RAMC

The Very Long Hiccup
Origins of the Army Medical Services in Malta

search maltaramc

The Emergence of the Army Medical Services in Malta

Introduction

On 5 September 1800, the Maltese Islands became a British Protectorate. Malta developed into an Island Fortress. Its strategic location in the centre of the Mediterranean, made it an important naval base and staging post for troops en route to the Middle East and India.

The path leading to the British Crown gaining control over Malta started on 12 June 1798, when Napoleon Bonaparte expelled the Order of St John of Jerusalem, that had ruled the islands since 26 October 1530. Napoleon rushed in such radical changes to the civil and religious administration, that he alienated the population. On 2 September 1798, simmering discontent erupted into an insurrection. The French withdrew behind the fortifications of Valletta and the Three Cities.

Malta's Achilles heel had always been its inability to feed itself. The island imported as much as two thirds of its annual consumption of wheat and barley from Sicily. Any disruption in the importation of food would inevitably starve the island into submission. In the besieged towns, provisions ran out on 4 September 1800, compelling General Claude Henri Vaubois to capitulate.

This chapter explores the medical aspects of the Maltese siege of 1798–1800, Nelson's so called Very Long Hiccup,1 which saw the start of the British Army Medical Services in Malta.

The Maltese Uprising – 2 September 1798

On 12 June 1798, the French Army of the East took Malta with virtually little opposition, mainly because it had promised to respect the religious privileges and freedom of worship of the Maltese. The administration of Regnaud de St Jean d'Angely soon reneged on the Articles of Capitulation signed on board L' Orient. Pensions and creditors ceased to be paid, depriving people of their livelihoods. Religious institutions were suppressed and the silver and gold of precious reliquaries were converted into bullion for the military chest.

On Sunday 2 September 1798, an angry crowd prevented the removal of silver and damask from the church of the suppressed Carmelite convent at Notabile (Mdina). Villagers from Zebbug and Siggiewi flocked to Rabat. The situation would have been defused, were it not for the arrogance of Louis Masson, the officer in charge of the Mdina garrison. He foolishly confronted them with sword unsheathed. The mob set upon him, and slew him. The French closed the gates of Mdina. They bombarded Rabat, killing Master Carpenter Giuseppe Galea. On the following day, the rebels gained entrance to Mdina and massacred the detachment of 65 men.2

The Maltese organised themselves. Armouries were raided and cannon from the coastal towers were dragged to batteries set up in strategic positions outside the fortified towns. The insurgents of Notabile, Rabat and Dingli were led by Notary Emmanuele Vitale, who was also elected commander of all Maltese troops. Those of Zurrieq and Zebbug, however, recognised only Canon Francesco Saverio Caruana. The armed camps were:3

The number of armed Maltese manning these posts was reported by Brigadier General Thomas Graham on 28 December 1799, as 2,358 men, consisting of 149 sergeants, 170 corporals and 2,039 private soldiers. In July 1800, Captain James Vivion RA, Acting Quarter Master General with responsibility for the pay and rations of the troops, returned a total of 3,282 men provided by the various casals to man the outposts. From these, on daily guard duty at the posts and batteries between St Julians and St Roche were 174 sergeants, 179 corporals and 1,854 privates (table I). This number concurs with the dispatch from General William Anne Villettes dated 15 May 1802, which stated that the number of volunteers in the field during the blockade never exceeded 4,000 men, of all ages and descriptions. When on duty, Vivion paid them at the rate of: sergeants 44 ounces of bread, pay 3d; corporals 44 ozs of bread, pay 2 1/2d; privates 40 ozs of bread, pay 2d. The men only received half pay when off guard duty.

Table I. Number of soldiers occupying each outpost.
Post Sgts Cpls Ptes Total
San Giuseppe (Hamrun) 24 14 182 220
Citta Vecchia and Rabat 8 4 136 148
Harhar or Borg 45 22 296 363
Ta' Borg (Tarxien) 15 26 220 261
Zabbar (St Roche) 8 39 366 413
San Antonio 8 7 89 104
Ta' Samra 29 13 158 200
Corradino 16 18 200 234
Zejtun 21 36 207 264
Total 174 179 1854 2207
Table I. Strength of Maltese at various posts prepared by J. Vivion upon the arrival of Maj Gen H. Pigot to take command of Malta in July 1800 (TNA:CO 158/6).

The uprising had a slim chance of success. The Maltese lacked the resources to dislodge the French from their impregnable strongholds. Moreover, not only did the countryside not grow enough food, but also, the harvest was stored in silos in the now occupied cities. The siege could only be terminated by either an internal revolt against a demoralised garrison, or through a total sea blockade, choking off the French from their logistical support. The first option was tried but was unsuccessful. On 11 January 1799, a plot to take Valletta from within failed. The gates of Marsamxetto Harbour and Porta Reale were to be opened, but the conspirators were discovered in the old Lazaretto by Lt Roussel who was waiting to be ferried across to Fort Manoel. A further attempt, to take Cottonera on the night of 15 February 1799, also floundered.

The alternative, that of starving the French by a total land and sea blockade, harmed the townfolk as much, if not more, than the garrison. On 18 September 1798, the Portuguese flag ship Principe Reale and three vessels under Admiral Marquis de Niza commenced a blockade of the Grand Harbour. They remained off Malta until 18 December 1799. De Niza disembarked his marines, twenty artillery men and two officers, and gave the Maltese firelocks and gunpowder. The names of two Portuguese appear in the burial register of Tarxien. Domenico Consalvo Drago, aged 28 years, died on 8 October 1798 at Corradino, and Emmanuele Franciscus aged 25 years, died on 12 January 1799.2

On 18 October 1798, the Portuguese were reinforced by HMS Alexander under Captain Alexander John Ball RN, HMS Terpsichore, the sloop La Bonne Citoyenne and HMS Incendiary. Vice Admiral Lord Keith, Commander in Chief of His Majesty's Ships in the Mediterranean, maintained a tight sea blockade which led to the eventual starvation and capitulation of the garrison.

British Reinforcements

The insurgents were initially supported by British gunners and around five hundred Portuguese and British marines. The first two infantry regiments under the command of Brigadier General Thomas Graham did not arrive until 10 December 1799.

The blockading naval squadron, which also included HMS Goliath, HMS Lion, and HMS Penelope cruised off Malta and moored at anchor in Marsaxlokk Bay, off St Julians and on St Paul's Bank where it restocked, watered and repaired sails and rigging damaged in the gales. In October 1798, Nelson had given Captain Alexander Ball RN command of the squadron blockading the French garrison and in February 1799, he was appointed by His Sicilian Majesty to the chief command of the Maltese.

On 20 December 1798, the Bomb Vessels Strombolo, Perseus and Bulldog with their tenders entered Marsaxlokk Bay. Each vessel had a subaltern, an NCO, and nine or ten gunners for service of the two mortars. Strombolo landed her 13 inch and 10 inch mortars and put ashore her carpenter, who prepared the platforms for the mortars. On 29 December, she disembarked Gunners William Crawford, John Mullholland and William Willey, under the command of Lieutenant James Vivion RA. The Perseus and Bulldog also landed their gunners.4

The surgeon of the Bulldog was Thomas Roblyn. He served during the blockade and surrender of Malta, and was taken prisoner at Ancona. Once released, he went to Egypt where he became surgeon to the brigade of sailors and co-operated with the army on shore during the fall of Cairo. He returned to England as surgeon of HMS Ulysses. In 1802, he was paid off at Woolwich, when the end of the French Revolutionary wars reduced many naval surgeons to half-pay.5

On 29 January 1799, Strombolo returned from Sicily and moored in St Paul's Bay, where she landed five more artillerymen. Later, two more gunners of Captain G Bowater's Company joined the detachment from the tender Severn. A gunner died on 24 January 1799. By the end of March 1799, two of this small party were dead and three were dangerously ill. Sixteen gunners, one bombardier and one corporal arrived on 26 December 1799 under Lieutenant Samuel Reynell RA, but they lacked essential winter clothing.6 This brought the total number of gunners in Malta to 2 officers, 2 corporals, 1 bombardier, and 23 gunners. In addition, three wives, Mrs Walker, Mrs Johnston, and Mrs McLaughlin accompanied the detachment. On 3 May 1800, an officer, 16 gunners, one bombardier from the transport Wakefield landed at Marsaxlokk Bay.

Marines from the naval squadron were deployed ashore in an infantry role. On Wednesday 16 January 1799, HMS Alexander landed her marines and 3 Lieutenants with 40 seamen but these returned on board on 19 February. In March 1799, Major James Weir RM landed in Malta with 60 marines. On Sunday 18 August 1799, HMS Lion disembarked her marines, and on 28 August HMS Audacious arrived off Marsaxlokk Bay and landed her marines. In December 1799, shortly after the arrival of the 30th and 89th Foot, the Portuguese marines on duty ashore were relieved by marines from HMS Culloden and Northumberland which disembarked the captain of marines, 3 lieutenants, 2 sergeants, 2 corporals, 1 drummer and 60 privates, with provisions for one month. The Northumberland also landed military stores and supplied the army with 5,300 lbs of flour and bread.

By 28 December 1799, Graham had 20 officers of marines, 17 sergeants, 7 drummers, and 312 private soldiers of whom 90 were sick. The marines occupied the camp of San Giuseppe, (Hamrun). They protected the road from Valletta to St Antonio and Citta Vecchia and supported the advanced posts and batteries of Ta' Samra and Jesuit's Hill.

On 22 January 1799, the French had occupied Naples and established the Parthaenopean Republic. To counteract their threat to Sicily, Lieutenant General Charles Stuart embarked the 30th and 89th Regiments at Minorca and arrived in Messina on 18 March. The risk to Sicily was short lived, freeing the British troops for deployment elsewhere. On Monday 9 December 1799, HMS Culloden and HMS Foudroyant with the 30th and 89th Regiments from Messina anchored in St Paul's Bay. Gales, rain, lightning and thunder greeting their arrival.

Graham would have preferred to have had the 90th Perthshire Light Infantry, which he had raised in 1794 and in which he had full confidence, rather than the 30th and 89th Foot.

I should feel a particular satisfaction, not only from the accession of numbers, but of quality of the troops, for I should be perfectly sure of their loyalty and attachment. I am concerned to state that these two regiments in which there are a great number of Irish of the worst description cannot be much relied on, three have already deserted from the advanced post of St Roche.7

On 11 December, the 30th moved from Birkirkara to Ghaxaq and Zejtun, near their supply ships at Marsaxlokk. Their task was to support the advanced post of Zabbar and the battery of St Roche to the far right. The 89th moved to Gudja and Luqa to secure the advanced post of Tarxien and Ta' Borg Battery in front of it. Three companies of the 89th remained at Naxxar. The post at the head of the Grand Harbour was left entirely to the Maltese as:

The marsh air rendered its location so unhealthy for our people that I was obliged to remove them, and though by that communication with the marines is interrupted, I was not sorry to be able to concentrate the two regiments towards the point of the greatest importance opposite Cottonera and Fort Ricasoli, from which the enemy could have such facility of coming out in force in several columns, though direct roads have been blocked. All the duty of the advanced part of the line in front of Zabbar is done by Maltese.7

Graham's orders were to assist the Maltese in expelling the French. However, he was to immediately re-embark his troops and return to Messina if local conditions precluded him from contributing significantly to the resolution of the siege. His force was insufficient to storm the extensive fortifications, and he could do no more than bolster the land blockade and wait for reinforcements.8

A company and a half of Neapolitan Artillery reached Malta on 19 January 1800. On 16 February 1800, 1,200 Neapolitan troops arrived on the Phaeton from Palermo and landed at Marsaxlokk. A further 900 men, under Colonel Fardella, arrived in April. The Neapolitans went to Birkirkara and reinforced Camp Harhar.

Table II Strength of 30th and 89th Regiments
Regiment Officers Sgts Rank and File Women Children
30th 31 34 418 20 15
89th 29 32 426 42 0
Total 58 66 840 62 15
Table II. Strength of 30th and 89th Regiments on their disembarkation at St Paul's Bay on 10 Dec 1799. (TNA:WO 17/2117).

On 10 May 1800, Graham had only 2,092 rank and file fit for duty. Of these, 400 were newly raised Maltese and more than 700 unreliable Neapolitans. In addition there were about 2,000 armed peasants under the command of Governor Ball. As half of these were allowed to go to work during the day, they were useless in an emergency, and were too tired and sleepy at night. They had no other officers, but sergeants, and though they were active brave hardy fellows, they were under no form of discipline nor restraint.

In May 1800, General Sir Ralph Abercrombie was granted command of British Troops in the Mediterranean. Abercrombie reached Minorca on 22 June 1800. Orders from Henry Dundas instructed him to assist the Austrians in Italy, and to augment British troops in Malta to 2,500 or 3,000 men, so as to render the blockade more effective, and release the marines back to the fleet. Accordingly, he embarked the 28th, 1st/40th, 2nd/40th, 48th, 90th, and De Roll's Regiment for Genoa. However, by the time he reached Leghorn, events had overtaken him. Napoleon had defeated the Austrians at Marengo on 14 June, and hostilities had ended. The 48th Regiment was redirected to Malta, where part of it arrived on 28 July 1800.

On 4 July 1800, Major General Henry Pigot arrived at Malta from Minorca with the 1st/35th (Dorsetshire) Regiment. The troops disembarked at St Paul's Bay. The 1st/35th moved into the Villa of Chevalier Paolo Parisio at Naxxar. On 18 July, 500 men of the 2nd/35th Regiment reached Malta, having left Minorca on 23 June. The 35th had left a number of sick behind in Minorca and a large number of them fell ill shortly after their arrival (Table III).

Abercrombie reached Malta on 17 July 1800. After inspecting the massive fortifications, he ruled out landing troops within the precincts of Forts St Elmo or Ricasoli to take either by storm or to attack the Cottonera on its land front. In fact, he did not think that Valletta would ever be forced to surrender. Captain Martin RN, commanding the blockading naval squadron, advised him that the sea blockade might be continued with tolerable certainty till the end of October but afterwards the maintenance of the blockade by sea becomes a matter of great uncertainty, and that a determined enemy naval squadron has much opportunity at that season of throwing in supplies.9 Abercrombie, therefore decided to withdraw the troops and lift the blockade, if the French had not surrendered by October 1800.

The French Garrison

The Army of the East departed for Egypt on 18 June 1798. It left behind 500 sick men in hospital and a garrison of between 3,650 and 6,000 men. Bosredon de Ransijat, President of the Civil Government Commission, gave the strength of the garrison as four divisions 3,650 strong. This was augmented by the crew of La Diane, Le Guillaume Tell and La Justice, which had escaped from the Battle of the Nile, to bring the total strength of the garrison to about 5,100 soldiers and sailors. On 31 December 1799, Lieutenant Colonel Lewis Lindenthal gave the strength of the French garrison as 2,500 soldiers, 1,500 sailors, 130 Guarde Nationale and 70 Maltese; a total of 4,280 men with 200 in hospital.

French troops made a number of sorties to spike the guns, collect fire wood and devastate the countryside. In the first sortie of 3 September 1798 to relieve Mdina, two companies of Carabiniers of the 23rd Demie-Brigade of Light Infantry were held in check at San Giuseppe by a large armed crowd. The insurgents lost Angelo Mallia and Giovanni Borg; the French lost T. Attard, G. B. Trigance and Ferroni, commanding the former Maltese Regiment of Cacciatori. Attard left a widow and 10 children; Trigance left seven orphaned children. On 23 November 1798, Regnaud de St Jean d'Angely reported to the French Directory that they had lost between 25 and 30 men in the first sortie and in a single sortie on Zabbar without any Success, and that there were around 400 sick in the hospital.

On 18 October 1798, Vaubois rebuffed the offer of the Marquis de Niza to evacuate Malta. At this very early stage in the siege, he was probably right to do so, for he was well stocked with grain and knew very well that the fortifications were virtually impregnable. Vaubois prolonged the miseries of the besieged towns by two years, through his conviction that the French Directory would eventually succour him. Indeed, a number of ships did manage to evade the naval blockade, but the supplies brought in were never enough to sustain a prolonged siege.

On 18 February 1800, the brig El Corso, HMS Alexander, HMS Success, HMS Foudroyant with Rear Admiral Lord Nelson, HMS Northumberland, HMS Audacious HMS Lion and La Bonne Citoyenne intercepted the armed store ship, Ville de Marseilles which had sailed from Toulon on 7 February loaded with salt meat, brandy, wine and clothing for the relief of Malta. Escorting it were the Genereux of seventy four guns, the Badine of twenty four guns, two corvettes and 4000 troops. The Genereux and Ville de Marseilles were captured and 147 French prisoners were received on board HMS Alexander, but the corvettes escaped.

On 29 March 1800, the French ship of war Le Guillaume Tell of eighty six guns and one thousand men, attempted to sail out of Valletta. She was intercepted by HMS Foudroyant, HMS Penelope and HMS Lion. After a most obstinate defence lasting three and a half hours, Le Guillaume Tell struck her colours and was taken as prize to Syracuse. She was subsequently renamed HMS Malta. Surgeon Nathaniel Wilson of HMS Penelope recorded in his journal that on boarding the captured ship:

There were found nearly 300 killed and wounded, out of which number there were 30 capital operations, a number far beyond the power of a surgeon and his mate to attend to. Several who lost their legs and arms, except a small portion of the skin by which they were suspended, remained in that state, without even the application of a tourniquet, for the space of from eight to ten hours, without haemorrhage of the least consequence taking place. This might be a great inducement to surgeons to delay operating during the time of action in order to have day light.10

The French were unable to break through the naval blockade, despite their determined efforts to relieve their garrison. On 18 June 1800, La Revanche from Toulon with 27 men, part laden with brandy, wine, cheese, pork, dispatches and provisions for Malta, was captured by HMS Phoenix. On 26 June, the Aviso Intreprenante of four guns and thirty six men, the Aviso La Redoutable with four guns and thirty six men, and the Felucca La Fortune which had left Santa Messa in Corsica t0 Valletta laden with provisions, were seized by HMS Success. On 1 August 1800, it was the turn of the French National Ketch L'Etoile of six guns and sixty men, laden with provisions from Toulon to be taken prize by the brig Vincejo.19

With his food stocks dwindling, Vaubois' hold on Malta for the Republic became increasingly precarious. On 24 August 1800, he let go of the frigates La Justice and La Diane of 42 guns with 114 men on board. These were pursued, and La Diane was captured by HMS Success the Genereux and HMS Northumberland after a running battle of some hours, but La Justice escaped under cover of darkness.

On 4 September 1800, Vaubois surrendered to Major General Henry Pigot. British troops took possession of Cottonera and Fort Ricasoli, Fort Tignè and Floriana. From that date, Great Britain retained a continuous military presence on the island until 31 March 1979.

Morbidity and Mortality of the Siege

Non Battle Casualties – Nutritional Deficiencies

The number of seamen in time of war who died by shipwreck, capture, fire, famine or sword are but inconsiderable in respect of such as are destroyed by the ship diseases and by the maladies of intemperate climates. — James Lind, An Essay on the most effectual means of preserving the health of seamen, 1757.

In September 1798, Regnaud de St Jean d'Angely, gave the population of Malta as 114,000, with 75,000 people occupying the countryside and 39,000 living within Valletta and the Three Cities. During the blockade the number of inhabitants dropped to 94,000. In February 1802, the memorandum of the Deputies of Malta and Gozo to Lord Hobart, Secretary of State for War and Colonies, declared that the Maltese losses in the siege of 1798–1800 were about 20,000 men, women and children.11 This figure concurs with that of Alexander Macaulay, secretary to Alexander Ball (1801–1804), who on 25 January 1804, remarked that during the French occupation the population of the two islands had decreased by 17,000.12 Chevalier Bosredon de Ransijat recorded that 555 military and 2,468 inhabitants had died in the towns by the end of the first twelve months of the insurrection, September 1798 to August 1799.13

The insurgents died of hunger, from wounds sustained in battle, and from diseases, predominantly gastrointestinal and pulmonary. The majority of the rebels were farmers, labourers, cotton weavers, or herdsmen. Their diet had consisted merely of barley bread, with a few small onions or radishes, a few salted olives and sardines. Supper consisted of soup with macaroni and bread. Ill health was due to insanitary conditions, where food and drink were contaminated with fecal matter, coupled with a poor diet which predisposed them to anaemia, a lowered immunity, and a reduced resistance to infection. Dr Charles Galland, Professor of Anatomy at the University of Malta (1839–1858), using the burial records for the years 1827 to 1836, estimated a labourer's life expectancy of 30.5 years.14

The two year siege of 1798—1800 bore striking parallels with that of 1940—1942.15 During both periods the civilian population suffered increased privation and anxiety. There was a progressive deterioration of the simple conditions of every day life. Food rations, and the supply of fuel to cook the little food available, were progressively curtailed.

The people were in fear for their lives as the insurgents bombarded the town. Vaubois stated that the extreme fear that females had of bombardments had caused them to come out in a scrofulous illness, which the doctors ascribed to suppressed fear.16

The water supply from the aqueduct was interrupted by the insurgents and the people in the cities had to rely on rain water collected in underground cisterns. This was contaminated with sewage from leaking cesspits, increasing the incidence of dysentery and typhoid. The inability to keep clean favoured the spread of scabies and body lice. The deteriorating sanitary arrangements manifested themselves in nematode infestation. Almost everyone in the towns had worms. Dr Robert narrates how his men became loaded with Ascaris lumbricoides which caused abdominal pain and intestinal obstruction.

Food became scarce and expensive to buy. The calorie value of the diet dropped to a dangerously low level as the siege became more severe, and fresh protective foods such as eggs, milk, vegetables, and meat became practically unobtainable. Fresh meat, mainly goats and horses was reserved for the hospitals. Nutritional deficiency disorders like scurvy from lack of Vitamin C, night blindness from lack of Vitamin A and pellagra due to Vitamin B3 deficiency became prominent in both sieges. A moderate amount of pellagra was reported by the Chief Government Medical Officer in his reports for the years 1941 and 1942.

The men ate insufficient calories to maintain their body temperature and lacked the energy to be constantly alert on guard duty. Vaubois repeatedly stated that his men were very fatigued. The inhabitants on the other hand were starved. Their bodies burnt up fat to obtain calories for the normal functions of daily life. Once this had gone, calories were derived from the breakdown of structural protein. They became the living skeletons that Vaubois saw all around him. In such a hypo-proteinaemic state they developed famine oedema and died from the slightest infection such as diarrhoea.

As the people became debilitated and their ability to fight infections declined, starvation, measles, typhoid, diarrhoea, and tuberculosis (phthisis) took their toll. Louis De Boisgelin in his Ancient and Modern Malta wrote:

Though the blockade had only lasted six months, the sufferings of the people were incredible. The number of civilian sick increased every day, and though it cannot be said that they literally died of hunger, yet they certainly were in want, not only of proper food for people in their situations, but of every comfort necessary for the restoration and preservation of their health. The mortality among the soldiers increased in an extraordinary manner and caused the utmost alarm, particularly as it was natural to suppose that the heats of the summer would still more increase it, none of the sick being as yet inured to the climate.17

The French troops who had disembarked at Malta on 10 June 1798 were veterans of campaigns in Italy and the Rhineland. They brought with them venereal diseases and malaria which they had acquired abroad. They were on a diet of bread, wine, salted meat, pork and small quantities of beans and rice, which predisposed them to scurvy, night blindness and pellagra. Vaubois may himself have shown the early signs of pellagra for on 14 February 1799 he wrote: Unhappy for me the salty air, L'air salin, of the country has made a turmoil in me. I am covered with scruffy and itchy patches (de dartres vive), and I am sensitive to change in mood, which, however, does not prevent me from doing my duty.16

Scurvy appeared concurrently with night blindness. Dr Robert, chief physician of the French hospitals in Malta, reported that when the remains of the squadron from Aboukir entered harbour, 50 sick with second degree and third degree scurvy were admitted into the hospital. Among the troops, scurvy appeared in a mild form at the end of Frimaire an 7, (November–December 1798), worsened during Germinal (March–April 1799), and decreased during Messidor (June–July 1799), only for it to be replaced by intermittent and putrid fevers.18 On 28 June 1799, Vaubois notified the Minister of War, that for several months, he had been losing between 100 and 130 men a month from illness.

The number of scorbutics in the Grand Hôpital increased from 400 to 636, so that it was necessary to open another hospital in the Auberge de Baviere. On 8 June 1799, Vaubois reported to the Minister of War that:

For ten months we have been blockaded a cruel epidemic, a terrible scurvy has taken a part of our comrades. A sickness of another type has deprived us of a number of defenders who are absolutely blind at night. The rebels are but living skeletons. They die about twenty a day and maybe more. For several months we lose through sickness 100 to 130 per month. Without the crew of the Guillaume tell, Diane and Justice we would have had to abandon the fortifications to the enemy.16

Night blindness, rheumatism and diarrhoea became acute in the winter of 1799. Dr Robert blamed night blindness on the penetrating night dew and exposure to the salt laden air, l'air vive et salin. The soldiers in Fort St Angelo and Fort St Elmo had more night blindness than those guarding the Floriana fortifications. Dr Robert considered the men stationed in the low lying region of Valletta to be more exposed to the cold damp and humid air than those on the lofty bastions, and hence more liable to night blindness. Those affected obtained relief of their cruel infirmity by using vapour baths, bains de vapeurs, at the hospital.

British troops were well supplied with fresh food and did not report any nutritional diseases, although a few cases of scurvy were reported in the journal of HMS Lion. However, drunkenness, venereal diseases, malnutrition, enteric fever, typhus or lice borne fever, tuberculosis or phthisis, accidental injuries from falls, and overcrowded unhygienic transports, all took a toll on their health. On 23 June 1800, Lt Anaeas Anderson, 1st/40th Foot recorded the terrible conditions when the 40th were all ordered to embark the Hindostan at Minorca.

The scene of confusion on going on board is not easily described, there being no less than 1,300 men and 60 officers crammed into one ship, without accommodation of any kind. There was not, indeed, sufficient space for the officers and men to lie down even on the deck, subjecting troops to such distressing inconvenience the heat of the weather would infallibly have carried off one third of them.20

Non Battle Casualties – Fevers

Fever is a symptom of an infectious illness, but in the 19th century it was itself classified as a disease. Before the advent of bacteriology it was virtually impossible to disentangle its aetiology. Fevers were named after the predominant symptom or the location where they occurred. Thus, there was malignant, jail or camp fever, intermittent or marsh fever and Mediterranean Fever (brucellosis). Fevers were thought to be transmitted either by a contagion, through contact with an ill person or his fomites, or through an infected atmosphere vitalised by miasma.

Fever was ubiquitous among the besieged and the besiegers during the two year siege. Dr Robert noted that in spring, the Maltese suffered from fevers of sudden onset and bilious type; in autumn putrid and malignant fevers developed; while in winter, the continuous, remittent and intermittent fevers made their appearance. Remittent and intermittent fevers were attributed to effluvia from marshes, but were probably malarian in origin. The parasite would have been brought over from Sicily and spread through the bite of the female anopheles mosquito, which bred in the stagnant waters around Marsa.

Table III Morbidity and Mortality British Troops December 1799 – November 1800
  24 Dec 24 Jan 23 Feb 24 Mar 24 Apr 24 May 24 Jun 24 Jul 24 Aug 24 Sep 24 Oct
30th Total 487 486 487 492 494 445 533 561 501 540 534
30th Sick 7 (1.44%) 11 (2.26%) 18 (3.69%) 18 (3.66%) 18 (3.64%) 22 (4.94%) 17 (3.19%) 24 (4.28%) 30 (5.99%) 36 (6.66%) 39 (7.30%)
30th Dead 1 0 3 0 1 2 4 5 4 7 0
89th Total 478 456 525 492 454 457 526 483 520 507 498
89th Sick 7 (1.45%) 84 (18.42%) 161 (30.66%) 90 (18.29%) 60 (13.22%) 31 (6.78%) 37 (7.03%) 33 (6.83%) 57 (10.96%) 65 (12.82%) 66 (13.25%)
89th Dead 2 25 16 6 0 0 3 1 13 3 2
1st/35th Total                 1029 996 936
1st/35th Sick                 197 (19.14%) 202 (20.28%) 180 (19.23%)
1st/35th Dead                 33 49 14
2nd/35th Total                 967 961 967
2nd/35th Sick                 66 (6.83%) 86 (8.95%) 125 (12.93%)
2nd/35th Dead                 4 6 8
48th Total                 625 696 666
48th Sick                 79 (12.64%) 82 (11.78%) 72 (10.81%)
48th Dead                 5 22 9
Table III. Morbidity and Mortality extracted from General Muster Books and Pay lists.

Louse borne typhus or Epidemic typhus, rears its ugly head in time of conflict. The causative pathogen, Rickettsia prowazeki, is passed on from human to human by the body-louse, Pediculus humanus. R. prowazeki multiplies in the lining of the gut so that louse droppings become infective within three to five days after a feed. Dried faeces retain their ability to transmit the disease for many months, thus being a vital factor in the epidemiology of the disease. People become ill ten to fourteen days after becoming infected.

French troops became infected with typhus fever. Dr Robert wrote that putrid fevers erupted in July to September 1799 and proved fatal when complicated by parotitis. Although secondary parotitis can complicate other infections such as typhoid fever, scarlet fever, diphtheria and pneumonia, it is more commonly associated with typhus fever. In severe cases of parotitis, patients develop an abscess with pus accumulating in their parotid gland and die of septicaemic blood poisoning.

In February 1800, typhus fever appeared on board the captured French ships, Le Genereux and Ville de Marseilles. Thomas Alldridge, Purser of HMS Lion, reported that:

Those prisoners infected with a bad fever were sent to Comino, an uninhabited isle to the north of Malta, where a sufficient quantity of clothes and provisions was first placed on one side of the isle. The prisoners were disembarked at the other end of the island, made to strip, wash in sea water and vinegar, and dress themselves in their new clothing.21

A typical case of typhus putrida was that of 15 year old midshipman Alfred Coulson of HMS Penelope. On the morning of 1 August 1800, Mr Coulson complained of having caught a cold the previous night. He had severe groin pains which prevented him from walking the deck in his watch. He developed a violent headache, was very hot, had an irregular pulse and great debility. On the third day his ankles and feet became swollen, he slept fretfully and complained of intense pains of his limbs. He became delirious on the fifth day of his illness, and acquired petechiae and a black discolouration of his teeth on the sixth day. He became sensless on the seventh day and died shortly after.10

In the first quarter of 1799, an epidemic of acute fevers, some of them petechial, broke out among the insurgents. This reached its height in the spring of that year. The fever was of a severe and malignant type, of the most serious nature, that had existed already in the countryside. Thousands succumbed. All the inhabitants were in a great panic. The first to be affected were 28 female refugees who had sought shelter in the bishop's seminary in Mdina. On 11 March 1799, the National Congress prohibited burials inside churches, lest the air became fouled with noxious miasma, and ordered the opening of new cemeteries outside the limits of villages.22

On 31 March 1799, Captain Alexander Ball on HMS Alexander reported to Admiral Nelson that the:

Miseries and wretched poverty of the Maltese have caused a malignant fever to break out, which has swept off a number of the troops as well as inhabitants. All the Portuguese and Neapolitan officers are sick, and some in a very dangerous way. Out of eleven British artillerymen who were landed here, two are dead and three are dangerously ill. The infection got into my ship, from having frequent communications with the inhabitants, and the sick list suddenly increased from five to twenty-seven, of which two only died, all the rest recovered and the ship is now as healthy as ever, by taking precautions and fitting up a house in an airy situation on shore, where I sent every man who had the slightest symptom of the fever.23

The location of this house in an airy situation is not known. On Saturday 13 April 1799, the captain's log of the Alexander records her location on St Paul's Bank when she received 6 men from the hospital and sent 3 sick men to the hospital. Another two sick men were sent to the hospital on Monday 15 April. On 20 May, she hoisted out all the boats and sent them for the sick and received the sick from the hospital.

Surgeon William Burnett of HMS Goliath declared that in May 1799, the ship's company was attacked with a fever similar to the one then prevalent in the island.

Our boats had been employed in watering at Marsascala when a boat's crew and an officer were left on shore all night. A few days later, the officer was attacked with fever and several of the boat's crew soon followed. It extended to about 40 of the ship's company and two midshipmen who were also employed in the boats, or had been on shore on leave, were among the number taken ill. The most prominent symptoms were nausea, and in some vomiting, succeeded by headache, flushed face, full and frequent pulse, thirst, and in most cases delirium with suppuration of the parotids in two or three instances. The sick were landed and placed in a large castle near St Paul's Bay under my care where the whole recovered.24

The castle in St Paul's Bay mentioned by Burnett, was most likely to have been Wignacourt Tower. Other ships' logs refer to towers as castles. That of HMS Alexander dated Wednesday 20 February 1799, mentions Marsa Sirocco Castle where the men under Captain Williams of the marines were quartered. HMS Goliath had been at single anchor off St Paul's from Wednesday 8 May to Tuesday 14 May 1799. On Thursday 9 May, an entry in the captain's log states sent the sick to the hospital on shore, and one dated 19 May notes hoisted the pinnace and sent her into Saint Paul's for the sick. The Master's Log entry for Thursday 9 May records sent a midshipman and nine men to the hospital.

By 20 August 1799, only 1,500 Maltese armed peasants were capable of doing duty, of whom a mere 600 men were fit for an assault on enemy lines. The sickness had increased to such an extent, that Ball had to disembark the Marines from HMS Lion and HMS Success, so as to strengthen the posts. On 31 August 1799, Ball opened a Temporary British Naval Hospital on shore for the many sick persons, principally of contagious fevers on board the ships of the blockading naval squadron.

The first two infantry regiments to arrive in Malta in December 1799 were relatively healthy, however they soon started to fall ill. On 6 January 1800, Graham reported that:

The 89th and the corps of Marines were suffering from the country fever, a kind of intermittent, many of these are convalescent, but on the least irregularity or fatigue they relapse and die, our bark is entirely exhausted, and all other medicines very deficient. I trust, however, that from the extension of the hospitals and the great care taken not to allow men to do duty when they feel any of the first symptoms, nor till they are perfectly re-established, that the alarming progress of this fever will be stopped. Surgeon Alexander Jamieson, an excellent man is at the head of our medical staff and takes great pains.25

The 89th at Luqa were particularly affected, while the 30th on duty a few miles away seemed to have escaped. Graham attributed their fevers to the men lying on cold stone floors and in January 1800 imported deal boards from Sicily for them to sleep on. He reduced their night duty as much as possible in an attempt to check its alarming progress. The 89th was moved from Luqa to Ghaxaq, as he was in no doubt that the sickness originated from the bad air of the marsh at the head of the harbour.

The marines also went down with fever. By 1 January 1800, eighty-five out of the 400 marines were sick. The following month, 121 marines were ill and 13 had died. On 23 July 1800, Lord Keith reported that of all the Marines landed at Malta only 178 men were left. The rest had been reduced by the fever of that island which is severely felt by the ships of the squadron. Surgeon James Young of HMS Lion wrote indignantly about their lack of medical attention:

The marines who had been disembarked and were doing duty on shore for some months, had suffered materially from sickness particularly for want of medicine and a properly regulated hospital – indeed it was disgraceful to see that a squadron frequently consisting of seven and eight sail of the line with smaller ships, had no proper establishment for their sick on shore, while the moment a couple of regiments arrived a superb hospital with every necessary convenience and luxury was immediately provided and to the humane attention of Dr A Jamieson, I am indebted for his reception and care of some of my wounded men after the action with Le Guillaume Tell.26

The contagious distemper did not slacken its grip during the second year of the siege. HMS Lion arrived at Malta from Syracuse on 20 January 1800 and served in the Mediterranean until 20 November 1800, when the ship was laid off. From 1 January 1800 to 21 November 1800, there was a total of 200 sick seamen of which a fourth were fever cases. Similarly, shortly after the arrival of HMS Penelope in Malta in March 1800, several of the crew were afflicted with fever. It is possible that this fever was viral hepatitis as the men complained of headache, pain in the back, nausea prostration of strength, and turned yellow after the third day. The ship had anchored in Gibraltar on 1 October 1799, where she had come in contact with HMS Vanguard which had a number of her crew ill with fever. Surgeon Nathaniel Wilson HMS Penelope was in no doubt that the contagion had spread to his ship from the Vanguard. In February and March 1800, HMS Northumberland landed a number of her crew ill with fever, several of whom died.

Table IV Sick seamen HMS Lion 1 January – 20 November 1800
Condition Sick List Discharged to duty Sent to hospital Died on board
Continued Fever 49 41 3 5
Fluxes 30 23 7 0
Scurvy 8 8 0 0
Ulcers 8 5 3 0
Wounds and accidents 58 48 6 4
Rheumatism 2 2 0 0
Lues venerea 14 14 0 0
Other 31 18 13 0
Total 200 159 32 9
Table IV Sick list (1 January–20 November 1800) from the medical journal of HMS Lion

Battle Casualties

In the naval engagement of 30 March 1800, which lasted four hours and resulted in the capture of the French Republican ship of war Le Guillaume Tell, HMS Foudroyant had 8 killed and 69 wounded, HMS Lion had 7 killed and 41 wounded, and HMS Penelope suffered 2 killed and 2 wounded. In the capture of the Genereux on 17 February 1800, a total of 9 were killed and wounded. James Young admitted the worst casualties to the Military Hospital on shore, as no naval hospital was still open. His medical log records that:

Several cartridges on the lower deck caught fire and in the explosion which was truly dreadful and alarming, the men who were contiguous were most miserably burnt. Scarce any part of their bodies escaping. Luckily the purser had a large stock of fine oil on board in which they were all immediately immersed to their great relief, the excruciating agony they suffered is not to be described. Upon snipping the vesicles, many degenerated into foul ulcers which were a length of time healing, and ultimately several of those who from proximity were most exposed to the violence of the explosion lost the use of their hands. The men who were deprived of their limbs by cannon ball had their operations performed immediately on the cessation of the firing and no untoward symptoms taking place soon recovered.26

A metal cannon ball hitting the hull of the ship splintered its oak and showered the gunners with flying shards, causing horrific lacerations. The killed and wounded of HMS Lion were:

  • Midshipman Roberts killed in action.
  • Seaman Thomas Collins killed in action.
  • Seaman David Cunningham killed in action.
  • Seaman Charles Burt ? killed in action.
  • Seaman Samuel Adamson amputated thigh.
  • Seaman John Shepheard amputated arm.
  • Maltese boy Michele Artada amputated arm.
  • Seaman Henry Quarterman extensive lacerated splinter wounds in both hamstrings and right thigh.
  • Seaman Robert Holmes lacerated thigh and loss of the top of his fingers.
  • Seaman John Fuller calf of leg torn off by splinter.
  • Boatswain's mate Thomas Kennedy fractured leg by splinter.
  • Seaman Jeremiah McCarthy fractured skull over the orbit by musket ball.
  • Seaman Patrick White wounded head by splinter.
  • Carpenter's mate John Cook violent contusion of the breast by splinter.
  • Seaman James Benwood wounded head and severe contusion of neck by splinter.
  • Surgeon's servant boy William Ellworthy blown up and died in a few hours being dreadfully burnt over the loins head and face.
  • Maltese boy Emanuel Samut blown up and died on 1 April after having been burnt over the whole body.
  • Maltese Giuseppe Pisani blown up and one eye burnt out of his head.
  • Maltese Sebastian de Silva blown up.
  • Maltese Michele Cardona blown up.
  • Maltese Robert Risse blown up.
  • Maltese Michele DeBono blown up.
  • Maltese Angelo Ferrigo blown up.
  • Seaman Major Houson blown up.
  • Seaman William Gibson blown up.
  • Seaman Thomas Woodrow blown up.
  • Seaman John Graham blown up.
  • Seaman John Hays blown up.
  • Seaman George Barclay blown up.
  • Seaman John Cooning blown up.
  • Seaman Thomas Dawdon blown up.
  • Marine Thomas King blown up.
  • Seaman Edmond Arboury blown up.
  • Seaman James Hull blown up.
  • Seaman John Gowan blown up.
  • Seaman Charles McCarthy blown up.
  • Seaman Patrick Ryan blown up.
  • Seaman Barty Bird blown up.
  • Seaman William Mason blown up.
  • Seaman James Robinson blown up.
  • Seaman George Peacock blown up.
  • Seaman George Castles blown up.
  • Seaman Edmond Jones blown up.
  • Seaman David Harrison blown up
  • Seaman Ross Smith blown up and died 12 April 1800.

Likewise, in the same engagement of 30 March 1800, the medical journal of HMS Penelope gave the following casualties.

  • Master H Damerall 34 years, killed in action by a shot to the center of the head which took away the top of his skull.
  • Midshipman H Sipthorp 16 years, contusion of his hand and wrist. He was standing beside Master Damerall and was wounded by flying fragments from Damerall's skull.
  • Pte Marine Charles Ogden 30 years, amputated arm which was carried away by a cannon ball except for a small portion of the skin above the elbow joint. It took ten minutes to remove him to the cockpit, during which time the wound hardly bled at all. Ogden was also badly injured in the abdomen by grape shot which carried away the whole of the abdominal muscles.
  • Ordinary seaman Lewis Prim 23 years, contused wound of his loins by a cannon shot lacerating skin of the abdomen. The whole of the lacerated skin sloughed away leaving an extensive ulcer with copious discharge. Several bits of the os ilium came away but he survived his injuries and was admitted to the military hospital.

On 6 March 1801, Captain Alexander Ball RN reported to Henry Dundas that the number killed or wounded due to hostilities amounted to three hundred. Parish burial registers for Valletta and the Three Cities, Birkirkara, Qormi and Zebbug and the parish of St Dominic in Valletta, record a total of 2,847 deaths among the insurgents for the period October 1798 to March 1800. Forty four Maltese men perished in what the registers describe as acie bellica, but others succumbed to their wounds later on. Among these were:2

  • Stanislao Lott, 50 years, died in the general commotion of 2 September 1798.
  • Giovanni Maria Grech, 26 years, died of wounds received in the bombardment of 15 September 1798; buried at Tarxien.
  • Michele Farrugia, 25 years, died of wounds on 19 September 1798 at Saura Hospital Rabat; buried at St Paul's church Rabat.
  • Lorenzo Xriha, 27 years, died of wounds on 19 September 1798 at the Zebbug Hospital.
  • Giuseppe Zammit, 20 years from Gudja, died on 9 October, post amputation of his leg at the Zebbug Hospital.
  • Salvatore Formosa, 25 years, died of wounds at Zebbug Hospital on 4 October 1798.
  • Antonio Ellul, 40 years, died of wounds on 5 October 1798.
  • Antonio Wizzini, 60 years, crushed to death on 5 October 1798 in the general commotion.
  • Angelo Mallia, 50 years, died in battle on 7 October 1798.
  • Alberto Vella, 21 years, died of wounds on 9 October 1798.
  • Giovanni Magro, 20 years died at Ta' Saura on 13 November 1798.
  • Pietro Ellul died on 9 December 1798 at the villa of Bishop Labini which had been converted into a hospital.
  • Enrico Sant, 30 years, died of wounds at Zebbug Hospital on 12 December 1798.
  • Michele Camilleri Frendo, 40 years, died of wounds on 18 December 1798.
  • Antonio Zammit, 56 years, died of wounds on 12 January 1799.
  • Fedele Farrugia, 32 years, died in the bombardment of 5 January 1799.
  • Giuseppe Vassallo, 26 years, died in the bombardment of 11 January 1799; buried at Tarxien.
  • Bianco P who had volunteered in Graham's newly raised force died in hospital on 28 June 1800.
  • Magri died on the bombardment of the trench at Ta' Borg at Casal Tarxien on 21 July 1800.

Military Hospitals

French Hospitals

The French reserved the Sacra Infermeria of the Order of St John in Valletta exclusively for their troops. It became their Grand Hôpital under the direction of their Chief Physician Robert. The hospital was fitted with 546 beds of which 80 were for the wounded. By June 1799, three more hospitals, had to be improvised, to accommodate the increase in the number of febrile and scorbutic patients.

In September 1798, the French had 700 soldiers in hospital among which were fever and venereal patients. Fever cases were probably recurrences of malaria contracted in Italy. In November 1798, Regnaud de St Jean d'Angely, reported that there were 400 sick in hospital. The patients had no shirts, nor sheets, nor drugs, which had all been exhausted following six months without a resupply. Between June 1798 and September 1800, 4,046 fever cases were treated in the hospital out of a garrison of about 5,000 men. Of these, fever patients 525 died and another 300 died of scurvy.

The sick were treated well. Vaubois ensured that they had adequate rations and that fresh meat was reserved for the patients of the hospitals. Those dying at the hospital were buried in the adjacent cemetery formerly used by the Order of St John.

Maltese Hospitals

Every available building was converted into a hospital for the Maltese sick. The old church of Saint Gregory, Zejtun, became a hospital for the armed camps on the Cottonera side of the harbour. Clemente Mifsud Bonnici, in his claim for compensation, alleged that he had spent 400 scudi of his own money on the hospital at Zejtun, that he had cured all the sick in that hospital, and that he had discovered the cause of the evil pestilence that was raging at the time.31

At the onset of the siege, Vincenzo Borg had 1,600 men who were maintained from the sale of cotton yarn. During the prevalence of the noxious influenza of 1799, Borg converted his large house at Birkirkara into a hospital for the sick and wounded. He lit fires in the streets, and devised every means for guarding the inhabitants against infection.27 Doctor Leopoldo Bernard was in charge of the hospital. Captain Alexander J Ball RN bore witness to Borg's zeal and activity during the blockade and after the surrender of Valletta appointed him Luogotenente or magistrate of his casal.

At Rabat, in the suburbs of Mdina, general hospitals were established in the Priory of Saint Dominic, at Santo Spirito hospital adjoining the church and convent of Saint Francis, at Saura Home for incurables, at Saint Sebastian church, at Saint Agatha's church and at the church of Saint Francis adjoining the Santo Spirito Hospital. The Bishop's Seminary at Mdina, and the country residence of Bishop Labini, in the locality between Zabbar and Zejtun, and St Joseph at Zebbug were also used as hospitals.

Physicians Salvatore Bernard (Medico Primario), Paolo Mallia, Giuseppe Vella and surgeons Aurelio Badatt and Michelangelo Bardon served on the staff of Santo Spirito and Saura hospitals. Physician Luigi Abela and surgeon Michelangelo Bardon served on the staff of the Grande Ospedale at St Dominic Priory.

A number of Maltese medical practitioners fought with their compatriots. They not only tended the sick and wounded, but also took up combatant roles. Amongst them was the physician and surgeon Antonio Muscat from Cospicua, a former surgeon of the Order's naval squadron, who served as second-in-command at Ta' Samra.28 This was the first advanced battery opposite the main gate of Floriana, and within range of the French guns. Samra was cannonaded so frequently, that only Muscat and two others survived the siege. On 11 January 1799, Muscat was amongst those chosen to be part of the forlorn hope in the attempt to take Valletta by stealth.

Other Maltese surgeons were Francesco Scicluna, Gregorio Saydon, and Francesco Caruana. Francesco Scicluna was the Medico dei Poveri of Senglea. He attended the sick of the villages of Naxxar, Birkirkara, Lija, Attard, and Balzan. Gaetano Saydon was the surgeon for the Zurrieq battalion. Francesco Caruana was surgeon for the Tarxien battalion and the posts at Corradino and Ta' Borg. Ludovigo Balbi was surgeon for the Zabbar battalion and Nicola Bezzina for the Zejtun battalion.

The Maltese who succumbed to their wounds were buried in their parish churches. Foreign soldiers were interred in fields adjacent to the hospitals where they died. Thus, on 27 December 1801, the Luogotenente of Zabbar claimed rent for houses at Casal Zabbar occupied by British troops, and for a piece of ground they used as a burial place. Similarly, British soldiers who died at Saura Hospital, after they occupied Mdina in September 1800, were buried in land owned by Rosa Cutajar, who on 28 August 1801, petitioned for, and obtained, a yearly pension of 7 scudi (1 scudo = 1s 8d or 8 new pence) in compensation for the loss of her property.29

Naval Hospitals

On 31 August 1799, Captain Alexander Ball opened a Temporary British Naval Hospital for the sick of the naval squadron. Mr Thomas Alldridge, purser of HMS Lion was appointed Superintendent of the hospital on a salary of five shillings a day, Thomas Burke as its surgeon on five shillings a day and an unnamed surgeon's mate on a salary of two shillings six pence a day.

Whereas there are on board HM ships under my orders, many sick persons principally of contagious fevers, it becomes absolutely necessary to establish a hospital on shore at this place. And in order that the sick at the said hospital may be regularly and properly victualled, and supplied with every necessary article, you are hereby appointed to superintend the said hospital, supplying the same with such provisions and necessaries, as may be demanded by the surgeon, keeping a true and exact account of all expenses attending the same, paying for house rent, and all contingent expenses.30

The Temporary British Naval Hospital admitted its first sick seamen on 30 August 1799 and closed on 17 November 1799. It admitted a total of 149 sick or wounded seamen from the following ships: Alexander (30 August–24 October) 91 men, Lion (3 September–20 October) 15 men, Success (8 September–28 October) 15 men, El Corso (9 September–15 September) 15 men, Audacious (11 September–2 November) 13 men (2 deaths), Stombolo (14 September–2 November) 7 men, and La Bonne Citoyenne (17 September–7 October) 5 men.

The ships' logs provide tantalising clues but none specifically mention the location of this naval hospital. On Saturday 31 August 1799, HMS Alexander was moored off Marsaxlokk Castle, when she sent the first 30 men to the hospital. Marine Edward Shea was too ill to be moved and died on board on 2 September. Two sick seamen were sent to the hospital on Thursday 5 September 1799; another two sick men landed on Tuesday 24 September while the ship was still at Marsaxlokk Bay. On Saturday 19 October 1799, the Alexander landed six lower deck guns 32 pounders and six main deck guns 18 pounders at Marsaxlokk for use of the Maltese. She also recovered the sick on board. On Tuesday 22 October 1799, HMS Alexander moved to St Paul's Bay and anchored in 16 fathoms of water off St Paul's Castle, where she landed her sick. HMS Bomb vessel Strombolo was also moored in St Paul's where her log recorded anchored here HMS Alexander with the sick of the squadron. Boats employed landing ditto to the hospital. Her log also documents that on Friday 1 November, while still in St Pauls' Bay, she sent Richard Gibson sick to the hospital and on Thursday 7 November 1799, she supplied the hospital with 43 gallons of wine and took discharged 9 men belonging to HMS Success.

Another naval hospital was probably opened in April 1800. On 31 March 1800, Surgeon James Young declared that as no naval hospital had been established on shore, his wounded from the engagement with the Le Guillaume Tell were sent to the military hospital. However, the log of HMS Alexander while at anchor off St Julians, has an entry dated Tuesday 25 March, which simply states carpenters employed fitting a hospital on shore for the sick. Their work must have soon been completed for on Friday 28 March the Alexander sent 26 men sick to the hospital, and on Friday 2 May 1800, while still off St Julians, she received the sick from the hospital. The Alexander had been moored in St Julians Bay since 1 March. One can only speculate that this hospital was within reach of St Julians Bay and could possibly have been located in Spinola Palace which would have made an ideal hospital. The log of HMS Northumberland moored in Marsaxlokk records receiving 32 men from the hospital on Tuesday 1 April 1800.

General Military Hospital

The army relied on regimental hospitals to care for its sick. These only had about 40 beds and General Hospitals became essential once these became full. The regimental hospital was administered by the surgeon with the aid of one or two assistant surgeons. On 17 July 1800, Captain John Vivion RA ordered the casal of Zejtun to requisition a large house to serve as a regimental hospital for the British Artillery. The hospitals of the 89th and 48th were colocated in a hired house at Luqa owned by Manuel Farrugia.

The Maltese Light Infantry was raised by Brigadier General Graham on 2 April 1800. It was commanded by Major Weir RM, and officered by men from the 30th and 89th Foot. On 8 May 1800, Assistant Surgeon James Alexander Campbell 89th Foot, was detached from his regiment to serve as surgeon to the Maltese Light Infantry. On 26 May, Campbell was ordered by Graham to set up a hospital at Gudja, as many of the recruits were sick and there was no place to put them.

The regimental surgeons and assistant surgeons who served in Malta during the blockade were:

In contrast to the Regimental Hospitals, General Hospitals opened only for the duration of the campaign and had their own separate staff medical officers. In February 1800, a General Hospital for British troops was opened in Zejtun, in the country house of Count Agostino and Paola Formosa de Fremeaux. Dr Alexander Jamieson acted as physician to the hospital and Mr John Price, Assistant Surgeon 30th regiment, was ordered to do duty there. The Neapolitan Artillery had no surgeon of its own, and its sick were admitted to the General Hospital. On 8 February 1800, General Fox sent over a surgeon's mate and some medical stores to Malta in a transport which sailed from Port Mahon under escort of the brig Vincejo. The Vincejo moored in Marsaxlokk bay on Tuesday 1 April 1800.

On 18 February 1800, a surgeon's mate and some medical stores were disembarked at Marsaxlokk Bay. On 22 February, Graham appointed Joseph Gunson Deputy Purveyor to the General Hospital. Purveyors and apothecaries were usually selected from experienced assistant surgeons or senior hospital mates. They were appointed to the staff of General Hospitals by the Inspector of Regimental Hospitals, but on campaigns the General Officer Commanding often filled vacant posts before the Army Medical Board in London became aware of them. The purveyor ensured that the hospital was well furnished with every item required, and provided the diets to the patients as prescribed by the physician. In addition he kept weekly accounts of provisions and expenditure and made requisitions for stores to the Surgeon–General.

The staff medical officers serving at the General Hospital Malta on 1 October 1800 were:

Epilogue

Article Seven of the capitulation agreed upon between General Vaubois and Major General Henry Pigot, commanding the troops and Captain Martin commanding the naval squadron, dealt with the care of the French sick. Those capable of being moved were embarked with their effects and a surgeon necessary for their care during the voyage. They were provided with provisions, surgical instruments and medicine chests. Those too sick to travel were transferred to Fort Manoel under the care of a French physician and surgeon. The medical staff were given free quarters and were returned to France once their services were no longer required.

With the departure of the French, the Maltese islands were taken under the protection of Great Britain. Sir Ralph Abercrombie appointed Major General Henry Pigot, Military Commander of the Island. Captain Alexander Ball was placed in charge of the Civil Government. Abercrombie instructed Pigot to secure the landings at St Paul's Bay and Marsaxlokk. Consequently, a body of Maltese cannoneers and militia were ordered to do constant duty there. These were supported by a few gunners from the British Artillery who were also stationed there to instruct the Maltese gunners, and to take charge of the guns and ammunition. A detachment of British Infantry occupied Citta Vecchia (Notabile or Mdina) in support of St Paul's Bay, and another detachment was at Zejtun in support of the batteries at Marsaxlokk. In recognition of his sterling service during the blockade, Captain James Vivion RA became Inspector of the Coast and of the Maltese Cannoneers and Militia, and was granted a daily allowance of 10 shillings a day. The troops were accommodated in such public buildings best suited for barracks, so that the inhabitants were relieved from housing them.

The staff officers of the Army Medical Services established themselves at the former Hospital of the Order of Saint John of Jerusalem in Lower Merchant Street Valletta. They not only looked after the medical needs of the garrison, but also, reluctantly became involved with the management of the civilian medical services and the quarantine department. The regimental surgeons, with their assistant surgeons, opened their regimental hospitals and set about the task of looking after their soldiers. Abercrombie most earnestly recommended British Troops serving in Malta to observe the strictest discipline and to cultivate by every means in their power the good will and confidence of the inhabitants.

Bibliography