The average strength of the Command was 4,602 men, exclusive of colonial troops. There were 4,249 admissions into hospital (923.3 admissions/1000 mean strength), with 68 deaths including 5 among the invalids (14.77 deaths/1000 mean strength). The Garrison Staff had 20 men with 4 admissions into hospital.
124 men returned to England as invalids; 57 of whom were discharged from the service. Soldiers were invalided because of: fevers (26), rheumatism (5), phthisis pulmonalis (11), nervous disorders (21), heart disease (20) mainly valvular heart disease, respiratory disorders (8), digestive disorders (8).
The average number constantly non-effective through sickness (mean daily sick), excluding the Royal Malta Fencible Artillery, was 272.04 men (59.11/1000 mean strength). The average sick time to each soldier was 21.57 days; the average duration of each case was 23.37 days.
There were 142 officers, with 76 cases of illness and 4 deaths. 8 officers were invalided to England. Fever generated half of the admissions; remittent fever caused 5 attacks and 1 death. Other deaths were from: dysentery; pleurisy and apoplexy.
There were 298 wives, with 241 attacks of illness and 6 deaths in the garrison; 9 women were invalided home. Fevers caused 61 attacks, among which were 4 cases of enteric fever and 1 of remittent fever.
Admissions were for: rheumatism (9), nervous diseases (12), eye disorders (14), respiratory diseases (12), digestive disorders (41), pregnancy and disorders of the generative system (15).
Deaths among the wives were from enteric fever (2) simple continued fever, cancer, phthisis pulmonalis and a self inflicted wound to the throat.
The garrison had 501 children with 488 admissions and 53 deaths. There were 44 cases of measles (2 deaths), 7 scarlet fever, 29 continued fevers, 2 remittent fever, 20 whooping cough, 12 diphtheria (3 deaths), 54 eye infections, 69 respiratory problems, 82 diarrhoea, 18 teething and 19 debility. Deaths were from: infantile convulsions (6), tabes mesenterica (5), tubercular meningitis (1), bronchitis (6), teething (4), enteritis (2), dysentery (3), tonsillitis (3), diarrhoea (12) premature birth (4) and debility (2).
The drainage works for Floriana and Valletta were commenced in 1875 and completed in 1885, under the supervision of Captain Tressider. The elected members of the Council of Government strongly opposed the scheme which cost in the region of £101,377.
The sewers were flushed by a steam pump located at Fort St Elmo. Previous to the use of steam, the pumps had been operated by a windmill which had broken down. Sewage was retained in the sewer by a sluice, until enough had accumulated to be flushed away.
Rain water for drinking was collected from roofs, ramparts and enclosures and stored in underground tanks where it was liable to become contaminated with sewage. Water from the aqueduct was also channeled in iron pipes and delivered directly to the various houses and barracks.
Health of the Garrison
Fever accounted for 1,034 admissions into hospital with 34 deaths. Admissions were for:
60 for nervous system diseases (3 deaths)
78 for circulatory diseases (2 deaths)
142 for respiratory conditions (3 deaths)
579 for digestive diseases (4 deaths)
354 for urinary problems
388 for cutaneous diseases
230 for rheumatism (1 death)
274 for syphilis
34 for phthisis (11 deaths)
499 for accidents (4 deaths)
Accidental deaths were from falls over battlements, one at Fort San Leonardo, the other at St Clements. There were two accidental deaths from drowning while bathing.
Under rheumatism were recorded 85 cases of rheumatic fever, one of which proved fatal. A large number of cases of the muscular form of rheumatism followed attacks of fever. Under nervous system disorders were recorded 30 cases of neuralgia which also accompanied fevers. The 3 deaths entered under nervous disorders were from apoplexy, one from delirium tremens and two from alcoholic poisoning. 47 cases were recorded under debility, chiefly the result of fever and the effects of climate.
There was 4 admissions for eruptive fevers, 2 for small-pox, 1 of scarlet fever and 1 of measles. Small-pox was introduced into Malta by sailors at the lazaretto and spread to the civil population which had 39 cases.
There were 93 admissions for enteric fever with 24 deaths. 14 cases of enteric fever with 6 deaths occurred at Valletta, 74 cases with 15 deaths were from Cottonera, five cases with 3 deaths came from Civita Vecchia. Medical officers believed that soldiers contracted enteric fever in the grog houses frequented by them outside the barracks. Consequently, many of these houses were placed out of bounds until the police physician certified that they were free of nuisances.
Continued fevers led to 837 admissions and 5 deaths. Febricula was responsible for 495 admissions; simple continued fever for 342 admissions with 5 deaths. The majority of the cases were mild and attributed to exposure to the sun. Some of the cases of simple continued fever were, however, very prolonged. They were complicated with frequent relapses, glandular swellings and muscular and neuralgic pains. The convalescents were left weak and unfit for active work. These symptoms were consisten with a diagnosis of brucellosis.
There were 3 cases of erysipelas and one of diphtheria which ended in death within four days. There were 96 admissions for paroxysmal fevers with 3 deaths, 24 admissions for ague, and 72 admissions and 3 deaths for remittent fever. The PMO described Maltese remittent fever as an irregular form of fever, not well understood, and which is often named Maltese Fever. In some of the cases many of the symptoms of enteric fever present themselves, but their pathology is quite distinct from that disease.
Among the reinforcements ordered for service with the Nile Expedition were the 3rd/Grenadiers, 2nd/Scots, and 1st/Coldstreams. The Guards were accompanied by their medical officers Surg-Maj Henry John Hughes Lawrence Gren Gds, Surgeon Ernest Harrold Fenn Gren Gds, Surg-Maj Constantine Caridi Read Coldm Gds, Surgeon Alexander Charles Archibald Alexander Coldm Gds, Surg-Maj Arthur Bowen Richards Myers Scots Gds, and Surgeon George Somerville Robinson Scots Gds.
Surg-Maj James Magill Coldstream Gds was already in the Sudan. He was wounded at Abu Klea on the 17th Jan, but recovered from his wounds.
Surg-Maj Read and Surgeon Alexander left England for Egypt on 18 February. They accompanied a detachment of the Army Hospital Corps and embarked on the Hospital Ship Ganges which had been fitted to accommodate 180 sick and wounded.
A number of hospital nurses on the permanent staff of various military hospitals embarked on the transport Arab. Many had served during the 1882 Egyptian Campaign. Other nurses left London in the first week of April 1885 by the Postal and Oriental Steamer Sutlej for service in the military hospitals in the Suakin Expedition.
On 9 Sept 1885, sixty two inmates at the Ospizio went down with violent vomiting and diarrhoea. The medical officer recommended their immediate segregation. 50 went to Selmun Palace; the others were moved to some old dilapidated huts which had been erected for the use of troops during the Crimean War.
The government decided against transferring the sick to Fort Chambray. This barracks was seldom occupied, but had been kept in reserve for troops in case of an epidemic breaking out in the garrison.
Chief Government Medical Officer
In 1885, the Governor Sir John Lintorn Simmons, created the post of Chief Government Medical Officer and Inspector of Hospitals under Ordinance No VIII of 1885.
The CGMO was the President of the Medical Board and advisor to the Government on Public Health. He was also Inspector of the Medical, Charitable and Quarantine Establishments, and Inspector of Prisons. The Medical Board dealt with all issues relating to the Sanitary Laws. It examined and reported on the fitness of applicants for the warrant to exercise the profession of physician, surgeon, and midwifery. It also regulated professional fees and advised the Government during epidemics.
On 3 June 1885, Dr Salvatore Luigi Pisani, Professor of Surgery, and Senior Visiting Surgeon to the Civil Hospital, became CGMO on an annual salary of £450.
On 3 June 1885, the office of Chief Police Physician held by Dr Ghio was abolished. Dr Ghio, aged 68 years, retired after 47 years service. The Police Physicians became District Medical Officers and part of the Charitable Institutions. They also performed the duties of District Sanitary Officers.