The average strength of the Command was 4,736 men, exclusive of colonial troops. There were 3,435 admissions into hospital (725.2 admissions/1000 mean strength), with 34 deaths including 8 among the invalids (7.17 deaths/1000 mean strength). The Garrison Staff had 36 men with 9 admissions into hospital and 1 death.
77 men returned to England as invalids, 59 of whom were discharged from the service. The principal cause of invaliding were fevers (13), tubercular diseases of the lungs (11), cardiac disease (11), debility (6) and respiratory disorders (5).
The average number constantly non-effective through sickness (mean daily sick), excluding the Royal Malta Fencible Artillery, was 220.82 men (46.62/1000 mean strength). The average sick time to each soldier was 17.02 days; the average duration of each case was 23.46 days.
There were 150 officers with 106 cases of illness. 8 officers were invalided to England. 43 of the admissions were due to fevers, of which 2 were enteric fever; 12 admissions were for disorders of the digestive system and 22 were for injuries.
There were 280 wives, with 207 attacks of illness and 3 deaths. Fevers caused 55 attacks, of which 2 were enteric, 2 remittent and the rest simple continued. 42 cases were returned as debility, 10 as rheumatism, 17 as bronchitis, 43 as disorders of the digestive system, 19 as diseases of the generative system or related to pregnancy. Deaths were from enteric fever (1), rheumatic fever (1) and bronchitis (1).
There were 486 children with 344 admissions and 24 deaths. Admissions were: 44 admissions for simple continued fever, 33 of debility (4 deaths), 65 of bronchial affections (2 deaths), 74 of diarrhoea (4 deaths), 38 of disorders of the digestive systems, 3 of diphtheria (1 death), dysentery (2 deaths), remittent fever (2 deaths), encephalitis (1 death), ascaris lumbricoides (1 death), cervical abscess (1 death), premature birth (1 death), scalding (1 death), tonsillitis (1 death).
On 14 Jan 1885, Mr Osbert Chadwick's scheme to increase the water supply was referred to a Select Committee of the Council of Government. It formed the subject of Ordinance No X of 1886.
An abundant supply of pure drinking water was introduced into the chief towns and villages. The water from the aqueduct was conveyed in iron pipes from springs in the Bingemma Hills. It was distributed to the numerous public fountains which had been erected in the towns and villages along its course. Drinking water was also diverted to private houses; a nominal sum being paid for every 1,000 gallons (4,526 ltrs) consumed in excess of the regulated allowance of three gallons per head per day (13.6 ltrs) supplied free.
By 1866, Valletta, Floriana and the crowded cities of Vittoriosa, Cospicua and Senglea had been thoroughly drained. Sewage was conveyed in glazed earthenware pipes to San Rocco, on the eastern side of the island where it was discharged into the sea at a considerable distance from the harbours.
The new drainage was blamed for the increased incidence of the observed febrile illnesses. It was alleged that
from the time the old fashioned emptying of cesspools was suppressed, and the house drains were carried into the main sewers, the fecal material stagnates in the pipes which lack sufficient water for flushing. It then infiltrates the subsoil, as the rock is porous, whence are poured into the atmosphere the products of putrid fermentations. The city then comes to lie under the malign influence of a poisonous miasma which is continually given off from these subterranean sources.
In 1886, Inspectors of Nuisances were appointed to enforce the sanitary regulations in streets and dwellings, supervise the lime washing of infected buildings, improve drainage and remove all rubbish likely to produce disease. Those suffering from infectious diseases were isolated at the Lazaretto.
Fever accounted for 832 admissions into hospital with 15 deaths. Admissions were for:
- 30 for nervous system diseases (2 deaths)
- 64 for circulatory diseases (1 death)
- 140 for respiratory conditions (3 deaths)
- 463 for digestive diseases (2 deaths)
- 6 for urinary problems
- 137 for generative disorders
- 231 for cutaneous diseases
- 161 for rheumatism
- 89 for primary syphilis
- 69 for secondary syphilis
- 260 for gonorrhoea
- 12 for phthisis (6 deaths)
- 460 for accidents (4 deaths)
- 20 for alcoholism
- 6 for parasitic diseases (taenia solium)
- 83 for debility
A new nomenclature of disease was introduced during the year; some venereal diseases were entered under diseases of the generative system while cases of febricula were grouped with the simple continued fevers. There were 34 admissions for enteric fever with 8 deaths. 30 of the cases with 7 deaths were at Cottonera, 3 with 1 death at Valletta, and 1 case which recovered at Citta Vecchia. Relapses were frequent among these cases and in all, convalescence was protracted. Other continued fevers led to 730 admissions and 2 deaths. Malarial fevers gave 11 admissions with 1 death from remittent fever. Of the malarial cases, 3 were intermittent with the rest being remittent. There were 53 admissions for dysentery ( 3 deaths), 3 cases of diphtheria (1 death) and 1 case of mumps.
Simple continued fevers led to 730 admissions with 2 deaths. The term febricula was discarded. The PMO, Surgeon-General James Sinclair stated that
while many cases were of a light ephemeral type, a large number were very protracted and developed symptoms not unlike those of enteric fever, and probably were a mild form of that disease. Simple continued fever was blamed on
imprudent exposure to the sun and abuse of intoxicating liquors.
A soldier at Fort Chambray Gozo died from multiple injuries following a fall from the roof of the barracks on to the square below. He was walking on the roof at night to cool himself and lost his footing. A death from drowning occurred off Fort Delimara when a boat capsized. Two other deaths were from falls over the bastion.
In 1866, Surg-Maj David Bruce identified the micrococcus, later Brucella melitensis, in sections of spleen belonging to Pte J Riddall 2nd/South Yorkshire Regiment, aged 20 years, who had died of fever on 26 Dec 1886, 15 days in his illness.
Bruce had received valuable assistance with the cultures of the micrococcus from Dr Giuseppe Caruana Scicluna (1853 – 1921). On 1 Feb 1881, Dr G Caruana Scicluna had entered Government service as an analytical chemist, and had been granted a government subsidy of £100 to complete his studies in chemistry in London and Paris. In 1888, he had studied Pasteur's treatment of hydrophobia in Naples.
In 1890, Caruana Scicluna was appointed sanitary inspector on a salary of £250, with an additional £30 a year, in compensation for relinquishing all private medical practice.
In 1895, on the reorganisation of the Department of Health, Caruana Scicluna devoted himself to the enforcement of the sanitary laws.
In 1901, he was passed over for promotion as Chief Government Medical Officer and Superintendent of the Public Health as the Governor did not consider his English and his social standing high enough for the office. His annual salary of £280 as senior medical officer attached to the Health Department was, however, augmented by £70. In 1905, he was promoted CGMO, a post he held until 1917.