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Early 19th Century Maltese Doctors
In the Service of the Crown

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Maltese Doctors and the Army Medical Department

Introduction

Events in the summer of 1798 produced tumultuous upheavals in the social, political and religious lives of the Maltese. On 12 June, the Order of St John of Jerusalem that had played such an integral part in their lives since 1530, was cast aside by the armies of Revolutionary France. Those employed by the Order suddenly found themselves out of work. The French offended the feelings of the Maltese by looting their churches and interfering with their religion. On 2 September 1798, the simmering discontent erupted into a insurrection. This lasted two years. By 4 September 1800, the French were starved into submission and Malta passed into the hands of the British Crown. Henceforth, the Maltese looked towards their new masters for the revival of their fortunes.

The expulsion of the French left the people in a state of political uncertainty. The economy was in ruins and the people impoverished. The medical services and charitable institutions which had been built up over centuries, and had provided medical employment were in disarray. Medical practitioners who had worked with the insurgents during the two years of famine and the typhus epidemic of 1800, expected to be reinstated to their former posts. It took time to reappoint them to their previous jobs or to pay their salaries. A typical example was that of Angelo Pace who had entered the medical service of the Order of St John in 1760. Pace was medico dei poveri (doctor of the poor) of Birgu (Vittoriosa) when the French abolished his post and the salary that went with it. Pace joined the insurgency at Mdina where he tended the wounded at the hospital set up in the church of St Sebastian, Rabat. Following the cessation of hostilities, Pace was reinstated in his previous post at Birgu but he did not receive a salary until a year later.1

The failure of the British to commit themselves to retain the islands created apprehension and uncertainty. In accordance with Article X of the Treaty of Amiens of 1801, Malta was to be restored to the Order of St John of Jerusalem. The military packed up and prepared to leave. The resumption of hostilities with France in May 1803 halted the evacuation of troops from Malta and a degree of stability descended on the islands. Economic difficulties, general uncertainties and the hardships faced by medical men were possible motives which led them to seek employment with the military. This was never expected to be a permanent arrangement as army medical officers served for the duration of hostilities and were relegated to half-pay when regiments were reduced at the end of the Napoleonic Wars.

This article follows the careers of Giuseppe Schembri, Lorenzo Sammut, Joseph (Josiah) Schembri and Gavino Patrizio Portelli. Their military service spanned the breadth of the Napoleonic Wars. It provides an insight into the medical education and service life of army medical officers in the early nineteenth century.

Assistant Surgeon Giuseppe Schembri c.1771 – 1835

Giuseppe Schembri was born around 1771. At the time of his birth, the Hospitallers of the Order of St John of Jerusalem under the despotic rule of the Portuguese Grandmaster Manoel Pinto de Fonseca (1741-1772), were in decline. Schembri lived his early years under three grandmasters: Fra Francesco Ximenes de Texada (1773-75), Emmanuel de Rohan Polduc (1775-97) and Ferdinand de Hompesch (1797-98). He would have been around 27 years of age when the Order of St John of Jerusalem was expelled from Malta by Napoleon Bonaparte. His return of military service, dated 4 March 1829, records his marriage date as 26 April 1804. He was thus around 33 years. This was rather late for a first marriage, as he does not record a previous marriage. His first son, Anthony, was born on 10 February 1805. A daughter, Mary, was born on 7 November 1816, and another daughter, Luigia, was delivered on 29 May 1821. It is not recorded whether there were any infant deaths to account for the gap of over eleven years between Anthony and Luigia. Schembri was away on deployment in Sicily from November 1807 and was held captive at Capri from 1808 till 1811.2

Little is known about his medical education, other than that he attended the hospitals at Malta, as well as studied and took a degree at the University of Naples. In the late 18th century a young lad of means could train as a surgeon at the Sacra Infermeria, the hospital of the Order of St John at Valletta. This was made possible through the foundation of a School of Anatomy and Surgery by Grand Master Nicolo Cotoner in 1676 and the establishment of a Faculty of Medicine in 1771 by Grand Master Manoel Pinto de Fonceca. Students apprenticed themselves to a surgeon and attended lectures in anatomy and demonstrations on the cadaver in the dissection room specially built in the cemetery of the Sacra Infermeria. Dissection of the body began in Malta in 1723. Students walked the hospital wards shadowing the senior dressers. They assisted at operations, attended postmortem examinations and were taught by the lithotomists how to cut for the bladder stone. At the Sacra Infermeria Schembri would have studied anatomy under Michel Angelo Grima (1731-1798) who held the Chair of Anatomy and Surgery from 1771 to 1797.3

The military service of Giuseppe Schembri was plagued with misfortune. In a way it reflected the turbulent times in which he lived when the Wars of Revolutionary France swept across the continent. It is not clear as to whether compelling financial problems or other ulterior motives induced him to seek an appointment with the British military at the advanced age of 30 years. It might have been a natural progression of swapping the medical service of the Order of St John for the military medical service of another power. Most recruits to the army medical service during the French wars joined in their early twenties as hospital mates. The majority expected to get promoted as assistant regimental surgeons of an infantry regiment and remain with that regiment for a considerable time, before returning to civilian life on half-pay. It was not so for Giuseppe Schembri. It appears that Schembri was initially attached to local regiments as a civilian medical practitioner since his military commission is not dated until 10 September 1807. The regiments he served with were disbanded shortly after he joined them, forcing him to move from one establishment to the next. His short military career in the Royal Regiment of Malta only lasted four years. He was relegated to half-pay on 25 March 1811. He then worked as a surgeon in the country giving his services without charge during the outbreak of plague in 1813-14.

On 15 September 1801, Giuseppe Schembri was appointed second assistant surgeon in the Maltese Light Infantry. This regiment was raised by Brigadier-General Thomas Graham in May 1800 to reinforce the 30th and 89th regiments during the land blockade of the French garrison. The men were enlisted for two years' local service. Its days were already numbered when Schembri took up his appointment. The Maltese Light Infantry was not expected to serve overseas, although the men were encouraged to volunteer for service abroad. Thus, on 22 September 1801 a detachment of 200 men embarked on HMS Athenian to reinforce the garrison at Porto Ferrajo. The Maltese Light Infantry arrived at Elba on 11 October 1801. In accordance with the Preliminary Treaty of Peace of 1 October 1801, Britain had to remove her troops from Elba, where Col Airey, with a small body of men, had resisted being dislodged by overwhelming opposition for four months. In April 1802, the detachment of the Maltese Light Infantry returned to Malta and was disbanded. Its 638 men were discharged, but most subsequently enlisted in the Maltese Provincial Battalions.

Schembri states that he served in the glorious expedition of Egypt from 3 November 1802 to 1803. He must have gone there to reinforce the garrison of Alexandria under the command of Major General John Stuart, as the French had given up Cairo in June 1801 and Alexandria had fallen on 30 August 1801. In compliance with the Treaty of Amiens, the garrison at Alexandria was completely withdrawn on 27 March 1803. This brought a brief respite in hostilities before war with France resumed on 16 May 1803.

At the onset of the French Revolutionary Wars the Army Medical Service was run by an Army Medical Board consisting of a Surgeon-General, a Physician General and an Inspector of Regimental Hospitals. In March 1798 the Secretary of State abolished the Board and held each member solely responsible for his own acts. Thomas Keate, (1745-1821), as Surgeon-General, nominated staff surgeons and regimental surgeons to the Commander-in-Chief at the Horse Guards for appointments to line regiments. Patronage and the purchase of regimental commissions played a significant part as to which regiments medical gentlemen were appointed to. At overseas stations, appointments to vacancies in regiments were usually made by the local garrison commander on the advice of his Principal Medical Officer. Approval was sought from Horse Guards but it took over two months to communicate with London.

Thus on 29 May 1806, in a communication to Lieut. General William Anne Villettes, commanding the Malta Garrison, Inspector of Hospitals William Franklin recommended that "the present strength of Froberg's levy rendering the service of an assistant surgeon necessary, I beg leave to recommend to you Dottore Giuseppe Schembri, who has been doing duty as an extra mate for some time past with the regiment, and has conducted himself in such manner as to induce me to believe that he is in every respect qualified for the situation. He has attended the hospitals of Malta, and has also studied and taken a degree at the University of Naples".4 Giuseppe Schembri does not appear in the Army List as an assistant surgeon with Froberg's Levy. Frederick Weber was the first surgeon appointed to the newly raised Froberg's Levy. His commission is dated 5 June 1806. The assistant surgeon was Augustus Strohmeyer. He received his commission on 10 September 1806.

The Surgeon-General had little authority to act on his own initiative and had forever to seek approval to fill vacancies in regiments from the Horse Guards via the Secretary of State. Thus on 8 September 1806, the reply from the War Office regarding Schembri's appointment to Froberg's Levy duly arrived. "I have the Secretary-at-War direction to transmit for the consideration of HRH the Commander-in-Chief, a letter from the Surgeon General, submitting for the reasons therein mentioned, the propriety of nominating hospital mate Augustus Strohmeyer as assistant surgeon Froberg's Levy, and of Mr Giuseppe Schembri being submitted to a medical and surgical examination at Malta, on passing which, Mr Keate recommends that he may be appointed assistant surgeon to the Royal Regiment of Malta, there being no longer a vacancy in the Corsican Regiment".5

Froberg's Levy arrived in Malta in April 1806. It was raised by Count Mountjoy Froberg and consisted of a motley group of soldiers from Germany, Poland, Greece, Constantinople, and Albania. The men did not speak a common language and were not understood by their officers. Many complained of their maltreatment at the hands of their Adjutant Captain Schwartz, who had improperly recruited them with false promises of promotion and extravagant descriptions of pay and allowances. In addition, Schwartz threatened to withdrawal their food if they refused to sign their attestation papers. The men had strong grounds for their complaints, but General Villettes felt that "the atrocious action they took to resolve their dissatisfaction was unjustified".6

The men quarreled with the inhabitants and were very unhappy when they found themselves confined to Fort Ricasoli. On 4 April 1807, their anger erupted into mutiny. About 200 dissatisfied Greeks, Bulgarians and Albanians killed the adjutant and forced the detachment of artillery stationed at the fort to load and point all the guns and mortars upon the garrison. They threatened to fire upon the town unless they were immediately put on board Russian vessels and sent to their own country or Corfu. The mutineers compelled others to join them. On 8 April, the Poles and the Germans escaped by forcing open one of the gates. A hard core of 30 mutineers refused to lay down their arms and shelled Valletta. On 11 April Lieut. Clermont and loyal soldiers of Froberg's Levy scaled the walls and stormed the fort. Two mutineers were captured, six retreated into the powder magazine, and the rest escaped into the surrounding countryside. On the night of 11 April, the rebels blew themselves up bringing the mutiny to an end. Froberg's Levy was disbanded and the men moved to Sicily.6 Schembri had attended the men of Froberg's Levy from 25 April 1806. Following its disbandment, he worked at the military hospital Valletta. On 25 October 1807 he accompanied those invalided out of the army to Gibraltar.

Medical gentlemen who aspired to enter the army medical service had to demonstrate orally their knowledge of surgery before one of the Royal Colleges. From 1798, they also had to prove their abilities as physicians before the Army Medical Board. Candidates could opt to be examined for a simple assistant's diploma at a cost of 1 guinea or a regimental surgeon's qualification at 3 guineas. In 1809, the fee rose to 2 guineas and 5 guineas respectively. The Army Medical Board examined candidates for commission on the first and the third Thursday of each month. Candidates abroad were examined by a Board of Hospital Officers.7

On 10 September 1807, Schembri was commissioned assistant surgeon in the Royal Regiment of Malta. He obtained his commission without purchase. Surgeon-General Thomas Keate, found "no objection to Mr Schembri being appointed to the situation in question for which he has been deemed qualified by the Board who examined him". Sir James Murray-Pulteney, Secretary at War (1807–1809), was "not aware of any grounds which should prevent the appointment from taking place accordingly".8

The Royal Regiment of Malta first appeared in the Army List of 30 Mar 1805. Major General William Anne Villettes, commanding the troops in Malta, was directed to raise a regiment of Maltese infantry for General Service. In October 1806, another General Order directed the consolidation of the two Maltese Provincial Battalions into one corps, and encouraged the discharged men to enlist in the Royal Regiment of Malta.

In October 1807, the Royal Regiment of Malta sailed for Sicily. In September 1808, it was ordered from Milazzo to Capri. The island of Capri, off the coast of Naples, had been taken from the French in May 1806 and garrisoned by the Royal Corsican Rangers, under Colonel Hudson Lowe. The Royal Corsican Rangers occupied the heights of Capri. The Royal Regiment of Malta under the command of Major Hamill held the positions of Ana Capri. Three companies of the Royal Regiment of Malta were to co-operate with three companies of the Royal Corsican Rangers for the defence of the sea line lying between the two positions. Unfortunately, on 4 October 1808, within a fortnight of the Royal Regiment of Malta arriving at Capri, the French overwhelmed Ana Capri, and almost the whole 680 men of the Royal Regiment of Malta were made prisoner. Heavy gales prevented reinforcements getting through. On 16 October, after a defence of twelve days, Hudson Lowe surrendered Capri to La Marque, General of Division and Chief of Staff of the French Army in the Kingdom of Naples. Schembri was held prisoner at Castel Nuovo near Naples. He was not released until 11 February 1810. On 26 April 1811, the Royal Regiment of Malta was disbanded as, after the debacle at Capri, it failed to attract recruits.

On 25 March 1811, Assistant Surgeon Giuseppe Schembri was discharged on half-pay. He was forty years old. In view of his age, he did not seek further military appointments but worked as a civilian doctor in the countryside. He died on 14 March 1835.

Assistant Surgeon Lorenzo Sammut

The medical education embarked upon by Lorenzo Sammut in the late 18th century was the standard training for prospective surgeons. The kind of surgery undertaken at the time was restricted by lack of anaesthesia and high mortality from wound sepsis. William Domeier, Physician to the Forces in Malta from 1806 to 1808 commented that "Maltese surgeons are not able to perform any important operations, at least not according to modern improvements. Some do not venture to perform any operation beyond bleeding, cupping and blistering. Nobody performs operations on the eyes, nor is there any dentist".9

The recognised qualification of the surgeon was the Membership of the Royal College of Surgeons. Sammut is the first recorded Maltese army surgeon to have gained such a qualification, and to have completed his training in England, rather than at Naples, as was customary at the time.

Lorenzo was the son of Antonia and the surgeon Fidele Sammut, formerly in the medical services of the Order of St John. Lorenzo followed in his father's footsteps. In 1794, he began his surgical training at the Sacra Infermeria. From 1794 to 1798, he studied anatomy under Michel Angelo Grima, the senior surgeon of the Order of St John. His studies were, however, disrupted by the French invasion of Malta. The Sacra Infermeria became a hospital for French troops and its patients moved to the nearby convent of Mary Magdalen, which became the Civil Hospital for Men. After the expulsion of the French, the University of Malta was reconstituted, and the Civil Hospital for Men became its teaching hospital.

The reopening of the University enabled Sammut to resume his studies. From 1800 to 1804, he attended the lectures and demonstrations in practical anatomy and practical surgery given at the National Hospital of Malta by Aurelio Badat. Badat started his surgical career in 1757 when he joined the navy of the Order of St John as a barber-surgeon. He studied in Paris for ten years at the Order's expense. On his return to Malta, Badat was appointed Senior Surgeon of the naval squadron of the Order of St John. In 1789 he became Principal Surgeon of the Women's Hospital. He succeeded Michel Angelo Grima to the Chair of Anatomy and Surgery when the latter retired on 2 April 1797.

In July 1807, Sammut was appointed Warrant Hospital Mate to the British Naval Hospital in Valletta on a daily salary of 7s 6d, with a lodging allowance of 10s 6d a day. Two years later, on 29 March 1809, he left the Naval Hospital in order to proceed to London to obtain broader clinical experience. The medical education provided by the teaching hospitals in London was primarily one of attendance at lectures. Surgical apprentices enrolled on courses of lectures at such teaching establishments as St Thomas's and St Bartholomew's Hospitals, or at private schools such as the Great Windmill Street School of Anatomy run by William Hunter, or that run by the former army Staff Surgeon Joseph Constantine Carpue.

Teaching on the wards was restricted to the copying of case notes, observing operations, and following surgical dressers on their rounds. Senior surgeons frequently took on paying pupils, often accommodating them in their own homes as resident pupils. The examination for membership of the Royal College of Surgeons consisted of a viva voce only. Students were not required to show proficiency in operative surgery, but had to prove attendance to a course of lectures on anatomy and surgery.

In 1809, Lorenzo Sammut pursued a typical medical educational route. Over six months he attended clinical lectures, concurrently with lectures on chemistry and therapeutics given by the physician and chemist George Pearson at St George's Hospital, lectures on midwifery given by Andrew Thyme, and lectures in anatomy, and practical anatomy. For six months, he studied physiology and surgery as a House Pupil of the anatomist Joshua Brookes, whose museum of human and comparative anatomy was second only to that of John Hunter.10

Sammut became a Member of the Royal College of Surgeons on 14 December 1809. He subsequently appeared before the Board of the Royal College of Surgeons, and the Army Medical Board, and, having passed the required examinations, was commissioned Hospital Mate for General Service on 4 January 1810. The fee for his commission as a Hospital Mate was £5 7s 6d. This was quite a substantial sum, considering that the daily rate of pay of a hospital mate was 6s 6d at home and 7s 6d abroad.21

The army had two classes of Hospital Mates, Warrant Hospital Mate for Temporary Service, and Commissioned Hospital Mates for General Service. The former were usually not highly qualified, as a certificate of attendance at a hospital for a year was all that was required. Warrant Hospital Mates were not eligible for a commission until they gained further qualifications. In June 1813, the rank of Commissioned Hospital Mate was replaced by that of Hospital Assistant to the Forces, whereas those appointed by warrant retained their rank of Hospital Mate. Hospital mates were appointed by the Inspector of Army Hospitals. He was the third member of the Army Medical Board that in conjunction with the Physician-General and the Surgeon-General run the affairs of the Army Medical Services. Sammut had to be recommended to the Horse Guards for a commission by Inspector of Army Hospitals Francis Knight via the Secretary-at-War. A letter from the War Office, dated 29 Dec 1809, stated that "in consequence of a letter of the 27 December 1809 from the Inspector General of Army Hospitals recommending that Mr Lorenzo Sammut may be appointed a Hospital Mate for General Service, I have the Secretary-at-War directions to request that you will submit his name to the Commander-in-Chief, in order that Mr Sammut may be appointed by commission agreeable to HM Warrant dated 22 May 1804.11

Most entrants to the service at the start of the Napoleonic Wars usually began their careers at the Army Depot on the Isle of Wight. Others went to Portsmouth where they served at the barracks at Gosport and Hilsea. Towards the end of the Napoleonic Wars recruits went to Duke of York Hospital, Chelsea. After the war new entrants to the service went to Fort Pitt in Chatham. Hospital Mate Sammut was taken on the strength of the army recruiting depot at Newport, Isle of Wight. He served at Hilsea Barracks until his embarkation for Malta.

From 26 April to 27 May 1811, Lorenzo Sammut is listed on the strength of the Naval Hospital Valletta, as an Assistant Hospital Mate; in June 1811, his name appears on the returns of the staff of the Military Hospital Valletta.

On 22 August 1811, Sammut was appointed assistant surgeon to the Royal Corsican Rangers, and moved to the Ionian Islands. He filled the vacancy created by assistant surgeon William Vallange who was promoted to 44th Regiment on 22 August 1811. The regimental surgeon was Oliver Haipin who took up his post on 11 April 1811. A second assistant surgeon, Alfeo Ferrara was commissioned to the Royal Corsican Rangers on 8 October 1812. While in the Ionian Islands, Sammut became surgeon to the 2nd (Duke of York) Greek Light Infantry Regiment, in accordance with a General Order dated Zante 4 April 1814. His name, however, does not appear in the Army List for the regiment is shown as having no established surgeon or assistant surgeon. The 2nd Regiment of Greek Light Infantry was raised on 22 May 1813. It was disbanded at Cephalonia on 24 October 1814. Sammut rejoined the Royal Corsican Rangers, and on its reduction in 1816, accompanied the discharged men to Messina, Naples and Genoa.

On 30 January 1817, Assistant Surgeon Lorenzo Sammut was relegated to half-pay, having served just under eight years. He returned to Malta and obtained a position as First Surgeon in the Female Hospital at Valletta. Lorenzo Sammut died towards the latter half of 1825. He left a very elderly mother with little means of financial support. Antonia Sammut received her husband's small pension from the Order of St John, but the French had discontinued the payment of pensions. On the surrender of Valletta, Antonia failed to claim the pension from the British administration, as she had other means of support at the time. The death of Lorenzo left her in "great distress". On 1 January 1826, she was granted a monthly pension of one pound fifteen shillings sterling.12

Apothecary to the Forces Joseph Schembri

The apothecary or druggist was regarded as nothing more than a shopkeeper by his professional brethren. His education was wholly practical consisting of an apprenticeship to a senior apothecary. By the early part of the 19th century the apothecary had become the established general medical practitioner. In the army, the apothecary was a medical staff officer placed in charge of the medicines and medical stores of a General Hospital. He was selected from the hospital mates or assistant surgeons and paid a salary of ten shillings a day. The rank of Apothecary to the Forces was abolished by the Royal Warrant of 29 July 1830, but was re-established on 23 October 1854.

Joseph Schembri was born on 2 April 1787. He was just sixteen years old when, in 1803, he began a two year apprenticeship to Mr G M Grech, Apothecary to the City of Valletta. In 1804, he attended the National Hospital of Malta, and over a period of twelve months followed the lectures in anatomy, physiology and the practice of surgery given by Aurelio Badat.13

At nineteen years of age, Joseph Schembri was examined by a Medical Board in Sicily on the orders of Inspector of Hospitals William Franklin, head of the medical staff in the Mediterranean. Joseph passed his examinations before the Army Medical Board and the Committee of the Royal College of Surgeons of London. On 17 January 1807, he was appointed Warrant Hospital Mate and served at the General Hospital Messina.

Early in the 19th century, Napoleon had secured total dominance over Europe. In an attempt to cripple England's trade, he not only imposed a continental embargo on British goods, but coerced those who opposed him with military force. Portugal was invaded as she refused to close her ports. An expedition under General Sir John Moore left Sicily to secure the Portuguese fleet and assist the Court to flee to Brazil. On 25 October 1807, Franklin ordered Hospital Mate Schembri to embark with the army. Moore's expedition was delayed by atrocious weather, so that by the time it reached Gibraltar on 1 December, it found that the Portuguese Court had already fled on 29 November. Moore's mission had become superfluous. Schembri disembarked at Gibraltar and, in April 1808, returned to the garrison hospital Messina.

On 9 April 1809, Austria was at war with France. To assist her allies, Britain launched diversionary attacks against the naval base at Antwerp, and on the Kingdom of Naples. On 25 June, Lieutenant General Sir John Stuart left Milazzo, Sicily, and attacked the islands of Ischia and Procida in the Gulf of Naples. Schembri was present at both sieges, but as Ischia was taken with very little resistance and the garrison of Procida surrendered during the day, his task could not have been arduous. After two months on this futile expedition, the army under Stuart returned to Milazzo. Hospital Mate Schembri took charge of the medical stores at Milazzo and did duty as a hospital mate in the garrison. He remained at Milazzo during the following eighteen months.

On 25 June 1812, Schembri accompanied a diversionary expedition to the eastern coast of Spain. An Anglo–Sicilian force under Lieutenant General Frederick Maitland was to threaten Catalonia so as to prevent Marshal Suchet from reinforcing Marshal Marmont's Army of Portugal. After many unavoidable delays the troops reached the eastern coast of Spain and on 15 August 1812 landed at Alicante. While at the General Hospital Alicante, Schembri became a Hospital Mate for General Service through a commission dated 17 December 1812. On 11 December 1812, the secretary to the Army Medical Board wrote the standard request to Lt Col Torrens at the Horse Guards. "Sir, I have the honour to recommend for the approval of HRH the Commander-in-chief Joseph Schembri gentleman to be Hospital Mate for General Service by Commission vice Gibb promoted".20 Hospital Mates for General Service were frequently referred to as Commissioned Hospital Mates. The last batch to be gazetted in this rank received their commissions on 20 April 1813. From 8 June 1813 new entrants were styled Hospital Assistants to the Forces. On 29 July 1830, this rank was replaced by that of Staff Assistant Surgeons.

Schembri Joseph became an Apothecary to the Forces on 14 October 1813. He remained in Spain until 1814, when he embarked on yet another diversionary expedition. Major General Lord William Bentinck, Commander of the Army of the Mediterranean, assembled his army at Milazzo and Palermo, with the intention of capturing Corsica. With this move he hoped to tie down the French army in Naples. Bentinck, however, altered his plans. On 10 March 1814, he landed at Leghorn from where he proceeded to attack Genoa. Apothecary to the Forces Schembri was present at the siege and capture of Genoa which fell on 17 April. From Genoa, Schembri was instructed by Inspector of Hospitals James Borland, head of the medical department in the Mediterranean, to return with the medical stores to Sicily, and to relieve "the gentleman in charge of the stores in that island".13

Napoleon abdicated in 1814 and was exiled at Elba. He escaped and returned to France, but on 18 June 1815, the conqueror of Europe met his downfall at Waterloo. At the ensuing Congress of Vienna, England agreed to withdraw her troops from Sicily. In June 1815, the Kingdom of the Two Sicilies, incorporating Naples and Sicily, was reconstituted. Following the evacuation of Sicily in October 1815, Schembri moved to Corfu to take charge of the medical stores of the Ionian Islands. On 25 April 1816, he was relieved by Apothecary to the Forces Edmund Starkie.

Joseph Schembri Schembri embarked for England in charge of invalids. He arrived there on 25 June 1816. He was discharged on half-pay on 25 August 181622. He was then 29 years old. While on half-pay, he spent twelve months at St George's Hospital London, and in 1817, four months at the Duke of York Hospital, Chelsea, preparing himself for the examination of the Royal College of Surgeons. In 1816, he attended a twelve month course of lectures in anatomy, physiology and surgery given by the surgeon and anatomist Joseph Constantine Carpue. The following year, he took a four month course of lectures in chemistry given by William Thomas Brande, and concurrently four months' lectures in the Principles and Practice of Surgery given by George James Guthrie. In the first half of the 19th century France was the undisputed leader in medical education and many students continued their studies there. In 1817, Schembri enrolled at the Hotel-Dieu Hospital in Paris where he followed a six month course of lectures in the Practice of Medicine given by Dr J B Larroque. Schembri became a member of the Royal College of Surgeons of London on 2 May 1817. On 30 June 1817, he was examined by the Army Medical Department and afterwards returned to Valletta.

On 26 August 1826, Apothecary to the Forces Joseph Schembri got married in Messina, Sicily, where he established his home. On 13 March 1835, aged forty-eight years he was recalled to full-pay and sent to the Ionian Islands. Apothecaries could not retire on half-pay until they completed 30 years service. Joseph Schembri retired on half-pay on 21 September 1860, at the venerable age of 73 years.

Assistant Surgeon Gavino Patrizio Portelli

Gavino Patrizio Portelli was born in Valletta on 16 March 1795. He was the son of Adele and the apothecary Joseph Portelli. His formative years with the Army Medical Department served him well, for on leaving the services, Portelli become an eminent member of the Maltese medical profession, occupied the Chair of Anatomy and Surgery at the University of Malta, (1822-1838), was Physician to the Civil Hospital, and an Inspector of the Charitable Institutions.

In 1808-1809, at the young age of thirteen, Gavino embarked on a 18 month course of lectures in anatomy given by the surgeon Francesco Buttigieg. Dr Buttigieg was born around 1743. He served in the naval department of the Order of St John of Jerusalem and subsequently in the hospitals of Malta. He held the Chair of Midwifery at the University of Malta until he retired on 31 December 1824, aged 82 years, having practiced the medical profession for a total of sixty years. The government granted him a pension equivalent to his salary of a professor of midwifery of 35 scudi a month. The scudo was equivalent to 1s 8d or 8 new pence.14

Gavino Portelli undertook a four year apprenticeship in his father's apothecary shop in Valletta. William Domeier had this to say about them: "The apothecary shops are upon the whole indifferent; but there is within a few years an English one established, which is preferable to the Maltese, but far from being perfect, this cannot be expected because both the owner and the shopkeeper are army surgeons who generally understand little pharmacy, medicines are sold dear, there being no rival shop and a Maltese apothecary is not able to make prescriptions written according to the London pharmacopeia".9

On 25 March 1809, Gavino was granted a warrant as a Dispenser of Medicines to the Garrison Hospital. He was only 15 years. His salary was five shillings a day. Hospital Mate Lorenzo Sammut was also at the Garrison Hospital at this time. Gavino was keen to further his education and, no doubt, would have learned from Sammut about student life in England. Thus, on 2 July 1812, "being desirous of a more extended field than Malta presented for acquiring professional knowledge", he enrolled himself at the Westminster and St George's Hospitals, where he completed his studies at considerable cost and expenditure to his father.26

In London, Gavino undertook a 14 month course of lectures in anatomy, physiology, and surgery given by Joseph Constantine Carpue. For four months, he attended the lectures on pharmaceutic chemistry given by the physician John Ayrton Paris. In 1813, Gavino enrolled on a four month course of lectures on the theory and practice of Physic given by Robert Hooper, and lectures on materia medica and chemistry given by Dr Joseph Ager. As he had not yet reached the age of twenty-two, Gavino was ineligible to sit for the membership of the Royal College of Surgeons. However, he passed the examination conducted before the Army Medical Board composed of Director General John Weir and the two principal inspectors Charles Ker and William Franklin. He was also approved by the committee of the Royal College of Surgeons London. Gavino had thus fulfilled the first step leading to an army medical commission.23

On 6 September 1813, Gavino was commissioned Hospital Assistant to the Forces and reported for duty at the Duke of York Hospital, Chelsea. His pay was 7s 6d a day, but £4 19s 6d were first deducted from pay as a fee for his commission.

On 26 November 1813, he reported to Inspector of Hospitals James Robert Grant, and on 9 December embarked at Ramsgate on the expedition of General Thomas Graham to Holland. The main objective of Graham's expedition was to capture Antwerp. However, at the storming of Bergen-op-Zoom on 8 and 9 March 1814, Graham's force was repelled with heavy losses. Four surgeons were taken prisoners by the French, and Gavino was said to have been lightly wounded. He was, however, fit enough to accompany the wounded men of the different regiments to York Hospital. He then joined the Army Depot at the Isle of Wight and did duty at Albany Hospital.24

On 26 May 1814, Gavino was commissioned assistant surgeon to the 2nd Battalion 10th Foot. A vacancy had arisen on 5 May 1814 through the promotion of assistant surgeon Thomas Rolston to staff assistant surgeon. Rolston died at Malta on 31 August 1826. Gavino left Portsmouth on 20 September 1814. He arrived at Malta on 25 October and reported for duty to the commanding officer 2nd/10th Regiment. The regimental surgeon was Charles B Hill. The first assistant surgeon was Hugh Orr. Gavino served with the regiment until December 1815. The regimental pay lists for 2nd/10th Foot show him being taken on the strength in September 1814. His regulated stoppage from pay was two and a half pence a day.19

On 23 January 1816, the 1st and 2nd Battalions 10th (North Lincolnshire) Regiments were amalgamated, and assistant surgeon Portelli was discharged on half-pay. His name appears in the army list for the last time on April 1816. Gavino returned to England to complete his studies. In February 1816, he attended three courses of lectures in midwifery given by Samuel Merriman. Merriman was a physician-accoucheur to the Middlesex Hospital, the Westminster General Dispensary and the Parochial Infirmary of St George, Hanover Square. Gavino would probably have become familiar with Merriman's "Synopsis of the various kinds of difficult parturition with practical remarks on the management of labours". This was printed in 1813 for the medical gentlemen who attended Merriman's courses of lectures. On 3 May 1816, Gavino became a Member of the Royal College of Surgeons, London.

Gavino was recalled from half-pay on 8 August 1816. He proceeded to the Isle of Wight, where, together with Staff Surgeon Ware, superintended the surgical division of the hospital. Two months later he embarked for Malta. In October 1816, he joined the 1st Battalion 10th Regiment at Corfu. On 30 August 1817, he went with the flank company to Zante, and was in charge of the hospital until 28 November 1818. Gavino was then ordered to proceed to Cephalonia and embark for Malta. He arrived at Malta on 22 December 1818, where Inspector of Hospitals Robert Grieves recommended him for the post of First Surgeon of the Civil Hospital "so as to introduce into the Civil Hospital the improved system of those of the mother country".15 Gavino took up his new appointment on 1 January 1819. In November 1822, he occupied the Chair of Anatomy and Surgery at the university. He also became a member of the Board of Health and the Medical Committee. His annual salary was £200.15

Gavino was discharged from the army on 24 March 1819 and placed on the half-pay list. Relegation to half-pay threatened to cut short a promising army career, but the expertise doctors gained on the battlefield served them well in their civilian life. The half-pay of an assistant surgeon was four shillings a day. This was looked upon as a pension for military service. However, those on half-pay were liable to be recalled to the service. Thus, on 24 July 1825, Gavino was quite taken aback when unexpectedly the Army Medical Department ordered him to fill the vacancy of second assistant surgeon 28th (North Gloucestershire) Regiment in the Ionian Islands. His name duly appeared in the army list as assistant surgeon 28th Foot, only for September and October 1825, as he did not take up his post.

An assistant surgeon was the first rung in the ladder for medical gentlemen who aspired to pursue a career in the army medical service. Gavino was by then First Surgeon in the Male Civil Hospital and Professor of Anatomy in the University. On 26 July 1825, he made representations to the Lieutenant Governor of Malta, Lieutenant General Sir Manley Power, to annul his posting order to 28th Foot. The army was not willing to pay their regimental surgeons half-pay of 4 shillings a day for life, if they could not deploy. The half-pay list acted as a reserve of officers who could be called upon when the need arose. Gavino set out his reasons for not complying with the request from the Army Medical Department.

"My knowledge of the English language and my professional studies acquired under the best practitioners in England combined, rendered my services desirable in an establishment not confined to the inhabitants of Malta, but in which men of all countries and especially foreign merchant seamen are continually received. I have now remained in the surgical charge of the establishment for six and a half years, and during that time have performed as many capital operations with entire success as can perhaps have fallen to the lot of many of my professional brethren, and have very materially aided the professional studies of the native students so that when I hold the appointment conferred on me by the late governor as extremely flattering I am led from the results to hope that the advantage to the Government of the island and the inhabitants have been equally beneficial, and that as a native Maltese in whom one blended from a residence in England and a connection with its military establishment, the disposition and habits of a British subject, a connecting link was given to the object of my pursuits which I may confidently assert would not have existed under the charge of a foreigner. Viewing my own situation as it is affected by the appointment to the second assistant surgeon of the 28th Regiment, it will not be deemed indecorous when I regard that the appointment as humiliating. It is almost the first step taken in the army by the very junior branches of the military service, it is the first appointment a Hospital assistant expects and has been very frequently conferred after only a few months service and to this I am about to be recalled from the surgency of one of the first Government establishments perhaps in Europe".16

The government could not afford to lose him. It petitioned Earl Bathurst to use his influence and power with the Army Medical Board so that Mr Portelli may be allowed to remain in the civil service of the Malta without forfeiting his right to the half-pay of his military rank. "The removal of Portelli from the civil service of the island in which he has made himself eminently useful, would be embarrassing to government for it will be exceedingly difficult, if not impossible, to find a person equally qualified in every respect for the duties which he has for a length of time discharged with great credit to himself, and to the entire satisfaction of government".17

In 1833, Gavino was once more recalled from half-pay. Once again the Civil Government intervened. Gavino remained in Malta but had to swap his half-pay for the commuted allowance of £213. This was returned to the Malta Treasury which increased Gavino's salary by 4 shillings a day, equivalent to his half-pay.17 Gavino's annual salary of £175 as surgeon to the civil hospital had included his military half-pay. The increase in salary to £200 was authorised, but was not to extend to his successor.18

On 28 November 1822, Gavino became Professor of Anatomy and Surgery on a salary of £25 15s. He augmented his income by a further £12 5s from paying students. In 1838, Major General Sir Henry Frederick Bouverie (1836-1843), objected to one person holding both the academic and clinical posts. Gavino had to relinquish the Chair of Anatomy and Surgery, which was conferred on Dr Charles Galland on 1 January 1839.

In 1837 Gavino volunteered to take charge of the temporary hospital established at Fort Ricasoli for the victims of the cholera outbreak.

On 1 January 1850, Gavino succeeded Antonio Speranza, as First Physician to the Civil Hospital. The Malta Mail protested about the way "Portelli was most strangely transplanted into the vacant post, on the grounds that a good surgeon might make a good physician, and that as an army surgeon Portelli was necessarily a physician". The Malta Mail considered that the government had erred in deducing that Gavino was fully competent for the office of Senior Physician, for whatever surgical merits he enjoyed, in the eyes of the paper, he had no such consideration as a physician.25

In February 1858, Joseph Becket Henry Collings, Inspector of the Charitable Institutions, succeeded Sir William Thornton as Auditor General of Malta. Gavino succeeded Collings as the new Inspector of Charities. His tenure was short lived for he retired in December 1858, and Ferdinando Vincenzo Inglott became the new Comptroller of the Charitable Institutions. Gavino Patrizio Portelli died on 7 January 1865. He was interred at the Capuchin Church, Floriana, but his grave was destroyed during the bombings of the second world war.

Epilogue

The lives of Giuseppe Schembri, Lorenzo Sammut, Joseph (Josiah) Schembri, and Gavino Patrizio Portelli, demonstrate that Maltese doctors were not averse to pursue every avenue that enhanced their medical knowledge or furthered their careers. They travelled to foreign universities to pursue higher knowledge irrespective of the personal and financial hardships which these entailed. At first, Maltese medical graduates headed to the Italian mainland. Under the British administration of Malta the Maltese headed to the English hospitals and universities where they undertook higher training and obtained the necessary higher qualifications which enabled them to obtain better employment on their return home. Maltese doctors in the early 19th century either took up work with the charitable institutions as doctors of the poor or entered the naval service of the Order of St John. It seems natural for those intent on a military medical career to seek employment with the British medical services which filled the vacuum left by the expulsion of the Military Order of St John. The four doctors portrayed here may not have influenced the events of their times, but they certainly were involved in the wars and campaigns which shaped the history of the 19th century. The experience they obtained on foreign service served them well on their return home. Gavino Portelli as Professor of Anatomy and Surgery for over 16 years was influential in shaping the medical careers of the young students who attended his courses. They were pioneers of their age and established a path for others to follow.

Bibliography