The average strength of the Command was 7161 men, exclusive of colonial troops. There were 5433 admissions into hospital (758.7 admissions/1000 mean strength), with 75 deaths (10.47 deaths/1000). The Garrison Staff had 83 men with 15 hospital admissions.
195 men returned to England as invalids; 103 of whom were discharged from the service. The average number constantly non-effective through sickness (mean daily sick), excluding the RMA, was 349.91 men (48.86/1000 mean strength). The average sick time to each soldier was 17.83 days; the average duration of each case was 23.51 days.
There were 186 officers, with 147 admissions and 3 deaths. 8 officers were invalided home. among the officers, simple continued fever caused 72 admissions and 2 deaths. The other death was due to accidental poisoning with mercury.
Fever accounted for 1040 admissions into hospital with 37 deaths. Admissions were for:
- 46 for nervous system diseases (2 deaths)
- 40 for circulatory diseases (2 deaths)
- 162 for respiratory conditions (4 deaths)
- 591 for digestive diseases (2 deaths)
- 19 for urinary problems
- 365 for generative disorders
- 371 for cutaneous diseases
- 178 for rheumatism
- 117 for primary syphilis
- 95 for secondary syphilis
- 664 for gonorrhoea
- 21 for phthisis (8 deaths)
- 721 for accidents (8 deaths)
- 24 for alcoholism (2 delirium tremens)
- 9 for parasitic diseases (taenia solium)
- 64 for debility
There was 1 admissions for eruptive fevers (measles), 101 for enteric fever (32 deaths), 29 for dysentery (2 deaths) and 294 for malarial fevers of which 171 were for ague and 121 for remittent fever. The increased incidence of malarial fevers followed the arrival of the 1st/North Staffordshire Regiment from Mauritius and a large draft of the 1st/Gloucestershire Regiment from India. Most were mild.
There were 938 admissions for simple continued fever with 5 deaths. Debility was a complication of protracted fevers.
There were 6 deaths from asphyxia from drowning and a suicide from a gunshot wound to the head.
The Order of St Francis (Franciscan Friars) cared for sufferers from leprosy. The Santo Spirito Hospital in Rabat formed part of their monastery.
In 1862, in reply to a questionnaire sent out by the Royal College of Physicians, it was officially stated that leprosy did not exist in Malta. In the following 20 years, however, cases were noted and action was taken on 24 Aug 1893, when legislation was enacted to register and compulsorily segregate lepers.
An additional wing to the poor house in Marsa was added to act as a leper asylum under the Ordinance No VII of 1893. On 11 Apr 1902, the Comptroller of the Charitable Institutions informed government that he proposed to have certain new works carried out to prevent male lepers from escaping from the asylum. He also proposed to construct a new wing for female lepers.
An Order in Council of 26 Sept 1901, provided £8000 for the construction of the building. The ground for the proposed additional buildings was rocky and unlevelled, which provided male lepers the opportunity to hide ropes and tools which facilitated their escape.
There were 300 wives, with 186 admissions and 1 death from valvular heart disease. Admissions were for simple continued fever (51), debility (34), bronchitis (14), dyspepsia (15).
There were 513 children with 407 cases of sickness and 33 deaths. The main diseases were: measles (93/8 deaths), simple continued fever (40/4 deaths), bronchitis (58/1 death) and conjunctivitis (17). An outbreak of purulent conjunctivitis occurred among the children in Gozo while measles affected those in Valletta.
Deaths were from diarrhoea (5), diphtheria (4), simple continued fever (4), prematurity (2), convulsions (1).
The PMO, Surgeon Major General J Inkson, remarked about the pressing need for proper hospital accommodation for women and children.
Deputy Inspector General Maxwell Rodgers RN
On 4 May 1893, the medical officers of the Mediterranean Fleet entertained Deputy-Inspector-General Maxwell Rodgers MD RN at dinner in the Union Club. Rodgers had retired from the naval service and had relinquished command of the Royal Naval Hospital.
Fleet-Surgeon Herbert M Ellis presided. On proposing the toast of the evening, Ellis referred to the long career of Dr Rodgers in the navy and to the kind and sympathetic manner in which he had habitually carried out his duties. This had secured him the affection and esteem of all those with whom he had come in contact. It was with feelings of sorrow that those present bade him farewell.
Rodgers replied that he appreciated with peculiar pleasure this manifestation of the good will of the medical officers of the fleet towards him. He parted from them and severed his connection with a service to which he had been always proud to belong, with a lively sense of grief. He then proposed the health and wished success to the medical officers of the Mediterranean Fleet.
Dr Ferdinando Vincenzo Inglott
Dr Ferdinando Vincenzo Inglott died on 25 Oct 1893. He had been appointed Comptroller of the Charitable Institutions on 17 Dec 1858 and an ex-officio member of the Council of Government.
The Offices of Comptroller of Contracts and of Inspector of Charities were amalgamated under Ferdinand Inglott. On 27 Sept 1888, his salary of £400 was increased to £500 a year but he never obtained his increase. Inglott reformed the Charitable Institutions and abolished the system of restraining lunatics in irons.
In May 1893, a memorandum was submitted to the Secretary of State for War, Mr Campbell-Bannerman, by a deputation from the Parliamentary Bills Committee of the British Medical Association. Among the proposals intended to urge various amendments in the conditions of service of the AMD were:
1. Consolidation of the Army Medical Staff and the Medical Staff Corps into a Medical Corps, along lines similar to the Corps of Royal Engineers, and Ordnance Store Corps, but with limited army command.
2. Restriction of foreign service to 5 years in India and healthy colonies and 3 years in unhealthy colonies, in accordance with the recommendation of the Camperdown Commission. With the introduction of the six-year rule, the only way medical officers could leave their posts was on a medical certificate. The extended period was unpopular, and many officers retired at 20 or 25 years service rather than risk lengthened tours.
3. Simplification of rank titles with the abolition of such compound names as Brigade-Surgeon-Lieutenant-Colonel.
4. The rule of having to serve
3 years in rank before an officer was permitted to have full pay on his retirement to be shortened to 1 or 2 years. At the time, higher rank was only achievable after a very long service. The rank of Brigade-Surgeon-Lieutenant-Colonel was reached after over 26 years' service, when the officer was about 49 to 50 years of age; that of Surgeon-Colonel, when the officer was 55 years old. Consequently, the higher ranks of Surgeon-Colonel and Surgeon-Major-General, with a compulsory retirement age of 60 years, changed so frequently, that it caused hardship and difficulty in providing staff to fill the administrative appointments abroad.
three years in a rank rule was instituted, not one single officer had retired voluntarily within that time. So frequent had been the consequent reliefs in the administrative ranks, that in the past 15 months no fewer than 10 changes had taken place in appointments held by Surgeon-Major-Generals, with a strength of 10 officers. Twenty changes occurred in appointments held by Surgeon-Colonels, with a strength of 24 officers. This resulted in 30 changes in 34 appointments, mostly due to unavoidable moves.
5. Extension of the service for Surgeon-Major-Generals beyond the age of 60 years to be granted only in exceptional circumstances. An extension of service in the top rank prevented promotion of the next senior Surgeon-Colonels and Brigade-Surgeon-Lieutenant-Colonels with the loss of higher rates of pension that this entailed, if these officers had to retired early through ill health.
6. Study time on full pay to be granted to officers to enable them to keep abreast in advances in professional knowledge. Recurrent and prolonged tours of foreign service, together with harassing duties in out-of-the-way places, rendered professional studies difficult or impossible.
7. Retention of the privilege of exchanges between medical officers, within a reasonable time after being warned for foreign service, and to be allowed to exchange abroad any time after returning home, if physically fit.
Inspector General Henry MacDonnell CB RN
Inspector General Henry MacDonnell succeeded DIG Maxwell Rodgers. MacDonnell was born in 1839, the son of William MacDonnell of Dublin. He was educated in Dublin and qualified LRCSI, LKQCP in 1861, entering the navy as assistant surgeon in 1861.
MacDonnell reached the rank of Inspector General in 1897. He was in charge of the Royal Naval Hospital Bighi from 1893 to 1896, Chatham Hospital from 1896 to 1897 and Haslar Hospital from 1893 to 1899. As Fleet Surgeon of HMS Invincible he was present at the bombardment of Alexandria on 11 July 1882 and served during the Egyptian War. In 1886, he married Frances Alice Holmes, daughter of Sir William R Holmes, Consular Service of Kilrea, Ireland.
MacDonnell retired in 1899 and died at Southsea on 2 Sept 1922, aged 83 years.