The Army Medical Department
And the Malta Garrison
1877

The average annual strength of the garrison was 5,556 men, exclusive of colonial troops. There were 4,983 admissions into hospital (896.8 admissions/1000 mean strength), with 38 deaths (6.8 deaths/1000 mean strength), including 8 invalids on their passage home or at the Invalid Depôt at Netley. The average number constantly sick was 255. There were 64 men of the Departmental Corps with 23 hospital admissions and 1 death.

105 invalids were returned home from Malta; 79 were finally discharged during the year. The average number constantly non-effective through sickness (mean daily sick), excluding the Royal Malta Fencible Artillery, was 255 men. The ratio per 1000 mean strength constantly sick was 45.90; the average sick time to each soldier was 16.75 days; the average duration of each case was 18.68 days.

There was an average of 228 officers, of whom 189 were sick; 1 died and 12 were invalided to England. Fever caused 57 of the admissions, 6 were from hepatitis with one officer developing a liver abscess. The death was from consumption.

There was an average of 406 wives and 778 children in the command. There were 319 attacks of illness in women and 578 attacks of illness in children. Two women died during the year, from pneumonia and peritonitis respectively.

Children sickened from eruptive fevers (16) and conjunctivitis (127); 39 children died. Deaths were from: simple continued fever (1), diphtheria (3), scarlet fever (3), meningitis (2), convulsions (7), croup (2), bronchitis (2), pneumonia (2), teething (5), enteritis (2), diarrhoea (6), congenital malformation (1), debility (4).

Fever accounted for 905 admissions into hospital (162.9/1000 mean strength) with 12 deaths (2.16/1000 mean strength). Admissions were for:

• 86 for nervous system diseases with 3 deaths
• 109 for circulatory diseases with 4 deaths
• 247 for respiratory conditions with 2 deaths
• 1018 for digestive diseases with 8 deaths
• 255 for urinary problems with 1 death
• 519 for cutaneous diseases
• 211 for rheumatism
• 139 for syphilis
• 35 for phthisis with 9 deaths
• 711 for accidents with 4 deaths

There were 2 suicides; one by poisoning with opium, the other by hanging. Of the four accidental deaths, 1 was due to multiple trauma, 2 were from skull fractures, and 1 was from drowning. 35 of the admissions of the nervous system were for neuralgia, 18 were for epilepsy. The deaths were for meningitis (1), apoplexy (1), paralysis (1). There were 178 admissions for conjunctivitis, which was common in September and October. The Principal Medical Officer attributed its origin to the heat and glare of the sun. Of the disorders of the digestive system, 5 deaths were due to dysentery and 2 from hepatitis.

There were 23 admissions for paroxysmal fevers (4.1/1000) and 873 for continued fevers (157.1/1000) with 11 deaths (1.98/1000). Of the fevers grouped under the continued fevers, enteric fever caused 29 admissions and 9 deaths. The disease was present throughout the year. There were 209 admissions for simple continued fever (37.6/1000 strength). Admissions for febricula were in the rate of 114.3/1000 strength. Of the 23 admissions for paroxysmal fevers, 10 were for ague and 13 for remittent fever.

On 24 Apr 1877, Russia under the pretext of succouring the Orthodox Balkan Christians, backed a nationalistic uprising of the Bulgarians, Serbs and other Balkan communities in their struggle against Ottoman rule. By the Treaty of San Stefano (3 Mar 1878) Servia, Montenegro, and Rumania became independent. Bulgaria was made a self-governing state and Turkey was allowed a small corridor from Constantinople to the Adriatic. The new states looked to their fellow Slavs in Russia for their protection.

England, fearing a Russian expansion towards the Mediterranean, sent the Mediterranean Fleet to the Sea of Marmora. It also deployed 7000 Native India Troops to Malta. On 13 July 1878, by the Treaty of Berlin, Britain gained Cyprus from the Ottoman Empire, although the Sultan remained the nominal ruler of the Island.

The drainage of the Three Cities by Mr John Lawson CE and Mr C Andrews CE was commenced in Dec 1877. At the time, the sewage of the Three Cities discharged into Dockyard Creek, 1500 yards to the east of the Grand Harbour.

The War Office and the Admiralty contributed £30,000 towards the estimated cost of £70,000. The local government was expected to contribute £40,000 out of its total annual revenues of £164,000. This was unaffordable without a rise in taxes, and the elected members of the Malta Council opposed the request for funds. The military went ahead with the project at its own expense, and the Government contributed £3000 towards the costs without the consent of the elected members.

In Aug 1877, the sudden arrival of the 2nd/2nd, and the 2nd/13th made it necessary to reoccupy the old lazaretto barracks and other buildings not hitherto in use. After the embarkation of the 2nd/2nd for India, the old Lazaretto Barracks on Manoel Island, which was unfit for habitation, was handed back to the Civil Government.

In 1877, officers of the AMD were granted full responsibility for all patients in military hospitals and for all soldiers attached to the hospitals. They also took command of the men of the Army Hospital Corps.

In Feb 1877, thirty three candidates passed through the Army Medical School, but only 23 candidates presented themselves for the 50 appointments offered for competitive entry in the AMD.