RAMC

Medical Officers of the Malta Garrison
Gatt Joseph Edward Henry

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Major Joseph Edward Henry Gatt MD MRCP (Eng) DTMH (Camb 1913) DPH (Ed)
14 Apr 1876 [Vittoriosa Malta] – 11 Nov 1960

Introduction

Major Joseph Edward Henry Gatt was one of the first two Maltese doctors to hold commissions in the Royal Army Medical Corps. The other was Lt Benjamin Howard Vella Dunbar MD (Malta) who was born at St Julians Malta on 19 September 1878 and was commissioned on 31 January 1903.

From 1901, the University of Malta held the privilege of nominating one graduate for a commission in the Royal Army Medical Corps. However, on 26 September 1901, medical degrees granted by the University of Malta became recognised by the General Medical Council, and graduates of the University of Malta became eligible to compete for commissions in the RAMC.

Service Record — Joseph Edward Henry Gatt

1901–1902 Civilian surgeon.

31 Jan 1903 Appointed Lieutenant RAMC on probation.

13 May 1903 Gained the Herbert Prize and the prize in pathology as well as the Marshall Webb Prize at the passing out examination of the RAMC.

17 Feb 1904–18 Mar 1904 On troop ship duty in the Mediterranean.

19 Mar 1904–18 Apr 1904 On duty in Ireland.

Apr 1904 Moved from Curragh to South Africa.

July 1904 Moved from South Africa to Transvaal.

Dec 1905 Change of station from Pretoria to Middelburg Transvaal.

31 July 1906 Promoted Captain RAMC.

18 Feb 1906–11 Apr 1906 On Home Leave.

13 Apr 1906 Embarked at Port Said for South Africa. In October 1906, arrived at Standerton Transvaal, from Middelburg Transvaal. Took over the duties of Medical Officer in charge troops, staff and married families in the cantonments instead of Civil Surgeon J Dalrymple who had left to set up in private practice at Volksrust.

31 July 1906 Promoted Captain RAMC.

Dec 1906 Change of station from Middelburg Transvaal to Pretoria.

Jan 1907 Change of station from Pretoria to Standerton Transvaal.

30 Sept 1908 Left South Africa for Irish Command.

Nov 1908 Moved to Cork.

Dec 1908 Change of station from Cork to Queenstown.

Feb 1909 Change of station from Queenstown to Limerick.

Nov 1909 Moved from Limerick to the Royal Army Medical College London.

Aug 1910 Moved from the Royal Army Medical College to Cosham, Portsmouth.

5 Jan 1911 Change of station from Cosham to Allahabad.

Aug 1911 Change of station from Benares to Allahabad.

Nov 1912 Change of station from Benares to Cawnpore.

27 Nov 1912–12 Nov 1913 In England on sick leave.

29 July 1913 Awarded the certificate of the school of Tropical Medicine with distinction.

10 Sept 1913 Passed the examinations for the Diploma in Tropical Medicine and Hygiene of the University of Cambridge.

13 Nov 1913–8 Dec 1918 Served in India.

Jan 1914 Change of station from Cawnpore to Benares.

31 Oct 1914 Promoted Major RAMC.

1916 Reported on the administration of a vaccine as a treatment for asthma to an officer's wife resident in the Murree Hills, Punjab Province British India. Dr Gatt wrote that he prepared an: autogenous vaccine from her nose, and later from her sputum. The organism was a streptococcus of medium length, but I now forget its chemical and biological characteristics. The patient received about twelve inoculations in all, in weekly doses varying from 150 to 500 millions. She showed a rapid improvement while she remained in the hills. I heard from her husband a year later that she was still free from paroxysms and also from chronic bronchitis.

1917 Served as a Sanitary Officer to the Waziristan Field Force.

9 Dec 1918–27 May 1919 On Home Leave.

28 May 1919–26 Sept 1919 Served with the North Russia Expeditionary Force.

18 June 1919–19 Sept 1919 Granted the rank of Acting Lieutenant Colonel.

27 Sept 1919–30 Jan 1923 In England.

28 Sept 1921 From Curragh Camp, Ireland Dr Gatt reported on a case of influenza with erythematous eruption and on streptococcal vaccines in asthma in the British Medical Journal.

Malta 6 Dec 1920 At Malta on leave.

Malta 5 Jan 1921 At Malta on leave.

31 Jan 1923 Placed on retired pay.

Apr 1931 Major J E H Gatt having reached the age limit of of liability to recall, ceased to belong to the Reserve of Officers.

6 June 1937 Writing from Fowey Cornwall, Dr Gatt listed 12 possible contributory factors for the persistently high infant mortality in Malta (250/1000):

  • Early marriages are the rule.
  • Large families and frequent pregnancies are also the rule, especially in the depressed classes.
  • The milk in Malta is largely obtained from goats because there is not sufficient pasture for the cow.
  • The dry season lasts generally throughout the best part of six months, April to September. During this period the temperature rises rapidly to 85 F (29.4 C) but winds prevail except during the month of July.
  • Condensed milk, often sweetened and of inferior quality, is very often looked upon with favour by the lowest classes, who may substitute it entirely for fresh milk.
  • This habit has established itself largely because of the ban on fresh milk from all sources imposed by the naval and military authorities for use by soldiers and sailors ever since the discovery of Brucella melitensis and the report of the Royal Commission that followed.
  • Undulant fever is rampant among the civil population (up to 5 per 1,000 of the population get this fever in the course of the year). But cases of infection are practically unknown under 5 years of age. Concurrently with the human infection a similar infection occurs in goats (up to 15 per 1,000 in some herds), though the goat is often apparently sound and its yield of milk unaffected.
  • The chief period of infant mortality coincides with the dry, hot, and windy season of the year; but the dominant affections are gastro-intestinal, not respiratory or circulatory. The same period coincides with the appearance of the housefly in vast numbers.
  • In spite of repeated periodical warnings issued by the public health department to boil all fresh milk before use, the incidence of undulant fever among the adult population, and of intestinal infections with a high mortality in infants, has not been appreciably reduced.
  • Goats are seldom fed on imported foodstuffs, and fresh green vegetables in considerable variety are available for animals and human beings in sufficient quantities throughout the year, with the exception that grazing is absent almost everywhere during the long dry season.
  • The methods of efficiently combating the growing social danger of undulant fever have preoccupied the Government of Malta for years; but apathy and prejudice even to passive resistance on the part of a considerable section of the community and the vested interests of the goat owner and milk vendor have proved insurmountable until the last few months.
  • Effective steps have at last been taken after a strenuous campaign for clean and safe milk, largely conducted by a few medical men in the lay press. It was pointed out that fresh milk has a food value infinitely superior to the tinned article, and that all that was required was to make it safe for all without enhancing its cost price. This could only be undertaken by the Government. Accordingly, pasteurisation on a large scale by the holder method has been decided upon, while special researches are being undertaken with a view to discovering efficient goat vaccine against Brucella infection. All the goats will gradually be rounded up and their free circulation in the public thoroughfares will no longer be possible. This experiment in social and communal hygiene, which will cost the Government an initial outlay of nearly £50,000, will be watched with the keenest interest not only in Malta but throughout the Empire.

19 July 1937 Represented the Malta Branch of the British Medical Association at its Annual Representative meeting in Belfast. Dr J E H Gatt said: that he came as representing the smallest unit of the British Medical Association in the Empire. The principal problem in Malta was how to deal with an ever-increasing population. The birth rate there was about double the birth rate in the United Kingdom, and with this went a high infant mortality of 250 per thousand. He believed he was right in saying that they would succeed in uniting the whole medical profession in Malta into a body which would work in harmony with the central Association.

On 23 July Dr Gatt presented a paper on the Prevention of Undulant fever in Malta with special reference to the consumption of goats' milk. After discussing briefly the high incidence of undulant fever and the high infant mortality in Malta Dr Gatt pointed out that since 1898 goats' milk had been banned as an article of food for all troops and marines in the Mediterranean, with the most beneficial results. Notification of the disease had been made compulsory, and the destruction of infected goats was carried out systematically. The Civil Government had finally decided to exercise complete control over the milk industry of the island, and it was hoped to secure clean and safe milk for all at a reasonable price by proper pasteurisation and distribution, and thus diminish the problems of undulant fever.

Bibliography

  • Entry No: 299. Drew R. 1968. Commissioned Officers in the Medical Services of the British Army 1690–1960. Vol. II. Roll of Officers in the Royal Army Medical Corps 1898–1960, London: Wellcome Historical Medical Library.
  • Succession Books Vol XXI, Returns of statement of service of RAMC Officers.
  • Gatt J E H., Influenza with erythematous eruption, Br Med J 1921; 2: 577 (Published 8 October 1921).
  • Gatt J E H., Health and milk supply of Malta, Br Med J 1937; 1: 1282 (Published 19 June 1937).
  • Gatt J E H., Streptococcal vaccines in asthma, Br Med J 1921; 2: 261 (Published 13 August 1921).
  • Gatt J E H., Undulant Fever in Malta, Br Med J 1938; 1: 454 (Published 26 February 1938).
  • Debono J E., Undulant Fever in Malta, Br Med J 1938; 1: 645 (Published 19 March 1938).