The Army Medical Department
And the Malta Garrison
1878

There was an average of 6,201 men in the Command, exclusive of colonial troops and the contingent of native troops from India which had been temporarily quartered in Malta. The Departmental Corps had 32 men.

There were 5,537 admissions into hospital (892.92/1000), with 57 deaths (9.19/1000), including 9 invalids on their passage home or at the Invalid Depôt at Netley.

303 invalids returned to England, 173 were ultimately discharged from the service. The average daily sick in hospital was 308 (49.67/1000). The average sick time to each soldier was 18.15 days; the average duration of each case was 20.31 days.

There was an average of 221 officers, with 217 attacks of illness and 1 death from enteric fever; 12 officers were invalided to England. Fever caused 85 admissions, 19 were from rheumatism, 41 from disorders of the digestive system with 14 from diarrhoea.

Fever led to 1,209 hospital admissions (195/1000) with 33 deaths (5.32/1000). Admissions were for:

• 47 for nervous system diseases with 3 deaths
• 102 for circulatory diseases with 4 deaths
• 257 for respiratory conditions with 2 deaths
• 967 for digestive diseases with 8 deaths
• 323 for urinary problems with 4 deaths
• 432 for cutaneous diseases
• 301 for rheumatism
• 125 for syphilis
• 76 for phthisis with 13 deaths
• 720 for accidents with 8 deaths

There was 1 suicide from poisoning with oxalic acid and two attempted suicides from cut throat. Skin ulcers gave 135 admissions and boils 116. Accidental deaths were from drowning (6 soldiers) and concussion of the brain (2).

There were 27 admissions for paroxysmal fevers (4.4/1000) with 1 death (0.21/1000), 1173 for continued fevers (189.2/1000) with 32 deaths (5.16/1000) and 4 for eruptive fevers (0.16/1000). These were for measles (2) and scarlet fever (2). Of the continued fevers, 920 were febricula, 159 simple continued and 94 enteric. Rheumatism was more prevalent than in 1877. There were 86 cases of orchitis.

All the 32 deaths from continued fevers were from enteric fever. Of the 35 cases treated at the Cottonera Hospital, seven were admitted from Polverista Barracks, two from Vittoriosa, one from Floriana, eight from Verdala Barracks, two from Fort St Angelo, one from Cottonera Hospital, three from Isola Gate Barracks, five from Fort Ricasoli, one from Notre Dame Barracks and five from Zabbar Gate.

Simple continued fever and febricula led to a large number of admissions during the latter half of the year; the highest in August.

Of the 125 cases of syphilis admitted to the Station Hospital Valletta, 93 were primary syphilis, 27 secondary syphilis and 5 venereal bubos. The men became infected in England. Deaths from nervous diseases were for apoplexy (2) and meningitis (1); epilepsy, neuralgia and sciatica each caused 9 admissions and 12 had a mental disorder. There were 12 cases of delirium tremens and 3 of alcoholic poisoning.

Three of the deaths for cardiovascular diseases were from aortic aneurysm and 1 from pericarditis. There were 2 deaths from pneumonia and 146 admissions for bronchitis. Gonorrhoea caused 259 admissions with strictures of the urethra in 10. A death occurred from a ruptured urethral with extravasation of urine in a soldier with a longstanding stricture.

There was an average of 523 wives and 962 children with 373 attacks of illness in women and 591 attacks of illness in children. 10 deaths in women were from: enteric fever (4), remittent fever (1), puerperal fever (1), phthisis (1), pericarditis (1) and debility (2).

The 53 deaths in children were from: simple continued fever (1), diphtheria (2), tabes mesenterica (2) anaemia (1) hereditary syphilis (1), meningitis (1), convulsions (1), diseases of the heart (1), croup (3), bronchitis (5), dysentery (2), diarrhoea (17), teething (8), premature birth (3) and debility (5).

On 28 Apr 1878, a contingent of Indian Native Troops, under the command of Major General J Ross CB, left Bombay and Crannanore. The troops arrived at Malta, via Suez and Port Said between 24 May and 8 June, and were held in readiness to intervene in the Russo-Turkish War.

Cholera broke out on the Clydesdale and Maraval. It was possibly brought on board at Bombay on 29 April, by a man who died of cholera that same day. Capt W Lane RA, officer commanding the troops on board, applied to the SS Malda for a medical officer, as he had only an apothecary on board. Surgeon-Major Raddock, 31st Punjab Native Infantry, moved to the Maraval and remained in medical charge of the Royal Artillery until they arrived at Port Said.

On 29 May, the Maraval docked at Malta with 101 men and 109 followers of the Royal Artillery. Two men died of cholera during the voyage.

The Clydesdale arrived on 2 June and went into a seven day quarantine. The men and horses were landed and accommodated in the Lazaretto. Those at Malta were: M Bty 1st Bde RA, F Bty 2nd Bde RA, Madras and Bombay European Sappers and Miners, 25 Regt Madras Native Infantry, 13 Regt Bengal Native Infantry, 31 Regt Bengal Native Infantry, 2nd Gurkhas, 9th Regt Native Infantry, 26th Regt Native Infantry.

6,000 Indian troops were encamped at Mriehel to the north-west of Qormi. The infantry detachment was stationed on Manoel Island. It was alleged that the villages close to where the Indian troops had been camped, showed a high incidence of leprosy.

Bde-Surg-Lt Col William Reed Murphy, Bengal Medical Service, arrived in Malta with the Indian Contingent and left when the expected war with Russia did not break out. He died in London on 7 Aug 1927 aged 77 years.

One of the medical officers on the Indian Expeditionary Force was Dr Henry Prescott Roberts MB (Ed 1868) LRCS (Ed 1868) MD (Ed 1877) 9th Bombay Infantry. He entered the Bombay Medical Service as assistant surgeon on 1 April 1869, becoming surgeon on 1 July 1873. He served with the Malta Cyprus contingent in 1878 and in the Afghan War. He resigned his commission on 11 Dec 1880 and settled in practice in Ealing, where he remained about thirty years. He retired in 1911, and settled in Hythe. He died in a nursing home at Ladbroke Grove London on 16 March 1913 aged 66 years.

On 13 July 1878, the Cyprus Convention of the Treaty of Berlin, granted Britain administration over Cyprus. British and Indian troops assembled in Malta in preparation for the occupation of Cyprus.

The PMO of the expedition was Deputy Surgeon General T B Beatty of the Bombay Medical Establishment. On 18 July 1878, Sir Garnet Wolseley arrived in Malta as High Commissioner for Cyprus and Commander-in-Chief of the Cypriot garrison. On 20 July, Wolseley embarked for Cyprus with the Indian Troops, and two British Battalions.

In Oct 1878, the Army Medical Department was in transition between the regimental system of hospital organisation and the newly introduced unification system. Although the hospitals were still regimental, the actual commissioning of medical officers in regiments had ceased. The new scheme was introduced during the Afghan Campaign 1878–1880. In the face of the enemy, all the medical officers and their subordinates were removed from their battalions. All the native hospital establishments were transferred from their regiments to the little understood new creations, called Field Hospitals.

A disgruntled surgeon-major complained: Men had paid large sums of money for exchanges to regiments just before the regimental system was abolished; paid heavy contributions to mess and band funds; bought expensive uniforms, yet never received one farthing of compensation, and the isolation of medical officers socially, is considered a very small matter. My own belief is, that nothing but a restoration of the regimental system, will ever make the army a desirable career.
A high scale of payment may bribe men to put up with the risks and discomforts, the loss of social pleasure, and the want of a home, inseparable from the army doctor's life under the unification scheme; but no one who has a fair prospect of success in civil life, will do well to take up a career where the prizes are so few, and the ordinary life so dreary and comfortless.
Formerly a medical officer had a home in his regiment, and, however badly off in other respects, had friends and associates; now he is a social waif, belonging to nobody, cared for by nobody — the Arab of the service.

Another unresolved grievances was the foreign service roster which one officer considered nothing more than a sham. Some men are kept at home year after year, and others of us depart upon a tour of foreign service, return, and again depart, seeing these favoured ones maintain their posts at home. Men may come and men may go, but they stay on for ever.

In 1878, the War Office Committee on the Army Medical Department proposed a reduction of 100 Executive Officers from the Staff Establishment. To save money, the number of surgeons and surgeons-majors was cut from 893 to 796. Army Surgeons had complained that their number was already too low for the duties they were ordered to perform. They grumbled that, owing to their small numbers, they could not possibly carry out their duties to the satisfaction of themselves or their patients. Regimental military officers and married soldiers, also complained vociferously. They moaned that they were unable to get medical officers to attend to their wives and families, as these were occupied on other duties. If a surgeon attended their regiments on one day, he was changed for some other surgeon the following day, owing to the few surgeons sent to each station for duty. Many regimental married officers had to employ civilian practitioners at an expense which they felt they should not have to bear. This caused an antipathy towards their military surgeon to whose services they were entitled.

Fort St Rocco was completed in 1878. Fort San Leonardo was also completed in the same year. Fort Madliena was built between 1878 and 1880. Construction on the north west defensive line including Fort Mosta and Fort Bingemma. The Dwejra Lines formed a continuous entrenchment along the crest of Dwejra Hill.