The Army Medical Department
And the Malta Garrison
1887

The average strength of the Command was 5,499 men, exclusive of colonial troops. There were 3,011 admissions into hospital, with 36 deaths including 4 among the invalids. The Garrison Staff had 9 men.

65 men returned to England as invalids, of whom 39 were discharged from the service. The average number constantly non-effective through sickness (mean daily sick), excluding the RMFA, was 197.63 men. The average sick time to each soldier was 13.12 days; the average duration of each case was 23.95 days.

There were 180 officers with 90 cases of illness and 3 deaths. 4 officers were invalided to England. Deaths were from bronchitis, cirrhosis of the liver and fracture of the skull.

Admissions/deaths were for/from 30 for nervous system (30), circulatory (29/1 death), respiratory (85/5 deaths), digestive (468/2 deaths), urinary (9), generative (172), cutaneous (186), rheumatism (160), primary syphilis (85), secondary syphilis (43), gonorrhoea (193), phthisis (13/4 deaths), accidents (479/4 deaths), alcoholism (15/1 delirium tremens), 8 parasitic diseases (8/1 taenia solium), and 71 for debility mainly post fever (71).

Fever accounted for 609 admissions into hospital with 15 deaths. There were 3 admissions for eruptive fevers, 2 of small-pox and 1 of measles; 14 for enteric fever (5 deaths), 12 of which were treated in Cottonera Hospital where all the deaths occurred, the other 2 admissions were at Forrest Hospital. There were 570 cases of simple continued fever (7 deaths), 19 admissions for dysentery (2 deaths) and 1 death from cholera. Malarial fevers caused 22 admissions (5 deaths). Of these 9 were of ague and 13 of remittent fevers.

Three of the cases of dysentery were transferred from an Indian troopship, two died. Many cases of venereal diseases were transferred from troopships arriving with troops for the garrison. Many of the case of rheumatism were sequelae to attacks of Malta Fever. The principal causes of admission for diseases of the nervous system were neuralgia and epilepsy. Orchitis, venereal ulcers and urethral strictures accounted for the majority of the diseases of the generative system. There were 34 admissions for synovitis, another complication of brucellosis.

Palpitations caused the majority of circulatory disorders. The medical officer in charge of Valletta attributed them to climate, with excess both in drink and tobacco among young soldiers to which as an exciting cause may be added the many steep ascents in the streets in and about Valletta.

Three accidental deaths were from drowning and the fourth to asphyxia. There were 476 admissions for local injuries mainly sprained ankles (73) and scalp wounds (67) and contusion of face (52).

In 1887, Surgeon David Bruce and the microbiologist Dr Giuseppe Caruana Scicluna isolated the micrococcus, later Brucella melitensis, from cultures of splenic tissues. The samples were from a private soldier, aged 25 years, who had died of fever on 6 July 1887.

Bruce said that although many cases of Malta Fever had occurred among the infantry in Valletta in 1887, there was not one single case of enteric fever. That no improvement had taken place in regard to the former fever, in spite of the improved drainage and water supply, would go to point out, that in all probability the poison of Malta Fever is an aerial one. The difficulty of proving this by experiment is very great, as the microbe isolated from the organs of the fatal cases requires such a long time and high temperatures for its growth, that it is completely masked by rapidly growing micro organisms.

Surgeon-General James Sinclair stated: The continued fever of Malta had been well worked out of late years, and its distinction from enteric with ulceration of Peyer's glands clearly demonstrated, both at the bedside and in the mortuary. The long duration, the small mortality, the tedious convalescence, the absence of bowel complaints or spots, the arthritic sequelae, the liability to relapse, and the persistent anaemia, all marked this fever as a distinct form, not recognised in the present nomenclature.

Anyone who had watched a case of Malta continued fever from its commencement to its end or convalescence must be satisfied it was neither enteric nor malarial, but from its very prolonged course, the condition of the spleen, which was always enlarged, and the anaemia which was gradually established, it seemed to be allied to pernicious anaemia.

There were 225 wives, with 217 attacks of illness and 7 deaths. Admissions were for: fevers (45/3 deaths), of which 3 were enteric, debility (56/1 death), digestive disorders (32), generative system disorders (23/2 deaths).

There were 393 children with 232 admissions and 29 deaths. Admissions were for: fevers (29), bronchial diseases (42), teething (22) and diarrhoea (47/8 deaths). Deaths were from teething (3), debility (3), simple continued fever (2), convulsions (2), bronchitis (2), enteritis (2), tubercular disease (2), premature birth (2), and dysentery (1).

The following were buried in Pietà Military Cemetery in 1887:

• 31 July Mrs Smith, aged 50 years, wife of Barrack Quarter Master Sgt.
• 8 Aug Mrs Elizabeth Sarah Freeman aged 33 years 5 months, wife of School Master Freeman.
• 22 Aug Infant child James William Ford aged 1 year 8 months, son of William Ford.
• 12 Oct Infant child Mary Blood aged 27 days, daughter of Sgt Maj Blood.
• 21 Oct Infant child Margaret Blood aged 5 weeks, daughter of Sgt Maj Blood.

• 28 Jan Robert Hume Brown son of Emmaline and Christopher Brown, Military Staff Clerk of Floriana, born on 2 Jan 1887.
• 16 May Gertrude Gwendoline Gyde daughter of Elizabeth Ratcliff and William Gyde, Acting School Master of Floriana, born on 6 Apr 1887.
• 17 May Violet Margarita May McKerrow daughter of Elizabeth and Sgt Alexander McKerrow, superintendent of barracks of Margarita Hill, born on 14 Apr 1887.

During the epidemic of 1887, there were 626 cases of cholera in the civil population with 462 deaths. There were only two cases of cholera among the troops. On 12 Nov 1887, the Governor appointed a committee to report on the cholera epidemic in the Maltese Islands. Its members were: President - CGMO, Carmelo Arpa Esq, Osbert Chadwick Esq ICE, John Colahan Brigade-Surgeon, G O Galea MD, William Hardman Esq, Fortunato Mizzi LLD, Agostino Naudi LLD, Canon P Pullicino DD, Roncali LLD, F Sceberras MD, D M Shaw DIG of Hospitals and Fleet.

On 22 Nov 1887, Dr Nicolo Tabone, Assistant Medical Officer of the Civil Hospital in Gozo, petitioned for an appointment as colonial assistant surgeon at St Lucia, so as to better his position.

His brother, Dr V Tabone had been appointed colonial medical office to Fiji in 1882, on the recommendation of the PMO Surgeon General William Alexander Mackinnon. Tabone moved from Fuji to St Lucia.

On 31 May 1887, the Civil Hospital in Gozo reported an outbreak of cerebro spinal meningitis in a family at Sannat Gozo which had broken out in Feb 1887.

Brigade-Surgeon Thomas Rudd and Surgeon Captain John George Coates identified the outbreak as Cerebro Spinal Meningitis. The family consisted of both parents, 4 daughters and 3 sons. The mother was the first to fall ill; the father was not affected. Family members infected were:

• Angela Sultana (50 yrs) fell ill on 22 Feb 1887, died on 7 May.
• Grazia (13 yrs) fell ill on 23 Feb, recovered on 15 May.
• Francesco (16 yrs) fell ill on 25 Feb, died on 4 April.
• Maria (27 yrs) fell ill on 22 Feb, died on 7 May.
• Gio Maria (7 yrs) fell ill on 25 Feb, recovered on 15 May.
• Giuseppe (25 yrs) fell ill on 2 May, recovered on 2 May.
• Margherita (18 yrs) fell ill on 3 May, died on 3 May.

This epidemic of cerebro spinal meningitis was described as a new disease in Malta.