The Army Medical Department
And the Malta Garrison
1884

The average strength of the Command was 4,637 men, exclusive of colonial troops. There were 3,897 admissions into hospital (840.4 admissions/1000 mean strength), with 43 deaths (9.27 deaths/1000 mean strength). The Garrison Staff had 20 men with 1 admission into hospital.

141 men returned to England as invalids, 83 of whom were discharged from the service. 25 men were invalided for phthisis pulmonalis; 25 men who had recovered from fever went home for change of climate; 17 men returned to England because of valvular heart disease. The average number constantly non-effective through sickness (mean daily sick), excluding the Royal Malta Fencible Artillery, was 258.93 men (55.84/1000 mean strength). The average sick time to each soldier was 20.43 days; the average duration of each case was 24.31 days.

There were 161 officers, with 87 cases of illness and 5 deaths. 10 officers were invalided to England. The principal diseases were: fevers (31), digestive disorders (13) and injuries (13). Deaths were from meningitis, gout, phthisis pulmonalis, acute rheumatism and extravasation of urine. The cause of invaliding were: fevers (4), sunstroke from Egypt, hepatitis, acute rheumatism, phthisis pulmonalis, dysentery and acute synovitis.

There were 281 wives, with 251 attacks of illness and 8 deaths. 9 women were invalided home. The prevailing diseases were fevers (44), rheumatism (7), anaemia (13), nervous disorders (9), respiratory conditions (9) and digestive disorders (36). There was one case of diphtheria and one of enteric fever. Four deaths were caused by phthisis pulmonalis, one by continued fever and three deaths occurred in childbirth.

There were 451 children with 306 admissions and 37 deaths. There were 8 cases of diphtheria (2 deaths), 3 of mumps (2 deaths). Other child deaths were from: fever (1), hereditary syphilis (1), scrofulous affections (8), meningitis (1), respiratory diseases (5), digestive disorders (14), premature birth (2) and debility (1).

Non medical military officers were subjected to periodical examinations up to the rank of field-officer. After the Crimean War, the Army Medical Department introduced examinations for promotion for its medical officers, but these were discarded in 1874.

The committee chaired by Lord Morley, which scrutinized the performance of the Army Medical Department following the 1882 Campaign in Egypt, recommended the resumption of examinations for promotion for medical officers. It commented that Medical officers, whose training was more of the most scientific nature, were deprived of any such test, and were promoted by seniority or selection, without the protective and stimulative influence of examinations.

In Sep 1884, an expedition was prepared for Egypt under the command of Lord Wolseley. Surgeon-General Irvine was the Principal Medical Officer for the campaign; Surgeon General Barnett was PMO at Suakin.

On 25 Sep, the Army Hospital Corps with a strength of 40 officers and 164 mon-commissioned officers and men, many of them wearing the medals for Egypt and South Africa, left Woolwich for Alexandria in the steam ship Anglian. The medical unit or bearer company consisted of 8 medical officers, 2 quartermasters and 213 men of the Army Hospital Corps. One bearer company was considered sufficient for a Division of 6,000 men. Each regiment had two men per company trained as stretcher bearers. The bearer company received the wounded in sheltered tents where temporary first aid was administered until the arrival of the field-hospital.

In 1884, the Medical Officers of the Army Medical Department were renamed Army Medical Staff. The Warrant Officers, NCOs and men of the Army Hospital Corps became the Medical Staff Corps. The Officer of Orderlies became Quarter-Master Army Medical Staff (AMS).

On 12 Nov June 1884, Queen Victoria approved revised regulations for the dress of officers of the medical staff. The colour of the uniform was changed from scarlet to blue in order to assimilate the dress to that of the uniform of the Medical Staff Corps

A clause in the Warrant authorised the Secretary of State to nominate gentlemen to fill vacancies in the Medical Staff if there were an insufficient number of competition candidates. On 25 Oct 1884, Lord Hartington declared that the improved conditions brought about by the Warrant had attracted sufficient numbers of eligible candidates for the clause to remain as a contingency only.

Fever accounted for 737 admissions into hospital with 23 deaths. Admissions were for:

• 83 for nervous system diseases
• 139 for circulatory diseases (1 death)
• 173 for respiratory conditions (3 deaths)
• 518 for digestive diseases (1 death)
• 305 for urinary problems
• 377 for cutaneous diseases
• 160 for rheumatism
• 340 for syphilis
• 47 for phthisis (5 deaths)
• 492 for accidents (3 deaths)

A soldier drowned in the Quarantine Harbour behind Lower St Elmo Barracks. Of the 160 cases of rheumatism, 41 were acute, the rest sequel to fever. Neuralgia (29 admissions) also complicated fever.

There was 4 admissions for eruptive fevers, 1 for measles and 3 for scarlet fever in young soldiers quartered in Verdala Barracks.

Continued fevers gave 625 admissions. There were 94 admissions for enteric fever with 22 deaths and 531 admissions for simple continued fevers. 46 cases of enteric fever 11 deaths occurred in Cottonera; 36 cases with 9 deaths were in Valletta; 6 cases with 2 deaths occurred at Forrest Station Hospital; 6 cases were from Civita Vecchia. In the Cottonera, only two cases occurred among the women and children occupying the same quarters as the men, which led the medical officer to assert that the disease was not picked up in the barracks but in the many grog shops in the vicinity of the barracks. Consequently, 44 grog shops in the Cottonera District were placed out of bounds.

Simple continued fevers and febricula were generally of a mild character, but some soldiers became very weak and anaemic, leading to their admission to the Sanatorium, Civita Vecchia. There were 2 cases of diphtheria, (one in Valletta, the other at Fort Ricasoli), and 3 of erysipelas.

There were 99 admissions for paroxysmal fevers with 1 death. Ague in men returning from Egypt caused 13 of the admissions; remittent fever accounted for 86 admissions of which 43 occurred at Cottonera and 38 at Valletta. The cases were described as mostly very tedious, all requiring admission to the Sanatorium.

No authority was granted to establish a Female Hospital at Malta. The wards hitherto used for the treatment of sick women landed from transports under authority Malta 16/837 was to be utilised under para 248 medical regulations for cases in garrison.

In 1884, it was decided to use English as the language of instruction for the 1885–1889 course of the Faculty of Medicine.

The first nursing sisters were employed in military hospitals in 1856. The Army Nursing Service came into formal existence in 1884. Ten years later, a reserve of nurses was formed under the name of Princess Christian's Army Nursing Reserve.

In the Royal Navy, the nursing staff of men was replaced by a trained staff of ladies in 1884 when the four main naval hospitals of Haslar, Devonport, Chatham and Malta were selected as the places for the experiment of placing women nurses in naval hospitals to be tried.