The Army Medical Department
And the Malta Garrison
1883

The average strength of the Command was 4611 men, exclusive of colonial troops. There were 3,526 admissions into hospital (764.7 admissions/1000 mean strength), with 40 deaths (8.68 deaths/1000 mean strength). The Garrison Staff had 37 men with 4 admissions into hospital and 1 death.

98 men returned to England as invalids, 34 of whom were discharged from the service. The average number constantly non-effective through sickness (mean daily sick), excluding the Royal Malta Fencible Artillery, was 246.60 men (53.48/1000 mean strength). The average sick time to each soldier was 19.52 days; the average duration of each case was 25.53 days.

There were 137 officers, with 67 attacks of illness and 1 death (phthisis pulmonalis). There were two cases of measles. 12 officers were invalided to England.

Fever accounted for 597 admissions into hospital with 19 deaths. Admissions were for:

• 61 for nervous system diseases (2 deaths)
• 109 for circulatory diseases (1 death)
• 150 for respiratory conditions (3 deaths)
• 524 for digestive diseases (4 deaths)
• 374 for urinary problems
• 313 for cutaneous diseases
• 122 for rheumatism
• 327 for syphilis (1 death)
• 27 for phthisis (3 deaths)
• 440 for accidents (7 deaths)

The increase in the incidence of primary syphilis began in May on the arrival of the troops from Egypt and continued during the whole of the summer months up to October. Among the admissions for diseases of the nervous system were 7 cases of sunstroke, 7 of epilepsy and 11 of mental disorders. The deaths were from meningitis and sunstroke in a man who had been sleeping in the sun after playing cricket all day.
The PMO attributed the increase in circulatory disorders to palpitations (66 out of 109), caused by the effects of vice and intemperance in young soldiers, debilitated by climate and also by the use of strong tobacco. Valve disease of the heart caused 30 admissions, with one death.

There was 1 admission for eruptive fevers (small-pox). Continued fevers led to 564 admissions with 17 deaths. There were 120 admissions for enteric fever (17 deaths), 260 for simple continued fevers and 184 for febricula. Small-pox occurred in a married soldier living in the Camerata. The attack was mild and there were no further outbreaks among the troops.

Station Hospital Valletta had 51 admissions and 9 deaths from enteric fevers, Cottonera Hospital had 64 admissions and 5 deaths and Forrest Hospital 5 admissions and 1 death from enteric. Two enteric deaths were returned from the Sanatorium Citta Vecchia. 21 cases of enteric were admitted from Upper St Elmo Barracks, where the water from the women's wash house had contaminated the tank used for storing rain water for drinking.

There were 18 admissions for paroxysmal fevers, of which 7 were for remittent fever and the remainder for ague. There were 3 admissions for choleraic diarrhoea, all in married men living in the Camerata.

There were 252 wives, with 251 attacks of illness and 3 deaths. The prevailing diseases were fevers, rheumatism, phthisis pulmonalis and diseases of the respiratory system. Deaths were from phthisis pulmonalis, enteritis and puerperal mania.

A woman of the Royal Artillery living in the Camerata had mild small-pox.

There were 417 children with 371 admissions and 44 deaths. Child deaths were from diphtheria (2), fevers (4), respiratory diseases (7), convulsions (4), digestive disorders (17), fractures (2). A child died from a fractured skull after falling out of a window.

In Sep 1883, Osbert Chadwick proposed several schemes to increase the water supply, such as an irrigation canal to convey water from the Fidden Dam to the Ta' Qali Reservoir. In 1884, Chadwick and Capt Tresidder RE submitted a Project for the drainage of Sliema.

Nearly all the barracks and hospitals were supplied with spring water from the aqueduct except those at Pembroke Camp and Forrest Station Hospital which relied on rain water. Water carts were resorted to during the dry season at considerable expense.

The drainage works in the Three Cities had progressed during the summer of 1878 to 1879. Those of Floriana advanced during the whole summer of 1882. In 1883, the drainage of Valletta had almost been completed, but work was interrupted during the outbreak of the cholera epidemic in Egypt. While work was in progress patients in the Station Hospital Valletta were transferred to Citta Vecchia and the Forrest Station Hospital to prevent them inhaling noxious miasma, when the main drains near the hospital were exposed.

On 18 Nov 1882, the Director of Education proposed for the Faculty of Medicine at the University to be reorganised. This would place medical students on an equal footing with those obtaining degrees recognised by the General Medical Council of England. The course was to last five years. Graduates were to be precluded from practicing until they had attended at a hospital for a year after passing their final examinations.

In 1883, the General Council of Medical Education and Registration did not have the legal power to recognise a degree from a foreign or colonial university as qualifying for registration in the General Medical Register of the United Kingdom as constituted by the Medical Act of 1858. An amendment to this Act in 1901 led to recognition of Maltese medical degrees by the General Council.

In 1883, Surgeon-Major Evatt AMS, Mr James Cantlie FRCS and Sgt Andrew Maclure of the London Scottish laid the foundation of the Volunteer Medical Associations which later became the Volunteer Hospital Corps. In Nov 1886, the Volunteer Hospital Corps became the Volunteer Medical Staff Corps. It subsequently took the title of The Royal Army Medical Corps Volunteers London Companies. Three of these London Companies was composed entirely of medical students.

In 1883, the Royal Red Cross Medal was instituted primarily for military nurses. The Military Medal and the Victoria Cross were extended to military nurses in 1916 and 1920 respectively.