The Army Medical Department
And the Malta Garrison
1879

The average strength of the Command was 4,668 men, exclusive of colonial troops. There were 4,073 admissions into hospital (872.53 admissions/1000 mean strength), with 29 deaths (6.21 deaths/1000 mean strength), including 3 invalids on their passage home or at the Invalid Depôt at Netley. The average daily sick in hospital was 216.98.

155 NCOs and men were returned to England as invalids of whom 67 were finally discharged from the service. Of these 12 were for rheumatism, 3 for secondary syphilis, 7 for tubercular. The average number constantly non-effective through sickness (mean daily sick), excluding the Royal Malta Fencible Artillery, was 216.98 men. The ratio per 1000 mean strength constantly sick was 46.48; the average sick time to each soldier was 16.97 days; the average duration of each case was 19.44 days.

There was an average of 203 officers, with 129 attacks of illness and 2 deaths from enteric fever; 18 officers were invalided to England. Fever caused 85 admissions, with 34 admissions from disorders of the digestive system.

Fever accounted for 1,029 admissions into hospital (220.4/1000 mean strength). Admissions were for:

• 64 for nervous system diseases with 1 death from tetanus
• 70 for circulatory diseases with 5 deaths
• 188 for respiratory conditions with 5 deaths
• 775 for digestive diseases with 2 deaths from liver abscess
• 240 for urinary problems
• 289 for cutaneous diseases
• 173 for rheumatism with 2 deaths
• 203 for syphilis
• 22 for phthisis with 6 deaths
• 526 for accidents with 6 deaths

Accidental deaths were the result of: multiple injuries (1), fracture skull (1), drowning (4) three of which from a capsizing of a boat at St Julian's Bay and one while bathing at Pembroke Camp. Of the diseases of the nervous system, 16 were for vertigo, 14 for neuralgia, 6 for epilepsy, 5 sciatica, 5 insanity, 8 for delirium tremens. There were 175 admissions for primary syphilis and 28 for secondary syphilis, 180 for gonorrhoea with 14 for urethral stricture. The PMO attributed the increase in venereal diseases to the arrival of the fleet from Besika Bay with the sailors having a large arrears of pay. Deaths from circulatory disease were from valvular heart disease (3), fibrous tumour of the heart (1) and aneurysm of the aorta (1). 68 admissions were for taenia solium.

There were 11 admissions for paroxysmal fevers (1.9/1000) with 10 ague and 1 remittent fever, 978 for continued fevers (209.5/1000) with 12 deaths (2.57/1000) and 5 for eruptive fevers (1.1/1000). Four were from measles and one from scarlet fever. There were 887 admissions for febricula which were very mild and ephemeral and occurred from April to October, 41 for simple continued fever (8.78/1000 strength) and 50 enteric fevers.

There was an average of 358 wives and 597 children with 280 attacks of illness in women and 1 death from dysentery. There were 439 attacks of illness in children with 30 deaths. The deaths were from: measles (4), simple continued fever (1), diphtheria (1), tabes mesenterica (1) phthisis (2), convulsions (2), hydrocephalus (2), epistaxis (1), bronchial catarrh (3) dyspepsia (1), diarrhoea (5), enteritis (1), colic (1) dentition (1), multiple injury (1) and debility (3).

In 1879, four beds in the Valletta Station Hospital were set aside as an infectious hospital for women and children.

The Dwejra Lines formed a continuous entrenchment along the crest of Dwejra Hill with a number of batteries and forts protecting the south from an invasion from the north. Fort Madliena was built between 1878 and 1880 on the right flank, north-east of Gharghur. Fort Mosta was built in the centre of the line to the north of Mosta. Fort Bingemma was to the left flank of the defensive line north of Ghemieri. Fort Pembroke was completed in 1879.

In 1879, Sir Julyan Penrose arrived in Malta to report on the civil establishment. Penrose recommended for the Medical Police to be placed under the Charitable Institutions and renamed District Medical Officers. The Sanitary Office, which had owed its origins to the demand for improved drainage and other sanitary reforms, had been in existence for only three years.

The Floriana Parade Ground only covered 10 acres of land and was far too small for drill. The War Office, therefore purchased 47 acres of land, known as Ta' Wied il Gionna at Marsa. When not in use for military purposes, the ground was used for recreation for the troops and became known as the Marsa Sports Ground.

The new Royal Warrant divided Medical officers into two groups. Class A Medical Officers were those who had entered the Army Medical Department prior to the Royal Warrant of 1876, and those who entered the AMD under the provisions of the 1879 Warrant.

Class B Medical Officers entered the service under the Warrant of 1876 for a limited ten year period of service. They were allowed to become Class A officers, provided they applied within two years from the date of the new warrant, and received a recommendation from the Director-General.

The Secretary for War reserved for himself the privilege of appointing half the candidates to the AMD. He admitted these through nomination from such qualified candidates as may be proposed by the Governing Bodies of public schools of medicine in the United Kingdom or in the colonies, as he may think proper. The other half were admitted through competition.

This new Warrant abolished the short-time service introduced by Lord Cardwell which compelled an army medical officer to retire after ten years' service with the colours. It also intended to abolish entrance to the AMD by competition on the grounds that the examination was deterring good officers from seeking commissions.

The Rt Hon Robert Farquharson opposed the Unification System which had removed regimental surgeons from their regiments. In Dec 1879. he argued, that he believed it to be a reason for the Army Medical Department not being attractive to young doctors. He stated that in olden days, the doctor, if a gentleman, was part and parcel of the regiment to which he belonged, not infrequently managing the mess and various business arrangements, the trusted adviser of all, from the colonel to the private, sharing in all the social pleasures, and in all the interests and good fellowships of the family circle to which he belonged. How effectually all this has been made a thing of the past, can be told only too effectually in the wretched lodging house lives of many medical officers now attached to some of our most important military stations.