The average strength of the Command was 6,353 men, exclusive of colonial troops. There were 3,477 admissions into hospital (547.3 admissions/1000 mean strength), with 40 deaths including 2 among the invalids (6.29 deaths/1000). The Garrison Staff had 8 men with 4 admissions into hospital.
77 men returned to England as invalids; 39 of whom were discharged from the service. The average number constantly non-effective through sickness (mean daily sick), excluding the RMFA, was 211.18 men (33.24/1000 mean strength). The average sick time to each soldier was 12.16 days; the average duration of each case was 22.23 days.
The extra troops were accommodated under canvas and in the Sanatorium Citta Vecchia; three officers' room were also handed over for use by the men of the artillery at St Elmo.
During the summer months half of the men slept in tents, but by the end of the year no tents were in use, all the men having returned to their quarters. Barrack rooms had no fireplaces to warm them up and were lit by gas or oil lamps.
There were 196 officers with 118 cases of illness and 4 deaths. 4 officers were invalided to England. Illness were from fevers (38), including 2 enteric, rheumatism (9), bronchitis (6), diarrhoea (10), hepatic diseases (6), injuries (18).
Officer deaths were from simple continued fever (1), enteric fever (1), meningitis (1), gunshot wound, suicide while in a state of temporary insanity.
There were 267 wives, with 234 attacks of illness and 5 deaths. Admissions were for: fevers (35/2 deaths), including 1 enteric, debility (54), rheumatism (11), nervous conditions chiefly neuralgia (15), digestive disorders (11), bronchitis (11), generative system disorders (21). Deaths were from puerperal septicaemia, dementia and burns.
There were 406 children with 261 admissions and 29 deaths. Admissions were for: measles (27), diphtheria (3/2 deaths), simple continued fevers (40/1 death), debility (27/4 deaths), conjunctivitis (26), bronchitis (54), diarrhoea (50/2 deaths), teething (14), eczema (13). Deaths were from convulsions (4), teething (3), prematurity at birth (3), brain abscess (1), meningitis (1), croup (1), pneumonia (1), gastritis (1), enteritis (1), accidental poisoning by strychnine (1).
Fever accounted for 498 admissions into hospital with 19 deaths. Admissions were for:
- 36 for nervous system diseases (2 deaths)
- 51 for circulatory diseases (1 death)
- 127 for respiratory conditions (5 deaths)
- 569 for digestive diseases (3 deaths)
- 14 for urinary problems
- 182 for generative disorders
- 255 for cutaneous diseases
- 143 for rheumatism (1 death from rheumatic fever)
- 84 for primary syphilis
- 86 for secondary syphilis
- 338 for gonorrhoea
- 11 for phthisis (3 deaths)
- 551 for accidents (4 deaths)
- 14 for alcoholism (1 death from delirium tremens)
- 17 for parasitic diseases (taenia solium)
- 74 for debility mainly post fever
There was 1 admission for eruptive fevers (measles), 18 for enteric fever (12 deaths), 452 cases of simple continued fever (3 deaths) and 27 admissions for dysentery (4 deaths). Malarial fevers caused 12 admissions. The enteric cases were treated in Valletta Station Hospital (6 admissions/5 deaths), Cottonera Station Hospital (10 admissions/6 deaths), Forrest Station Hospital (1 admissions), Gozo (1 admission/1 death). Simple continued fevers included febricula, where the fever only lasted a few days and the large number of cases called Malta fever.
Two of the fatal cases of dysentery had been transferred from troopships. 17 of the admissions (1 death) occurred at Cottonera and were of a mild type, 4 occurred at Citta Vecchia (1 death), 3 at Valletta (2 deaths), 2 at Gozo and 1 at Forrest.
Accidental deaths were from drowning and a fractured skull following a fall down a ditch in the dark. A soldier took his own life by jumping off the roof of his barracks; another slit his own throat with a razor while in a state of temporary insanity.
The annual dinner of the Malta and Mediterranean Branch of the British Medical Journal was held on the Monday in Christmas week. Brigade Surgeon O'Dwyer, Army Medical Staff (AMS), took the chair. He proposed the toast of The British Medical Association and coupled it with the name of Surgeon Major Manche, to whose indefatigable exertions the success of the Branch had been largely due.
Surgeon Major Manche, acknowledged the toast proposed by Staff-Surgeon Williams RN and paid a compliment to the energy displayed by the Naval Secretary Surgeon Moore RN.
Surgeon General Duncan Alexander Campbell Fraser stated that:
Malta fever is a well defined disease, depending on a specific poison or germ, which according to Surgeon Bruce, pursues a totally different course when cultivated in gelatine from the bacillus associated with enteric fever. In the earlier stages it is impossible to discriminate between Malta fever and enteric fever, but so far as treatment is concerned, it is not a matter of great consequence. Many of the cases were severe and were followed by protracted convalescence with relapse and complications of rheumatism, sciatica, and general debility.
During 1888, the Medical Staff of the Army was reduced. With the exception of the operations for the relief of Suakin, England did not have any little wars on hand. This enabled the War Office to reduce the strength of the Medical Staff by the simple process of not filling up vacancies caused by death and retirement.
No competitive entry examination took place during 1887, and the one due in Feb 1889 was cancelled. Measures were taken to form a reserve of medical officers from the Volunteer Medical Service, which would enable the War Office to dispense with an increase of the Regular Medical Staff of the army by employing the Reserves on Home Service, thus releasing the regulars for field service.
The economically minded reformers in the House of Commons favoured reducing the Medical Staff of the army by placing the medical charge of troops at home under the care of civil practitioners at contract rates, and employing the regulars solely on foreign service. If approved, this proposal would have meant almost continuous service in India for the medical officers of the army.
With the exception of Gibraltar and Malta, the number of foreign stations requiring more than a very few medical officers was very small.
The British Medical Association commented that it remained to be seen whether civil practitioners, of a class deemed competent for such duties, were likely to accept the contract rates for the discharge of the multifarious duties army medical officers were called upon daily to perform.
Firstly, candidates for the Medical Staff of the army were not accepted for military duty without previous special examination by an independent Board of London examiners.
Secondly, Army Medical Staff officers had to undertake a course of instruction in the Army Medical School, and pass an examination at the end of it. They could not rise to the higher grades of the service without showing, by yet another examination, that they had kept pace with the science and practical knowledge of the day.
Was all this to be demanded of civil practitioners at contract rates? demanded the BMA.