The Army Medical Department
And the Malta Garrison
1881

The average strength of the Command was 4,553 men, exclusive of colonial troops. There were 4,118 admissions into hospital (904.4 admissions/1000 mean strength), with 52 deaths (11.12 deaths/1000 mean strength), including 6 invalids on their passage home or at the Invalid Depôt at Netley. The Garrison Staff had an average strength of 17 men. The main causes of admission into hospital were fevers, rheumatism, venereal diseases and diseases of the respiratory, digestive and cutaneous systems.

129 NCOs and men were returned to England as invalids; 42 were discharged from the service. The average number constantly non-effective through sickness (mean daily sick), excluding the Royal Malta Fencible Artillery, was 264.14 men. The ratio per 1000 mean strength constantly sick was 58.01; the average sick time to each soldier was 21.18 days; the average duration of each case was 23.41 days.

There was an average of 172 officers, with 147 attacks of illness; 9 were invalided to England. The principal diseases were fever and digestive system disorders. There were two mild cases of diphtheria.

Fever accounted for 920 admissions into hospital with 20 deaths. Hospital admissions were for:

• 65 for nervous system diseases (4 deaths)
• 63 for circulatory diseases (3 deaths)
• 208 for respiratory conditions (2 deaths)
• 557 for digestive diseases (3 deaths)
• 430 for urinary problems
• 370 for cutaneous diseases
• 172 for rheumatism
• 148 for syphilis
• 45 for phthisis (14 deaths)
• 431 for accidents (4 deaths)

Other deaths were from sunstroke (1), valvular heart disease (1), pneumonia (2). Surgeon General Mackinnon performed a colotomy on a soldier with rectal cancer but the men died 83 days post op. Of the four deaths by drowning, three followed the capsizing of their boat in the Grand Harbour and one while bathing at St Elmo. The accidental deaths were from skull fractures (3) and 1 from gunshot wound. A soldier fell down some steps at Fort Verdala fracturing his skull, another fell from St James Cavalier during the night, and a gunner threw himself out of the window at Fort St Angelo also fracturing his skull.

There were 59 cases of eruptive fevers, of which 13 were measles and 46 dengue fever. In autumn 1881, dengue fever broke out in Malta. The navy had 41 cases admitted to the military hospital Valletta. The disease commenced with severe headaches, pain between the eyes with redness, pain all over the body chiefly affecting the lumbar region and calves; joint pain only occurring in severe cases. A few were accompanied by an erythematous eruption which appeared on the third or fourth day on the chest and upper limbs, joint of the elbows and knees and sometimes covered the whole body. The fever then abated. The average time in hospital was 14 days. Dengue fever was imported from Egypt where it had prevailed in August. The epidemic in Malta gradually subsided and was over by Dec 1881.

Continued fevers led to 752 admissions with 14 deaths. There were 46 cases of enteric fever (13 deaths). The admissions came from the Cottonera District (24), Forrest (15) and Civita Vecchia (1). Eight of the deaths occurred in the Cottonera District.

There were 76 admissions for paroxysmal fevers of which 69 were for remittent fevers, with 6 deaths. Most of the cases came from the Valletta District.

In Nov 1881, General Sir Arthur Borton, recommended appointing a high ranking army medical officer as his independent and distinguished advisor in the dispensation of the £30,000 which was spent annually on the Charitable Institutions. The Principal Medical Officer of the garrison was appointed to the post as the Governor argued that anyone of a lesser rank would be unpalatable to the professional officers of the Medical Board.

The position of the army medical officer was somewhat ambiguous. He was a member of the Lunatic Asylum Board, and as an advisor to the Governor would have had to visit and report on the Lunatic Asylum separately from the other visitors. The Maltese doctors on the Board were unlikely to act very harmoniously with an outsider thus placed over them. It was reported that his presence on the Board would be worse than useless, as the Maltese would constitute themselves into an indivious opposition and boycott him. To make the PMO a referee when there was a difference of opinion between the Comptroller of the Charitable Institutions and the Lunatic Asylum Board, of which he was himself a member, would be absurd.

Borton thus limited his duties to visiting and inspecting the various medical institutions, and giving advice to the Comptroller in non clinical matters. The War Office had to be consulted before the PMO could take over the proposed duties. The Governor felt that the assistance of the PMO as inspector and visitor of the medical establishments would be of great value to the Government of Malta. He saw no objection to the PMO also being a member of the Lunatic Asylum Board, as it would only be giving him a more special connection with that particular establishment, and a voice in its management, in addition to his power of reporting to the commissioners of charity.

Officers were promoted by seniority from the date of their commission. If promoted out of sequence an officer was granted Brevet Rank. He then had two ranks, an army rank, dating from their commission, and a higher regimental rank, the Brevet Rank.

There was an average of 340 wives in the garrison with 408 attacks of illness and 3 deaths. Two of the deaths were from remittent fever and phthisis pulmonalis.

There were 529 children with 549 admissions and 44 deaths. Child admissions were for fever (134), diarrhoea (91), bronchitis (54) and conjunctivitis (67). Deaths were due to diarrhoea, convulsions, debility, meningitis, tabes mesenterica and diphtheria.

In 1881, Sliema was provided with a branch from the aqueduct. The apparatus for distilling sea water, which had been constructed early in the year, was insufficient to supply the needs of a growing population especially in times of scarcity of water.

The Dwejra Lines to protect the southern part of Malta were completed in 1881. In 1897, on the occasion of Queen's Victoria Diamond Jubilee, the Lines were renamed the Victoria Lines.