradles were in contact in some places, and row of beds occupied the middle of the wards and filled the recesses of the windows. There was no accommodation for sick commissioned and warrant officers. On 1 April 1828, a house in Strada Palazzo del Vescovo was rented out as an officers' sick quarters. The house was also used to isolate four cases of measles from HMS Britannia to prevent the disease from running amok through the ship's company.³⁴

The Armeria had a surgeon, a dispenser or junior surgeon, and a hospital mate. The hospital mate slept in the hospital; the surgeon shared the upper floor of house number 22 on the Marina Grande with the agent of the hospital. A matron looked after the linen, bed sheets, coverlets and patient's clothing. Linen was changed every Sunday morning and sent out in the country to a washerwomen. It was returned on Saturday evening ready for the cycle of bed changes to roll out again. Locally employed civilians were taken on as cooks, porters, messengers and labourers. The nurses were illiterate Maltese labourers with no medical knowledge. In May 1830, the nurse attendants were: Giacomo Caruana, Francesco Domickly, Ralfo Portelli, Vincenzo Bianco, Angelo Galea, Giocchino Portelli, Francesco D'Aquas, and Giovanni Farrugia. They were paid at the daily rate of two shillings and one penny.³⁵

The staff of the naval hospital from 1819 to 1832 consisted of:

• Surgeon
  1. John Allen — until 8 December 1827.
  2. John Liddell — from 22 October 1827, former surgeon HMS Asia.
• Hospital Agents
  1. Henry Stephens Dyer
  2. William Aloes — from October 1819 to December 1827, when he became Agent Victualler and Naval Store Keeper at Cork and Hawlbowline, Cork Harbour.
  3. Charles Desbro Holworthy — from 1827 to June 1828 when he moved to Melville Hospital Chatham.
  4. Archibald Murray — from 17 April 1828 to April 1832.
  5. John Liddell — On 1 April 1832, assumed the joint duties of surgeon and agent to the naval hospital.
• Dispensers
  1. Henry D Morison
  2. Henry Donnet — from 7 December 1822. Died in Malta on 5 September 1833, aged 60 years from cardiac disease. His son Henry Donnet junior also acted as a dispenser to the hospital.
• Chaplain
  1. John Thomas Howe Le Mesurier — from 1 January 1814.
• Matron
  1. Lucy Staines — from 1 March 1814.
• Hospital Assistant Surgeons
  1. Joseph Stilon — Resident Medical Officer at the Dockyard.
  2. Robert J Dallas
  3. Thomas Donald — invalided on 12 November 1828 with a diseased liver and general ill health. Succeeded by assistant surgeon Peter Marshall HMS Revenge.
  4. Peter Marshall — Fell ill on 3 March 1828, and was replaced with assistant surgeon Robert Maxwell HMS Asia until Marshall's recovery on 31 May 1828.
  5. Henry Holmes — On 23 November 1830, was labouring under a severe affection of the head to which he was very liable and which prevented him doing much duty since he joined the hospital. Assistant Surgeon R Hopley HMS Windsor Castle stood in during the illness of Mr Holmes.
  6. W H Jones — Supernumerary assistant surgeon HMS Britannia.
• Hospital Mates as when demand arose
  1. Charles Smith — from 5 November 1829, assistant surgeon HMS Spartiate. Fell ill on 15 March 1830, when assistant surgeon John Read was landed from the Windsor Castle to serve at the hospital.
  2. John Read — assistant surgeon Windsor Castle. In February 1834, Mr Read was appointed to HMS Madagascar and Mr James Moteley assistant surgeon HMS Caledonia replaced Read at the hospital.
  3. Archibald Gilchrist — Supernumerary Surgeon HMS Asia attended patients with small pox as were landed from the squadron. Recalled to help at the hospital from 8 to 31 March 1830.
  4. James Butter — assistant surgeon HMS Dartmouth was sent by Sir Thomas Staines, Senior officer Malta Station, on 26 July 1829 to attend the sick at the lazaretto.

Most of the burden of work fell on the hospital mate, but Mr Joseph Stilon was appointed Resident Medical Officer at the Dock Yard to reduce some of the workload from the hospital surgeon. There were not only the inpatients to look after, but medical cover had also to be extended to the Naval Bakery, the Victualling Yard, the Dockyard, the Lazaretto and from 1830, the construction workers at Bighi Hospital. Surgeons from the ships in harbour were disembarked whenever extra assistance was required in the hospital. Thus, on 30 September 1829, Mr John Naulty HMS Beagle was employed from 26 June to 3 July to attend surgeon Houston of HMS Erebus, who was landed at the lazaretto afflicted with enteritis.

Seldom a day passed without one or more patients being landed in quarantine at the lazaretto needing a nurse and a surgeon. On 13 October 1828, hospital assistant surgeon Thomas Donald was sent to the lazaretto into quarantine to give surgical aid to a seamen of HMS Blonde with a fractured thigh. Nurses were also detached from the hospital to the lazaretto to attend on manic patients who often required two nurses to restrain them.

On 22 October 1829, a nurse was placed into quarantine to attend on Captain's Steward Thomas Wood of HMS Pelican who was landed at the lazaretto in the last stage of fever and who died the day he was disembarked. The nurse had to perform a quarantine of twelve days. Although listed as employed in the hospital books, the nurse was effectively lost to the Armeria Hospital. On 25 February 1830, three nurses were employed in the quarantine station. One attended a patient from HMS Asia afflicted with confluent small pox; another with the master of HMS Ferret affected with an obstinate chronic disease of the skin and a third nurse attended three patients from HMS Pelican and one from HMS Madagascar.³⁴

The sick in the lazaretto were the responsibility of the Vittoriosa Hospital but the quarantine station had not been established as a separate annex with its own furniture and staff. Consequently, whenever a patient was admitted there, hospital stores and food from the main hospital had to be sent over. In bad weather this often meant a long land circuit to Manoel Island. The hospital messenger would take the patient's breakfast, medicines and other provisions for the day across to Valletta and then use a government's boat to carry him over from Marsamxetto office.

On 10 November 1828, the admiral authorised the hospital to fly a plain red flag on its boats whenever it entered the Quarantine Harbour. However, on 20 September 1831, the hospital boat used to transport bedding and other articles to the lazaretto was refused admission by an overzealous quarantine guard. He demanded that a pass be produced, declaring that he knew of no exemption for hospital boats with that flag.

Running the hospital was irksome enough, without having to content with the barrage of letters from the Victualling Board demanding justification for every item of expenditure, no matter how trivial. Thus, on 13 February 1824, the agent of the hospital had to seek permission to purchase such mundane items as 300 rotoli of feathers to replenish 365 pillows which had lost their stuffing over fourteen years of continuous use. The Commissioners sitting in London forever chastised the surgeon for employing more than the regulated one nurse per seven patients. They failed to comprehend that lunatic patients needed one or two nurses to manage them during their outbursts, and that when a nurse was confined with his charges in the lazaretto, he was effectively lost to the main hospital.³⁶

Invalids waiting for their passage home, no longer needing hospital treatment, became bored and so troublesome that on occasions the military had to be called out to control them. Desertion from the hospital was rife. It was not possible to prevent patients absconding. The hospital was surrounded with flat topped houses from which it was only separated by a very narrow lane. The remaining space was occupied by a low bastion, the embrasure of which was just six feet above ground. A sergeant of the Royal Marines was responsible for their conduct, but the invalids abused him with impunity. In 1827, invalid Francis Robinson assaulted Sgt Morley RM, having entered his quarters and struck him several severe blows on his head. It was with great difficulty that the sergeant made his escape into the court yard. In September 1827, the hospital had about 42 invalids waiting for their passage home.

The inhabitants around the hospital frequently complained about the unruliness of the sailors. On 20 September 1827, Gio Ballo Bonomo informed Surgeon Allen that his family had been almost daily oppressed by the uncivil treatment of the sailors who were in the naval hospital, whilst they do nothing but descending and ascending the wall or bastion of St John's with ropes, knocking the doors of my house situated at Vittoriosa Strada Bastione del Fosso No 5 6, and drawing stones for the said doors, and so my family is in a continual vexation.³⁷

Patients dying at the hospital had their belongings auctioned off by the agent of the hospital who forwarded the money to any known relative. The dead were buried in Rock Gate Cemetery. Roman Catholic seamen were buried in the church of San Lorenzo Vittoriosa. Thus, on 20 January 1832, Private Marine William Field of HMS Donegal who died at the hospital on 13 January, being a Roman Catholic received burial in the church of San Lorenzo.

On 5 October 1820, Vice Admiral and Commander in Chief Graham Moore reiterated the mantra of his predecessors that the Armeria was in the wrong location and not a suitable building for a hospital. However, the considerable expense that had been spent upon it and the few patients under its roof, (from 80 to 100 patients), did not justify either its relocation or building a larger one. In the event of an unexpected emergency Moore assumed that:

The Civil Government would give up some of the army hospitals for the use of the navy or hire a building for that purpose, but if their Lordships should be of opinion that it is expedient to establish a hospital on a scale adequate to the circumstances which a war might call for, I have no hesitation in recommending that the Bighi Palace and grounds should be obtained from the Civil Government for that purpose. I agree with Sir Thomas Freemantle in thinking that this situation unites every requisite for such a purpose and it might be considered on a large or smaller scale with the means of, and in view to, being enlarged as their Lordships might determine. Their certainly is not any immediate occasion for it, as the present hospital is adequate to a time of peace.³⁸

On 13 June 1827, Vice Admiral Edward Codrington once again drew the attention of the Admiralty to the pressing need to construct a new naval hospital, as the present one was no longer capable of containing the number of hospital cases which the winter weather usually occasioned.

This inefficient building has cost several thousand pounds since it was taken over instead of the hospital in Valletta and it requires a considerable expense annually to make it available. I am therefore persuaded that it would be good economy to erect such a part of the proposed new naval hospital as would suffice for the present purpose, leaving the rest of the plan to be complete hererafter.

The Lords Commissioners of the Admiralty offered Codrington a return to the Grand Prison in Valletta. This was quite objectional to both admiral and General Sir Frederick Ponsonby, who in unison upheld their conviction that

Nothing can be so eligible in every point of view for a naval hospital as the situation of the Palace of Bighi. I have understood that the estimate for the naval hospital was £30,000. I am persuaded that that sum would suffice for that purpose and for the erection of a suitable house for the admiral on a site from whence all the movements of the shipping may be observed and the orders of the admiral communicated by signal without having boats and officers in such constant attendance on shore.

On 6 November 1827, Vice Admiral Sir Edward Codrington informed the Lieutenant Governor of Malta, Major General Frederick Ponsonby, that the Combined Fleet of France, Russia, and England would proceed to Malta after the Battle of Navarino and to make preparations for the reception of the sick and wounded and for refitting the ships.

On 10 November, Fort Ricasoli was handed over to William Aloes for use as a Temporary Naval Hospital. The armeria lacked the capacity to take the wounded of the Combined Fleet. Surgeon John Allen had expected himself to take charge of the wounded. However, on 21 October, Codrington, being aware of his advanced age and infirmity, and not wishing to trust him with the care of the wounded, appointed Surgeon John Liddell of HMS Asia, Acting Physician to the Fleet. The admiral had no authority to promote his surgeon to a physician. This was the prerogative of the Lords Admiralty or in vacancies, by an acting order from the Commander-in-Chief. Liddell's appointment was disallowed but he was given the post of surgeon to the Malta Hospital on the retirement of John Allen. In justifying the appointment of Dr Liddell as Physician of the Fleet, Codrington explained that:

first and foremost, the wounded generally may have the benefit of doctor Liddell's superior advice and assistance in the Temporary Hospital at Fort Ricasoli, and that their being supplied with every thing requisite for the occasion, may depend upon his judgement alone; and secondly that Dr J Allen, surgeon of the naval hospital here from a total incompetency to perform the duties of his office, may be deprived of any cause from interfering.³⁹

Fort Ricasoli was converted into a lazaretto for the short quarantine of observation which the ships had to perform. It was placed under the control of Superintendent of Quarantine Hector Greig. On 15 November, the Ordnance supplied 100 blankets, 250 sheets, and 200 woollen coverlets. In addition, a number of items were purchased including 60 wash hand basins, 60 spitting pots, 60 white plates, and straw for filling bed cases. The staff for the hospital consisted of an under steward, a cook for the English and another for the Russian patients, four labourers, three washermen, two seamstresses and two men with their boat to convey stores.

The British Squadron admitted 71 officers and men; the Russian Squadron 60 men, while the French took their wounded to Toulon. Mr Peter Marshall assistant surgeon of the Hind Cutter at the Battle of Navarino attended all the wounded on their disembarkation at Malta. From 4 November to 23 December 1827, Alexander S Allen and William Orr assistant surgeons of HMS Asia and the Hind Cutter assisted Surgeon John Liddell with the wounded at the Ricasoli Naval Hospital.

The British wounded remained under the care of the respective surgeon of the ships to which they belonged. The naval medical staff had worked tirelessly at Navarino and all surgeons deserved equal recognition. However, HRH The Lord High Admiral decided to promote out of turn only the most senior assistant surgeons of the squadron. The list below gives the ships at Navarino together with their respective medical complement.⁴⁰

• Asia — Assistant surgeon Alexander Sewell Allen, Assistant surgeon D J Hall.
• Albion — Surgeon Lear, Assistant surgeon William F O'Kane, Assistant surgeon Edward Leach.
• Genoa — Assistant surgeon William Lindsay, Assistant surgeon James Mein.
• Glasgow — Assistant surgeon H Goloney.
• Cambrian — Assistant surgeon William Rythers.
• Dartmouth — Assistant surgeon Andrew Smith.
• Talbot — Surgeon Joshua Little, Assistant surgeon B Browning, Assistant surgeon Thomas James Dickinson.
• Rose — Assistant surgeon James Hattey.
• Philomel — Assistant surgeon James Campbell.
• Brisk — Assistant surgeon Hamilton Dickinson Robert Henning.
• Mosquito — Assistant surgeon Thomas Henry Burton Crosse.

On 5 April 1828, the Russian sick and wounded were all discharged to their respective ships. The Temporary Hospital at Fort Ricasoli was handed back to the Ordnance on 12 April 1828. Mr Peter Marshall, who had been in charge of all the wounded of the squadron on their disembarkation at Malta, became assistant surgeon at the Naval Hospital Malta.

As a reward for his professional services to the Russian wounded, Acting Physician of the Fleet John Liddell was invested by the Emperor of Russia with the Order of Saint Ann, ornamented with diamonds. In 1855, he became Director General of the Medical Department of the Navy. He died on 29 May 1868, aged 74 years, at his residence in Chester Square, London and was interred in the cemetery of the Royal Hospital Greenwich.

The Palace of Bighi, built in 1675 for Fra Giovanni Bighi, stood proud on the San Salvatore Promontory overlooking Kalkara and Rinella Creeks. The house had the advantage of being in a well ventilated place with good access from the sea. The only drawback was the expense of converting a ruinous building into a functioning hospital for the sick and wounded of the fleet, when houses in Valletta could be hired cheaply.

In his letter to Thomas Troubridge, dated Corsica 21 December 1803, Nelson rightly appreciated that Bighi is certainly the only proper place, as it stands insulated with grounds and has every means of comfort, but to complete it for 150 men would cost besides the purchase of house and grounds £1,000 and £2,000 more to put it in order. Ball says £5,000 would do the whole but I say for five read £10,000.⁵

On 9 January 1809, Admiral C Collingwood was also enticed by the situation on the south side of the harbour which appeared to him:

Admirably suited for a hospital, where a large unfinished house with spacious enclosures for garden, which is near the shore of the harbour, quite unconnected with other buildings, and seems to admit of every convenience being made for the reception of the sick. The building on the site belongs to Government and the estimate to make it a hospital by additional building is about £16,000, which would include houses for the officers.²⁹

Building a new naval hospital to replace the one in the Grand Prison was desirable, but not essential. The matter gathered dust, and was not revived until 1829 when Russia assumed a belligerent stance towards Turkey. The Russians were made to understand that if they proceeded in the extension of their blockade of the Dardanelles, the consequence would be war.

In August 1829, the state of affairs in the Mediterranean, persuaded the Government of the necessity to increase its military forces in that quarter. The fleet was augmented from six thousand to eight thousand men and from six to nine sail of the line. There being the prospect of the fleet being called into immediate action, it was requisite to augment the hospital. However, in early 1830, the greater part of the additional force despatched in the previous autumn, was recalled and the emergency was deemed to be over.⁸

In March 1830, during the debate on the Navy Estimates, a conversation took place between Mr Joseph Hume, Sir George Clerk, Sir George Cockburn, Sir Matthew White Ridley, Mr Henry Bright and Mr John Maberly, relative to the grant of £23,457 for building a Naval Hospital at Malta.

In moving the Navy Estimates, Lord of the Admiralty Sir George Clerk vindicated the Government's decision to build a new naval hospital at Malta. The building of that hospital had been determined upon in consequence of the increase of the naval force in the Mediterranean and of the lack of accommodation for the sick in the Vittoriosa Hospital. In July 1829, the Admiralty had submitted an estimate of £17,000 for building the hospital to the Treasury. This had been rejected, but in August, however, in consequence of the emergency which had rendered it necessary to send an increased force into the Mediterranean, the Admiralty deemed it appropriate to proceed with the building of the hospital.

Mr John Maberly, Member for Abingdon, objected to the vote being passed, on the ground of irregularity in commencing the work before the sanction of Parliament had been obtained for the necessary expenditure. In his opinion, Government had failed to make out the case of emergency, and their conduct had evinced a total disregard of the opinion of Parliament. He thought it very strange that a sum of £17,000 should be expended in building a hospital on a foreign station at a time of peace. Mr Joseph Hume, Member for Aberdeen Burghs, agreed. In his despatch of May 1829, Sir Pulteney Malcolm had given the number of sick in a force of 6,000 as a hundred. Mr Hume admitted that the old hospital was inconvenient, but he contended that the new one was not wanted. There having never been a larger force than 6,000 men in the Mediterranean, he could not possible conceive that £17,000 ought to be expended to supply accommodation for one hundred men.⁸

Lord of the Admiralty Sir George Cockburn defended the Navy Estimates.

The Government had endeavoured as long as possible to avoid the expense of erecting a new hospital at Malta. However, after the Battle of Navarino, it received the most distressing reports of the misery which our wounded sailors experienced from the situation and the inadequate accommodation of the old hospital. It was at this period far from improbable that another engagement might have occurred. A large additional force was sent to the Mediterranean, to provide for the wants of which the old hospital was wholly inadequate. Government therefore, considered it a duty to provide against such a contingency, and he did not believe that a British House of Commons would blame the Government for what it had done.⁸

On 31 October 1829, Thomas Collings opened his office to kick start the process of converting the Palace of Bighi into a hospital. Architect Salvadore Xerri was appointed to oversee the building on designs submitted by Colonel George Whitmore RE. Much work had to be done before the foundation stone could be laid. Labourers, blacksmiths, glaciers, plumbers, masons and boys had to be employed, and contracts by sealed tenders entered into for the supply of raw materials. The cheapest tender was always selected and when the contractor failed to deliver, the work was set back until a fresh source could be secured. Over 542 timber beams of Venetian Red Pine of varying lengths were required for building the hospital and 67 beams for roofing Bighi Palace.

The land and houses around Bighi were in private ownership and their purchase had to be negotiated with the proprietors. On 27 November 1829, was purchased the property of Mr Francesco Zammit, on 24 December that of Baron Giuseppe Testaferrata, and on 27 January 1830 that belonging to Mr Michaele Agius for £187 10s sterling. On 31 December, a contract was signed with Mr Salvadore Pirotti for the purchase of certain landed property at Bighi for £162 10s as freehold, and for the purchase of his interest in a perpetual lease of action on the property at Bighi, valued as freehold at £121 13s 4d, for the price of £100 3s 4d. A house on Mr Zammit's property was made habitable and occupied by the architect to enable him to be close to the works. A property belonging to Giovanni Scicluna was purchased on 3 December.

Before the first spade could disturb the ground, the advice of Dr Gravagna, Physician of Police, had to be sought about the potential risks of reviving the plague. In 1813, Bighi had been used as a plague hospital and the deceased were interred within its grounds. Gravagna recommended covering the site with rubbish and paving slabs. This was completed between 6 and 20 November 1829 at a cost of £5 0s 11d, when a mason, three labourers and three boys were employed in covering the burying ground with stones from an old wall.⁴¹

On 23 January 1830, Salvadore Xerri took on his brother Gaetano as his assistant at the rate of three shillings and four pence a day. On the death of Salvadore on 11 February 1830, Mr Gaetano Xerri took upon himself the duties of Architect and Superintendent of the works at Bighi.

On 23 March 1830, the foundation stone of the North Pavilion was laid by Vice Admiral Sir Pultney Malcolm. Beneath the stone were deposited 1 sovereign, 1 half sovereign, 1 crown, 1 half crown, 1 shilling, 1 sixpence, 1 penny, 1 half penny 1 farthing, 1 grani, 1 dollar of Malta of the last Grandmaster Ferdinand Von Hompesch together with an engraved brass plate for which the engraver was paid £2 10 shillings. The North Pavilion cost £5,596 9s 10d to complete. Work on the foundations of the South Pavilion commenced on 22 July 1830. The sum on its completion amounted to £4,477 8s 10d.

Bighi Palace was refurbished so as to accommodate the Dispenser and two hospital assistants. The upper floor was converted into a hospital chapel. The cost of repairing the old palace was £1,208 6 shillings.

On 28 October 1831, as was customary in Malta the workers were indulged with a moderate allowance of wine to celebrate the completion of the roof of the new building. The new burying ground was prepared on 24 February 1832 and on 21 June 1832 was completed the hospital gate and porch.

On 20 July 1832, surgeon John Liddell took possession of the new naval hospital. The patients were removed from the Armeria Naval Hospital into the Royal Naval Hospital Bighi on the following day. From 2 November 1829 to 25 September 1832, when the accounts were finally completed, a total of £23,470 9s 5d had been expended on the hospital and its grounds. The cost included the accommodation of the hospital staff.

Following the 1939–45 war, it became evident that the size of the military force in Malta did not justify the retention of both an army and a navy hospital. The Royal Naval Hospital Bighi had a peace time establishment of 261 beds, capable of expansion in war to 354 beds, but had no maternity beds or isolation ward. The David Bruce Military Hospital Mtarfa had 235 beds, of which 53 were obstetric beds located in a wing separate from the main hospital building. It also had only one operating theatre which was not air conditioned, while facilities for out patients were limited.

In 1957, the working party of the Ministry of Defence Medical Services Coordinating Committee, decided on economical but not medical grounds, that Bighi should serve as the Combined Services Hospital. However, a revision of their estimates carried out in 1960 by the Manager Navy Works Malta found that their costings had been based on unreliable data.

In March 1960, a new report recommended the David Bruce Military Hospital as the future Combined Services Hospital. The recommendation was approved in January 1961, but the Defence White Paper of February 1962 outlined a naval drawdown. With less troops on the island a hospital of 206 beds would be sufficient for service needs.⁴²

The David Bruce Military Hospital was transferred to the Royal Navy in October 1962, when the Royal Army Medical Corps severed its ties with Malta. From November 1962, the Navy became responsible for hospital services in Malta.

The final decision to move the naval hospital from Bighi to Mtarfa was taken in 1967. Rebuilding started in February 1969. This included the provision of a new air-conditioned operating suite and a ground floor out-patients complex which reflected the trend away from predominantly in-patient investigations and treatment to out-patient care. The x-ray department, pharmacy, laboratory and physiotherapy department were grouped in close proximity to the out-patients facilities. The main building also housed the large medical stores required to supply service medical centres in Malta and Libya, as well as visiting ships.

The Royal Naval Hospital Bighi served the sick and wounded of the Mediterranean Fleet up to 22 September 1970. On that day, the patients were transferred to the refurbished David Bruce Military Hospital. Its last Principal Medical Officer was Surgeon Captain Cyril L. T. McClintock RN.

The hospital was formally opened on 2 October 1970 by Lady Dorman, wife of the Governor General Sir Maurice Dorman, and was taken over by the Medical Director General (Naval) Surgeon Vice Admiral Eric Blackburn Bradbury RN. The new naval hospital retained the name of the former military hospital and became the David Bruce Royal Naval Hospital Mtarfa. It was a tri-service hospital as evidenced by the Rod of Asclepius of the Royal Army Medical Corps, The Caduceus of Royal Airforce Medical Services and the Naval Crown adorning its main entrance.

The David Bruce Royal Naval Hospital Mtarfa served the military forces in Malta and entitled Maltese civilians until the withdrawal of British troops from Malta on 31 March 1979, ending an illustrious chapter in the medical care of service personnel in the Maltese Islands.