The custom in Malta was for herdsmen to drive their goats through the streets in the morning and evening, and to stop and milk them at the houses of their customers.
Malta Fever was responsible for a large portion of serious cases admitted to hospital and for soldiers being invalided with chronic neuralgia. It taxed the nursing staff to the utmost, many of whom contracted the disease in the performance of their duties.
At the Cottonera Hospital there was a staff of four female nurses. During 1904 and 1905, a total of six nursing sisters became infected. The sisters' quarters were in a detached house in the hospital grounds.
At the Military Hospital Valletta, four ladies of the Queen Alexandra's Imperial Military Nursing Service were employed in nursing the sick. One became infected.
At the Military Families Hospital which was situated alongside the Military Hospital Valletta, the head nurse fell ill on 20 June 1905. In Valletta the sisters lived in the Hospital Quadrangle. Up to July 1905, it was the practice to milk the goats that had provided milk for the patients at Valletta Hospital on a plot of ground within a few yards of the sisters' quarters. The fouling of the ground by the goats was blamed for transmitting Mediterranean fever to the nursing staff.
In 1905, a house was hired in Old Mint Street Valletta to accommodate ten nursing sisters. The hiring was a ten minute walk from the Station Hospital.
A Standing Order stipulated that all fresh milk for the troops had to be boiled in the cook house before being issued. Only condensed milk was allowed in some of the camps.
The Malta Fever Commission investigated how the germ entered the body. The members of the commission were: Col David Bruce, Lt Col Davies, Maj Horrocks, Capt Kennedy, Staff Surgeon Shaw RN, and Dr Themistocles Zammit. In 1905, all the members of the Commission were in Malta, except for Col Bruce.
With the object of ascertaining by experimental inoculation whether goats could be infected with this disease, the commissioners had six of these animals from two different herds brought to their lazaretto. On 14 June 1905, Dr T Zammit, as a preliminary step to the experimental work, took blood from each of them and tested the action of their serum on the micrococcus melitensis. To his great surprise he found that the serum of five of those animals when considerably diluted caused agglutination of the microbe, and, obtaining similar results on the following day, he forwarded samples of the blood to the Public Health Laboratory, where Major Horrocks confirmed his important discovery.
On 23 June 1905, Major Horrocks reported the discovery of the Micrococcus melitensis in the milk of an apparently healthy goat. By 26 June, he had found the Micrococcus melitensis in the milk of 5 goats and Dr T Zammit had found it in the blood of one of these goats on 18 June 1905. Further examinations of animals in herds supplying milk to the Valletta Station Hospital, and Forrest Hospital found the Micrococcus melitensis being exuded with the milk in enormous numbers even when the animals were in full milk, with no apparent changes in either the physical or chemical characters of the milk.
On 18 July 1905, Col Bruce received preliminary reports from Maj Horrocks, Capt Kennedy, and Dr T Zammit on the propagation of Malta Fever by goats. As many as 50% of the goats in Malta reacted positive to Malta Fever when examined by the serum agglutination test.
The total strength of the garrison was 10,019 men. There were Officers 217, females 548, children 860. The Command was distributed as follows: Malta and Gozo 8294 men; Crete Detachment 860 men; RMA: Officers 35, men 593, women 135, children 360.
In Crete were the 2nd/Royal Sussex and the 1st/Kings Royal Rifle Corps.
Two camps had been established at Ghajn Tuffieha and Mellieha Bay. In 1905, Mellieha camp consisted of just tents and hutments. A hut served as a non-dieted hospital.
Ghajn Tuffieha Camp was occupied all year round by troops undergoing Mounted Infantry training. Their numbers varied monthly. The men were in tents and lived practically outdoors. A number of marquees formed a non-dieted hospital for the troops.
St Andrew's Barracks lay about half a mile from the sea and 200 feet above sea level. The barracks were not lived in before 1905 and were occupied for the first time in April 1905. The company blocks were two-storied with four rooms on each floor.
In the Corradino District new married blocks were taken into use during the year and were occupied by staff of the military prison.
Pembroke Musketry Camp was occupied during part of the year. It was situated on rough ground which in wet weather became a mass of sticky mud.
Field Ambulances came into existence in 1905, when, following the experiences of the South African War, the hitherto completely separate units of Bearer Coys and the Field Hospital of a hundred beds were combined.
In the South African War, the Bearer Coys were part of the brigade. They collected the casualties off the battle field and rendered first aid. Once this task was completed they marched off with their brigades. The two medical units did not mutually assist one other, so that during the military action the Field Hospital lay idle and the Bearer Coys were overwhelmed.
Following the South African War, the transport element (Bearer Coy) was combined with the treatment element (hospital staff). The Field Ambulance was divided into a Bearer Division and a Tent Division both of which were subdivided into three equal sections known as A, B and C.
A Major commanded a Field Ambulance, while the sections were under the command of RAMC captains. The role of the Field Ambulance was to collect the sick and wounded from the forward area, render first aid and evacuate casualties to a Casualty Clearing Station (CCS). The personnel of a Field Ambulance consisted of seven medical officers, a quartermaster and about 220 men. One or more sections usually B and C would be sent forward to form an Advanced Dressing Station (ADS). Section A, Headquarter Section, usually remained in the rear to form a Main Dressing Station (MDS). Casualties from an ADS were transported in motor ambulances to a MDS.
The irrigation treatment for Gonorrhoea was introduced in the Cottonera Hospital in 1905, and later in the other hospitals in Malta. Potassium permanganate 1-2 grains to the pint, and silver nitrate 2 grains to the pint, or albargin 2.5 to 5 grains to the pint were used for urethral irrigation. The patients were kept on a milk diet with porridge and barley water till the scalding had ceased, and then placed on an ordinary diet. Tinned milk was used in the porridge.
The acute phase was treated with 5 grain citrate of lithium and 10 grain of urotropin to relieve scalding. In the sub acute stage, the patient was prescribed balsam of copaiba, sandal wood oil or cubebs. Benzoic acid 15 grain three times a day was used when the urine was turbid. Major Charles Edward Pollock, noted that in his experience none of the drugs given orally were of much use.
Army Medical Department, Sanitary Report for the year 1905, Vol XLVII, London 1906.
Corps News, August 1904.
Distribution of RAMC Officers. Corps News. Vol IV: 6; June 1905.
Distribution of RAMC Officers. Corps News Vol VI: 6; July 1906.
No 8. Stations of units of the Regular, Militia, Yeomanry and Volunteer Forces - 1 January 1905. HM Stationery Office.
Gerrard J.J., Further notes on fevers in Malta. J.R Army Med Corps, July 1909, xiii; 1: 18-32.
Pollock C. E., Remarks on the treatment of Gonorrhoea in Malta.. J R Army Med Corps (1909), 13: 375-383.
Steiner J., The Medical Department of the British Army. J Roy Army Med Corps (1908), X: 547-551.