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Full text of "Parliamentary papers, Volume 45"

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ACCOUNTS AND PAPERS: 

THIRTT-SEVEN VOLUMES. 



- (9.) - 



HEALTH OF THE NAVY. 



Session 
9 February -^ — 21 August 1871. 



VOL. XLV. 



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ACCOUNTS AND PAPERS; 

1871. 



THIRTY-SEVEN VOLUMES.— CONTENTS OF THE 

NINTH VOLUME. 



N.B.— TiSJ? Figures at the beginning of tbe line, eorretpond mth the N* at the 
t of each Paper ; and the Figures at the end of the line, refer to the MS. Paging 
lie Vobtmea arranged for The Home of Commons. 



HEALTH OF THE NAVY: 
Statistical Report on the Health of the Navy, for the Year 1869 - p. r 



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NAVY (HEALTH). 



KKTUllN to an Older of Uie HononnUe The Hovw of Commona, 
dated 2i July 1871 ;— /or. 



A C O P Y 

OF THE 

STATISTICAL REPORT 

ON THE 

HEALTH OF THE NAVY, 

For the Year 1869. 



{Mr. Goschen,) 



Ordtrid, bp The Hoaw of Commoiis, to kePrhUfd, 
26 Jufy 1871. 



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TO 
THE BIGHT HONOUBABLE 

THE FIRST LORD OP THE ADMIRALTY, 

&c. &c. &c. 



Sir, 

1 HAVE the honour to lay before you the accom- 
panying Report of the Health of Ihe Navy for the year 
1869, to which several Papers in connection with ttie Naval 
Establishments and the Naval Medical Service are appended. 

I have the honour to be. 
Sir, 
. Your most obedient Servant^ 

A. Armstrong, 

Director General. 



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( V ) 

TO 

THE DIRECTOR GENERAL 

OF TBE 

MEDICAL DEPAETMENT OP THE NAVY. 



Sir, 
I HAVE the honour to submit the Statistical Report of 
the Health of the Navy for the year 1869. 

Compared with the preceding year, there was a slight 
reduction in the ratios of cases entered on the sick-list, and 
of invaliding, but there was an increase in the death-rate 
to the extent of 1* per 1,000. This was altogether attri- 
butable to the prevalence of yellow fever on the North 
America and West Indies, and South-East C!oast of America 
Stations, with which unhappily some of the vessels of the 
squadron employed there were brought in contact. 

On the Home Station, although there was a slight 
increase in the ratio of cases of that form of disease against 
which the Contagious Diseases Act is directed, the majority 
of the cases were contracted in places to which the Act does 
not extend. The medical officers, without exception, bear 
testimony to the value of legislation in this direction, and, 
as a rule, advocate its extension. 

Measles was extensively epidemic in one of the training 
ships for boys. The disease .was of a mild character, how- 
ever, and caused no mortality. 

In the Mediterranean a rather extensive epidemic of 
febrile disease occurred in the Caledonia shortly after her 
being re* commissioned at Malta. The history and nature 

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of the outbreak is fully detailed in the report on that 
station. 

On the North America and West Indies Station, yellow 
fever was extensively epidemic. This malignant form of 
disease iqjpeared in eight or nine of the vessels of the 
squadron, as the result of communication with infected 
localities. One himdred cases altogether were entered* on 
the sick-list, of which forty-eight had a fatal termination. 
This is so much in excess of the average mortality of the 
disease, that there can be little doubt that many other cases 
occurred which were, from their less virulent character, 
classed under some other form of fever. 

On the South-East Coast of America Station, yellow 
fever prevailed at Rio de Janeiro, and attacked some of the 
crew of the Receiving ship permanently stationed there. Of 
six cases, four proved fatal. 

On the West Coast of Africa and Cape of Good Hope 
Station, the benefits derived from removing the vessels of 
the squadron to other stations, after a limited period of 
service, continue to be experienced. Compared with the 
preceding year, there was a reduction in the ratio of cases 
entered on the sick-list, to the extent of 248*1 ; in the 
invaliding rate, of 19'3 ; and in the ratio of mortality, of 2*6 
per 1,000. The total death-rate on that station for the year 
1869 was 10-4 per 1,000, being the lowest on record. 

On the East Indies Station cholera created great ravages 
at Zanzibar. Happily only two cases occurred in the 
squadron, both of which, however, proved fatal. It is inte- 
resting to note, that while this malignant form of disease pre- 
vailed so extensively at Zanzibar and on the opposite coast 
of Eastern Africa, the island^ of Nos Beh, Mayotta, and 
Seychelles enjoyed an entire immunity from the disease, 
consequent, it is said, on the strict quarantine regulations 
that were enforced. An interesting accoimt of the Zanzibar 
epidemic will be found in the report on this station. 

It had long been felt that information connected with the 

sanitary 



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sanitary condition of i?rtiat may be termed the great establish- 
ments of the service, viz., the Naval Hospitals, Marine Divi- 
sions^ and the Dockyards, had never been obtained in such a 
form as to render it av^able for a Report of this kind. By 
your direction, and with the view still further to illustrate all 
that pertains to the health-state of the Navy, that defect 
has now been remedied, and interesting reports on those 
brai^chesof the service wiU be found in the Appendix. 

The adoption of the Nomenclature of diseases recently 
issued by a joint committee appointed by the Royal College 
of Physicians, and which has become the standard of classi- 
fication for the different public services, has rendered some 
changes necessary in the plan of this Report as compared 
with those of previous years. The changes, however, are 
not great, and any temporary disadvantages which they 
may involve will be amply compensated for by the more 
scientific basis upon which the new classification is founded, 
and the greater precision of technical phraseology their 
adoption is likely to ensure for the future, in the numerous 
returns firom which these Reports are compiled. 

I have the honour to be. 

Sir, 

Your most obedient Servant, 

Alex. E. Mackat, m.d. 

Deputy Inspector General 
of Hospitals and Fleets. 

Admiralty, Somerset House, 
26 October 1871. 



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CONTENTS. 



HOME STATION. 

PAGE 

Number of Vessels and Mean Force ----- 1 

Daily Loss of Service from Disease, &c. 1 

Class I. General Diseases: 

Section A., or Febrile Group 1 

Measles 2 

Epidemic in the St. Vincent . ^ - o 

Small-Pox 3 

in the Bellerophon - - - - ^ 
in the Dauntless, Fisgnrd, Implacable, 

and President - - . - 4 

Scarlet Fever - • 5 

in the Duke of Wellington - - 5 

Relapsing Fever in the Fisgard - - . - 

Typhus Fever - 6 

in the Cambridge, Eagle, Minotaur, 

and St Vincent - - - 7 

Simple Continued Fever 9 

in the Bellerophon, St. 

Vincent, and Warrior 9 

Cholera 9 

in the Excellent, Warrior, and St. Vincent 10 

Influenza, in the St. Vincent - - - - 10 
Class IT. General Diseases : 

Section B., or Constitutional Group - * - - - - 10 

Rheumatism 10 

Syphilis 11 

Phthisis Pulmonalis 14 

Epithelioma ------- 14 

Class III. Diseases of the Nervous System and Organs of the 

Special Senses 14 

Class IV. Diseases of the Circulatory System - - . . is 

Class V. fc VI. Diseases of the Absorbent System and Ductless 

Glands- . - . ^ - - 16 

Class VII. Diseases of the Respiratory System - - - - 16 

Class VIII. Diseases of the Digestive System - - - - 16 

Class IX. & X. Diseases of the Urinary and Generative Systems 18 

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PAGE 

Class XI. Diseases of the Organs of Locomotion - - - 18 

Class XII. & XIII. Diseases of the Cellular Tissue and Cutaneous 

System is 

Unclassed Diseases ---- is 

Wounds and Injuries 18 

Invalided -•-.----. 19 

Tables I. to VI. 20 to 37 

MEDITERRANEAN STATION. 

Number and Class of Vessels, and Mean Force - - - - 38 

Daily Loss of Service from Disease, &c. ----- 38 

Class I. General Diseases: 

Section A., or Febrile Group 88 

Measles 88 

in the Caledonia and Royal Oak - - 39 

Typhus Fever --...-- 40 

Enteric Fever 40 

in the Caledonia - - - - 40 

in the Cruiser - - - - 47 

in the Newport - - . - 4S 

Simple Continued Fever 49 

in the Caledonia and 

Lord Warden - - 49 

Ague and Remittent Fever - . - . 50 

in the Antelope - 50 

in the Cockatrice - 61 

in the Newport - 52 

Influenza * - 52 

Class II. General Diseases: 

Section B., or Constitutional Group ..... 53 

Rheumatism ....... 53 

Syphilis, Primary and Secondary - - - 53 

Phthisis Pulmonalis ... - 64 

Class III. Diseases of tlie Nervous System, and Organs of the 

Special Senses ----.-... 54 

Class IV. Diseases of the Circulatory System - - . - 55 

Class V. & VI. Diseases of the Absorbent System and Ductless 

Glands 50 

Class VII. Diseases of the Respiratory System - - . . 57 

Class VIII. Diseases of the Digestive System .... 53 

Diarrhoea 58 

in the Caledonia and Royal Oak . . 53 

Worms -•-•----.58 

Class IX. & X. Diseases of the Urinary and Generative Systems - 59 

Class XI. Diseases of the Organs of Locomotion ... 59 



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PAGE 

Class XIL & XIIL Diseases of the Cellular Tissue and Cuta- 
neous System -------.- co 

Unclassed Diseases -.-- 60 

Delirium Tremens 60 

Poisoning 60. 

Wounds and Injuries -------- 60 

Inyalided -- 60 

Tables I. to YI. 61 to 75 

NORTH AMERICAN AND WEST INDIAN STATION. 

Number and Class of Vessels, and Mean Force - - - - 76 

Daily Loss of Service from Disease, &c. . - - - . 75 
Class I. General Diseases: 

Section A., or Febrile Group 76 

Small-Pox - 76 

Simple Continued Fever 77 

in the Aboukir - - 77 

Yellow Fever ------ 79 

in the Aboukir - - . - 78 

in the Barracouta ... 73 

in the Defence - - - - 83 

in the Eclipse and Favorite - 85 

in the Jason, Philomel, and Terror 86 

in the Yestal - - . . 88 

Observations on the Cases treated 
in the Royal Naval Hospital, 

Jamaica 92 

Class IL General Diseases : 

Section B., or Constitutional Group 101 

Rheumatism 101 

Syphilis, Primary and Secondary - - • 101 

Class III. Diseases of the Nervous System and Organs of the 

Special Senses 102 

Class I Y. Diseases of the Circulatory System - - - - 103 

Class Y. & YI. Diseases of the Absorbent System and Ductless 

Glands 103 

Class YII. Diseases of the Respiratory System - - - • 103 

Class YIIL Diseases of the Digestive System - - - - 104 

Class IX. & X. Diseases of the Urinary and Generative Systems 105 

Class XI. Diseases of the Organs of Locomotion - - - 105 

Class XII. & XIII. Diseases of the Cellular Tissue and Cuta- 
neous System - 105 

Unclassed Diseases -- 106 

Wounds and Injuries 106 

Invalided 107 

Tables I. to YI. 108 to 123 

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SOUTH EAST COAST OF AMERICA STATION. 

PAGE 

Number and Class of Vessels, and Mean Force - - - - 124 

Daily Loss of Service from Disease, &c 124 

Class I. General Disea^s : 

Section A, or Febrile Group 124 

Typhus Fever in the Nassau - - - • 124 

Enteric Fever - 125 

in the Beacon - - - - 125 

in the Cracker - - - - 126 

in the Narcissus - - - - 127 

Simple Continued Fever 127 

Yellow Fever in the Egmont - - - - 127 

Ague in the Beacon - - - - - - 133 

Remarks on, by the medical officer of the 

Cracker - . - . . 134 

Remittent Fever 130 

Cholera in the Egmont 1 36 

Class II. General Diseases: 

Section 9-> or Constitutional Group - ^- - - - le36 

Syphilis, Primary and Secondary - - - 137 
Class III. Diseases of the Nervoas System and Organs of the 

Special Senses 137 

Apoplexy -------137 

Tetanus 137 

Class IV. Diseases of the Circulatory System - - - - 1 39 
Class V. & VI. Diseases of the Absorbent System and Ductless 

Glands 139 

Class VII. Diseases of the Respiratory System - - - - 140 

Class Vril» Diseases of the Digestive System - - • - 140 

Class IX. & X. Diseases of the Urinary and Generative Systems - 141 

Class XI. Diseases of the Organs of Locomotion - - - 141 
Class X[I. & XIII. Diseases of the Cellular and Cutaneous 

Systems - 141 

Unclassed Diseases 141 

Wounds and Injuries 141 

Invaliding - - - - - - - - - 141 

Tables I. to VI. 142 to 15-2 

PACIFIC STATION. 

Number and Class of Vessels, and Mean Force - - - - 153 

Daily Loss of Service from Disease, &c. - - • - - 153 



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Claes I. General Diseases : page 

Section A., or Febrile Group I63 

Small'Pox in the CameleoB - - - - 16* 

Enteric Fever 166 

in the Zealous * - - • 156 

Simple Continued Fever 168 

Ague 168 

Remittent Fever 169 

Class 11. General Diseases : 

Section B., or Constitutional Group 169 

Rheumatism - 169 

Syphilis, Primary and Secondary - - - 160 
Class 111. Diseases of the Nervous System and Organs of the 

Spedal Senses - 166 

Class IV. Diseases of the Circulatory System - - - - 166 

Class V.&VI. Diseasesof the Absorbent System and Ductless Glands 169 

Class y 11. Diseases of the Respiratory System - - - - 169 

Class VIU. Diseases of the Digestive System • - - - 171 

Class IX. & X. Diseases of the Urinary and Generative Systems - 174 

Class XI. Diseases of the Organs of Locomotion - - - 176 

Class XU. k XIII. Diseases of the Cellular and Cutaneous Systems 1 76 

Unclassed Disease^ •- 178 

Wounds and Injuries *-178 

Invaliding -.--....• 179 

Tables I. to VI. 180 to 194 

WEST COAST OF AFRICA AND CAPE OF GOOD HOPE 

STATION. 

dumber and Class of Vessels, and Mean Force - - - - 195 

Daily Loss of Service from Diseases, &c. - - - - - 196 
Class I. General Diseases : 

Section A., or Febrile Group 196 

Simple Continued Fever 196 

Ague 196 

Remittent Fever in the Danae - ' - - 196 

in the Fly - - . - 197 

in the Lynx - . - - 200 

in the Pandora, Peterel, and 

Pioneer - - - . 203 

in the Vindictive - . - 2O6 

in the Sinus • - . . 2O6 

Class II. Qeneral Diseases : 

Section B., or Constitutional Group 206 

Rheumatism 206 

SyphiliS; Primary and Secondary . . - 207 

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PAGE 

Class III. Diseases of the Nervous System and Organs of the 

Special Senses ......... 207 

Class IV. Diseases of the Circulatory System - - - . 208 

Class V. k VI. Diseases of the Absorbent System and Ductless 

Glands 209 

Class VII. Diseases of the Respiratory System ... - 209 

Class VIII. Diseases of the Digestive System ... - 209 

Class IX. & X. Diseases of the Urinary and Generative Systems 210 

Class Xt. Diseases of the Organs of Locomotion ... 210 

Class XII. & XIII. Diseases of the Cellular Tissue and Cutaneous 

System ... .<i^.«*« 311 

Unclassed Diseases «i...212 

Wounds and Injuries --...--. 212 

Ini«liding *««. ........ s|(| 

Tables I. to VI. 218 to 327 

EAST INDIA STATION. 

Number of Vessels^ and Mean Force • - - . - - 288 

Daily Loss of Service from Disease^ &c* 228 

Class I. General Diseases: 

Section A., or Febrile Group 228 

Small^Pox in the Forte^ Jumna^ and Ootavla - 229 

Measles 880 

Enteric Fever ... ---281 

Simple Continued Fever in the Euphrates - - 281 

Remittent Fever in the Cossack ... 282 

Cholera in the Dryad .... 283 

in the Malabar 244 

Class II. General Diseases: 

Section B., or Constitutional Group 244 

Rheumatism - - 244 

Syphilis, Primary and Secondary - - . 045 

Class III. Diseases of the Nervous System and Organs of the 

Special Senses 246 

Sunstroke in the Cossack, Dryad, Euphrates, and 

Forte 247 

Encephalitis 248 

Class IV. Diseases of the Circulatory System ... - 249 

Class V. k, VI. Dbeases of the Absorbent System and Ductless 

Glands 249 

Class VII. Diseases of the Respiratory System .... 260 

Class VIII. Diseases of the Digestive System - - - . 250 

Dysentery and Diarrhoea in the Daphne and Forte - 260 

in the Jumna and Star ^ - 261 

Class IX. & X. Diseases of the Urinary and Generative Systems - 252 

Class XI. Diseases of the Organs of Logomotion ... 263 



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PAGE 

CkfiB XII. & XIII. Diseases of the Cellular and Cutaneous 

Sjstem 268 

Unclaflsed Diseases 263 

Woonds and Injuries - - . 263 

Invalided - 264 

Tables I. to VI. 265 to 268 

CHINA STATION. 

Number of Vessels^ and Mean Force 260 

Daily Loss of Service from Diseasei &c. 260 

Class I. Creneral Diseases : 

SectioD A., or Febrile Group ** - 260 

Small-Pox in the Icarus^ Leven^ and Salamis - 270 

in the Zebra 271 

Typhus Fever in the Argus and Icarus - - 271 

; Enteric Fever - 274 

Simple Continued Fever 274 

in the Avon, Princess 

Charlotte, and Rodney 276 

ia the Zebra and Perseus 276 

Ague and Remittent Fever - - * - - 276 

Mumps -• 276 

Class II. General Diseases : 

Section B^ or Constitutional Group 276 

Rheumatism 276 

Syphilis, Primary and Secondary . - - 277 

Purpura - - 283 

Class III. Diseases of the Nervous System and Organs of the 

Special Senses 284 

Apoplexy 284 

Class IV. Diseases of the Circulatory System - - - . 280 
Class y. & yi. Diseases of the Absorbent System and Ductless 

Glands 287 

Class yil. Diseases of the Respiratory System ... - 287 

Catarrh 288 

Class yilL Diseases of the Digestive System .... 288 

Dysentery and Diarrhoea in the Adventure, Hornet, 

and Ocean . • • 280 

in the Perseus, Princess 

Charlotte, and Rodney 200 

Other Diseases of the Stomach and Bowels . - 201 

Class IX. &; X. Diseases of the Urinary and Generative Systems 201 

Class XL Diseases of the Organs of Locomotion ... 202 

Class XIL & XIII. Diseases of the Cellular Tissue and Cuta- 
neous System 202 

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PAGB 

Unclassed Diseases 292 

Delirium Tremeus 292 

Poisoning - - - -.- - - - 292 

Wounds and Injuries 298 

Invalided 293 

Tables I. to VL 294 to 811 



AUSTRALIAN STATION. 

Mean Force, and Number and Class of Vessels - - - . 812 

Daily Loss of Service from Disease^ &c. - - - - - 312 

Class I. Crenerai Diseases : 

Section A., or Febrile Group - - - - - - 812 

Enteric Fever in the Blanche - . - • 812 

in the Wellington - - - 312 

Simple Continued Fever ----- 318 

Remittent Fever in the Virago - - - 818 

Class II. General Diseases : 

Section B., or Constitutional Group - - - - - 816 

Rheumatism 315 

Syphilis, Primary and Secondary . • - 316 

Class III. Diseases of the Nervous System and Organs of the 

Special Senses .-.----.- 317 

Apoplexy - - 817 

Diseases of the Eye - .---.. 317 

Class IV. Diseases of the Circulatory System - - - - 818 

Class V. iii VI. Diseases of the Absorbent System and Ductless 

Glands 318 

Class VII. Diseases of the Respiratory System - - - - 318 

Class VIII. Diseases of the Digestive System - - - - 318 

Class IX. & X. Diseases of the Urinary and Generative Systems 319 

Class XI. Diseases of the Organs of Locomotion - - . 319 

Class XII. & XIII. Diseases of the Cellular Tissue and Cuta- 
neous System -- 819 

Unclassed Diseases ...dl^ 

Delirum Tremens 319 

Poisoning - - - - -- - - 319 

Wounds and Injuries -..-..-. 320 

Invalided 820 

Tables I. to VI. ' - 821 to 381 



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IRREGULAR FORCE. page 
Mean Force, and Number and Class of Vessels - - - - 832 

Daily Loss of Service from Disease, &c. 832 

Class L General Diseases: 

Section A., or Febrile Group - 882 

Scarlet Fever 382 

Measles 833 

Enteric Fever -.-.--- 833 

Simple Continued Fever 834 

Yellow Fever in the Barrosa - - - - 334 
in the Lapwing - - . - 335 
in the Malacca and Racoon • - 837 

Cholera 339 

Class IL General Diseases : 
Section B., or Constitutional Group ----- 340 

Primary and Secondary Syphilis ... 340 

Table showing where Cases of Syphilis in Juno 

were contracted - - - - - 341 

Class III. Diseases of the Nervous System and Organs of the 
Special Senses 343 

Apoplexy 848 

Class IV. Diseases of the Circulatory System - - - . 344 

Class V, & VI. Diseases of the Absorbent System and Ductless 

Glands -----...-. 344 

Class VII. Diseases of the Respiratory System - - - - 344 

Claas VII L Diseases of the Digestive System - - - - 846 

Dysentery and Diarrhoea - « - - - 345 

Class IX. & X. Diseases of the Urinary and Generative Systems 847 

Class XI. Diseases of the Organs of Locomotion - - - 847 

Class XII. & XIII. Diseases ofthe Cellular Tissue and Cutaneous 

System 347 

Unclassed Dbeases - . 343 

Delirium Tremens 848 

Wounds and Injuries 848 

Invalided 848 

Tables I. to VI. 860 to 365 

TOTAL FORCE. 

Number of Men employed see 

Cases of Sickness 300 

Loss of Service on the various Stations ..... 360 

Invaliding Rate ---------. 367 

Death Rate 867 

Table showing the Ratios of Cases of Disease and Injury, and of 
Deaths on the various Stations - • - - - -868 

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Class I. General Diseases: page 

Section A., or Febrile Group 369 

Eruptive Fevers 369 

Scarlet Fever - • - - - - - 370 

Measles 370 

Typhus Fever 370 

Enteric Fever 370 

Continued Fevers - - - - - - 870 

Yellow Fever 370 

Relapsing Fever - ..... 370 

Periodic Fevers 370 

Remittent Fever 370 

Other Diseases 370 

Hooping Cough - - • - -. -371 

Erysipelas - 371 

Pyaemia 371 

Mumps - - - - - •- - -871 

Influenza - - - - - - - -371 

Class II. General Diseases: 

Section B., or Constitutional Group 871 

Rheumatism - - -*- '- - - -371 
Table showing comparative prevalence of Rheumatism 

in 1868 and 1869 371 

Syphilis, Primary and Secondary - - - . 871 

Phthisis 872 

Class III. Diseases of the- Nervous System and Organs of the 

Special Senses 872 

Class IV. Diseases of the Circulatory System .... 872 

Class v. & YI. Diseases of the Absorbent System and Ductless 

Glands --. 372 

Class VII. Diseases of the Respiratory System - - - - 373 

Class VIII. Diseases of the Digestive System .... 373 

Class IX. & X. Diseases of the Urinary and Generative Systems - 373 

Class XI. Diseases of the Organs of Locomotion - - . . 373 

Class XII. & XIII. Diseases of the Cellular Tissue and Cutaneous 

System 374 

Unclassed Diseases 374 

Wounds and Injuries - - - - - - -- - 374 

Table showing the Ratio per 1,000 of Force of Cases, Invalidings, 

and MortaUty, on the different Stations ----- 375 

Table showing the Increase and Decrease in the Ratios of Cases, 

Invalidings, and Deaths, in 1869 376 

Summary 376 

Tables I. to VI. - - - 377 to 389 

List of Ships, with the Names of Medical OflJcers strvin^ in them 30 1 

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INDEX TO APPENDIX. 



TAGE 

Medical and Surgical Reports for the Yeat 1860, of the Royal 
• Marine Division at — 

Fort Cnmberland and Eastney - - - . - 2 

Portsmouth (Forton) 23 

Plymouth -41 

Chatham 49 

Medical apd Surgical Reports of Her Majesty's Dockyard at — 

Sheemess 01 

Chathafn -- - - - - - - - 79 

Portsmouth ----SO 

Devonport --- 99 

Keyham - - - - - - - - -ill 

Pembroke - -.- - - - - - -119 

fledical and Surgical Reports of the Royal Naval Hospital at — 

Haslar 131 

Plymouth 161 

Chatham 196 

Haulbowline ------.. 209 

Medical and Surgical Reports of the Royal Naval Lunatic Asylum at 

Great Yarmouth - - - - - - - -210 

Notes on Heat, as a Physiological and Pathological, Hygienic, and 

Therapeutic Agent, by Surgeon Alexander Rattray, m.d., r.n. - 239 

Notes and Statistics relating to the Boys under Training for the 

Royal Navy in 1870, by Staff Surgeon Seaton Wade, r.n. - 249 

Notes on the Relative Value of Vaccination Marks from 2,500 Cases, 

by Assistant Surgeon Edward L. Moss, m,d., r.n., f.r.c.s.e. - 266 



384. 



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( XX ) 



ERRATA IN 1869 REPORT. 



Page 20, in table, irfBtead of 4 cases of apoplexy, read 3 cases of apoplexy. 

„ 46, line 46 ,, in the station - ^, on the station. 

„ for Port Royal „ from Port Royal. 

yy activism „ actinism. 

^ in percussion ,, on percussion. 

y, longer any question „ no longer any question. 

„ Zealous ,, Topaze. 



„ 89 


„ 18 


„ 93 


„ 17 


„ 126 


.. 40 


„ 138 


„ 14 


„ 168 


« 13 



ERRATA IN 1869 APPENDIX. 



Page 12, lino 41, instead of ally . read allay. 
„ .33 „ 28 „ dyspepsia „ dyspnoea. 



56 



3 
8 



two cases „ three cases (scarlet fever), 
does ,, dose. 



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C 1 ] 



HOME STATION. 



Oh the Yarious commands comprised in the Home Station in 1869, Home 

riz., the Nore, Portsmouth, Plymouth, Qneenstown, and the Channel Statknu 

Fleet, sLxty-nine vessels were employed — viz., eleven iron-clads ; 

two vessels of the fourth rate; one of the fifth rate; twelve 

stationary ships ; eight drill ships ; fifteen coast-guard ships, several 

of which were iron-clad; six training ships; five steam-vessels; 

one yacht ; two storeships ; four training brigs ; one gun-vessel ; 

and Gne gunboat. Of this force the only vessels employed on duties 

in any way analogous to those on active service on foreign stations, 

were eleven of the iron-clads and one vessel of the fourth rate, which 

composed the Channel Fleet. The duties on which the other vesseb 

were employed were various and special. The returns from forty- 

caght of the vessels were for the whole twelve months, and from the 

remainder for periods varying from two to eleven months. The mean 

force correctea for time was 22,100, and the total number of cases 

of disease and injury entered on the sick-list 19,892, which is in the 

ratio of 900* per 1,000 of force, being an increase, compared with 

the precedinff year, equal to 8* per 1,000. Of these, 666 were 

invalided and 153 ^ed, the former bein^ in the ratio of 25*6 and 

the latter of 6'9 per 1,000. Compared with the preceding year 

there was an increase in the invaliding rate to the extent of 3'7 per 

1,000, and a reduction in the ratio of mortality of "6 per 1,000. 

The daily loss of service from Section A. of general diseases, 
which comprises the febrile group, was in the ratio of 1*3 per 1,000 ; 
from Section B., which may oe said to comprehend the constitutional 
j7t)iip, 9'3 ; from diseases of the nervous system and organs of the 
special senses, I'l ; of the circulatory system, '5 ; of the absorbent 
svstem and ductless glands, '5 ; of the respiratory sjstem, 3*1 ; of 
the digestive system, 1*7 ; of the urinary and generative system, 3*; 
of the organs of locomotion, '4; of the cellular tissue and cutaneous 
system, 7*5; from unclassed diseases, *4; and from wounds and 
injuries of various kinds, 6*1. The average number of men daily 
sick was 846*7, which is in the ratio of 38*3 per 1,000 of force, being 
an increase, compared with the preceding year, equal to -6 per 1,000. 

L General Diseases.— Section A., or Febrile Group. 

Taken in the order in which they stand in Table I., there were Class I. 
eight cases of smaU-pox, two of vaccinia, 284 of measles, twenty-four Sect A. 
of scarlet fever, one of relapsing fever, four of typhus fever, eleven 
of enteric fever, 240 of simple continued fever. 111 of ague, nine of 
reoittent fever, three of cholera, three of hooping-cough, ten of 

3M. A mumps. 



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2 MEDICAL STATISTICAL BBTUBNS 

Home mumps, thirty of influenza, and forty-four of erysipelas, undei 
Station. treatment during the year. Of these, two persons were invalided 

z: 1 for simple continued lever, and one for erysipelas ; the deaths in^ 

^!i? 1* eluded one from scarlet fever, one from typhus fever, five from enteric 

^^'^ * fever, two from simple continued fever, one from cholera, two from 

erysipelas, and oi^e from diphtheria. As no entry of this lattei 

disease appears on the case table, the original entry was doubtlesfi 

under another designation. 

Measles. — The only vessel in which this disease was extensively 
^demic was the St. Vincent, in which there were 238 cases. One 
or more cases occurred also in the Asia, Boscawen, Britannia, 
Cambridge, Castor, Implacable, Impregnable, Pembroke, Royal 
Adelaide, Squirrel, Trafalgar, Valiant, and Victory. In all, the 
disease proved mild. 

The outbreak in the St. Vincent is thus recorded by the stafl 
surgeon* of the vessel : — " An epidemic of measles broke out in the 
month of May, and first manifested itself on the 3rd of that 
month in the persons of two second-class boys, one of whom had 
been on shore at Portsea and Portsmouth on liie 22nd, 25th, and 
29th of April; the other had been at Gosport on the 1 8th of the 
same month. The former boy whilst in nospital was found to be 
labouring under venereal disease, contracted doubtless when last on 
shore, when possibly he was at the same time exposed to the con- 
tagion of measles; there can be little doubt, tnerefore, that he 
first brought the malady on board the ship. It spread rapidly, 
and attained its culminating point, as regards the numbers afiTecte^, 
on the 14th of the same month in which it made its appearance, 
and it gradually declined from that date, and disappeared alto- 
ff ether on the 3rd of June, having been exactly of one month's 
duration. 

" The epidemic was of an exceedingly mild character, particularly 
toward its termination, when it partook more of the nature of a 
mild influenza. The symptoms which each of the boys, who were 
chiefly the subjects of the malady, presented in a ereater or less 
degree were shivering, frontal headache and giddiness, pains of 
the eyeballs, dimness of vision, coryza, snifflings, sneezing, huB- 
kiness, or sonorousness of voice, dryness of throat, and m some 
instances rawness of chest ; the piilsations at the wrist ranging from 
95 to 120, generally feeble and small ; the tongue greyish, being 
but thinly furred, and invariably moist ; the skin generally mottled, 
or otherwise covered with a genuine rubeolar eruption, most 
apparent on the face, chest, abdomen, and back. In a certain 
number, probably forty in all of the whole number affected (234), 
some degree of epigastric uneasiness, attended with nausea and 
occasional vomiting, existed. The bowels were generally found to 
be regular, opened twice daily. In the whole number jtfected 
during the epidemic, the rubeolar eruption had appeared in twenty- 
four when sent to hospital, but this doubtless presents no relative 
proportion to those in whom it subsequently. presented. 

"During 

* Staff Suigeon Wm. Hoggan. 

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OP TBB HOHE 6TATI0K. 3 

"Bnriiig the preralence of the epidemic every neoessaiy pre- g^SS^ 

eBtxm was taken to prevent a spread of the nudady, and even- 

tmDy with good effect The ship's company and boys were minutely dais L 

moected vj me daily at Divisions^ the ship was kept clean and SMt A. 

ireil ventilated^ and disinfected by means of carbolic acid^ which was 

fieely used tluonghout^ and otiierwise by means of fuel stoves. 

The boys were restricted to their playground in Haslar Fields 

and during their absence for that purpose or for exercise in boats out 

of tli€ karbour, the ports were thrown open so as to admit of a free 

emrent of air throughout the ship. On the return of the boys &om 

Haslar Hospital on the 9th of June and days immediately following, 

tbej were^ as a precautioniUT measure, sent and maintained, by 

Admiralty order, on board Her Majesty's Ship Victoria, anchored 

It the head of the harbour, until the 14th of June, when they pro- 

ee^ied with others on board the St. Vincent to join the ships to 

whidi they were severally appointed, viz., the Endymion, Warrior, 

and Agincourt The boys of Her Majesty's brig Ferret, all of 

vhom, after the wreck of that vessel at Dover on the 29th of March, 

were borne on the books of and victualled on board the St. Vincent, 

lod nuinv of whom had suffered from the malady (measles), were sent 

to the Boscawen (their mother ship), or otherwise sent on their 

Midsummer leave of absence. During the holidays which extended 

from the 11th of June to the 3rd of July, the hold, spirit-room, and, 

iQ&ct, every nook and cranny beneath the lower deck was cleared 

onty disinfected, and whitewashed." 

Ihere is ]K)thiiig worthy of observaticm in connection with the 
caees of measlea occurrii^ in the other vessels. 

^aU'pox. — There were eight cases altogether of this form of 
feier in the Home Force during the year, one or two of which were 
of oonoderable severity. 

Two cases oecnrred in the Bellerophon. The first appeared while 
the?ewelwa8 at lisbon, in the person of a man who did duty as 
V^etsoao, and was in consequence often on shore, in the afternoon, 
'*»»iiig fot two or three hours. There can be but littie doubt 
^he ecmtracted the disease on shore, but its source could not be 
^>^Med. There were onl^ two cases under treatment at the time in 
uiJ]nd)lio establishment m Lisbon; the city was, indeed, remarkablv 
i^fitMn &e disease, and the man himseli was not aware of small- 
V^ being in any house that he frequented. As soon as the true 
^^ttore of his attack was realised he was at once sent to the British 
^al Naval BLospital at Lisbon, where it proved to be of rather a 
ttrere character. The vesicles were exceedingly numerous, although 
Bot confluent. There was no hemorrhage into the vesicles, but 
^'^tAxis occurred during the progress oi the case, which resulted 
u^ourably, although the man was a good deal marked. He had 
wen vacdnated in earlv life. The second case occurred at Ports- 
i^^lh, in the person of a seaman who had been in London on leave, 
ud on his return presented himself with febrile symptoms. On tiie 
following day a papular eruption presented itself, and he was at once 
I^jAarged to Hadar Hospital, where the disease ran a mild course. 
lUs man had also been vacdinate<l in childhood. Li both these 
cnei the dothee of &e patients were sent to the hospital with them, 

384. A 2 for 



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4 MEDICAL STATISTICAL BETT7BHS 

V 

Home for the purpose of disinfection, and the places. to which ther h» 

Station. been confined in the ship were careftdly washed out with a aolatioi 

^jr~j of carbolic acid. 

Sect A. There was a single case of small-pox in the Dauntless, at Hull 

It occurred in the person of a seaman who was doing duty in one o 
the tenders to the ship, and who presented himself on board with i 
very suspicious eruption covering bis face, arms, and body. He wa 
not permitted to go below, nor to mix with the ship's company, bu 
was at once removed to sick quarters on shore, where the cas< 
proved to be of a very modified character. He had several goo< 
vaccination cicatrices. 

In the month of April three cases of small-pox occurred in mei 
borne on the books of the Fisgard. The first was in the persoz 
of a petty officer who had been on short leave in London, but wh( 
stated that he had not been exposed to the disease. He was wel 
vaccinated. The second case ocqurred in one of the crew of the 
Porcupine, which vessel was manned by hired civilians from th< 
Shetlaud Islands, who were engaged for surveying duties during the 
summer, and thereafter discharged to the shore. All her crew were 
known to have been exposed, shortly before, to the poison of meaalesj 
but not of small-pox. This man was completely unprotectedj 
nevertheless the attack through which he passed was nuld. The 
last case was in the person of one of the permanent crew of the 
Fisgard, an intelligent ship's corporal, who, when off duty, lived in 
the town of Woolwich, at his own house, being married. He 
escorted the second case, who leant upon his arm, to the Herbert 
Hospital. He was not only well vaccinated, but stated that he had 
suffered from small-pox, although no traces of the disease were dis- 
cernible. With reference to the ori^n of these cases, the stafi 
surgeon* of the Fisgard observes: — "The first two cases were un- 
accountable, and in the absence of any other positive or probable 
conununication of the disease, the third case must have resulted from 
the second, and must have possessed a wonderful proclivity to the 
reception of the poison of this exanthem. On the assumption that 
he was thus infected, and in no other way, he presented the eruption 
within three days after exposure to the contagion, so that the period 
of incubation was almost niL This, too, it must be remembered, if 
bis statement be trustworthy (and there is no ground for doubting it), 
was not his first, but his second attack. The disease was authentic, 
but exceedingly modified." 

There was a single case of small-pox in the Implacable, at Ply- 
mouth. It occurred in the person of a boy, who presented very 
good vaccination cicatrices, and in whom the attack was very nuld. 
When on leave, he had visited a friend's house in which there was 
a child labouring under the disease. 

In the President, at London, a mild case of small-pox occurred, in 
the person of a petty officer who resided in Poplar. No reference is 
made as to the probable origin of the disease, nor is it stated whether 
the man had been previously vaccinated or not. 

Scarkt 

"^ Staff Surgeon C. K. Ord, x«d. 

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OF THE HOME STATION. O 

Scarlet Fever. — Twenty-four cases of this exanthem were under Home 
irai^aaent daring the year> of which one proved fataL The only Station. 
Am in which the disease appears to have made any progress was the rT'^j 
Jhake of Wellington, in wnich seven cases^ including the fatal one, ^t*il 
oecnrred. There were single cases in the Asia, Boscawen, ExceUent, ^^^ 
Ganges, Ldon, Monarch, and Trafalgar ; the Northumberland and 
tlie Pembroke, including the Sheemess Reserve, had each two 
cases ; and there were three cases in the Royal George and in the 
St Vinront, 

The history of the outbreak in the Duke of Wellington is thus 
riven by the surgeon* of the ship: — " During the period em- 
Dneed in this journal seven cases of scarlatina occurred; the first 
duee in boys. The first of these possibly received infection on 
dbore^ as ten davs previous to his complaining he had obtained after- 
noon leave* Of the other two, one had not left the ship for a period 
often weeks, and the other had not been on leave for five weeks, so 
that in all probability they were infected on board. 

*' The 200 boys who were then in this ship occupied the middle 
deck^ and were separated from the rest of the ship's company; but I 
deoned it advisable to have them at once removed to Her Majesty's 
Ship Victory, where they were widely berthed and carefully ex- 
amined every day. All those affected with sore-throat were separated 
for observation, but no other case of fever presented itself, and at 
the ex{^ration of a fortnight they would have returned to the ship 
had not another case of scarlatina occurred amongst the Marines. 
Hie subject of it was placed on the sick-list on the 15th of June 
widi snspicious symptoms, and was separated for observation ; the 
nest morning the characteristic rash made its appearance, and he 
was removed to hospital. He had not been on shore for three 
weeks. 

*^ The middle deck being unoccupied, I recommended that the 
Marine messes shoidd be removed there from the lower deck, as 
diere etiU seemed to be some source of infection in the ship. The 
cxew were examined from time to time, but this proved to be an 
isolated case, and on the 30th of June the boys were allowed to 
letnm to the ship from Her Majesty's Ship Victory. 

* Foot Ae last twelve months scarlatina nas been prevalent in this 
neighbourhood, but no other case occurred until the 29th of October, 
vhen ^ petty officer, who, being a married man, slept on shore every 
night, was attacked. He was isolated for twenty-four hours for 
observation before being sent to hospital. The mess to which this 
Bian belonged was situated forward on the middle deck, and away 
firom other messes. The petty officers forming the mess were ex- 
amined, but the case proved to be a solitary one, and could have had 
Ho connection with the next case which presented itself on the 22nd 
rf November in the person of a Marine. He reported himself on 
tlie evening of the 2lst, and was isolated for observation. During 
file night a well-marked rash made its appearance on the body, and 
in the morning he was removed to hospital. This man came on board 

frpm 

• Surgeon Fzedk. Blake. 
384. A3 



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6 MEDICAL STATIflXIGAIi SXTUBN8 

Home ^^ breaking his leave on the 29th of October, and had not visited 
Station. tbe shore since, as he was nndei^oing punishment. From the 9th 

to the 1 6th of November he was imprisoned in a cell on the orlop deck, 

®^ J* where he must have contracted the disease. I carefully investigated 
"^ * the history of the previous occupant of this cell, without being able to 
discover any clue to the source of the infection ; but, on maJring 
further inquiry, I found that clothes and bedding belonging to 
deserters and invalids who had died on their passage home had been 
stowed in the cell, and I considered that the man had been infected 
from this source. 

** As this Marine had frequented and slept in his mess till the night 
on which the rash appeared, I thought it prudent to advise the re- 
moval of the mess on board her Majesty's ship Victory, where they 
remained for twelve days. No otiber case occurred. The cell in 
which the Marine had been confined was fumigated with sulphur and 
washed with lime and carbolic acid." 

Under the head of ** Hygiene," the same officer observes, in con- 
nection with the subject : — ^* Another source of infection, which is 
in constant operation on board, is the custom of storing bedding and 
clothes belonging to deserters from other ships, as well as of invalids 
and men who have died on their passage home. These are not oidy 
stored, but sold and distributed about the diip. Deserters again, 
who are usually brought on board from the lowest haunts, are 
allowed to remain in clothes soiled, and possibly infected, as no pro- 
vision ia made to enable the ccunmanding officer to issue fresh 
clothes. I believe that in future all beddm^ and clothes that are 
sent on board will be inspected, and if worth Keeping will be imme- 
cUately removed to Haslar Hospital to undergo the process of disin- 
fection before being stored; and deserters will be provided with 
suits of clothes made and kept expressly for them." 

The case which proved fatal occurred in the person of a boy who 
was under treatment in Haslar HospitaL From the commencement 
of desquamation he had suffered from idbuminuria for a. fortnight, 
but without any urgent sjrmptoms, when he suddenly became con- 
vulsed and insensible, and died in twelve hours. 

Relapsing Fever. — A single case of this form of fever appears in 
the returns from the Fisgard. It occurred in the person of a boy 
who had recently entered the service, and had been granted leave to 
visit his friends in London. While there he resided in a house 
where a female relative was ill with fever, but of what nature he 
could not say. Very shortly after, he was taken ill and removed to 
the London Fever Hospital, where he remained three weeks, and 
was discharged on his recovery from what was noted on his bed- 
ticket, and was, his physician told him, " relapsing fever." 

The disease was very epidemic in London at the time. On the 
boy's return to the Fisgard, he still complained of giddiness, 
occasional shiverings, and of sleeplessness, and he was accordingly sent 
to the Herbert Hospital to hasten his recovery. 

Typhus Fever. — Four cases of this malignant form of fever 
oecurred in tlie force during^ the twelve months, one of which proved 
fatal. This case presented, itseli in tibe peeson of a petty officer of 

tic 



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OF THE BXmm STATIOK 7 

the Cambridge^ who was taken ill when on shore, and visited at his Howe 
lionse. His symptoms being of an obscure character, he was permitted Station. 
to return on board on the lollowing morning. The surgeon* of the (aasTL 
ahip^ who was himself confined to bed at the time, says : — *^ He was g^^^ ^ 
Tisited on the 8th of March in one of the foulest localities of Devon- 
port. On the following morning he came on board, was placed in 
bed and kept under observation. It does not appear that the 
assistant surgeons had any suspicion at this time of the true character 
of the disease ; the symptoms were so ambi^ous ; the amount of 
pyrexia, &Ci being but littie obvious, and his chief complaint being of 
an excruciating pain in the course of the sciatic nerve of the left leg. 
On the evening of the 11th it was reported to me that he muttered 
a good deal when apparently asleep. I contrived to visit him late in 
the evening, and found him approaching a typhoid condition. His 
tongue was foul and dry, the pulse small and much accelerated, 
soirdes forming on the teeth, intellect blunted, &c. ; he had passed 
bis evacuations naturally. He was carefully fed during the night 
with beef-tea, arrow-root, wine, &c., and in the morning was 
conveyed in a cot to the hospital. He died two days after his 
admission. This case was an example of the low insidious form of 
blood-poisoning occasionally to be met with in all these three towns, 
and perhaps the worst form of fever to be found in this country." 

On admission to Plymouth Hospital he was speechless, breathing 
stertorously, and could only be roused with difficulty. The pupils 
were contracted, the fece flushed, the tonjgue dry and brown, and 
the lips and teeth covered with sordes. The pulse could not be 
counted, and there were several dark livid patches on various parts 
of the body. He continued gradually to get worse, the stertor 
increased, the pupils were contracted to a pin's point, there was 

Srfect insensibility, and he died comatose at 6 a.m. of the 13th of 
arch. On post-mortem examination of the body, the superficial 
veins of the brain were found congested, the arachnoid thickened, , 
and there was some sub-arachnoid efiusion. The substance of the 
brain was healthy, and the ventricles empty. The heart was large, 
both sides filled with fluid blood, and clots of decolorised fibrine. 
The lungs were much congested and filled with a frothy fluid ; the 
Uver and spleen were large, and the latter very friable and congested. 
The bladder was thickened, and nearly full of clear urine. 

Single cases of typhus appear in the returns from the Eagle, 
MiDotaur, and St. Vincent The case in the Eagle was accompanied 
with the characteristic eruption of the disease. The patient was 
treated in sick quarters and recovered. The cases in the Minotaur and 
St. Vincent were of a somewhat doubtful character. The subject of 
the disease in the Minotaur was a seaman; he presented himself at 
Milford on the 12th of October, complaining of inflammation of the 
ear. He had only joined the ship a few days previously, and said 
that he was very wet and uncomfortable in the gunboat which 
brought him round. He had had a discharge from the right ear, he 
8ud, for five years. On the 14th he had a shivering fit and was 

observed 

* Surgeon Michael Walling, h.d. 
384. -^^-4 



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8 MEDICAL STATISTICAL BSTUBN8 

Home obserred to be silent and dejected. On the 15th he complained of 
Station. severe headache^ and the discharge from the ear stopp^; he was 

retching during the day. On the 18th the pulse was 122, the akin 

2*J* J* hot, and the discharge from the ear had reappeared; but frontal 
^^^ ^ headache still persisted. On the night of that day he was delirious. 
On the 20th there was less delirium. On the 21st and 22nd delirium 
was more constant^ and there was much restlessness. In the after- 
noon of the lattef day the delirium ceased on the application of a 
blister to the vertex. Expectoration, however, was pneumonic, being^ 
rusty and tenacious. On the 25th he was landed at JLisbon Hospital^ 
where he died on the 27th. 

The following report of the post-mortem examination of the body 
is given by the staff surgeon* of the ship : — " Body rigid and ema- 
ciated ; arachnoid membrane thickened, and the surface of the brain 
congested; medullary portion of a dull white colour; venr little 
fluid in the ventricles. Chest. — Heart displaced to the left side ; 
. pericardium filled with serum ; three pints of sero-sanguineous fluid 
m the chest ; left pleura costalis adherent ; left lung soft, rotten, and 
infiltrated with pus ; the right lung also disorganised, the upper lobe 
being hepatizea, and the middle lobe infiltrated with pus. The 
liver, spleen, pancreas, and kidneys were soft." 

The staff surgeon adds: — " The patient was unfavourablv situated 
during his illness : confined to a dark sick-berth, and the snip being 
at sea, it was not possible to open the scuttles to procure efficient 
ventilation ; the noises also prevented auscultation. Notwithstand- 
ing that he rallied on the tenth day of the fever, the pleuro-pneu- 
monia advanced insidiously, and so exhausted him that unfavourable 
symptoms soon supervened." 

From the history of this somewhat obscure case, it appears rather 
to have been one of meningitis occasioned by disease of the bones 
connected with the ear, and resulting in pyaemia. It is to be re- 

fretted that the condition of the petrous portion of the temporal 
one and of the mastoid cells was not examined. On Table lY. 
the death is recorded under Diseases of the Brain. 

With reference to the case of typhus which appears in connection 
with the St. Vincent, the staff surgeon observes : — " Under this 
head is tabulated a case, which more properly was one of typho- 
pneumonia, affecting a boy, and to whicn he unhappily succumbed 
at Haslar, on the 28th of November. He had been sent thither on 
the 19th of the same month. Having been the subject of scabies, he 
had recently undergone the process of sulphur inunction, from which 
he was freed on the 16th of November. Two dajs afterwards he 
was placed on the sick-list with febrile pneumonia, and diarrhoeio 
svmptoms. He had just been entered into the service, and had in 
all probability contracted the malady on shore, where I understand 
he bad been wandering about for three months in search of a mother 
who had deserted him and two other children, and he had been 
sleeping in various unions, and doubtless by the wayside.^ 

Simple 

* Staff Sai^g;eon Hart Gimlett, mj>. 

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OF THE HOME ATATIOK. 9 

Simple Continued Fever. — There were 240 cases of this form of Home 
icver under treatment during the year, of which two were invalided Station, 

and two had a fatal termination. Although the majority of the cases ' 

were of a comparatively trifling character, some were sufficiently S^f* 
prolonged and severe, as may be evidenced by the fact that each case 
was on an average thuteen days under treatment. The only vessels 
in which they occurred in any ^eat niunbers were the Bellerophon, 
the St. Vincent, and the Wamor. 

There were thirty-eight cases of this fever in the Bellerophon ; 
and, with reference, to them the surgeon* observes : — " Thirty-two 
of them were discharged to duty cured, and six sent to hospital for 
treatment. The first case sent to Lisbon Hospital had rather urgent 

rptoms, and I thought it was better at once to remove him to the 
e. He was a thin delicate-looking boy, and had suffered for a 
lon^ time from ague. The second case was under treatment 
on Doard this ship from the 14th of April till the lOth of May. 
I thought he was not sufficiently ill to be left at Lisbon 
Hospital, as the ship was going to England, but he did not 
recover on the passage home; a persistent dry brown tongue 
in the morning, with not skin and pyrexial symptoms, remained. 
It had not much effect upon liis appearance, nor did he lose 
much flesh. I supported him with wine and beef tea, and on 
arriving at Spitheaa sent him to Haslar Hospital A third case 
also was kept on board for ten days, and discharged to Haslar 
as soon as an opportunity offered. The symptoms were rather 
severe, and at first complicated with a little rheumatism of the left 
biee, which however disappeared in a few days, but the low con- 
tinued fever remained, with flabby tongue, quick pulse, giddiness, 
weakness, and listlessness. • • . The cases that were treated on 
board varied in duration and severity, but they were all simple con- 
tinned fever of a mild type. Some got well after two or three days' 
treatment, whereas others took a longer time to run their course. 
The young and the old took longest. Those between twenty-five and 
thirty-five years of age only averaged four days ; the young averaged 
ten days, and Hie old nineteen ; growing youth and declining strength 
being, of course, most inimical to reparation." 

In the St Vincent, in which there were twenty cases of this form 
of fever, ten were treated on board, and the remainder sent to 
hospital. Those treated on board are said to have been of a mild 
ephemeral character, such as are common in the hotter months of 
tine year. The cases sent to hospital were of longer duration, and 
of a graver nature. 

There were forty-three cases of simple continued fever in the 
Warrior; but little information, however, is given in connection with 
^em. The average duration of each case was between six and 
seven days. 

Cholera. — Three cases of cholera appear in the returns from the 
force ; one in the Excellent, one in the St. Vincent, and one in the 
Warrior. The case in the Warrior proved fieitaL In this instance^ 

in 



• Surgeon Nicholas LittUton. 
384. 



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10 MEDICAL STATiaTICAL SETUBKS 

Home ^^ which the case 10 classed in the retams from Haslar Hospital^ 
Station. whither he had been discharffed^ as one of sporadic cholera, the maai 

was suddenly seized, while on leave, with severe vomiting and purging^ 

tSass I. accompanied by great prostration, which, on admission on the third day. 
Sect A. had increased to complete collapse, with suppressicm of urine, extreme 
irritability of the stomach, and frequent very loose motions, pale, 
but not rice-water. He nillied for a few days, but sank exhausted 
on the twelfth day. Post-mortem examination of the body showed 
inflammatory congestion of the small intestines, without uleer- 
ation. 

In the Excellent the case of cholera is thus recorded by the staff 
Bureeon :* — ** A remarkable and isolated case of this disease occurred 
on me evening of the 18th of January. A coastguard man, a&t. 29, 
who had lately joined, was seized with purging at 3.30 p.m., but he 
did not apply for medical aid until 7 p.m. At that time there was 
vomiting, accompanied by copious rice-water stools, Mid cramps, both 
in the abdomen and lower extremities ; the tongue was cold, the 
arms and legs remarkably so ; the voice was weak ; the countenance 
sunken; the pulse, a thread. All medicine was at first rejected. 
Subsequently a large dose of calomel was given, followed by some 
brandy and laudanum, heat and friction being assiduously employed. 
There was no vomiting after the calomel Keaction set in about 
midnight, and the purging gradually ceased. Next morning he suf- 
fered principally from weakness. He passed no urine from the 
commencement of the attack until he left the ship next dajr for* 
hospital. The secretion had been completely suppressed, for, on intro- 
ducing a catheter, the bladder was found to be empty. 

** No cause could be assigned for the attack, which closely resem- 
bled the Asiatic form of the disease. The man was so weakened that 
he was obliged to give up his drilling for some months." 

In the return from the St. Vincent the attack is classed as ''cholera 
sostiva," and is said to have been of a simple transitory character, 
sharp while it lasted, and for which no cause could be assigned. 
The man was only on the sick-list two days. 

Influenza. — A slight epidemic of this disease in a mild form 
appeared in the St. Vincent between the 1st and 14th of November. 
It affected the boys chiefly, and was considered to be attributable to 
the very cold, humid, and generally inclement state of the weather, 
and to the sudden alternations of temperature to which the ship's 
company was subjected during that time. Although the affection 
prevailed very generally amongst the boys, it was only deemed 
necessary to place twenty-six ot them on the sick-list, all of whom 
were soon enabled to return to duty. 

U General Diseases.— Section B., or Constttntional Group. 

Class n. Rheumatism. — There were 1,062 cases of rheumatism under treat- 
8eot B. ment during the year, which is m the ratio of 48- per 1,000 of force,. 

being,* 

* Stiff Sm^^oon Jwph HendMson, irj>; 

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OV TH8 HOUB 0TATC(>F^ 11 

being a reduction^ eompsred with the preceding year, equal to 3* per Home 

1,000. Of these, twenty-six were inralided, giving a ratio of Station. 

jiiflt one-half of that of 1868. The total number of days' sickness mlirTT 

occasioned by the disease was 20,011, which gives an average of aJct R 
neariy nineteen days to each case. During the year nearly fifty-five 
men were daily inefficient from this cause. 

Syphilid. — Nine hundred and thirty-two cases, of primary syphilis 
and 284 cases of secondary syphilis were under treatment during the 
year; the former bein^ in the ratio of 42*1 per 1,000, and the latter 
of 12*8. Compared with the preceding year there was an increase 
in the ratio of primary syphilis to the extent of 5' per 1,000, and a 
reduction in the ratio of secondary syphilis to the extent of 3*1 per 
1,000. The average duration of each case of primary syphilis was 
about thirty-seven days, and each case of secondarv syphilis about 
forty-one days. Of the total number of cases, five of primary 
disease and sixteen of secondary disease were invalided, and one 
of secondary disease proved fatal. 

There were forty-one cases of primary syphilis and thirteen of 
secondary syphilis in the Asia. VTith reference to the first six 
months of the year, during which twenty-six cases of primary and 
eleven of secondary disease occurred, but little information is given 
by the medical officer then in charge* ; but, during the latter half of 
the year, his successorf observes ; — ** Seventeen attacks of syphilis 
have occurred, fifteen of primary and two of secondary. Seven of 
the former and both of the latter were sent to hospital 

** This disease has increased in the last six months among the crew, 
more particularly the Marines. I can only account for it by stating 
that most of the men have been afiected at Southampton, a town to 
which the Contagious Diseases Act does not extend.'^ 

In the Duke of Wellington there were seventy-three cases of 
nrimary and thirty-six of secondary syphilis. From the Ist of 
January to the 6th of March, there were nine cases of primary 
and eight of secondary disease, with reference to which the staff 
surgeon} observes : — *^ That two of the former were stated to have 
contracted the disease, one at Aldershot, and one at Southampton. 
Two only were hospital cases, the majority being trivial superncial 
Bores, yielding to a few days' cleanliness and local applications.'* 
During the remainder of the year, when another medical officer was 
in charge, venereal diseases appeared to increase steadily, a large 
number of the c^ses, however, being contracted beyond the neigh- 
bourhood of the port. The surgeon observes : — ** The increase of 
disease during the last quarter appeared to depend on some local 
cause, the reason of which I endeavoured to ascertain by inquiries 
and investigation. As regards the arrangements and duties of the 
police, I believe them to oe as efficient as the nature of the Con- 
tagious Act will permit. 

'* A visit I paid to the Lock wards of Landport Hospital, over 

whidx 

* Staff Sui^eon Charles Forbes, mj>. f Staff Suigeon PHdft. K'Rayner. 

X Staff Surgeon Wm. T. WUson. 
384. 



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12 MEDICAL STATISTICAL BETUBKS 

Home which I was conducted by the house surgeon of that institution, 
^ ^^^ ' impressed me that the arrangements were defective, both as re- 
jj gards the treatment and examination of the patients. The rule 
j^' of assiffninc two Lock wards to each of the medical officers of the 
hospital did not appear to conduce to the efficiency or discipline 
of tne establishment." 

In the Excellent, in which there were fifty-five cases of primary 
disease and sixteen of secondary, the staff surgeon remarks that 
there was a great increase in the diseases during the latter six months 
of the year. He says, " As regards primary sores, 1869 is a com- 
plete inversion of 1868 , • . . The returns from tiiis ship are cal- 
culated, in my opinion, to give a tolerably accurate indication of the 
condition of this port with reference to the prevalence of venereal 
disease. 

'^ It is quite clear that, notwithstanding the v^ant administra- 
tion of the Contagious Diseases Act, much syphms and gonorrhoea 
escapes detection, and prostitutes continue to ply their calling and 
to propagate disease, who ought to be under treatment in hospitaL 
In the present restricted operation of the law, such a state of things 
is perhaps imavoidable. But in the meantime much good might be 
effected by more frequent examinations. There are at this place 
about 600 prostitutes Known to the police as such. A compulsory 
weekly examination of each would be very desirable. At present 
inspection is often eluded, and there is no doubt that women affected 
witn gonorrhcea occasionally use astringent injections so effectually 
as to enable them to pass an inspection without being detected; 
and this perhaps partially accounts for the circumstance that whea 
primary sores appeared to be much on the decrease gonorrhoea held 
its ground or exhibited an increase." 

There were tiiirty-seven cases of primanr syphilis and twenty- 
one of secondary syphilis in the Hercules. In a considerable number 
of these cases the disease was contracted at ports to which tiie 
Contagious Diseases Act does not extend, such as Lisbon, London^ 
Portlimd, Milford, and Gravesend. 

There were fifty-two cases of primary syphilis and ten of secon- 
dary syphilis in tiie Northumberland ; but very few observations 
are maae in connection with them. Speaking of Gibraltar, the 
surgeon* observes : — " This is not by any means a good place to give 
men leave, for the wretched women are numerous, and disease 
amongst them is at times very severe. The men have few amuse- 
ments, drink is very plentiful, and the high license duties charged 
for the sale of drink induce the sellers to concoct and sell the vilest 
stuff." He also implies that the Contagious Diseases Act is very 
imperfectiy carried out on tiiat island, a fact which has frequentiy 
been commented on by medical officers. 

In the Pembroke and Sheemess Reserve, there were eighty-three 
cases of primary syphilis and sixteen of secondary syphilis. With 
regard to the effect of leave upon ships' companies, the surgeonf of 

the 

• Surgeon aClift. f Suigwm T. Haian. 

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OF THE HOME 8TATIOK. 13 

the Pembroke makes the following observations: — ^^'One of the Home 
most prized privileges connected with Home Service consists in the Station , 
liberal amount of general and special leave usually granted. To such Class 11. 
of the men as are married this is a great boon, but to those who are Sect B. 
not it frequently becomes quite the reverse. Sailors and soldiers^ 
the former especially on account of their peculiar training, are pro- 
verbially an impressionable race, and very few of them possess 
sufficient strengtn of mind to resist the incentives to drunkenness 
and debauchery so conspicuously and unblushinglv displayed in all 
sea-port and garrison towns, with the ill-concealed ODJect of en- 
snaring them. These are evils which cannot be wholly remedied, 
except by withholding the privilege of leave altogether, and this is 
a course, unjustifiable at any time, which no one would think of 
adopting nowadays. Drunkenness, the besetting sin of soldiers and 
sailors, although very much on the decline, will, it is to be feared, 
alwavs exist more or less, but the diseases resulting from de- 
bauchery, meaning by the term impure connection with prostitutes, 
are happily becoming numerically fewer year by year, in towns pro- 
tected by the provisions of the Contagious Diseases Act The 
statistics of the last few years clearly prove this assertion. 

*^ The men of this ship have had abundance of leave, general and 
privileged, during the period of this Journal, including fourteen days 
after they were paid on from the Agincourt. While on long leave 
many of them visited remote parts of the kingdom, and were exposed 
to the ordinary sources of contagion prevailing in most places. On 
such occasions they were always examined on their return, and 
although a great many admitted they had ^^ gone with women " in 
unprotected towns ana villages, I am bound to say that most of 
them escaped, and that of the number of cases of venereal — syphilis 
and gonorrhoea — under treatment for the entire period, the propor- 
tion of those contracted in protected towns to those not so favoured 
stands in the ratio of 15 to 14, an anomaly which would appear 
singular were it not generally known that prostitutes arriving from 
unprotected places very often succeed in communicating the disease, 
in quick succession to several persons before they are detected. It 
must also be borne in mind that men, whether they be sailors, sol- 
diers, or civilians, who may have contracted the disease in London 
or other inland towns, communicate it very frequently to the 
wretched creatures eaining a precarious livelihood by prostitution in 
protected places, and who may have previously been supplied with 
a clean bill of health. They in turn infei^t others, and so the 
disease is kept alive in full vigour, but on a greatly reduced scale to 
what it used to be. The only remedy for this state of things will 
be the application of the provisions of the Act to everjr town in the 
United kingdom, and if those who are now so loud in their out- 
cries and protestations against one of the most salutary Acts of Par- 
liament ever passed were only to realise the incalculable benefit its 
universal appucation would confer on generations yet unborn, and 
could only estimate the lives of suffering and misery the victims of 
inherited syphilis are doomed to lead, to say nothing of the shame 
and the torture ihe silly victims of their own indiscretion so often 
endure, I have no doubt whatever that, intensely prejudiced and 
sternly moral as they may be, and no doubt are at present, — pity 

384. for 



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vl4 MEMOAL STAnarXOAL SBTCBKS 

Bone for the sufferiiige of victinifl *^ in jpM»e/' if not for those of the afflicted 

■^^^^ ^* in esse,** would overbear all scruplee, and that instead of being 

•CSlaH n. opponents they would become ardent supporters of the Act." 

Beot B. The staff surgeon* of the Sheemess Reserve^ remarks^ ihat^ as a 

rule, the disease, as contracted in Sheemess, was of a more tractable 

character than formerly, being more amenable to treatment 

There were fortj-four cases of primary syphilis, and nine of se- 
4)ondary syphilis, m the Warrior. Very few comments are made 
upon uiem, but the staff surgeonf observes that, " In Portsmouli 
the Act seems to have done good, but the outlying towns, where it 
IS not in force, produce a larger quota, so that to stamp out the 
disease a generid law is required, which the feeling of the public 
at present prevents." 

Phthisis Pfdmonalis. — One hundred and twenty-two cases of this 
disease were under treatment, of which eighty-nine were invalided, 
and twenty-two terminated fatally^ All me ratios under this head 
'were lower than those of the preceding year. 

Epithelioma. — A fatal case of this disease occurred in the person 
of an old pensioner borne on the books of the Asia. He was ori- 
ginally placed on the sick-list for abscess connected with the lower 
jaw. Ulceration of the soft parts covering the jaw of a cancerous 
nature set in and extended, and carried him off, exhausted, after 
having been more than two years under treatment. 

in. Diseases of the Kervous System and Organs of the 
Special Senses. 

Class in. Under this head 547 cases of various forms of disease were placed 
on the sick-list during the year, of which seventy-seven were invalided 
and thirteen proved fataL No comparison can be drawn between 
the various ratios during the present year as compared with former 
years, the new nomenclature of diseases having added to this class 
a number of affections which formerly were differently placed. 

Apoplexy proved fatal in two cases. The subject oi one of the 
attacks was a warrant oflBcer of the Sheemess reserve, who appears 
to have laboured under a complication of diseases, having previously 
suffered from chronic disease of the liver, hasmoptysis, gangrenous 
ulceration of the tonffue, and diarrhoea. The apoplectic seizure 
which carried him off was his second attack. The otiier fatal 
case occurred in the person of a commissioned officer of the Royal 
Adelaide, who had been complaining for a few days of loss of appetite, 
pains in the head, drowsiness, and general debility. He was suadenly 
seized with giddiness when in the act of leaving the wardroom, and 
was at once conveyed to his cabin, where deam took place in a few 
minutes. 

There were ten deaths from various forms of disease of the brain 
and its membranes. 

A private of the £oyal Marine Artillery in the Hercules, a well- 
proportioned man, apparently in robust health, was placed on the 

sick- 

* Staff Surgeon Janes Lilbumey m.d. f Staff Suigeon J. C. Walsh. 

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01* TAB HOMB 8TA7I<»r. 15 

Mk^liet on the 7th of August, oottplainhig of intense pain in Hmne 
tbe right ear ; great irritability of ^he stomach set in, acecMnpanied . ^tatigg . 
with intense and permstent headache. On the 11th he had a severe Class HI. 
rigor, followed by profuse perspiration, and on tiie 12th there was a 
free purulent discharge from the ear. The symptoms subsequently 
beoame somewhat allotted, but a dull headaiche continued ; he was 
Tery depressed, and on the 14th the puoils were dilated ; the pulse 
yery slow, and he was passing his stools and urine involuntarily. 
In this condition be was discbacged to Plymoutii .Hospital, where 
he died on the following day. On post-mortem examination of the 
body, the dura mater of the right side was observed to be of a dirty 
green colour, and on slitting it up, about four ounces of fetid pus 
escaped from between it and the arachnoid. The surface of the 
r^ht hemisphere of the brain was coated with pus. There was 
ulceration of the size of a florin on the under surface of the right 
posterior lobe. This had pierced the pia mater. Over the petrous 
portion of the temporal bone, which was found to be in a state of 
caries, the dura mater was ulcerated. 

A boy of the Boyal George was sent into Plym^outii Hospital for 
the treatment of diarrhopa. On admission he was found to be in a 
state of extreme debility with repeated rigors ; he had a flushed 
and anxious face, and was soporose, but readily roused to answer 
ipiestions. The pulse was ^eble and frequent, and the tongue 
creamy. There was much purulent discharge from the left ear, 
with tenderness over the temporal and mastoid regions. He stated 
that he had been subject to a discharge from his ear since childhood. 
He symptoms gradually became worse, assuming those of pysBmic 
poisoning. He dxed on t^e 7th of May. On post-mortem examination 
of the body, the petrous portion of the left temporal bone was found 
to be extensively diseased, with pus effiised on its surface, communi- 
cating with the jugular foramen. Purulent matter was also effused 
on the under surface of the crura cerebri and posterior lobe, and in 
the latter an ulcerated spot was found. The bony case of the audi- 
tory canal was extensively carious. 

The majority of the otner fatal cases of disease of the brain had 
their origin in caries of the petrous portion of the temporal bone. 

IV. Diseases of the Oireulatory System. 

There was a reduction in the ratio of deaths cominj^ under this head. Class 17* 
compared with the preceding year, but the ratio oi cases and invalid- 
ing were higher. Of 217 cases of all forms of disease entered on 
the sick-list, ninety-nine were invalided, and twenty terminated 
fatally. There were twelve deaths from organic disease of the 
heart, and eight from aneurism. 

V. ft VI. Diseases of the Absorbent System and Ductless 

Glands. 

Under this head appear 131 oases of sympathetic bubo, and three Classes 
rf adenitis. The latter were re-entries of one man, a seaman of the V. ft VL 
Asia, strongly antd heavily built, but of a highly strumous diathesis. 
He soffered from chrome enlargement ot the cervical and sub- 

M4. maxillary 



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10 MEDICAL STATISTICAL BSTUBHS 

Q^^^ maxillary glands^ for which he had been at various tunes under 
Station. treatment The glands behind and below the left ear were nearly 

the size of an orange^ with great thickening and hardening of the 

Claiias surrounding tissue. He was 246 days under treatment on board 
Y. ftYI. ship and in hospital. 

Each case of s^pnpathelic bubo was« on an ayerage^ between 
thirty-three and thirty-four days under Ixeatment. 

yiL DiBeases of the Bespiratoiy System. 

Class Vn. The removal of influenza to the Class of General Diseases, Sec- 
tion A.5 and of phthisis pulmonalis to Section B. of the same class, 
very much alters the character of this section of diseases, as compared 
with the preceding year. Of those of which the classification is 
unchanged, however, there is very little difference in the different 
ratios, compared with those of 1868. Of 327 cases of various forms 
of inflanunatory disease, nineteen were invalided and twenty-four 
proved fatal. 

Vm. Diseases of the Digestive System. 

Glass Yin. Under this head, 2,533 cases were placed on the sick-list; of 
which, sixty-five were invalided and seven terminated fatally. 

A fatal case of peritonitis occurred in the person of a boy of the 
Ganges, who was admitted into Plymouth Hospital on the ni^ht of 
the 11th of June. In the report that was brought with him, it was 
stated that he had been ill for five days with pyrexia, constipated 
bowels, and vomiting (apparently fsBcal matter). On his admission, 
he complained of pain all over the abdomen, not much increased on 

Eressure except over the colon and caecum. The abdomen was 
ard, and he stated that his bowels were loose. The skin was hot 
and dry ; the tongue coated and dry, and the pulse 130 per minute* 
The expression of the face was very sunken. During the night he 
had three or four liquid brown stools, and vomited some dark matter, 
but without any ftecal odour. He complained of no pain, but died 
quietly at 7 a.m. of the 12th, ten hours after admission. On post- 
mortem examination of the body, a considerable quantity of fluid was 
found in the abdominal cavitr. The parietal layer of the peritoneum 
was extensively covered with recent lymph. The omentum, trans- 
verse colon, and small intestines were glued together by the same 
effusion. The peritoneal coat of all the intestines, and especially of 
the caecum, was deeply congested. In the ctecum there was a hard 
mass of undigested food containing some large raisin stones, but there 
was no inflammation of the mucous membrane. 

In Table IV., under the head of dyspepsia, a fatal case appears in 
connection with the Duke of Wellington. It occurred in the person 
of a petty officer, who was placed on the sick-list on the 29th of 
April, compbdning chiefly of dyspepsia and vomiting. He had suf- 
fered some months from dyspnoea, and presented a most cachectic 
appearance, having a scaly eruption on both feet and legs, and there 
being an occasiond discharge from an old abscess in the right thigh, 
for which he was invalidea from Ae Pacific in 1865. Although 
entered on the sick-list under the head of dyspepma and debility, the 

disease 



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OP THE HOME STATION. 17 

diaesse whicli carried him off was double pneumonia, which, it would Home 
appear^ had been insidiously gaining upon him without affecting him Statioiu 
to such a d^ree as to interfere with his duties as sick-berth Zl 

steward* On examining his chest, the whole of the right side and Class VIIL 
the upper part of the left were found dull on percussion, with 
tabular respiration* He was discharged to Haslar Hospital for 
treatment on the 1st of Maj, being then, according to the hos- 
ptal report, in a moribund state. He died on the 5th of the same 
month. 

A fatal case of dysentery occurred in the person of an officer who 
had contracted the disease originally in China, and the same may 
be said of a fatal case of diarrhoea occurring in a seaman of the 
Fimurd. 

A fatal case of abscess of the liver occurred in Plymouth Hos- 
ptal in the person of an officer of the Boyal Adelaide, who had suf- 
fered some years previously from inflammation of that organ. On 
admission, on the 3l6t of May, he was in an extremely low, prostrate 
condition. The tongue was found brown and dry ; the lips and 
ieeib covered with sordes ; pulse 100, and very weak ; the skin and 
conjunctiv8D were icteroid; tne bowels costive; the urine dark brown 
in colour, but not scanty. It was found to be free from albumen, but 
loaded with bile* He was slightly delirious on the evening of his 
admission. On the nights of uie 2nd and 3rd of June he had rigors, 
followed by heat, and on the morning of the 4th he was violently 
delirious* Another shivering fit occurred on the 6th, afler which 
the pulse rose to 116, and he was very restless. From that time the 
case took a rapidly downward course ; most distressing hiccough set 
in. He vms constantly delirious and moaning. The urine became 
TfiT scanty and almost black, and he died on the morning of the 
14tL 

On post-mortem examination of the body, the liver was found 
nther small, the external surface of the whole organ mottled, and 
"hob-nailed." The gall bladder was distended with bile. The 
whole hepatic tissue was foimd studded with abscesses of various 
sizes, but all small, and apparently connected with the portal vessels, 
which were full of pus. Some of these abscesses showed through 
the surface of the liver. The left lobe was much shrunken and 
bard, and presented the appearance of cirrhosis ; weight 4 lbs 7 J ozs. 
There were some old adhesions between the pancreas and the trans- 
verse colon, and the kidneys were firmly adherent to the surroundiug 
parts ; but they, as well as all the other abdominal and thoracic 
TOcera were healthy in structure. 

A warrant officer of the Indus who had been for several months 
suffering from chronic disease of the liver and diarrhoea died in 
Plymouth Hospital. On post-mortem examination of the body, the 
longs were found to be studded with tubercle, the omentum was 
adherent all over the intestines. The mesenteric glands were much 
eolai^ed, and some of them were of a cheesy consistence. The 
small intestines were so matted together and disorganised, that they 
gave way in several places during removal. There were more than 
twenty distinct patches of ulceration on various parts of the mucous 
membrane, some as large as three or four inches square. 
384. B 



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18 MEDICAL STATISTICAL RETURNS 

st^n. I^ A X* Diseases of the Urinaiy and Generative Systems. 

Deducting from this group primary and secondary syphilis, wliich 

ClaMM IZ. have been transferred to General Diseases, Section fe., the ratios 

* ^ of cases and invaliding under this head are somewhat larger than in 

the previous year, but the death-rate in both years was alike. In 

the ratio of cases of gonorrhoea, there was an increase to the extent 

of 7-3 per 1,000. 

Of 1,312 cases of all forms of disease, forty- two were invalided, 
and six proved fataL In the majority of fatal cases death resuked 
from Bright's disease of the kidneys. 

XL Diseases of the Organs of Locomotion. 

Class XL There were ninety-seven cases of various forms of disease of the 
bones and joints, of which nineteen were in invalided. 

XTT. ftXin. Diseases of the Cellular Tissue and Cutaneous 

System. 

ClasMi XIL Of 4,517 cases of various forms of disease coming under this head, 
ftXin. forty-five were invalided, and two proved fatal. The ratios are 
almost preciselv the same as in the previous year. 

In the two mtal cases death resulted in one instance from car- 
buncle, and in the other from the exhaustion caused by the forma- 
tion and discharge of several large scrofulous abscesses on different 
parts of the body. 

Undassed Diseases. 

There were 123 cases of debility, forty-two cases of delirium 
tremens, and twelve cases of poisoning under treatment, of which 
eighteen cases of debility, two of delirium tremens, and one of 
poisoning were invalided. 

Delirium Tremens. — Of the forty-two cases of this degrading 
form of disease, six occurred in commissioned officers, one in a 
warrant officer, three in petty officers, one in a leading seaman, 
three in able seamen, seven in stokers, five in bandsmen, twelve in 
marines, and in four instances the ratings have not been ascer- 
tained. 

Poisoning. — Under this head twelve cases appear, of which five 
were examples of lead poisoning, six were alcoholic, and one was a 
case of mussel-poisoning. They all recovered, but in one instance 
lead palsy existed to such an extent that it was necessary to invalid 
the subject of the attack. 

Wounds and Injuries. 

Eleven men sustained fatal fracture of the skull, seven by falling 
from aloft; one while on leave; one hj falling from the upper to the 
main deck ; and in two instances it is not stated how the accident 
occurred. A man sustained fatal fracture of the spine by a box of 
coals falling upon him ; and another man sustained a similar injury 

by 



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OF THE HOME STATION. 19 

by falling from a window. A man sustained dislocation of the neck Home 
by falling from aloft ; a man sustained fracture of the ribs and fatal Station. 

internal injuries by falling from aloft ; and two men were killed by 

the bursting of the boiler of a steam vessel. 

Twenty-two persons were drowned during the year. Of these 
nx fell overboard ; nine were capsized in boats ; one fell into the 
harbour from a railway embankment ; one fell into a dock ; one fell 
into a canal ; one was drowned while with a swimming party ; and 
one man, while labouring under delirium tremens^ eludea his guard, 
jumped overboard, and was drowned. 

A man committed suicide by swallowing oxalic acid. 

The total number of deaths was 153, which is in the ratio of 6*9 
per 1,000, being a decrease, compared with the preceding year, equal 
to "6 per 1,000. The death-rate from disease only was 5*1 per 1,000. 
In 1868 it was 5*5 

Inyalided. 

Under General Diseases, Section A., three persons were inva- 
lided, viz., two for the sequelae of fever ; and one for erysipelas. 
Under Section B., 145 were invalided, of which tw*ty-six were 
for rheumatism ; one for gout ; five for primaiy, and sixteen for 
secondary syphiiis; six for scrofula; eightv-nine for pulmonary 
consumption ; one for purpura ; and one for dropsy. Seventy-seven 
persons were invaUdea for diseases of the nervous system, and organs 
of the special senses ; ninety-nine for diseases of the circulatory 
system; two for diseases of the absorbent system and ductless 
glands ; twenty-three for diseases of the respiratory system ; sixty- 
five for diseases of the digestive system ; of which thirty^-nine were 
for hernia; forty-two for diseases of the urinary and generative 
^sterns; nineteen for diseaaesof the organs of locomotion; forty-five 
for diseases of the cellular tissue and cutaneous system; twenty-one 
for unclassed diseases; and twenty-five for woimds and injuries of 
various kinds. 

The total number invalided was 566, which is in the ratio of 25*6 
per 1,000, being an increase compared with the preceding year 
equal to 3*7 per 1,000. 



384. B 2 

/Google 



Digitized by^ 



20 



MEDICAL STATISTICAL RETURNS 



Table, No. l. 

Showing the Number of Cases of all Diseases and Injuries, and the Number Invalided 
and Dead, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



CasM. 



Namber. 



I. General Diseases, Section A. 

Small-pox - - - 

Vaccinia - - . 

Measles - . - . 
Scarlet Fever 

Typhus Fever - - 
Enteric Fever 

Relapsing Fever - 

Simple continued Fever - 

Ague - - . . 

Remittent Fever • 

Cholera - - . . 

Diphtheria • - . 
Hooping Cough 

Mumps - « . . 

Influenza - . . 

Erysipelas • « . 



II. General Diseases, Section B- : 

Rheumatism • - . . 
Gout 

Tumour Cystic - - - 

Scrofula - . - - 
Phthisis Pulmonalis 

Epithelioma . • . - 

Purpura and Anaemia - 

Dropsy - - - - - 



III. Diseases of fhe ITervous Sys- 
tem and Organs of the 
Special Senses: 

Apoplexy - - - . 

Sunstroke «... 

Paralysis - - - . 

Vertigo - - - - • 

Epilepsy - - - - 

Neuralgia - . . . 

Insanity ..... 



8 

2 

284 

24 

4 
11 

1 
240 
111 

9 

3 

3 
10 
30 
44 



1,062 

62 

1)32 

284 

1 

11 

122 

2 

3 

9 



4 
3 
20 
18 
40 
80 
24 



Ratio 
per 

1,000 
of 

Force. 



12-8 
1- 
•1 
•4 

10-8 
6- 
•4 
•1 

•1 

•4 

1-3 

1-9 



48- 
2-3 
421 
12-8 

•4 
5-5 

•1 
•4 



•1 
•1 
•9 
•8 

2- 

3-6 

1- 



Invalided. 



Number. 



Ratio 
per 

1,000 
of 

Force. 



20 
1 
5 

16 

6 
89 

1 
1 



15 
19 
13 



M 

•2 
•7 



•6 
•8 

•5 



Dead. 



Number. 



Ratio 

per 
1,000 

of 
Force. 



22 
1 

1 
2 



Digitized by 



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OF THE HOME STATION. 



21 



Tabli, No. 1. — Showing the Number of Cases of all Diseases, &o. — continued. 



DISEASE OR INJURY. 



in. Diseases of fheVeryons Sys- 
tem, ^^'^<onttnued. 

Other Diseases of theBrain^ &c. 
Diseases of the Nervous System 
Diseases of the Eye 
Diaeeses of the Ear - 
Diseases of the Nose 

lY. Diseases of the Circulatory 
System: 

Disease of the f Functional - 

Bean -\Organic - 
Aneurism - . . . 
Varicose Veins ... 

T. ft YI. Diseases of the Absor- 
bentSystem and Ductless 
Glands: 

BvL\>o(:^p.) . . . 

Glandular Diseases 

Tn. Diseases of the Respiratory 
System: 

Dlseaaes of the Larynx - 
Catairh - - - . . 
Hiemoptysis ->->.. 
Asthma ..... 
Other Diseases of the Lungs - 

Hn. Diseases of the Digestive 
System: 

Cynanche .... 
Diseases of the Mouth, Teeth, 

&c. - - - - - 
Dyspepsia .... 
Djrsentery .... 
Diarrhoea .... 
Colic and Constipation - 
Haemorrhoids ... 
Hernia - - - - . 
Worms - - - . - 
Other Diseases of the Stomach, 

Intestines, &c ... 
Diseases of the Liver, Spleen, 

&c. ..... 

3S4. 



CMei. 



Nnmber. 



10 

4 

258 

66 

13 



135 

49 

6 

27 



131 
8 



5 

2,507 

31 

7 



865 

20 

545 

12 

620 

164 

52 

74 

37 

43 

101 



Ratio 
per 

1,000 
of 

Forot. 



•4 

•1 

11-6 

3- 

•5 



61 

2-2 

•2 

1-2 



5-9 
•3 



•2 

113-4 

1-4 

•3 
14-7 



39»1 

•9 

24-6 

•5 

28- 

7-4 

2-3 

3-3 

1-6 

I'D- 

4*5 



InralidecL 



Namber. 



10 

12 

1 



31 

52 

2 

14 



2 
2 

19 



39 

11 
4 



Ratio 

1,000 

of 
Force. 



1-4 
2-3 



17 

•4 
•1 



DeMl. 



Nombe r 



10 



12 
8 



1 
24 



Ratio 
per 

1,000 
of 

Foroe, 



B 3 



Digitized by 



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22 



HEDIOAL STATISTIOAL BETURK8 



Table, No. I.— Showing the Number of Cases of all Diseases, kc.-'-continHed. 




Cm.. 


Invalided. 


Dead. 


DISEASE OR INJURY. 




Ratio 
1,000 
Force. 




Ratio 
per 




^Ratio 
per 




Number. 


Number. 


1,000 
of 

rOTCtm 


Number. 


IfiOO 

of- 

Force. 


IX.ftZ. Diseases of the TTrinary 
and Generative Systems : 














Diseases of the Kidneys - 
IMscasefe of the Bladder - 
Gonorrhoea - . - . 
Diseases of the Organs of Gene- 
ration - . - - 
Stricture - . - - 
Varicocele - - - - 
Orchitis 


42 
16 

856 

13 

71 

12 

302 


1-9 
•7 

38-7 

•5 

3-2 

•5 

13-6 


13 

4 

8 
7 
8 
2 


•5 
•1 

•a 

•3 
•3 


5 
1 


•2 


XI Diseases of the Organs of 
Locomotion : 














Diseases of the Bones and 
Joints, &c. - - - - 


97 


4-3 


19 


•8 


— 


— 


XIT. ft Xni. Diseases of the 
Cellular Tissue and Cuta- 
neous System: 














Phlegmon and Abscess - 

Ulcer 

Erythema - . - - 
Diseases of the Skm 
Carbuncle - - - - 
Scabies -.*--. 


2,782 

1,198 

38 

283 

221 


125-8 

539 

1-7 

12-8 

10* 


2 
40 

3 


1-8 
•1 


1 
1 


— 


TTnelassed: 








■ 




: 


Debility .... 
Delirium Tremens - - - 
Poisoning - - * - - 


123 
42 
12 


5-5 

1-9 

•5 


18 
2 
1 


•8 


■ — 


• — 


Wowds and Injuries : 








I 






Wounds, Injuries, &c. -^ 
Burns and Scalds - - . 
Submemon and Drowning - 
Hanging .... 
Suicide - - - - - 


4,022 

165 

25 

1 
1 


181-9 
7-4 
11 


25 


1-1 


17 

22 

1 


•7 
•9 


Total - - - 


19,892 


900- 


566 


25-6 


153 


6-9 



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OF THE HOME STATION. 



23 



Table, No. 2. 

Shoving the Number of Days' Sickness from each Disease and from Injuries, the 

Average Number of Men Sick Daily, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



Number of Dayt* SickneM 



On Board. 



L General Diseases, Section A. : 

Small-pox - - - . 

Vaocima - - - . 

Measles - - - - 

Scarlet Fever - - - 
Typhus Fever 
Enteric Fever 
Relapsing Fever 
Simple continued Fever 

Ague - - - - 

Remittent Fever - 

Cholera - - - - 

Diphtheria - - - 
Hooping Cough 

Mumps - - - - 
Influenza ... 

Erysipelas - - - 



n. Oeneral Diseases, Section B. 

Rheumatism - - - - 
Gout 

Tumour, Cystic - 

Scrofula - . - 
Phthisis Pulmonalis 

Epithelioma - - - . 

Purpura and Ansmla • 

I^ropsy - - - . 



m. Diseases of the Heryous 
System and Organs of the 
Special Senses: 

Apoplexy - - - - 

Sunstroke - - - - 

Paralysis - - - - 

Vertigo - - - - - 

Epilepsy . . - - 

Neuralgia - - - - 

Insanity . . - - 

384. 



394 

21 

164 

107 

19 

88 

4 

1,184 

856 

133 

5 



In HoapitaL 



21 
124 
151 
365 



9,727 

606 

14,780 

3,245 

13 

235 

1,152 

79 

61 

103 



4 
39 
113 
72 
504 
545 
139 



180 

6,587 

17 

2 

516 

1,939 
311 
101 

2 

180 

81 

28 

872 



10,284 

91 

19,617 

8,418 

776 

8,647 

46 

43 

550 



Total. 



574 

21 

6,7A1 

124 

21 

604 

4 

3,123 

1,167 

234 

5 

2 

151 

206 

179 

1,237 



20,011 

697 

84,397 

11,663 

13 

1,010 

9,799 

126 

104 

653 



Average Number of 
Men Sick Daily. 



23 


27 


102 


141 


1,093 


1,206 


327 


399 


440 


944 


423 


968 


956 


1,096 



Number. 



1-6 

18*4 
•3 

7-6 

8-6 

31 

•6 



'4 

•5 

•4 

3-3 



64*8 

1-6 

94-2 

31-9 

2-7 

26 8 

•3 

•2 

1-7 



•3 
3-3 
1- 
2-5 
2-6 



Ratio 

per 

1,000 of 

Force. 



2-4 

4-2 
1-4 

•1 
1-2 



b4 



Digitized by 



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24 



MEDICAL STATISTICAL BETUBNS 



Tablb, No. 2.— Showing the Number of Days' Sickness from each Disease, 


&c.— row^. 




Nmnber of Days' Sicknen 


i\verage Number of 
Men Sick Daily. 


DISEASE OB INJURY. 










Ratio 




On Board. 


In Hospital. 


Total. 


Number. 


per 
1,000 of 
Force. 


III. Diseases of the B'ervous Sys- 












tem, &C. — continued. 












Other Diseases of the Brain, &c. 


. 62 


623 


685 


1-8 


— 


Diseases of the Nervous System 


26 


60 


86 


•2 


— 


Diseases of the Eye 


2,815 


2,377 


5,1112 


14-2 


•6 


Diseases of the £ar 


570 


346 


916 


2-5 


•1 


Diseases of the Nose 


49 


106 


155 


•4 


— 


IV. Diseases of the Circnlatory 












System : 












Disease of the / Functional - 
Heart - | Organic - 


1,079 


2,100 


3,185 


8-7 


3 


846 


1.564 


1,910 


5-2 


•i 


Aneurism - - - - 


72 


246 


318 


•8 


— 


Varicose Veins - - . 


174 


316 


490 


1-3 


— 


V. & VI. Diseases of the Absorb- 












ent System and Dnctless 










- 


Olands: 












Bnho (Symp.) ... 


2,478 


1,880 


_ 4,367 


11-9 


•5 


Glandular Diseases 


95 


151 


H'iG 


•6 


— • 


Vll. Diseases of the Respiratory 












System : 












Diseases of the Larynx - 


06 


100 


136 


•3 





Catarrh 


14,082 


1,168 


15,250 


41-7 


1-8 


H«raoptysis - - - - 


191 


681 


872 


2-3 


•1 


Asthma - - - - - 


104 


64 


168 


•4 


— 


Other Diseases of the Lungs - 


3,087 


6,819 


9,906 


27-6 


1-2 


Vin. Diseases of the Digestive 












System: 












Cynanche . - . - 


5,322 


1,115 


6,437 


17-6 


•7 


Diseases of the Mouth, Teeth, 












&c. 


146 


21 


167 


•4 


_ 


Dyspepsia . - . - 


2,.555 


1,367 


3,922 


^107 


-4 


Dysentery - - - . 


134 


(555 


789 


2-1 


„— 


Diarrhoea - • - - 


2,435 


575 


3,010 


8-2 


•3 


Colic and Constipation - 


612 


116 


728 


1-9 




Hflpmorrhoids - . . 


476 


149 


625 


1-7 


. 


Hernia - - - . - 


447 


83 


530 


1-4 





Worms - - - - - 


170 




170 


•4 


.^ 


Otlier Diseases of the Stomach, 












Intestines, &c. ... 


368 


1,143 


1,611 


41 


•1 


Diseases of the Liver, Spleen, 












&c 


1,007 


1,011 


2,018 


5-5 


•2 



Digitized by 



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OF THB HOME STATIOK. 



25 



Tabi^No. 2, — Showing the Number of Days* SicknesB from each Disease, &c. — eoni^* 




Number of Days' Sickness 


Men Sick DaUy. 


DISEASE OR INJURY. 










Ratio 




On Board. 


InHospitaL 


Total. 


Number. 


per 

iJDOOof 

Force. 


IX.ftX. Diseases of the TTrinary 
OeneratiTe Systems : 












Diseases of the Kidneys 
Diseases of the Bladder 
Gonorrhoea - - - - 
Diseases of the Organs of 
Generation ... 
Stricture - - - - 
Varicocele - • - - 
Oiehitis .... 


331 

42 

11,943 

109 

450 

86 

3,421 


1,329 

148 

3,869 

524 

2,135 

64 

1,880 


1,660 

190 

16,802 

633 
2,685 

150 
5,801 


4*5 

•5 

48-2 

1-7 
7- 

•4 
14-5 


•2 

"^3 

—6 

• 


XI. Diseases of the Organs of 
Locomotion: 












Diseases of the Bones, Joints, 
&c 


1,085 


2,378 


3,468 


9-4 


•4 


Zn. ft Zm. Diseases of the 
Cellnlar Tissne and Cuta- 












Phlegmon and Abscess - 

Ulcer 

Erythema - - . - 
Diseases of the Skin 
Carbuncle - - - - 
Scabies .... 


22,038 

17,183 

359 

3,055 

12 

2,194 


3,760 

11,348 

146 

2,266 

63 

600 


26,788 

28,531 

504 

5,321 

75 

2,794 


70-6 
781 

1-3 

14-5 

•2 

7-6 


31 
3-6 

•6 

•3 


Undassed: 












Debility - - . - 
Delirium Tremens 
Poisoning - - . - 


973 

182 

66 


2,543 
561 
230 


8,516 
683 
296 


96 

1-8 

•8 


•4 


Womids and Lqnries : 

Wounds, Injuries, &c. - 
Burns and Scalds - - - 
Submersion and Drowning - 
Hanging ... - 
Suicide 


38,816 

1,579 

18 

5 

6 


9,547 

409 

48 


48,363 

1,988 

61 

5 

6 


182-5 

6-4 

•1 


5-9 
•2 


Totals - - - 


177,788 


131,264 


309,062 


8467 


388 



384. 



Digitized by 



Google 



26 



MEDICAL fiXATISTIGAL BETUBNS 



Table, No. 8. - 
Showiitg the Number Invalided from each 



CAUSE 
INVALIDING. 


8 

s 


l! 

55 


^1 

ii 


^ 


s 


i 


1 


1 

m 


•c 

m 


, 


1 




I. General Diseaies, Section A. : 

Continned Fever ... 
Erytipelas ..... 

II. General DisesMs, Section B. : 

Rhenmatiga .... 
Gout --.-.- 

8n>hiii-{l2Jr<2ry: : : 

Scroftila 

Phthisis ..... 
Anasmia ..... 
Dropsy 

Organs of the Special Senses : 
Meningitis - * - • - - 
Paralysis 

Bp"eP«y 

insanity ..... 
Diseases of the Eye ... 
Diseases of the Ear ... 
Diseases of the Nose ... 

IV. Diseases of the Circnlatory System : 
Disease of ( Fonctional 
the Heart t Organic ... 
Aneurism . . . . - 
Varicoee Veins .... 

V. & VI. Diseases of the Absorbent System 
and Ductless Glands i 
BuboCSymp.) . - . - 
Glandular Diseases ... 

VII. Diseasesofthe Respiratory System: 
Catarrh ..... 
Hsmoptysis .... 
Other Diseaeee of the Lung* 

Cynanche ..... 
Diseases of the Mouth, &c. . - 

Dyspepsia 

Dysentery ..... 
Diarrhosa ..... 
Hernia ..... 
Other Diseases of the Stomach, Ac 
Diseases of the Liver, 8te. • 

IX. & X. Diseases of the Urinary and 

Generative Systems ; 

Diseasesofthe Kidneys . . 

Diseases of the Bladder - . 

Diseases of the Organs of Geoa- 

ration . . - . - 

Varicocele . . - - - 
Orchitis 

XI. Diseases of the Organs of Loco- 
motion: 
Diseases of Bones, dec. 

XII. & XIII. Diseases of the CellnUr 

Phlegmon and Abscess 

Ulcer 

Diseases of the Skin ... 

Cndaseed: 

^^DebiUty 

Delirium Tremeas ... 

Poisoning ..... 
Wounds and Injaries . . . - 


1 


1 

Z 


1 

1 
1 

I 
1 


1 

1 

9 

1 

1 

1 
I 

I 

I 

1 
I 

1 

1 
9 


1 
1 

i 

I 
1 

1 

9 
1 

I 

T 

1 

I 

! 


I 
1 

I 


1 

1 
I 

T 

1 


I 


I 


I 


1 

i 

1 
1 
1 

1 

1 

• 

T 

1 

1 

s 

1 




Total . - . 


1 


I 


6 


S 


15 


4 


8 


I 


1 


8 


16 





Digitized by 



Google 



OF THE HOME STATION. 



27 



Table, No. 8. 
Ship employed on the Home Station. 







1 
1 


i 


1 
1 




j 


, 


j 


i 


1 


1 


J 


1 


1 


1 


, 






1 
1 

: 

1 

." 

1 


T 
1 


1 

i 
1 

1 

1 

1 

2 

1 
1 


1 

«■ 


• 

a 

1 

4 

8 

1 

i 

1 

1 

8 

a 

1 

1 
1 

9 

S 

1 


8 


I 
1 

8 

_ 

a 
1 

a 

4 

1 

1 

i 

1 

1 

1 

1 
1 


a 
1 

4 

1 

• 

a 
1 

4 

1 
1 

a 

1 

1 
1 


1 
1 


1 

I 

1 

4 

1 

1 

1 

1 

1 


1 

1 
3 

7 

I 

1 

3 

1 

I 

1 

1 


1 
1 

I 
1 

1 

1 

3 


a 
a 

4 

- 
1 

1 

a 


i 
a 

a 

a 
1 

1 

4 

1 
3 

a 

1 

1 

81 

1 

a 

1 


1 

a 

3 

1 

8 

1 

1 

8 

8 

I 

1 

1 


1 

1 
i 

1 

1 


a 




' 


4 


11 


' 


19 


a 


84 


88 


a|,a 


19 


8 


18 


49 


81 


8 





384. 



Digitized by 



Google 



28 



HEDICAI. STATISTICAIi BETUBNS 





Tablx, No. 3. — Sbowimo the Number Imvalioxd from each 


• 


- 


• 


- 




CAUSE 

or 

INVALIDING. 


1 


i 

a 


1 


1 


1 




S 






a 

1 




1 
1 
1 


Continued Fe»er - - • 

Bryiipelw 

II. General Diseases, Section B. : 

Kheumatism - - • • 
Goat 

SypW"- {f:Sn'2ry : '. I 
Scrofhla . - . - - 

PhUiisis 

Aoasmia 

Dropsy 

Organs of the Special Senses : 

Paralysis 

Insanity . - • . • 
Diseases of the Bye - • • 
Diseases of the Ear - - • 
Diseases of the Nose . - - 

IV. Diseases of the Circulatory System : 
Disease of (Functional - • 
the Heart \ Organic - - - 
Aneurism . • . • • 
Varicose Veins . . - - 

and Ductiess Glands: 
hnhoiSvmp.) . . - • 
Glandular Diseases . • • 

VII. Diseases of Uie Respiratory System : 

Catarrh 

HflBmoptysis - - . . 
OUier Diseases of tiie Lungs 

VIII. Diseases of Uie Digestive System : 

Cynanche - - - - - 
Diseases of Uie Montii, ftc 

Dyspepsia 

Dysentery - . - - - 
DfarrhcBa • • • . • 
Hernia . . - . . 
Other Diseases of the Stomach, ftc. 

IX. 4c X. Diseases of the Urinary and 

Generative Systems : 
, Diseases of the Kidneys • • 
Diseases of tiie Bladder - • 
Diseases of the Organs of Gene- 
ration - - - - • 
Stricture • - . . . 
Varic6cele-~ - . • • 
Orchitis ' 

XI. Disesses of the Organs of Loco- 
motion: 
Diseases of Bones, &c. • * 

XIL 6c XIII. Diseases «f the CelluUr 

Tissue and Cutnoeous System: 

Phlegmon and Abscess 

Ulcer ----.. 

Disesses of the Skin • . • 

Undasfed: 

Debility - - . . . 
Delirium Tremens • • • 
Poisoning - - • • - 

Woonds Md Iqjnries • . • . 
Total - - • 


9 

1 
8 

1 

i 
a 

4 

i 

6 

1 
1 
1 

6 
9 

9 
1 

9 
9 


1 
I 


T 

• 


T 
I 
1 

4 
I 

T 

1 
I 


1 

9 
9 

1 
9 

i 

1 

9 

3 


1 

T 
1 

1 
I 

1 


1 


1 
1 

4 

1 

1 
I 

9 

9 

9 

9 

I 

•• 
1 

T 

4 

9 

1 
1 


I 

1 


I 

s 

7 

■■ 
T 

1 


1 

•• 

1 




46 


9 


I 


u 


17 


6 


9 


99 


9 


6 


9 



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OF THE HOME STATION. 



29 





• 


• 


- 


- 


Ship employed on the Home Station— co»/iiii««rf. 












1^- 

111 


1 


1 


1 


1 


1 


CO 


> 

00 


, 


1 


, 


i 


> 


m 
> 


r 


i 


1 




1 

1 

t 

1 
i 

• 

• 

1 

s 

1 

s 
1 


I 

1 

• 


i 

1 

1 


I 
1 

T 


I 

1 
1 

I 
3 

S 
1 

1 
« 

1 
1 

i 

I 

1 


• 
1 

1 
1 

I 
I 


3 

1 
1 


4 

4 

3 

1 
1 
1 

ft 

T 
i 

1 


1 
I 

8 

8 

1 

1 


1 
1 


i 

I 
1 

1 


; 


1 

4 

I 

3 


1 


3 

! 

- 


s 

3 

1 

1 
3 

* 


3 

96 

1 
6 
16 
6 

89 

1 
1 

I 

1ft 
19 
IS 
16 

'f 

81 

63 

2 

14 

1 
1 

3 
3 
19 

1 
8 

5 

1 
89 
11 

4 

13 

4 

8 

7 
8 

3 

19 

3 

40 

8 

18 

3 
1 

38 




» 


i 


4 


3 


u 


7 


4 1 n 


8 


S 


8 


1 


U 


1 


ft 


11 


566 



384. 



D 



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30 



MEDICAL STATISTICAL RETURNS 



Table, No. 4. - 
Showing the Number of Deaths in each 



CAUSE 

of 
DEATH. 





ts 


ci 


















■g 


S 




^ 




t: E 


t"s 




^ 


1 

'4 


3 C 




., 




< 


^^ 


-«j<5 


< 


n 



J -2 



1 1 



Q^ 



^ 

b 



2 3 



612 



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OP THE HOME STATION. 



31 



- Table, No. 4. 
Ship employed on tiie Home Station. 






I 



a 



S 



^ a jf I ^ a 



'S 

.s 
§-1 



Ills 






1 

It:- 



1 

32 

1 
1 
2 



12 

8 



1 
24 



1 
1 

17 

29 

1 



-2 



4 4 4 



3 6 



10 



6 4 



1 1 
- 2 



ft 1 



5 2 



15 3 



3 8 



163 



384. 



E 



Digitized by VjOOQIC 



Neuralgia - - - - - 
Insanity - - " "^ " 
Other Diseaseii of the Brain, &c. - 
Diseases of the Nenrons Syatem - 
Diseases of the Eye - - - 
Diseases of the Ear - - - 
Diseases of the Nose - - - 



lY. Diceatet of the Circulatory System: 

Disease of the Heart {^Jgi^i^'! 

Pericarditis 

Aneurism » - - - • 
Varicose Veins - - - - 



V &VL Diseaacsoflhe Absorbent System 
and Ductless Glands : 



Bubo {Svmp.) 
Glandular Dlieaset 







- 


* 


— 


o 


1 


~ 





— 


- 


— 


S 




*■ 


1 


" 


I 


1 


« 


„ 


- 


— 


— 


2 


. 


« 


_ 


1 


•« 


. 




„ 






- 


10 


1 





3 


10 


^ 


- 


2 


8 


4 




2 


„ 








1 


' 


" 


~ 


^ 


. 




4 




2 




"• 


— 


2 


2 


M 


5 


1 


"• 


- 


1 


~ 


• 


I 




*" 


•• 


— 


— 


M 


1 


^ 


1 










2 


*" 


1 


s 


1 


1 


- 


1 


- 



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OF T 



- Showing the Number of Gases of all Disease 



Ic 
c 

1; 


8 

3 




1 
1 

- 

1 
t 
I 


s 
1 

1 8 
- 1 

9 
1 

3 
8 

- 18 

I 8 

8 

-1 - 


1 

1 
1 
1 

S 
1 

1 


I 

1 
1 

1 


1 

1 

1 

1 

6 

1 

S 

1 

1 

9 


5 

2 

S 
1 

13 

4 

1 
3 

S 


1 

% 
1 
5 

1 

6 

1 



1 


1 


4 

2 
8 

17 

1 

2 

1 

8 


1 
2 

1 
1 


4 

1 
2 

1 


1 
1 


IS 

1 

2 
S 

2 
5 

I 

14 
8 

12 

4 

2 
18 


i 

1 

3 
2 


I 

1 

2 


1 


1 

8 

1 
3 


- 


8 

1 

I 
1 
8 
3 
2 

1 
11 
6 

6 

2 

1 
2 


9 

1 

8 

1 
1 

a 

7 
9 



384. 



Digitized by 



Google 



34 



Table, No. 6.— Show ntz^ttiecL 



DISEASE OB INJUBY. 



YIL DiseanMofllieBMpintoiySTttem: 

DiMasai of the Laiynx 
Catarrh - - - - ■ 
Hemoptydt . - - . 
A»thma . - - - - 
Other DiMiMt of the LoBgs 



^1 

II 



11 



US 



VIII. DiBOMes of the Digettire Syitemi 



Cynanche - - - - - 
Dieeaeee of the Month, Teeth, Ice 
Dyq;w|Mla . - - - - 
Dysenteiy - - - - - 
Diarrhoea - - - - - 
Colic and Constipation 
Bnmonfaoidt - - - - 
Hernia . - - - - 
Worms - - " ^ ■ " 
Other Diseases of the Stomach, 

Intestines, 8ec. 
Diseases of the Urer, Spleen, fte. 



IX. Be X. Diseases of the UrinAxy and 
OeneratiTe Systems: 

DiMases of the Kidneys - - 
Diseases of the Bladder 
GonorrlKBa - - - • - 
Diseases of the Organs of Oenera- 

tion. 
Stricture - - - - - 
Taricocele - - - - - 
Orchitis 



XI. DiseaseeoftbeOigaoiofliooomotion: 



Diseases of the Bones • 
Diseases of the Joints • 
Diseases of the Moscles, 4cc. 
Diseaaes of the Barsss 



Xn. ft XIII. Diseases of the Oenolar 
Tissue and Cutaneous System: 



Phlegmon and Abeoest 
Ulcer - . - - 
Erythema - - - 
Diseases of the Skin • 
Scabies - - - 



UneltMed : 



Debility - - 
Drtirinm Tremens 
Poisoning - 



Wounds and IiOnriei: 



Wonnds, fto. - - • 
Bums and Scalds 
Submersion and Drowning • 
Hanging - - - - 
Suicide - - - - 



13 



ToTa& 



1 

128 

5 

7 



109 177 253 088 1 66 



II 
1 
8 
8 



101 
5 



15 



10 



77 



4S 



100 



20 21 



04 



183 
02 



210 
6 

1 



888 



S3 
1 

2 



40 



270 



132 

13 

16 



180 
8 



; 



700 



45 
23 

1 
8 

4 




2 

a I 



448 



Digitized by 



Google 



35 



TABi^ie StatioDr— continued. 



I 



1 
103 



14 



SO 

1 
17 



85 
I 
1 



s I 



11 



51 
SI 



7 15 
1< 1 



S3 



14 



81 



10 



1 
13 



3 

18 



6 
el 



10 



75 
1 



47 85 



00 07 



17 



S84 aOB 



131 
10 



108 



50 



10 



54 



101 
87 



4 

I 



5 

S,807 

81 

7 

317 



885 

SO 

545 
IS 

oso 

184 
58 
74 
37 
43 

101 



48 

18 

858 

18 

ri 
11 

308 



DISEASE OB INJURY. 



VIL DiMuea of the Bcq>imtor7 SjBtem, 

IMwuM of tha Larynx. 

Oaterrh. 

HaBmoptjtif. 

Aithma. 

Other DlMtsei of the Lungs 

Tni. Dlaeana of the Digestve Sjitem: 



155 
8 

S 



Si 1,005 88 



8,781 

1,193 

88 

S83 
SSI 



4|0SS 
185 
85 

1 
1 



19,801 



DlwaMt of the Mooth, Teeth, ftc. 

Dyspepeia. 

Dymnteiy. 

DlarrhcBa. 

Oolio and Ckmttipation. 

HflBmorrhoids. 

Hernia. 

Worma. 

Other Diwasee of the Stomach. 

Inteetinen, frc. 
BiwaMt of the LlTer, Spleen, ftc. 

IX. 8t X. Dleeaeet of the Urinair and 

GeneratiTe Syftemi: 
Dleeaeet of the Kidneyi. 
Diieaaet of the Bladder. 
Ooaorrhora. 
DiaeaMa of the Oigans of Genera. 

tlon. 
fltrleture . 
Varicocele. 
OBchltia. 



XI. Dieeaweof theOrgantofLocomotion : 
Dlieaaee of the Bones. 
Diseases of the Joints. 
Diseases of the Mosdes, ftc. 
Diseases of the BursM. 

^'^' Jf ^'"- D'**"** of the Cellular 
Tissue and Cutaneous System: 

Phlegmon and Abecess. 

Ulcer. 
Erythema. 
Diseases of the Skin. 
Scabies. 

Undassed: 

Debility. 

Delirium Tremens. 
Poisoning. 

Wounds and Injuries: 

Wounds, fre. 

Bums and Scalds. 

Submersion and Drowning. 

Hanging. 

Suicide. 

• - - Total. 



384. 



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38 MEDICAL STATISTICAL RETURNS 



MEDITERRANEAN STATION. 



Medi- In the year 1869, the squadron on the Mediterranean Station 

*^"*?^" comprised nineteen vessels, viz, : six ironclads, one fourth-rate, two 

y sloops, two gun vessels, four steun vessels, three gunboats, and one 

Q^g^ j^ receiving ship, permanently stationed at Malta. The Returns from 
gg^ ^ thirteen of the vessels were for the whole year, and from the re- 
minder for periods varying from three to six months. The mean 
force, corrected for time, was 3,970, and the total number of cases 
of disease and injury entered on the sick-list 5,669, which is in the 
ratio of 1,427*9 per 1,000, being an increase, compared with the 
preceding year, equal to 64*8 per 1,000. Of these, 157 were in- 
valided and thirty-two died, the former being in the ratio of 39*5 
and the latter of 8- per 1,000. Compared with the preceding year 
there was an increase in the invaliding rate to the extent en 12*7 
per 1,000, but the ratio of mortality was lower by '7 per 1,000. 

The average daily loss of service from Oeneral Diseases, Section 
A., or Febrile Group, was in the ratio of 5*4 per 1,000; from 
Section B», or Constitutional Group 8*2 ; from diseases of the ner- 
vous system and organs of the special senses *5 ; of the circulatory 
system '4 ; of the absorbent system and ductless glands '3 ; of the 
respiratory system 2*9; of the di^jestive system 3*1 ; of the urinary 
ana generative systems 2*8 ; of the organs of locomotion '5 ; of the 
celliuar tissue and cutaneous system 13*5 ; from uuclassed diseases 1* ; 
and from wounds and injuries of various kinds 11*4. The average 
number of men daily on the sick-list was 210*8, which is in the 
ratio of 53* per 1,000, being an increase, compared with the pre- 
ceding year, equal to 1*7 per 1,000. 

I. Oeneral Diseases.— Section A., or Febrile Group. 

There were twenty cases of measles, one of typhus, eight of 
enteric fever, 143 of simple continued fever, fifty-one of ague, 
twenty-five of remittent fever, one of mumps, 198 of influemsa, and 
twenty-seven of erysipelas, under treatment during the year ; and 
of these, six cases of ague, one of remittent fever, and one of in- 
fluenza were invalided ; and three cases of enteric fever had a fatal 
termination. 

Measles. — There were four cases of this form of eruptive fever in 
the Caledonia, one in the Lord Warden, one in the Rapid, and 
fourteen in the Royal Oak. 

In 



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OF THB MEDlTJBBBAlfBAK STATION. 39 

In the Caledonia the first case of measles occurred on the 154 <rf ^ ^J^^*in 
Miroh, after the vessel had left Malta for Naples. The surgeon* SteSon. 

Mjs : — ^^ Previous to the appearance of this case several had occurred »_ 

on board the Royal Oak^ the seizures extending over a considerable Class I. 

period. All these, as soon as declared^ were removed to fiighi Sect A. 

Hospital, but the disease did not entirely cease until the whole of 

the bedding of the crew was luided at the hospital^ and thoroughly 

washed and aired. Our first case happened in the person of a 

robust, healthv youn^ man, one of the barge's crew. His duty took 

him daily to the admiral's house in Valetta, where he was employed 

die greater part of the day, returning on board to sleep. Measles 

wai at the tmie prevalent amongst children on shore, but the patient 

was not aware of having visited any house where it existed. 

The sick-bay being almost empty on the occurrence of this case, 
one side of it was screened off, and the patient placed there, whilst 
any nimecessary communication was cut off, and carbolic acid kept 
constantlv and freely scattered about. The symptoms proved very 

Sht, and he convalesced satisfactorily. After a short interval, and 
en at Naples, two other cases broke out, in neither of which could 
the source of infection be traced. The patients had not been in the 
sick-bay since the first man's illness, neither did they belong to his 
mess, nor even to the adjoining one. Immediately the disease declared 
itself they were removed to the sick-bay, and with the first man kept 
perfectly separated from the other sick as well as from visitors to 
the bay, until after our return to Malta, where the means were pro- 
curable of having their bedding and clothes well washed and aired 
before they were allowed to return to their messes. We then hoped 
that no further case would occur, but on the 10th of April another 
presented itself, and, being in Malta, he was sent without delay to 
ffighi^ Hospital. As in the other cases, no trace of the source of 
infection was discoverable. All the cases proved very slight indeed, 
and eince their occurrence no others have shown themselves.'' 

A dnele case of measles occurred in the Lord Warden, in the 
person of a Marine who had ioined the ship from the Kevenge, on 
board of which a Marine in the next mess to him suffered from the 
disease. There was also a single and very mild case of measles in 
the Rapid; it occurred at Malta in the person of an officer, who was 
at once sent to hospital. 

In the Boyal Oak, in which there were fourteen cases of this 
exanthem, the surgeon* says : — ** Early in the year we were sub- 
jected to a partial epidemic of measles, which was introduced to the 
ship from the shore at Malta, where it was then very prevalent. 
The type was mild, with very light febrile symptoms. The means 
adopted for its check proved effectual, namely, that of constant 
supervision of all men who were apparently or decidedly labouring 
under catarrhal symptoms, immediate and complete segregation of 
suspected cases, and finally the lower deck was cleaned out, white- 
washed all round, the deck scrubbed with disinfectant powder, and 

well 



• Surgeon J. G. T. Forbes. t Surgeon W. H. Clarke. 

384. G 2 



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40 MEDICAL STATISTICAL EETUEN8 

Medi- well ventilated by means of " bogies " and windsails. The men's 

ierranean clothing and blankets were all washed at the Hospital Steam 

Station. Lavatory at Bighi ; general leave on shore was prohibited ; the men 

pjjyig J and officers^ as their attacks became declared, were at once removed 

Sect A. ^ ^^ Naval Hospital, and so the disease disappeared, and we left 

Malta for the Piraeus. Up to this tunc there were thirteen cases, 

but on our return to Malta to be docked we had another solitary 

case in December. 

Typhus Fever. — A single case of this alarming form of fever 
occurred in the person of a seaman of the Enterprise at Barcelona. 
The attack was of great severity, but the man recovered. The 
surgeon* of the ship observes : — " This man had a ^eat struggle 
for life. There was no hospital to send him to, but fortunately we 
were enabled to procure plenty of ice, which helped to combat the 
head symptoms. I have no doubt that malaria at the port of Bar- 
celona was the exciting cause of the attack. The fever was some- 
what peculiar in its character, being of the relapsing type at first, 
and running into pure typhus. Tne man was well isolated from 
the rest of the ship's company in the battery, and no other case 
occurred.** 

Enteric Fever. — There were eight cases of this insidious and dan- 
gerous form of fever in theBOuadron; of which three proved fatal. 
Three cases occurred in the Caledonia in her second commission, 
two in the Cruiser, and three in the Newport. 

In the Caledonia the three cases of enteric fever occurred simul- 
. taneously with an epidemic of febrile disease of a somewhat mixed 
character. The stafi^-surgeonf of the vessel has divided the cases 
occurring during this epidemic into three classes ; first, enteric or 
typhoid lever with specific eruption, of which the three cases noted 
above are the examples. Second, enteric fever without spots; 
of which there were twenty-two ca^es; and. Third, influenza 
enterica; of which there were 198 cases. 

On Table I. the first of these classes appears under the head of 
Enteric Fever ; the second under that of Continued Fever ; and the 
third under that of Influenza. As these different forms of febrile 
disease occurred at the same time, it is thought better to consider them 
altogether in this place, and to give the report of the staff-surgeon in 
detail, as it presents many features of considerable interest It may 
be premised that the crew of the Caledonia which suffered from this 
epidemic had only recently arrived from England, having been 
brought out in the Revenge, which vessel took home the old crew 
which had been thus relieved. On the passage out, the general 
health of the men was very indifferent, owing to the prevalence of 
an epidemic which commenced very soon after leaving England, in 
the lorm of " febrile catarrh," accompanied by inflammatory sore- 
throat 



* Siugeon ?♦ W, WaDsce, m.d. f Staff Sui^geon J. Cotton, m.d. 

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OP THE MEDITERRANEAN STATION. 41 

throat of a low type, and great prostration. One of the medical Medi- 
officers* remarks : — The weather at this time was wet and sunless, *s^**^ 

T€Qtilation was arrested in consequence of the necessity of keeping ^' 

the ports closed, which also prevented the drying of the decks, the Class I 
whole tending to render the air between decks, raw, unpleasant, and g^, ^ 
much resembling a London mist. This continued until passing 
Gibraltar, when we suddenly came into almost tropical heat. With 
the change of temperature the character of the epidemic underwent 
modification ; the throat affections subsided, and the cases appeared 
to class themselves under two heads, viz. : I. those with intestinal 
irritation; and II. those in which intense paroxysmal headache and 
severe pain in the cardiac region formed the principal points of 
observation." 

He staff-surgeon thus describes the condition of the crew on their 
passage out, and after joining the Caledonia : — " During the neces- 
sary exposure consequent on embarkation at Plymouth, many of the 
men baa their beds, and nearly all had their clothes, wet ; and, as 
rain continued during three days after leaving, we had every cir- 
cumstance conducive to the spread of contagious and infectious 
poison, namely, moisture, heat, and bad ventilation. Shortly after 
onr departure the numerous cases of cynanche and catarrh presented 
many symptoms which made me apprehensive of an outbreak of 
scarlatina. About one-third of these cases evinced symptoms of 
very unusual depression and debility ; the skin was cold and clammy, 
the pulse weak, the mucous membrane of the mouth and fauces pre- 
sented a most unpleasant erysipelatous hue ; men were ^ddy and 
Seunt, and many complained of pain affecting the left thoracic region, 
the cause of which was not apparent on careftil stethoscopic exami- 
nation. From the period of our escape from the rainy season in 
England until our arrival in Malta, the voyage had been in every 
way favourable, and the temperature such that blue clothes were 
w<vn up to the latter period. Summer and the sirocco wind, how- 
ever, had fairly set in, and we found the weather at Malta exces- 
tivehr hot, close, and oppressive. 

" The Caledonia lay moored in the Grand Harbour. The old crew 
had been living in the Hibemia since the 26th of April, and the 
vacated ship was a perfect pattern of neatness, cleanness, and good 
order. During the interim of nearly a month, a working party had 
been engaged in scraping, cleaning, and whitewashing their old ship, 
which always has been in remarkable order. In short, no crew ever 
joined a ship under circumstances more apparently favourable. 

** Malta, at the time of ofir arrival, was remarkably healthy ; on 
the day after (the 23rd), the number of sick of the whole fleet in 
harbour (ourselves excepted) only amounted to eighty, and the 
unnber in hospital to twenty. Our own sick-list was large, forty- 
one, but the only peculiarity about it was the prevalence of the 
typhoid influence described. 

** The TOOcess of exchanging the Kevenge for the Caledonia was 
npidly effected on the 27th, and was very trying to men who had 

so 



* Asmal. Surgeon Belgrave Ninnis, ac d, 
384. G 3 



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42 MEDICAL fiXATISTICAL BETUBNS 

Medi- 00 quicklj exchanged the cold weather of England for the tropical 
terranean heat existing at Malta ; and the different nature of the two 
B tatioD . ships required some time to be properly understood. The Cale- 
ClsM I. donia is a wooden line-of-battle ship converted into a frigate 
geoi A. and armour plated. Thus the orlop deck becomes our present 
sleeping; or lower deck. Orlop decks have ever given trouble as 
regards ventilation, and this is increased in the Caledonia by the im- 
mense space taken up by the engines, and the increased thickness of 
her sides, which of course renders access of air through the scuttles 
more difficult. Improvements had, however, been emcied bv intro- 
ducing fourteen tubes, each six inches in diameter, whicn open 
syphon-fashion on the upper deck, and thus assist in ventilating the 
men's quarters. The hollow iron masts have also been very im- 
perfectly utilised for the purpose of ventilation* In cool weather 
there is sufficient circulation of air for comfort and respiration. In 
warm weather, and especially at sea, there is sufficient air for respi- 
ration only. Our great difficulty is during oppressively hot weather, 
when there is no breeze. In these ironclads, under such circum- 
stances, the sun's rays are inunediately conveyed by the iron casing 
to tiie wooden lining. Wood is very slow in absorbing heat ; un- 
fortunately it retains heat, so acquired, long, and parts with it 
gradually. Thus, during the southern summer the thick wooden 
lining gives off a uniform high temperature during the night, cooling 
in time to receive a fresh supply next morning. Under such cir- 
cumstances the normal temperature of our sleeping deck is from 85* 
to 90% and our main deck is littie better, as modem ports are small 
and modern guns lai^e. 

" Our rapid entrance into this temperature ' fagged ' the men 
very much, as they slept badly at night, and the usual short nap at 
dinner-time was impossible. In fact, after meals, the men usuallv 
looked as if they had just escaped from the early stage of a Turkim 
bath. 

** On the 5th of June the ship departed for exercise, returning on 
the evening of the 17th. It was during this interval that the typhoid 
influence which had apparently accompanied us since leaving England 
ac<juired the character of an epidemic. On the 16th of Jane, in the 
vicmity of Malta, and eleven days after being at sea, about 11 p.m., 
nearly fifty of the ship's company, and some of the officers, were 
suddenly attacked with diarrhoea. From the 5th to the 16th of June 
thirty anomalous cases had occurred, but on ^e 17th we had eight 
sick; and, from the 1 7th to the 30th of June (inclusive) the number 
was ninety-four. Total for June, 124 cases. 

" I am inclined to attribute the outbreak of diarrhoea on the night 
of the 16th to the same poisonous influence as that occasioning our 
enidenaic, and consider it simply as an instance of the culmination of 
the poison. From this date it appeared to acquire a certain infectious 
power so far as the men in the Caledonia were concerned. Every 
one acquainted with the public service knows how fanciful men are 
in the causes they assign for attacks of this kind. Most of the 
men supposed that the bowel complaint had arisen from preserved 
meat they had eaten on the previous day ; some fancied that it had 
resulted from drinking distilled water which had passed through a 

leathern 



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OF THE MEDITBBBANEAN STATION. 48 

laitibeni tatie^ which might previously have been used for salt water. ^^^ 
I, nyself, at llie time, thought that it might have occurred from a S^i^ 

ffudden change of temperature during the night. On subsequent * 

careful inquiry, however, it turned out that some men had diarrhoea ClaM I* 
wbo had eaten no preserved meat, and others diarrhoea who had Sect A. 
drunk no water. Unfortunately for my own theory, the night had 
been a good honest tropical night, warm throughout, and with no 
change whatever to disturb its serenity. 

•• Our ^ Influenza Enterica' attacked its victims in a form which 
now may rapidly be described. In probably one-fourth of the 
eases a man would present himself with a very pale face and a 
weak filow pulse ; the skin was cold, the respiration laboured ; the 
breath seemed cold and clammy, like the skin. Headache was 
soraetimeB complained of, but more frequently vertigo, and soreness 
of the limbs, and the individual seemed ready to faint. Almost in- 
variably there was thordcic pain, confined to the left side, In these 
nndeveloped cases the patient had usually a whitish tongue. These 
symptoms lasted from one to three days, and not unfrequently there 
wae no pyrejda whatever. Long - continued debility, however, 
usnally followed, and I may state, from unpleasant personal ex- 
perience, that the latter symptom was most troublesome. 

♦* A considerable number likewise suffered from complaints to 
which they had become liable, either from constitutional tendency 
or from pevious service in unhealthy climates. Some have subse- 
quently been invalided for suspected tubercle, some for rheumatism, 
some for dysenteric diarrhoea contracted in China ; others appeared 
to be left particularly subject to the noxious influence of the usual 
station fever. So much for what may be termed simple cases. 

** In the great majority, however, in addition to the symptoms 
described, the patient had a red irritable tongue, and erysipelatous 
redness of the whole buccal mucous membrane. Such individuals 
had invariably a troublesome diarrhoea, in a few attended with nausea 
and sickness, and in nearly all with pyrexia, by no means, however, 
well marked, recurring at uncertain intervals, and probably more 
from gastric and intestinal irritation than from any other cause. In 
these the cmnmon circumstance was observed, that all attempts to 
check the diarrhoea were invariably followed by exacerbation of the 
fever; and mild laxatives, with a nourishing and more stimulating 
diet^ were best adapted for the patient's welfare. 

" In the end of June the epidemic appeared to be nearly gone, 
but on the 7th of July we proceeded to the trving summer climate of 
SicQy and Naples, and there was a renewal of the disease, which 
finally only left us towards the end of September, when probably 
nearly every susceptible person on board had been attacked. The 
finopeanuice of the disease seemed assisted by a cruise outside the 
Mraiterranean, and the general health of our youqg crew was 
thereby greatly benefited ; indeed nothing more unfortunate could 
vdl have occurred than an outbreak of the epidemic in question in 
early summer ; it left men weak and unfit for hard work during the 
whole hot weather, and the cases of debility and of sunstroke which 
i^^ar in the Nosological Betum are simply the consequences that 
ott^t be expected from this cause. Curiously enough, the termina- 

384. G 4 tion 



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44 AIEDICAL STATISTICAL RETURNS 

^^^j^^ iion of the epidemic was marked by the same phenomena observed 

Station. ^^^^ ^^^ leaving England^ We had a^ain a doabtfiil form of 

— ^ * cynanche and tendency to lirng complication. Finally we had a 

Class I. small plague of boils> herpes, and eczema. Nearly one-third of our 

Sect A. numerous boik and slight injuries evinced a herpetic circle^ or had 

eczematous eruption, or some spots of impetigo. 

*^ In reference to the nosolc^cal arrangement of the disease, I 
stated in the first Return for tJune, that the lapse of individuab so 
affected into evident typhoid was the termination chiefly to be feared, 
and therefore I classed them all under the heading of Simple Con- 
tinued Fever. Such an arrangement at the time was absolutely 
necessary. In the carefully corrected return for this Journal the 
term Continued Fever appears illogical for a form of disease which 
so frequently presented the peculiarity of continuing without fever, 
and I have considered it more correct to class all such cases as 
* Enteric,' dividing them by the usual letters. Under the letter 
A. are comprised three cases with the usual abdominal eruption of 
what in England and France is generally considered as true typhoid ; 
under B. are cases of the usual station fever, which appear to me in 
well-marked cases to differ from the true typhoid solely in the 
absence of abdominal eruption. I consider them to have been mild 
cases of typhoid or enteric fever. The cases of our epidemic have 
been selected as carefully as possible, and classed under C. 

" A. Typhoid with roseoloid abdominal spots. Three cases ; one 
was seven aays under treatment on board, and sixty-four in hospitaL 
Another was four days under treatment on board, and fiftv-seven in 
hospital. Another, a bad case, was twenty-eight days on board, and 
remains in hospital. 

** B. Enteric fever : station fever ; no spots. Usual typhoid re- 
missions ; tendency to pleuro-pneiunonia and diarrhoea. According 
to its usual custom in mild cases, tending to spontaneous con- 
valescence after a few days, but in a large number leaving the patient 
long weak and cachectic, and predisposed to constitutional oisease. 
Total number of cases, twentv-two ; invalided from hospital, four ; 
remaining in hospital, one. Average total time unfit for duty^ in- 
cluding hospital time, forty-one days. 

** C. Influenza Enterica. Great depression of the heart's action 5 
thoracic pain of left side ; lassitude and debility, long continued ; an 
apparent tendency to erythema of the gastro-pulmonary mucous 
membrane, usually attended with diarrhoea, disease tending to lapse 
into enteric fever and pleuro-pneumonia. Pyrexia uncertam in un- 
complicated cases ; great disposition to herpes, eczema, and erythema^ 
Total cases, 198. Sent to hospital, forty-nine; subsequentiy in- 
valided from hospital, twelve ; from the ship, eleven. The causes 
of invaliding appear to have been: tubercular deposit, or plastic 
deposit from pleuro-pneumonia, three ; bronchitis, one ; chronic gas- 
tritis, two I chronic diarrhcea, two ; debility, anaemia and palpita- 
tion, fifteen. Total invalided, twenty-three. 

Origin and latent Period, — Our three cases of evident typhoid 
appear to have been contracted while the ship was at l^ta. In 

the 



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OF TH£ B£E]>IT£BBANEAN STATION. 45 

tie first two cases I considered the latent period as from eight to ^edi- * 
azteen days^ supposing the fever originated at Malta. If, however, s^tation^ 

we suppose that typhoid may not only originate from sewage and ' 

oliier poisons^ but occasionally prove infectious, the latent period may Class I. 
Ittve been ei^ht or nine days in both cases, as the secona man may Sect A. 
hsYe received the disease nrom the first. Both men were stokers. 
The third case appears likewise to have caught fever at Malta, but 
we had no opportunity of judging as to the latent period in his case, 
as the shipwatf in M^ta from the 13th of October to the 4th of 
November, and the disease appeared on the 5 th of November, the 
cby after proceeding to sea. 

*0f the cases of station-enteric fever, twenty-two in number, I 
may remark that the majority appeared likewise to derive their 
origin from Malta, but others from Sicily and Naples, a few from 
Gibraltar. It appears an open question if, under certain conditions, 
this disease likewise may not propagate itself by infection. Suffi- 
ciently accurate information as to the latent period could not be 
obtained ; but in our severest case, where the patient appears to 
have been infected at Malta, the disease manifested itself nine 
days after leaving the island. 

" One peculiar form of sickness appears, as already stated, to have 
originated from a typhoid influence, which left England with us in 
the Revenge^ and nnally assumed an epidemic form in this ship 
while the latter was at sea, near Malta, in the middle of June. At 
first the poison appeared chiefly confined to the Marines and the 
adjacent messes. None of our stokers were attacked until the 17 th. 
As may readily be supposed, in a ship with so much sickness during 
the snmmer, cases became much complicated with slight forms of 
sunstroke, vertigo from heat, and debibty after the month of June ; 
I therefore confine the following Table to that month : — 

June: 
Marines, and marine petty officers on board - 
Able seamen ------ 

Letding seamen ------ 

Oidinary seamen ------ 

Boys 

Stdien - - 

Artifioen, 18 ; potjr^ officers, artificers, 18 - 

IHty imo&n (artincers and leading stokers 

deducted) ------ 

Warrant officers, all attacked . - . 

Onn-room officers 

Ward-room officers ----- 17 - 6-8 „ „ 

"I have endeavoured to obtain information as to the period 
which intervened before individuals newly joining the ship auring 
its endemic period were attacked. In July four men returned from 
gaol considerably debilitated. 

" Two had symptoms - 
One „ 

One „ 

** A midshipman joined during the height of the influence ; he 

▼to taken ill twelve days after joining (in June). In August the 

384, weather 



Nos. 






96 - 38-5 ] 


per cent, attacked. 


89 - 12- 


)) 


)i 


19 - 10-5 


jf 


}) 


123 - 19-5 


11 


}) 


96 - 26- 


11 


)} 


42 - 71 


}) 


ii 


36 - 22-2 


11 


11 


59 11-8 


n 


)f 


3 - 100- 


)t 


11 


18 - 16-6 


}i 


i» 



doubtful - 


- 24 hours after joining. 


evident 


3 days „ 


evident 


- 4 days „ 



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46 MEDICAL STATISTICAL EETUBNS 

Medi- weather was cooler, and the poisonous influence more feeble. A 
Si^on^ bojr was taken ill after being on board four days, and a Marine after 

being twelve days on board. These peculiarities caused me to 

Claisl. believe that the disease possessed infectious properties, which 
Sect A. required concentration of sick individuals as well as a high 
temperature. My impression likewise is, that when the human 
body had received the poison, the period of incubation was short. 
It will be remembered that we only remained fourteen days in 
Malta after arriving there, and that the disease assumed its 
epidemic form eleven days after being at sea." 

" On our return to Malta after the outbreak, I strongly advised 
that, in place of transferring our ship's company to the guardship 
here (Hibemia), the Caledonia herself should be hauled broadside 
to the wind in JBishi Bay ; the men excused from arduous duties 
during the heat oi the day, and that cases of sickness should be 
largely sent to hospital, in order as much as possible to prevent the 
concentration of the poison on board. These simple means, with an 
extra bsue of cocoa to the men immediately after they rose in the 
morning, appeared highly successful, and I hoped at the time that 
we should have the smp tolerably healthy by the end of June. 

'* In these heavy ships at sea, however, ventilation is sadly inter- 
fered with, as it is very seldom indeed that the lower deck scuttles 
can be kept out, and from this want of ventilation, and the re-appli- 
cation of a good steady heat when we again put to sea, we nad a 
further manifestation of the typhoid influence. No doubt what was 
required was a cruise to some colder region. 

" The reasons for strongly objecting to transfer our men to the 
Hibemia are evident. The Caledonia, as a mere ship, is perfectly 
healthy, and the advantage of changing one ship for tne other 
would have solely been that from absence of iron-plating; in the 
Hibemia our men would have slept better in consequence of the 
lower temperature at night. It appeared quite certain, however, 
that if we had exchanged, our men would again have been subjected 
to great fatigue and various forms of exposure. They woula have 
been engaged in removing tanks, scraping bilges, whitewashing 
holds, and, in short, in duties almost certain to be followed by a 
development of poison, which otherwise the innate strength of their 
constitutions might have enabled them to shake off. My belief is, 
that our comparatively trivial sickness would have been converted 
into malignant fever, and our new crew would have been dis- 
organised, and most certainly they would not have felt themselves 
safe in the Caledonia during the rest of the commiaaion. 

*^ At the time it was recommended that the ship should be sent 
to Bighi Bay, I likewise recommended that as soon as possible she 
should be detached from the squadron and sent to Corfu until per- 
fectly healthy. Unfortunately the number of ships in the station at 
that time was so small, that it may be doubted if the absence of the 
Caledonia was compatible with the efficacy of the fleet ; and as none 
of the other ships suffered from our epidemic, we have no cause for 
regret* 

^' I may here remark, that in disposing of pur crew at night, we 

had 



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09 THE MfiDITBBBANBAN STATION. 



47 



bidaa numj as the place could accommodate on the main deck ; but 
is I similar case of the kind, I should strongly recommend that an 
Afning should be spread, and that as many of the crew as possible 
Aoold sleep on the upper deck. 

He following Table gives the febrile cases as they occurred in 
the respectiye months : — 



MoVTHt. 


Nomher of 

developed 

Typhoid Cases. 


Number of 
Enteric Cases or 
Station Ferer. 


Influenza 
Eotsrica. 


JoM - - - - - 






124 
45 
28 


Jilr . - - 




2 

15 

3 

2 


Stptcmber 




2 








Nofodicr. 
Dember- 


TcffALS - - - 


1 


— 




3 


22 


198 



Medi- 
terranean 
Station. 

Class I. 
Sect A. 



In the cases detailed in the Journal the routine of treatment has 
been omitted, as much as possible, for necessary purposes of brevity, 
l&deed, the nature of these morbid poisons, or rather their action 
(HI the human frame, is now so well understood, that details 
of the kind are not requisite, for where we have no antidote we 
must ever be chiefly guided by the circumstance that, supporting 
the system judiciously, enables it to resist most abnormal innuences, 
when circumstances of age and diet are in our favour. The success 
" of modem practice depends upon resisting disease more by sup- 
porting strength, and gaining time, than by emulating it in de- 
creasing the vigour and number of our patients." In the form of 
complamt under consideration we were greatly assisted by the 
circumstance that id most cases we could sufficiently preserve the 
streogth of the majority of our men to keep them out of bed, and 
b & open air on the upper deck; hence we were enabled, as 
much as possible in a ship, to prevent local concentration of the 
pcHBQO, when our departure from Malta removed us from the 
nluable assistance of the Naval Hospital; fortunately, too, this 
station is one in which supplies of most articles required from the 
shore for sick people are easily procurable, and I am much pleased 
to add that all our usual service supplies have been ample^ and re- 
nuffkably good in quality." 

This excellent and exhaustive report is so complete that it calls 
for no ccmiments. It appears to indicate the propriety of giving 
AS much rest as possible to a new ship's companv recently arrived 
<Hi a station, particularly if they have already suffered from an out- 
hreak of epidemic disease. The three cases of specific enteric fever 
were doubtleBS attributable to the pemicions influence of the atmo- 
sphere of Malta Harbour, where that formidable type of fever has 
w many years been endemic. 

There were two cases of enteric fever in the Cruiser, both of 
which proved fatal. The first of these occurred at Malta, in the 



384. 



person 



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48 MEDICAL STATISTICAL BETURNS 

Medi- person of a young officer who was placed on the sick-list on the 4th 
twwnean of July with febrile symptoms of considerable severity, for which 
Station jjg ^^ discharged to Malta Hospital on the 6th. On his admission 
Class I there he was in a very prostrate condition, the fever being decidedly 
Sect A.' ^^ ^^^ enteric type, accompanied with great abdominal tenderness, 
^mpanitis, thickly coated tongue, frontal headache, diarrhoea, and 
delirium. Intense pulmonary congestion, especially of the right 
lung, quickly supervened, characterised by great dyspnoea, cough, 
and blood-viscid expectoration, fine crepitation, &c. The prostra- 
tion finally became extreme, the stools became black and tarry- 
looking, and he died on the 8th of August On post-mortem 
examination of the body, the right lung was found to be in a state 
of red hepatization, the lower third of the ileum externally of a 
port-wine colour, and internally of an ashy hue, while Peyer's glands 
were found in various stages of congestion, infiltration, hypertrophy, 
and ulceration ; the surface of some beipg ash-coloured with a black 
areola. There was also slight effusion into the cerebral ventricles, 
and some congestion of the cerebral substance. 

The second case was that of a Marine who was entered on the 
sick-list at sea, on the 25th of August, four days after leaving Port 
Mahon, and nineteen after leaving Naples. At Naples the ship lay 
close to the shore near the mouths of some open sewers, the smell 
from which at times was very offensive. At nrst the case presented 
all the symptoms of pneumonia of the left lung, which under treat- 
ment subsided ; the cough, pain, and expectoration ceased, and he 
appeared to be going on well until the 2nd of September, when 
febrile symptoms again set in, with pain in the abdomen, diarrhoea, 
watery, light-coloured stools, and dry brown tongue, and from that 
time he gradually got worse, and expired on the morning of the 9th 
of September, seven days after the abdominal symptoms set in, and 
fifteen from his first entry on the sick-list 

In the Newport there were three cases of enteric fever, of which 
one proved fatol in the person of a boy who had been sent from the 
Azov, the tender to the Newport, to the Hibemia, on the 31st of 
July, for the treatment of a sprained ankle. While there, febrile 
symptoms set in, which proved of such severity that on the 7th of 
August he was sent to Malta Hospital, where ne died on the 9th 
with all the symptoms of enteric fever. With reference to the cases 
generally, the medical officer* of the vessel observes: "Three 
cases of typhoid fever call for some remarks. Unfortunately they 
did not come under my observation at all, as they occurred in Her 
Majesty's ship Azov during our absence at Alexandria. Her 
Majesty's ship Azov, sailing gunboat, attached as auxiliary to the 
survey, was left at Pantelhtria from the 6th to the 26th of July, 
whilst the Newport went to Alexandria. She lay during this time 
in the small harbour by the principal village* There was generally 
a sea breeze blowing in, but sometimes during calm weather a very 
unpleasant odour was manifest on board, owing to the proximity of 

the 

* Aasist. Surgeon Richard Cannon, 

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06Oil« JL* 



OF THE MEDITEBBAKEAN STATION. 49 

the rocks below the village^ which were used as a common necessary Medi- 
b? the inhabitants. The greater part of the crew, including the *S???®"* 

two boys who afterwards suffered firom fever, were away from the ^' 

diip daring most of the time she was at Pantellaria. The surveying qj^^ j^ 

party was camped on various parts of the island in the loftiest and 

healthiest situations, and on a ground of volcanic scoria. Owin^ to 

its insular position, the nature of its soil, the height of its mountams, 

and the constant sea breezes, Pantellaria offers no nidus for malaria. 

There was thus very little at Pantellaria to account for this outbreak 

of fever. On her return to Malta, the Azov lay in Sliema Creek, 

a healthy spot; thence the first case was sent with a sprained 

ankle to Her Majesty's ship Hibemia, then in the Grand Harbour, 

Valletta, and while on board her, fever of a malignant type developed 

itself in him with such intensity that he died three days after being 

sent to hospital, and five days from the invasion of the disease." 

** The Azov soon after moved to Dockyard Creek for five days. 
Dockyard Creek in simmier is a stinking sewer. There the second 
boy sickened of a mild typhoid fever, was sent to Malta Hospital, 
and returned to the Newport covalescent. He then suffered from a 
relapse of a mild character. At the time he was taken ill some of 
the other men of the Azov suffered from headache and slight febrile 
symptoms, which soon psssed off. At this time, as always, the bilges 
of the Azov were kept sweet and clean, and no unpleasant odour 
was perceptible on board.** 

** The fever in the first case was probably acquired at Pantellaria, 
and due to emanations from the filtn about the harbour. The brig 
had not been in Dockyard Creek at all. The second boy may also 
have acquired the germs of his fever at Pantellaria, but suspicion 
will point more strongly to Dockyard Creek, as the place whence 
the cbsease took its ongin. No fever in an epidemic form existed 
at Pantellaria whilst the Azov lay there, nor is fever at any time 
common on the island." 

Simple Continued Fever. — Of this form of fever 143 cases were 
under treatment during the twelve months, but they caused no loss 
to the service either by death or invaliding. They were tedious, 
however, in their progress to recovery; tne average duration of 
each case on board ship and in hospital bein^ between twenty-three 
and twenty-four days. The vessels in wnich they occurred in 
largest numbers were the Caledonia, the Lord Warden, and the 
Bapid. The form in which the disease presented itself in the 
Caledonia has already been fully detailed in the report from that 
vesseL 

In the Lord Warden there were thirty-five cases of simple con- 
tinued fever. The great majority of these were of the mildest 
character. In those which occurred during the warm weather, 
rigors, headache, jgeneral pains, and sharp diarrhoea with a loaded 
tongue, ushered m the feorile symptoms, which invariably passed 
off with profuse perspiration at night, leaving only a degree of 
weakness and of general soreness, instead of the sharp pains in the 
back and limbs oi the preceding day. 

384. There 



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tetLA. 



50 MEDICAL STATISTICAL BSTDBK8 

Medi- There were thirty-eix cases of this form of feyer in the Bapidj 

temnMn most of which were of a very mild character^ terminating in recoyerys 

Station. in, on an average, between nine and ten days. Eighteen of the 

^r~ cases occurred at Patras, where a mild form of fever prevailed at 

ClaM L ^jjg time, and ten on the coast of Syria during the summer. The 

most severe case occurred in the person of a mess, servant who was 

112 days under treatment. It was distinguished by most obstinate 

rheumatic complication, and by debility. 

Ague and Remittent Fever. — Fifty-one cases of ague and twenty- 
five of remittent fever were under treatment during the year. The 
average duration of each case of ague on board ship and in hospital 
was between ten and eleven days ; and of each case of remittent 
fever, nearly thirty-two days. 

There wejre eight cases of ague, and four of remittent fever, in the 
Antelope. They were all contracted at Therapia. The medical 
officer* says "The sunmner had been unusually hot, and water very 
scarce, scarcely sufficient to irrigate the rich gardens of the valleys 
around ; the winds light, and the dews extremely heavy. Such con- 
ditions seemed favourable to the development of any unusual severity 
or amount of the ordinary continued ^vers. Still the tdtal number 
of cases and the characters of the fevers were not extraordinary, 
except, perhaps, amount the troops of a larffe camp on a hill, of 
300 or 400 feet in height near the Sultan's Valley, opposite our 
anchorage on the Asiatic side. They were under canvas, underwent 
an amount of drill unusual to Turks, and a few days previous to the 
maximum amount of fever were exposed to some heavy rains. The 
mortality was, as far as I could learn, extremely small, though the 
fevers were insidious, obscure, of typhoid tendency, and oi tardy 
convalescence, leaving much wasting and spansemia^ a type said to 
be the common one otthe district 

" Ours commenced in the middle of August, and on the 7th of 
September, when the disease had nearly reached its maximum 
in the Bosphorus, and when I was anxiously waiting a further in- 
crease of its amount or severity, to urge a cruise in the Black Sea, 
or that of Marmora, we were ordered to sea for three weeks. 
Though we then passed a week at Smyrna, where some mild fever 
existed, we had no more cases. On our return to Therapia, fever 
had much abated there, and towards the latter half of October, alto- 
gether ceased. Twelve cases occurred on board ; of these, the four 
remittents were in boys arrived from England a year previously, 
and who had never had fever before. Of the eight cases of ague, 
four occurred in ibree boys of the same batch ; fliree were in men 
who had served in the West Coast of Africa, and on this station, in 
our ship, with immunity from anything like fever; one only in 
a seaman, who as a boy in this ship had had two very severe attacks 
of remittent on the West Coast of Africa. The remittent, com- 
menced insidiously ; the patient, after a few dajs' malaise, and pro* 
bably an obscure exacerbation, presenting himself with languori 

depression, 

* AsBist. Siij;geon J. S. Levis. 

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OP THE BCEDITEREANEAN STATION. 51 

depreeeion^ headache^ some congestion of eyes, and infira-orbital 

bludi; very trifling vascular excitement, dryish tongue, covered t^iranean 

with a thin white coat, skin hot, and slight thirst For a day or station. 

two, distinct, but slight and brief chills ushered in a more declared 

pyrexia, with increase of headache, and moderate acceleration of Otais I. 
poise. After one to twelve hours, copious perspiration set in, and ^^^ ^ 
the patient soon reverted to his former state of obscure fever. The 
sweating stage was the most marked of all. For a few days things 
went on in the same manner ; one tolerably well-pronoimced, or 
several short, barely perceptible, exacerbations, followed by more 
or less copious perspiration, occurring each day. The pulse then 
began to subside and the tongue to clean, the headache ceased, and 
the patient felt cheerful and well, but wasting continued, the 
spansemic expression increased, the appetite refused to improve, and 
copious perspiration, sometimes preceded by a very little headache, 
generally occurred in the evenings for several days. After this, as 
the appetite improved, recovery proceeded steadily, though slowly. 

^^ The intermittents were all characterised by similar languor, 
persistent anorexia, wasting, and spansemia. Two were pecufiarly 
obscure ; after the first faintly marked paroxysm, it was next to 
impossible to pronouce the seizures febrile. Four had tolerably 
well-marked attacks. All the above were pretty clearly of the ter- 
tian type. Another case had distinct tertian recurrences, whilst in 
each intervening evening he appeared to undergo a short feebly 
declared paroxysm consisting merely of headache and slight heat of 
surface, followed by moderate perspiration. This case might be set 
down as a double tertian or obscure quotidian. It seems almost 
absurd to note anxiously the exact type of these fevers, all badly 
nronounced, and shading into each other in such a puzzling manner. 
In fact, I believe it to be nearly impossible to thoroughly satisfy 
cmeself on this matter without frequent use of the thermoscope and 
sphygmograph, which would doubtless yield results very neat and 
interesting at least, though F question their practical utility. 

** Treatment consisted of a saline purge, quinine, and nursing. 
Having been told that the fevers here do not bear much quinine, 
I gave in my two first remittent cases only five grains three times 
a day. In the others, and most of the cases of ague, from fifteen to 
twenty grains, followed by t^n grains three times a day for a day 
or two ; then five grains three times a day until fever had clearly 
ceased, when two grains and a half were used three times daily, with 
chalybeates. Having shortly acq^uired more confidence, I treated 
one case without any, until it plainly showed itself to be a double 
tertian or obscure quotidian, when quinine soon put a stop to it. On 
the whole, I think the cases showed the advantage of the larger 
doses, and if I have the opportunity again, I shall push it further 
and more freely. The subsequent disproportionately severe and 
persistent effects of these little fevers were of course partly attri-* 
Datable to continuance within the range of malaria during a con* 
siderable part of their course, and had we remained during Septem* 
her at Therapia, I have do doubt they would have been much more 
fOTmidable.'' 

There were nineteen cases of ague and ten of remittent fever in 
384- the 



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52 MEDIOAI. STATISTICAL BETURNS 

Medi- the Cockatrice^ which vessel was almost exclusively employed in the 
temnean River Danube. With reference to the use of quinine in these feverd. 
Station. the medical officer* observes : " Having seen many cases of inter- 
^ - mittent and remittent fever amongst the inhabitants of the diflTerent 
£~* /• towns upon the Lower Danube^ as also amongst the crews of the 
^^ merchant grain vessels, and having tried mai^y remedies, I feel con- 

vinced that quinine must be given at some stage of the fever before 
the disease can be eradicated from the system. In the case of new 
comers upon the station, comparatively small doses are necessary ; 
but in the case of old residents on the station, it is requisite to ad- 
minister it in large doses. In all cases it is most beneficial to give 
it in combination with some anodyne, such as conium, hyosciamus. 
or Dover's powder. The former I have found the best concomitant." 

"To produce the beneficial effects of ^uinine^ 

I have invariably found it necessary to administer it until giddiness 
and ringing in the ears appear. As soon as these symptoms declare 
themselves, I have seen the paroxysms deferred ana milder. At 
such a period of the fever I decrease the dose of quinine, but at the 
same time give stimulants and good diet. Conium, by its action as 
an anodyne and calmative, prevents all the irritability oi the stomach, 
which is usually occasioned by large doses of quiinine. I believe 
much more in the administration oi the druff in the solid form than 
in solution. In the latter it almost always disagrees.'' 

" As a prophylactic, quinine is most necessary, especially where 
men are employed in gr near swamps, or upon boat service ; but it 
must be given in large doses (six grains), night and morning, and 
combined with some stimulant, such as sherry or rum and water. 
I know many old stagers on the Danube works who would sooner 
go to their duty along the banks of the river without their dinner 
and tobacco than without their allowance of quinine. If they should, 
even for a day, forget their allowance, they are almost certan to feel 
indisposed, or have an attack of ague in a few hours." 

In the Newport there were fifteen cases of ague. They occurred 
in men who had suffered from remittent fever during the previous 
year, while serving on the South Coast of Sicily. The medical 
officer says that relapses occurred so frequently amongst tliese 
men, that it was found necessary to invalid four of them ; and he 
observes, that the climate of the Mediterranean seems peculiarly 
unfavourable to those who have acquired malarial fever on its 
coasts, and that change seems absolutely necessary to re-establish 
their health. 

i«/?Mcwza.— Under this head are classed 198 cases, which occurred 
as an epidemic in the Caledonia, and which have been already 
detailed. 



* Assist* Surgeon A. Irwin Bolton, ii.d. 



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OP THE MEDITERKAXEAN StATIOX. 53 

H General Diseaaes.— Section B.— Constitutional Group. temuiean 

Rheumatism. — Of thia disease 254 cases were under treatment^ * 

which ia in the ratio of 63*9 per 1,000, being a reduction compajred Clais II . 
with the preceding year equal to 31*9 per 1,000» Of these, seven- Sect B. 
teen were invalided, which gives a ratio much in excess of 1868. 
The average duration of each case on board ship, and in hospital, 
was between eighteen and nineteen days. In 1868 the average 
duration was between seventeen and eighteen days. 

The ship in which the largest number of cases occurred was the 
Royal Oak. The disease was considered attributable to the perni- 
cious influence of the climate of the Mediterranean, but it was also 
conjectured that many of them had a syphilitic origin. 

St/pkilisy Primary and Secondary. — One hundred and fifty-three 
caaes of primary syphilis, and thirty-nine of secondary syphilis were 
under treament during the year, and of these, one case of primary, 
and seven of secondary syphilis were invalided. The ratio of cases 
of primary syphilis was 38*5 per 1,000, and of the secondary form 
of the disease 9-8 per 1,000. Compared with the preceding year, there 
was a reduction in the ratio of cases of primary disease to the extent 
of 9- per 1,000, and of secondary disease to that of M per 1,000. 
Each case of primary syphilis was on an average between tnirty-four 
and thirty-five days under treatment ; and each case of the secondary 
form nearly thirty-three days. The treatment was slightly more 
prolonged in both varieties than in the previous year. 

The vessels in which the greatest number of cases of primary 
syphilis occurred were the Caledonia, Endymion, Enterprise, Lord 
Warden, Prince Consort, and Royal Oak. 

There is nothing noteworthy in connection with the cases occurring 
in the Caledonia. Being a recently commissioned ship, they were 
mostly of English origin. 

The surgeon of the Endymion says, with reference to the 
cases that occurred in that vessel, '* A comj>aratively heavy 
amount of sickness appears under this head, exceeding that of 
any like period of the ship's commission. Every case originated at 
Gibraltar, v?here there is little or no supervision of prostitution. 
Fifteen cases were added to the sick-list, the other two being 
re-entries of patients returned from hospital on our leaving the 
station. A few more cases of a minor character were detected on 
the inspection of the men as lately ordered, but treated without 
being placed on the sick-list. 

"It is unfortunate that some measures are not adopted at 
Gibraltar to prevent such a large amount of preventible disease. 
Whikt Malta is ahnost free from it, Gibraltar is a perfect hot-bed 
for all sorts of venereal diseases. Cadiz, which bears a bad name for 
venereal disease, did not produce a single case, although many 
ipecial and privilege leave men were daily on shore. The cases of 
syphilis presented generally the character of the second class of sore, 
apt to produce bubo, and more intractable than those we met with 
Iwt year at Trieste^" ^. 

384, H Thero 



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54 MEDICAL STATISTICAL KETUENS 

M«dl. There were fourteen cases of primary, and three of secondary syphilis 

terranean in the Enterprise ; but with the exception of the observation that 

Station. they occasioned more than one-fourth of the total number of days' sick- 

p^ Ij ness in the ship, no information is given in connection with them. 

Sect B. ^^ ^^ Lord Warden there were eighteen cases of primary, and 

three of secondary syphilis. They were mostly contracted at the 
Pirceus, at Naples, Messina, and Lisbon* Some of the cases were of 
considerable sererity, but the information respecting them is scanty. 

There were twenty-three cases of primary, and four of secondary 
syphilis in the Prince Consort. The majority of the cases of primary 
diseases were contracted at Naples, the Sicilian ports, and Gibraltar. 

In the Royal Oak, there were thirty cases of primary, and elevdn 
of secondary syphilis, concerning which the surgeon remarks : 
*' Syphilis i^ain engrosses attention, not alone from the cases it 
presents, and the loss of service it entails, but that there is such a 
hesitation' in the minds of many to carry out preventive measures in 
connection with it. I found that, at Gibraltar, there is no regular 
j^olice supervision of the public women, and we had many cases 
from that place that might have been avoided in an English garrison 
town if medical examination was insisted on, and hospital accom- 
modation provided. At Malta and the Pirseus matters are now 
different. There the police exercise their power, and medical in- 
spections of the women are held« 

Phthisis Pulmonalis, — Eighteen cases of this formidable disease 
were added during the twelve months ; but it will be observed by 
referring to Table 1., that twenty were invalided, and four proved 
fatal. This apparent discrepancy arises from the fact, either of 
several of the cases having been entered on the previous year, or from 
their original entry having been that of some other chest affection. 

IIL DiseaMB of the NervouB System, and Organs of the 
Special Senses. 

Class III. Under this head, seventy-four cases of various forms of disease 
were entered on the sick-list, of which ten were invalided, and one 
proved fatal. In this instance, the man, a marine, of Her Majesty's 
Ship Hibemia, was sent to Malta Hos^tal, on the 31st of Julv, for 
deafness, of which he had complained since the 13th, and which was 
at first accompanied by otorrhcjua. On the Ist of September he had 
an epileptic seizure, and subsequently several paroxysms occurred 
whicn he described as being preceded by an aura. He became 
extremely cachectic ; several boils covered with an ashy crust formed 
on his person, especially one over the left malar bone, which in size 
approached to a carbuncle, and extruded a fetid, ash coloured slough. 
There was also a tendency to passive haemorrhage, both from this 
boil and from the urinary organs. The cachexia rapidly increased, 
there was paralysis of the right facial nerve, with stertorous breath- 
ing, involuntary passage of faeces, &c., and he expired on the 12th 
of^September, a slight epileptic seizure having immediately preceded 
his death. On post-mortem examination of the body, the cerebral 

membranes 



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OP THE M£DIT£RBAN£AN STATION. 55 

iMmbranes generally were found much congested and thickened Medl- 

with considerable serous effusion into the sub-arachnoid spaces. ^^J?**** 

The cerebrum^ cerebellum, pons varolii, and medulla oblongata were ^woon. 

apiNurently healthy, except that numerous bloody points were seen (Jlasi in. 
on indaing the former. 

IVi Diseases of fhe Circulatory System. 

Sixteen cases of various forms of disease appear under this head. Class IV. 
of which eight were invalided, and two proved fatal. The ratio of 
ewaea is only one-half of that of the previous year, but there is a 
fimctional increase in the invaliding and death-r^Ctes. 

An interesting case of aneurism occurred in the case of a marine 
of the Caledonia. It is thus recorded by the surgeon* of the ship. 
** A very interesting case of popliteal aneurism occurred, which has 
been successfully treated bv compression of the femoral artery in 
Searpa's triangle. The patient, a tall, healthy, well made marine 
artilleryman, who had been on shore drinking and breaking his 
leave, was ignorant of having sustained any injury when on snore, 
bnt when he came on board ne complained of pain about the left 
pojditeal space, and on examination a pulsating tumour was found 
oocnpying the position of the artery. This was readily reduced by 
pressure. But it immediately regained its size on the pressure being 
removed. A distinct bruit was audible on applying the stethoscope, 
and the j^ulsation was distinct at whatever point felt Satisfied of 
its aneurismal character, compression of the femoral in the anterior 
pari of the ihigh was attempted by securing a four pound weight 
over its course. This, however, proving irksome to the patient, the 
weight was removed, and pressure by means of the thumb was 
attempted as continuously as circumstances admitted.^ An instru- 
ment was meanwhile constructed by one of the engineers in the 
form of a horseshoe-shaped clamp, having a pad secured at the inner 
surface of one extremity, and an ordinary tourniquet at the other, 
by turning which, pressure over the artery could be regulated. This 
was so applied round the thigh, that compression was effected oyer 
the femoral artery, a few inches below Poupart's ligament, whilst 
the fflnall padded point posteriorly, forming the counter pressure, 
and securing the instrument, afforded the patient very little incon- 
venience. He very soon appreciated th^ object of the treatment, 
aad maintained pretty firm pressure during the day, relaxing it a 
fitde before going to sleep. The pulsations were almost from the 
first arrested, and irfter a few days' application of the instrument, 
they recurred very slightly. on relaxing the pressure, and sub- 
sequently complete removal of pressure failed to re-induce pulsation. 
It was, however, continued for some time longer, when the tumour 
having disappeared, and no pulsation being perceived in the course 
of the artery at this point, the apparatus was dispensed with, and 
several weeks have elapsed without the least appearance 

of 



• Surgeon J. G. T. Forbes. 
384. h2 



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56 M£DICAL STATISTICAL BETU&NS 

Medi- of a relapse. He complains of a sense of numbness about the 

^7?*^*" popliteal space^ and occasional soreness of the hamstring tendons and 

'^°' calf of the leg after much walkings so that I have not yet sent him 

Class IV. to duty^ but get him to do nursing duty in the sick bay.*' 

There were two deaths from organic disease of the heart. One 
of these occurred in the person of a boy of the Caledonia, who was 
placed on the sick-list on the 27th of December 1868, complaining 
of slight catarrhal symptoms^ with debility and cough of two or three 
day*s duration, but no expectoration. The pulse was weak and 
abnormally rapid, and the general appearance of the patient 
unhealthy. Under treatment the cougli ceased, and no decided 
evidence of pulmonary disease was evinced. On the morning of the 
8th of January he had no complaint, the appetite and spirits were 
good, and at 12.45 p.m. he remarked to the steward wnat a ffood 
dinner he had just made. In another minute he fell off his cnair 
and expired. On post-mortem examination the body was observed 
to be by no means emaciated. The chest was rounded, and well 
formed anteriorly. Tubercle was found deposited in both lunn, 
but especially so in the right, where it was infiltrated, and at me 
apex a small cavity existed. The pericardium contained a consi- 
derable quantity of serum; the heart was slightly enlarged, and 
appeared perfectly flaccid. The ventricles of the brain contained 
a good deal of efiused serum^ and the cerebral substance was dotted 
with congested vessels. 

The other fatal case was a pettv officer of the Prince Consort^ 
who was admitted into Malta Hospital on the 7th of July with a 
distinct cardiac bruit, systolic in time, and heard both at the left 
apex, and also^ but more faintly, at the base. There was consider- 
able palpitation, prsecordial pain, occasional haemoptysis, and severe 
dygpnoca. As the case progressed, the bruit at the base increased in 
duration and intensity, and became louder as the stethosccg)e 
travelled along the course of the ascending aorta, thus simulating 
an aneurismal murmur. He was invalided on the morning of the 
10th of August, but the same evening he had an attack of vomitings 
and copious expectoration of frothy matter containing large quan- 
tities of florid blood. The same state of things continued in a 
mitigated form during the night ; he complained of intense abdo- 
minal pain, his countenance appeared blanched, and he expired on 
the morning of the 11th. Ai'ter death two of the cusps of the 
aortic valves were foimd immensely thickened, and hypertrophied^ 
and one of the cusps was dilated into a iK)uch by firm fibrinous clots. 
The left ventricle was the seat of excentric hypertrophy. 



V. and VI Biseaaes of the Absorbent System and 
Ductless Glands. 

Class V. Twenty cases of sympathetic bubo, and one classed as adenitis 

and VI. were under treatment, but there was nothing of any importance in 
connection with them. 



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OP THE BIEDITERRANEAN STATION. 57 

Vn. Diseases of the Respiratory System. Medi- 

Ucder this head 493 cases of various forms of disease were entered station, 
on the sick-list^ and of these nine were in valided^ and four proved fatal. ._ 

An attack of haemoptysis, caused by sudden fright, occurred in the Clau VII. 
person of a petty officer of the Royal Oak, who, when on duty on 
the forecastle, exercising shifting top-gallant masts, observed the 
fore top-gallant mast topple over. The surgeon says, ** Sudden fear 
iod mental emotion came upon him, he fell back in a half faint, and 
emitted a large quantity of blood from his mouth. Being carried 
to the sick bay, I found him very anxious, and at intervals, m a very 
ccmvulsive manner, he coughed up large quantities of frothy, bright 
cdonred blood. He continued for some days coughing up blood. 
The treatment adopted was perfect quiet, resting in bed, with the 
head and chest elevated by pillows, and kept very cool. Draughts 
of dilute sulphuric acid and morphia were given every four hours, 
and low diet prescribed. The greatest relief in his case was expe- 
rienced from constantlv sucking clear ice. Some months prior to 
this occurrence, he suffered from an attack of pleurisy .'* He reco- 
vered, but as his symptoms began to show evidence of a phthisical 
tendency, he was brought forward for survey, and invalided. 

Of the fatal cases one was the result of emphysema, one of bron- 
chitis, and two of pneumonia. The case of emphysema occurred in 
the person of a seaman of tlie Caledonia, a coloured man, who was 
sent to Malta hospital for the treatment of syphilb. The hospital 
report, as furnished by the Deputy Inspector General,* is as follows: 
— *^ This man was discharged from hospital on the 30th of June, 
convalescent from a syphilitic sore, situated on the upper surface of 
die base of the penis. On the 20th of July he was re-admitted, the 
sore having broKen out afresh. On the 4th of September icteric 
symptoms appeared, with constipation, clay-coloured stools, and 
dark-coloured urine. On the 10th February comjjUcation became 
apparent, with viscid muco-purulent sputa, diminution of the respi- 
ratory murmur in the left lung, bronchophony, ereat dyspnoea, and 
fever. These symptoms increased, the sputa hecame rusty and 
extremely tenacious; there was little or no dulness on percussion; 
the respiratorv murmur was entirely lost on the right side, with fine 
crejntation below ; rhonchus was also heard over the right lung ; the 
dyspnoea became most urgent ; the skin was covered with a profuse 
perspiration, and he expired at 12.10 p.m. of the 19th. On post- 
mortem examination of the body the heart was found slightly en- 
larged ; the sub-pleural connective tissue enormously^ distended with 
air, so as to resemble large nodulated coils of intestine. The right 
pleura over the diaphragm was in a state of suppuration, and there 
was a small quantity oi pus in the pleural sac. Both lungs were 
excessively collapsed; the right was also congested, and more col- 
lapsed than the left. There appeared to be no emphysematous state 
of the areolar tissue connecting the pulmonary lobules. The liver 
was slightly enlarged, and possessed a nutmeg-like appearance." 

The fataJ case of bronchitis was complicated with very extensive 
disease of the heart. There were no points of interest in connection 
with the cases of pneumonia. 



• Deputv Inspector General W. T. Domville, m.i>. 
384. h3 



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68 MEDICAL STATISTICAL RETURNS 

umiim ^^™- Diseases of the Digestive System. 

Station. Under this head 770 cases of various forms of disease were entered 

^ Z1-- on the sick-list, chiefly cases of cynanche, dyspepsia, and diarrhoea. 

CUM VXII. Qf ^ijg ^Qioi number nine were invalided, and two proved fatal. 

Diarrhcea.— 0£ this affection 264 cases were under treatment, the 
average duration of each case on board ship and in hospital being 
between four and five davs. The vessels m which this affection 
prevailed were the Caledoma, the Lord Warden, and the lioyal Oak. 
The nature of the diarrhoja which prevailed so extensively in the 
former vessel, and in so complicated a form, has been already de- 
scribed in the history of the epidemic fever which prevailed at the 
time,* and requires no further notice here. In the Lord Warden 
the attacks of diarrhoea occurred chiefly during the warm weather, 
and were of little importance. 

There were forty-four cases of diarrhoea in the Royal Oak. The 
surgeon says : — " This amount of diarrhoea chiefly arope in the sum- 
mer months, when the ship, although more at sea, touched at various 
ports, where fruit was obtained in abundance. On one occasion our 
water, condensed on board, owing to a leakage in the pipes of the 
condenser, became brackish, and was used for a couple of d^s in 
that state. Being discovered so, it was at once discontinued, but 
produced several cases of intestinal disturbance, which we had to 
class under diarrhoea. One case alone was severe ;^ it merged into 
dysentery, and the boy became very much emaciated; his con- 
valescence was very prolonged, but eventually he made a good re- 
covery." 

Worms.— Under this head twenty-five cases came under observation. 
Many of these were, however, recurrences of attacks in the same 
person. In the great proportion of cases the entozoon was the taenia. 

In the Antelope there were ten cases of worms, in eight of which the 
parasite was the taenia. The medical officer says of taenia :— " There 
were eight entries, of which one was a warrant officer, who had been 
treated for tapeworm several times, on the West Coast of Africa, 
with small or moderate doses of ext filicis. These brought away 
large quantities, but did not get him rid of all. On the 26th of 
April 1868, he took half an ounce, and repeated it after nearly three 
weeks. Thence to June, 1869, he declared himself perfectly free 
from worms, and in better health than he had been for vears. Of 
the remainder, one was a re-entry, whom I had to place regularly on the 
Ust. The others were not excused from work during the treatment. 
Believing; the limitation of the dose of ext. filicis to the usual ji., or 
jiss. of the posolo^st, to be unnecessary, and often unadvisable, 1 ad- 
ministered 3iv. on an empty stomach in the morning, having the 
evening before cleared out the bowels by a purge composed of scam- 
mony, bitartrate of potass, and calomel. All food was then forbidden 
until the bowels had acted, which they generally did from two to five 
times in the forenoon under the influence of a little Epsom salts. 
In no case did I discover a head ; but in each fragments very close 
to it made their appearance. In most I repeated the dose after 
ten days or a fortnight. In one only of these did any more frag- 
ments 



o Ante, p. 41 , 

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OF THE BfEPITERRANEAK BTATION. 



59 



menta eome ftway. Ip one, who avoided the second do«e, the 
growth of the worm compelled a re-entry, as above alluded to. 
All have Bince appeared perfectly free from any. All occurred 
in the Bosphorus, between June and September. There 1 have 
never seen any fresh pork on board, and I believe that our men 
had little or none ashore or afloat. At Malta, where we had 
served fix>m the 2nd of February to the 5th of May, they con- 
sumed a ffood deal. That consumed on board was usually brought 
off cooked, and not seen previously by the purchasers. I remember 
haying often remarked on its fine appearance. 

" On arrival at Malta I intend to institute an examination of all 
brought oil board, as far as I can. Such must often be inconvenient 
in ships carrying only one medical oflScer ; but, even in the best re- 
g[ulated vessels, the attempt to suppress l^nia in this way seems to 
me to be almost hopeless. The efficient plan, in my opinion, would 
be careful examination of all the pork killed or offered for sale on 
the island^ by competent public examiners. Medical men ashore can, 
of course, do much to prevent the disease in the pig ; but, amongst 
the wretched peasant population of Malta, I am afraid their efforts 
would not be sufficient to stamp it out altogether." 

lathe Lee there were si« cases of taenia, but their origin could not 
be ascertained. They were all consequent on a visit to Beyrout. 
The water used on board was condensed, but no information is given 
is to the food obtained by the men from the shore. Kousso was the 
agent successfully employed in the treatment of these cases. 

There were five entries for taenia in the Rapid, four of these being 
in the person of one man, who had suffered I'rom the j)araeite two 
years before, at Patras, apd previously in China. Repeated doses of 
iWile shield fern, although dislodging at different times large portions 
of the worm, failed to effect a permanent cure. In the other man, the 
same remedy was effectual. 



Medi. 

terrauaaa 
'Station. 

COawVUL 



IX and X. DiBeases of fhe Urinary and Generative 

Systems, 

Of this class of diseases, 188 cases were entered on the sick-list; 
of which, 103 were cases of gonorrhoea and forty-six of orchitis, the 
roy'ority of which were doubtless of gonorrhoeal origin. The average 
duration of each case of gonorrhoea was about nineteen days, and of 
each case of orchitis between thirty and thirty-one days. No re- 
marks appear necessary in connection with the other diseases of this 
class. Under the head of Diseases of the Kidneys, Bright's disease 
pteponderated, and under Diseases of the Bladder, inflammation of 
that organ. 



Class IX. 
andX. 



XI. Diseases of the Organs of Locomotion* 

Under diseases of the bones and joints, twenty-two cases were 
entered on the sick-list ; of which, nine were invalided. Each case 
^aa on an average thirty-seven days under treatment. The diseases 
which necessitated the invaliding were synovitis, disease of the 
vertebrae, and disease of the hip-joint. 

384. H 4 



Class IX. 



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60 MEDICAL STATISTICAL BETVBKS 

Medi' xn. and Xm Diseases of the CeUulax Tissue and 

*s^S?' Cfutaneous System. 

One thousand dx hundred and seventy-six cases of various forms 

^^^imT* ^f ^®^*8e were entered under this head; of which, 1,314 were cases 
ana aIU. ^f j^^jjg ^^^^ abscesses. Of the total number of cases, nine were 
invalided and one proved fatal. In this latter instance the disease 
was abscess evidently connected with the lumbar vertebras. The 
man, a marine of the Caledonia, had been sent into Malta Hospital 
for treatment in 1868, and from thence he had been invalided. On 
the homeward voyage it appears to have been considered unadvisable 
to take him beyond Gibraltar, where he was accordingly landed and 
placed in the Military Hospital, in which establishment he died. 
But little information has been obtained in connection with him. 

Unclassed Diseases. 

Delirium Tremens. — Four cases of this disease were under treat- 
ment ; of which, one occurred in an officer, one m a leading seaman, 
one in an ordinary seaman, and the rating of the fourth person has 
not been ascertained. 

Poisoning. — Of the two cases which appear under this head, 
one was occasioned by lead and the other by alcohol; both re- 
covered. 

Wounds and Injuries. 

Four men sustained fatal fracture of the skull ; one by falling 
from aloft, one by falling into a boat, one by falling over battlements, 
and one by falling over a cliff. 

Nine men were drowned by the capsizing of boats, and two cases 
of suicide resulted from men jumping overboard while labouring 
under temporary insanity. 

The total number of deaths was thirty-two, which is in the ratio 
of '8 per 1,000, being a decrease, compared with the preceding year, 
equal to -7 per 1,000. 

Invalided, 

Under General Diseases, Section A., eight persons were in- 
valided, viz., six for ague, one for the sequelaB of remittent fever, 
and one for influenza; and under Section B., forty-nine, viz., seven- 
teen for rheumatism, one for primary syphilis, seven for secondary 
syphilis, two for scrofula, twenty for phthisis, one for dropsy, and 
one for diabetes. Ten persons were invalided for diseases of the 
nervous system and organs of the special senses, eight for diseases 
of the circulatory system, nine for diseases of the respiratory system, 
nine for diseases of the digestive system, eleven for diseases of the 
urinary and generative systems, nine for diseases of the organs of 
locomotion, mne for diseases of the cellular tissue and cutaneous 
systems, thirty-one for unclassed diseases, thirty of which were from 
climactic cachexia, and four for wounds and injuries. The total 
number invalided was 157, which is in the ratio of 39*5 per 1,000, 
being an increase, compared with the preceding year, equal to 12'7 
per 1,000. 



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OF THE MEDITEBBAKEAN BTATIOK. 



61 



Tablk, No. 1. 

Showhtg the Number of Cases of all Diseases and Injuries^ and the Number 
Inyalided and Dead, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



I. General Diieaaes, Section A. : 



Measles - - - 
Typhue Fever 
Enteric Fever 
Simple continued Fever • 
Ague - - - . 
Remittent Fever - 
Mumps - :. - . 
Influenza 
Erysipelas 



n. General Diseases, SeotionB. 

Rheumatism • • . 
Gout 



CasM. 



Number. 



/Primary - 
LSecondary - 



Syphilis 

Soofola 
Phthiflb Pulmonalis 
Dropsy - - - 
Diabetes 



ni IKseasesof theVerYoasSvB- 
tem, and Organs of the 
Special Senses: 

Sunstroke - - - - 

Paralysis - - - - 

Vertigo 

Epilepsy - - - - 

Neuralgia - - . - 

Insanity - - - - 
Disease of the Brain, &c. 
Diseases cf the Eye 

Diseases of the Ear • - - 



384. 



20 

1 

8 

143 

61 

25 

1 

198 

27 



254 

2 

158 

89 

5 

18 



5 
3 
4 
8 
10 



29 
15 



Ratio 

1,000 

of 
Force, 



5' 

•2 

2- 

80- 

12-8 

6-2 

•2 

40-8 

6-8 



63-9 

•5 

38*5 

9-8 

1-2 

4-5 

•6 



1-2 
7 
1 

2* 
25 



73 

3-7 



Invslided.- 



Number. 



17 

1 
7 
2 
20 
1 
1 



1 

3 

I 
1 
4 



Ratio 

P«' 
1,000 

of 
Force. 



1-5 
2 



4-2 

•2 
1-7 

•5 
5- 

•2 

•2 



Dead. 



Number. 



Ratio 

P«>- 
1,000 

of 
Force. 



Digitized by 



Google 



62 



MEDICAL STATISTICAL BETUttNil 



Tablb, No. 1. — Showing the Number of Cases of all Diseases, &c 


. — continued. 




; Caae«. 

1 


lovalided. 


Dead. 


DISEASE OR INJURY. 


Nmnber. 


Ritio 
per 

1^00 
of 

Force. 


Number. 


Ratio 

P" 
1,000 

of 
Force. 


NumbM-. 


Ratio 

per 
1,000 

of 
Force. 


rV. Diseases of the Circulatory 
System: 














Disease of the f Fonctional 
Heart -(Oi^ganic - 
Aneurism - - - - 
Varicose Veins 


7 
6 

1 
2 


17 

1-5 

•2 

•5 


1 
4 

3 


•2 
1- 

•7 


2 


•5 


V. & VI. Diseases of the Absorb- 
ent System and Ductless 
Glands: 














Bubo (Symp.) - - - 
Glandular Diseases 


20 

1 


5- 
•2 


-- 


— 


— 


— 


V 11. Diseases of the Bespiratory 
System: 














Diseases of the Larynx - 

Catarrh 

Haemoptysis - - - - 
Asthma . - - - 
Other Diseases of the Lungs - 


31 
425 

1 

1 

35 


7-8 

10? 

•2 

•2 

8-8 


2 

1 
6 


•5 

•2 

1-5 


4 


1- 


VUl. DisMMes of the Digestive 
System : 














Cjnancho - . - - 
Diseases of the Mouth, Teeth, 

&c. 

Dyspepsia . . - - 
Dysentery - - - - 
Diarrhoea - - - - 
Colic and Constipation - 
Hsomorrhoids - - - 
Worms - - - - - 
Other Diseases of Stomach, 

Intestines, &c. - - - 
Diseases of the Liver, &c. 


162 

5 

246 

G 

264 

29 

8 

25 

4 
21 


40-8 

1-2 
61-9 

1-5 
66-4 

7-3 

2- 

6-2 

1- 
5-2 


1 
1 
3 

1 

1 
2 


2 
'2 
•7 
•2 

•2 
•5 


2 


•5 


IX. & X. Diseases^f the Urinary 
and Generative Systems : 














Diseases of the Kidneys - 
Diseases of the Bladder - 
GonorrhoBa - - - - 


11 

3 

JOd 


2-7 
259 


4 


1- 


•— 


— 



Digitized by 



Google 



OF THE MEDITBSBA.MEAN STATION. 



63 



Table, No. 1.— Showing the Number of Cases of all Diseases, kc— continued. 




Gate*. 


lovalided. 


Dead. 


DISEASE OR INJURY. 


Niupber. 


Ratio 

per 
1,000 

of 
Force. 


Number. 


RaUo 

per 
1,000 

of 
Porce. 


Number. 


Ratio 

per 

1,000 

of 
Force. 


IX. &X. Diseasesof the Urinary and 
Gemrative Systems- c(mt<^. 












Diseases of the Organs of Gene- 
ration . - . - 
Stricture .... 
Varicocele . - - - 
Orchitis 


1 
Id 

8 
46 


•2 
4- 
2- 
11-5 


2 

1 
2 
2 


•5 
•2 
•6 
•5 


— 


— 


n. Diseases of the Organs of 
Loeomotion: 














Diseases of the Bones, Joints, 
&c. 


22 


6-6 


9 


2-2 


— 


— 


Zn. ft XIJUL. Piseaies of the 
Cellular Tissue and Cata- 














Phlegmon and Abscess - 

Ulcer 

Eiythema - - - - 
Diseases of the Skin - 
Scabies . - - - 


1,314 

315 

2 

43 

2 


330^ 

79-3 

•6 

10-8 

•5 


4 

3 

2 


1- 
•7 

•5 


1 


•2 


Undassed: 














Debility - - . - 
Non-descentofTesMs - 
Delirium 'tremens - - - 
Poisoning . - - - 


61 

4 
2 


16-3 

!• 

•5 


30 

1 


7-5 
•2 


— 


— 


Wounds and Injuries; 

Wounds, Injuries, &c. - 
Bums and Scalds - - - 
Submersion and Drowning - 
Suicide - - - - - 


1,315 
70 
10 


331-2 

17-6 

2-5 


4 


!• 


4 

9 
2 


1- 

2-2 
•5 


Totals - - - 


6,669 


1,427-9 


167 


89-5 


32 


8- 



384. 



Digitized by 



Google 



64 



MEDICAL STATISTICAL RETURNS 



Tablb, No. 2. 

SnewiNG the Number of Days' Sickness from each Disease and from Injuries, the 
Average Number of Meu Sick Daily, with the Ratio per 1,000 of Force. 





Number of Days* SickneM 


Average Number of 
Men 8U;k Daily. 


DISEASE OR INJURY. 


/ 








Ratio 




OnBotrd. 


In Honpitml. 


Total. 


Number. 


per 

l.0i)0of 

Force. 


I. General Diseases, Section A. : 












SmaU-pos - - - - 


_ 


15 


16 


— 


— 


Measles 


84 


447 


531 


1-4 


•3 


Typhus Fever 
£nterio Fever 


01 


09 


130 


•3 


— 


76 


309 


384 


1- 


•2 


Simple continued Fever - 


1,605 


1,078 


3,343 


91 


2-2 


Ague - - - 


626 


17 


542 


1-4 


•3 


Remittent Fever - 


611 


287 


798 


21 


•5 


Mumps - - - - - 


2 




2 


— 


— 


Influenza - - . - 


1,434 


755 


2,189 


6-9 


1-4 


Erysipelas . - - - 


371 


431 


802 


21 


•5 


>ases, Section B. : 












m — m. ^ 


2,881 


1,860 


4,741 


12-9 


3-2 


- - - . 


06 


42 


107 


•2 


— 


Primary - 


3,387 


1,890 


6,283 


14-4 


3-6 


Secondary - 


733 


561 


1,284 


3-5 


•8 


- - - _ 


108 


. 


1C8 


•2 


— 


tnonalls 


349 


693 


942 


2-5 


•6 


" " ■• " 


4 


" 


4 


" 


" 


the Nervous Sys- 
d Organs of the 






















Senses: 












« 


167 


. 


107 


•4 


•1 


. - - . 


24 


. 


24 


— 





.... 


17 


- 


17 








.... 


69 


33 


92 


•2 


___ 


.... 


09 


. 


09 


•1 


___ 


[le Brain 


32 


. 


32 





___ 


le Eye 


300 


104 


404 


1-2 


•3 


lie Ear 


99 


76 


176 


•4 


■I 



Digitized 



by Google 



OF THE M£PIT£RfiAN£AN STATION. 



65 



TiBLBy No. 2.— Showing the Number of Days* Sickness from each Disease, &c. — cani^. 



DISEASE OR INJURY. 



IT. Diseases of the Circulatory 
System: 

Diseases of they Functiunal - 

Heart - lOi^anic 

Aneurism .... 
Yaricoso Veins - - - 



V. A YI. Diseases of the Absorb- 
ent System and Duchess 
Olaaos: 

Glandular Diseases 



TU Biseasesof the Bespiratory 
System: 

Diseases of the Larynx - 

Catarrh 

Hcmi^tyals • - - - 
Asthma ----- 
Other Diseases of the Lungs - 

▼m. Diseases of the Digestive 
System: 

C;paiiche - . - - 
Diseases of the Mouth> Teeth, 

Dyspepsia - - - - 
Dysentery - - - . 
Dianrfacea .... 
Colic and Constipation - 
HAmorriioids . . - 

Worms - - - - - 
Other Diseases of the Stomach, 
Intestines, &c. - - - 
Diseases of the Liver, kc 

OLftX. Diseases of the Urinary 
and Generative Systems : 

Diseases of the Kidneys, &c. - 
Diseases of the Bladder - 
Gonorrhoea - - - - 

384. 



Number of D%y* Sickoess 



On Board. 



166 

173 

79 

95 



838 
24 



222 

2,355 

36 

6 

630 



1,070 

18 

1,133 

207 

1,091 

107 

JOO 

77 

55 
221 



133 

16 

1,711 



In HospiuL 



224 

127 

12 



158 



92 
03 
S8 

985 



207 
93 
44 
80 
86 



240 
154 



135 

78 

303 



Total. 



390 

300 

79 

107 



496 
24 



314 

2,418 

74 

6 

1,616 



1,159 

18 

1,310 

300 

1,135 

187 

186 

77 

295 
375 



268 

94 

2,014 



Average Number of 
Men Sick Daily. 



Number. 



1-3 



•8 

6-6 

•2 

4-4 



31 



30 
•8 

31 
•5 
•5 
•2 

•8 



•7 
6-5 



Ratio 

per 

1,000 of 

Force. 



•2 
1-6 



11 



•2 

•2 



•1 
1-3 



Digitized by 



Google 



66 



MEDICAL STATISTICAL BETURNS 



Table, No. 2.— Showing the Number of Days' Sickness from eacl 


1 Disease, i 


kc— CO»K 




If otnber ot Days* Sicknen 


Average Number of 
BlenSidt Daily. 


BISEASB OH INJURY. 


' 








Ratio 




On Board. 


In Hoapital. 


Total. 


Number. 


per 
1,000 of 
Force. 


IX. & X. Diseases of the Urinary and 
Generative Systems— con^. 












Diseases of the Organs of Gene- 
ration - - - - 
Stricture - * - - 
Varicocele - - - 
Orchitis 


2 
160 
109 
671 


81 
605 

744 


83 

765 

109 

1,416 


•2 
2- 

•2 
3-8 


•5 
•9 


ZI. Diseases of the Organs of 
Locomotion: 












Diseases of the Bones, Joints, 
&c. 


359 


460 


819 


2-2 


•5 


Xn. & Xni. Diseases of the 
Cellnlar Tissue and Cuta- 
neons System: 












md Abscess - 
the Skin 


12,456 

4,938 

51 

649 

14 


820 
1,008 

12 


13,276 

5,946 

51 

661 

14 


36-3 
16-2 

1- 

18 


01 
4- 

•4 


t of Testis - 
remens - - - 


460 
32 
43 
11 


1,044 


1,504 
32 
43 
11 


41 
•1 


1 


Djuries: 












d Injuries, &c. 
Scalds - . 


13,809 
724 


2,121 


15,990 

724 


43-8 
1-9 


11- 
•4 


Totals - - - 


57,633 


19,326 


76,959 


210-8 


63- 



Digitized by 



Google 



OP THE MEDITERRANEAN 8TATI0N. 



67 



Table, No. 3. 
Showing the Number Invalided from each Ship on the Mediterranean Station. 



C AU8E 

OF 

INVALIDING. 



I General DiieaaeB, Section A. ; 



Ague - 

Remittent Fever 
Inflaenza •« 



n. General Diseases, Section B. 

Bheumatism 

( Primary 



Scrofiila 

Phthisis - 

Diabetes - ; 

Dropsjr - - 



HL IKseases of the Nerrons 
System and Organs of 
the Special Senses : 



Paralysis - - - 
Epilepsy - . - 
Insanity - - . 
Disease of the Brain, &c. 
I'iseaies of the £ye - 



nr. IKseases of the Circulatory 



Disease of the f Functional • 

Heart -\Organic 
Varicose Veins - 



ll 



^ Diseases of the Bespira- 
tory System: 

Diseases of the Larynx 
Hcmoptvsis - - - 
Other Diseases of the Langs 

384. 






ii!^ 



l!l 



r 



17 
1 
7 
2 

20 
1 
1 



1 
4 
3 



Digitized by 



Google 



68 



HEDIOAL STATISTICAL BETCBNS 



Table^ No. 3. — Showing the Number Invalided from each Ship, &c. — continued. 


CA USE 

OF 

INVALIDING 


< 


II 

32 


c^ 


1 


i 


1 


s 


1 


i 


1 


0U 


J 


i 
I 

OS 


1 


VIII. Diseases of the Digestive 
System: 

Diseases of the Mouth, &c. 
Dyspepsia - - - - - 
Djrsentery . - . - 
Diarrhcea - - - . 
Other Diseases of the Sto< 
mach, &c. - - - 
Diseases of the Liver^ &c. - 

IX. & X. Diseases of the Uri- 

nary and Generative 
Systems: 

Diseases of the Kidneys - 

Diseases of the Organs of 

Generation - - - 

Stricture - - - - 

'2- - - . 

of the Organs of 

tion: 

fBones, Joints, &c. 

Diseases of Cel- 
Lssue and Cutane- 
tem: 
I and Abscess 

teases of Skin 

;nt of Testis - 
Injuries : 


al 


1 

1 
1 


1 
1 

1 

16 


1 

1 


2 


z 

1 

1 

2 


1 


- 


2 

63 
2 

3 

63 


1 

I 


1 
1 
1 

1 

2 
1 

3 

1 

3 

1 

2 


2 


• 

1 
1 

4 


1 
1 
3 
1 

1 
2 

4 

2 

1 
2 
2 

9 

4 
3 
2 

30 

1 

4 


Total - - - 


•2 


G 

1 


36 


7 


4 


6 


4 


3 


31 


6 


27 


2 


23 


157 



(a) Spioal colamdi 



(6) lodudiog I In Skykrk. 



Digitized by 



Google 



OF THE MEDITERBANEAN 6TATI0K. 



69 



Table, No. 4. 

Seowiyo the Nambcr of Deaths in each Ship ernplojed on the 
Mediterranean Station. 



CAUSB 

or 

DEATH. 


11 


T'i 

I's 


8 


i 

1 


X 


^ 


£ 


§ 


M 

6 
I 

OS 


1 


L General Diseases, Seotion A. : 






















Euteric Fever - - - 


- 


- 


2 


- 


- 


• 


1 


- 


- 


3 


U. fieaeral Diseases, Section B. : 






















Phthisia ... - 


- 


- 


- 


- 


- 


1 


- 


1 


2 


4 


in. Diseases of the Kenrons 
System and Organs of 
Special Senses: 






















Di«eafies of th« Bruin, Sic. - 


- 


- 


" 


- 


1 


- 


- 


• 


- 


1 


IV. Diseases of the Circnlatory 
System: 






















Heart Disease, Organic 


1 


- 


- 


- 


- 


~ 


- 


1 


- 


2 


VIL Diseases of the Eespira- 
tory System: 






















Other Diseases of the Lungs 


- 


1 


- 


- 


- 


1 


- 


- 


2 


4 


VULL Diseases of tlie Digestive 
System: 

Diseases of the Stonmch, &c. 






















- 


- 


1 


- 


- 


- , 


- 


1 


- 


2 


XII. & Xin. Diseases of the 
Cellular Tissue and Cu 
taneons System: 






















Phlegmon and Abscess 


1 


- 


- 


- 


- 


- 


- 


- 


- 


1 


Wounds and Injuries: 






















Wounds . . - - 
Submersion and Drowning - 
Suicide . - - - 


_ 


1 
1 


«. 


1 


-. 


2 

1 


8 


1 


- 


4 
9 

2 


Total - - - 


2 


3 


3 


1 


1 


6 


9 


4 


4 


32 



384. 



Digitized by 



Google 



70 



MEDICAL STATISTICAL RETUEKS 



Table, No. 6 - - • 
Showiko the Noraber of Cases of all Diseases and 



Injuries 



DISEASE or IJIJURY. 



I. General IKseases, Section A. : 

Moasltt- . • • . 

Typhus Fever * • . 

Enteric Fever . . . 
Simple Continued Fever 

Ague - . • . . 

Reroittent Fever - - . 

Influenza - - . . 

Afumps - - • . . 

Erysipelaa - . • . 



II. General Diseases, Section B.: 
KheumatiBin •> • . . 
<^oat ----•, 

«^p-»«{l3y : : 

Scrofula 

PhthisU ruliDonalis 

Dropsy - - - . , 



III. Diseases of the ITervona Sys- 
tem ^jad Organs of the 
Special Senses: 

Sunstroke - . * ^ 

Paralysis .... 

Vertigo - - . . . 

Epilepsy - . . . 

Neuralgia - - . . 

Diseases of the Eye 

Diseases of the Ear 

TV. Diseases of the Circulatory 
System: 
Disease of the r Functional 
Heart, tOrganic - 
Aneurism .... 
Varicose Veins - - . 

V. & VI. Diseases of the Ab- 
sorbent System and Dnct- 
less Glands: 

Bubo (Symp.) - - . 

Glandular Diseases 

711. Diseases of the Bespiratory 

System: 
» Diseases of tho Larynx - 

Catarrh • - - - . 

HaamoptysiB .... 

Asthma 

^ther Diseases of Lungs - ! 



< 



4 



4 
4 



15 






3 
1 



22 

3 
1 



3 
1 



.62 



§-§1 
• I I 



3 
2« 



108 
16 

18 

2 

15 

12 



27 
4 



I 



is 



1 



11 

19 
ID 



3 
4 



16 






7 

7 



27 
2 



Digitized by 



Google 



OF 7HS MBBITE&BANEAN STATION. 



71 



- Table, No. 6. 
ia the SUpB employed on the- Mbditbbranean Station. 



. 1 

a 


a 
U3 




• 


J 


1 


1 


li 


1 


i 
& 


S 

"3 

P4 


1 


• 
IS 


J 


- 


1 


- 


- 


- 


1 


- 


- 


- 


I 


14 


^ 


- 


20 
1 


2 
2 

- 


1 


1 

4 


4 
1 


2 


35 


3 

7 

16 


D* 


2 
1 


96 


2 
6 




2 
2 


8 

143 

61 

25 

198 


I - 


- 


— 


- 


— 


— 


— 


— 


I 


— 


- 


- 


1 


\" " 


• 


■" 


• 


1 


"• 


• 


— 


■■ 


7 


"• 


*" 


27 


9 

17 

1 


11 

14 
9 


17 
5 


7 

4 


2 
2 


36 

18 
3 


7 
2 


28: 

2^ 
4 


7 

1 


17 

1 


60 

30 
11 


3 


6 


264 

2 

163 

39 


mm 


1 
9 


3 


"" 


"~ 


5 


. 


3: 


^ 


I 


1 
2 


^ 


» 


6 
18 




















2 








2 


















2 










6 


— 


• 


1 


- 


- 


• 


- 


- 


- 


- 


1 


- 


— 


3 


1 


1 


1 
1 
1 
2 

1 


1 


1 


1 
4 


1 


2- 
1 
2 


2 

2 

1 
2 


1 


3 
3 


- 


2 


4 

8 

10 

29 

16 


1 


- 


- 


- 


- 


3 
1 


- 


1 


3 


1 




r 




7 
6 


— 


— 


- 


^» 


— 


- 


- 


- 


— 


— 


— 


- 


- 


1 
















1 












2 




1 




1 


1 


4 




6^ 


2 




1 






20 


" 


■ 


" 


" 


■■ 


^ 


"* 


^ 


' 


1 




■■ 




1 


9 


22 


7 


14 


I 
7 


63 


8 


1 
60 


14 


1 
12 


26 


It 


18 


31 
426 


- 


^^ 


- 


- 


1 


1 
8 




4 


- 


- 


1 





2 


1 
1 

35 



384. 



12 



Digitized by 



Google 



72 



MEDICAL STATI8TICAI. RETURKS 



Table, No. 5. — Showing the Number of Ca^es of all Diseases and Injuries 



DISEASE or INJURY. 


1 
Antelope. 


Caledonia 
(First Com- 
mission). 


Caledonia 

(Second 

Commission) 


•0 
2 


i 


.2 

1 




VIII. Diseases of the Digestive 
















System: 
















Cvnanche . . . - 


10 • 


2 


«, 




. 


7 




Diseases of Mouth, Teeth, &c. 


- 


- 


- 


.. 


- 






Dyipepsia - - - - 


1 


9 


71 


2 


5 


7 




D\-8entery . - - . 


- 


- 


1 


. 


— 






Diarrhoea - - - - 


13 


11 


62 


1 


13 


8 




Colic and Constipation - 


1 


- 


4 


1 


2 


1 




Haemorrhoids- - - - 


1 


1 


. 


« 


1 


1 




Worms 


10 


1 


_ 


^. 


^ 






Diseases of Stomach, lutes- ^ 
















tines, &c. - - - -j 


" 


~ 


*" 


— 


— 


1 




Dbeasesof the Liver, Spleen, &c. 


- 


1 


1 


1 


1 


1 




IZ.&X. Diseases of the Urinary 
















and Generative Systems : 
















Diseases of the Kidneys - 


. 


1 


« 


^ 


«. 


^ 




Diseases of the Bladder - 


. 


«. 


1 


^ 


^ 


^ 




Gonorrhcea - - - - 


7 


2 


9 


_ 


8 


10 




Diseases of the Organs of Ge-1 
















neration - - - -/ 






" 


— 


~ 


"■ 




Stricture - - . - 


. 


. 


3 


_ 


„ 


1 




Variocele . • . - 


. 


. 




_ 


_ 






Orchitis- . - - 


1 


5 


"7 


• - 


- 


2 




XI. Diseases of the Organs of 
















Loeomotion: 
















Diiseases of the Bones 


2 


^ 


1 




_ 






Diseases of tlie Joints 


^ 


«. 




_ 


1 


_ 




Diseases oC the Burss 


- 


- 


2 


- 


1 


- 




XII. & XUl. Diseases of the 
















Cellular Tissue and Cu- 
















taneous System: 
















Phlegmon and Abscess - 


24 


8fi 


211 


5 


3 


35 




Ulcer 


2 


9 


31 


2 


1 


6 




Erythema - - - . 


— 


_ 












Diseases of the Skin 


1 


1 


14 




1 


1 




Scabies - - - - - 


- 






- 








Vnolassed: 
















Debility 


_ 


^ 


25 






1 




Delirium Tremens - - - 


. 


^ 












Poisoning - - - - 


- 


- 


- 


- 


. 


_ 




Wounds and Injuries : 
















Wounds, &c. - 


54 


74 


213 


5 


9 


83 




Bums and Scolds - 


1 


8 


10 


1 


1 






Submersion and Drowning 


- 




1 






- 




Total - - - 


J (58 


yi3 


1,053 


50 


100 


181 





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OF THE MBDITERRAKEAN STATION. 



73 





in the 


Sliips 


employed on 


the Medi 


terrane 

1 
1 


;an Station— 


continued. 










i 

s 


i 

1 

1 


i 

'£ 


•-» 


J 


s 

1 


o 9 

0- o 


1 


'S, 

es 


i 

o 


3 

H 


'i 


J 

1 




5 


3 


7 




3 


36 


4 


30 


6 


7 


44 






162 




4 


4 


2 


■• 


4 


19 


3 


1 
17 


4 
11 


17 


70 


. 


«, 


5 
246 




1 
2 


6 

1 
1 


3 
7 


6 
1 

1 


11 
2 

6 


30 

1 
1 


11 


15 
5 
1 

1 


1 
3 
4 


1 

10 
1 

5 


44 
3 

2 


- 


14 


6 

264 

29 

8 
26 




- 


- 


- 


« 


- 


1 


- 


1 


- 


1 


- 


- 


- 


4 


, 


2 


1 


- 


- 


2 


1 


7 


1 


1 


1 


- 


- 


21 






1 








1 


1 


1 


3 


1 


2 






11 




3 


16 


1 


3 


6 


1 
6 

1 


1 


3 


3 


7 


16 


3 


- 


3 
103 

1 




1 

1 


2 
2 


- 


1 


2 


2 
13 


2 

1 


5 
5 
5 


- 


- 


7 


- 


2 


10 

8 

46 




- 


- 


- 


- 


- 


3 

1 


- 


2 


- 


1 


1 
3 


- 


- 


8 

7 










' 




1 




3 












7 




28 
12 


25 
12 


24 

7 


6 


12 

4 


231 
38 


33 
16 


2-27 
50 


20 


08 
16 


217 
99 


17 

2 


12 
9 


1,314 
316 




^ 


3 


1 
2 


■■ 


_ 


'I 


4 


3 


^ 


3 


4 


1 


• 


2 
43 


1 


— 


1 


"• 


— 


~ 


— 


"* 


"" 


"" 


1 


"" 


— 


2 


1 


1 


3 


^ 


1 


11 


2 


2 


2 


3 


7 


2 


-A 


61 




1 


Ca)T 


1 


(6)1 


- 


- 


- 


- 


- 


- 


2 


- 


- 


4 

2 




27 

2 

I 


30 


20 
3 
3 


9 
4 


9 

1 


2^9 
11 


22 
3 
5 


245 
11 


26 


63 
4 


209 
16 


19 


5 


1,316 
70 
10 




1^ 


107 


133 


63 


78 


827 


155 


776 


121 


320 


913 


69 


73 


6,669 



(«) By liud. 



(i*) By alcohol. 



384. 



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74 



MEDICAL STATISTICAL B£TURNS 



Tabus, No. 6« 



Sbowimo the Names of ike 8bip&^ the Average Complenients^ &c. ; tlie NnmW of 

Men Sick Dailj, m eaeh Ship; 



P. O. Paid off. 



Rato,&e. 


NAMES 

SHIPS. 


Where 


When 
CommiMioned. 


Number 

of 
Gunt. 


Tonnage. 


Her«e 

Power. 




Iron Clad - 


Caledonia • 


-P.O. 


DeTonport • 


27 April IS«5 


SO 


4,125 


S. 1.000 






Caledonia 


. C. 


Malta 


1 June 1B69 


80 


4,125 


S. 1,000 






Enterprise 


- 


Malta 


1 July 1868 


4 


993 


S. 160 






Lord Warden - 


- 


Devunptirt - 


SI July 1867 


IS 


4,080 


S. 1,000 






Prince Contort 


• • 


Devonport • 


2 April 1868 


24 


4,045 


S. 1,000 






Royal Oak . 


- 


Porumtmth 


UDec. 1867 


24 


4,056 


s. too 




Fourth Rata 


Btidymion 


-P.O. 


Sheernew - 


27 Sept. 18C6 


21 


2,486 


S. 500 




Slttop 


CmiMr • . 


^ ^ 


P»rtMiwnith 


27 July 1866 


3 


752 


S. 60 






Rapid • 


- 


Woolwich - 


U May 1868 


S 


672 


S. 160 




Gaa Vtfl*el - 


Jaieur - 


. 


Sheeroets • 


26 Aug. 1867 


5 


427 


S. 80 






Lee . . 


» • 


SheerncM - 


10 June 1867 


5 


431 


S. 80 




Steam VciPel 


Antelope 


« , 


Woolwich . 


12 July 1866 


S 


650 


P. 260 






Caradoc • 


-P.O. 


Woolwich . 


21 Feb. 1867 


8 


676 


P. 36» 




(Surreying) 


Newport - 


• • 


Devonport - 


3 April 1868 


6 


425 


S. 60 






P»yche - 


- 


Malta 


IJan. 1867 


2 


835 


P. 250 




Gun Boat ^ 


Cocatrice 


• • 


Malta 


9 Feb. 1866 


2 


269 


S. 60 






Trinculo 


- 


Portsmouth 


-Mar. 1867 


2 


273 


S. 60 






Wiiard . 


- 


Malta 


27 Mar. 1866 


2 


270 


S. 60 




Receiving Ship - 


Hibernia 


• " 


Malta 


2 April 1867 




2,530 


- 





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OF THE MEDITERBANEAN 8TATI0K. 



75 



Tablb, No. 6. 



CtMs; the Total Namber of Days' Sickness on Board; the Average Number of 
and the Namber Discharged to Hoapital. 



C. CommiMioned. 





Period* 


Con- 
plemeots. 


Average 
Com- 
plementa 
eorrecteti 
for Time. 


Number of 
CaMMof 

Injury. 


Number of 

hayt* 

Sickneca oo 

Board. 


Avenge 

Number of Men 

Sick Daily for 

TwelT« 

Montha, 


Ratio per 
1,000 of 
Average 
Force of 

each Ship. 


Number 
Diacbargt^ 

to 
Hospital. 




liuLteSl May 


690 


290 


313 


3.294 


9- 


81* 






liucltSlDee. 


636 


370 


1,053 


10,459 


28*6 


77-2 


106 




Ymr . 


145 


145 


167 


2,213 


6- 


41-3 






Y« . . 


680 


680 


827 


7,829 


21-4 


31-4 


66 




Ytar • . 


660 


660 


775 


8,b01 


24*1 


36-5 


27 




Year - . 


680 


680 


913 


9,940 


27-2 


40- 


50 




1 Jan. to 21 May 


516 


200 


184 


1,606 


4*4 


22- 






Yor 


185 


185 


181 


2,072 


5*6 


30-2 


15 




Y«r 


135 


135 


320 


3,182 


8-7 


64-4 


13 




1 Oct. to 31 Dee. 


70 


20 


63 


484 


1-8 


65- 






1 hAj to 31 Dec. 


65 


30 


78 


415 


I'l 


36-6 






Ycv . - 


90 


90 


168 


1,916 


5-2 


57-7 




*IJaLtD9Jiaiie • 


65 


30 


30 


235 


•6 


20- 






Yew 


60 


80 


155 


1,250 


3-4 


42-5 






Y«r 


70 


70 


121 


798 


2-1 


30- 






Yor - . 


50 


60 


106 


592 


1-6 


32- 






Yeu . . 


45 


45 


59 


592 


16 


35*6 






Y«, 

1 


45 


45 


73 


662 


1-8 


40' 




« 


1 


165 


165 


133 


1,341 


3-6 


21-8 


3 



384. 



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76 



MEDICAL STATISTICAL EETUBK8 OF THE 



NORTH AMERICAN AND WEST INDIAN STATION 



North 

American 

and 

"West Indian 

Station. 



Class I. 
Sect A. 



The squadron on die North American and West Indian Station 
in the year 1869 comprised seventeen vessek; viz., four iron-clads ; 
two fourth-rates ; two sixth-rates ; four sloops ; three gun-veesehs ; 
one receiving ship permanently stationed at Port Royal, Jamaica ; 
and one floating oattery permanently stationed at Bermuda. The 
returns from eleven of the vessels were for the whole year, and 
from the remainder for periods varying from four to nine months. 
The mean force corrected for time was 3,500, and the total number 
of cases of disease and injury entered on the sick-list 5,210, which 
is in the ratio of 1488*5 per 1,000 of force, being an increase, com- 
pared widi the preceding year, equal to 62*2 per 1,000. Of these 120 
were invalided, and eighty-two proved fatal> the former being in the 
ratio of 34*2, and the latter of 23*4 per 1,000. Compared with the 
previous year there was a reduction to the extent of 4*6 per 1,000 
m the invaliding-rate, but an increase in the ratio of mortality 
equal to 14*2 per 1,000, an increase altogether attributable to the 
prevalence of yellow fever at; Jamaica and elsewhere. 

The average daily loss of service from General Diseases, Section 
A., or Febnle Group, was in the ratio of 5*9 per 1,000; from 
Section B., or Constitutional Group, 9*7 ; from diseases of the 
nervous system and organs of the special senses, '9 ; of the circu- 
latory system, '6 ; of the absorbent system and ductless glands, '9 ; 
of the respiratory system, 3*3 ; of the digestive system, 2*4 ; of the 
urinary and generative system, 2*5 ; of the organs of locomotion, '2 ; 
of the cellular and cutaneous systems, 11*5 ; from unclassed diseases, 
1*2 ; and from wounds and injuries of various kinds, 8*6. The 
average number of men sick daily was 180*7, which is in the ratio 
of 51*6 per 1,000, being a reduction, compared with the preceding 
year, equal to 5*4 per 1,000. 

I. General Diseases.— Section A., or Febrile Group. 

Under this head 683 cases of various forms of disease were entered 
on the sick-list, of which four were invalided, and fifty-seven proved 
fatal. Of the deaths one was from small-pox; four were from 
continued fever ; forty-eight from yellow fever ; two from remittent 
fever ; and two from pyoemia. 

SmalUpox. — The only case of small-pox which occurred in the 
squadron was in the person of a seijeant of marines of the Defence, 
and it occurred at Lisbon before the ship had reached the station* 

On 



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NORTH AMERICAN AND WEST INDIAN STATION. 




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NORTH AHERIGAN AND WEST INDIAN STATION. 



77 



On the 6th of April this man had slept in a house in Lisbon ; he 
I felt nnvvell on the following night, ana was entered on the sick-list 
on the 8th with well-marked febrile symptoms. He was immediately 
I discharged to the Naval Hospital^ where the specific form of the 
disease rapidly developed itself; tiie eruption became confluent and 
iKsmorrhi^ic^ and he oied on the evening of the 12 th day from that 
on which he had slept on shore. He stated that he had been vaoci- 
oated^ but there was no appearance of a cicatrice on either arm. 

Simple Contintied Fever. — There were 511 cases entered under 
this head^ of which three were invalided and four proved fatal. The 
average duration of each case was between nine and ten days. The 
Tcssefi in which the greatest number of cases occurred were the 
Aboukir, the FhilomeX the Terror, and the Vestal. 

In the Aboukir there were 301 cases classed as simple continued 
fever, several of which, however, afterwards proved to be cases of 
specific yellow fever. Of the total number of cases 119 were sent 
to hospital, and of this number only eighty-four were admitted by 
the Deputv Inspector General* to be of the simple character imputed 
to them, the remainder being entered under the head of specific 
yellow fever. Of the eighty-four cases admitted to hospital, the 
Deputy Inspector General observes : ** The majority of these cases 
were characterised by a high temperature of body, headache, quick 
and full pnlse, general malidse, and disturbance of the digestive 
organs. They ran a course varying from twenty-four, thirty-six, 
forty-eight, to seventy-two hours, and owed their origin to fatigue 
and exposure to a tropical sun. The subjects of these cases were in 
a condition similar, though in an exaggerated degree, to that of men 
who having undergone great bodily fatigue from hard work and 
exposure had exhausted their physical powers, and who, though not 
what is termed ill, stood iu need of sleep, food, and drink, to be 
restored to their former vigour. 

As several of these men came under treatment at the same time, 
as they had undergone simile fatigue and exposure, were all about 
the same age, and presented similar symptoms, different modes of 
treatment were adopted according to the degree of severity of the 
sTmptoms, In the severer cases the bisulphites were administered, 
in o&ers quinine, in a third class simple salines, whilst in those 
where the indication for rest was evident, simple diluents were 
also given, whilst sleep and rest were encouraged. The result was 
the same ; the fever ran its course according to its severity, and 
was not influenced whether for evil or for good by the meaicinea 
exhibited. 

In the history' ^f these cases no paludal nor other poison had been 
at work. At the time when these men were exposed the sun shone 
bright in the heavens, the sky was unclouded, the temperature in 
the shade was 88" Fahrenheit, and a south-easterly wind was blow- 
ing. The wind had passed over the Caribbean Sea, and over the 
•andy soil upon which Port Royal stands, before it had reached 

these 



North 

American 

and 

West India:i 
Station. 

Class I. 
Sect A. 



* Deputy Inspector General J. L. Donnet, M.p. 
384. K 



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78 



MEDICAL STATISTICAL BETUBKS OF THE 



North 

Amerioan 

and 

West Indian 

Station* 

Class L 
Sect A. 



these men, and consequenlly could not have been impregnated with 
any malarious influence. The causes which produced mese fevers 
are to be met with in other parts of the worla and are not peculiar 
to Port £ojal; and in their action will produce similar results, 
influenced m some measure by the powers of resistance or the 
amount of yital force which the constitution may chance to possess 
at the time of its subjection to their influence.'' 

There were tlurty-nine cases of ^mple continued fever in the 
Philoniel, but littie information is given in connection with them. 
The average duration of each case was between eight and nine 
days. 

Littie or no information is ^iven in connection with the cases of 
simple continued fever occurring in the Terror and Vestal. 

Yellow Fever. — One hundred cases of tiiis deadly form of fever 
were entered on the sick-list during the year, and of these, forty- 
eight proved fatal. Tliis is more than double the average ratio of 
mortality of the disease, and is accounted for by the fact that many 
cases of what have been returned as simple continued fever were 
doubtiess cases of the mor6 fatal type. 

The vessels of the squadron in which yellow fever appeared were 
the Aboukir, the Barracouta, the Defence, the Eclipse, tiie Fa- 
vourite, the Jason, the Philomel, the Terror, and the Vestal. 

Only seventeen cases of yellow fever appear in the Return from 
tiie Aboukir, but, as has been previously observed in reference to 
the cases of simple continued fever in that vessel, there can be no 
question, indeed it is stated so by the medical officer of the ship, 
tiiat many of them were undoubted cases of yellow fever. The 
medical officer* in charge of the ship during the first eight months 
of the year says : — " Although only one case of yellow fever appears 
on the Nosological Table, fourteen others sent to hospital from the 
ship, assumed the yellow fever type. These cases were in many 
instances sent to hospital on mere suspicion, and before the disease 
had become developed, and in other instances owing to the large num- 
ber of fever cases they were sent to hospital for want of room or 
accommodation on board." Of the total number of cases of fever 
sent to hospital from this vessel during the year 1869, seven deaths 
resulted from specific yellow fever. 

There were six cases of yellow fever in the Barracouta, of which 
four died. With reference to these cases, the surgeonf of the vessel 
makes the following observations : — ^* Five patients were under 
treatment for yellow fever in the month of July, four of whom were 
placed on the list on the passage between Jamaica and Bermuda, 
and while the ship was in quarantine at the latter place. Of these, 
two died on board, one recovered ; the remidning two died in hos- 
pital. This form of complaint was not specially recognised until 

the 



* Burgeon John Coogan. 



t Sorgoon R. C. Pasley Lawrenson* 



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NOBTH AUEBICAN AKD WEST INDIAN STATION. 



79 



the evemnff of the 12th of July, two days after leaving Port Royal, 
and would have escaped detection then, if a system of testing albu- 
men in the urine of all the feverish cases had not been systematically 
adopted from the first. The nature of the disease in the early 
symptoms exhibited nothing to point out ite true malignant type, 
as they more or less resembled those of the simple continued fever ; 
but from the recent exposure the ship had been subjected to at 
Havana and Port Boyal, there was great fear that the yellow fever 
poison was latent in the Barracouta. 

" The dates of the ship's movements prior, during, and subsecment 
to the epidemic on board were at Havana from the 19th of June 
to the 1st of July ; at Port Eoyal, Jamaica, from the 6th t)f July to 
the lOth; at sea from the 10th to the 17th; at Bermuda from the 
17th of July to the 28th ; arrived at Halifax on the 2nd of August. 
While the ship remained at Havana— twelve days— the disease was 
prevalent on shore, and particularly amongst the shipping. The 
Spanish officer of health allowed us free pratique, and stated that 
the port was healthy, but in a few days I became accidentally cog- 
nisant of the risk we were being exposed to, although the sickness 
was on the decline. We were then the only English man-of-war in 
the harbour, and upon making my commanding officer acquainted 
with ihe great danger we were in by remaining in the place, I was 
informed that our presence was required to watch British interests 
until we should be relieved by some other vesseL Under these 
circumstances, it became a paramount duty to take every precaution 
of guarding against conununication between the otiier ships and us, 
and prevent any of our people from landing except when absolutely 
requisite. 

" As medical officer of the ship, with great responsibility, I cannot 
avoid saying that it was at least unfair to leave me in ignorance of 
the nnhealthy condition of Havana at that time. Our authorities 
must have been aware of the state of the public health, and whoever 
the charge may fall upon, some might consider them morally re- 
sponsible, though perhaps inadvertentiy, to some extent for the 
loss inflicted upon tiie public service in this ship, and subse- 
quentiy through us upon the naval portion of the community at Ber- 
muda, . 

•^ It was during a visit to the Military Hospital at Havana, on the 
26th of June, that I became acquamted for the first time with the 
appearance of the disease in all its stages. Dr. R H. Pozzio, the 
prmdpal m charge of that establishment, from whom I gamed mucli 
valuable information, and who had several cases under his care at 
the time, informed me of the extent to which the « vomito mneto 
was prevailing. Knowing, however, the great danger run by ex- 
posing myself to the risk of contagion, the hospital being then 
fr^from infection, I deemed.it prudent not to submit myseU 
again to either cluuQce of communicating the disease to the ship s 
company. Upon this account I resolved to refrain from visiting 
any of the hospitab, but indirectiy became informed of the 8®^^*^ 
form of treatment pursued by the Spanish physiciwis. At the 
same time I instituted a strict watch upon the health ot the ship 
by suggesting all the sanitary precautions that common sense 



North 

American 

and 

West Indian 

Btation. 

Class I. 
Sect. A. 



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80 



MEDICAL STATISTICAL RETURNS OF THE 



Nt)r(li 

American 

and 

''Vest Indian 

Station. 

Class I. 
Sect A. 



could dictate ; non-exposure of the men to the sun or rwn ; fre^ 
ventilation throughout the vessel by wind-sails; daily removal of 
the bilge accumulations ; besides a constant and liberal supply of 
carbolic acid solution wherever its action was required. 

** If our immunity from yellow fever while we remained at Havana 
depended upon these measures, it can only amount to negative 
evidence, yet it would be scarcely logical to infer that we should 
have enjoyed the same freedom from sickness if our people had 
carried on the common daily routine of a man-K>f-war, and been 
granted the usual leave privueges. No cases of fever in any form 
had been under treatment whue the ship was at Havana, ^et all 
die foreign men-of-war, and a gi^eat portion of the merchant shippings 
had more or less suffered. The great saving clause in our case 
depended upon the prevalence of the northerly winds at that time, 
which blow in from seawards, a matter of great import, as the health 
of the commimity bears a direct ratio to the wind's direction, the 
hmd breeze having a marked ii^uence in raising the rate of sickness 
as it passes over a city specially located to more than predispose, if 
not to generate all the varieties of malarious poisons^ from its low, 
marshy situation, defective sewerage, and remarkable apathy on the 

?art of the population to pay attention to the principles of hygiene. 
?he usual condition of the public health at Havana cannot be betteF 
stated than by euoting the pertinent remarks of Dr. J. J. Cornilliacf/ 
in his "Researches on the Origin and Propagation of Yellow Fever in 
the Antilles : *' Chaque annee, de Mai ft Octobre, il y a la fifivre 
** jaune a la Havane . • . . La Havane seule jomt ce funeste 
" privil^^e de cons^rver constamment le fl&iu dans son sein." 

*^ Having left Havana on the 1st of July, the ship arrived ai 
Port Royal, Jamaica, on the 6th, between which dates three cases 
of simple continued fever were under treatment. While at the 
latter port these cases became convalescent, and no additional casea 
were entered until the 11th, when two of the ship's company were 
attacked with the primary symptoms of yellow fever ; one died ia 
five days, the other becoming convalescent. On the 13th a petty 
officer was placed on the list for the same complaint, and died on 
the 16th.^ On the 16th the chief engineer was brought under obser- 
vation, discharged to Bermuda Hospital on the 18th, where he died 
two days afterwards with the worst symptoms. Upon our arrival 
at Bermuda the ship was placed in quarantine for twenty-one days, 
but a fresh case having occurred on the 26th, ten daya subsequent 
to the last one, she was ordered to Halifax. The sick re-embarked 
and again discharged to hospital on the 2nd of August. 

As the clinical statement of each patient's case is fully entered 
in the journal, only a few remarks will be made on the hbtory of the 



The febrile symptoms were generally ushered in by chills, and 
although the patients usually presented themselves for treatment in 
the mornings, the^ premonitory signs of sickness seemed frequently 
to have set in during the night, the patients invariably stating that 
they had been in perfect health previously. When the cases cune 
tmder observation thejr presented nothing to distinguish them from 
the common type of simple continued fever, so that no attempt at 

classification 



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olassificalion could be made until the evidence of the malignant 
form was established by the violence of febrile reaction, and the 
pathognomic sign of albuminous urine. The complaint may be 
dividea into three stages; 1st stage, lasting about twelve hours, 
fi*ontal headache, rachudgia, eyes suffused, puffiness of lower lids ; 
fiiee expressive of great anxiety^ skin hot, pungent; tongue 
moist, whitish; pulse full, hard, quick, ranging sometimes to 
120; axillary temperature increased from two to four degrees; 
sometimes vomiting, generally nausea; diarrhoea was troublesome 
in^ one case; and m every instance there existed anorexia^ 
diirsty drowsiness, but no sleep. 2nd stage, from twelve to twenty-' 
four hours, abatement of the acute symptoms with more listlessness. 
Zrd stage, jErom two to seven days, ardent febrile reaction, 
which may terminate in convalescence or death either mbre or 
less rapidly. Albumen was not observed in the urine before the 
second day, and was noticed to increase in quantity with the ten- 
dency to death', the gastric symptoms setting in about the same 
time. 

Knowing the insidious character of this formidable disease in its 
invasion, and being in daily expectation of its attack^ I resolved to 
meet it chiefly by precautionary measures, upon sanitary principles. 
To some extent, as already mentioned, this plan had been carried 
out since the ship was at Havana. As cases oisimple continued fever 
had been under treatment at the time, and prior to those of the 
yellow type, I was suspicious of the malignant febrile poison being 
latent in the ship. Accordingly I put into practice a system ol* 
surveillance without creating alarm, by keeping, a strict and constant 
watch on the lower deck for any premonitory signs of sickness 
among the men. All feverish cases were carefully isolated and 
screened off in ample clear space on the upper deck ; a staff of well- 
selected nurses and attendants was chosen, and upon the least 
symptoms of malignancy appearing, still further segregation was 
enforced hj removing the patient to a place still further to leeward, 
with special attendants. All evacuations were speedily thrown 
overboard, also the foul clothing and articles of bedding, &c. used 
by the yellow fever patients, whether convalescent or dead. Car- 
bolic acid solutions were freely and extensively employed where 
ike necessity of its action was required. 

The treatment, medicinally, depended more upon general prin- 
dples than any specific method, as continually symptoms of a 
perplexing nature would arise, referable either to the head, digestive; 
system, liver or kidneys, that required some special remedial mea^ 
sore. To some extent the administration of medicine commenced 
by giving an emetic, ipecacuanha, followed by a calomel, saline, or 
castor oil purge, according to the circumstances of the case. The 
uigent symptoms generally subsided after the alimentary canal had 
been well opened. Diaphoretics in small doses, avoiding antimony, 
as it produces gastric irritation, assisted by wet warm blanket- 
packing, seemed to give relief by inducing perspiration, but the 
oeneficial effects soon passed offi Quinine was at first administered 
in large doses, but as it was observed to mask the head symptoms, 
and produce no good result, its use was discontinued except in con- 

384. • vfilcscc 



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North valescent cases^ when it was given combined with iron. Efferves- 
American cing draughts and local sinapisms were employed to combat the 
and gastric irritability, and prepare the stomach for the assimilation of 

fitat*^^^ K)od. In addition, recourse was had to some of the remedies recom- 
^^° ' mended hj various authorities, soda hvposulph., potassae chlorat.. 
Class I. ^^^ ^^ ^^^ ^^^ perchlorid; but all medicinal agents seemed 
Sect. A. iiiore or less empirical. Much greater value seemed, in m^ opinion, to 
result from exhibiting a nourishing diet, ext. camis, cmcken soup, 
calf 's-foot jelly given in small quantities, and combined with lime 
water and sodaB oicarb. The still and effervescing French wines, 
and brandy and water, were apparently borne with such good effect 
that I regretted n6t having used them early in the fever. . . . 
" The ship having special Admiralty orders to proceed to Ber- 
muda for the purpose ot assisting to take the Floating Dock into the 
harbour, may explain the reason of our not going north when it 
was discovered yellow fever had appeared on board; and as a 

auarantine establishment existed on tiie island, it was resolved b^ 
le commanding officer to have our cases disembarked, and wait 
there for further orders, instead of steaming to Halifax, as suggested 
by me directly I became aware of the specific malignant nature of 
the fever. Accordingly we were placed in quarantme for twenty- 
one days, as mentioned before ; the sick being landed, and the list 
reduced to a cypher, we were congratulatinff ourselves that we 
should soon be granted free pratique ; but, as already stated, a fresh 
case having occurred on the 26th of July, or nine days after our 
arrival at Bermuda, the civil authorities insisting upon the quick 
removal of the ship, we left next day for Halifax. Since then the 
health of the ship's company has been in so satisfactory a condition 
that any further remarks are not required upon this subject.** . . 
•* The visits of this ship to two infected ports, Havana and Port 
Royal, in July, complicates the question as to when the fever was 
introduced on board. At first I was inclined to think it came from 
Havana, which would give it a period of ten days incubation for the 
first case, but now I am more disposed to credit Jamaica, if not with 
the whole responsibility, most certainly with a share. Although no 
leave was given to the ship's company, and we onlv remainea four 
days, yet as the place was beginning to be very unhealthy, the dis- 
ease could easily nave been imported into the snip through a variety 
of channels, by the number oi strangers, of whom we had a great 
influx, as the vessel was not expected to return to the island again. 
The chief engineer, who died on the 20th, or the fourth day of 
sickness, was every night on shore at Port Royal between the 6tfi 
and 10th of the month, and I should feel inclined to trace his illness 
to that place. The ship herself, I am induced to believe, was free 
from infection throughout, although the fact of the last case 
occurring on the 26th, or sixteen days after, may seem to indicate 
otherwise. Yet as he was a subject, from his chachectic consti- 
tution, susceptible to infection, he might have been only suffering 
from the simple continued type when sent to the quarantine island 
at Bermuda, and as that place was positively infected then, as 
appears from subsequent records, he was almost certain of imbibing 
the true malignant form. 

"It 



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'^ It may be worth recording that all the men who suffered more 
or less from fever, of whatever variety, had their sleeping berths on 
the fore-troop deck, and, with one exception, on tlie starooard side, 
but their hammocks were wide apart, and they all belonged to 
different messes.^ 

This minute, yet concise and admirable report, speaks for itself^ 
and obviates the necessity of making any remarks upon it. The 
ctdpable concealment of the prevalence of epidemic diseases in 
foreign ports by the local officials has frequently been alluded^ to in 
tliese reports. The only safeguard against this would be vigilance 
and prompt action on the part of our consular establishments when 
any of our men-of-war were signalled as approaching the harbour. 
Unhappily this does not appear to constitute any part of consular 
duties, and our vessels for the most part are first made acquainted 
with the existence and prevalence of infectious diseases by their 
sudden appearance amongst the ship's company. 

Although twenty-nine cases only of yellow fever appear in the 
returns from the Defence^ it is more than probable that many others 
existed^ al^oush not recognised, considering that seventeen cases 
proved fatal. U nfortunately the medical journal of the ship is per- 
fectly valueless as regards this severe and fatal epidemic, and all 
that can be gathered from it is that the dbease was contracted at 
Havana; that on tiie death of the first case the ship went to sea for 
two days and returned to Havana, from thence to Santiago de Cuba, 
where an officer died of the disease ; from thence arrived at Port 
Soyal, where several cases of yellow fever were taken to the hos- 

fital, ** and more nearly every day to the end of the month." At 
^ort Royal the vessel was by some extraordinarv fatality kept until 
the XOth of August, when she went to San Domingo, and from 
thence to Halifax. 

The Deputy Inspector General of the Naval Hospital at Port 
Boyal makes the following remarks on the epidemic in the 
Defence :—*' About this time (19th July) Her Majes^'s ship 
Defence entered the harbour of Port Royal, having the infection of 
yellow fever on board. This vessel had left Port Royal on the 4th 
of June for the Havana, where she arrived on the 9th, and where 
ehe found yellow fever prevailing among the Spanish men-of-war 
and merchant shipping in the harbour. On the 27th of June, in 
the harbour of the Havana, the first case of yellow fever made its 
appearance on board the Defence, in the person of the commander's 
servant, which had a fatal termination on the 1st of July, the fifth 
day of the fever. On the 14th of July this vessel arrived at Port- 
au-Prince in the Republic of Haiti, in which place yellow fever 
likewise prevailed, and where it so raged as to have caused a high 
rate of mortality among the crew of his Imperial Majesty's cor- 
vette D'Estrees, the commander and several of the crew having 

fallen victims to it. ' . , . i . xi. i. i. r 

«' Within a few days after the Defence's amval m the harbour ot 

Port Royal she sent several cases of yellow fever to this hospital, 

the type of which was of such severity as to have caused a mortality 

384. ^^ 



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of 50 per cent. With these cases of yellow fever there were like- 
wise several of simple continued fever^ and as these occurred at the 
same time in men who had been subjected to similar influences^ it 
became a question whether they were wni^ly ^ades of one disease, 
attributable to the same cause^ and only differmg in symptoms from 
the amount of virus imbibed. And it did seem, primd facie ^ that 
there was some foundation for the acceptance of this theory, for in 
this instance, men had been subjected to the same influences, and 
had fallen ill about the same time, within a zope which is believed 
to be the habitat of yellow fever ; and as some importance was 
attached to the theory that all diseases run into the reigning one, 
it was believed by those who raised the question, that both the 
yellow and the simple continued fever, were the result of the actiou 
of one and the same cause, only differing in type from the circum- 
stance of constitution, of age, temperament, habits, and other 
contingencies. 

" If these fevers had been known only in that part of the globe 
which is acknowledged to be the zone of yellow fever, and only 
there, the parallel which had been thus established between the 
simple contmued and yellow fever might have been sustained, for 
at the outset, and during the first days the symptoms of both 
appeared analogous, and to all seemine identical. But the conclu-r 
sion had only coincidence for its foundation, for tiioueh it did 
happen that the circumstances which attended this outbredc seemed 
to tavour a belief in this theory, there was no warrant for the 
p^umption that any necessary causative connection existed between 
them. 

"The determining causes which produced one are essentially 
different from those which produce^ the other; the causes which 
originate simple con inued fever are in existence all over the world, 
and are not of a specific nature, whereas those which generate 
yellow fever are limited to a geographical position, and are of a 
specific nature*'* 

Without questioning for one moment the facts that simple coik. 
tinned fever and yellow fever are neither the same thing nor due to 
the same causes, it may be observed that in all epidemics, cases which 
are unquestionably examples of the prevailing disease have been 
known to occur in bo mild a form as to create considerable doubt 
as to their real character. This has been noted in epidemics of 
small-pox, scarlet fever, measles, cholera, and the like. And so 
with yellow fever,^ mAuj cases which m^ht be fairly considered 
attributable to the infection of the yellow wver poison have occurred 
during an epidemic in so mild a form as to lead to their being 
classed as cases of simple continued fever. The difficulty medictd 
officers have experienced in classifying cases of febrile disease 
during an epidemic of a specific fever, has been frequently noticed 
in these reports, some havmg gone so far as to class those only as 
yellow fever wUch had a fatal termination. 
There 

• Vide " Statistical Report of the Health of the Navy, for the Year 18G7," 
wherein proofs are adduced to show that Yellow Fever is a fever tut generis^ dis- 
tinct from othe** forms of fever. 



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There were nine cases of yellow fever in the Eclipse, of which 
ooe proved fatal. On Table IV. two deaths from this disease ap- 
pear in connection with this ship, which is strictly correct, the other 
cise bein^ that of a boy who had been discharged in the month of 
April to Jamaica Hospital, for the treatment of scrofula. There he 
omtracted the fever which carried him oiF. 

The outbreak in the Eclipse was attributable to exposure at Ha- 
Tina. The vessel had anchored there on the 26th of June, at which 
time yellow fever was very prevalent, and very fatal, in a Spanish 
man-of-war, and was spreading amongst the merchant shipping. On 
the 1st of July, in consequence of a aeath from this disease on board 
the Defence, and several men being attacked with febrile symptoms, 
the squadron left Havana, and the Eclipse, parting company with it, 
proceeded to Nassau. In consequence of there not being sufficient 
water in the harbour, the vessel was anchored close to the small island 
cf Salt Cay. On the morning of reaching that anchorage a youngofficer, 
a sob-lieutenant, was placed on the sick-list with symptoms of fever. 
The Surgeon* says :— " .... he had felt unwell from the day 
wc left the Havana; had been a good deal out of the ship, visiting 
friends on shore, and no doubt exposed to the infection of fever." In 
the temporary absence of a ward-room officer he occupied the vacant 
cabin. The^ next person attacked was the navigating lieutenant, 
then the senior lieutenant, then one of the carpenter's crew, the pay- 
master, the boatswain, the chief engineer, and the captain, in whom 
the disease had a very rapidly fatal termination, suppression of urine 
having set in early. A consultation was held with the principal 
military medical officer, when it was decided that the captain died 
from an attack of specific yellow fever ; that the disease was intro- 
duced into the ship by the sub-lieutenant, and communicated through 
him to the wardroom officers ; that the captain must also have con- 
tracted the disease from him, as he was in the habit, when strong 
enough to be removed, to lie on a sofa in his (the captain's) cabin ; 
and that, taking into consideration the rapidly spreading and malig- 
nant nature of the disease (six officers being then under treatment), 
it was of the utmost necessity that the ship should be removed as 
8oon as possible to a cooler climate. This was accordingly done, the 
vessel starting at once with all despatch for Halifax, the effect of 
which was, t£tt " the immediate arrest of the disease, with the im- 
proved condition of those suffering from it, was most marked as the 
temperature became reduced." In two of these cases only was 
albumen found in the urine ; in a third, this secretion, as has been 
already observed^ was completely suppressed from a very early 
period. 

Tliere were two cases of yellow fever in the Favorite, both of 
which proved fatal. The men had been on leave to Kingston, 
Jamaica, where the disease was prevailing amon^ the merchant sea- 
men. In both cases the attack was ushered in with rigors, followed 
by a high state of pyrexia, with much physical prostration and 

mental 



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'^ Surgeon H. F. B. Head. 
L 



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mental depression, with giddiness, severe pain at the epigastrium, 
and great anxiety. 

In the Jason there were two cases of yellow fever, both of which 
recovered. Forty-eight hours' leave had been granted to the ship's 
company at Port Royal, with the distinct understanding that no man 
was to go to Kingston. The Surgeon* says : — " After a three 
months' absence in Jamaica, in Cuba, and liaite, we returned to 
Port Koyal on the 3rd of April. Things were in pretty much the 
same condition as when we left. Scarce^ a day passed without a 
case of yellow fever in the Kingston Hospital, some of them of the 
most fatal type, and one death had occurred, just before our ar- 
rival, in the Naval Hospital at Port Royal. It was decided to give 
forty-eight hours' leave to the ship's company at Port Royal, strict 
orders being given that no men were to go to Kingston. Soon after 
the men went ashore it became known that some had gone to Kings- 
ston, and every exertion was at once made to get them back ; but it 
was impossible to get hold of all, and some slept in Kingston on the 
nights of the 8th and 9th of April. On the 10th of April the Jason 
saded for Barbadoes, to call at Aux Caves and San Domingo, and on 
the 12th and 16th the two cases recorded as yellow fever occurred. 
Both these men slept in Kingston (in the same quarter of the town 
which supplied cases tc the hospital) ; both men were well accli- 
matised, and were the only cases of fever met with during the month, 
and I have no doubt that both were true cases of the disease." In 
both the urine was distinctly albuminous, and in one it was suppressed 
for forty-two hours. 

Seven cases of yellow fever appear in the returns from the Philomel, 
of which five proved fatal. The disease was contracted at Port Royal, 
Jamaica, and as soon as its true character was ascertained the vessel 
was ordered to proceed to Halifax, touching at Havana. On arriv- 
ing at that port nine cases of fever were under treatment, and, in- 
stead of hurrying with them as rapidly as possible to the northward, 
the vessel, on the recommendation of the medical ofl5cer,t was detained 
at Havana ; six of the cases were landed, the next day two, and the 
following day three ; and of these eleven cases, three, including the com- 
mander of the vessel, died. Happily the disease did not spread 
further ; but nothing could justify the adoption of a step so flagrantly 
in opposition to all experience as to detain a yellow-fevcr-stricken 
ship in the harbour of Havana, for the purpose of having her disin- 
fected and fumigated. It was most unfortunate that, at a time when 
every hour was of such momentous importance to those on board, the 
exigencies of the public service shoula have necessitated the Philo- 
mel being ordered to the Havana, instead of making a direct course, 
and with as much speed as possible, to Halifax. 

Two cases of vellow fever appear in the returns from the Terror, both 
of which proved fatal. The circumstances under which they occurred 

It will be remembered that on 

the 



are most interesting and instructive 



• Surgeon W. H. Lloyd, m j) 



t i^saistant-Surgeon J. G. Clarke. 



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the arrival of the Barracouta at Bermuda, with several cases of 
yellow fever on board, the vessel was placed in quarantine, and her 
sick landed at the quarantine establishment on Ports Island, when, 
on the appearance of a fresh case some days afterwards, the civil 
authorities insisted upon the sick and the ship leaving the island, the 
cases were re-embarxed, and the Barracouta left for Halifax. What 
occurred thereafter is thus reported by the Deputy Inspector 
General* of the Naval Hospital at Bermuda: — " Immediately after 
the sick had quitted Ports Island, due precautions were taken by the 
assistant surgeonf in charge. The bedding and clothes used by the 
officer who had died were destroyed by fire ; those of the patients 
were submitted to a careful process of disinfection, and it was my 
order that the whole should be retained on Ports Island until the 
cold season had set in, an order which was strictly carried out. On 
the 2nd of August the nurse was discharged by order of the health 
officer, and my control over and connection with Ports Island 
ceased. 

" On the 4th of September a boat arrived at the Hospital Creek, 
having on board two sick marines from Ports Island. The assistant 
sui^eon} on duty, with a commendable prudence, before granting 
their admission into the hospital, sent for mc ; and, on consultation, 
we both came to the conclusion that the men were labouring under 
the symptoms of yellow fever. I immediately reported the circum- 
stance to the senior officer in charge, and had the men at once re- 
moved to Ports Island. 

" At a loss at first to account for this unexpected outbreak of fever, 
I soon learned that a party of Marines had been sent, on the 23rd of 
August, from the dockyard, to execute the ordinary repairs on Ports 
Island, where they had been ever since, occupying the wards of the 
hospital as a dormitory, and for ordinary barrack purjjoses. 

** On the 6th instant, in the morning, one of the marines, and in the 
evening the other died. Fully alive to the risk the others ran of con- 
tracting the fever, I wrote to the senior officer, stating that 'in presence 
of the outbreak of yellow fever last week, at Ports Island, whereby, 
not only the two men attacked with the fever, but also seven healthy 
Marines (who happened to be of the working party) and one pilot 
were held there in quarantine, I beg respectfully to suggest, as one 
of the cases has already proved fatal, that these men, who, by acci- 
dent, are compelled to be confined on a spot now proved still to con- 
tain the taint of a contagious fever, be removed to Halifax as soon 
as circumstances will admit, in company with a medical officer, a step 
which will give them the fairest chance of escape, and reduce to a 
minimum the risk to the general commimity.' From inability, I pre- 
sume, to carry these suggestions into effect, no immediate action was 
taken, save an offer to remove the men on board a gun-vessel, which 
the civil authorities declined, and the men continued at Ports Island. 

" Several days now elapsed without any further case occurring, 

when. 



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• Deputy Inspector General Thomas Nelson, M.d. 

t Asaistant-Sargeon Robert More, m.d. 
X Assistant-Snrgeon Thomas Bowen Thomas, m.d. 
384L • L 2 



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when, on the 13th, the assistant surgeon* in charge of the quarantine 
establishment reported to me another man attacked with the specific 
fever. No sooner was his Excellency the Governor made acquainted 
with this untoward event, than he gave orders that the whole of the 
people detained in quarantine and Ports Island should be conveyed 
with the least possible delay to Halifax. The gunboat Albacore 
accordingly was selected to carry out this order;' every dispatch 
was made to get her ready, and on the 18 th she put to sea, carrying 
with her, in audition to her officers and crew, seven Marines, of whom 
one was sick with the fever, one coloured pilot, and two coloured 
nurses, with Dr. Thomas in medical charge." 

Unhappily the fatal consequences of premature communication 
with a hospital which had contained yellow fever patients did not 
terminate with the Albacore leaving Bermuda. On the evening of 
the 20th, two days after leaving the island. Dr. Thomas was attacked 
with the fever. With most admirable self-denying thou^htfulness 
for those under his medical charge, he privately communicated his 
suspicions to the commanding officer, and to avoid any unnecessary 
alarm he expressed a strong conviction that the disease would not 
spread further, requesting tnat the nature of his illness might be 
concealed from the others. His attack seems to have been of great 
severity, and he succumbed to it on the evening of the fifth day, the 
service being thus deprived of a young officer of rare promise and 
of the highest professional attainments. 

There were twenty six cases of yellow fever in the Vestal, of 
which four proved fatal. The narrative of this epidemic is of consider- 
able interest, and is thus given by the medical officerf in charge : — 

'^ On our arrival at Port-au-rrince, on the 6th of August, we 
found yellow fellow raging on board the French gun- vessel 
Curieux, she having, it was reported, contracted it at Martinique, 
where the surgeon, who was the first attacked and the first death, 
was in the habit of visiting the hospital on shore, in which, at the 
time, were yellow fever cases. The disease spread rapidly through 
this vessel, and communicated itself to her consort, the D'Estrees, 
and before these ships left for the north, they had both lost their 
commander, surgeon, and several subordinate officers, besides a lai'ge 
number of men. This excessive mortality was no doubt owing to 
their remaining so long in the unfavourable climate of Port-au- 
Prince, througn some unwillingness to leave the station. They 
made an attempt to check the spread of the fever in the Curieux by 
clearing out the ship, and billeting the men in a country house 
belonging to a French resident at Bizothon ; but this measure was 
not crowned with the desired success, and the deaths continued to 
such an extent, that quite a cemetery sprung up near the villa. 
Finally, when they had lost the greater part of their men, they 
started for Fortress Monroe, the last report 1 heard from the unfor- 
timate ship being that she had none of her original crew left. 

" The D'Estrees hung on after the departure of the Curieux, but 

sh6 

• Assistant Surgeon T. B. Thomas, m.d. 
f M. Upington Greany, m.d. 



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she finally also left for the north, and for Europe, affording us, by the 
melancholy results of her procrastination, a warning, which proved 
useful to us subsequently. During our stay in the harbour of 
Port-au-Prince with these French vessels, every care was taken on 
our part to avoid communication with them, and on one occassion, 
when the D'Estrecs anchored too close to us, we shifted billet, and 
gave her a wide berth, and these efforts of ours to prevent our crew 
getting infected, were crowned with success, for though we were 
unfortunately also attacked by the disease, it was not communicated 
to us either from the ship or the shore, but in a manner which I 
will now relate. 

** On the 9th of September, 1869, Her Majesty's ship Britomart 
arrived at Port-au-Pnnce, for Port Royal, Jamuca, with some men 
belon^n^ to Her Majesty's ship Defence, then supposed to be on 
the Haytian coast, but which vessel had in reality gone north, in 
consequence of the continuance of fever on board. The Britomart 
also brought the officer appointed acting surgeon of the Vestal. 
The men oelonging to the befence were discharged to this ship, 
and unhappily among them were two men who had been attacked 
with yellow fever while on the passage from Port Royal to Port-au- 
Prince, both, from the outset, very unpromising cases, but of whom 
one recovered. These men were on board 3ie Vestal, over 36 
hours, and no doubt exists in my mind that the subsequent spread 
of the disease in this ship was caused by direct contagion arising 
from their near presence. 

" These men were landed on the morning of the 11th at Port-au- 
Prince, and placed in a house hired by the consul for us, and I was 
ordered to go on shore and attend them, which 1 accordingly ^d, 
having also under my charge Her Majesty's ship Britomart, which 
was ordered to remain at Port-au-Prince. 

'* As 1 have above stated, one of the two men first attacked died 
on shore, as did also a boy belonging to Her Majesty's ship Defence, 
who was attacked on board the Britomart. There were several 
cases of fever on board the Britomart belonging to her own ship's 
company, but they were all of a mild character, except the navi- 
gating sub-lieutenant, who had rather a sharp attack, the symptoms 
being those of a * remittent^' but which yielded to free purgation, 
and general antiphlogistic treatment at the outset, and subsequent 
administration of quinine. 

" The Vestal arrived back at Port-au-Prince on the 25th of Sep- 
tember without a medical officer, the acting surgeon having been 
discharged to the Aboukir to do duty. While at Port Koyal, 
several men were sent to hospital, some of them fever cases, but I 
have left it for the above-named gentleman to report on these, as I 
possess no official information about them. On the Vestal's arrival 
in the harbour of Port-au-Prince, I was ordered to go on board and 
see the sick, by the commander, and on doing so, found several 
men and officers convalescing from fever ; ana one boy, age 17, 
evidently attacked with yellow fever. On reporting this circum- 
stance to the commander, he expressed an opinion, in which I con- 
curred, that it would be advisable to land the case at once, and as 
the ship was under orders for sea the same evening, I did so without 

384. L 3 delay. 



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delay^ and placed him, as well as my other patient, under the care 
of a local practitioner of much repute, and a graduate (M.D.) of the 
University of Paris. 

" We did not start on the evening of the 25th, as at first intended, 
but left early next morning, havmg the Britomart in tow. We 
towed her as far as Cape Dame Marie, and then went for a cruise 
to Turk Island and Magna. On the evening of the 26th, the next 
case of yellow fever appeared in the person of a wardroom ser- 
vant, and though the commander had at first purposed to run across 
to Santiago de Cuba, on my reporting to him that the case was one 
of undoubted yellow fever, he decided on returning to Portr-au- 
Prince, where accordingly we arrived on the night of the 30th of 
September, and at daybreak next morning I removed him on shore 
by the commander's order, but he was then in a moribund state, 
and expired on the morning of the 2nd of October. 

" We found that the boy previously landed had died on the morn- 
ing of the 30th of September, but the other cases, two petty officers 
belonging to Her Majesty^ ship Defence were doing well. On the 
evening of the 1st of October a consultation was held, when I gave 
it as my opinion that the only reliable measure for checking the 
progress of the disease, was immediate sailing for a colder latitude, 
and accordingly at noon on the 2nd of October we started for 
Halifax, having, up to this time, lost four men, viz., two belonging 
to Her Majesty's ship Defence, and two from our own ship's com- 
pany. Our departure, I may here remark, was acquiesced in by 
Her Majesty's Charge d' Affaires. It was proved that we had not left 
Hay ti a day too soon, by the number of lever cases admitted to the 
list. On the 1st there were three; on the 2nd, four; on the 3rd, 
five ; on the 5th, two ; but by this time we were getting clear of 
Hayti, and the depressing influence which seemed to hang about 
its coasts, and the admissions began to decrease in number, the last 
case occurring on the 12 th of October. 

" On the night of the 11th of October, a petty officer of Her Ma- 
jestys ship Defence died ; making the fifth and last death from the 
disease, and the third in the small number of Defence's men on 
board. The extent to which the fever spread among these men was 
very remarkable ; among nine men there were six cases ; and, as 
already stated, three of them fatal. This, of course, is explained by 
the fact that the first cases occurred among this little body, and the 
nurses were, as is usual, drawn from the patient's messmates, and 
contracted the disease in that way. Moreover, they being strangers 
on board our ship, were, I imagine, drawn more together than they 
otherwise would have been. 

*• The beneficial effect the reduction of temperature has on yellow 
fever was well exemplified in our case. On the 12th of October 
occurred our last case of fever, and on this day the thermometer had 
fallen from 90% as at Port-au-Prince, to 81% and of course continued 
to decrease as we went north, with the greatest benefit to our sick. 
The majority of these, however, were sught cases ; in none was I 
able to find albumen in the urine, nor were there any cases in which 
black vomit appeared, though all had sickness of stomach, and some 
to a very distressing extent. The vomiting was altogether bilious, 

and 



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and amenable to the remedial measures I employed, chiefly saline 
effervescents. 

" I have reported one case as belonging to the * Apoplectic 
Grade/ a form of yellow fever recognised by Dr. Macdonald, and 
which variety, being unaware of its existence, puzzled me at first a 
great deal when I found it occurring on board, but which I found 
leas formidable to treat than Dr. Macdonald's cases, from which he 
deduced his experience ; the convalescence was, however, protracted, 
tnd the reduction of strength remarkable. I have since learned 
from a medical man, that this form is not uncommon at Trinidad, but 
it would appeal-, notwithstanding, to be a rare variety of the disease. 

*' The state of the tongue in these cases was of two kinds, either 
white with injected papmse, or yellowish brown, with red edges 
aod tip, the redness in some approaching scarlet. No * prognosis ' 
could be formed of the cases from the presence of either of these two 
t^pes, for of the fatal cases two had the tongue in the first men- 
tioned state and three in the latter. 

** The accession of the fever was generally sudden, the patient 
bein^ all at once attacked with violent headache and lumbar pains, 
the majority of the patients describing their symptoms as coming 
on after meals, and usually I found that that they had made a good 
breakfast or dinner, as the case may be. Of course I can understand 
that a man would hold out perhaps as long as he could before coming 
to the doctor; but our men were very watchful durinof the pro- 
gress of this epidemic, and never delayed applying for relief as soon 
as they found anything the matter with them. Besides, I was very 
particular in inquiring, in each case, the length of the premonitory 
symptoms ; and, as I have already stated, found that the attack came 
on suddenly, or if there were any premonitory warnings they escaped 
the patient's notice. 

** Touching the presence of albumen in the urine, my experience 
has been, that in all cases in which it appeared there was also black 
Tomit, and that they were synchronous m their occurrence. This, 
I. am aware, is different from the general experience of my brother 
medical officers during the late epidemic ; but I only describe the 
symptoms as they occurred to me. I do not even know if two or 
more distinct forms of fever, as distinct as * typhus' and Myphoid' 
are not now included under the general term of yellow fever, for 
the disease has not been fully reasoned out, as indeed is evident from 
the various quasi-specifics which have been put forward for its 
treatment. In the treatment of these cases attention was directed 
to obviating the tendency to death, as our ffreat author happily puts it. 
I endeavoured to keep the bowels open, me skin and kidneys going, 
and to support the hourly loss of vital power, by nourishment and 
stimulants, a treatment which, after many conversations with practi- 
tioners in the various West Indian Islands, both before and subse- 
quent to the outbreak in this ship, I look upon as the best in our 
present knowledge of the disease. Dr. Bellot, a great Havannah 
authority on yellow fever, is accustomed, 1 understand, to bleed in 
almost lul his cases, if seen in the early stage ; and I myself have 
been advised at Port-au-Prince to use the lancet, but I saw no 
case in which it would be allowable to do so. I should rather fancy 

384. h 4 that 



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that such a proceeding would be fatal to any chance of a patient *8 
recovery. 

" As for the ^ Creole ' treatment of the fever, so much vaunted 
by * lay members,' who not only tell, but commit to paper, wonder- 
ful cures effected by it, all I can say is, that the least said about it 
the better. I was rather curious on the matter, for though I did 
not believe all I had heard or read about the coloured people's skill 
in this disease, I still thought it possible that some of their remedies 
might be of use. But after careful watching of some of the most 
renowned irregular practitioners at Port-au-Prince, I have come to the 
conclusion that they are ignorant, of the disease to a marvel. Their 
drinks and potions are harmless — climes, pine-apples, &c. and some 
demulcents, forming the staple of them. Rubbing the whole body 
with a mixture of limes, camphor, and salt, is looked upon as almost 
enough to recover a man from ' death's door,'' and as a stimulant, 
may not be altogether useless ; but in their iterance of the more 
ordinary rudiments of nursing, they do not omy passive^ but active 
harm. Thev think nothing of raising a man, however weak, bolt 
upright in the bed, to give him a drink ; and I saw one poor French 
sailor, whose sudden <&ath I attribute to his being placed erect in 
an armchair, though I endeavoured to point out to his attendant the 
danger of it; however, they being also his physicians, took no 
notice of these representations coming from a white man and a 
foreigner. Their obstinacy and confidence in their own superior 
knowledge make them very impracticable, and they require con- 
stant watching when you employ them as nurses, otherwise you 
will find that they calmly ignore your directions, and carry on their 
own treatment, as I found several times at Port-au-Prince to my 
great annoyance." 

In concluding the history of the various outbreaks of yellow fever 
which occurred in the squadron on the North America and West 
Indies Station in the year 1869, it has been thought advisable to 
introduce the following observations on the cases which occurred in 
the Royal Naval Hospital at Port Royal, and on the subject of 
yellow fever generally, by the Deputy Inspector General of that 
establishment, an officer of great experience, and who has already 
enriched the literature of this disease by extensive and original 
observations.* 

" Why one year should be more or less healthy than another is 
a question which cannot be answered with any degree of certainty, 
for after wet, dry, or the ordinary seasons, epidemics have been 
known to break out without any tangible cause for their appear- 
ance. 

" If yellow fever be a specific disease, as observation denotes it to 
be, it must have a specific cause for its origin, and this cause must 
be in existence at the time of an outbreak of an epidemic. That 
some connection does exist between the cause and the atmosperic 

influences 



Vide " Statistical Report of the Health of the Navy for the Year 1867," 
Appendix, No. 11. 



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inflaences there can be little doubt, yet we qualify our belief by 
reservation, and are obliged to confess our inability to connect them 
by any exact rule. Syuenham, with an honesty which stamped his 
character, has said, * I have carefully examined the different con- 
stitutions of different years, as to the manifest qualities of the air, 
yet I must own I have hitherto made no progress, having found that 
years (perfectly agreeing as to their temperature and other sensible 
properties) have produced very different tribes of diseases, and 



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" In 1869 the weather at Port Royal during the first part of the 
year was dry, but little rain fell, and a scarcity of water was felt ; 
at the fall of the year, however, much rain fell, and heavy thunder- 
storms occurred. 

" We know that organic germs, animal and vegetable, are hastened 
or retarded in their growth by meteorological or telluric influences, 
whether these influences depend on wet or dry weather, electric 
changes, activism, heat, or other causes ; and if the germs which 
generate yellow fever approximate in any way to these organisms, 
die reason is plain that they too must be liable to the same in- 
fluences. 

" Although Bacon has laid down the rule, " Non fingendum, aut 
" excogitandum, sed inveniendum, quid natura aut faciat, aut ferat," 
a certain amount of speculation cannot be avoided, for with all the 
attention, the faithful and steady observation that may be brouo'ht 
to bear upon the study of causation, there is something that escapes 
our research, something that so baffles our endeavours and sets our 
efforts at naught, that despite a fixed determination to carry out our 
study, we are obliged to deviate in some measure from the mathe- 
matical path to seek one in the more fascinating, though the more 
misty, one of speculation. 

" The history of the fever which occurred in 1869 would seem 
to favour the theory that the germs, which generated the epi- 
demic, had their origm in the marshy and swampy grounds in the 
vicinity of the locafitjr where the ships that became infected were 
anchored, and the choice made of these ships, to the exclusion of the 
others in the harbour, assisted towards confirming this belief. If, 
therefore, this theory be accepted, we must bring ourselves to admit 
that yellow fever may have birth in localities such as these ; that its 
origin may be due to some effluvium, germ, or organism generated 
on the surface, or within the bowels of the earth ; and if so, that it 
finds a habitat in such places, and that therefore yellow fever is 
endemic in the island of Jamaica. 

" But in the admission and acceptance of these inferences there is 
reason to believe that howsoever generated and whatsoever its cause, 
this noxious principle differs in total* from that which produces simple 

continued 



• This opinion does not coincide with that expressed in the Beport npon 
QnwMmtine addressed to Her Majesty in 1852, by the CommiBsioners appointed 
by the General Board of Health of England, to investigate this question with 
reference to yellow fever, " that the medical men who have had opportunities of 
personally witnessing this disease on the largest scale, and under the greatest 

384. 



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continued fever and the types of remittent fever ; for, as with the 
various poisons, whether organic or niinera], we find a special mode 
of action ; each poison characterised by its group of symptoms, each 
group differing distinctly^ one from the other ; so do we find witli 
the group of symptoms which characterise the various fevers of the 
West Indies which fall under observation, a distinct type for each, 
characterised by its own pathognomic signs ; each so marked as to 
stamp it with an individuality dependent upon the essence of the 
cause, and with regard to the specific form of yellow fever, this 
would appear to receive confirmation from the history of the various 
epidemics which have occurred since the 17th century, whether 
described by a Ferreira da Rosa, a Simao de Cunha, a Chisholm, a 
Kush, a Blair, or a Louis ; for in all these epidemics an individuality 
has been noticed, and in the epidemics which have occurred at 
various epochs in the same place, the same individuality has been 
observed. The epidemic of yellow fever which happened in Lisbon 
in the year 1723 differed in no ways, in its chief outlines, from that 
which devastated the same city in 1857. 

^^ The question has perhaps assumed a wider range than a simple 
summary of facts might have warranted, yet though it may not be 
immediately relevant to the case in point, it may be well to state 
here that the fevers in the West Indies do assume modifications 
which obscure their character, and render them less defined, and 
less precise in their outline. These modifications may be accounted 
for by the admixture and absorption into the system of other 
poisons beside that of yellow fever, which running a parallel course, 
jostle and confoimd the symptoms and characters in each, in such 
guise as to render them less distinct, but not in sufficiently marked 
a manner as to prevent them being recognised as diagnostic signs. 



" Symptoms, — The symptoms which characterised the sixty-four 
cases of yellow fever were chills, followed by headache, general 
malaise, rachialgia, pain of limbs, epigastric tenderness, nausea, 
vomiting, high pulse and temperature, a sordid or clean tongue, 
yellowness of the eyes and skin, albuminous urine, if not suppressed, 
suppression of urine, insomnia, jactitation, and blacK vomit, 
hsemorrhages, hiccough, subsultus tendinum, delirium, coma, and 
convulsions before death. 

" It was remarked that rigors ushered in the fever in thirty-eight 
of these cases, and this symptom was either observed, or had been 
sufficiently noteworthy to cause it to be mentioned by the patient ; 
but though it was not recorded in the remaining twenty-six, it did 
not follow that it had not occurred, as from the little importance 
sometimes attached to it, whether from want of memory or state of 
the patient it may not have been mentioned. When the chills did 
occur, they varied in degree, bein^ slight in some and severe in others 

" In every case there was headache. The symptom engaged the 

frontal 

variety of circumstances, have, with scarcely one exception, arrived at the con- 
clusion that intermittent, remittent, and yellow fever are modifications of the 
same disease influenced by peculiar conditions." — " Second Report on Quarantine. 
Yellow Fever 1852. General Board of Health," p. 4. 



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frontid part^ and more especially the supraorbital region. Giddi- 
ness frequently accompanied the headache. The eyes wore an ex- 
pression of heaviness, were congested, watery, and yellow, having in 
some that peculiar look which is noted as the heavy eye of the 
drunkard ; they were ferretty and glistening in some cases. 

" The expression of the face was a study in itself. It assumed a 
listless, dull, and sullen character, and in the bad cases was indica- 
tive of the stage of the disease. There was in some an expression 
of anxiety, in others apathy, whilst in many the natural expression 
remained. The decubitus throughout the progress of the disease 
was aa a rule, dorsaL 

" The face was dusky and of a mahogany hue, or of that colour 
which is remarkable in those portions of an English sailor's neck 
left exposed to the action of a tropical sun. 

'^ Kachialgia was a distressing symptom, and much complained of; 
it was to the spine what headache was to the head, an indication of 
some abnormflu state, and in no pyrexia is this symptom so well 
marked as it is in yellow fever, except it he in the first stage of 
small-pox ; great complaint was made likewise of the limbs. 

" Sighing was a frequent sign of extreme weakness with the bad 
cases, and when interrupted was of ominous prognosis. 

^* Epigastric tenderness was indicative of nervous depression ; it 
was sometimes met without its concomitant symptom, vomiting; 
where black vomit was urgent, the tenderness was usually great, 
still it did not follow that its degree coincided with the quantity of 
matter vomited. 

" This distressing Symptom of vomiting was observed in the 
majority of cases which offered any degree of severity, and even in 
those which terminated favourably, it was sometimes one of the 
first symptoms and the source of much distress. Of the sixty-four 
cases it was not present in sixteen. In the forty-eight cases in 
which this symptom appeared, the matter ejected varied in quan- 
tity as in quality. It was sometimes caused by the ingestion of food 
or drink, and this occurred : — 



In 11. 



6. 
22. 
16. There was no vomiting. 



On the 2nd 


day 


of the fever 


in 


99 


3rd 




» 


99 




99 


4th 




5> 


99 




3> 


5th 




99 


^> 




5> 


6th 




*9 


» 





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Where vomiting was readily induced by taking milk, 

water, medicine, or food of any kind. 
The matters vomited were the ingesta, and only occurred 

some time after. 
A greenish bitter fluid formed the matters ejected. 
Blood, which must have been swallowed, as there was 

oozing of this fluid from the gums. 
Flocculent brown matter. 
Black vomit. 



" In the twenty-two cases in which black vomit occurred this 
symptom appeared : — 

- - 5 

- 5 

- 5 

- 5 

- 2 



384. 



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^^ It was sometimes preceded by acid emctations^'and a burning pain 
at the epigastric region; it would be ejected seemingly vnthout 
effort, and m great quantities, a gallon in the space of twelve hours. 
When about to settle after havmg been ejected, the black vomit 
assumed the appearance of sooty patches in water ; frequently when 
mixed with mucus, it clung to the sides of the vessel, and offered 
an appearance which is not to be mistaken. It always presented an 
acid reaction. 

^^ Under the microscope this black matter was amorphous, and of a 
reddish brown colour; it was sometimes mixed up with columnar- 
epithelium, and cylindrical stomach epithelium. No animalculse 
were ever seen. 

" It was not a necessary consequence for the disease to prove fatal 
when black vomit was a symptom, for of the above twenty-two 
cases, sixteen died, whilst six recovered. 

*^ Black vomit is not a symptom limited to yellow fever ; it is 
observed in remittent fever, and has occurred as a symptom in 
subjects who have sustained severe nervous shocks from mjury. 

^^ Black vomit had, for some persons, a peculiar smell by which it 
was recognised, but this peculiarity was perceptible to only a few. 
It possessed no virulent quality, for the medical men and the nurses 
were occasionally bespattered with this matter, but in no instance 
was any evil consequence known to ensue. 

" Besides the black vomit, hsemorrhages were observed in twenty- 
seven : — 

From the mouth and gums it occurred in - - - 11 
„ nose --------7 

„ urethra -------l 

„ petechiae in the legs ----- 1 

Mixed witn the urinary secretion - - - - i 

In stool ---------6 

*^ The colour of the skin varied from a li^ht citrine hue to a deep 
golden, and in many of the fatal cases this colour deepened after 
death ; and this was likewise observed in several who recovered, in 
whom, with the progress of convalescence, the colour became more 
pronounced. The conjunctivae sympathised in colour with the skin. 

" The temperature of the surface was always above the normal 
line ; it ranged between 99** and 106*. "Where the skin was dry, 
the sense of touch conveyed a pungency and tingling to the fingers ; 
but when, as it frequently happened to be, moist, the touch indi- 
cated a temperature at variance with the thermometer, for when 
the surface seemed cool, this instrument showed a high degree of 
temperature, so that the hand could not be depended upon. The 
skin was frequently greasy, and had a shiny appearance. 

^^ The tongue varied ; it sometimes was clean, sometimes coated, 
and when coated, was white, vellow, or brown. In a few cases it 
had the appearance of raw beef, and when haemorrhage was occurring 
from the gums, or the buccal cavity, it was coated with blood. 

" The pulse was quick and frequent at the commencement of the 
fever, became sometimes irregular and intermittent, beating slow 
and measuredly when convalescence set in. The causes which 
produced this slowness of the pulse, so remarkable during the con- 
valescence 



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valescence of yellow fever, were owing to some modification of the 
blood, whereby its stimulating powers upon the action of the heart 
became diminished, and this may have been due to the poison of 
yellow fever not being entirely eliminated from the system, or to an 
admixture of bile with the vital fiuid, depressing the nervous system. 
In fevers of other types, the sudden fall of the pulse would be in- 
dicative of the approach of typhoid symptoms, but not so in yellow 
fever, where the pulse frequently fails as low as forty, the patient 
having entered convalescence. 

" The urine secreted was frequently normal in quantity, even in 
the bad cases, whilst in a few there was entire or partial suppression. 
This suppression of the secretion was always a bad symptom, it 
occurred entirely in four, partially in twelve. It sometimes hap- 
pened that no urine was voiaed, and this would have been considered 
an entire suppression had not the catheter, when introduced, drawn 
off a quantity of this secretion, which was retained, owing to the 
apathetic state of the system. In one instance the urine was charged 
with blood to such an extent as to form half the quantity of the 
secretion. 

" The characteristic and essentially pathognomic symptom of this 
disease was the presence of albumen in the urine, and in every one 
of these sixty-four cases this system obtained, and it may be stated 
with some degree of certainty, that where this symptom was present, 
together with a high temperature of the body, provided likewise, 
the observation has taken place within the limits of the habitat of 
yellow fever, or where an epidemic of this fever may be prevailing, 
this diagnosis would, as a rule, prove correct. 

" Albuminuria is a symptom met with in many diseases, and it fre- 
quently co-exists with the symptoms which characterise remittent 
fever ; but the symptoms, the habitat, the history, and other circum- 
stances which attend remittent, would assist m distinguishing it 
from the specific form of yellow fever. 

"Insomnia; restlessness; delirium; a tremulous state of the mus- 
cles; subsultus tendinum ; hiccough; carphology; and convulsions, 
were all characteristic of the severity of the disease. 

" In one of the fatal cases, the deliriiun commenced by symptoms 
very much allied to those of aphasia, or more properly to those of 
amnesia, for it evinced itself by the loss of words to express the idea, 
and the employment of others having no connection with the idea 
the patient wished to convey, and of this he showed consciousness 
by a gesture of impatience. At the post-mortem examination no 
abnormal change was observable in the third convolution of the left 
side of the anterior lobe of the cerebrum, nor was the corpus striatum 
of that side in any way affected. 

** Hiccough occurred in eight of these cases. 

" In six cases convulsions were observed ; they preceded death, and 
Were expressed by convulsive twitchings of the muscles of the face, 
anns, and body. In one they were of such severity as to cause the 

Satient to fall from his bed, and a fracture of the skull, found after 
eath, could only be attributed to the fall sustained during one 
of the fits. These convulsions may have been due to the effects of 
384, unemic 



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40. 

12. 

10. 

2. 

a rule^ strong and 



uraemic poisonings to congestion^ or to a superabundance of bile in 
the blood. 

" The saliva; cutaneous perspiration ; black vomit; urine; and 
hsemorrhagic stools presented a highly acid reaction. 

The ages of the sixty-four persons attacked were : — 

Between the ages of 17 and 25 
„ „ 26 „ 30 

5> 99 31 „ 38 

Of the age of - 43 - - 

" The subjects, prior to the attack^ were, as 
vigorous, and only in a very few exceptions did the contrary obtain. 
It was remarkable that the weakly, and those addicted to intem- 
perance, were less liable to the infection, 

" A theory which obtained among the old practitioners of the West 
Indies was, that a relaxed state of the system was necessary to 
health, and they inculcated that all Europeans coming to the West 
Indies should reduce their constitutions by repeated bleedings, 

1)urging8, and other depressing measures, so as to bring it to the 
evel of the Creoles. It did, certainly, appear that the yellow fever 
poison had less hold upon a debilitated and worn-out constitution, 
and as has been remarked that scrofulous, tuberculous, and dirty 
people furnish the best nidus for the lodgment and development of 
parasitic disease ; so did it happen that the robust and healthy con- 
stitution proved to be the aptest soil for the development of this 
virus, and the best pabulum for it to feed upon.* 

** The eruptions observed in the course of the fever in these sixty- 
four cases were : — 



A vesicular eruption on nates in - - 
Herpes Labialis (proving hsBmorrhagic in 1) 
PetechisB on legs (hadmorrhagic) 
Lichen tropicus - - - - - 
Urticaria ------ 



1 
5 
1 

1 
1 



" The deaths in the majority of these cases occurred on the fifth 
day of the fever. 

" Treatment — When it so happened that the patients came under 
observation at the onset of the fever, the first care was to get rid 
of all vitiated secretions by means of purgative medicine, and this 
provided no indication to the contrary existed, for the bowels were 
sometimes lax ; but even so, as this laxness depended upon some 
vice of the secretions, it was considered advisable to use laxatives 
to assist in improving this state. With the regulation of the bowels 
the other symptoms such as headache, nausea, heat of surface, were 
attended to. The headache was alleviated by cutting the hair, if 
long, and by the application of cold lotions ; shaving the head was 
not requirea* 

" Nausea and vomiting were partly subdued by the application of 

sinapisms^ 

* Although this relaxed state of the system afforded an immanity from yellow 
fever, it certainly predisposed to all other forma of fever not of the yellow type. 



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sinapisms, and of chloroform in vapour, to the epigastric region ; by 
the internal exhibition of effervescing draughts, chlorodyne, chlo- 
roform, and carbolic acid, and ease was sometimes found in giving 
amall quantities of broths and wine ; ice always proved a grateful 
assistant in the alleviation of this symptom. Sponging the surface 
daily, and keeping down the temperature of the body, always proved 
beneficial, and grateful to the patient's feelings. 

" In insomnia and jactitation sleep and rest frequently followed 
bathing the head, face, chest, and arms with cold water ; chlorodyne 
proved of some good in the most obstinate cases of sleeplessness. 

" Where hsemorrhage occurred from the mouth, nostrils, &c., the 
application of the tinct. ferri perchlorid externally, succeeded in 
checking them* When the haemorrhage was internal, gallic acid, 
and carbolic acid with ice were exhibited with partial benefit. 

" Hiccough found a relief in a variety of medicine, but it was 
impossible to say which would produce a cessation of the symptom, 
for a small portion of ice would frequently check it, where other 
more powerful medicines would fail. 

" The chief measure adopted in the treatment of this disease was 
directed towards counteracting the effects of the toxic element, and 
this consisted in the use of medicines possessing antiseptic pro- 
perties, and a preference was given to sulphurous acid whether alone 
in solution in water, or combined with the alkalies. The bisulphitis 
certainly possessed some power, but it was difficult to state whether 
this power consisted in arresting or retarding morbid fermentation, 
or wiiether it only assbted, by the alkaline properties of these salts, 
in neutndising the highly acid secretions of the system, and thus 
restoring them to their normal state. 

'^ A trial was given to carbolic acid ; it was of benefit in those 
cases where there was great irritability of the stomach, and a ten- 
dency to haemorrhage ; but it did not seem to possess the highly 
vaunted antiseptic properties in this fever which were attributed to 
it by some. 

" When the stomach could receive food (it mattered little at what 
period of the disease), broths, beef tea, whether made from beef, 
essence of beef, ext. camis or otherwise, were given, and Avine was 
likewise administered at the same time, especially if it proved 
grateful to the patient ; and these were given with a view of assisting 
to expel the septic, and of supplanting it by fresh and healthy 
material. 



North 

American 

and 

West Indian 

Station. 

ClaMl. 
Sect. A* 



** Post-mortem Appearances. — As the disease has proved chiefly 
fatal to young men, who, up to the day of seizure, had been in the 
full enjoyment of health, it followed that the bodies examined were 
muscular and well nourished, and it did seem that the waste of 
tissue was not so great, nor carried to that extent, which an 
** a priori " argument, prompted by the great virulence of the 
sjrmptoms during life, would have suggested. 

*^ The hvpostatic marks were of a deep leaden blue colour, and 
occupied the dependent parts of the body, whilst the skin of the 
chest, of the abaomen, and upper part of the thighs presented hues 
varying from citrine to the deepest yellow, 

384. '' Head. 



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100 



MEDICAL STATISTICAL RETUBN8 OF THE 



North 

American 

and 

West Indian 

Station. 

Class! 
Sect. A. 



" Head, — The meninges were congested in several, and where any 
adhesions were found between the calvarium and dura mater, 
blood in great or small quantities flowed on the removal of the 
former. The cerebral substance was usually firm; the centrum 
ovale presented puncta vasculosa, and a limpid clear fluid was 
sometimes found in the ventricles. 

** The lungs and heart were, as a rule, healthy. 

** The stomach and intestines frequently presented inflammatory 
patches on their mucous coats, but these patches were not signi- 
ficant of specific disease. 

" When black vomit had occurred during lifetime it was found in 
the stomach after death. The mucous coat of the stomach when 
washed of this matter, sometimes oflTered a healthy appearance un- 
stained by this matter, with scarcely any apparent lesion ; but it 
sometimes did happen that black specks attached themselves so 
firmly as to resist all washing ; this coat was firm and could not 
readily be scraped off with a scalpel. It was observed to be partly 
congested in some, and wholly in a few. The congested patches 
presenting an arborescent appearance, or a surface having a series of 
punctated red dots. 

" The liver, as a rule, was of a fawn colour, both extemalljr and 
internally ; was exsanguine when cut into, and under the micros- 
cope showed the hepatic cells to be obliterated or obscured by 
numerous oil globules. It was the organ most prominently 
affected. 

^^ The spleen was natural in appearance and in structure, and this 
is characteristic in yellow fever, for in typhoid, tvphus, measles^ 
small-pox, scarlet fever, remittent and intermittent fevers, there is 
softemng and enlargement of this organ, whilst none is observed in 
yellow fever. 

*^ The kidneys were sometimes congested. 

" The bladder in cases of suppression was found empty and col- 
lapsed upon itself." 

It is impossible to review the history of the different outbreaks of 
yellow fever which occurred in the squadron on the North American 
and West Indian Station in 1869, without reflecting upon the 
unhappy necessity that appears to have existed, of keeping fever- 
smitten ships in localities where a high atmospheric temperature 
prevailed. It cannot be too often repeated nor too strongly stated, 
that the only chance for a ship's company, amongst whom yellow 
fever has made its appearance, is to have them conveyed with the 
utmost speed to a cold latitude. The accumulated mass of ex- 
perience on this point is so great that nothing but the most urgent 
necessity should justify any temporising or procrastination in respect 
to this measure. Although the station orders are explicit and most 
stringent on this point, and senior and commanding oflficers are, 
generally speaking, aware ofthenature of the disease and of the only 
effectual antidote, there is reason to fear that in some instances they 
have not appeared to be alive to the instant necessity of adopting it, 
and thus valuable lives have been sacrificed which a clear appreciation 
of the position, and promptitude of action, might have saved. 



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NOBTH AHEBICAN AND WEST INDIAN STATION. 101 



H General Diseases.— Section B., or Constitutional Group. 



North 
American 



Under this head 504 cases were entered on the sick-list ; viz., 278 ^^^ 

ofrheumatiBm; one of gout; 123 of primary syphilis ; eiehtv-four g^Jfon 

of secondary syphilis ; two of scrofula ; and sixteen of phthisis * 

pohnonalis. Ctf these the total number invalided was twenty-nine. Class IL 

and three cases of phthisis terminated fatally. Sect B. 

Bhsumatism. — Compared with the preceding year there was a 
reduction in the ratio of cases of this disease to the extent of 12*6 
wr 1,000, but there was a trifling increase in the invaUding-rate. 
Each case of rheumatism was, on an average, fifteen days under 
treatment 

Svphilisf Primary and Secondary, — There was a great decrease 
in the ratio of cases of primary syphilis compared with the preceding 
year; a decrease in fact to the extent of 32-9 per 1,000. There 
was also a decrease in the ratio of cases of secondary syphilis. 
Altogether 123 cases of primary syphilis were entered on the sick- 
list, and eighty-four of secondary syphilis. Each case of primary 
eyphilis was on an average between thirty-eight and thirty-nine days 
under treatment and each caseof secondary syphilisa little over thirty- * 
six days. But little is to be said in connection with these cases. One 
or two of the medical officers comment on the advantages the 
ship's company had enjoyed by the legislation which had taken place 
in several places in connection with the surveillence of prostitution. 
The surgeon of the Jason observes : — 

'^ I am glad to be able to say that a change for the better in tliis 
matter is now to be h(^d for in Barbadoes. The working of the 
Contagious Diseases Act was commenced in the month of November, 
and promises to succeed very well. Fifty beds have been provided 
in the Colony, in a hospital that seems to answer the purpose very 
well, and for the future the Home Government tates half the 
expense, the yearly estimated cost being 25 /. a bed. In the same 
enclosure is a well-arranged building for examination, and the whole 
arrangements appear to be very satisfactory. The senior practi- 
tioner in the island has taken charge of both the examining depart- 
ment and hospital, and there is no doubt that the law will be 
effectually worked* There is an examination day every week, and 
up to the end of December there had been seven. Out of about 
seventy women examined, eighteen had been detained in the 
hospital. The police have got close upon 500 names on their list, 
ana there seems a ¥rillingness on the part of the women to come 
forward for examination. 

" Trinidad has passed, and just commenced to carry out, an Act on 
the same model, without any money aid from home. No special 
appointments have been made in connection with it. A few beds in 
the Colonial Hospital are set apart for the purpose, and the resident 
surgeon carries out the duty of examining officer. Five patients 
had been admitted when I was there in the early part of January 
1870. The number of prostitutes cannot be nearly so large as at 

384, M Barbadoes 



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102 



MEDICAL STATISTICAL RETURNS OF THE 



North 

Amorican 

and 

West Indian 

Station. 

Class n. 
Sect. B. 



Class III. 



Barbadoes with its garrison, but the law must prove beneficial, if 
only as an example to the smaller islands, and may save us much 
disease." 

The staff surgeon of the Royal Alfred* observes, with reference 
to some cases ofsyphilis : " These cases were contracted at Halifiix, 
where, from some causes which I could not ascertain, the measures 
adopted for putting down prostitution were much laxer than they 
had been heretofore. But the greater prevalence of the disease 
among our men may probably oe accounted for by the greater 
intimacy existing between them and the female domestics of the city, 
than during the first year of the ship's commission, when there was 
not a single hard chancre among them. The amount of amateur 
prostitution carried on at Halifax is very great, and I believe the 
amount of disease is in equal proportion ; disease which the C!on- 
tagious Diseases Act, if in force, which it is not, at Halifax, would 
have little or no control over. The number of professional prosti- 
tutes, I believe, was comparatively few in 1867 and 1868, but in the 
year 1869, on account ol the less stringent measures that were put 
in force with the view of suppressing prostitution, it appeared tnat 
considerable importations of unfortunates had arrived from other 
parts of the States." 

Another medical officerf writing of the same place, obsei'vcs: 
^^ Syphilis is much more common here than formerly, and if dirt and 
personal uncleanness will encourage it, the lower classes of prosti- 
tutes give it ample opportunity. At one time severe restrictions, 
almost prohibitory, were placea by the municipal government over 
houses of ill-fame, which had the effect of checking open prostitu- 
tion, altliough it encouraged much irregular intercourse anil illegiti- 
macy. But these restrictive regulations have lately been relaxed, 
and now prostitutes abound in open competition and shame. 

" In a sea port and garrison town such as Halifax, the operation 
of a ^ Contagious Diseases Act ' would be of great advantage in a 
sanitary and economic point of view. The people of Halifax would 
be wilhng to adopt it, but it rests with the Dominion Government 
to declare it. One di6iculty lies of course in the expense, which 
the Colony is scarcely willing to incur without the proper support 
and assistance of the Home Government and Exchequer; and, as 
the subject affects the interests more of the soldiers and sailors of 
the Crown than the inhabitants themselves, it is natural that they 
should hang back until England declares what amount of the 
expense she will bear in carrying out the provisions of such an Act." 

ni. Diseases of the Nervous System, and QrgaAs of the 
Speoial Senses. 

One hundred and eleven cases of all forms of disease were admitted 
under this head, of which eighteen were invalided and one proved 
fatal. The fatal case was one of apoplexy. It occurred in the 

person 

^ Staff Surgeon D. Lloyd Morgan, m.d. 
f Staff Surgeon Wm. Loudon Gk>rdon, m.d. 



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XORTH AMERICAN AND WEST INDIAN STATION. 



103 



North 

American 

and 

West Indian 

StatioD. 

Class m. 



person of an officer of the Royal Alfred, who was debilitated in con- 
stitution^ and had not recovered a severe injury he had sustained 
some months previously, when he had his nasal bones fractured, and 
suffered concussion of the brain. Just before his last fatal attack, 
he had been in his usual health, but had been much fagged and worn 
by arduous duties. He had seated himself at luncheon after a fore- 
noon of hard work, and had just commenced eating when he was 
observed to become suddenly deadly pale, with a painful expression 
of face, and attempting to make an effort to speak, but almost imme- 
diately afterwards he fell back unconscious, and was removed in- 
sensible to his cabin. It was at once evident that there was no 
hope. At first he could move both arms and legs, but it soon 
became apparent that paralysis of the right side oi the body had 
taken place, which at first partial became in a few hours complete 
He never rallied, and death took place in twenty-four hours. He 
was fifty-two years of age, with the arcus senilis well marked. He 
had a pale face, with a square set body and short neck. 

IV. Diseases of the Circulatory System. 

Under this head forty-six cases of various forms of disease were Class IV. 
entered on the sick-list, of which thirteen were invalided and two 
proved fatal. Compared with the preceding year there was a reduc- 
tion in the ratio of cases to the extent of 3*9 per 1,000 in the inva- 
liding rate of 2*2, and in the ratio of mortality of 1*. Of the two 
fatal cases one occurred in the person of a petty officer of the Doris, 
who had long been excused from all heavy duty, and was merely 
retained on board pending his discharge from the service, his time 
having expired. The day previous to his death he heard of his dis- 
charge and of the pension that had been awarded him, and the excite- 
ment consequent thereon is said to have been the cause of his death. 

The other fatal case was that of a stoker of the Philomel. He 
died on the passage home, in the mail steamer, having been invalided 
for very extensive head disease. 

V. and VI. Diseases of the Absorbent System and 
Duetless Glands. 

Sixty-five cases of sympathetic bubo appear under this head. Class V. 
The average duration of each case was about nineteen days and and VI. 
a half, but they possessed no interest in any other respect. 

VH. Diseases of ^the Bespiratory System. 

Under this head 476 cases were entered on the sick-list, of which Class VII. 
seven were invalidedjand four proved fatal. Ordinary catarrh was 
the most common affections, and of this alone 408 cases were under 
treatment. They were of but little importance, however, the average 
duration of each case being a little over six days. 

Of the fat^l cases three were from pneumonia, and one from 
bronchitis. 

A boy of the Jason was entered on the sick-list on the 21st of 

April,*at Barbadoes. He had been previously healthy, but on that 

384. M 2 lay 



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104 



MEDICAL STATISTICAL RETURNS OF THE 



North day he was seized with pain over the lower part of the right chest 

American accompanied by a good deal of febrile disturbance, cough, and slight 

w t*l^d* mucous expectoration. Under the treatment to which he was sub- 

^tation*^ jected, the symptoms were ameliorated, and although a friction 

' sound became audible at the seat of pain, he appeared to improve 

Class VII. utftil the 25th, when a re-accession of fever took place with dyspnoea 
and a constant short cough, the pain increasing in severity. On the 
29th the expectoration was dusky and slightly tinged with blood, 
crepitation coarse and fine was audible all over the right lung, and 
the dyspnoea and cough had increased. On the 1st of May he was 
discharged to the Military Hospital at Barbadoes. At that time 
there was no improvement in his symptoms : his strength had fallen 
off, and there was still much fever. The pulse was 104. Tempera- 
ture 103. Skin moist. The cough was very frequent and dis- 
tressing, and he had some diarrhoea. 

In the Military Hospital he improved slightly up to the 17th of 
May, when the cough became worse. On the night of the 17th he 
suddenly became much lower, the upper part of the right lung being 
congested, and r&les in every part oi it. At the same time the left 
was emphysematous, and doing very little work. He died on the 
morning of the 18th. 

On post mortem examination of the body, the right lung was 
found to be firmly attached to the costal pleura, so much so tnat it 
was with great diflSculty that a separation could be effected. On 
cutting into the lung it seemed to be almost a solid mass, small drops 
of pus escaping slowly from some of the cells. It seemed never to 
have recovered from the third stage of the original disease. The 
left lung was emphysematous, but otherwise healthy. 

There was nothing of interest in the other cases. 

Vm. Diseases of the Digestive System. 

Cla«» VIIL Under this head 759 cases of various forms of disease came on the 
sick-list; of which, 144 were cases of cynanche; 217 dyspepsia; 
and 265 diarrhoea. These cases, as a rule, were of a very trivial 
character, the average duration of each case of cynanche being about 
ei^ht days ; of each case of dyspepsia, four days ; and of each case 
ofdiarrhoea, five days. 

Of thirty-one cases of dysentery that were under treatment, 
twenty-five appear in the returns from the Terror, and of these, 
eighteen occurred between the 1st of October and the 12th of No- 
vember. The disease is said to have been of a subacute character, 
but the information given with respect to it is of the most meagre 
description. The average duration of each case on board ship, and 
in hospital, were a little over twelve days. 

Of the total number of cases in this class entered on the sick-list, 
ten were invalided, viz. : one for dyspepsia ; one for chronic diar- 
rhoea ; five for hernia ; and three for diseases of the liven 



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NORTH AMERICAN AND WEST INDIAN STATION. 



105 



North 

American 

and 

West Indian 

Station. 

Class DL 
and X. 



IX. and X. Diseases of the Urinary and Generative 

Syst-ems. 

Tiro hundred and four cases of various forms of these diseases 
were entered on the sick-list, 123 of which were cases of gonorrhoea, 
and fifty-seven of orchitis, chiefly of gonorrhoeal origin. One case 
of Bright's disease, and one of stricture were invalided. The average 
duration of each case of gonorihoDa was about sixteen days, and of 
each case of orchitis seventeen days. 

The case of Bright's disease occurred in the person of a lamp- 
trimmer of the Jason. He had had an attack of haemoptysis three 
years previously, when at Halifax, and had subsequently been 
five times on the sick-list ; and under treatment, at other times, 
for Bvmptoms of tubercular disease. While under treatment for 
incipient phthisis in November 1868, his ankles and le^ became 
cedematous, continuing so for two months. This subsided, and was 
followed by oedema of the face, the eyelids being for some time 
nearly closed. He had for a long time complainea of pain in the 
thiglis and knees, and his appearance and complexion were of the 
bloated waxy character of Wright's disease. From the beginning 
of the year his urine had been highly albuminous, with a specific 
gravity of 1'020. 

XL Diseases of the Qi^^ans of Locomotion. 

Seventeen cases appear under this head, the average duration Class X. 
of each being about wree weeks. They were chiefly cases of syno - 
vitis and bursitis. 



Xn. and Xm. Diseases of the Cellular Tissue and Cutaneous 

System. 

Boils, abscesses, ulcers formed the great bulk of the cases coming 
under this head. Of the two former 949 cases were entered on the 
Bick-lisi) of which four were invalided ; and of the latter there were 
310 cases, of which five were invalided. No features of interest were 
connected with the majority of these cases ; but an interesting case 
occurred in the Royal Alfred, and was one of those invalided. It is 
thus reported on by the Staff* Surgeon* of the sliip : — " The patient 
was an able seaman, who had been undergoing cell punishment. 
He was entered on the sick-list on the 30th of January, complaining 
of a deep-seated pain in the lefl hip, between the trochanter major 
and the tuber ischii, and in the course of the sciatic nei've. The case 
was treated as one of a rheumatic character, as there was no history 
of any previous injury. There was no indication of any inflam- 
matory action going on until the 18th of February, when it was 
observed that the man had been suffering from rigors on the 
previous night; the pulse was 120, and the temperature increased. 

There 



Class ZII. 
and ZIII. 



384. 



* Staff Snrgeon David Uoyd Morgan, m.d. 
m3 



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106 MEDICAL STATISTICAL RETURNS OF THE 

North There was discovered deep-seated fluctuation at the seat of pain. On 

American the 19 th the evidence of the formation of pus became more distinct 

^^d within an area bounded above by the brim of the pelvis, and below the 

^tion ^ junction of the upper with the middle third of the thigh, and laterally 

* by the tuber ischii and great trochanter. The fluctuation wa^ more 

Class XII. distinct at the upper and lower parts of the tumour than over its 
and XIII. centre, where, indeed, it was but obscurely felt, if at all. It was 
found, however, by palpation, that the matter above communicated 
with the matter below. A valvular incision was made into the most 
depending part of the tumour, in an oblique and upward direction, 
with a broad scalpel, previously dipped in the oil and carbolic solu- 
tion of Lister ; the point of puncture, also, being covered over with 
a square piece of calico, also dipped in the solution. There was a 
copious discharge of matter, mixed with small clots of blood, evi- 
dently the result of a former deep-seated contusion and extravasation, 
caused, it afterwards transpired, by the rough handling which the 
man underwent when being secured by the ship's corporals, with the 
view of preventing him making a disturbance when in a very ex- 
cited state from the effects of drink. The valvular opening was 
kept patent with lint dipped in the antiseptic solution. A. compress 
was applie() to the tumour from above downwards, and the opening 
was carefully dressed with the carbolic and paste. It will be seen 
by reference to the details of the case, that the abscess was very 
nearly closed, when, in my absence, the man was allowed to walk 
about ; the result was inflammation and suppuration. The patient 
was discharged to Bermuda Hospital in my absence, and invalided 
from that establishment. It is very clear that this case would have 
turned out quite as successful as every other case has done under my 
care, treated after Lister's antiseptic plan, if, unfortunately, the 
dressing had not been discontinued, and the patient allowed to walk 
about." 

Unclassed Diseases. 

Under this head 103 cases of debility, five of delirium tremens, 
and two of poisoning were entered on the sick-list. Of the cases of 
debility, eighteen were invalided, and two proved fatal. 

Of the cases of delirium, one occurred in a warrant officer, one in 
a shipwright, one in an artificer, one in a stoker, and in one the 
rating has not been ascertained. 

Of the two cases of poisoning, one was alcholic, the other by lead. 

Wounds and Injuries. 

Three men sustained fatal injuries. Of these one fell from aloft 
and dislocated^his neck : one sustained fracture of the skull by being 
struck with a windlass ; and one fell over a pier, and sustained a 
fatal injury of the spine. 

Nine^'persons were drowned; one by* falling into'a dock ; one in 
attempting to swim ashore; one in attempting to swim across a 
ferry ; three by falling overboard ; two by capsizing of boats ; 
and the circumstances under which one man was drowned have not 
been given. 

The 



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NORTH AMKHICAN AND WEST INDIAN STATION. 107 

The total number of deaths was eighty-two, which is in the ratio 
of 23*4 per 1,000, being an increase compared with the preceding 
year equal to 14*2 per 1,000. That this large increase was almost 
entirely due to the mortality from yellow lever, is shown by the 
fact that deducting the deaths from that disease, the ratio of mor- 
tality for 1869 would only have been 9*7. 



North 

American 

and 

West Indian 

Station. 



Inyalided. 

Under General Diseases, Section A., four persons were invalided, 
viz., three for ample continued fever, and one for ague ; and under 
Section B., twenty-nine persons were invalided ; thirteen being for 
rheumatism; one for primanr syphilis; six for secondary syphilis ; 
two for scrofula ; and seven K)r phthisis pulmonalis. Eighteen per- 
sons were invalided for diseases of the nervous system, and organs of 
the special senses ; thirteen for diseases of the circulatory system ; 
seven for diseases of the respiratory system ; ten for diseases of the 
digestive system ; two for diseases of the urinary and generative 
system; mne for diseases of the cellular tissue and cutaneous 
system ; eijghteen for unclassed diseases ; and ten for wounds and 
injuries or various kinds. The total number invalided was 120, 
which is in the ratio of 34*2 per 1,000, being a reduction compared 
with the preceding year equal to 4*6 per 1,000. 



384. 



m4 



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108 



MEDICAL STATISTICAL RETURNS OF THE 



Table, No, l. 



Showing the Number of Cases of all Diseases and InjurieSyand the Number Invalided 
and Dead, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



I. General Diseases, Section A. : 

Small-pox - - - , 

Measles - - . . 
Simple contiDued Fever - 
Yellow Fever 

Ague - - - - 

Remittent Fever - 

Cholera - - - - 

Pyasmia - « - 
Erysipelas - 



II. General Diseases, Section B- : 

Rheumatism - - • - 

Gout 

/Primary - 
'\ Secondary - 
Scrofula - - - - 
Phthisis Palmonalis 



Cmm. 



Nainber. 



Syphilis 



m. Diseases of the Hervons Sys- 
tem and Organs of the 
Special Senses : 

Apoplexy - - - - 

Sunstroke - - - - 

Paralysis - - - - 

Vertigo - - - - - 

£pilepsy - « - - 

Neuralgia - - " - 

Insanity - - - - 
Diseases of the Nervous System 
Diseases of the Eye 

Diseases of the Ear - - - 
Diseases of the Nose 



1 

5 

511 

100 

20 

20 

1 

1 

12 



278 

1 

123 

84 

2 

10 



1 

16 

1 

10 

13 

15 

7 

4 

31 

13 

1 



Ratio 

P«" 
1,000 

of 
Force. 



•2 

1*4 

140* 

28*5 

7-4 

7-4 

•2 

•2 

3-4 



79-4 
•2 

351 

24- 
•5 
4-5 



•2 

4-2 
•2 
2-8 
3-7 
4-2 
2- 
11 
8-8 
3-7 
•2 



InTilided. 



Nomber. 



13 

1 

2 
7 



Ratio 

P« 
1,000 

of 
Foroe. 



3-7 

•2 

1-7 

•5 



Dead. 



Number. 



4 
48 

2 

2 



•2 

•5 

1-7 

•8 
•2 
•8 
•6 



Ratio 

per 

1,000 

of 
Foree. 



11 
13-7 

•6 

•5 



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NORTH AUERICAK AND WEST INDIAN STATION. 



109 



Table, No. 1.— Showing the Number of Cages of all Diseases, &c.- 


'^continued. 




OMet. 


iDTiIided. 


Dead. 


1H8EASE OR INJURY. 




Ratio 
per 




Ratio 




Ratio 
per 




Nomber. 


1,000 

of 
Force. 


Number. 


1,000 

of 
Foree. 


Nrnnber. 


1,000 

of 
Force. 


IV. IHieases of the Circulatory 














Syitem: 














Disease of the rFancUonal - 
Heart -\Orgaiiic - 


29 


8-2 


2 


•5 




— 


6 


1-7 


5 


1-4 


2 


•5 


Aneurlsiii . - - - 


1 


•2 


— 


— 


— 


— 


Varicoso Veins - - 


10 


2-8 


6 


1-7 


~ 


~ 


V.ftVLBiseaset ofihe Absor- 














bentSystem and DucUomi 














Glands: 














Bnbo (i^^wi^.) 


6S 


18-5 


~~" 


"■"" 


'~~ 


^"^ 


Vn. IKseasesoffheBespiratory 
System: 

Diseases of the Larynx - 














1 


•2 


•^ 





— 


— 


Catarrh 


406 


116-6 


— 





— 


— 


Hmnoptysis - - - - 


6 


1-7 


3 


•8 


— 


- — 


Asthma 


3 


•8 


— 


— 


— 


— 


Other Diseases of the Lungs - 


67 


16-2 


4 


11 


4 


11 


Vnr. Diseases of the Digestiye 














System: 














Oynanche - - - - 


144 


41-1 


— 


^ 


— 


— 


Diseases of the Mouth, Teeth, 














&c. 


1 


•2 


— 


— 


~~ 


•^ 


Dy^^epsU . . - - 


217 


62- 


1 


•2 


— 


^~ 


Dvsenteiy - - . - 
Diarrhoea - - - - 


31 
265 


8*8 
75-7 


1 


•2 


— 


— 


Colie and Constipation - 


54 


15-4 


— 


— 


— 


— " 


Hemorrhoids . - - 


12 


3*4 


— 


— 


"^ 


"~~ 


Hernia - - - - - 


10 


2-8 


5 


1-4 


— 


— " 


Worms - - - - - 


8 


2'2 


— 


— 


— 


— 


Other Diseasesof the Stomach, 














&c. - - • - 


10 


2-8 


— 


— 


— 


— 


Diseases of the Lirer, &c. 


7 


2* 


3 


•8 






DLftX. Diseases of the Trinary 














and OeneratiTe Systems : 














Diseases of the Kidneys - 


9 


2-5 


1 


•2 


— 


-^ 


Diseases of the Bladder - 


3 


•8 


~"^ 


"^~ 






Gonorrhoea - - - - 


123 


351 




""~ 







S84. 



Digitized by 



Google 



no 



MEDICAL STATISTICAL BETUKN8 OF THE 



Table, No. 1.— Showing the Number of Caaes of all Diseases, kc-^continued. 

CasM* Invalided. Dead. 



DISBASE OR INJURY. 



IX. & X. Diseases of the Uri- 
nary and Generative 

Systems — continued. 

Disoases of the Organs of Gene- 
ration - - . - 
Stricture - . - - 
Orchitis- . - - . 



ZI. Diseases of the Organs of 
Looomotion : 

Diseases of the Bones, Joints, 
&c. - - - - . 



Xn. ft Xm. Diseases of the 
Cellular Tissue and Cuta- 
neous System: 

Phlegmon and Ahscess - 

Ulcer 

Erythema . - - . 

Diseases of the Skin 

Scabies - . - - - 



Unclassed: 



Debility 

Delirium Tremens - 

Poisonmg - - 



Wonnds and Iiguries : 

Wounds, Injuries, &c. - 
Bums and bcalds - 
Submersion and Drowning 
Not stated . 

Totals - - 



Number. 



4 

8 
67 



17 



949 
810 

2 
48 

2 



103 
5 
2 



888 

29 

8 



6,210 



Ratio 
per 

1,000 
of 

Force. 



M 

2-2 

16-2 



4-8 



27M 
88-5 

•5 
137 

•5 



29*4 

1-4 

•6 



253-4 
8-2 
2-2 



Number. 



1488-6 



18 



10 



120 



Ratio 

P«" 
1,000 

of 
Force. 



M 
1-4 



61 



2-8 



34-2 



Number. 



82 



Ratio 

per 
1,000 

of 
Force. 



15 
•2 



23-4 



Digitized by 



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KOBTH AMERICAN AND WEST INDIAN STATION. 



Ill 



Table, No. 2, 

Showing the Number of Days' Sickness from each Disease and from Injuries, the 

Average Number of Men Sick Daily, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



General Diseases, Section A. 

Small-pox 

Measles - - - - 

Simple continued Fever 

Yellow Fever - 

Ague - - - - 

Remittent Fever - 

Cholera - - - - 

Pyaemia - 

Erysipelas 



n. General Diseases, Section B. : 

Rheumatism - - . . 

Gout 

a,i^k:i:<. f Primary 
Syphilis jg^ondiiy - - 
Scrofula - . . 

Phthisis Pulmonalis 



m. Diseases of the Hervous 
System and Organs of the 
Special Senses: 

Apoplexy - - - - 

Sunstroke - - - - 

Paralysis - . - - 

Vertigo - - - - - 

Epilepsy - . . - 

Neuralgia - - - - 

Insanity . - - . 
Diseases of the Nervous System 
Diseases of the Eye 
Diseases of the Ear 
Diseases of the Nose 

384. 



Number of Days* Sickness 



On Board. 



2 

6^ 

3,165 

r.39 

151 

476 

2 

8 

153 



2,713 

21 

2,800 

1,794 

10 

303 



1 

123 

21 

68 

59 

81 

66 

14 

327 

158 

1 



In Hospital. 



1,745 

1,206 

121 

114 



1,360 

26 

1,965 

962 

67 

763 



80 

42 

41 

104 

163 

250 

105 

11 



ToTAt. 



2 

52 

4,900 

1,845 

272 

590 

2 

8 

161 



4,073 
47 

4,766 

2,756 
77 

1,066 



1 

203 

63 
109 
163 

81 
229 

14 
577 
263 

12 



Average Number of 
Men Sick Daily. 



Number. 



•1 
13-4 
5- 

•7 
1-6 



111 

•1 

13- 

7-5 

•2 

20 



•5 
•1 
•2 
•4 
•2 
6 

1-6 
•7 



Ratio 

per 

1,000 of 

Force. 



3*8 

1-4 

•2 

•4 



31 

87 
21 



Digitized by 



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112 



MEDICAL STATISTICAL RETURNS OF THE 



Table, No. 2.— Showing the Number of Dayg* Sickness from each Disease, kc.--cont^. 



DISEASE OR INJURY. 



ly. Diseases of the Circulatory 
System : 

Disease of the ( Functional - 

Heart - \ Organic - 

Aneurism - . . . 

Varicose Veins - - . 



v. & VI. Diseases of the Absorb- 
ent System and Ductless 
Glands: 



Number of Dtys* SickncM 



Bubo (Sjmp.) 



TIL Diseases of the Bespiratory 
System: 

Diseases of the Larynx - 
Catarrh 



Hemoptysis - - . 
Asthma - - - « 
Other Diseases of the Lungs 



vill. Diseases of the Digestiye 
System: 

Cynanche . - . . 
Diseases of the Mouth, &c. - 
Dyspepsia . - - . 
Dysentery - - - . 
Diairhoea .... 
Colic and Constipation - 
Hemorrhoids - . . 

Heruia ..... 
Worms - - - - . 
Other Diseases of the Stomach. 
&c. - . . - ! 
Diseases of the Li^er, &c. 



OnBotrd. 



271 
6G 
65 

153 



In Hospital. 



1,165 



2,328 

10 

27 

735 



872 

1 

845 

160 

1,135 

232 

175 

71 

44 

77 
165 



243 
104 

73 



96 



49 

328 

41 

24 

1,034 



300 

122 

218 

187 

18 

35 

48 



Total. 



514 

170 

55 

226 



1,261 



78 

2,656 

51 

51 

1,769 



1,172 

1 

967 

378 

1,322 

250 

210 

119 

44 



143 220 

153 318 



Average Nombe r of 
Men Sick Daily. 



Number. 



1-4 
•4 
•1 
•6 



3-4 



•2 

72 

•1 

•1 

4-8 



3-2 

2-6 

1- 

3-6 
•6 
•5 
•3 
•1 

•6 
•8 



Ratio 

1,000 of 
Force. 



2' 
V3 



Digitized by 



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NOBTH AMEBICAN AND WEST INDIAN STATION. 



113 



Table, No. 2,— Showing the Number of Days* Sickness from each Disease, &c.— cow^-*. 


« 


Number of Days' Sickness 


Average Number of 
Men Sick DaUy. 


DISEASE OR INJURY. 










Ratio 


I 


On Boiuil. 


In Hospitsl. 


Total. 


Number. 


per 

1,000 of 

Force. 


DLftX. Diseases of fheTrinary 
and Generatiye Systems : 












Diseases of the Kidneys 
Diseases of the Bladder 
Gonorrhoea - - - - 
Diseases of the Orgsns of 
Generation - - - 
Stricture . - - . 
Orchitis - . - - 


86 

32 

1,882 

40 

78 

767 


20 

34 

264 

160 
120 
220 


106 

66 
2,0«6 

199 
198 
977 


•2 

•1 

57 

•5 

•5 
2-6 


1-6 

•1 
•1 
•7 


XL IKseases of the Organs of 
Locomotion : 












Disesses of the Bones, Joints, 
&c 


267 


98 


365 


•9 


•2 


Zn. * Xm. Diseases of the 
Cellular Tissue and Cuta- 
neous System : 












Phlegmon and Abscess - 

Ulcer 

Erythema - . . - 
Diseases of the Skin - 
Scabies .... 


7,410 
4,663 

27 
512 

13 


884 
1,251 

251 


8,300 

5,904 

31 

763 

13 


22-7 
16-1 

2- 


6-4 
4-6 

•5 


Tnclassed: 












Debility - - - . 
Delirium Tremens 
Poisoning .... 


805 
14 
10 


700 
S3 
12 


1,695 
47 
22 


4-3 
•1 


1-2 


Wounds and Iiyuries : 












Wounds, Injuries, &c. - 
Burns and Scalds . - - 
Submersion and Drowning - 


8,666 
305 

2 


2,167 
6 


10,833 
311 

2 


29-6 
•8 


84 
•2 


Totals - - - 


47,400 


18,672 


65,981 


180-7 


616 



384. 



Digitized by 



Google 



114 



MEDICAL STATISTICAL RETURNS OF THE 



Table, No. 3. 

Showing the Number Invalided from each Ship on the North American and 

West Indian Station. 



CAUSE 

or 

INVALIDING. 



I. General Diseases, Section A. : 

Simple Continued Fever - 
Ague . . - - - 



II. General Diseases, Section B. : 
Rheumatism . - " " 
Syphilis {^"Sy ." - 



Scrofula 
Phthisis 



III. Diseases of the Nervous 
System and Organs of 
the Special Senses: 



Paralysis - - - - 

Vertigo - - - - 

Epilepsy - - - - 

Insanity - - - - 

Diseases of the Nervous 

System - - - - 

Diseases of the Eye - 

Diseases of the Ear - 



ly. Diseases of the Circulatory 
System: 

Disease of the/ Functional - 

Heart - l^Organic 
Varicose Veins - - - 



VII. Diseases of the^Bespira- 
tory System: 



Hsmoptvsis - - - 
Other Diseases of the Lungs 



I 



§ IS 



1 - 



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NOBTH AMERICAN AND WEST INDIAN STATION. 



115 



Table^ No. 8. — Showing the N amber Inyalided from each Ship, &c. — continued. 



CAUSE 

OP 

INVALIDING 


.5: 

M 

J 

< 


i 


i 


j 


Eclipse. 

Favorite. 

Gunboats. 


^ 


1 


1 
1 

4 

7 


1 

2 

3 

8 


< 8 

1 

1 
5 


"^ i 

^1 


i 


H 


1 


J 


Vm. Diieaaes of the Digeftiye 
System: 

Diarrhoea - - . - 
Hernia - - - . 

Diseases of the Liver, &a - 

IX &X. Diieases of the Uri- 
nary and Oeneratiye 
Syitems: 
Disease of the Kidneys 

Strictare - - - - 

ZIL & XIII. Diseases of Cel- 
lular Tissue and Cutane- 
ousISystem: 

Phlegmon and Abscess 
Ulcer 

Tnclassed: 

DebUity - - . . 

Wonnds and Iignries : 

Wounds - - - - 

Total - - - 


1 
1 

10 


~ 


1 

1 
3 


3 

9 

4 
29" 


1 
1 

1 
8 


4 


1 

1 


1 

1 

5 


1 
4 


7 


I 

2 

6 


1 

1 

1 

_ 

10 


1 

2 
6 


1 
1 
5 
3 

1 
1 

4 

5 

18 

10 
120 



384. 



Digitized by 



Google 



116 



MEDICAL STATISTICAL RETURNS OP THE 



Table, No. 4. 

Showing the Number of Deaths in each Ship employed - 



CAUSE OF DEATH. 



I. General Diseases, Section A. : 
Small-pox] . . . . 
Simple Continued Fever - 
Yellow Fever - - - . 
Remittent Fever ' - 
Pyemia - - - - . 






II. Oeneral Diseases, Section B. 
Phthisis 



III. Diseases of the Heryons System and 
Organs of the Special Senses: 
Apoplexy ----.. 



TV. Diseases of the Circulatory System: 

Disease of the Heart, Oi^anic - 

VII. Diseases of the Bespiratory System: 
Diseases of the Lungs . . - . 

Unclassed : 

Debility 



Wounds and Iquries : 

Wounds, Sic, - - - 
Submersion and Drowning 
Not stated 



Total 



i 



I 



1 

17 



•5 
& 



I 
'I 



Digitized by 



Google 



NORTH AMERICAN AND WEST INDIAN STATION. 



117 



- Table, No. 4. 
on the North American and West Indian Station. 





























1 


1 


d 


1 


1 


Royal Alfred 

(First 

Commission) 


1 T 


i 


1^ 


1 


1 




_ 




^ 


4 


^ 


^ 


^ 


. 


^^ 


^ 


1 
4 




2 


5 


- 


- 


5 


- 


- 


- 


2 


4 


48 




— 


— 


- 


— 


1 


- 


— 


-. 


— 


1 


2 


r 










1 




1 






2 






1 


: 


*" 


; 


*" 


1 


"• 


^ 


1 


8 

1 




- 


- 


1 


- 


1 

1 


- 


1 


- 


- 




2 

4 
2 
3 










1 
















- 


1 


1 


I 


- 


- 


1 


1 


2 


- 







"" 


1 


"" 


^ 


^ 


^ 


"" 


~ 


"" 


— 


1 




2 


8 


2 


6 


8 


1 


8 


2 


4 


6 


82 



384. 



N 



Digitized by 



Google 



118 



MBDICAIi STATIftTICAL BETUBNS OF THE 



Table, No. 6. - 
Showing the Number of Cases of all Diseases and Injuries in the 



DISEASE or INJURY. 


1 


09 

1 


«; 


§ 




i 






2 
< 


1 


& 


1 


1 


§ 




I. Oeneral Diseases, Section A. : 
















Small-pox - - - - 


- 


- 


- 


1 


- 


- 




Measles - - - - - 


- 


- 


- 


- 


- 


- 




Simple Continued Fever 


301 


9 


8 


12 


11 


10 




Yellow Fever 


17 


6 


— 


29 


- 


9 




Ague - . - - - 


3 


1 


1 


4 


- 


2 




Remittent Fever - - - 


8 


- 


3 


- 


— 


4 




Cholera- - - - . 


1 


- 


- 


— 


— 


— 




Erysipelas - - - - 


- 


3 


- 


2 


- 


- 




Pyjemia - - 


^ 


" 


"■ 


~" 


— 


^ 




n. General Diseases, Section B. : 
















Rheumatism - - - - 


4i) 


3 


1 


16 


17 


14 




Gout ----- 


— 


- 


— 


— 


- 


— 




«.vp''^ {£^o"Xy : : 


9 
5 


4 

2 


8 

6 


6 


3 
2 


5 
3 




Scrofula 


- 


— 


- 


1 


— 


1 




Phthisis Fulmonalis 


1 


- 


1 


— 


1 


- 




III. Diseases of the Nervous Sys- 
















tem and Organs of the 
















Special Senses: 
Apoplexy - - - - 
















^ 


. 


» 


. 


. 


_ 




Sunstroke - - - - 


^ 


^ 


1 


10 


. 


^ 




Paralysis . - - - 


_ 


„ 




« 


_ 


_ 




Vertigo 


4 


^ 


. 


1 


~ 


«, 




Epilepsy - - - - 


1 


. 


. 


3 




„ 




Neuralgia - - - - 


1 


2 


5 


- 


- 


.. 




Insanity - - - - 


2 


. 


. 


— 


. 


1 




Diseases of the Nervous System 


(a) 2 


. 


_ 


^ 


-. 






Diseases of the Eye 


^ 5 


_ 


„ 


2 


« 


_ 




Diseases of the Ear 


4 


1 


^ 


2 


_ 


_ 




Diseases of the Nose 






1 




- 


- 




lY. Diseases of the Circulatory 
















System: 
















Disease of the f Functional 
Heart i.Organic - 


7 


1 






_ 


1 




1 




I 


,^ 


2 






Aneurism . - - - 




_ 


^ 


_ 








Varicose Veins 


2 


_ 


^ 


4 


. 


„ 




V. & VI. Diseases of the Ab- 
















sorbent System and Duct- 
less Glands : 






























Bubo (Symp.) 


4 


1 


2 


14 


2 


2 




VII. Diseases of the Eespiratory 
System: 
Diseases of the Lai*ynx - 
















« 


„ 


« 


« 


.. 


_ 




Catarrh 


22 


10 


4 


2 


10 


19 




Hficmoptysis - - - - 


1 


- 


- 


- 


2 


- 




Asthma 


- 


— 


» 


~ 


- 


~ 




Other Diseases of the Lungs - 


11 


4 


- 


7 


- 


1 





(a) Hypochondriatit. 



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NOBTH AHEBIGAN AND WEST INDIAN STATION. 



119 



- Table, No. 5. 
Ships employed on the North American and West Indian Station. 















^ -? 


•T4 '^ 










1 
1 


• 

c 

i 


i 


.2 


i 
1 


1 


RoyalAlfr 

(First 

Commisdo 


rt v-^O 


1 

« 


H 


>• 


t5 














"" 










1 


« 


. 


. 


_ 


. 


. 


4 


. 


1 


— 


- 


5 


11 


16 


3 


13 


39 


3 


. 


. 


10 


42 


23 


511 


2 


2 


«. 


. 


7 




^ 


. 


- 


2 


26 


100 


^ 


5 




^ 




„ 


_ 


2 


- 


» 


8 


26 


3 


1 


- 


- 


6 


- 


- 


- 


- 


- 


1 


26 


. 


^ 


« 


. 


^ 


. 


. 


_ 


— 


. 


— 


1 


— 


- 


1 


. 


•. 


. 


- 


2 


- 


2 


- 


12 


— 


— 


- 


- 


- 


— 


1 


— 


^ 


"■ 


• 


1 


34 


10 


7 


36 


6 


7 


16 


18 


7 


16 


21 


278 


~ 


. 


«. 


1 


« 


. 


-. 


— 


— 


— 


— 


1 


10 


21 


7 


8 


5 


9 


6 


2 


1 


4 


16 


123 


1 ^ 


23 


4 


- 




16 


12 


4 


- 


2 


- 


d4 


- 


• 


. 


_ 


^ 


_ 


. 


— 


— 


. 


. 


2 


r 


3 


*■ 


"" 


" 


1 


2 


1 


1 


3 


■ 


16 


' 














1 








1 


- 


- 


. 


— 


3 


- 


- 


1 


- 


- 


- 


16 


.. 


« 


_ 


_ 


^ 


^ 


« 


1 


— 


. 


. 


1 


^ 


.. 


_ 


_ 


_ 


_ 


^ 


- 


2 


. 


3 


10 


1 


. 


^ 


1 


2 


1 


. 


1 


1 


2 


- 


13 




. 


„ 


1 




„ 


« 


1 


- 


1 


4 


15 


.. 


- 


. 




-. 


1 


- 


- 


- 


3 


- 


7 


__ 


^ 


. 


_ 


1 


^ 


M 


1 


- 


. 


— 


4 


3 


6 


^ 


1 




6 


1 


2 


2 


3 


1 


31 






1 




- 




2 


1 


- 


2 


- 


13 


— 


"" 


— 


"• 


— 


"- 


"• 






" 


*" 


1 




4 




3 




1 




2 


2 


7 


1 


29 


^ 




1 




z 




1 


1 


- 




^ 


6 


^ 


„ 




_^ 


„ 


_ 


1 


— 


- 


- 


. 


1 


1 


1 


— 


- 


— 


— 


1 




1 


"~ 


■" 


10 


3 


10 


3 


6 


2 




- 


- 


2 


13 


2 


65 














1 










1 


40 


13 


1 


64 


11 


12 


42 


22 


28 


61 


47 


408 


1 


- 


. 


. 


. 


- 


- 


1 


- 


- 


1 


6 


^ 


. 


^ 


• 


« 


_ 


3 


- 


- 


- 


- 


3 


4 


2 


- 


4 


2 


^ 


7 


5 


"" 


8 


-2 


57 



384. 



it2 



Digitized by 



Google 



120 



MEDICAL STATISTICAL BETUBKS OF THE 



Table, No. 5. — Showing tbe Number of Cases of all Diseases and Injuries 



DISEASE or INJURY. 



cq 






Q 



1 

P 



I 



'■■} 



Tin. Diseases of the Digestive 
System: 
Cynanche - . - - 
Diseases of Mouth, Teeth, &c. 
Dyspepsia - - - - 
Dysentery - - - - 
Diarrhcea - . - - 
Colic and Constipation - 
Htemorrhoids - - - - 
Hernia - - - - - 
"Worms - - - 
Other Diseases of the Stomach, 

Intestines, &c. - 
Diseases of the Liver, Spleen, &c. 

IX. ft X. Diseases of the Urinary 
and Generative Systems : 
Diseases of the Kidneys - 
Diseases of th« Bladder 
Gonorrhoea - - - - 
Diseases of the Organs of Ge-'\ 
neration - - - -f 
Stricture - - - - 
Orchitis- - - - 

XI. Diseases of the Organs of 

Locomotion: 

Diseases of the Bones 
Diseases of the Joints 
Diseases of the Burss 

XII. ft Xni. Diseases of the 

Cellular Tissue and Cu- 
taneous System: 

Phlegmon and Abscess - 

Ulcer 

Erythema - - - - 

Diseases of the Skin 

Scabies - - - - - 

Unclassed: 

Debility- . - . - 
Delirium Tremens - - - 
Poisoning - . - . 

Wounds and Injuries : 

Wounds, &c. - - - - 

Burns and Scalds - * - 

Submersion and Drowning - 

Total - - - 



17 
3 

]6 
4 
2 
2 



22 
1 

1 

3 



61 
44 

13 



18 

(*)1 



74 
2 



751 



4 

5 

6 
4 
1 

1 



29 
15 



36 
2 
1 



173 



4 

2 

22 
2 



12 
5 
1 



105 



15 
84 

19 

7 

4 

1 

4 
2 



1 
20 



233 
24 



10 
1 



115 
8 



672 



38 
9 



26 

1 



152 



16 

12 
3 
1 



6(i 

8 



37 
1 



221 



W By aloobol. 



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NOBTH AMEBICAM AKD WEST INDIAN STATION. 



121 



384. 



(c) Bjr lend. 
K3 





in the 


Ships 


employed on 


the North American an 


d West I 

HI 


ndian i 


Station 


— continued. 




i 
1 


•-> 


1 








Royal Alfred 

(First 

Commission) 


1 




• 

i 
> 


»4 

< 

1 




1 


1 


3 


23 


1 


9 


21 


23 


G 


19 


7 


144 

1 

217 

31 

265 

64 

12 

10 

8 




9 

11 
8 


13 
23 


7 

8 
3 


8 

12 
4 

1 


9 
G 

1 


2 
1 
6 
2 

1 


6 

8 

2 
6 

3 


6 
16 

1 


9 
2 
7 

2 


6 
26 
69 

2 

1 

1 


23 

29 
6 
2 


- 


- 


- 


- 


- 


- 


1 


- 


1 


- 


2 


10 


— 


- 


1 


- 


- 


1 


1 


- 


- 


- 


- 


7 


_ 


3 




, 


. 


2 


. 




1 




2 


9 


1 « 


^ 


2 


9 


2 


2 
9 


20 


9 


6 


"" 


8 


3 
123 




- 


•- 


- 


- 


- 


- 


- 


- 


2 


1 


- 


4 




2 


4 


1 


1 
3 


'l 


2 


2 

7 


4 


1 
1 


2 

4 


7 


8 
57 






1 












1 






1 


7 




— 


— 


1 


• 


- 


~ 


— 


•« 


1 


— 


— 


2 






1 














3 






8 




40 
22 


70 
23 


34 
8 


36 
17 


61 
3 


11 
6 


76 
21 


41 
16 


48 
28 


44 
26 


61 
36 


949 
310 




1 


2 


3 


~ 


.. 


^ 


6 


1 

4 


6 


3 


4 


2 
48 




• 


— 


"" 


— 


— 


*" 


"• 


1 


1 


— 


"" 


2 




6 


11 


^ 


_ 


13 


. 




1 


3 


6 


21 


103 




- 


- 


- 


- 


- 


- 


(.)"l 


- 


- 


2 


- 


6 
2 




38 

1 


39 

1 


29 
3 


66 
2 

1 


38 
6 


36 


113 

1 


66 

1 


79 

1 


66 
2 


51 
2 


888 

29 

8 




273 


308 


131 


310 


216 


147 


394 


248 


266 


429 


416 


6,210 



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122 



MEDICAL STATISTICAL RETURNS OP THE 



Table, No. 6. 



Showing the Names of the Ships ; the Average Complements, &c. ; the Number of 

Men Sick Daily, in each Ship -, 



P.O. Paid off. 



C. Coi 



Rate,&c. 


NAMES 

of 
SHIPS. 


Where 
Coromitiioned. 


When 
Commissioned. 


Number 

of 
Guns. 


Tonnage. 


Horse 
Power. 




Iron Clad - 


Defence - 


. S.C. 


Devonport • 


18 Jan. 1868 


16 


3,720 


S. 600 






Favorite - 


-P.O. 


Sheemesa - 


8 Feb. 1866 


10 


2,094 


S. 400 






Royal Alfred - 


-P.O. 


Portnnouth 


15 Jan. 1867 


18 


4,068 


8. 800 






Royal Alfred - 


- c. 


Halifax - 


I Sept. 1869 


18 


4,068 


S. 800 




Fourth Rate 


Doria - 


-P.O. 


Devonport - 


5 Feb. 1866 


24 


2,483 


S. 800 






Phoebe - 


.S.C. 


Devonport - 


6 May 1867 


30 


2,896 


8. 600 




Sixth Rate • 


Eclipse - 


. 


Sheemesa - 


2 June 1868 


6 


1,273 


S. 360 






Jason - 


- 


Devonport - 


7 May 1866 


17 


1,711 


S. 400 




Sloop- 


Barracoota 


. . 


Sheernew - 


18March]866 


6 


1,063 


P. 300 






Niobe - 


- 


Woolwich . 


11 Feb. 1867 


4 


1,083 


S. 300 






Royalist - 


- 


Woolwich - 


14 Jan. 1868 


3 


669 


S. 160 






VoaUl . 


- 


Devonport • 


26 Jan. 1867 


4 


1,081 


S. 300 




Gun Vewel - 


D;irt - 


. ^ 


Portsmouth 


27 Aug. 1866 


5 


428 


S. 80 






MuUet - 


- 


Sheemesa - 


6Msy 1866 


5 


430 


S. 80 






Philomel 


- 


Woolwich • 


21 April 1868 


3 


664 


S. 160 




ReeeiTing Ship - 


Aboukir - 


- 


Jamaica 


I April 1867 


86 


3,091 


S. 400 




Floating Battery 


Terror - 


- 


Bermuda ^ 


1 Jan. 1868 


16 


1,971 


S. 200 





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NORTH AMEBIC AN AND WEST INDIAN STATION. 



123 



Table, No. 6. 



Cases ; the Total Number of Days' Sickness on Board ; the Average Number of 
and the Number Discharged to Hospital. 









S. 


C. Station changed. 










PMiod. 


Average 

Com- 
plemenU. 


Average 
Com. 
plements 
corrected 
for Time. 


Number 

of 

Cases of 

Disease and 

Injury. 


Number of 

Days* 

Sickness 

on Board. 


Average 
Number of 
Men Sick 

Daily 
for Twelve 

Months. 


Ratio 

per 1,000 

of Average 

Force of 

each Ship. 


Number 
Discharged 

to 
Hospital. 




1 AprUtoSlDec. 


445 


335 


672 


4^59 


13-5 


40-2 


88 




1 Jan. to 25 Aug. 


265 


165 


273 


3,219 


8*8 


63*3 


12 




1 Jan. to 31 Aog. 


660 


440 


394 


6,126 


14- 


31-8 


8 


1 Sept to 31 Dec. 


770 


255 


248 


2,462 


6-7 


26-2 


7 




1 Jan. to 16 Jane 


500 


230 


152 


1,253 


3*4 


14-7 


7 




1 Jan. to 30 June 


545 


270 


147 


2,729 


7-4 


27-4 


3 




Y«T 


1S5 


185 


221 


2,166 


5-9 


31 '8 


9 




Year 


260 


260 


308 


3,315 


9- 


34-6 


4 




Year 


190 


190 


173 


1,869 


51 


26-8 


20 




Year 


155 


155 


310 


1,934 


5-2 


33-5 


24 




Year 


125 


125 


265 


2329 


7-7 


61-6 


9 




Year 


155 


155 


416 


3,743 


10-2 


65-8 


26 




Year - - 


65 


65 


105 


904 


2-4 


36-9 


14 




Year 


65 


65 


131 


1,057 


2-8 


43- 


7 




Year 


80 


80 


215 


2,058 


5-6 


70- 


19 




Year - - 


195 


195 


751 


5,637 


15-4 


78-9 


. 162 




Year 


330 


330 


429 


2,25S 


61 


18-4 


128 



384. 



N 4 



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124 MEDICAL STATISTICAL BETUBNS OF THE 



SOUTH EAST COAST OF AMERICA STATION. 



South East The squadron on the South East Coast of America^ during the 
Coast of year 1869, comprised eleven vesssels, viz., one fourth-rate; one 
StaUoD^ Bixth-rate ; one sloop ; three gun-vessels ; two steam vessels ; two 
■■ gunboats ; and one receiving ship permanently stationed at Rio de 

Janeiro. There was also a small detachment of marines at the 
Falkland Islands. The Returns from four of these vessels and from 
the Marine detachment are for the whole year, and from the re- 
mainder of the vessels for periods varying from three to eight 
months. The mean force corrected for time was 930, and the total 
number of cases of disease and injury entered on the sick-list 1,402, 
which is in the ratio of 1507*5 per 1,000, being a decrease compared 
with the preceding year equal to 1 1 -9 per 1,0(K). Of these nineteen 
were invalided and twenty died, the former being in the ratio of 
20*4, and the latter of 21*5 per 1,000. The invaliding rate is 
abnost precisely the same as that of the previous twelve months, 
but there is an increase in the death-rate to the extent of 6* per 
1,000. 

The average daily loss of service from General Diseases, Section 
A,, or Febrile Group, was in the ratio of 5*7 per 1,000; from Section 
B., or Constitutional Group, 3*7 ; from diseases of the nervous system 
and organs of the special senses, '7 ; of the circulatory system, '3 ; 
of the absorbent system and ductless glands, '4 ; of the respiratory 
system, 3*7 ; of the digestive system, 6*1 ; of the urinary and gene- 
rative systems, '7 ; oi the organs of locomotion, '3 ; of the cellular 
tissue and cutaneous svstem, 8*6 ; from unclassed diseases, *5 ; and 
from wounds and injuries of various kinds, 9*4. The average 
number of men sick daily was forty-one, which is in the ratio of 44* 
per 1,000 of force, being a reduction compared with the preceding 
year equal to 8*1 per 1,000. 

L General Diseases.— Section A., or Febrile Group. 

Class I. Under this head 203 cases of various forms of febrile disease were 

Sect A. entered on the sick-list,* viz., six of typhus fever ; three of enteric 
fever ; seventjr-eight of simple continued fever ; six of yellow fever ; 
sixty-eight of ague ; forty of remittent fever : one of cholera, and 
one of mfluenza. Of these, both cases of typhus fever, two of 
enteric fever, four of yellow fever, and the case of cholera, proved 
fatal. 

Typhus Fever. — All the cases of this form of fever occurred in the 
Nassau. It is doubtful whether the disease was, however, true 

typhus 



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SOUTH EAST COAST OF AMERICA STATION. 125 

typhus fever. The surgeon* of the vessel says, that during their South East 
stay at Rio de Janeiro, where they had arrived from the Straits Coast of 
of Magellan, on the 20th of Mav. " Six cases of continued fever America 
of a very virulent type occurrecl among the men, two of which Station. 
ended fatally after six days' illness. Of the six cases four occurred Class I. 
among the marines. The first case was entered on the 2nd of June. g^^^ j^ 
The patient, a marine, stated that he was seized suddenly with 
violent headache and pain in the back and loins whilst engaged in 
drawing provisions from Her Majesty's ship Egmont. He had been 
a eood deal exposed to the sun. Next day another marine and an 
orainary seaman were put on the list. Both these ended fatally. 
They had been on leave on shore a few days before. On the 7th 
another case occurred in an able seaman who had been out of the 
the ship. The ship sailed from Bio on the 9th, and on the 10th and 
12ih respectively two marines were entered on the list. Both these 
had contracted the disease before the ship sailed. No fresh cases 
occurred after this date. 

'^ Though I have entered these as cases of typhus fever, the disease 
was of a peculiar type, and only in one case was there any eruption 
observed. In most cases violent headache and pain in the back and 
loins were the first symptoms complained of, followed rapidly by 
great prostration in the cases that ended fatally. In one case there 
was irritability of the stomach and vomiting of bilious matter before 
death. The patients generally retained consciousness to the last, 
though there was often low delirium at night. The favourable cases 
made a good recovery after the|average of thirty days on the sick-list. 

'^ All the cases were treated on board, as they would not be re- 
ceived on board the hospital ship Egmont, and there was no suitable 
place on shore. They were screened off under the topgallant fore- 
castle on deck, and separated from the rest of the ship's company. 

" I am of opinion that the infection was introduced by the men 
who had been on leave on shore at Rio, where the disease prevailed 
to a considerable extent, as one of these men was ill for two days 
before he presented himself." 

In the only one of these cases which showed any eruption it was 
merely a slight red efflorescence on the forehead and neck, and 
does noes not appear to have been in any way characteristic of true 
typhus. 

Enteric Fever. — Three cases of this form of fever appeared in the 
squadron ; one in the Beacon, one in the Cracker, and one in the 
Narcissus. Of these the case in the Cracker, and that in the Nar- 
cissus, proved fatal. 

In the Beacon the case of enteric fever occurred at Asuncion, in 
the person of a boy who was in daily communication with the shore 
for some time previous to admission. The attack was a slight one, 
no eruption was observed, but the type of fever was decidedly 
enteric. He was twenty-three days on the sick-list. 

The 



* Surgeon Samuel Campbell, m.d. 
384. 



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126 MEDICAL STATISTICAL RBTUBN8 OP THE 

South Eatt The medical officer* of the vessel observes : — " Enteric fever 
CoMt of does not seem to have been endemic in the Paraguay, but to have 
Stat*"^* made its appearance with the Brazilians. There can be no doubt 

' that once generated in the Brazilian camp, all the conditions favour- 

Olaisl. *^^® ^ ^^ extension were present. At Asuncion, as at Palma 
Sect a! (where we were stationed in 1868), there was a complete neglect of 
all sanitary precautions. Animal refuse of every aescription was 
allowed to collect in and about the town ; so that after the place had 
been occupied about a month or two by the army, it might be said 
to be a collection of concentrated impurities.'' 

The case of enteric fever in the Cracker occurred in the person of 
an ordinary seaman who had suffered when in Paraguay from the 
diarrhoea so prevalent on board, having been on the sick-list from the 
25th to the 31st of January, and again from the 20th to the 24th of 
February. It subsequently transpired that, although continuing to 
do duty and making no complaint, he did not regain much strength 
after the last attack, despite the improved climate of Monte Video, 
and the superior food attainable. He was again placed on the sick- 
list on the 5th of March, stating that in the two previous evenings he 
had suffered from cold chills subsequent to fever, irritability of 
stomach, and colicky diarrhcea during the day. He had, neverthe- 
less, made no complaint, and on the evening of the 4th had pulled in 
from the outer to the inner anchorage at Monte Video, getting wet 
through owing to the heavy sea at 3ie time. The medical officerf 
says : — . . " he was a quiet, reserved, zealous man, unwilling to 
complain on account of the heavy sick-list at the time on board." On 
the 8th the tongue was very red, fissured, and dry ; the skin was hot, 
the pulse 100, small and weak ; there was slight uneasiness on pres- 
sure over the rieht iliac fossa, and some suspicious rose-coloured 
spots about the abdomen. In the evening he had had four stools 
" pea soup" in appearance ; there was less fever, and the skin was 
active, but he had a troublesome tearing cough. On the 9th the 
report was *^ Delirious during night, answers questions unsatisfac- 
torily ; when left alone mutters to himself; he has a fevered dusky 
appearance ; no action of bowels during the night ; tongue clean, 
bnght red, dry and fissured; pulse 100, very weak; skm hot and 
pungent; some uneasiness, with gurgling, on pressure over right 
ileo coBCfd valve. Troublesome cough ; viscid rusty sputum ; defec- 
tive respiration over base of right lung posteriorily, with crepitation 
and dulness in percussion." 

The case being one of undoubted enteric fever, witii intercurrent 
pneumonia, he was at once removed to sick quarters at Monte Video, 
where he died on the 18th of March. 

On post-mortem examination of the body " there were several 
characteristic patches of ulceration situated principally at the lower 
end of tiie small intestine ; the mesenteric glands were enlarged ; 
there was no perforation ; the spleen was large and friable. There 

was 

^ AssiBtaiit Sargeon J. T. Oomerford, m^d. 
j- Assistant Sargeon Alexander Tumbull, x.d. 



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SOUTH EAST COAST OP AMEBICA STATION. 



127 



WM general congestion of both lungs/ posteriorly, with hepatization 
of their bases, most extensive on the right side. 

" No other case occurred among the crew, nor was this fever pre- 
valent on shore. In that case, as well as in all cases of dysentery 
and diarrhoe^ great care was taken to have all the discharges mixed 
with a solution of carbolic acid, with which all the utensils and 
waterdosets were frequently cleaned." 

The third fatal case of enteric fever occurred in the person of a 
non-commissioned officer of Marines, of the Narcissus. He was 
placed on the sick-list on the 8th of May, the vessel being then at 
sea, five days from Bio de Janeiro, bound for England. He had 
been on shore.at Bio on the 25th of April for ten hours. Fever was 
nrevalent on shore at the time, and several deaths from yellow fever 
W been reported. 

When he presented himself he complained of headache, rigors, 
pain in the back and extremities, general debility, and complete 
anorexia ; in fact, he had the ordinary symptoms of simple continued 
fever, which was prevalent in the ship at tne time. His symptoms 
gradually became aggravated, without, however, presenting the 
characteristic features of enteric fever. There was no abdominal 
tenderness, and no eruption, and although diarrhoea was pre- 
valent^ the stools were not typical of enteric fever. He died on 
the 20th day, and the post-mortem examination of the body showed 
the pathognomonic lesions of the disease. The intestinal mucous 
membrane generally was much congested and of a dark colour, and 
Peyer's patches were deeply ulcerated, especially at the lower part 
of the ileum. The ulcers had thickened edges, with sloughy 
centres, and were, some of them, as large as a florin. 

Simple Continued Fever. — Seventy-eight cases of simple con- 
tinuedTfever occurred in the squadron, the vessels in which they 
prevailed most being the Cracker, the Egmont, the Greyhound, and 
the Narcissus. Some of them appear to have been of considerable 
severity. The average duration of each case was about ten days, 
but many ran a much longer course. In the Narcissus the average 
duration of each case was twenty-three days, and one case in the 
Cracker, which the medical officer says might more properly have 
been classed as enteric, was thirty-eight days under treatment. 

Yellow Fever. — Six cases of this fatal form of fever were entered 
on the sick-list. They all occurred in the Egmont, the stationary 
receiving ship at Bio de Janeiro, and of the six, four proved fatal. 

The surgeon* of the Egmont has furnished the following report 
on the outbreak of yellow fever at Bio de Janeiro in 1869, and on 
the cases on board that vessel. " Yellow fever made its appearance 
amongst the merchant shipping at Bio early in April 1869, but 
through what means it was miported I am unable to say, although 

I have 



South East 

Coast of 

America 

Station. 

Class I. 
Becv* A< 



384. 



^ Surgeon Thomas McCarthy. 



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128 MEDICAL STATISTICAL EETURNS OF THE 

South East I have taken every means in my power to ascertain. A very 
Coast of general feeling appeared to prevail at Rio that it had been brought 
Stotion* Aere by an Italian merchant ship named Creola del Plata^ which 

* arrived with passengers from Buenos Ayres, She had originally 

Glass I. cleared from Genoa, and having remained for about thirty days at 
Sect. A. Porto Praya, in Santiago, one of the Cape de Verd Islands, whicn was 
free from fever, arrived at Rio on the 23rd of March. There had been 
sickness on board, and 120 of the passengers continued the voyage 
in one of the London, Belgian, and Brazilian steamers, which sailed 
on the 26th or 27th of March. On the 9th of April the sailors 
complained to the Italian Consul that they were all sick with 
* vomits.' The same day a passenger who had been removed to a 
hotel on shore, died ; and on the same day the mate, on being re- 
moved to the Misericordia Hospital, died on entering the hospital. 
A request was sent to the Italian Consulate for permission to make 
a post-mortem examination of the body, in order to ascertain if the 
disease was yellow fever or not. The examination was made, but 
decided nothing. Three more sailors and one more passenger also 
died, but only one on board the ship. With the exception of the 
master, two boys of fifteen years of age, and one sailor, the whole 
of the crew of nineteen persons, and three passengers were attacked, 
and of these, six died. 

" As before mentioned, the idea prevailed very generally that this 
ship brought the disease to Rio, but it is evident mat she was only 
the ship on board of which the fever was observed or detected first. 
No ship during the year was placed in quarantine. No yellow flag 
was at any time hoisted by a merchant ship in the harbour, for 
if it had, it would have been immediately observed on board the 
Egmont. May not the admission to pratique of the ship that im- 
ported the disease have been the means of communicating it to the 
merchant vessels immediately surrounding her, and from whom it 
then gradually spread ? 

^^ From this time cases continued to occur on board the merchant 
shipping, but not very numerously. As they occurred they were at 
once removed to the Government Hospital devoted to the reception 
of infectious diseases, none being allowed to remain on board, but 
no quarantine was at any time established. The disease, however, 
did not spread on shore to any extent, nor appear to create any 
alarm in the city amongst the inhabitants, nor have I been able to 
discover any instance where it attacked any of the attendants on 
the sick. 

** The proportion of deaths to recoveries was about one to three, or 
one to four, varying somewhat, and being rather higher in those 
cases treated in the Government Hospital than in those treated in 
private ones ; the only reason for which, I conceive to have been, 
that the patients had a great -dread 6f going to the public hospital, 
being impressed with a sense of fear that they would not recover 
there, which induced a state of despondency unfavourable to recovery, 
an unfounded fear, for the hospital was well ventilated, beautifully 
clean, and nothing could exceed the kindness of the sisters of mercy 
who act as nurses to the sick. The disease has all along, with but 

few 



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SOUTH EAST COAST OF AMEBICA STATION. 129 

few exceptions^ been confined to sea-faring men, Norwegians, Danes, South East 
English, Germans, a few French, and Portuguese. It principally Coast of 
attacked persons between the ages of fifteen and thirty-five. Station* 

** Scarcely any females were attac&ed, but an English medical man ' 

in practice in the citjr, told me that he had attended one woman, and ^^ J* 
that he knew of another that was seized with the disease. They were ^^ ^ 
married, pregnant, and both died. The symptoms generally consisted 
of firontal headache, great pains or throbbing of the eyeballs, which 
frequently presented a sumised appearance, pain across the small 
of the back and in the thighs, and a sense ot general discomfort ; 
rigors followed by fever of an ardent type, usually in the young, 
and generally aggravated towards night ; great thirst, cold water 
being generally preferred to any other drink ; nausea and epigastric 
tenderness when emetics had been administered, in the begmnii^ 
more especiaUy. The urine was always deep coloured, and of high 
specific gravity, and in bad cases nearly always albuminous. There 
was great general restlessness, but the countenance did not usuaUy 
denote mental anxiety, but rather apathy. There was seldom mucn 
delirium, except in bad cases, and tnen usually of a low muttering 
character, but I saw one or two cases in which there was some diffi- 
culty in inducing the patient to remain in bed. The appearance of 
yellowness of the surmce varied much, sometimes not snpwing imtii 
after death ; in other cases a lemon hue of skin over the forehead, 
and of the eyes could be seen on the second or third day ; sometimes 
more or less general discoloration of the whole surface of the body. 
The tongue, at first covered with a brown or white coat, became after 
the fifth or sixth day red about the edges, and sometimes dry. In 
bad cases ecchymosis formed on the eyelids, and petechias on the 
neck^ back, abdomen, and shins. Occasionally blood would be 
detected in the urine, and in all fatal cases suppression of that 
secretion occurred towards the end. 

" Black vomit seneraUy came on about the third or fourth day, 
sometimes not until the sixth or seventh, and I saw one fatal case m 
which it suddenly appeared on the eleventh, and when the patient 
appeared convalescent about half an hour before it set in. It was 
always at first of a coffee-ground appearance, sometimes assuming 
gradually the consistence of tar or treacle. Occasionally the stools 
assumed this character, and in two cases on board the Egmont a 
large quantity of it was passed per anum after death. The tendency 
to death was generally by syncope, but occasionally death was 

!>receded by convulsions. The duration of the disease was usually 
rem four to twelve days, and in favourable cases frequently an 
eruption of boils formea towards the termination. The stools 
were never found free from bile, and the bowels, in those cases which 
I had an opportunity of watching, were invariably loose throughout. 

After some observations on treatment, in which nothing novel 
appears, he continues : *^ General bleeding was never employed, and 
leeches, which at the commencement oi the epidemic were used 
whenever a suffused condition of the countenance or the presence 
of head symptoms indicated them, had to be given up, on account 
of the great difficulty experienced in staunching the bleeding from 

384. the 



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130 MEDICAL STATISTICAL BETUBNS OF THE 

Soath East the bites. Turpentine in small doses was sometimes given and found 
Coast of useful. Fomentations, turpentine stupes, sinapisms, cold applica- 
StoSStt* tions, ice, &c., were all employed according as their use was 

' indicated. 

Class I. -^^ to the effect the administration of medicine had on the progress 

Sect A. or termination of the disease, the opportunities I had of forming an 
opinion were too few to enable me to judge. The worst cases 
hurried on to a fatal issue quite uninfluenced by any treatment. 
In the milder ones, I believe Uie use of quinine to have been most 
beneficial, after the liver had been unloaded and free action of the 
bowels set up by the use of mercurial and saline purgatives. 

The first t>vo cases which appeared in the Egmont were in the 
persons of a marine and a mess servant, one of whom was placed on 
the sick-list on the 20th of July, and died on the 28th, vomiting 
latterly from time to time small quantities of nearly black vomit 
of about the consistence of treacle and of a very offensive smeU. 
This man had been on shore on leave on the 12th for about four 
hours in the afternoon, coining on board sober before sunset. It 
was not ascertained where he had gone to whilst on shore. He had 
only recentiy joined the ship from England. 

The next case occurred in the mess servant. He was placed on 
the sick-list on the 30th of July. His duties frequentiy took 
him on shore. His case did not appear to be an urgent one on board 
ship, but as some yellowness of the skin and conjunctiva appeared 
on the 2nd of August, it was thought better for the safety of the 
ship's company to remove him to the fever hospital, wmch was 
accordingly done. There he progressed most favourably, and on the 
evening of the 13th or 14th tne surgeon on visiting him con^tu- 
lated lum on the great improvement which had taken place in his 
case. He was very cheenul and wished much to be allowed to 
walk in the garden, which he had been promised he should in a few 
daye. The surgeon had scarcely left the hospital, when black 
vomit suddenly came on ; lasted during the night, and in the morn- 
ing he died. He was a strong, florid, healthy young man who had 
been for some time on the station. 

No other cases occurred on board the Egmont until the middle 
of December, the health of the ship's company during the interval 
being comparatively good. The surgeon continues " The fever 
amongst the shipping had considerably decreased, and the proportion 
of deaths was much less. On the 4th of December the Egmont 
was hauled into the Imperial Dock for the purpose of having a very 
serious leak in her bows, under water, repaired, which it was neces- 
sary to have done as soon as possible, as the constant working at 
the pumps twice daily, for the purpose of keeping her tree, was 
trying very heavily the strength of a very small diip's company, 
only about ninety men (the Egmont being a two-decker), most of 
whom had other heavy duties to perform in hoisting in and out 
stores. It was expected that she would only have been a couple of 
days in dock, but was unavoidably detained for eight days* The 
dock is close and hot, being excavated from the solid rock of Cobrasi 

having 



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SOUTH EAST COAST OF AMEBIC A STATION. 131 

Vmying a northern aspect, and being consequently deprived, to a Soaih East 
great degree, of the benefit of the sea-breeze. The health of the S^** *./' 
ship's company remained good. Whilst there, quinine in four-grain gtoSonT 
doses, in port wine, was issued morning and evening, and continued - — ' 
for a fortnight after leaving. Extra issues of rum, lime-juice, and Gmb L 
cocoa were served out daily. The weather was exceptionally cool for Sect A. 
the season in which the smp was in the dock, which was flooded every 
night ; nevertheless, a disagreeable smell was perceived by many, 
chiefly at night. There being no one on the sick-list at the time, 
most of the Slip's company were berthed in the sick bay, which is 
situated beneatn the top^^allant forecastle, and is spacious, airy, and 
splendidly ventilated Tne ship was hauled out into die stream on 
the 12tb." 

On the 15th an able seaman presented himself, complaining of 
frontal headache, which he ascribed to exposure to the sun during 
the day, whilst employed alongside the landing-place, waiting for 
stores. Febrile symptoms of some severity set m, but there was 
no vomiting until the afternoon of the 18th, when he vomited four 
times, the matters ejected being black. Suppression of urine took 
place during the night. Black vomit continued at intervals, and on 
the morning of the 19th he died, the skin and coi^unctiv» having 
assumed a faint yellow hue. 

Following this case, three others occurred, one on the 17th, one 
on the 18th, and the last on the 20th. The two former made good 
recoveries, although in one there was much restless and noisy deli- 
rium^ but the last case proved fatal. It occurred in a young officer 
of a delicate habit of body, who had recently ioined the ship. lie 
died on the 23rd, death being preceded by copious black vomiting, 
and by suppression of urine. In none of these cases is any reference 
made to the urine being albuminous or otherwise, from which it may 
be presumed that it was not tested. 

Referring to the cases of yellow fever which occurred in the 
Egmont, the medical officer of the Cracker makes the following 
observations: " Shortly after our arrival at Rio, viz., on the 19th 
and 23rd of December, two cases of yellow fever terminated fatally 
on board the Egmont. The ship had been placed in dock on Cobras 
Island on the 4th, and removed to an anchorage alongside Euchadas 
Island on the 18th, the ship's company imfortunately being retained 
on board in this the hot and rainy season. Prior to her entry into 
dock, a party of men from Her Majesty's ship Pylades had been 
berthed on board the Egmont, assisting to clear her. They returned 
to their own ship on the Egmont being docked, and no sickness 
occurred amongst them. The cases of yellow fever on board the 
Egmont, four in all, were entered on the sick-list either in the dock 
or within three days of her leaving it, after which no fresh case was 
entered before the end of the year. At the time, I considered the 
fever resembled the outbreak on board Her Majesty's ship Bristol, 
in January 1866, viz., a fever with all the recognised symptoms of 
specific yellow fever, including albuminous urine, and suppression 
of urine ; but at the same time not contagious, and nothing subse- 

384. quently 



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132 MEDICAL STATISTICAL BETUENS OF THE 

South East quendy arose during our stay in Rio to alter my opinion. The fever 

^^<>^ was apparently due to local causes arising in or near the dock on 

Station. Cobras Island. I say near^ because the shipping in the inner har- 

hour suffered severely from the same fever at the same time ; more 

Class I. severelv, I was informed^ than had been the case for ten years past. 

Sect A. while tihe shipping in ihe outer harbour were exempt, ana very few 
cases were reported in the city. 

^^ On making inquiries among the medical men on shore, I found 
they did not consider the fever conta^ous. They anticipated, how- 
ever, that it would increase, and probably become epidemic during 
the intensely hot and unhealthy months of February and March. 
They attributed the present outbreak to the great heat of the wea- 
ther, associated as it was with much rain, and damp sultry weather, 
and all condemned the inner harbour as an anchorage at this season, 
and under existing circumstances. They considered the fever to be 
of a malarious type. 

" The immunity from sickness enjoyed by the crew of the Pylades 
employed on board the E^ont prior to her entry into the dock, the 
sudden apparent arrest oi the disease on board the Egmont on her 
leaving the dock, and moving to a comparatively better position in 
the inner harbour, the exemption from the disease enjoyed by all 
those in constant attendance on the sick, although not protected by 
a previous attack, were the chief grounds for my considering the 
disease of a malarious and non-contagious character, and due to local 
miasmata arising in or near the dock. 

" I nevertheless considered it my duty to represent to the com- 
mander of this vessel that it was desirable to prepare for sea with i^ 
dispatch, so that should the disease appear on board, we might be 
ready to leave Rio at once. When m the following month, viz., 
January 1870, two fresh cases arose on board the Emiont, then at 
anchor in the inner harbour, alongside Euchados island, chieflv 
used as a coal dep6t, one of which cases terminated fatally, with 
black vomit, &c., on tiie 18th ; although 1 saw no reason to alter my 
views as to the nature of the fever, I represented to the commanding 
officer that many more experienced medical men considered the dis- 
ease was contagious, and as we had been in constant communication 
with Her Majesty's ship Emiont, receiving men and stores, and 
obliged to send working parties to her even on the I8th, I considered 
it advisable to quit Kio at the earliest possible opportunity. We 
consequently left on the morning of the 19th with a clear sick-list. 
The true nature of the fever on ooard the Egmont cannot be deter* 
mined at present'" 

These sound and practical observations are very much to the 
purpose, and it reflects great credit on this officer that he did not 
allow the theory he h^ assumed to be correct, to influence his 
judgment, but giving the benefit of the doubt to the ship's company 
tinder his medical charge, counselled a prompt retreat from the pre- 
sence of an enemy whose invasion is always attended with disastrous 
results. 

Affue. 

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SOUTH EAST COAST OF AMERICA STATION. 133 

Ague. — Sixty-eight cases of intermittent fever were entered on South East 
the sick-list during the year, of which fifty-six occurred on board Coast of 
the Beacon, and were attributable to the malarious influences of the gJJ^onu 

Biver Paraguay. The medical officer says : " Fifty-six cases of ague 

occurred. Of these, forty-five were added at Asuncion, and eleven (jiagg I. 
ifterwards. Those latter, however, all occurred in subjects who Sect A. 
liad previously suffered from the disease at Asuncion. All were 
mild cases of the quotidian type, with the intermissions distinctly 
marked ; most suffered from only one or two paroxysms, but one 
tedious case from five. The men were kept on the list, and quinine 
conlintied to be given for three or four days after tiie paroxysm 
ceased. Average time on sick-list 5*5 davs. In one case which was 
invalided, the aguish attack was slight, but seemed to induce, in a 
weak constitution, such obstinate dyspeptic symptoms, that, although 
no organic disease was present, it was deemed advisable to invalid 
him and give him the benefit of a complete change of climate. On 
our arrival at Asuncion on the 20th of February the river was very 
low, and consequently lar^e portions of marshy ground were exposed 
to the sun. About the nuddle of March the river began to rise, and 
continued rising until the beginning of May ; from which time, till 
the date of our leaving, it remained stationary. 

Between the 1st and 20th of March, ten cases of ague were added ; 
from Maith the 20th to April the 20th no case occurred ; between 
the latter date and the time of our leaving, the 10th of June, thirty- 
five were added. 

It will be seen that on our first arrival, while the river was low, 
ten cases occurred ; that as soon as the river began to rise, and the 
low land was covered, no additions were made for a month, and that 
after the river reached a certain height ague reappeared. The 
only explanation that occurs to me of the reappearance of the 
disease, when the swampy land was in great part covered, and the 
weather getting cooler, is that, as the river continued to rise, the 
banks got broken down, and the river forcing its way into the Gran 
Chaco, dislodged larffe masses of decomposing vegetation, which 
then floated down with the current. 

Those masses (called by the Paraguayans " Camelotes") continued 
to descend the river from the middle of April until we left. In their 
course, considerable quantities were brought by the current across 
the bows of the shipping. The quantity thus accumulated during 
a day was often sufficient not only to form a large collection about 
the DOW, but to extend aft as far as the gangways, and was of such 
solidity that the men could walk about on it. It generally occupied 
the ship's company three or four hours every morning in removing 
the accumulation of the previous day. The odour arising from 
these camelotes was very offensive, and I think the fact of our 
having been for two months almost constantly exposed to their 
influence accounts for the large number of cases of malarious 
disease added during that period." 

He elsewhere says : — " Quinine was not given as a prophylactic 
at Paraguay, because the medical men at Buenos Ayres, and also 
two of Mie medical officers of the Para^ayan army, with whom I 
had an opportunity of conversing, gave it as their opinion that such 

384. proceeding 



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134 



MEDICAL STATISTICAL BSTURNB OF THfi 



South East 
Coast of 
America 
Station. 

ClaML 

Sect A. 



proceeding would be useless. Ships ordered up the river ought to 
provide wemselves with an extra ailowanoe of quinine. During 
the four months we were therei although great care was taken not 
to waste any, thirteen ounces were used. To preserve the health of 
the crew while at Asuncion, no general leave was given; condensed 
water was used for drinking and culinary purposes; care was taken 
not to expose the men to the sun during the heat of the day ; an 
extra allowance of coffee was served out in the morning, and mos- 
quito curtains were supplied to the men, as without them it would 
be almost impossible to sleep* I think this last measure prevented a 
great deal of sickness, not onl^ from the ulcers produced by mosquito- 
bites, which are always slow in healinff,but also from the debility in- 
duced by want of sleep* We remainedat Monte Video a month after 
coming down the river. During this time the health of the crew did 
not appear to improve, and they continued to present a debilitated 
appearance ; we were ihen sent to cruise outside the mouth of the 
Kiver Plate. This was attended by a marked^improvement, and the 
health of the ship's company became in great measure re-established.'" 

On the influence of the climate, and the concomitants of the River 
Paraguay, on the health of our seamen, at the time the Cracker and 
and JSeacon were employed at Asuncion, the medical officer of the 
former vessel observes : — ** From our own experience, that of the 
Beacon, and of the foreign vessels — ^men of war— -serving in Para- 
guay, it is evident that malaria has much to do in producing, or 
markedly modifying, the majority of the diseases met with in the 
Kiver plate and its tributaries, especially the Paraguay, although 
I hardly think it does so to such an extent as to justify or call ^r 
a regular daily issue of quinine during service in that nver. Such 
was the opinion of the medical men I consulted, who had lengthened 
experience of service on the banks of the Paraguay, and dthough 
at one time I doubted the soundness of their views, further experi- 
ence has led me to coincide with them. Service in Paraguay, if 
confined to the cool months, June, July, and August, would not 
prove very, if at all, injurious to a ship's crew. 

" On our first arrival in Para^ay, warned by the experience of 
others as to the extremely debilitating effects of the climate of 
Paraguay, more especially during the summer season, great atten- 
tion was paid to the preservation of the health of the crew ; the 
ill-effects of an exceedingly high temperature, with intense burning 
sunshine, were guarded against by means of awnings, and cessation 
from all heavpr drills or work not absolutelv necessary. 

" One temble source of suffering to tne crew, one which none 
but the actual sufferers can thoroughly appreciate, was the swarms 
of mosquitos infesting the ship from sunset to sunrise. The men 
being unprovided with mosquito nets (the only effective protection), 
passed the greater jpart of the night in walking the deck unable to 
rest. Instead of night being welcomed as a period of rest and 
repose, after exhaustion from the heat and labour of the day, its 
approach was dreaded, and daylight anxiously looked for as the 
only termination to their sufferings. The bad effects of such nights 
upon the sick were very apparent, and it was found necessary to 
envelope the cots and hammocks in flags. As it was advisable to 

do 



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SOUTH EAST COAST OP AMEBIC A STATION. 136 

do as mach ne possible of the absolutely essential work in the early Soutli East 
morning and in the evenings^ the men were allowed from noon to Coast of 
lialf'pMt three in the afternoon for rest. Even this was seriously gJJJJin^ 

distorbed by the swarms of flies infesting the ship in the day- * 

tone. Claasl. 

" The citjr of Asuncion was at this time occupied by the Allied •©<'*• ^ 
Army^ consisting of Brazilians, Argentines, and Uruguayans, with 
witfi a host of sutlers, mule-drivers, «c., in attendance. Owing to 
a total absence of all sanitary arrangements, the filthy condition of 
die city and its environs may be more easily imagined than described, 
Sewage matter of every description was thrown into the streets, or 
lay exposed in the courts, &c., immediately adjoining. Dead horses, 
mules, and cattle, lay about in every direction, exposed to the rays of 
a tropical sun, and carrion crows were the only scavengers. No leave 
was given to the crew, and the vessel was anchored more than half-a- 
mile off the Asuncion bank of the river. Much sickness, especially 
dysentery, dysenteric diarrhoja, and diarrhoea and fever prevailed 
among llie merchant shipping in the riv(^, and the residents on 
shore. 

" The nourishment of the crew was defective. On our arrival 
no vegetables could be procured; and the flesh of over-driven 
cattle being the only fresh meat to be had, the ordinary sea rations, 
with lime-juice, were issued in preference until towards the end of 
January ; vegetables were then obtained, as well as somewhat better 
beef, which were subsequently served out. Owing to the very exor- 
bitant price of vegetables, and of supplies of all kmds, the men were 
unable to supplement their service ration of inferior fresh beef and 
vegetables, which, poor as it was, seemed preferable to the salt meat 
ration. As the service ration of vegetables, half a pound minus all 
waste, when unassisted by private supplies, appeared to me, as it 
always has done, so very inadequate, lime-juice was continued as an 
issue, during our service in Paraguay. The biscuit was much dete- 
riorated by climate, though of this the men made no complaint. 
The men were always provided on turning out of a morning, either 
with an extra allowance of cocoa or their breakfast. 

" From the above it will be seen that the crew were exposed to 
aHi • the ill-effects of an intense tropical climate, in a fresh-water 
river, far inland, surrounded by vast tracts of flooded and recently 
flooded marshy lands, rapidly drying up, and their strength seriously 
impaired by want of sleep and defective food. Under these cir- 
cumstances, it can hardly oe a matter of surprise that much sickness 
resulted, which, in itself, had a dispiriting effect upon the men, 
aggravated as it was by the monotonous uninteresting nature of the 
service on which they were employed, and the uncertainty as to how 
long that service would last. 

" At the commencement of the year, and until the 12th of Janu- 
ary, no sickness of any consequence occurred on board. Then three 
cases of sunstroke occurred, and the sick-list rose rapidly, the cases 
being those of dysentery, diarrhoea, remittent fever, &c. On the 
24th of January a mild, though distinct, case of quotidian ague was 
entered. The man had suffered formerly from dysentery in China, 
but never before from ague. Some difficulty was experienced at 
first in classifjring some of the cases accurately^ as to wnether they 
should be classeu as remittent fever or diarrhoea* Subsequent ex- 

384. O 2 perience, 



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136 



MEDICAL STATISTICAL RETUBNB OF THE 



South East 
Coast of 
America 
Station. 

Class I. 
Sect A. 



perience^ however, induced me to classify as remittent fever all 
those doubtful cases which were accompanied by mild fever and 
headache of a more or less periodic or remittent character, vertigo, 
persistent anorexia, and subsequent ansemia, even though attended 
with diarrhoea. After our departure from Paraguay and return 
to Monte Video, cases of remittent fever, ague, diarrhoea, dysentery, 
and jaundice occurred, and to my mind were strong evidence of the 
malarious poisoning to which the crew had been subjected in Parar 
guay, and from which vessels stationed at Monte Video and Buenos 
Ay res are apparently not exempt. 

^' Although the officers suffered much less than the men, they 
did not entirely escape, and their greater immunity may have arisen, 
in great measure, from their better diet, and more perfect rest, owing 
to their possessing mosquito nets." 

Such topographical observations as these are very interesting and 
extremely valuable to those who may hereafter be called upon to 
serve in we same locality. 

Remittent Fever. — Forty cases of this form of fever were entered 
on the sick-list, twenty-three of which occurred in the Cracker. Of 
the total number of cases, thirty-two were due to service in the 
River Paraguay. The chief characteristic of the disease was the 
debility which followed it, and the tedious convalescence. The 
average duration of each case was about three weeks. 

Cholera.— A single and fatal case of what is returned as cholera 
maligna occurred in the Egmont, in the person of a delicate-looking 
boy who had only recently Joined the ship from England, who was 
placed on the sick-list at Kio on the 6th of May. He was brought 
to the sick-bay early in the morning of that day by one of the ship's 
police, who had found him lying on the form in his mess, and seeing 
nim looking very ill brought him up. His lips were blue; there 
was a blue tinge below the eyes, and the skin was cold. He sud 
that he had had frequent vomiting and purging during the night, 
which had ceased at 4 a.m. He nad no vomiting after coming to 
the sick-bay ; his skin got warmer, and his bowels were not moved 
until^ 1 p.m., when he passed a large white watery stool. The 
reaction was, however, only temporary, the surface gradually 
becoming again cold, notwithstanding assiduous friction, and con- 
stant application of warmth by means of hot bottles, blwkets, and 
heat over the epigastrium. Warm brandy-and-water was given 
from to time, as well as ammonia and ether. Chlorodyne in small 
doses was given, and appeared to raise somewhat the volume of the 
pulse, but only for a moment. The features assumed the pinched 
appearance, the breath the coldness, and the skin the clammy, 
corpse-like feel characteristic of the disease. He gradually sank, 
ana died at 2 p.m. At the moment of death a very large rice-water 
stool passed away. 

II General Diseases.— Section B., Constitutional Group* 

Seventy-eight cases of various forms of disease appear in this 
section, of which sixty-two were cases of rheumatism. One case of 
rheumatism, and two of phthisis proved fatal. The majority of the 

cases 



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SOUTH EAST COAST OP AMEBICA STATION. 137 

cases of rheumatism occurred in the Nassau^ which was employed South East 

Burrejing the Straits of Magellan. The average duration of each Coast of 

case was about twelve days. ^™^^ 

^ Station. 

Syphilis, Primary and Secondary. — Only six cases of the former Class II. 
and seven of the latter form of disease were under treatment during Sect B. 
the twelve months. Combined, however, they involved a loss of 
490 days' service. 

nL Diseases of the Nervous System and (h^^ans of the 
Special Senses. 

Under this head, thirty-eight cases of different forms of disease Class IIL 
were entered on the sick-list, of which three were invalided, and 
three proved fatal. 

Apoplexy. — A fatal case of apoplexv occurred in the person of a 
stoker of the Narcissus, an old man of a verv irritable temper, and 
worn-down constitution, but generally speaking temperate in his 
habits. After eating a verv hearty supper of preserved meat on the 
evening of the 22nd March, the ship being then under steam, he 
went on duty into the stokehold at 8 p.m., and very soon after was 
seen to stagger and fall. He was brought at once up to the 
sick-bav in an unconscious state, with violent muscular spasms 
and dilated pupils, in which condition he remained about four 
hours^ when he rallied, and on the following evening was quite con^ 
seious. -At 11 a.m., after taking some beef-tea and wine, he fell 
back in his bed and expired. No examination of the body after 
death took place. 

Tetanus. — A fiital case of this disease occurred in the person^of a 
voung ordinary seaman of the Cracker, who, on the 6th of Septem- 
ber, at Asuncion, in shoving off his boat from the shore, trod on a 
broken bottle and received a slight wound across the ball and outer 
side of the right great toe. The cut was half an inch long and only 
akin deep ; it bled freely, and no sand or broken elass could be 
detected in it ; its edges were brought together by aahesive plaster, 
and water dressing applied. On Uie 13th the wound had healed 
and he was discharged to duty. On the 14th, a small portion of the 
cicatrix was found to have opened ; it was dressed, and he continued 
at his duty, wearing his shoes, and on the 18th the wound had 
again healed. On the 19th the ship reached Buenos Ay res, having 
Idft Asuncion on the 11th. On uie evening of the 19th he was 
re-entered on the sick-list. He stated that he had knocked the cica- 
trix, which appeared tender and irritable. Poultices were applied. 
Thefurtherhistoryof thecase is better given in the report of the medical 
o£Bcer of the vessel. "20th September. — Complains of pain of 
chest at lower end of sternum. There was no constitutional dis- 
turbance, and no importance was attached to this pain, doubtless 
diaphragmatic, and tne first indication of the ^rave nature of the 
case : however, this was not recognised at the tune, but as he stated 
that early in the morning of the 17th, when sleeping in his hammock 
slung on deck, be was so cold he was compelled to turn out and go 

384, 3 below. 



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138 MEDICAL BTATISTICAL RETURXg OF THE 

S th Ea t ^^^^"^^ *^® P*^"^ ^*® considered to be rheumatic. The wound is atUl 
Coaat of tender ; continue warm poultices. 21st September. — Has passed a 
America restless nighty which he attributes to the pain in chest. He was 
Station. ordered to keep his hammock, and a sinapism to be applied to seat of 

pain. No change in the appearance of the cicatrix. 1 p.m. — He 

Class in, gent for me and complained that on attempting to turn in his ham- 
mock ' his shoulders had been frozen stiff.' Tnere was no muscular 
spasm present when I reached his hammock, but the pulse was much 
accelerated, and he was bathed in perspiration. The bowels were 
constipated. At 1.15 p.m., the spasms returned^ affecting the muscles 
of the nape of the neck, shoulders, and arms, shortly followed by 
partial opisthotonos. The cicatrix was laid open and examined, but 
no foreign body could be discovered in it. 

^' As there could be longer any question as to the very serious 
nature of the case, he was at once removed to the British Hospital, 
Buenos Ayres, where he arrived at 3.45 p.m., by which time there 
was well-marked opisthotonos; the stemo-mastoid, fadal, and 
abdominal muscles were also involved. Pulse seventy-six. 8kin 
perspiring profusely. Bowels confined. 

" 22nd September. — On visiting him this morning the resident medi- 
cal officer kindly furnished me wim the following report Shortly after 
his admission the spasms increased rapidly m frequency and in- 
tensity, and in the evening there was complete opbthotonos, the 
body resting on the occiput and heels, with every appearance of an 
immediate latal termination. A blister had been applied to the 
nape and over the upper dorsal vertebrae, with ice to the loins, 
Cdomel and jalap, and turpentine enemata, had been employed, but 
unsuccessfully. Croton on was then ordered, and a free evacuation 
of the bowels obtained. Bromide of potassium was given in scruple 
doses at short intervals. At 7 p.m„ sub-cutaneous division of the 
inn^r branches of the internal plantar and musculo-cutaneous nerves 
was performed, after which the severity of the symptoms was 
greatly lessened. Prior to the operation an excessively sensitive 
spot was observed at the external end of the cicatrix, pressure on 
which induced violent spasms ; this at once ceased on section of the 
nerves, but an excessive irritability of all the superficial nerves on 
both sides of the body was observed. 

" After the operation, the bromide was discontinued, and the tinc- 
ture of belladonna given in frequent small doses. 

** ITiis morning his face was flushed; bathed in sweat; pupils 
slightly dilated. He expressed himself as easier. He had slept at 
intervals during the night. Pulse seventy-six ; respiration twenty- 
eight. The spasms occur at longer intervals and are less violent ; 
one was induced during my visit by attempting to drink, but this 
is not always so, and he had been able to take a fair amount of fluid 
nourishment, wine, milk, beef-tea, &c. 

** 23rd September. — On visiting him this morning, I learned that 
the tincture of belladonna had been continued until there was dry- 
ness of the fauces, slight dilatation of the pupils, and delirium, but 
no sensible improvement resulted ; on the contrary, there had been 
a slight exacerbation towards the evening as on the previous day 
when the belladonna was discontinued and the bromide again given. 

He 

Digitized by VjOOQIC 



SOUTH EAST COAST OF AMJIEICA STATION. 139 

He passed a fair night, sleeping at intervals. The spasms were South East 
milder, chieflj afTeoting tie shoulaers, nape of neck, and face. Pulse Coast of 
eighty; breathing twenty-eight; bowels acting; urine passed ^^^lolT 
freelj. ' 

" Early this forenoon a sudden change for the worse occurred ; the (Jiggg jji 
breathing became shallow and hurried, and he died in the after- 
noon. 

^' The ship sailed the same day for Monte Video, and no examina- 
tion of the body was made." 

In remarking on thii ptunful case, the same officer observes : ^^ Te- 
tanus is very common in the Argentine Confederation and Paraguay 
(and Brazil also, I believe). It is much dreaded by all civil and 
military surgeons in the two former countries. The idiopathic and 
traomatic varieties are both met with. Trismus neonatorum is very 
common and fataL Tetanus was most common in the military hos- 
pitals in Paraguay during the cold season, and in Buenos Ayres the 
medical men are inclined to associate it with 'pamperos,' a cold 
southerly wind common to this country and Paraguay. The case 
just detailed appeared to suffer from evening exacerbations ; to be 
of an intermittent type, which mi^ht be due to exposure to marsh 
miasmata in Paraguay, during bis first and only visit to tliat 
country. 

'^ I am not aware that the importance of epigastric pain shooting to 
the back,— diaphragmatic pain, — is generally recognised as one of 
the earliest and most characteristic premonitory symptoms of this 
disease. In the case on board this ship, thb symptom was present 
some tliirty hours before the neck or jaws were affected ; stiffness 
and pain of which are stated in the text-books to be the ^rst symp- 
toms of the disease. A medical friend at Buenos Ajrres of con- 
siderable surgical experience, however, considers this epigastric or 
diaphragmatic pain as the first indication of the disease, and lays 
down the following axiom as the result of his experience at Buenos 
Ayres : ' Epigastnc pains shooting through the spine after wounds 
indicates the onset of tetanus, whereas prcecordial distress under 
similar circumstances indicates pysBmia.' " 



IV. Diseases of the Ciraulatory SjrsteiiL 

There is very little to be said under this head. Four cases only Class IV. 
of functional disease of the heart were entered on the sick-list, and 
of these one was invalided. The average duration of each case was 
between thirty-two and thirty-three days. 



V. & VI* Diseases of the Absorbent System and Duetless 

Glands. 

Seven cases of sympathetic bubo, and two of inflammation of the Classes 
lymphatics, were entered on the sick-list, and came under this head. 7. & VI- 
They were of no special interest ; the total number days' sickness 
resulting from them was 168. 

384. O 4 



Digitized 



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140 MEDICAL STATISTICAL BETUBNS OF THE 

^Sft^ Vn. Diseases of theBespiratory System. 

Stotion. Under this head 183 cases were entered on the sick-list, of which 

— -^ 171 were ordinary catarrh. From all diseases one person was 
ClaM Vll. invalided and three died. Of the deaths, one was from bronchitis 
and two from pneumonia. There was nothing to call for observa- 
tion in connection with the diseases in this class. 

VnL Diseases of the Digestive System. 

Class ym. Three hundred and twenty^nine cases of various forms of disease 
appear under this head, but they fortunately caused little loss to the 
service by invaliding, and none by deaths The most important affec* 
tions were dysentery and diarrhoea, of which there were fifteen cases 
ofthe former and 179 of the latter. Of these the Cracker alone re- 
turns twelve case of dysentery and fifty-ei^ht of diarrhoea. The 
medical officer states that three ofthe cases of ^sentery would perhaps 
more appropriately have been classed as dvsenteric diarrhoea, or even 
as fi^ver with enteric complication, but tnat whatever their correct 
classification might t^e, they were, he was convinced, the results of 
malarious poisoning, quite as much as the cases of remittent fever and 
ague that were occurring at the same time, and he attaches much import- 
ance to the opinions of those who look on most of the dvsentery and 
diarrhoea met with in the rivers Paraguay, Parana, ana Plate as of 
malarious origin. Ofthe cases of diarrhoea he states that the greater 
number and me severest cases were met with during riv^r service, 
more especially in Paraguay, during the hot season. Tlieir duration 
varied from two to sixteen days, and they were evidently, he thinks, 
due to climatic and local causes, in connection with uiat service. 
They were characterised by severe colic and troublesome tenesmus ; 
thin, liquid, coffee-coloured dejections ; in one case vomiting and rice- 
water stools, but no cramps or collapse. Mild aperients, astringents, 
opiates, and quinine were the chief remedies employed ; the btter, 
combined with Dover's powder, being highly beneficial. 

In the Beacon, in which there were two cases of dysentery and 
seventeen of diarrhoea, the medical officer observes that both cases 
of dysentery occurred at Asuncion. " In one the dysentery 
symptoms were complicated by remittent fever, the spleen became 
enlarged and the man was invalided. The other, a healthy Marine, 
was sent to duty after thirty-six days' illness. The dysenteric 
symptoms were not urgent, but a strong tendency to remission was 
observed, hence the t^iousness of the case. Neither of these men 
had been on shore, and they had no opportunity of committing any 
irregularity on board. The crew had n*esh meat five times a week, 
and condensed water alone was used on board. It would appear, 
therefore, that these cases were caused by the general malarious 
influences to which the ship was exposed at Asuncion." He states 
further, that in the dysentery and oiarrhoea opcurring at that place, 
quinine was the most valuable remedial ageni 



Digitized by Vj005l^ 



SOUTH EAST COAST OF AMERICA STATION. 141 

South East 

DL ft X. DiBeases of fhe Urinary and Oenerative Systems. Coast of 

^ ^ Amenca 

There is nothing of a noteworthy character in the returns under Station, 
this head. The only diseases entered on the sick-list were ^ __. 
gonorrhoea, of which there were six cases, stricture three cases, and ^^^% 
orchitis five cases. The total days' sickness from these diseases was 
323, which gives an aven^ duration of about twenty-three days 
to each case. 

XL Diseases of the Organs of Loeomotion. 

There was nothing of the slightest importance under this head. Class XI. 
The cases were chiefly various forms of bursitis and synovitis. 

XIL & Xm. Diseases of fhe Cellular and Cutaneous 

Two hundred and seventy-eight cases of various forms of disease classes Xn. 
were entered on the sick-list under this head. Of these, 212 were atttt. ' 
boils and abscesses, and fifty-three were ulcers. The average dura- 
tion of each of these cases of the former afiection was between nine 
and ten days, and of the latter, seventeen days. Many of the ulcers 
were caused by mosquito bites. 

Unclassed Diseases. , 

Under this head appear ten cases of debility, from climatic cachexia 
chiefly, and three cases of alcoholic poisoning. 

Wounds and Injuries. 

A man sustained fatal fracture of the skull by falling from a pier ; 
and a man was drowned by falling overboard from aloft. These 
were the only fatal casualties in the squadron during the year. 

The total number of deaths was twenty, which is in the ratio of 
21*5 per 1,000 of force, being an increase, compared with the preced- 
ing year, equal to 6* per 1,000. This increase was altogether owing 
to the prevalence of febrile diseases, and especially of yellow fever. 

Invaliding. 

In General Diseases, Section A., one person was invalided for 
the sequelae of remittent fever ; and in Section B., one for phthisis 
pulmonalis. Three persons were invalided for diseases of the 
nervous system and organs of the special senses ; one for diseases 
of the circulatory system ; one for diseases of the respiratory system ; 
five for diseases of the digestive system ; four for unclassed diseases ; 
and three for wounds and injuries of various kinds. The total 
number invalided was nineteen, which is in the ratio of 20*4 per 
1,000 of force, being almost precisely the same invaliding rate as in 
the previous year. 



384. 

/'Google 



Digitized by ^ 



142 



MEDICAL STATISTICAL BETUBNS OF THE 



Tablb, No. 1. 

Showing the Number of Caies of all Dibbasbb and Injuries, and the Number 
Invaudkd and Dead, with the Ratio per 1,000 of Force. 





Cuei. 


Iiivdided. 


Dead. 


DISEASE OR INJURY. 


Number. 


Ratio 

per 
1,000 

of 
Force. 


Number. 


Ratio 

1,000 

of 
Force. 


Number. 


Ratio 

per 
1,000 

of 
Force. 


I. General Diseases, Seetion A. : 




■ 










Typhus Feyer 
Enteric Fever 
Simple continued Fever - 
Yellow Fever 

Ague 

Remittent Fever - 

Cholera 

Influenza . . . - 


6 

3 

78 

6 

68 

40 

I 

I 


6-4 

3-2 

83-8 

C-4 

781 

43- 
X- 
1- 


1 


1- 


2 
2 

4 

1 


21 
21 

4-3 
1- 


II. General Diseases, Section B. : 














Rheumatism - - - - 
Gout 

Phthisb Pulmonalis 


63 
1 

6 
7 
2 


66-6 
1* 
6-4 
7-6 
21 


1 


1 


1 
2 


1- 
21 


m. Diseases of fheVervonsSrs- 
t4)ni, and Organs of the 
Special Senses: 










• 




Apoplexy - - . - 
Sunstroke . - - - 
Paralysis - - . - 
Vertigo 

Epilepsy - - . . 
Neuralgia - - - - 
Insanity - - 
Diseases of the Nervous System 
Diseases of tlie Eye 
Diseases of the Ear 


2 

3 

16 

1 


1- 
7-6 

1- 
1- 

7-5 
2-1 
3-2 
161 
1- 


I 

1 

1 


1- 


1 
1 

1 


1- 
1- 

1- 



Digitized by 



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SOUTH EAST COAST OF AMERICA STATION, 



143 



Table, No. 1.— Showing the Number of Cases of all Diseases, 4cc continued. 



DISEASE OR INJURY. 



IV. Diseases of the Circulatory 
System: 



T. ft VI. Diseases of the Absorb- 
ent System and Ductless 
Olanos: 

Bobo (Symp.) - - - 
Glandular System - 



Vn. Diseases of the Eespiratory 
System: 



Catarrh - 

Hsmoptysis - - - 

Other biseases of the Lungs 



Vm. Diseases of the Digestive 
System: 

Cynanohe - - - - 
Dyspepsia - - - - 
Dysenteiy - - - - 
Diarrhoea - - . . 
Colic and CoDstipation - 
Hiemorrhoids . - - 
Worms - - - - - 
Other Diseases of the Stomach, 

&c. - - - - 
Diseases of the Liyer, Spleen, 

&c. - -, - 



IX. ftX. Diseases of the TTrinary 
and Generative Systems : 

Gonorrhoea - - - - 
Stricture - - - - 
Orchitis , - - - 

384. 



Cmm. 



Niunber. 



7 
2 



171 

1 

11 



38 

68 

15 

170 

18 

4 

2 



6 
3 
5 



Ratio 

per 
1,000 

of 
Force. 



4-3 



7-5 
21 



183*8 

1- 
11-8 



40-8 

781 

161 

192-4 

19-3 

4-3 

21 



6-3 



6-4 
3-2 
6-3 



Invalided, 



Number. 



Ratio 

per 
1,000 

of 
Force. 



Dead. 



Number. 



3'2 
1- 



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144 



MEDICAL STATISTICAL BETUBNB OF THE 



Table, No. 1.— Showing the Number of Cases of all Diseases, &c. — continued. 





Ctaee. 


Invalided. 


Dead. 


DISEASE OR INJURY. 


Number. 


Ratio 

1,000 
of 
Foice. 


Number. 


Ratio 

1,000 

of 
Porce. 


Number. 


Ratio 

per 
1,000 

of 
Force. 


XI. Diseases of the Organs of 
Locomotion: 

Diseases of the Bones, Joints, kc. 

Xn. & XIII. Diseases of the 
Cellular Tissue and Cuta- 
neons System: 

Phlegmon and Abscess - 

Ulcer 

Erythema . - - - 

Diseases of the Skin 

Scabies - - - - 

TTnclassed: 

DebiUty - - . - 
Poisoning - . . - 

Wonnds and Injuries : 

Wounds, Injuries, &c. - 
Bums and Scalds - - - 
Submersion and Drowning - 


7 

212 

63 

1 

3 

9 

10 
3 

236 
9 

1 


76 

227-9 

66*9 

1- 

3-2 

9-6 

10-7 
3-2 

263-7 
9-6 
1- 


4 
3 


4-3 
8-2 


1 


1- 
1- 


Totals - - - 


1,402 


1,607-6 


19 


20-4 


20 


21-6 



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HEDICAIi STATISTICAL BETUBNS OF THE 



145 



Table, No. 2. 

Showing the Number of Days' Sickness from each Disease and from Injuries, the 
Average Nomber of Men Sick Daily, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



L General Diseases, Section A.: 

Typhus Fever 
Enteric Fever 
Simple continued Fever - 
Yellow Fever 
Ague - - . . 
Remittent Fever - - 
Cholera- ... 
Influenza ... 



n. General Diseases, Section B.: 

Bheumatism - - - . 
Gout 



Phthids Pulmonalis 



in. 



Diseases of the Hervona S;s* 
tern, and Organs of the 
Special Senses: 

Apoplexy - - - - 

Sunstroke ... 

Paralysis . - - - 

Vertigo - - . - - 

Neur^a . . . - 
Insani^ . . - - 
Diseases of the Nerrons System 
Diseases of the Eye 
Diseases of the Ear 



384. 



Number of Days' Sickness 



OnBoutl. 



136 
47 

772 
26 

357 

795 

1 

10 



620 
14 
245 
222 
139 



1 
72 

1 

2 

55 

11 

23 

139 

4 



In Hospital. 



10 



131 



23 
28 



23 
30 



39 

2 

10 



Total. 



186 
67 

772 

26 

367 

795 

1 

10 



761 
14 
245 
245 
167 



24 

72 

30 

1 

2 

56 

50 

26 

149 

4 



Arenge Nnmber of 
Men Sick Daily. 



Nnmber. 



•3 

•1 

21 

•9 
21 



•6 
•6 
•4 



Ratio 

per 

1,000 of 

Force. 



•3 
•1 

2-2 

•9 
2-2 



21 

•6 
•6 
•4 



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146 



MEDICAL STATISTICAL RETURNS OF THE 



Table, No. 2. — Showing the Number of Days' Sickness from each Disease, &c. — cont"^. 




Number of Days* Sickom 


Men Side Daily. 


DISEASE OR INJURY. 










Ratio 




On Board. 


InHoq>ital. 


Total. 


Number. 


1,000 of 
Foroe. 


IV. Diseases of the (Krcnlatory 
Sjriteni: 












Heart -J 


53 


76 


129 


•3 


•3 


V. ft VI. Diseases of the AbsorV 
ent System and Ductless 












Bnho (S^p.) 


125 


36 


161 


4 


•* 


Glandular Diseases 


7 


" 


7 


— 


_ 


vn. DiseasesoftheEcspiratory 
System! 












Catarrh 


898 


- 


898 


2-4 


2-5 


Hemoptysis - - - - 


19 


- 


19 


— 


— 


Other Diseases of the Lungs - 


471 


- 


471 


1-2 


1-2 


VUl. Diseases of the' Digestive 
System: 












Cjnanche . - - - 


186 


- 


186 


•5 


•5 


Dyspepsia - - - - 


422 


16 


• 438 


1-2 


1-2 


Dysentery - - - - 


333 


145 


478 


1-3 


1*3 


Dianrhcea - * - . - 


909 


28 


937 


2-5 


2-6 


Colic and Constipation - 


87 


- 


87 


•2 


•2 


Hemorrhoids . - - 


35 


- 


35 







Worms - - - - - 


18 


- 


18 


■ 


_ 


Diseases of the Stomach, kc. - 


-* 


48 


48 


•1 


•1 


Diseases of the Li?er, &c. 


106 




106 


•2 


•2 


IZ.&X. Diseases of the Vrinary 
and Generative Systems : 












Gonorrhoea - - - - 


210 


• 


210 


•5 


•5 


Stricture - - - . 


36 


-. 


36 






Orchitis . ^ ^ . 


77 




77 


2 





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SOUTH EAST COAST OT AMEBICA STATION. 



147 



Table, No. 2. — Showing the Number of Days' Sickness from each Disease, &c. — cont^. 





Number of Days* Sickness 


Average Number of 
Men Sick Daily. 


BISBASE OR INJURY. 


/ " '■ ■ ■" 
On Board. 


In Hospital. 


Total. 


Number. 


Ratio 

per 

1,000 of 

Force. 


XL Diseaies of the Organs of 
Locomotion: 

Diseases of the Bones, Joints, 
&c. 

XIL ft Xm. Diseases of the 
Cellnlar Tissue and Cuta- 
neous System: 

PM^;mon and Abscess - 

Ulcer 

Erj'thema - - - - 

Diseases of the Skin 

Scabies - - - - - 

Unelassed: 
DebiUty 
Poisoning - - - - 

Wounds and Injuries : 

Wounds, Injuries^ &r. - 
Bums and Scalds - - - 


126 

2,018 

901 

6 

69 



100 
49 

2,932 
92 


16 
38 

242 


140 

2,018 

901 

6 

69 

47 

160 
49 

3,174 
92 


•3 

6-5 
2-4 

•1 
•1 

•4 
•1 

8-6 
•2 


•3 

6-9 

2-6 

•1 
•1 

•4 
•1 

li-2 
•2 


Totals - - - 


14,036 


940 


14,976 


41- 


44 



384. 



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148 



MEDICAL STATISTICAL RETUBNS OF THE 



Table, No. 8. 

Showing the Number Invalided fVom each Ship on the South East Coast of 

America Station. 



CAUSE OP INVALIDING. 



I. General Diseases, Section A. : 
Remittent Ferer 

n. General Diseases, Section B. 
Phthisis - - . - 



in. Diseases of the Hervons System and 
Organs of the Special Senses : 



Vertigo - - - - - 
Diseases of the Nerfous System 
Diseases of the Eye ... 



IT. Diseases of the Circulatory System: 
Fanctional Disease of the Heart 

Vn. Diseases of theBespiratorySystem: 
Diseases of the Lungs ... 



Vni. Diseases of the Digestive System : 

Dyspepsia - . - - - 
Dysentery - . . . - 
Diseases of the Stomach, &c. - 

Vnclassed: 

Debility 



Wonnds and Injuries : . 
Wounds - 



Total - 



I 






I 
I 



I 



1 



J 

3 



19 



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SOUTH EAST COAST OF AMEKICA STATION. 



149] 



Table, No. 4. 

Shoeing the Number of Dbaths in each Ship employed on the South East Coast of 

America Station. 



CAUSE OF DEATH. 



-3 



§ 






S 



L General Diseases, Section A. : 
Typhus Fever - - - 
Enteric Fever - - - 
Yellow Fever - - - 
Cholera .... 



n. General DiBeases, Section B. : 
Bheumatism - - - 
Phthids . - - - 



in. Diseases of the Vervous System and 
Organs of the Special Senses : 
Apoplexy ------ 



Paralysis - - - - - 
Diseases of the Nervous System - 

Vn. Diseases of the Sespiratory System 
Diseases of the Lungs - . - - 



(a)l 



Wounds and Injuries : 
Wounds 
Drowned - 



Total 



(a) Tetanui. 



2 
2 

4 
1 



20 



384. 



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150 



MEDICAL STATISTICAL BETUBNS OF TH£ 



Table, No. 6. 

Showing the Namber of Casbs of all Diseases and Injuries in the Ships employed 
on the South East Coast of America Station. 



DISEASE OR INJURY. 


a 

1 

66 
9 

5 

1 

2 
80 


j 


J 


1 


1 

'a 

4 

2 

2 


If 

i 

1 
3 


& 


1 


1 


2- 


1 

I 


i 


.J 

< 

1 


I. General Diseases, Section A. : 
Typhus Fever - - - 
Enteric Fever . . - 
Sunple contmued Fever - 
Yellow Fever 

Ague 

Remittent Fever - - - 
Cholera - - . - 
Influenza - * - - 

n. General Diseases, Section B. : 
Rheumatbm - - - - 
Gout 

sypj^«{£3ry : : 

Phthisis Pulmontlis 

m Diseases of the Hervons 
System and Organs of 
the Special Senses : 
Apoplexy - "- - - 
Sunstroke - - . - 
Vertigo - - - - - 
Epilepsy - . - - 
Neuralgia .... 
Insanity - - - - 
Diseases of the Nervous System 
Diseases of the Eye 
Diseases of the Ear 

IT. Diseases of the Circulatory 
System: 
Diseasesof the Heart, Functional 

V. & VI. Diseasesof the Ahsor- 
bent System and Duct- 
less Glands: 
Buho (Sywip.) . - . 
Glandular System - - . 

VU. Diseases of the Respiratory 

System: 

Catarrh - - . . 

Uoemoptysis - - - - 

Other Diseases of the Lnngs - 


1 
21 

6 
23 

5 
6 

3 

1 

1 
(a)i 

2 



17 

6 

1 

1 
I 

1 
5 


13 

7 
1 
2 

1 

1 

1 

8 

1 

2 

16 
4 


1 
23 

5 

11 

1 
2 

1 

2 

2 

1 

76 
1 
6 


6 
2 

21 

2 

1 
2 

4 


1 
3 

3 

4 
5 

1 

13 


1 

1 
1 

1 

1 
7 


1 

4 

1 

1 
3 


1 

2 

1 

5 

1 


6 
3 

78 

6 

68 

40 

1 
1 

62 
1 
6 
7 
2 

1 
7 

1 
1 

I 

3 

15 

1 

4 

7 

2 

171 

1 
11 



(a) Tetanus. 



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SOUTH EASt COAST 0$* AMERICA STATION. 



161 



Table No. 5. — Showing the Number of Cases of all Diseases and Injuries, &c. — cont^. 



DISEASE OR INJURY. 


i 


1 


4i 

1 


1 


J 


ii 


1 


^ 


1 


J 


1 


1 


J 

^ 

1 


Vm. Diseases of the Digestive 
System: 




























Cynanche - - - - 
Dyspepsia - - - - 
Dysentery - ^ - - 
Diarrhcea - - - - 
Colic and Constipation - 
Haemorrhoids ... 

Worms 

Diseases of the Liver^ Spleen, 


2 

1 


7 

7 

12 

58 

6 

2 


1 
37 

19 


9 

16 
1 
2 

1 
2 


2 




14 
5 

36 

7 


1 
3 

5 

1 


4 
6 
1 

7 
2 

I 


1 
7 

5 

1 


2 

14 

I 
1 


1 
1 


38 

68 

15 

179 

18 

4 

2 

5 


IX.ftX. Diseases of the Vrinary 
and Oeneratiye Systems : 




























Gonorrhoea - - - - 
Stricture - « . - 
Orchitis- - - - - 


1 


- 


1 


2 
1 


- 


^ 


3 
1 
2 


• 


1 


1 


1 


: 


6 
3 
5 


XI. Diseases of fhe Organs of 
Locomotion: 




























Diseasesof the Bones, Joints, &c. 


- 


2 


- 


3 


- 


- 


1 


- 


- 


- 


1 


- 


7 


Xa. A Xni. Diseases of the 
Cellular Tissue and Cu- 
taneous System: 




























Phlegmon and Abscess - 

Ulcer 

Erythema - - - - 

fHseases of the Skin 

Scabies 


15 
9 


32 
4 

1 
8 


12 

3 

1 


33 

10 

1 

1 


- 


1 


62 
18 

1 


19 
3 


9 
3 


14 
2 


12 


3 

1 


212 

53 

1 

3 

9 


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4 


1 


1 


1 


- 


^6)3 


1 


- 


- 


1 


1 


- 


10 
3 


Wounds and Injuries : 




























Wounds, &c. - - - - 
Bams and Scalds - - - 
Submersion and Drowning - 


14 
1 


11 
3 


18 
I 


25 

1 


2 


1 


107 
3 
1 


21 


IG 


7 


13 
56 


1 


236 
9 
1 


Total - - - 


168 


23-2 


126 


166 


12 


9 


394 [91 


80 


51 


17 


1,402 



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OP THE PACIFIC STATION. 153 



PACIFIC STATION. 



The squadron on the Pacific station^ in the year 1869^ comprised Pacific 
thirteen vesseb^ yiz,, one ironckd; one fourth-rate; four sixth- Statioiu 
rates; three sloops; three gun-vessels^ and one storeship perma- """" 
nently stationed at Valparaiso. There was also a small detachment 
of marines on the Island of San Juan de Fuca. The returns irom 
eight of the vessels and from the marine detachment were for the whole 
twelve months^ and from the remaining vessels for periods varying 
irom six to nine months. The mean force corrected for time was 
2»330, and the total number of cases entered on the sick-list 3,39 1« 
wiich is in the ratio of 1455 '3 per 1,000 of force, being a reduction 
compared with the preceding year equal to 199*1 per 1,000. Of 
these, fifty -nine were invalided, and thirty died ; the former bein^ 
in the ratio of 25-3, and the latter of 12-8 per 1,000. Compared 
with the vear 1868 there was a reduction in the invaliding rate to the 
extent of 12*2 per 1,000, but the ratio of mortality was higher by 
4-8 per 1,000. 

The average daily loss of service from General Diseases, Section 
A., or Febnle Group, was in the ratio of 2*2 per 1,000; from 
Section B., or Constitutional Group, 17*1 ; from diseases of the ner- 
vous system, and organs of the special senses, 1*2 ; of the circulatory 
system, *3 ; of the absorbent system and ductless glands, 1*3 ; of the 
respiratory system, 4*7; of the digestive system, 3*9; of the urinary 
W generative systems, 3*8 ; of the cellular tissue and cutaneous 
system, 11* ; from unclassed diseases, 3* ; and from wounds and in- 
jwies of various kinds, 9*2. The average number of men sick 
daily was 135*8, which is in the ratio of 58*2 per 1,000 of force, 
being a reduction compared with the preceding year, equal to 5 '2 
per 1,000. 

L General Diseases.— Section A., or Febrile Group. 

Under this head. 111 cases of various forms of disease were entered Class I. 
on the sick-list, viz., twentv of small-pox ; three of enteric fever; Sect A. 
seventy of simple continuea fever ; thirteen of ague ; four of remit- 
tent fever, and one of erysipelas Of these, one case of ague was in- 
valided ; and two cases of enteric fever, and one case of simple 
continued fever proved fatal. 

384. P 3 Small-^ 



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154 MEDICAL STATISTICAL BETUBNS 

Pacific SmalUpox. — All the cases of this disease occurred in the Cameleon. 

BtatioD. The history of the epidemic is thus given by the surgeon* of the ship. 
" The first case occurred on the let of April, in the person of a 

Class I. seaman belonging to No. 2 mess ; the second occurred m the same 

^^^^ mess, on the 23rd; the third, on the 27th, in No. 11 mess; the 
fourth, on the 28th, in No. 13 mess : the disease then appeared in the 
steerage and ward-room, and finally, with an irregular course, spread 
over the lower deck ; the captain's cabin, gun-room, engineer's mess, 

and Nos. 3, 12, 14, 15 and 17 messes alone escaping. 

« 

" Two cases presented formidable symptoms, namely, that of a 
petty officer, a dark-complexioned man, a native of St. Helena, and 
that of the ward-room steward, a Mulatto, a native of Jamaica. 
The premonitory fever and pains in each were most severe, accom- 
panied with wandering delirium. The pustules were confluent on the 
&ce and extremities." ... ^^ As the cases occurred they were 
immediately segregated below the topgallant forecastle, and duly 
screened off, having for attendants men who had previously suffered 
from the disease, and all possible communication with the remainder 
of the ship's company prevented till arrangements were made with 
the Pacific Steam Company for the use of Morro Island, where 
ample house accommodation for the officers and healthy portion of the 
crew, and hospital accommodation for the sick, were obtained. The 
hospital is situated on the very summit of the island ; I should say at 
the least 400 feet above the level of the sea. It is built of iron, is 
well ventilated, and has a good verandah surrounding the house, with 
detached cook-house, waterclosets, and bath room. On the morning 
of the 4th of May the sick were landed, and the remainder of the 
ship's company on the following day. Between the 5th and the 
20ih of May the ship was twice battened down, and fumigated with 
chlorine gas, the ship's company's beds and bedding being suspended 
from the beams of the lower deck, and between those dates the 
lower decks were scraped and whitewashed frequently, and all due 
attention paid to ventilation, &c. Before the disembarkation of the 
crew all moveable articles from the holds, lower deck, and cabins 
were removed to the upper deck when the ship was permitted to 
remain with open hatches, lower deck ports, &c. till the 10th of May, 
when she was again battened down and fumigated as before, the 
hatches remaining closed for twenty-four hours. The same operation 
was gone through on the 15th, and from the 17th working parties 
were daily sent off to the ship, for the purpose of thoroughly 
cleansing, painting and whitewashmg the vessel before the embarka- 
tion of me officers and healthy portion of the crew, which took place 
on the 31st of May, on which date two officers were discharged from 
hospital, and sent on board. 

" Eight patients were discharged from hospital on the 2nd of 
June, leaving ten under treatment. One ran from hospital on the 
3rd, an engmeer's cook, who wUs nearly well. He haa entered at 
Panama a snort time previously, and has not since been heard of. 

The 

• Sui^geon F. A. Brice, m.d. 

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OF THE PACIFIC STATION. 155 

The nine remaining persons were, in compliance with an order from p ,n 
the Commander in Chief, embarked on the evening of the 7th of station. 
June. Four of them were again segregated under the forecastle, — - 

as desquamation was incomplete, and the remaining five were dis- Class I. 
charged to light duty. On the morning of the 9th of June the ^^^ ^ 
Cameleon sailed from Tobago for Esquimault. 

*' Before the discharge of these patients from hospital, all their 
wearing apparel, as well as bed and bedding, were inunersed in boil- 
ing water, to which permanganate of potash was added, and after- 
wards fumigated. But in several instances the articles were in such 
a state as to necessitate their being destroyed. 

** The epidemic is said to have been brought to Panama from San 
Francisco about the end of October or beginning of November 1868, 
by one of the American steam packets running between these ports. 
Be that as it may, a case of small-pox was imported into Tobago from 
Panama on the 20th of December 1868, occurring in a native of the 
place who had been working at Panama in connection with the 
company's steamers wharf. After this date all communication with 
the shore at Tobago was prohibited ; and, as four or five cases 
occurred on shore up to the 4th of January 1869, the Cameleon was 
shifted to an anchorage about three miles off Panama, where she 
remained until the 1st of February, when she returned to Tobago 
for the Durpose of ^ving the ship's company leave, it having been 
reportea that the island was free from the disease. Acconlingly 
commencing on the 8th, forty-eight hours leave was granted to 
each watch, the whole crew being off to their leave on the 12th. 

*^ On the 18th, there again being a report that the disease had re- 
appeared, I went on shore, and wim a vast amount of difficulty (from 
the unwillingness on the part of the inhabitants to give informa- 
tion which might prove a great pecimiary loss to them) ascertained 
that there were five or six cases of a confluent nature, and very 
many of a discrete form, all confined to native children, who were 
unprotected. These people look on the disease with indifference, 
have no faith in vaccination, and treat their patients by placing them 
in close dark rooms, applying greasy cloths to the face, hands and 
feet, and when the pustules begin to discharge and form crusts they 
apply cloths dipped in vinegar and water to them till they are 
Bottened, when they take a shell and with the edge scrape the whole 
off, leaving the sufferer in a very exhausted state from shock and 
sometimes loss of blood. 

** There is no doubt that the disease was communicated from the 
shore to the ship, as variola was at that time in an epidemic form, 
both at Panama and Tobago, where the mortality was very great 
amongst the natives, few of them being protected ; but by what 
means it was conveyed on board is doubnul, as little communication 
was had with Panama, and that exclusively by officers, and the 
first man attacked with the disease did not belong to any boat, 
nor had he been out, of the ship since the 12th of February. 
I consider that the convejrance of the virus may be attributed 
more than probably to articles of provision^ received daily from 
the Government contractor or bumboat from Panama ; or even 
to the water received on board, which was purchased from the 

384. p 4 American 



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156 MEDICAL STATISTICAL BETUBNS 

^l^^ American Steam Packet Company. This water is obtsuned at 

' Tobago from a spring about 200 feet above the level of the sea, 

ffl ftMf I. and after a descent of about 300 yards in a valley^ over gravel. 
Sect* A. the stream is dammed up by a wall, from which an iron pipe 
about four inches in diameter conveys all the water from the 
stream to the large iron tanks close to the beach, which very seldom 
overflow except in the rainy season, the demand being so great for 
the shipping lying in the bay. Now that portion of the stream 
between the above named spring and the dam is a constant resort 
for bathing by both sexes, and^there 1 have constantly seen patients 
convalescent from small-pox washing their persons, desquamation 
going on freely at the same time. This, I think, may be looked 
upon as another means by which the virus may have been com- 
municated to the ship, and generated in the system either by deglu- 
tition or application to the person/' 

Enteric Fever. — There were three cases of this form of fever in 
the squadron during the year ; one in the Topaze, and two in the 
Zealous. Of these, the case in the Topaze, and one of those in the 
Zealous proved fatal. In the former instance the person affected, 
a young ordinary seaman, was placed on the sick-list at Valparaiso 
on the 9th of January, complaining chiefly of debility, suffused eyes, 
and general catarrhal symptoms, over which, treatment seemea to 
have little control. He became emaciated, and nausea set in, the 
tongue becoming very red at the tip and edges, but not furred. On 
the 17th he was seized with diarrhoea, which, although checked, 
speedily recurred, and on the 22nd there was low wandering deli- 
rium. On the 25th a rose-coloured rash appeared over the chest 
and abdomen, which, however, soon disappeared. Diarrhoea now 
appears to have become urgent, the stools being frequent, and very 
liquid. Delirium was almost constant, and his symptoms gradually 
becoming worse, he died on the morning of the 2nd of I ebruary. 
No post-mortem examination of the body was made. 

With reference to the two cases of enteric fever which occurred 
in the Zealous, the staff-surgeon* of that vessel observes — *^ Two 
cases of enteric fever occurred at Valparaiso within a few days of 
each other. Both of the men had been on leave on shore, and one of 
them was known to have visited a house in which persons were lying 
in bed sick of the same form of fever. The other case could not so 
well be traced to any source of contagion, principally from the un- 
willingness of the man to give any infonnation. One case was much 
more severe than the other, and terminated fatally after an illness 
of about six davs. He died at sick quarters at V alparaiso. The 
other case was left behind at the same place when the ship left, as 
he was not in a fit condition to be brought on board, but it appeared 
probable that he would eventually recover. On inquiring amongst 
the different medical men with whom I had an opportunity of 
conversing, I was informed that this disease is seldom seen at 

Valparaiso, 



* Staff Surgeon John Oockin. 

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OP THE PACIFIC STATION, 157 

ValparaiBO, and indeed that such cases are never seen in practice ; Pacific 
but it apjpears that the poorer part of the population are not at all Station. 
looked after, and unless they can afford to pay for a medical man, ciaMl. 
they get no attendance whatever. There are no surgeons to attend g^^ j^ 
the poor gratuitously, and there is no poor law ; the consequence is, 
that when they are attacked by disease, nature does her own work, 
and people- live or die according to the severity of the attack. It is 
not to be wondered at that enteric fever should have found a home 
at Valparaiso. There is hardly such a thing as a drain in the place, 
and it is by no means usual to have any conveniences for natural 
purposes attached to the houses. The principal business streets 
are kept in a little better order than the others, but the whole of the 
ground in some localities becomes saturated with ordure, and 
as all the water, or at any rate the greater part of that used for 
drinking, is obtained from the ravines or cataracts intersecting the 
hills above the town, it is obvious that during the rains very much 
decomposing animal debris must be mixed up with it, and conse- 
quently the only wonder is that fever and dvsentery do not exist to 
a greater extent. In the case which was longest under treatment 
on board (nine days^, the symptoms at first were very slight, and only 
increased in intensity after a sudden outbreak of delirium, during 
which he jumped overboard, and was nearly drowned. After this 
he became much worse, and was sent to the hospital, where he was 
doing well when the ship left. The other case was much more severe 
from the first, probably from his not having applied until he no 
longer felt himself able to move about. He soon became violently 
delirious, and was sent to the hospital after being only two days 
under supervision. He only lived three days after he was sent on 
shore, getting gradually worse all the time, and death appeared 
to take place from urssmic poisoning, as there was absolute sup- 
pression of urine for three days prior to the fatal termination. In 
this case no spots were observed on the abdomen, probably because 
there was not sufficient time for them to become developed. In the 
other case the lenticular spots were noticed after the first week. The 
urine in both cases was albuminous from the first. The post mortem 
examination of the case, which proved fatal, showed the enteric 
lesions usually found in this disease, although not in a very ad- 
Tanced stage.'* 

There can be no question of the capabilities Valparaiso possesses 
for originating enteric fever and bowel complaints generally. They 
have been frequently referred to in these Reports, and in that for 
1868* it is stated that these diseases are not at all uncommon, and 
their origin is attributed to defective drainage and an impure water 
supply. The lesson to be gained from this knowledge is, of course, 
that at Valparaiso, and in all localities similarly circumstanced, 
distilled water only should be used on board our ships of war for 
drinking and culinary purposes. 

Simple 



"* Statistical Report of the Health of the Navy, for the Year 1868," p. 145. 
384. ' 



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158 MEDICAL 8TATI8TICAL EETUENS 

Pacific Simple Continued Fever. — Seventy cases altogether of this form 

Station. of fever occurred in the squadron, twenty-eight of which appear in 

the Betums from the Cameleon. In that vessel the majority of the 

Cl^M !• cases occurred while she was employed surveying the coast of Cen- 
Sect A. tral America. They were attributed to climatic causes. One death 
appears under this head. The case was that of an officer, and is 
somewhat obscure, the febrile symptoms not being of a very pro- 
nounced character. 

-^i^TMe.— Thirteen cases of ague occurred in the Squadron, ten of 
which appear in the Returns from the Chanticleer. With reference 
to seven of these cases the surgeon* of the vessel observes " Seven 
cases were entered on the sick-list, all of which occurred soon after 
leaving Manzanilla, where miasmatic fevers are very common, and 
where the disease appears to have been contracted. Two of the men 
attacked had, when there, been engaged with a fishinff party on 
shore. To all so employed quinine had been given on their return 
to the ship. The other men had not been out of the ship during 
her stay at that port, but two of them had suffered previouslv from 
ague op the China station. One of these was sent to. hospital on 
the arrival of the ship at Valparaiso. Most of the cases were of 
the quotidian type, but as the disease advanced, the length of the 
interval in some instances increased, while in others the paroxysms 
were irregular, and towards the end of the complaint there was 
headache only at the usual time for the paroxysm to occur. In 
two cases pain in the region of the spleen was complained of, and in 
all there was marked debility throughout." 

The same officer makes the following medico-topographical re- 
marks on the place where the fever was contracted : — *^ Man- 
zanilla is situated on the coast of Mexico, in lat 19^ 6*. N. long, 
104". 24'. W. The harbour is of a horse-shoe shape, open to the 
southward, and surrounded by thickly wooded hills from 300 to 500 
feet high. Immediately behind the beach, on the east side of the 
harbour, are a number of lagoons containing brackish water, and 
fringed with mangrove trees. These lagoons contain numerous 
alligators. The town is built at the south-east comer of the har- 
bour, and consists of from forty to fifty houses, which are chiefly 
constructed of undressed wood, and thatched with coarse grass. The 
largest lagoon is situated behind the town, separated from it in part 
only by a low hill. It runs in an easterly direction for a distance 
of about thirty miles. A canal is at present being cut by the 
Mexican Government to convey the water from a large river into 
this lagoon at its eastern extremity, partly with the view of keeping 
the water in the lagoon at a stated level, and ensuring a constant 
current through it, with the hope of improving the health of the 
town, and also that water communication may be obtained from 
Manzanilla towards the town of Colima. The diseases prevalent 
on shore, and to which the crews of ships are most liable, are inter- 
mittent and remittent fevers. These are most common and most 

severe 

♦ SuTf^on Maxwell Rodgers, m.d. 

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OP THE PACIFIC STATION. 159 

Bevere about the end of the wet seasons and the beginning of the Pacific 
dry. I was informed that in September of last year there was a * Station. 

severe outbreak of miasmatic fever at Manzanilla, consequent on " 

the making of a cutting, which lowered the water considerably in ^™* *• 
one of the lagoons, leaving exposed large quantities of slimy mud, ®^* ^ 
and decomposed vegetable matters. The wind was blowing at the 
time from the lagoon, in the direction of the town, and several of 
the inhabitants were suddenly attacked with vomiting, followed 
by fever; while silver and articles painted white were turned black. 
At the time of our stay, the health of the town was said to be good. 
The ship was anchored at some distance off shore. With one excep- 
tion there was a squall off the land every day, with heavy rain, loud 
thunder, and most vivid lightning ; these squalls generaJly came on 
in the evening. Otherwise, the weather was very fine. The thermo- 
meter ranged from 81** to 86% and the barometer from 29*96 to 
30-09." 

Remittent Fever. — Only four cases of this form of fever were 
under treatment in the squadron during the year, and of these, 
three were in the Malacca. No information is given in connection 
with them^ but that they must have been of a very tedious character 
is apparent from the fact that the average duration of each case on 
the sick-list was nearly sixty-five days. 



n. General Diseases, Section B., or Constitutional Oroup. 

Under this head, 486 cases of various forms of disease were ciass II 
entered on the sick-list, viz., 197 of rhematism, two of gout, 177 of g^^^ -j^' 
primary syphilis, ninety-nine of secondary syphilis, one of scrofula, 
nine of phthisis pulmonalis, and one of dropsy. Of the total 
number of cases, twenty-four were invalided, and four proved fatal. 
It will be observed on referring to Table I., that while only nine 
cases of phthisis appear, ten were invalided, and four terminated 
fatally. This apparent discrepancy, as has repeatedly been observed 
in these Reports, arises either from several of those invalided or 
dead, being cases which were entered on the sick-list in the previous 
year, or from the fact that, when first placed on the list, the 
phthisical symptoms were not developed, and they were entered 
under another head. 

RheumatUm. — Of this disease, as has already been said, 197 cases 
were under treatment. This is in the ratio of 84*5 per 1,000, which 
is a decrease compared with the preceding year equal to 20*2 per 
1,000. The avenge duration of each case on the sick-list was 
between sixteen and seventeen days. The surgeon* of the Charybdis, 
in which vessel thirty cases occurred, observes : — ^^ This is a very 
common complaint in every part of the Pacific station. It is 

generally 

* Sargeon John 0. Metter, M.n. 
384. 



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160 MEDICAL STATISTICAL RETURNS 

Pacific generally met with in the sub-acute form, is difficult to treat. 
Station. medicine having apparently but little effect on the symptoms; it 
— runs a tedious course, and generally produces, or is accompanied by. 
Class n. a low state of general health. Thirty cases occurred requiring 466 
Sect B. ^ya on the sick-list ; three being ultimately sent to hospitaL A 
few cases of a more decidedly acute nature, and accompanied by- 
swelling of the joints, have occurred, and these have yielded more 
readily to treatment. Heart complication has appeared only in 
one case, in which sub-acute rheumatism followed an attack of 
bronchitis. 

"Many cases are no doubt associated with syphilis, and when 
rheumatism supervenes in that disease, it is most difficult to cure. 
There was no distinct history of sjrphilitic complication in any of 
the cases sent to hospital, although in the course of the year several 
cases of secondary syphilis have been under treatment, and some 
sent to hospital, in which rheumatism was a prominent feature." 

Syphilisy Primary and Secondary. — One hundred and seventy- 
seven cases of primary, and ninety-nine of secondary syphilis were 
entered on the sick-list during the year, and of these two of primary, 
and four of secondary syphilis were invaded. The average duration 
of each case of the primary form of the disease was nearly thirty- 
five days, and of each case of the secondary variety forty-six days. 
About seventeen men were on an average daily incapacitated from 
the primary disease, and between twelve and thirteen from the 
<»econdary form. 

The vessels which suffered most from these affections were the 
V /harybdis, the Malacca, the Nereus, the Satellite, the Topaze, and 
the Zealous. 

In the Charybdis there were fifteen cases of primary, and ten of 
secondary syphilis. There appears, however, some discrepancy 
between these numbers as returned on the nosological tables by the 
surgeon of the ship, and his remarks upon them, which are to the 
following effect : — " Venereal disease has been much more common 
this year than at any previous time. This is attributable to the 
opportunities of contracting the disease at Valparaiso and other 
Chilian ports. 

** Thirty-four fresh attacks have been entered on the sick-list, 
namely, twenty-one of primary syphilis and thirteen of gonorrhoea. 
All these excepting a single case of gonorrhoea occurred since 
arriving on this station in February, ^e total number of entries 
on the sick-list for venereal disease is thirty-six. Six of these are 
re-entries of syphilitic cases, with secondary symptoms. In addition 
to the thirty thus remaining, four cases have occurred, two of 
primary sore and two of gonorrhoea, but as they were apparently 
slight in their nature, and as they appeared either in officers or men 
employed in light duty on the lower deck, they were treated with- 
out being placed on the sick-list. The total number of days' sick- 
ness from venereal disease was 1,638, a number considerably greater 
than a fourth of the total sickness from all causes during the year. 

^^ Thb disease appears to affect the inhabitants of Valparaiso and 

other 



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OP THE PACIFIC STATION. 161 

other Chilian ports, to a most unusual extent. No police regula- Pacific 
tions exist to prevent its spread, nor is there any medical supervision Station. 

of the women affected, nor public institutions for their treatment. 

The unhappy consequences of such neglect are experienced by CIbm n. 
every ship's company that visits these ports, and while the people Sect B. 
and authorities are so indifferent to their own welfare, little improve- 
ment can be expected with respect to the prevalence of this disease 
amongst the crews of ships. 

** Of the twenty-one fresh cases, secondary symptoms have 
appeared in eight, while two have been discharged to hospital 
before sufficient time had elapsed for their development. Eleven 
continue as yet free. Fifteen of these cases contracted the disease 
tit Valparaiso ; four at Victoria, Vancouver's Island; one at Panama; 
and one at Talcuhuano." 

In the Malacca there were ei^ht cases of primary, and fourteen of 
secondary syphilis, all of which were contracted at Valparaiso. 
Some of the cases of both forms of the disease presented very severe 
symptoms. 

The medical officer* of the Nereus, which vessel is permanently 
stationed at Valparaiso, and in the returns from which there appear 
nine cases of pnmary, and five of secondary syphilis, observes: — 
" There is no legislative enactment in Valparaiso on the subject of 
prostitution at present, but in the face of considerable opposition, 
and after at least one failure, there is every prospect of an enactment, 
similar to that in force in France, being brought into operation 
some time in 1870." 

The cases of syphilis in the Satellite do not call for any remark. 

There were thirty-eight cases of primary, and twenty-eight of 
secondary syphilis in the Topaze, with reference to which the 
surgeont remarks : — " It is almost supererogatory to remark on this 
complaint, which has been the perfect scourge of the southern division 
of me station, and so much aggravated by the prevalence of the 
practice of concealment, whether as primary or secondary, by the 
entire crew, who do not appreciate the significance and value of 
at once reporting the disease. It may be noted that there is no 
re^tration of prostitutes in the ports of Chili. The type of disease 
wmchwas contracted was very severe at Valparaiso ana Coquimbo, 
but there was very little disease as far as could be ascertained in 
Peru. 

** The bubo which resulted from the sore was most difficult to treat, 
so difficult as to make one almost despair of effecting any permanent 
benefit. In many cases when apparently cured, the patient on 
resuming duty for a few days, would return to the sick-list in by no 
means a favourable condition. Secondary sores were very common, 
but skin affections not so frequent. Rheumatism as a sequela was most 
intractable. There was no special sore that could lead me to deter- 
mine that secondary effects would be likely to follow it, A mere 

abrasion 

*■ Assist. Surgeon George Mair, u.d. f Surgeon J. L. Palmer. 

384. 



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162 MEDICAL STATISTICAL BETUBNS 

Pacific abrasion or excoriation which has healed in a day or two^ has been 
Station, followed by lasting sequelae." 

ClaM n. In the Zealous there were sixty-six cases of primary, and seven- 

Seot B. teen of secondary syphilis. The staff surgeon makes die following 
observations with respect to Vdpanuso, the head-quarters of the 
southern diyision of the station, and to the forms of syphilitic 
disease contracted there : — " The more disreputable part of the 
females are at this port openly prostitutes. There are a very large 
number of women who obtain their living solely by prostitution. 
Many parts of the town are entirely inhabited by this class of 
persons, who ply their trade completely unchecked by any super- 
vision, and they consequently contract and propagate disease to an 
alarming extent Soon after the arrival of the Zealous at this port, the 
men were allowed leave to go on shore. From that time there have 
been plenty of syphilitic cases under treatment. The disease 
appears to be very severe, and I have noticed that if caught from 
Spaniards and Portuffuese, and their half-breeds, it is generdly much 
more severe than when caught from other sources, and generaJly 
much more difficult to be eradicated from the system. The number 
of cases that occurred after leave was given at Valparaiso was very 
gr^at, and no advice appeared to have any effect in checking the 
men from exposing themselves to the chance of contagion, it is 
much to be regretted that such a very unhealthy place should be 
the head-quarters of the Navy in the Pacific, and it becomes a 
question whether, as long as the Government will do nothing to 
prevent the spread of the disease, it would not be advisable to shift 
the position of the depot ship to some other place. There are 
ports either to the north or south of Valparaiso that might be found 
equally available for the position of the depot ship, and several in 
which she would be raucn safer than she appears to be at present. 
However, should it be considered politic not to change the position 
of the depot ship, and as men-of-war must call there for stores, regula- 
tions might be made, that no leave should be given to die crew 
while the vessel was in the port, and that ships should remain there 
as short a time a.s possible." 

With reference to the disease itself, he says, " A few of these 
cases were contracted at Esquimalt, and some also at Coquimbo, 
but by far the greater number were the result of our visit to Val- 
paraiso. As I nave previously remarked, in speaking of that port, it 
is the most unhealthy place on the Pacific Station, f^r, although the 
smaller vessels suffer a good deal from the effects of tropical cumate 
while they are serving on the Coast of Mexico, or that of Central 
America, yet the average of sickness does not appear so great in 
these parts as at Valparaiso. 

" Syphilis appears to be very virulent when propagated from the 
Spanish half-breed to the English sailor. Many of tne chancres were 
exceedingly severe, and soon followed by secondary symptoms, and 
these also were of considerable urgency. The character of the 
chancres differed much; in some cases there was hardness surrounding 
them, or they were placed on a hard base, and in several cases there 

was 



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OF THE PACIFIC STATION. 163 

very considerable induration with hardly any ulceration, and Padfic 
occasionally simple abrasions. Some of the chancres again had no Station. 

hardness at all around them, although there might be considerable 

inflammatory swelling of the prepuce or glans. Some of the sores Cl**» H. 
were followed by bubo, and others, and indeed the greater number, Sect B. 
healed without any complication. When a bubo followed a chancre, 
it seldom suppurated; a few cases did so, but the majority re- 
mained indolent for a long time, neither adyancing nor receding, 
but eventually being abson)ed. It was attempted m most cases to 
prevent suppuration, and with success generally; occasionally it 
tailed, and matter formed : which of the cases were cured in the 
shortest time it is difficult to say. Almost every variety of primary 
chancre was seen, and the fdfter effects were as various as the first 
affections. The secondary phenomena generally showed themselves 
in a short time ; throat and skin diseases being the most frequent 
complaints. In those patients who joined the ship with the disease 
upon them, and in whom it was probable that mercurial treatment 
had been adopted primarily, the secondary affections when they 
appeared were more severe, and rheumatic pains were common. 
In those cases in which mercury had not been had recourse to, 
the pains were but seldom present and then only in mild form. 
Pustular and papular eruptions were the most general symptoms, 
and in a few cases they were severe, and required lengthened 
treatment* It did not appear from experience of these cases, that 
anything decided could be determined as to the contagious nature 
or otherwise of any particular chancre. It was not possible to 
decide what would produce secondary symptoms, and what would 
not It appears from the cases under treatment, that several 
patients had chancres on hardened bases which have not been fol- 
lowed by any secondary symptoms up to the present time ; and in 
some of the cases in which they have appeared, the chancres have 
not presented any distinct character, and in more than one case 
have been decidedly of the soft variety. It appears, therefore, im- 
possible to say positively what sore may be followed by secondary 
sequelae, nor is it at all advisable to state decidedly that any sore 
will be free from them. The number of buboes that followed the 
appearance of chancres was not numerous, but when they did arise, 
they were generally very tedious in their course, being for the most 
part indolent, neither advancing nor receding, whatever treatment 
was adopted. Some of them became discussed after some time, and 
left no remains behind, but others suppurated and discharged freely. 
In the latter cases the patients do not appear to have been longer on 
the sick-list than in the former. 

** The treatment adopted was very simple, and, as a rule, very 
satisfactory. As a local application to chancres when they were of 
the usual character, chloride of zinc lotion and carbolic acid lotion 
were generally used. Where sloughing showed itself, or where the 
base of the chancre was covered with a slough, perchloride of iron 
was applied, dissolved in glprcerine. This application always appeared 
to have the effect of causing the separation of the slough, and the 
putting on of a healthy action by the sore, and then we chloride 

384. of 



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164 MEDICAL STATISTICAL EETUENS 

Pacific of zinc generally completed the cure. This lotion has been found use- 
Stadon. ful in dl cases, and tends very much to promote healthy action. The 

application of sulphate of iron has been found of advantage, causing 

Y**f V* the sores to heal in a shorter time than they would otherwise probably 
have done. Occasionally nitrate of silver has been used, but its 
action does not appear to be so beneficial as the other applications 
that have been mentioned. In a few cases in which there was con- 
siderable induration, sulphate of copper in solution appeared to pro- 
duce good effects, but this was not often had recourse to. Where 
there was much swelling of the prepuce, injections of chloride 
of zinc lotion underneath it, and the application of cold cloths, ap- 
peared to produce resolution of the swelling. When buboes appeared 
they were at first ordered to be kept wet with cold water, but this 
is a rather unsatisfactory method of treatment ; it is not possible to 
keep the patients in their hammocks constanti^ ; at least, it is only 
to DC done by constant vigilance and untiring perseverance." 

'* When suppuration of the bubo has taken place^ 

a very small opening should be made in it, and all the fluid 

1)ressed out ; the sac should then be injected with chloride of zinc 
otion, a small piece of lint, dipped in the same lotion, applied 
over the opening, and a poultice over all. The injection should be 
repeated every morning as long as any sac remains, but under this 
treatment it appears very soon to contract, and the discharge to 
lessen. Pressure should then be applied by a compress and bandage, 
zinc lotion being still used to the opening, and the discharge will 
gradually cease, and a perfect cure be the result. This has been the 
treatment adopted in every case in which suppuration has taken 
place, and it has been attended with most desirable results. None 
of the old sinuses that used to be the bugbear of buboes have been 
present. 

When secondary affections showed themselves, which, in the 
patients who contracted disease at Valparaiso appeared to be rather 
more often the case than in those who had the disease from other 
sources, the treatment consisted in giving alternate doses of solution 
of iodide of potassiimi, and solution of sulphate of iron, with local 
treatment to the throat, in cases where this was required, of inhala- 
tion of steam, medicated or not, as necessary, and the use of the 
chlorate of potass garde. It does not appear, however, that gargles 
as a rule do very much good ; it is a question whether they are ever 
allowed to flow sufficiently backward to reach the parts they are 
intended to medicate. Hot baths were sometimes used, and perfect 
cleanliness insisted on, and under these means the patient ^nerally 
recovered after a certain time. Occasionally a mixture of iodide of 
potassium and potassio-tartrate of iron, which will mix without de- 
composition, was used, and apparentiv with good effect. It has 
never been tiie practice to give even the smallest quantity of mer- 
cury for the cure of this disease, and I believe that very much 
injury results on all occasions from the employment of this drug in 
tiie treatment of venereal diseases. Syphilitic rheumatism appears 
to be easily removed bjr the exhibition of iodide of potassium in 
ten grain doses, or even in larger doses if occasion require, and if it 

is 



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OP THE PACIFIC STATION. 165 

18 at all obstinate^ becoming much worse at night, which is its general Pacific 
character, the exhibition of a few grains of quinine given before Station, 
bedtime, appears to have the effect of preventing its recurring, and CisM II. 
by this means of enabling the iodide to exert its curative influence. g^^*^ j^' 
Several cases have been treated on this plan with success. None of 
the more severe forms of the disease, nodes and other affections of 
the bones, rupia, or secondary ulceration, have been present, 
and it is probable that they may not be seen except in very rare 
cases, and in those in which mercury has been used. 

IIL Diseases of the Nervous System^ and Organs of the 
Special Senses. 

Under this head seventy-one cases of various forms of disease Class HI. 
were entered on the sick-list, of which eleven were invalided, and 
two proved fatal. One of the fatal cases occurred in the person of 
a seaman of the Chanticleer, who was invalided for chronic bron- 
chitis, and sent home in a contract steamer, on board of which he 
died with all the sjrmptoms of cerebral softening. Very little in- 
formation is given m connection with his case, and no post-mortem 
examination of the body appears to have been made. 

The other fatal case was one of embolism of the basilar artery. 
It occurred in the person of a petty officer of the Reindeer, who 
had a short time before the fatal seizure been under treatment for 
rheumatism. On the morning of the 11th of April, he was found 
insensible in his hammock. His messmates had failed to rouse him, 
and immediately sent for the medical oflicer of the vessel, who found 
him breathing loudly, and quite unconscious. He was at once dis- 
charged to the Pacific Steam Navigation Company's Hospital 
at Callao, from which the following report of the case was re- 
ceived : — 

" Aijril 1 1th.— Received in a state of insensibility, withloud snoring 
breathing. Pulse 72, soft and regular; skin moist and warm; 
bladder empty. It was impossible to rouse him to consciousness, 
but he was to some extent sensible on being shaken, or spoken to 
loudly and manifested some uneasiness. The left pupil responded 
feebly to the action of light, whilst the right was contracted and 
fixed, but the patient had the power of considerable muscular re- 
sistance, and it was a matter of difficulty to administer a mustard 
emetic by the stomach pump. He had also muscular power both in 
the arms and legs, whicn he exerted voluntarily during the adminis- 
tration of the emetic Immediately on admission sinapisms were 
appKed to the calves of the legs, and shortly afterwards profuse 
I)erspiration appeared, and both pupils became contracted and in- 
sensible. The bladder acted well, and the urine was normal. The 
bowels were well opened by a turpentine enema, and the stomach 
was washed out after he had vomited the mustard, but the matter 
vomited was the same as that injected into the stomach. The 
breathing became quiet and regular, and at no time could it have 
been said to Iiave beea stertorous. The hearts sounds were regular 
and normal. 

*^ April 12th.— The breathing has been quiet and natural throujach 
384. Q the 



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166 MEDICAL STATISTICAL RETURNS 

Pacific the night> but no change has taken place in the patient's general 
Station. condition. He lies on his back, and cannot be roused, but he 
^ Ij- retains muscular power, and there is some reflex action on tickling 
tiaM 111. ^g ^Yes of the feet, whilst the nostrils are readily irritated by 
ammonia, and the patient shows considerable sensibility to its action. 
Electro-magnetism elicits active muscular contractions of the extre- 
mities, and both sides appear to be equally sensitive. Under the 
influence of the ammonia and the electro-magnetism the left pupil 
dilated and became sensitive to light, but not actively so ; the right 
remains fixed. The bowels have been moved ; stools natural and 
digested ; has made water in a full stream, and the bladder is now 
empty. Pulse 72, regular and soft ; skin moist and warm ; tongue 
moist. Enemata of beef-tea have been thrown into the rectum. 

" April 13th. — Has swallowed a considerable quantity of strong 
coffee^ put into the mouth in teaspoonsful. The left pupil has agiun 
become contracted, and is barely sensitive to light ; the right re- 
mains fixed, and contracted to the size of a pin's head. The bowels 
have been moved by a turpentine enema, and he continues to make 
water in a full stream, but the urine has acquired an ammoniacal 
odour. Pulse 78, regular and soft; skin warm and moist; ex- 
tremities warm ; breafliing quiet. 

" April 14th. — Pulse 110, feeble and fluttering; extremities cold; 
breathing more noisy, and slightly blowing. The bowels were 
moved by an enema. The bladder is empty. The pupils remain 
in the same state. The comesD are flaccid, from absorption of the 
aqueous humour. Has continued to swallow brandy and water, strong 
beef-tea, and cofiee, by teaspoonsful. Has now no muscular power 
or sense, and reflex action cannot be excited. Gradually sank, and 
died at 11 p.m. 

" Autopsy, Twelve Hours after Death. — Body in fair condition, as 
regards muscular development. Slight rigor mortis. On opening 
the skull there was founa to be great congestion of the vessels of 
the dura mater, as also of the sinuses. The vessels of the brain 
were highly congested, but there was no effusion into the ventricles. 
Tliere was slight sero-san^uineous effusion at the base of the brain. 
The basilar artery was found greatly distended, and thoroughly 
occluded bv a firm clot of blood, whicn was adherent to the sides of 
the sac, and the sac itself was adherent by bands of recent lymph to the 
arachnoid. The right ophthalmic artery was also largely dilated and 
thoroughly occluded by a clot, and the sac rested against the right 
optic nerve, just anterior to the commissure. The left ventricle of the 
heart contained a firm partially-organised fibrinous mass, adhering 
firmly to the corda tendineaj by the one extremity, whilst the other 
floated into the orifice of the aorta, and appeared to be frayed. The 
other organs were healthy. Stomach full of the fluid swallowed 
before death." 

IV. Diseases of the Circulatory System. 

Class IV. Under this head, eighteen cases of various forms of disease were 
entered on the sick-list, of which eight were invalided and three ter- 
minated fatally. All the deaths were occasioned by organic disease 
of the heart. Compared with the preceding year there was a great 

reduction 



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OP THE PACIFIC STATION. 167 

reduction in the ratio of cases and of invaliding^ but the death-rate Pacific 
was much higher. ^J^- 

Of the three fatal cases, one occurred in the person of a Marine Claw IV. 
of the Chanticleer, who, on admission to the sick-list, stated that on 
the previous evening he had been called on to make a sudden and 
violent effort in the discharge of his duty, and that he was imme- 
diately afterwards seized with severe palpitation and diflSculty of 
breathing, which had continued since. He said that he had for some 
time suflfered from palpitation, but never so much as to require him 
to apply for treatment, and that before the present attack he had 
felt in his usual good health. 

On examination, the heart's action was found to be very rapid, 

and the impulse strong ; the pulse was frequent and irregidar. 

On percussion, the cardiac dulness was greatly increased. The 

sounds were indistinct A loud double murmur, loudest at the base 

of the heart, was heard with the second sound, and was propagated 

in the course of the large arteries. The respiration was hurried, but 

the lungs were healthy. He was placed on the sick-list on the 7th 

of Aprfl. On the lOth the heart's action was more rapid. Dyspnoea 

and cough had much increased, and there was some oedema oi the 

feet. On the 11th his symptoms became more aggravated, and 

oedema extended to the legs. Moist rales were prevalent over the 

chest In this way he went on, his symptoms gradually becoming 

more aggravated, with clearer evidences of pulmonary congestion 

until the 17th, when he died. 

On post-mortem examination of the body, both lungs were found 
to be highly congested. The heart was much enlarged, particularly 
the left ventricle. The aortic valves were much diseased. One 
appeared to have been recently ruptured ; it was torn from the free 
maigin to within two lines oi the convex margin. Other organs 
were healthy. 

A private Marine of the detachment stationed on the Island of 
San Juan de Fuca, presented himself in November 1868, complaining 
of cough, which he stated was of some eight or ten days' dumtion. 
He also complained of shortness of breathing, which he said he had 
suffered from for some time back. On stethoscopic examination of 
the chest, a loud cardiac bruit was distinctly audible over the 
greater part of the chest anteriorly, a i)rolonged murmur taking the 
place of the natural healthy sounds. There was also extensive car- 
diac dulness. The pulse was rapid, but not intermittent. Under 
the treatment to which he was subjected, some improvement took 
place in the cough, but the other symptoms remained unchanged. 
His appetite continued good until the ?Jth of December, when he 
was seized with vomiting and headache, lie also experienced a 
bounding sensation in the cardiac region. A few days afterwards 
oedema of the face and trunk made its appearance, but there was 
none of the limbs. Towards the end of December he became very 
much worse ; the pulse became more rapid and feeble, and he com- 
plained of general debility. His face became congested also. On 
the 8th of January 1869, the dyspnoea became very urgent, so much 
80 that he was obliged to sit up m a chair, and in the evening of 

384. Q 2 Qiat 



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168 MEDICAL STATISTICAL EETUBNS 

Pacific that day he died somewhat suddenly. The heart was founds on post- 
Station, mortem examination of the body, to be greatly enlarged, with cor- 
Qlg^^^^ responding enlargement of its chambers. Its walls were considera- 
bly thickened. ITie heart was very flabby and coated with fat, and 
its muscular texture looked pale and unhealthy. It weighed twenty- 
three ounces. The valves were not diseased apparently, with the 
exception of the semilunar valves, which appeared somewhat 
shrivelled. The orifices were not contracted. The lungs were 
very much congested. The right lung was hepatised and contracted, 
and perfectly adherent to the walls of the chest by old adhesions, 
which could with difficulty be broken down. 

The third fatal case also occurred in the person of a Marine. He 
belonged to the Zealous, and while in his mess, the vessel being at 
Valjjaraiso at the time, suddenly staggered and fell. Assistance 
was immediately rendered, but life was found to be extinct. On post- 
mortem examination, the body, externally, seemed perfectly healthy. 
On opening the pericardium, only the usual amount of serum was 
found. The heart was much enlarged, from hypertrophy of the 
left ventricle. The muscular tissue of the heart was healthy. The 
valves,* with the exception of the semilunar ones, were healthy. 
Specks of bony deposit were found near the corpora aurantii of the 
semilunar valves. The aorta was much thickened, and at half an 
inch from the margin of the valves was converted into a ring of bone, 
from the amount of atheromatous matter which extended along the 
vessel. The right auricle and ventricle were filled with clotted 
blood. No aneurism nor other lesion existed. 

A case of aneurism appears in Table V.,in connection with the Cha- 
rybdis. It occurred in the person of a petty officer, who had been 
placed on the sick-list on the 9th November, c^aplaining of pain in 
the lower and posterior part of the left chest With the exception 
of dyspeptic symptoms, there were no indications for treatment 
further than the application of fomentations to the chest and the ex- 
hibition of aperients. On the 21st of November, no improvement 
having taken place in his symptoms, a further examination was 
made, when, the surgeon observes, " abnormally distinct pulsation 
was felt over the whole course of the abdominal aorta, most distinct 
at the left side of, and superior to, the umbilicus. A bellows bruit 
was heard in the same situation, which could be heard also in the 
subclavian as well as in the femoral arteries. The pulsation in the 
iliac arteries, also, was increased. Indications of an indistinct 
tumour could be felt, of a spindle shape,'and overlying the position of 
the aorta, superior to the umbilicus. The murmur m the situation 
of the tumour was noted to be synchronous with the pulse at the 
wrist. I'he i)hysical signs at the cardiac region appeared to be 
natural, although the impulse was not perceptible to the finger, and 
the heart's sounds were perhaps wanting in force. 

*' He now gave the following statement of the conmiencement of bw 
complaint :— Four days before he was put on the sick-list, he felt ack 
after drinking beer, and vomited. The vomiting was followed by 
pain in the epigastrium, which has continued in some degree ever since, 
out became suddenly much worse while running on shore at drill/ on 



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OF THE PACIFIC STATION. 



169 



the day he was admitted to the list. The pain has had the character 
of a heavy weight, with a feeling of to-and-fro motion; becomes 
worse after taking food, on walking, or on pressure over its site ; and 
is always referred to the same place, between the umbilicus and the 
false nbs on the left side. It is liable to recur in paroxysms, 
and is then relieved by the patient turning on the leit side, and 
almost on the belly. Sometimes it passes to the back, to a spot 
within two inches of the spine, on the same level with that to which 
it is referred anteriorly. 

** He is a man who looks rather old for his years (thirty-eight), but 
is fairly developed physically, except on the right side of the chest, 
where the ribs project anteriorly at the lower end of the sternum. 
No arcus senilis exists, and he denies ever having had venereal 
disease. The pulse is rather feeble, but beats regularly at 60." 

He was kept under observation for some time, and ultimately dis- 
charged to the Naval Hospital at Greenwich, where he remained at 
the end of the year, his symptoms not having changed in any respect. 



Pacific 
Station. 

Class IT. 



V. and VI. Diseases of the Absorbent System and Ductless Classes 

Glands. V. and VI. 

Thirty-five cases of sympathetic bubo, and one of adenitis appear 
under this head. Each case of the former affection was a little 
over thirty-three days, and the case of adenitis twenty-six days under 
treatment. 

Vn. Diseases of the Respiratory System. 

Under this head 399 cases of catarrh ; two of haemoptysis ; forty- Class VII. 
five of various inflammatory diseases of the lungs were under treat- 
ment, and of the total number four were invalided and four proved 
fatal. As a rule the catarrhal cases were not of much importance. 
The surgeon of the Topaze, in which there were seventy-four cases, 
says that there was less evidence this year of their being connected 
with any malarial influences, than on lormer occasions. 

In the Zealous, in which there were 103 cases, the staff surgeon 
observes, " There were numerous cases of catarrh ; about one-eighth 
of the total sickness depended on this cause. They were not, how- 
ever, generally severe cases, but were almost all brought on by 
exposure of some sort or other during the winter at Esquimault, 
where they were one of the principal complaints ; but thev were 
easily cured and the treatment had nothing peculiar about it. ' 

Of the four fatal cases, two were from pneumonia, one from 
bronchitis, and one from what was reported as congestion of the 
lungs. In this last case, however, the pulmonary affection appears 
to have been dependent upon cardiac and aortic disease. It occurred 
in the person of a Marine of the Zealous who, on the 9th of 
August, presented himself complaining of cold and cough. He was 
brought up to the sick-bay by nis messmates who had seen that he 
had not been well for some days, but could not induce him to 
apply for treatment. He said that he had caught cold some days 

384. Q 3 previously 



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170 MEDICAL STATISTICAL RETURNS 

Pacific previously and had not been well since, that he had pain about the 
Station. chest, and some difficulty of breathing, but he thought it would get 
C[^7~rrfj better of itself. He had slight cough and some mucous expectora- 
tion. On examination by the stethoscope harsh respiration was 
heard nearly over the whole chest. No crepitation was distinguish- 
able, and there was no dulness on percussion. The respiration was 
hurried, and he leaned forward to breathe more easily, as he said. 
He complained of pain at the upper part of the sternum. The 
heart's sounds gave no indication of disease. He was placed in bed, 
and ordered to have a mustard cataplasm applied between the 
shoulders, and a dose of diaphoretic mixture was given him contdn- 
ing five minims of tincture of digitalis. About half an hour alter 
this he complained of increase of pain in the chest, and also at the 
pit of the stomach, and said that he had a feeling of choking in his 
throat. He got up to go to the water-closet which is at one end of the 
sick-bay, and while there asked some one to bring him a light. 
Before he could be reached he fell forward off the seat, aud was 
taken up insensible. Every method was tried to produce re-anima- 
tion, but in a few minutes the breathing ceased, and he was dead. 

On post-mortem examination of the body fourteen hours after 
death, much frothy fluid was found issuing from the nose and 
mouth ; the depending part« of the body were everywhere much 
discoloured, as also the left side of the face. The skin as well as 
the conjunctivae had somewhat of a yellowish tinge. The body was 
well nourished and •muscular. Large prominent veins were ob- 
served passing over the chest and shoulder of the left side. On 
making an incision over the sternum much fluid venous blood 
escaped, more particularly from the upper part, and blood flowed 
very freely as the incision was extended up the neck, from a large 
and prominent plexus of veins, occupying the base of the neck, and 
reaching forward over the trachea. On raising the sternum from 
its attacnments, a very considerable quantity of serum was found in 
the cavities of the pleune and pericardium (subsequently some also 
was found in the abdominal cavity). The lungs on beiog removed 
showed evidence of considerable congestion, and there were one or 
two spots of recent adhesion, easily broken down. They were 
crepitant throughout, and there did not appear any traces of tuber- 
cle ; on being cut into, the "surfaces imraeaiately presented a quan- 
tity of frothy fluid mixed with blood, and the colour was darker 
than natural. On removing the heart and aorta it was found that 
the heart was abnormally Targe ; the walls of the right ventricle 
appeared very thin, and the cavity was distended, but otherwise 
the structure appeared healthy. It contained a clot evidently not 
recent, being nearly white. The auricle on the same side was 
healthy but contained a small clot. The pulmonary artery was 
normal. The left ventricle was very much dilated and hypertro- 
phied, being nearly twice the natural size ; but its structure, as f»r 
as could be seen, appeared healthy. The aortic valves were very 
much thickened, and it was evident that they could not close the 
orifice of the artery. The arch of the aorta was, however, the prin- 
cipal seat of the disease. It was dilated to an unusual extent, and 
the walls were very much roughened and atheromatous, and having 

several 



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OP THE PACIFIC STATION. 171 

several plates of bone dispersed about it in diflferent parts. The Pacific 

dilatation extended all through the arch of the aorta downwards Station. 

beyond that portion, to the descending part of the vessel. The 

trachea was very much congested, its inner surface being quite Clasf VII. 

pink. The liver was rather roughened externally, and on being 

cut into was harder than natur5. The other organs appearea 

healthy. 

There were no points of particular interest in the other fatal 
cases. 

VULL Diseases of the Digestive System. 

Under this head 635 cases were entered on the sick-list, of which Class VIII. 
five were invalided and three proved fatal. The most prominent 
diseases numerically were cynanche, dyspepsia, and diarrhoea. 
With reference to the latter affection the surgeon of the Charybdb, 
in which vessel there were fourteen cases, observes, " The larger 
number of the cases of diarrhoea occurred at Valparaiso in the month 
of March immediately after our arrival there, when it appeared 
almost in an epidemic form for a short time." ....** Slight 
fever was present in most of the cases ; the discharges from the 
bowels were frequent and watery, attended with tenesmus, but never 
accompanied by blood, nor was vomiting present in any case. 
Diaphoretics and a few days' quiet in the hammock were generally 
found efficient to effect a cure in those so ill as to require to be 
placed on the sick-list." 

He elsewhere makes the following observations on the water 
supply and general sanitary condition of Valparaiso, as bearing on 
the prevalence of bowel complaints and other affections. " The town 
of Valparaiso is placed at the base of a range of steep hills which 
run out from the mainland in a south-westerly direction. The 
principal streets run parallel with the seashore, and are built upon 
a narrow strip of level land facing northwards ; between the sea 
and the hills, the inferior streets run back from these and ascend 
the steep sides of the hills more or less. The houses in these streets 
are of one storey, built upon the sides of ravines or * quebradas,' 
and are nearly all composed of mud, with earth floors. The ravines 
are the common receptacle of refuse thrown out from tJiese houses ; 
no drainage exists except what the natural form of the surface 
affords. The consequence is that during the dry months an im- 
mense accumulation of the most offensive nature is formed in these 
hollows. It is not merely the refuse and offal from the houses that 
finds its way there, but human excreta abound in every comer. 
By the end of summer a great portion of these collections remain on 
the ground in a state of dust, and is readily dispersed by the strong 
gusts of wind common in the autumn, which sweep down the hills 
over the town, and across the bay. A little later, neavy rains wash 
what may be left, down to the lower level ground in the shape of 
filthy streams from each ravine, which at many points pass through 
the town in wide uncovered channels, and at length find an exit at 
the shore where much of the offensive material is deposited. The 
houses stand close upon the shore itself, which is in a most filthy 
state. It is used as the common latrine of the inhabitants, and as 

384. Q 4 the 



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172 MEDICAL STATISTICAL BETURNS 

Pacific *^^ "'*^^*' convenient place to throw out all carcasses of dead animals, 
Station. offal, and refuse of every kind. The influence of a hot sun upon such 
— -- accumulations can only result in the production of miasmata as 
Claw Vni. deleterious to health as they are offensive to the sense of smell, 
and I think there is little doubt that they are frequently the cause 
of febricula and diarrhoea. The malaria is probably carried to the 
ships in the bay by the high winds, which are suflSciently strong 
to convey the dust of the town far into the harbour ; but in addi- 
tion to this possible source of infection it is highly probable that 
even u short exposure while on leave, to the more concentrated 
form of malaria prevailing, might be sufficient, especially in such 
places as seamen generally frequent, to produce m some all the 
symptoms referred to. 

" The water used by our ships at Valparaiso is very[far from being 
so good as it should be. I found it in March to contain a con- 
siderable sediment of decaying vegetable and other organic matter, 
with great numbers of animalculas, including many varieties of 
entomostracae, polypes, and annelidae. The filtered water gave a 
copious brown deposit, with permanganate of potash. 

" The arrangements for collecting and conveying the water to the 
ships appear to be very faultv. The water is principally derived 
from the surface drainage of the hills in the neighbourhood. This 
is collected in an open tank placed in one of tne ravines nearly 
outside the town. On both sides of this ravine are several inhabited 
houses, standing in such a position that all matters thrown from 
them readily find their way into the tank, either carried there 
by the wina in the form of dust, or washed into it by heavy 
rains. Under these circumstances, and considering the dirty habits 
of the people, it is easy to see that the water collected in an open 
tank, the sides of which are not raised much above the immediately 
surrounding level, must contain large quantities of very offensive 
impurities. 

" From the tank the water is conveyed to the shore through iron 
pipes, passing at a small distance under the surface of the ground 
througn the town. It is then taken on board a sailing tank, and so 
brought to the different ships. The sailing tank too was far from 
being in a properly clean state, and the accumulation in it of dirt 
from various sources, added to the originally impure condition of 
the water. 

" Occasionally a small quantity of water was condensed on board 
our ships at Valparaiso for drinking and cooking purposes, but the 
tank water was more frequently used. Water contaming organic 
impurities, such as were evident in this, and especially under certain 
conditions of decomposition, the result of a high temperature, is a 
known fertile source of diarrhoea in those who make use of it ; and 
it is also a well-known fact that by the habitual use of such water, 
the system may become accustomed to it, so that although the 
residents of the locality may use it with apparent impunity, it im- 
mediately produces in strangers symptoms indicative of more or less 
derangement or disease of the intestinal canal. Such, I believe, was 
the cause and source of many of the cases of diarrhoea which appeared 
in this ship, more especially, perhaps, of those that do not appear 

on 



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OF THE PACIFIC STATION. 173 

on the sick-list, which were much more numerous than the graver Pacific 
forms of the disease. S*^*^"- 

" Although in the present instance, from the want of sufficiently p, -^jj 
extended observations, there may be absence of conclusive proof of * 
harm arising from the use of this water, yet it appears to me to be 
at some time a very likely source of much and serious disease. It 
cannot but happen that fascal dejections lying about on the ground 
above the tank, become mixed with the water it contains ; and as it 
is known that fever of a typhoid form is a very prevalent disease 
amongst the inhabitants of Valparaiso, there is every risk of convey- 
ing that or other similar disease to those on board ship who make 
use of the water. 

" The prevention of disease is a more desirable object to attain, and 
will always be found of much greater benefit to any body of people, 
than the cure of it. Here we seem to have an opportunity to make 
use of the knowledge at our command to arrive at so desirable an 
end. With that view it would, I consider, be a safe and wise 
measure to discontinue the use of this water, and as no better source 
of supply is to be found on shore at present, to use only condensed 
water, which I am informed can be made for about the same cost 
per ton as is paid for the tank water." 

The surgeon of the Chanticleer says, in reference to some cases of 
diarrhoea tnat occurred on board that vessel at Valparaiso that they 
were "caused by change of diet, and the free use of fruit and 
vegetables, after having been for a long time previously on salt 
provisions. The water supplied to ships is very impure, strongly 
rankish, and contains chloride of sodium, and traces of sulphate of 
lime, but the crew at the time were using condensed water, so that 
this could not have been the cause. Several of these cases were 
accompanied by considerable gastric derangement, but readily 
yielded to treatment" 

A fatal case of enteritis and gastritis occurred in the person of 
a petty oflScer of the Zealous. He was addicted to intemperance, 
and had been on shore on leave, where he was seen drunk, but on 
his coming off to the ship he was quite sober, and performed his 
duty for two days in apparently good health before the fatal attack 
set in. This occurred about two hours after eating a hearty supper 
consisting principally of beef, with mustard, vinegar, and pepper in 
considerable quantities. His first symptoms were intense abaominal 
pains, with cramps, and vomiting and purging. The vomiting 
ceased after all the food had been rejected. He never rallied from 
the first attack, although the pain under the influence of chlorodyne 
was much relieved. He sank after about thirty-six hours' illness. 
At first the attack very much resembled one of cholera, but some 
of the symptoms were very different from those frequent in that 
disease. The pulse at the wrist did not become smaller during the 
whole time, the skin retained its heat, and the kidneys performed 
their functions. There was no collapse. 

On post-mortem examination of the body the whole digestive 
canal from the oesophagus to the rectum was found to be in a state 
of intense indammation. The peritoneum did not appear to be 

384. included 



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174 



MEDICAL STATISTICAL RETURNS 



Pacific 
Station. 



Class VIII. 



included in the disease, but the mucous membrane from one end to 
the other showed signs of intense action, although there did not 
appear to be erosions on' any part. The staff surgeon observes ; 
" The cause of this sudden and fatal attack appears involved in 
complete mystery. The patient himself declared that he could not 
account for his illness, and there was no reason to suppose that any- 
thing abnormal had produced it, unless we lay it at the door of 
much vile stuff sold under the name of spirits, to which it was 
known that the unfortunate patient was somewhat addicted." 

A fatal case of what is returned as dysentery occurred in the 
person of a seaman of the Topaze, but the symptoms were of a very 
anomalous character, and the pathological appearances on post-mortem 
examination of the body were rather those of enteritis than 
dysentery. 

A fatal case of jaundice occurred in the person of a petty officer 
of the Pylades, who had led a very irregular life. He was entered 
on the sick-list on the 22nd of August complaining of constant 
cough, loss of appetite, and failing strength. Under 3ie treatment 
to which he was subjected the catarrhal symptoms subsided, but the 
debility increased. On the 29th he complained of having passed 
a restless night, and the following night was also a bad one, there 
being some amount of wandering delirium. Well-marked symptoms 
of jaundice now set in, and in this state he was discharged to the 
Civil Hospital at Monte Video, where he expired on the 3rd of 
September. On the day^ following his discharge to hospital, the 
abdomen became tympanitic and tender all over ; the stools were 
frequent, and debility increased ; the urine was loaded with bile 
pigment, und the faeces presented a light clay colour. No examina- 
tion of the body was made after death. 



IX. and X. Diseases of the Urinary and Generative 

Systems. 

Classes IX. Under this head 149 cases of various forms of disease were placed 

and X on the sick-list, of which one was invalided and one proved fatal. 

The most important affection numerically was gonorrhoea, of which 

there were eighty^ix cases, the average duration of each case being 

twenty-five days. 

The fatal case was one of waxy degeneration of the kidneys and 
liver. The patient, a non-commissioned officer of Marines of the 
Reindeer was placed on the sick-list on the 10th of June, with pains 
of a wandering character, affecting all his limbs as well as the lumbar 
region, and he had occasional shivering fits resembling ague. On 
testing his urine it was found to be loaded with albumen. In 
this condition he was discharged to the Civil Hospital at Valparaiso, 
where on admission he still complained of these symptoms, which he 
said were rheumatic. His countenance was very sallow, the tongue 
was red and glazed, with a tendency to dryness ; the skin was dry but 
not pre ter naturally hot (a fact, however, which was not tested by 
the thermometer ^ ; the pulse was sharp, 86 per minute ; the bowels 

were 



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OF THE PACIFIC STATION. 



175 



were regular, and the heart-sounds normal. The urine was highly 
albuminous, the albumen occupying the space of half the quantity of 
urine examined, sp. gr. 1006. Under the microscope neither blood 
globules nor renal casts could be detected. There was no oedema 
of the extremities. On percussing the abdomen the liver could be 
felt very distinctly over a very extended space, and stretching across 
into the left hypochondrium, but it was not tender on pressure. 
On the 29th of June an attack of diarrhoea came on which was readily 
checked, but on the following day he complained of not being able 
to pass his urine. During the previous twelve hours he had only 
passed one ounce which was loaded with lithates, but it contained 
no blood nor casts. The pulse was 120, and the stomach very irri- 
table, rejecting everything he took. He was ordered the effer- 
vescing tartrate of soda with hydrocyanic acid, and was packed in 
blankets. In this way he perspired profusely, and continued to do 
so until his death, but the suppression of urine continued. Urasmic 
poisoning now set in, his pulse became irregular, and convulsive 
twitchings of the extremities came on early m the morning of the 
3rd of July ; these increased during the day and following night, 
and at 8 a.m. of the 4th, after a violent epileptic convulsion, he 
^ed. There was no coma nor tendency to coma. Post-mortem 
examination of the body revealed most characteristic waxy degenera- 
tion of the liver and kidneys. Both organs were enormously large, 
the Jiver weighing 9 lbs. 10 oz., and the kidneys 1 lb. 11 oz. The 
spleen and pancreas were also very large. 



Pacific 
Station. 



Classes IX. 
and X. 



XI. DiBoases of the Organs of Locomotion. 

Under this head thirteen cases appear, all of which seem to have 
been discharged to duty after being on an average about twelve days 
under treatment There was nothing of importance or interest in 
connection with them. 



Class XI. 



XH and Xm. Diseases of the Cellnlar and 
Cutaneous Systems. 

Seven hundred and fort^-five cases of various forms of disease Classes XII. 
were entered on the sick-list under this head, and of these one was and XIII. 
invalided and one proved fatal. There were altogether 564 cases of 
phlegmon and abscess, and 155 of ulcer ; each case of the former 
affection being on an average between nine and ten days under 
treatment, and each case of the latter between twenty-two and 
twenty-three days. 

The fatal case was one of abscess of the cellular tbsue behind the 
right kidney. It occurred in the person of a seaman of the Sparrow- 
hawk, and was considered to be a case of hepatic abscess until post- 
mortem examination of the body revealed the true character of the 
disease. A collection of matter was found in the cellular tissue 
behind the right kidney, the liver being free from disease. The 
abscess had communicated through the diaphnigm with the right 
lung, and also opened into the laige intestine. ''Ine case is of suffi- 

384. cient 



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176 MEDICAL STATISTICAL BETimKS 

Pacific cient interest to justify its being reported in the words of the medical 
^J^' officer* of the sick quarters at Esquimault, where thd man died. 
Classes XII " • • • ®^« twenty-five, was received on the 10th of February 
and XIII, labouring under an obscure train of S3rmptoms having reference 
eeemingly to chronic hepatic disorder. He was sallow, sub-jaun- 
diced, emaciated, and debilitated. There was pain and tenderness 
in the right hypochondrium and right lumbar region. The area of 
hepatic dulness was enlarged downwards, but there was no fulness 
nor bulging of the ribs. There were no chest symptoms, either 
manifest or revealed by the stethescope. The appetite was bad, and 
the bowels irregular. He was treated at first with mineral acids 
and tonics. Aperients were at first required to procure regular 
action of the bowels; subsequently they became relaxed, and a 
troublesome diarrhoea was established which never altogether ceased, 
and contributed in a great measure to the fatal termination. 

^* About the 8th of March he first complained of cough accom- 

Eiinied with muco-purulent sputum. The latter was at first slight, 
ut soon became profuse, consisting almost entirely of intensely 
fetid pus. The pain and tenderness in right hypochondrium and 
right fiank were also much increased, so that the slightest touch 
caused great suffering. The weight of the bedclothes even caused 
annoyance, and the patient could not tolerate any prolonged exa- 
mination either with stethoscope or by percussion. Loud coarse 
crepitation, amounting at times to gurgling, was heard, however, 
over the lower part of the right chest, and abscess connected with 
the liver was diagnosed, which was thought to have burst into the 
lung, Bed sores were established, and the patient was placed in an 
air-bed with great relief to his sufferings. On the 21st of March a 
sharp rigor, followed by increased pam and tenderness in the side 
took place, and from this date severe exacerbations of pain were 
frequent. The cough and sputum gradually diminished, and by the 
27th of April had quite ceased; and, with the exception of the 
diarrhoea, nis condition seemed to be improving. On the 7th of 
May oedematous swelling of the left foot and ankle was noticed. 
This gradually extended as high as the knee, but was, until w ithin a 
few days of his death, confined to the left lower extremity. As 
there was also tenderness along the inner part of the left thigh this 
circumstance was thought to indicate venous obstruction, and the 
prelude of a pyaemic condition. The hypo-sulphate of soda was 
therefore prescribed, but with no very decided result. On the 1st 
of May, the patient noticed a discharge per anum which came on 
suddenly, and on examination proved to be sero-purulent matter ; 
this discharge lasted for ten days, and was sufficient to saturate the 
clothes placed underneath to protect the bed. It was considered 
to be also the result of hepatic abscess bursting into the intestinal 
canal. The discharge from the lung, it will be observed, ceased 
a few days before this latter escape of matter per anum took 
place. Ajiodynes and astringents were now frequently necessary to 
allay distress and check diarrhoea, which had become exhaustive. 

The 

* Snifeon Geoiige BeUamy . 

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OP THE PACIFIC STATION. 177 

The patient took nourishment fairly, and a pint of wine daily, but Pacific 

his condition gradually became worse, and he sank from exhaustion Station. 

on the 23rd of May. ^ 1,,^ 

^ Classes XII. 

" Autopsy. — Thirty-nine hours after death. Body, — Extremely ^nd XIII. 

emaciated. Lower limbs from knees downwards cedematous, left one 
mostly so. Abdomen quite flaccid, and free from flatus or col* 
lection of fluid. Chest. — Left lung healthy ; the usual hypostatic 
congestion on the posterior aspect. Right lung, upper lobe healthy ; 
lower lobe almost entirely disorganised from infiltration of purulent 
matter. It appeared to form the sac of an abscess which commu- 
nicated, by a large ragged opening in the diaphragm, with another 
larger cavity below that organ. The middle lobe of the lung (right) 
was in part, healthy and crepitant, but its lower portion approximated 
in appearance to the lower lobe, being partially disorganised by the 
passage of pus through its tissue. No trace of tubercular matter 
was seen, but in many places the smaller bronchial passages ter- 
minated in ragged cavities partially filled with curdy pus which was 
highly fetid and appeared to be of old formation. Liver. — Kather 
larger than natural but healthy in structure, and free from abscess 
either primary or secondary. Posterior parts congested and of 
dark purple colour. On removing this organ, the right kidney was 
found to DC lying in, or rather forming the anterior wall of a very 
large abscess, containing a quantity of thick grumous offensive pus. 
On the posterior aspect of the right kidney, about its centre, was a dark 
ecchymosed patch the size of half-a-crown ; this, appeared of old 
standing, and on making a section in a transverse direction, small 
patches of lymph were seen embedded in the cortical structure of 
the kidney ; ouier parts of this organ were healthy. The abscess 
above mentioned appeared to be situated in the cellular tissue behind 
the kidney and extended from the margin of the lower rib above, 
to the crest of the ileum below. In the transversa direction it 
extended from the sides of the lumbar vertebrae to the outer border 
of the quadratus lumborum muscle. This muscle and those adjoin- 
ing, viz., the psoas magnus, iliacus internus, and the mass of mus- 
cular substance forming the erector spinae, were blackened, softened, 
and in a great measure disorganised from the prolonged contact of 
purulent matter. The bones in the vicinity, corresponding to the 
circumference of the abscess, were all affected with superficial 
necrosis, being denuded of periosteum and of a black colour. Thus, 
the lower margin of the last rib, the transverse ])rocesses of the five 
lumbar vertebrae, the upper border of the crista ilii, as well as a por- 
tion of the ventral surface of the iliac bone were all superficially 
necrosed, the diseased state being apparently secondary to the 
formation of the abscess. A large ragged opening existed in the 
diaphragm corresponding to the passage of the muscular structures 
(psoas magnus, &c.) through that organ, being situated altogether 
behind the liver and pentoneum. Fhrough the opening, which 
would admit three fingers readily, pus flowed freely on making 
pressure on the kidney below. Two or three perforations also 
existed in the muscles above named, by which the pus found its 
way to the subcutaneous cellular tissue in the right lumbar region, 
accounting for the pain, tenderness, and tumefaction observed in 
384. that 



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Pacific 
Station* 



Classes XII. 
' andXm. 



178 



Medical statistical setubn^ 



that locality during life. The colon, at the point where it first im* 
pinges on the kidney in its upward course, was found glued to the 
cellular tissue around that organ, and a small opening existed about 
the size of a pea, by which pus found its way from the cavity of the 
abscess into the interior of the canal accounting for the discharge 
of pus i>er anum during life. 

'* Other organs healthy in chest and abdomen. Head not exa- 
mined. Bladder contained about eight ounces of urine." 



Unclassed Diseases. 

Twenty-nine cases were entered on the sick-list under this head, 
of which two were invalided, and one proved fatal. The fatal case 
was one of delirium tremens* 

Delirium Tremens, — There were three cases of this degrading 
disease under treatment, of which, one occurred in the person of a 
conmiissioned officer, one in a Marine, and one in a bandsman. In 
the case of the officer the disease proved fatal. 

Alcoholic Poisoning. — Five cases of alcoholism were under 
treatment, four occurring in the persons of Marines and one in an 
able seaman, all of the Satellite. The irritability of the stomach 
in these cases seems to have been speedily overcome by the applica- 
tion of sinapisms to the epigastrium, and the exhibition of a mixture 
containing powdered capsicum, citric acid^ sugar^ and water. 



Wounds and Injuries. 

A petty-officer was killed by the accidental discharge of a com- 
rade's rifle ; and another petty -officer sustained fatal fracture of the 
skull by a blow from the tiller. A man sustained fatal fracture of 
the i«pine by falling from a height of about forty feet from a tree 
up which he had climbed in search of fruit ; and a man was killed 
by falling from aloft, his skull being extensively fractured. 

Three men were accidentally drowned, one in bathing from the 
ship ; one by being capsized in a canoe v and in the third instance, 
the man was found drowned. A man, in a fit of temporary insanity 
it is supiK)sed, conunitted suicide by jumping overboard. 

The total number of deaths was thirty, which is in the ratio of 
12-8 per 1,000, being an increase compared with the preceding year 
equal to 4*8 per 1,000. 



Invaliding. 

In General Diseases, Section A., one person was invalided for 
ague ; and in Section B., six persons were invalided for rheumatism ; 
two for primary syphilis ; four for secondary syphilis ; two for 
scrofula; and ten for phthisis pulmonalis. Eleven persons were 
invalided for diseases of the nervous system, and organs of the 

special 



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OF THE PACIFIC STATION. 179 

special senses ; eight for diseases of the circulatory system ; four Pacific 
for diseases of the respiratory system ; five for diseases of the Station. 
digestive system ; one lor diseases of the urinary and generative •"""" 

system; one for diseases of the cellular tissue and cutaneous 
system ; two for unclassed diseases ; and two for the results of 
wounds and injuries. The total number invalided was fifty-nine, 
which is in the ratio of 25'3 per 1,000 of force, being a reduction, 
compared with the preceding year, equal to 12*2 per 1,000. 



384. 

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180 



MEMCAL STATISTICAL RETURNS 



Table, No. 1. 

Showing the Number of Cases of all Diseases and Injuries, and the Number luTalided 
and Dead, with the Ratio per 1,000 of Force. 



DISEASE OU INJURY. 



Cmm. 



Number. 



I. General Diseases, Section A. : 

Small-pox - - - . 
Enteric Fever 
Simple continued Fever - 
Ague - - - - 
Remittent Fever - 
Erysipelas - - - 



II. General Diseases, Section B- 

Rheumatism - - - • 

Gout . - . - - 

r Primary - 
"\Sccondary - 

Scrofula - . - . 
Phthisis Pulmtinalis 

Dropsy - - - - ■ 



Syphilis 



III. Diseases of tiie Vervous Sys- 
tem and Organs of the 
Special Senses : 

Sunstroke . - - - 

Paralysis - . - - 

Vertigo - - - - - 

Epilepsy . . - - 

Neuralgia - - - - 

Insanity . . . - 
Diseases of the Brain 
Diseases of the Nervous System 
Diseases of the Eye 

Diseases of the Ear - - - 
Diseases of the Nose 



197 
*i 

177 

09 

1 

9 

1 



1 
4 
3 
8 
14 
1 

3 

30 

5 

2 



Ratio 
per 

1,000 
of 

Force. 



20 


8-5 


3 


1-2 


70 


20* 


13 


5-6 


4 


17 


1 


•4 



84*5 

•8 

75*9 

42-4 

•4 

3-8 

•4 



•4 
1-7 
1-2 
.T4 
6- 

•4 

1-2 

12-8 

2-1 

•8 



Invalided. 



Number. 



2 

4 

2 

10 



1 
4 

2 
1 



Ratio 
per 

1,000 
of 

Force. 



2-5 

•8 
1-7 

•8 
4-2 



•4 
1-7 

•8 
•4 

1-2 



Dead. 



Number. 



Ratio 

per 

1,000 

of 
Force. 



2 
1 



•8 
•4 



1-7 



Digitized by 



Google 



OF THE PACIFIC STATION. 



181 



Table, No. 1. — Showing the Number of Cases of all Diseases, &c. — continued. 



DISEASE OR INJURY. 



IV. Diseases of the Circulatory 
System: 

Disease of the r Functional 
Bean -\Oiganic - 
Aneurism - - . - 
Varicose Veins « - - 



V. & VI.Disease8 of the Absorb- 
entlSystem and Ductless 
Glands: 



Bubo (iSymp,) 
Glandular Diseases 



Vn. Diseases of the Bespiratory 
System: 

Catarrh - - - - - 
nasmoptysis - - - - 
Diseases of the Lungs 

Vm. Diseases of the Digestive 
System : 

Cynanche - - - - 
Diseases of the Mouth; Teeth, 

&c. - - - - - 
Dyspepsia -. - - - 
Dysentery - - - - 
Diarrhoea - - - - 
Colic and Constipation - 
Haemorrhoids . - - 

Hernia - - - - - 
Worms - - - - - 
Other Diseases of the Stomach, 

Intestines, &c. - - - 
Diseases of the Liver, Spleen, 

&c. - - * - - 



DL &X. Diseases of the ITrinary 
and Generative Systems : 

Diseases of the Kidneys - 
Diseases of the Bladder - 
Cronorrhoea - - - - 

384. 



CuKt. 



Number. 



35 
1 



399 
45 



94 

2 

189 

4 

262 

47 

10 

4 

7 



12 



Ratio 
per 

1,000 
of 

Force. 



2-6 

3-4 

•4 

1-2 



15- 



171-2 

•8 

19-3 



40-3 

•8 

811 

1-7 

112 4 

201 

42 

1-7 

3- 

1-7 

51 



1-7 

•4 

36-9 



Invalided. 



Number. 



6 
2 



R 



Ratio 

1,000 

of 
Force. 



2-6 
•8 



•4 
1-2 



Dead. 



Namber. 



Digitized by 



Google 



182 



MEDICAL STATISTICAL RETURNS 



Table, No. L — Showing the Number of Cases of all Diseases, kc^continued. 



DISEASE OR INJURY. 



IX. & Z. Diseases of the ITri- 
nary and Oenerative 
Systems^coM^mtfeJ. 

DlsoaBes of the Oigans of Gene- 
ration .... 
Stricture - . - - 
Varicocele - ~ - - 
Orchitis- . . . - 

XI. Diseases of the Organs of 

Loeomotion : 

Diseases of the Bones, Joints, 
&c. - - - - - 

XII. & XIII. Diseases of the 

Cellnlar Tissue and Cuta- 
neous System : 

Phlegmon and Abscess - 

Ulcer 

Carbuncle - - - - 

Diseases of the Skin 

Scabies - - - - . 



ITnclassed: 

Debility 

Delirium Tremens - 

Poisoning by Alcohol 



Wounds and Injuries : 

Wounds, Injuries, &c. - 
Burns and Scalds - 
Suicide - - - . 
Submersi m and Drownuig 



Totals 



Guet* 



Number. 



2 


•8 


16 


6-8 


1 


•4 


39 


167 



13 



21 
3 
5 



628 
18 



3,890 



Ratio 
per 

1,000 
of 

Force. 



6-5 



564 


242- 


155 


eo5 


1 


•4 


24 


10-3 


1 


•4 



9- 

1-2 

21 



269-5 

77 

21 



1454-5 



Invalided. 



Number. 



50 



Ratio 
per 
1,000 

of 
Force. 



25-3 



Dead. 



Nomber. 



30 



Ratio 
per 
1,000 

of 
Force* 



17 

•4 
1-2 



12-8 



Digitized by 



Google 



OF THE PACIFIC STATION. 



183 



Table, No. 2. 

Showing the Number of Days' Sickness from each Disease and from Injuries, the 
Average Number of Men Sick Daily, with the Ratio per 1,000 of Force. 



DISEASE OR INJUKY. 



Kumber of Dayi* Sickoccs 



On Board. 



In HospiuU 




Average Number of 
Men Siek Duly. 



Number. 



Ratio 

per 

1,000 of 

Force. 



I. General Dueases, Section A. : 

Small-pox - - . . 
Enteric Ferer 
Simple continued Fever 
Ague - . - - . 
R^ttent Fever - 
Erysipelas . - - . 



n. General Diseases, Section B. 

Rheumatism - - - . 
Gout 

^^^^MLISy : : 

Scrofula - . - 

Phthisis Puhnonalis 

Oropsy 



m Diseases of the Veryous 
System and Organs of the 
Special Senses: 

Sunstroke - - - - 
Paralysis - - - - 
Vertigo - - - - - 
Epilepsy - . . - 
Neuralgia .... 
Insanity - - - - 

Other (useases of the Brain - 
Diseases of the Ner? ous System 
Diseases of the Eye 
Diseases of the E^ 
Diseases of the Nose 

384. 



739 

640 

166 

259 

6 



2,313 

8 

4,108 

i^,.398 

45 

454 

4 



a 

68 

15 

113 

168 

36 

16 

471 

37 

11 

b2 



149 
44 
35 
49 



994 

1,966 

1,102 

66 

194 



64 

151 

37" 
154 

60 



888 
66 
675 
215 
259 
5 



3,307 

8 

6,164 

4,560 

111 

648 

4 



3 
132 

15 
264 
168 

72 
154 

16 
531 

37 

11 



2-4 
•1 

1-8 
•5 

7 



9- 

16-8 

12-4 

•3 

1-7 



•7 
•4 
•1 
•4 

1-4 
•1 



•7 
•2 
•3 



3-8 

T2 

5-3 

•1 

•7 



•3 
.1 

•1 

•6 



Digitized by 



Google 



184 



MEDICAL STATISTICAL BETUBNS 



Table, No. 2,— Showing the Number of Days* Sickness from each Disease, kc^cont"^. 




Number of Days' SickneM 


Men Sick DaUy. 


DISEASE OR INJURY. 










Ratio 




OoBoaH. 


In Hospital. 


Total. 


Number. 


per 

1.000 of 

Force. 


IV. Diseases of the Circulatory 
System: 












Disease of the f Functional - 

Heart - \ Organic - 
Aneurism - . - - 
Varicose Veins 


122 
193 

27 
66 


52 
26 


122 

245 

53 

66 


•3 
•6 
•1 
•1 


•1 
•2 


V. ft VI. Diseases of the Absorb- 
ent System and Ductless 
Olaads: 












BnhoiSpnp.) 
Glandular Diseases 


1,162 
23 


3 


1,162 
26 


31 


1-3 


Vll. Diseases of the Sespiratory 
System: 












Catarrh 

Hflemoptjrsis - - - - 
Other Diseases of the Lungs - 


2,731 

11 

797 


10 
498 


2,741 

11 

1,295 


7-5 
3-5 


3-2 
1-5 


VIII. Diseases of the Digestive 
System: 












Cynanche . - - . 
Dyspepsia . - - - 
Dysenteiy - - - . 
Diarrhoea .... 
Colic and Constipation - 
Hemorrhoids - . . 
Hernia - - - . - 
Worms - - - - - 
Other Diseases of the Stomach 
Diseases of the Mouth, Teeth, 

&c. - - - - - 
Diseases of the Lirer, Spleen, 

&c. - - - - . 


374 

1,021 

72 

1,305 

154 

90 

09 

25 

101 

7 

311 


89 
4 

23 
215 


374 

1,110 

72 

1,309 

154 

90 

112 

25 

316 

7 

311 


1- 

3- 
.1 

3-5 
•4 
•2 
•3 

•8 
•8 


•4 

1-2 

1-5 
•1 

•1 

"^3 

•3 



Digitized by 



Google 



OF THE PACIFIC STATION. 



185 



Table, No. 2, — Showing the Number of Days* Sickness from each Disease, &c. — cont^. 



» 


Number of Days' Sickness 


Ayerage Number of 
Men Sick Daily. 


DISEASE OR INJURY. 


c 








Ratio 




On Board. 


In Hospital. 


Total. 


Number. 


l,^of 
Force. 


IX. &X. Diseases of the XTrinary 
and Oenerative Systems : 












Diseases of the Kidneys 
Diseases of the Bladder 
Gonorrhoea - - - - 
Diseases of the Orgsnt of 
Generation - - - 
Stricture - - - - 
VaricocQle - - - - 
Orchitis - . . - 


22 
7 

2,022 

18 

294 
232 
448 


17 

17 

128 

268 
134 


39 

24 

2,150 

18 
562 
232 
582 


•1 
5-8 

1-5 

•6 

1-5 


2-4 

•6 
•2 

•6 


ZI. Diseases of the Organs of 
Locomotion : 












Diseases of the Bones, Joints, 
&c. 


155 


- 


155 


•4 


•1 


XII. ft Xm. Diseases of the 
Cellnlar Tissne and Cnta- 
neons System : 












Phlegmon and Abscess - 

Ulcer 

Carbuncle 

Diseases of the Skin - 

Scabies - - - - 


4,996 

3,208 

62 

683 

2 


274 
268 

109 
2 


5,270 
3,476 

62 
792 

4 


14-4 

9-5 

•1 

21 


61 

4- 

•9 


TTnelassed: 












Debility ... - 
Delirium Tremens 


317 
9 


11 


328 
9 


•8 


•8 


Wonnds and Iiynries : 

Wounds, Injuries, &c. - 
Bums and Scalds - - - 
Poisoning by Alcohol - 


6,631 

187 

26 


1,120 


7,751 

187 

26 


21-2 
•5 


9- 

•2 


Totals - - - 


41,178 


8,393 


49,571 


185-8 


58-2 



384. 



b3 



Digitized by 



Google 



186 



MEPICAL STATISTICAL RETURNS 



Tablb, No. 3, 
Showing the Number Invalided from each Ship employed on the Pacific Station. 



CAU »E 

OF 

INVALIDING. 


1 


1 


.ss 


i 


;2 




j 


1 


s 


i 


•- 


1 


I. General Diseasei, Section A. : 
Ague ^ . . . - 

n. General Diseases, Section B. : 
Bheumaiism 

="-d,: ; 

Scrofula .... 
PhthisiB - - - . 

III. Diseases of the Vervous 

System and Organs of 
the Special Senses: 

Vertigo .... 
Epilepsy - - - . 
Insanity . - - - 
Other diseases of the Brain - 
Diseases of the Eye - 

IV. Diseases of the Cironlatory 

System: 

Disease of the Hearty Organic 
Varicose VeiiiB - - - 

Vil. Diseases of the Bespira- 
tory System: 

Hemoptysis ... 
Other Diseases of the Lungs 


2 

1 

2 


1 
1 

1 


3 

1 

1 
1 

1 
3 

1 

1 


1 
1 


1 

1 
1 


1 
1 

2 


1 
2 

1 


1 


1 
1 

1 


2 


3 

2 
2 

1 

1 

1 


1 

6 
2 
4 
2 
10 

1 
4 
2 
1 
3 

6 
2 

1 
3 



Digitized by 



Google 



OF THE PACIFIC STATION. 



187 



Table, No. 3. — Showing the Number Invalided from each Ship, &c. — continued. 



CAUSE 

OP 

INVALIDING. 


o 


1 


1 


^ 


^ 


i 

I 


& 


1 


.^ 


1 


f2 


1 


1 


YIII. DiBcases of the Digestive 
System: 
Dyspepsia - - - - 

Hernia - - - - 

Other Diseases of the Sto- 
mach, Intestines, &o. 

Diseases of the Liver, &c. - 

IX. ft X. Diseases of the ITri- 
nary and Generative 
Systems: 
Stricture - - - - 

Xn. ft Xm. Diseases of the 
Cellular Tissue and Cu- 
taneous System: 

Ulcer 

TTnelassed: 

DebUity - - - . - 

Wounds and Injuries : 

Wounds . - - - 




1 

1 

1 
2 




1 


^ 


1 


- 


- 






1 


1 
1 

1 


1 
1 

2 

1 

1 

1 
2 
2 


Total ^ - - 


5 


8 


11 


3 


3 


5 


4 


1 


1 


3 


3 


12 


69 



384. 



R 4 



Digitized by 



Google 



188 



MEDICAL STATISTICAL RETURNS 



Tablb^ No. 4. 
Showing the Number of Deaths in each Ship employed on the Pacific Statiok. 



CAUSE OF DEATH. 


j 


i 


1 


II 

si 


i 

I 


•s 


1 


s 


i 

1- 


H 


1 


1 


I. General Diseases, Section A. : 
Enteric Fever - - • 
Simple Continued Fever - 

n. General Diseases, Section B.: 
PhthisU 

TTT. Diseases of the Vervons 
System and Organs of the 
Special Senses: 

Diseases of the Brain 

IV. Diseases of the Circulatory 
System: 

Disease of the Heart, Organic- 

V II. Diseases of the Sespiratory 
System: 

Diseases of the Lungs - 

VIII. Diseases of the Digestive 
System: 

Dysentery - - - . 

Other Diseases of the Stomach, 
Intestines, &c. - 

Jaundice - - - - 




1 

1 

1 




1 


I 


1 


1 

2 




- 


1 

1 
2 
1 


1 
2 

1 
I 


2 

1 

4 

2 
3 
4 

I 

1 
1 



Digitized by 



Google 



OF THE PACIFIC STATION. 



189 



Table, No. 4.— Showing the Number of Deaths in 


each 


Ship, &( 


I. -^ continued. 


CAUSE OF DEATH. 


j 


j 


.a 
u 


§1 
li 


i 


1 


1 


2 

;= 


1 


H 


j 


4 

1 


IX. & X. Diseases of the Vrinary 
and Oeneratiye Systems : 

Disease of the Kidneys - 

Xn. & Xm. Diseases of the Cel 
Inlar Tissue and Cntaneons 
8]r>tem: 

Abscess* - . . - 

Vnokssed: 

Delirium Tremens - 

Woonds and Iiynries : 

Wounds, &c. - - - - 

Suicide 

Submersion and Drowning - 


1 

1 


2 


1 


1 


- 


1 


- 


1 


1 


1 


(a)l 


1 

1 

1 

4 
1 
3 


Total - - - 


2 


6 


1 


2 


1 


2 


8 


1 


1 


6 


6 


30 



(a) By drowning. 



384. 



Digitized by 



Google 



190 



MEDICAL STATISTICAL BETURN9 



Tablb^ No. 6. - 
Showing the Number of Cases of all Diseases and Injuries 



DISEASE OR INJURY. 









B 




O 




4J 


Jj 


Si 


1 


i 




20 


4 


28 


- 


- 


1 


18 


1 


4 


2 


- 


•. 


» 


- 


2 


- 


- 


1 


2 


2 


- 


- 


* 


-i 


_ 


- 


2 


1 


« 






- 


2 


— 


- 




" 


1 


2 


• 1 


"• 


. 


16 


— 


. 


6 


2 



s 

6 






I. Oeneral Diseases, Seetion A. : 



Small-pox ------ 

Enteric Fever - . - - - 
Simple Continued Fever - . - 
Ague ------- 

Remittent Fever - - . - - 
Erysipelas ------ 

II. General Diseases, Seetion B. : 

Rheumatism ..... 
Gout 

sypi^il^Sy: : : : 

Scrofula - . - - . 

Phthisis Fulmonalis - • . . 
Dropsy ,-...- 

III. Diseases of the Vervons Svstem and 

Organs of the Special Senses : 

Sunstroke - 

Paralysis ------ 

Vertigo 

Epilep8)r ------ 

Neuralgia ------ 

Insanity -.-.-- 
Diseases of the Nervous System - 
Diseases of the Eye - - - - 

Diseases of the Eiar . - - . 
Diseases of the Nose - . . . 

IV. Diseases of the Circulatory System : 

Disease of the fFunctional - - - 

Heart \.Oiganic - - - 

Aneurism ------ 

Varicose Veins ----- 

V. ft VI. Diseases of the Absorbent 

System and Ductless Glands : 



Bubo (iS^rw.) 
Glandular Dis 

Vn. Diseases oftheBespiratory System: 



Catarrh . - - - 
Hemoptvsis . - - 
Other Diseases of the Lungs 



12 

10 



15 

8 

1 



19 

7 



(a) Myditit. 



30 

15 
10 



(a) I 
S 
2 



29 
9 



19 

8 

14 

1 



28 
2 



Digitized 



by Google 



OP THE PACIFIC STATION. 



191 



384. 



- Table, No. 6. 
in the Ships employed on the Pacific Station. 





1 
14 


S5 


& 


1 


1 

.S 


4 


1 


S 

1 


,£ 


e5 








t 














20 




- 


«. 


m. 


. 


«. 


„ 


. 


1 


2 


3 




- 


3 


- 


^ 


10 


1 


- 


3 


- 


70 




- 


- 


- 


1 


- 


- 


2 


- 


- 


13 




— 


- 


— 


— 


1 


. 


- 


- 


— 


4 






^ 


1 


"" 


— 


■■ 


" 


"~ 


"* 


1 




3 




5 


24 




18 


10 


9 


44 


197 




— 


. 


— 


~ 


1 


_ 


. 


— 


1 


2 


- 


9 


9 


6 


1 


10 


2 


38 


00 


177 


» 


5 


- 


5 


- 





10 


28 


17 


99 


- 


. 


— 


■• 


_ 


. 


. 


« 


— 


1 


1 - 


- 


1 


1 


1 


. 


- 


- 


2 


9 










1 


" 


■ 








1 




1 


















1 






- 


1 


1 


. 


1 


- 


- 


1 


4 




^ 


. 


— 


— 


— 


_ 


. 


- 


m. 


3 




^ 


-. 


- 


1 


. 


mm 


1 


- 


2 


8 




1 


5 


1 


1 


1 


1 


- 


2 


- 


14 




^ 


— 


— 


— 


_ 


«. 


— 


— 


1 


1 




. 


mm 


- 


(b)l 


. 


«. 


- 


- 


.. 


3 




mm 


- 


- 


1 


2 


2 


4 


1 


10 


30 




mm 


— 


— 


— 


— 


» 


- 


— 


2 


6 




— 


• 


" 




"• 


• 


1 


■" 


^ 


2 








1 


1 










2 







mm 


- 


2 


- 


. 


. 


- 


1 


1 


8 




mm 


. 


— 


" 


. 


. 


- 


— 


- 


1 




■" 


1 






1 


■" 






■ 


3 




1 




3 


4 


1 






1 


5 


35 




• 


"* 






"• 


"" 




" 


" 


1 




3 


3 


17 


44 


4 


33 


20 


■ 74 


103 


399 




« 


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— 


2 


_ 


«. 


— 


- 


m. 


2 




"" 


4 


2 




— 


— 


2 


4 


7 


45 



(d) Embolism. 



Digitized by 



Google 



192 



MEDICAL STATISTICAL BETUBKS 



Table, No. 5. — Showing the Number of Cases of all Diseases and 



DISEASE OR INJURY. 



8 



•I 



s 



I 



Vm. Diseases of the Digestive Sjrstem : 
Cynanchc ------ 

Diseases of the Mouth, Teeth, &c. 
Dyspepsia ------ 

Dysentery ------ 

Diarrhoea ------ 

Colic and Constipation - - - - 

Hemorrhoids - - - . - 
Hernia ------ 

Worms -.---- 

Other Diseases of the Stomach, Intes- 
tines, &c. . . - - _ 
Diseases of the Liver, Spleen, &c. 



DL 



& X. Diseases of the Vrinary and 
Generative Systems: 
Diseases of the Kidneys - - - 
Diseases of the Bladder ... 
Gonorrhcea ------ 

Diseases of the Organs of Generation - 
Stricture ------ 

Varicocele ------ 

Orchitis ----.« 



XI, Diseases of the Organs of Locomotion 
Diseases of the Bones, Joints, &c. - 



Zn. & Xnr. Diseases of the Cellnlar 
Tissue and Cutaneous Syirtem : 
Phlegmon and Abscess - - . - 

Ulcer - - 

Diseases of the Skin - . . - 
Carbuncle ------ 

Scabies 



ITnclassed: 

DebiUty - - - - 
Delirium Tremens 
Poisoning by Alcohol • 

Wounds and Iiguries : 

Wounds, &c. - - - 
Bums and Scalds 
Submersion and Drowning " 



Total - - 



37 



9 
2 
1 

1 



48 

10 

3 



62 



246 



21 

23 
13 

2 
1 

1 



11 

1 
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62 
15 



49 
2 



292 



11 

5 
2 
14 
1 
1 



1 
11 

2 

2 



61 

18 
2 



57 
2 
1 



304 



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OF THE PACIFIC STATION. 



193 



Injuries 


in the Ships employed on 


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or AFBICA AND CAPE OS GOOD HOPE STATION. 195 



WEST COAST OF AFRICA AND CAPE OF 
GOOD HOPE STATION. 



In the year 1869 the Cape of Good Hope was separated from West Coast 

the East Indies Station, and added to the West Coast of Africa ^^^^ . 

Station, and the boundaries of the united Cape of Good Hope and Go^dlSope 
West Coast of Africa Station were defined as loUows : — Station. 

North,— By the parallel of 20** N. in the Atlantic, and by • 

parallel of 23'' 30' S. in the Indian Ocean. 
East— By 95*» E. longitude. 
South. — By the Antarctic Circle. 
West.— By 26« W. longitude. 

The squadron on the station comprised twenty vessels, viz, : — 
three of the sixth-rate; one sloop; nine gun-vessels; two steam 
vessels ; one receiving ship permanentiy stationed in Simon's Bay ; 
and four store ships, one of which was permanently stationed at 
Ascension, and another at Jellah Coffee. The returns from eleven 
of these vessels are for the whole year, and from the remainder for 
periods varying from two to nine months. The mean force cor- 
rected for time was 1,730, and the total number of cases of disease 
and injury entered on the sick-list, 2,795, which is in the ratio of 
1615*6 per 1,000 of force, being a reduction, compared with the 
preceding year, equal to 248*1 per 1,000. Of these 112 were inva- 
lided, and eighteen proved fatal, the former beinff in the ratio of 
64*7, and the latter of 10*4 per 1,000. Compared with the pre- 
ceding year, there was a reduction in the invaliding rate to the 
extent of 19*6, and in the ratio of mortality of 2*6 per 1,000. 

The average number of men sick daily from Class I., General 
Diseases, Section A., was in the ratio of 7*8 per 1,000, and from 
Section B., 8*9. From diseases of the nervous system and organs 
of the special senses, the average daily sick rate was 1*5; of the 
circulatory system^ *4 ; of the absorbent system and ductiess glands, 
1*2; of the respiratory system^ 2*7; of the digestive system, 5* ; of 
the urinary and generative systems, 4*4 ; ot the organs of loco- 
motion, *4 ; of tiie cellular tissue and cutaneous system, 10*5 ; from 
unclassed diseases, 1*5; and from wounds and injuries of various 
kinds, 9*3. The average number of men daily sick was 98*8, which 
is in the ratio of 57*1 per 1,000, which is a fractional increase com* 
pared with the precedmg year* 

384. 



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West Coast 

of Africa 

and Cape of 

Good Hope 

Station. 

Class I. 
Scot. A. 



196 MEDICAL STATISTICAL liETUBNS OF THE WEST COAST 

I. General Diseases.— Section A., or Febrile Group. 

Under this head 347 cases of various forms of disease were en- 
tered on the sick-list, viz. : — 124 of simple continued fever; twenty- 
one of ague; 199 of remittent fever; one of mumps, and two of 
erysipelas ; and of these, one of simple continued fever, two of ague, 
eighteen of remittent fever, and one of erysipelas, were invalided, 
and three of remittent fever proved fatal Each case of simple con- 
tinued fever was on an average a little over seven days under treat- 
ment : each case of ague between eleven and twelve davs ; each 
case of remittent fever about twenty davs; the case oi mumps 
thirteen days, and each case of erysipelas tJbree days. 



Simple continued Fever. — ^The Fly, the Myrmidon, and the Pan- 
dora were the vessels in which this form of fever prevailed in 
greatest niunbers. They were, however, as a rule, of so little 
importance, that but little information is given in connection with 
them. They were mainly attributable to insolation, and to exposure 
to alternations of temperature. 

Affue. — There was very little ague on the station, the vessels 
showing the largest number of cases being the Danae and the 
Pioneer, in both of which vessels they were very few and of 
little importance. 

Remittent Fever. — There were seven cases of this form of fever 
in the Danae, three of which were contracted at Fernando Po, 
and the remainder at Lagos. The three cases at Fernando Po 
occurred in the persons of two officers, one attack being a relapse. 
In the first case the officer had been constantly employed on shore 
for two months building a coal-shed. A few days previous to the 
vessel leaving Fernando Po, he had gone by boat round the island, 
and one night encamped near a river in Melville Bay, where the 
ground was low. The surgeon* of the vessel says, " .... it 
is very probable that during this time the malarious poison was 
taken into the system, his health being previously undermined by 
fatigue and exposure to the sun ; the period of incubation, therefore, 
was nine days. In this case there was much irritability of stomach, 
and not till sinapisms were applied to the pit of the stomach could 
it be allayed . ... he remained imder treatment nine days." 
The next case was also in the person of an officer, who had been in 
the habit of taking almost daily fatiguing exercise in walking up to 
the sanatorium at Bassile, in Fernando Po. In the expedition 
round the island he accompanied the officer whose case has just been 
referred to, and they were both attacked within a day of each other. 
In this case there was very little sickness, and the patient was seven 
days under treatment. The third case, as has been previously 
observed, was a relapse. It occurred in the person of the officer 
first attacked, who, through his importunity, had probably been dis- 

charged 

* Sarg;eon J. F. MitchelL 



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OF AFRICA AND CAPE OF GOOD HOPE STATION. 197 

charged to duty too soon. Seven days afterwards he irapmdently West Coast 
went on shore at Accra, and exposed himself to the sun, the result of Africa 
of which was a recurrence of the febrile affection. The other four «"^ ^^« ^^ 
cases of remittent fever in this vessel occurred in the Michaelmas ^gjat'^n^ 
quarter of the year, and were attributable to exposure in the Lagos J.!?"' 
lagoon. Class I. 

Sect. A. 
There were fifty-two cases of remittent fever in the Ply, of which 
one proved fatal. Fortv-four of these occurred during the Christmas 
quarter under the following circumstances, as narrated by the 
medical oflScer* of the vessel. " Having left Loando on the 5th of 
November, we reached the River Congo on the llth, and proceeded 
to Banana Creek to coal. We remained here until the 15th, 
lashed alongside the pier, exposed to the emanations of a swampy 
creek about sixty yards to windward, which separates the English 
from the Dutch factory. This creek is influenced by the tide, and 
at low water its banks are exposed, consisting of black soft mud, 
fringed with mangrove bushes (the creek is about forty yards in 
width) ; this being acted on by a powerful sun (thermometer 87**) 
emits a most disagreeable odour, as I have personally experienced. 
From the close proximity of this creek, the people in the English 
factory suffer a good deal from ague, whilst the people in the other 
factories to windward of the swamp enjoy good health. We left 
Banana Creek on the 15th for Punta da Linha, a settlement thirty - 
eight miles up the river from it« mouth ; it is situated on the right 
bimk of the nver, and consists of a number of factories, English, 
French, and Portuguese, who carry on a large trade with the natives 
in ground-nuts and palm kernels. The country between Banana 
and Punta da Linha is thickly wooded, and, inland, is hilly. The 
banks of the river are low and very swampy, and covered with 
mangrove bushes and large mangrove trees. The river here is in- 
tersected by numerous creeks. We left on the following day for 
Embomah, thirty-six miles higher up, which we reached the same 
day. The intervening country is for the first twenty miles swampy 
and thickly wooded ; for the remainder it is open, thinly wooded, 
and appears to be well cultivated ; it is also very hilly. At Em- 
bomah there are a few small branch factories, the people there being 
agents of those at Punta da Linha and Banana Creek ; the settle* 
ment is close to the water's edge ; the traders are mostly Portuguese. 
The place, while we were there, was considered by the residents to 
be very healthy. The river here is nearly three miles in width, and 
and contains a number of islands. The current was about three 
knots whilst we lay there, bearing down numerous floating islands, 
which renders navigation at times dangerous. We remained at 
Embomah from the 17th to the 22nd of Kovember, anchored within 
forty yards of the shore, which was lined at intervals with reeds. 
Whilst we lay there, a party of men were emjployed on shore, work- 
ing under cover at the rigging and sails. These men received five 
grains of quinine before going on shore, and also on their return on 

board 



• Aseistant Surgeon E, ^V. Doyle. 
384. S 



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W«t Coast 

of Africa 

and Cape of 

Good Hope 

Station. 

Class I. 
Sect A. 



198 MEDICAL STATISTICAL RETIJSHS OF THE WEST COAST 

board in the evening. They were working in eight of the ship, 
within a few yai^ds of the bank of the river, in a large shed, and 
were not much exposed to the sun. Nevertheless, most of them con- 
tracted remittent fever soon afterwards. During this time the wea- 
ther was intensely hot, the thermometer seldom under 90" Fahr. 
at noon, with very little rain. The place also swarmed with mos* 
quitoes, which effectually prevented one from obtaining any rest. 
We left on the morning of the 22nd for Punta da Linha, arriving the 
game afternoon ; there wo continued until the 30th, when we left 
for Kabenda. During the time we were in the river I administered 
five grains of quinine to every white man daily. Up to the 26th of 
November no sickness had occurred. On the 27th seven men were 
put on tlie sick-list with febrile symptoms, which soon assumed 
the remittent form. On the 29th two men were added ; on the Ist 
of December, ten ; 2nd, two; 3rd, three; 4 th, one ; 5th, two; 8th, 
one; 11th, one; 17th, one; 25th, one; and 28th, one. These last 
two cai»es were of a mild nature, and could not be attributed to the 
malarious influence of the River Congo, which we left on the 1st of 
December. The period of incubation in the first cases, allowing 
them to have inhaled the malarial poison the day we left Banana 
Creek, would be thirteen days. Whilst we lay at Punta da Linha 
none of the men were allowed on shore, although the residents con- 
sidered the place healthy. I met here two Englishmen, one of 
whom had been five, the other six, years in the river. They informed 
me, that with the exception of an attack of fever on arriving first, 
they had enjoyed good health ; but that if they were guilty of any 
excess, either in drinking or undue exposure to the sun, they were 
certain to have an attack of ague, which left them unwell for some 
days. Whilst we lay there, a merchant ship had been lying moored 
to the bank of the river ; she had been three weeks there, during 
which none of the men had taken quinine. The captain having 
consulted me, I advised him to issue it at once. Soon after, how- 
ever, all his men were attacked with fever, and she was obliged to 
put in to Ascension in distress. It is a well-known fact that no ship 
can lie a month in any of these rivers in the hot season without a 
certain amount of sickness. 

" In the cases of remittent fever which were contracted in the 
river, the symptoms were well marked. The fever was generally 
preceded by languor, lassitude, and wandering pains in the bacfe 
and limbs, accompanied by loss of appetite, a feeling of weakness 
and rigors. In some cases, however, there were no premonitory 
symptoms, the patient being seized with violent frontal headache, 
and severe pain in the lumbar region, sickness of stomach, and giddi- 
ness. The pulse was generally quick and weak, ranging from 90 to 
110, tongue coated with a white fur, and red at the edges; face 
sometimes flushed, more generally pale ; eyes congested. In four 
or five cases diairboea was a prominent symptom. The remissions 
always occurred during the day, commencing generally at 7 a.m. 
and terminating at 4 p.m., at which time the frontal headache and 
pain in the back and limbs increased in force ; the skin became hot 
and dr^, the patient restless and excited, and the symptoms gra- 
dually in^eased until midnight ; thirst was constantly complamed 

of, 



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OW AFBICA AND CAPE OP GOOD HOPE STATION. 



199 



of, aa also inability to sleep. In several cases there was delirium ; 
in some cases there appeared to be a slight remission about midnight, 
but in most of the cases the patient spent a wretched night, unable 
to sleep, tortured by violent headache and intense thirst, which 
nothing seemed to allay. There was also nausea and inclination to 
vomit, on attempting to drink any fluid. 

** At the outset, in men of robust habit of body, there is often 
delirium ; the patient becomes very much excited, insists on getting 
out of his hammock, talks wildly to himself, and labours under the 
idea that some one has injiu-ed him. As a rule, they are easily 
pacified ; promise them anything they ask for, and assure them that 
you will guard them from all danger, and they will generally 
Decome tranquil. Nevertheless, these cases sometimes give a good 
deal of anxiety ; thejr require to be constantly watched. In one 
case, a stoker was seized m the act of netting through a gun-port ; 
in another, a Marine tried to get out through the gangway ; both 
were suffering from remittent fever, and delirious. As the fever 

f)rogresses, however, delirium of a low kind supervenes ; the patient 
ie« on his bed motionless, unconscious of everything around him, 
muttering to himself; his face pale, the skin moist and clammy, 
tongue covered with brown sordes, and the pulse weak and quick. 
On being spoken to, he answers questions in a stupid sort of 
manner, probably complains of dull aching pain in the head, 
inability to sleep, and intense thirst; immediately afterwards he 
relapses into the state in which he was when adoressed. During 
this period the sensation of hunger is absent, there is an utter 
aversion for food ; if the case is about to terminate fatally, the pulse 
becomes quick, weak, and intermittent, the skin cold and clammy, 
the teeth and lips covered with sordes ; the patient is constantly 
muttering to himself, and picking at the bedclothes ; passes his 
urine and fteces in bed, and either sinks from exhaustion, or is 
seized with convulsions and expires. 

" Although I have witnessed but one case of remittent fever which 
terminated fatally, I have had under treatment several, in which the 
patients were almost pulseless, with cold and clammy skin, and low 
muttering delirium, which had lasted for some days, and afforded 
little hope of recovery, but which were brought round by the use of 
stimulants. From the type of remittent fever I have witnessed on 
this coast, I do not consider that there is any danger to life, pro- 
vided that the person attacked has been in good health previously, 
is free from organic disease, and has been judiciously treated." 

** In no case of remittent fever that came under treatment 

during the year did I find it necessary to have recourse to anti- 
phlogistic remedies. The treatment I found most successful, and 
that which is usually adopted on the coast by medical men, was as 
follows : On a patient presenting himself with symptoms of remittent 
fever, I administered at once five grains of quinine, with one ounce 
of Epsom salts. On the bowels being freely opened, I then gave 
five-grain doses of quinine twice daily. If there was much frontal 
headache, cold lotions to the head, constantly applied, gave much 
'relief. As most of the cases were complicated with a good deal of 
gastric irritability, bismuth in five-grain doses, in combination with 
384. S 2 two 



West Coast 

of Africa 

and Cape of 

Good Uop« 

Station. 

Class I. 
Eteot A 



Digitized by 



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West CoMt 

of Africa 

and Cape of 

Good Hope 

Station. 

Sect A. 



200 MEblCAL STATISTICAL EETUENS OF THE WEST COAST 

two minims of dilute hydrocyanic acid, generally allayed the vomit- 
ing; if it did not^ sinapisms were applied to the epigastrium. 
Durinff the first week the patient seldom had any appetite, reject- 
ing an nourishment with loathing. After that tune, when the 
irritability of the stomach had subsided, beef tea, or clucken broth 
in small quantities, and at intervals, was ^ven with success. Thirst 
was much complained of, as a rule. In those cases, after lime-juice 
had been taken for a few days, and patients stated that it did not 
allay their thirst, I found claret and water to answer best. 

" As the fever assumed a typhoid character, there was generally 
great mental despondency ; this it was of the utmost imuortance to 
combat by cheering the patient up, assuring him of nis speedy 
recovery, «nd insisting on his taking nourishment, although he might 
feel a strong disinclination to do so. I have never found it necessary 
to give more than eight ounces of wine in the twenty-four hours. 
The risk of giving it is, that it is liable to bring on a return of 
the headache, as I found in some cases. Where want of sleep is 
an urgent symptom, from ten to fifteen grains of Dover's powder 
answer well, even although there may oe a certain amount of 
headache. At first I was somewhat diflSdent of administering Dover's 
powder in cases where there was much frontal headache ; I tried tinc- 
ture of hyoscyamus, but finding it did not answer well, had recourse 
to Dover's powder with, in several instances, the best results. In 
some, cinchonism was produced after quinine had been taken for a few 
days, but without producing any abatement of the febrile symptoms, 
as it is supposed to do." 

There was only one case of remittent fever in the Investigator, 
and two in the Jaseur. The crew of the former vessel were berthed 
on board the Flora at Ascension, during the whole period for which 
her Returns are rendered, and their health improved very much. 
The Jaseur was only a vciy short time on the station during the 
year, she having been transferred to the Mediterranean. 

There were forty-four cases of remittent fever in the Lynx, all 
attributable to service in the Kiver Nicer. The medical officer* 
gives the following report of the outbreak : — '^ Forty-four cases of 
this form of fever were under treatment during the year, all of 
which occurred during, or in consequence of, the Niger Expedition. 
The first case occurred on the 6th of August, fifteen days after 
entering the river. From that time to the end of August, the 
disease went on increasing, then graduallv decreased till the 13th of 
November, when the last case was admitted. Of these forty-four 
cases, thirty were discharged to duty, twelve to hospital, and two 
died. The average duration of each case on the sick-list on board 
ship was ten days. Two patients were three times on the list with 
it, and four twice. The attack usually commenced in the evening 
a little before the usual time of exacerbation. The patient com- 
plained of headache and general malaisQ. The tongue would be 
found foul, pulse about eighty, and the bowels confined. A draught 

containing 

♦ Assistant Burgeon W. P. M. Boyle. 



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OF AFBICA AND CAPE OP GOOD HOPE STATION. 201 

containing half an ounce of sulphate of magnesia and ten grains of West Coast 
quinine was always given at once, and usually with great benefit. ^^J^ ci^e of 
About the second day great pain in the back was generally com- q^q^ Hope 
plained of, as was also great irritability of stomach, with constant Station. 

vomiting. The exacerbation usually occurred about 8 p.m., and 

the remisssion at 6 a.m. The remission was in most cases accom- Class I. 
pcuiied by great exhaustion and tendency to syncope. The urine ^^^^* ■*" 
was scanty and high coloured, in some cases nearly of the appear- 
ance of porter. Delirium occurred in but few instances — those in 
which there was most debility. The febrile symptoms in most cases 
did not last more than a week, the subsequent debility being the 
most serious part of the illniess. 

" The treatment consisted in giving saline diaphoretics, ten-grain 
doses of quinine twice a day, evaporating lotions to the head, with 
stimulants as required. I found the chief difficulty in procuring 
suitable drinks for the patients. Lime-juice was nearly always 
rejected after the first two or three days. Barley-water, rice-water, 
&c., nearly always caused vomiting. Toast-and-water proved to 
be the most grateful and satisfying when taken in small quantities. 
A wineglassful every quarter of an hour was the quantity allowed, 
as I found that as much as could be taken with any probability of 
its being retained. The champagne obtained at Lagos was of such 
an inferior (quality, that it always acted as an instant emetic. A 
small quantity of weak brandy-and-water was found very service- 
able in some cases in which nothing else could be kept on the 
stomach. I think it would be very advisable to supply ships with 
a quantity of claret, which could be obtained at a low price, and 
would, I feel convinced, be of very great utility. An ice machine 
would be invaluable in river service, where nothing cold can be 
obtain^. One, belonging to the officers of this ship, was unfor- 
tunately broken soon after entorinff the river, but I found that 
immersing bottles in a solution of the freezing mixture, rendered 
the drink much more acceptable. This irritability of stomach was 
one of the most difficult things to overcome. Not only did fever 
patients suffer from it, but men who were otherwise well would be 
seized with fits of vomiting in the middle of their work, and scarcely 
any person in the ship escaped. No violent retching generally ac- 
companied it ; the stomach appeared to be quite passive ; mustard 
poultices applied to the epigastrium seemed to produce more good 
effect than anything else, and occasional five-grain doses of nitrate 
of bismutli proved beneficial. 

** It was impossible to separate the sick from the rest of the ship's 
company, as would have been desirable. Some of them were kept on 
deck under treble awnings, but there was not room for more than a 
dozen at the outside, ana the rest had to remain on the lower deck. 

*' The lower deck was frequently sprinkled with a solution of 
carbolic acid, as were also the bilges, holds, and, in fact, every part 
of the ship. The ventilation could scarcely have been more 
perfect, or the ship more clean throughout/* 

The exposure to which the crew of the Lynx was subjected was 
very great. On the 26th of June the vessel left Ascension and 
reached I^os on the 5th of July, remaining there until the 21st. 

384. 8 3 " While 



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202 MEDICAL STATISTICAL RBTURNS OP THE WEST COAST 



West Coast 

of Afidca 

and Cape of 

Grood dope 

Station. 

Class I. 
Sect. A. 



*' While there, we took in the usual Niger stores, and flannel suf- 
ficient for two cholera belts was issued to each man. AVe entered 
the Niger on the 23rd of July, and anchored off Akana about half- 
a-mile from the entrance. The river here is about three quarters of 
a mile wide, with low banks overgrown with mangroves. Rheumatic 
affections are exceedingly common. We were three days among 
the mangroves in the Delta, and arrived at Onitsha, 165 miles from 
the entrance, on the Slst of July and remained three days. About 
this place the banks of the river begin to get pretty high and the 
country is well wooded. Fever is not very prevalent here, but 
children are very subject to craw-craw, or the yaws. This the na- 
tives cure by the application of a preparation of the lees of palm 
oil. We arrived at Lukoja, 282 miles up, on the 7th of August, 
having one case of fever on board. 

" Lukoja is a large town on the right bank of the river, containing 
about 5,000 inhabitants. It is built nearly on a plain at the foot of 
a range of mountains. There is not the slightest attempt at drain- 
age ; nevertheless the place is very healthy, according to the report 
01 Her Majesty's consul. There is but little fever even in the 
rainy season. We remained here a week, then proceeded about 
twenty-five miles up the River Binneh or Tchadda. During the 
time we were in this river (three days) the ship frequently got 
aground. In order to get her off, the boats had to be sent away to 
lay out anchors, &c., thus exposing the men a good deal. Returned 
to Lukoja, where we remained till the 17th of August, when 
we proceeded up the Niger. While at Lukoja the fever became 
general. 

*^ Ari'ived at Egga, 358 miles up, on the 19th of August, and re- 
mained one day. The river here is very wide, and the banks low 
and swampy. The merchant steamers lying close to the town get 
a good many cases of fever. Arrived at Muraki, 400 miles up, on 
the 21st of August and remained till the Ist of September. The 
river here is about 1,000 yards wide and the banks of a moderate 
height ; we anchored in the middle of the stream. This is the 
highest point the Lynx reached, but the Pioneer went some twenty 
miles up the River Kirduna towards Biddah. At this place a large 
number of cases of fever occurred. There are large swamps on each 
side, a little distance inland, from which no doubt the malaria pro- 
ceeded. 

"We left here on the 1st of September and proceeded down the 
river. On the 3rd the ship grounded between Egga and Lukoja, 
and remained on shore five days. On the third day, nine of the 
worst cases of fever were sent on to Lukoja in the Pioneer. They 
were received at the consulate, where they were under the care of 
the medical oflScer of the Pioneer. 

" On getting afloat again we proceeded down the river, stopping as 
little as possible, and arrived at Akana on the 12th of September; 
remainea there twenty-four hours, and proceeded to Ascension, 
touching at Lagos and Jellah Coffee. Arrived at Ascension on the 
4th of October, and remained till the end of the year. 

** While in the Niger, the weather was generally fine ; ther- 
mometer about 88^ in the shade. When there was any wind, it 

invariably 



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OF AFBICA AND CAPE OF GOOD HOPE STATION. 203 

invariably blew up the river, but it was nearly always calm. For West Coast 
the last lew davs it rained continually, rendering it utterly impos- of Africa 
siblo for the watch on deck to keep dry." Go1)d^ iSo ^q 

There were six cases of remittent fever in the Myrmidon. They Station. 
usually commenced with loss of appetite, nausea, and sometimes an Class I. 
unpleasant taste in the mouth. Headache was mostly frontal, with gect. JL 
acnin^ in the back, and general malaise. At night there was fever, 
hot dry akin, bounding pulse, increased headache and thirst, with 
ext/eme restlessness. The tongue was generally dry and coated ; 
the conjunctivas injected. 

The medical officer* savs, *' The period of this accession varied 
from an hour to three or four. The patient was then left relieved, 
but headache remained. In some there was yellowness of skin and 
conjunctivte, especially in one case in which there was continual and 
excessive vomiting. The urine, in two cases, was very high-coloured 
and scanty. The bowels generally costive and indicating the necessity 
for the administration of salines. Fever generally diminished by suc- 
cessive accessions. Convalesence tedious, with a tendency to relapse. 
Tenderness on pressure over the right hypochondrium, in three 
cases out of six. Great sleeplessness in all cases, and, as far as I 
found, opium in any form contra-indicated." 

There were five cases of remittent fever in the Pandora, at- 
tributable, apparently, to service in the River Congo ; but little 
information, however, is given in connection with them. They 
appear to have been tedious, the average duration of each case being 
between twenty -five and twenty-six days. 

In the Peterel there were fourteen cases of remittent fever, mostly 
attributable to river service ; on one occasion they were contracted in 
the Maputa on the East Coast of Africa, and subsequently in the rivers 
on the West Coast. The average duration of each of these cases 
was between eleven and twelve days. They presented no especial 
features of interest. 

There were forty-two cases of remittent fever in the Pioneer, not 
a large number, when it is considered that during nearly the whole 
year the vessel was stationed, with brief exceptions, in the lagoon 
at Lagos, and that she was employed in an expedition up the 
Niger. The medical officerf gives the following sketch of the 
medical topography of Lagos : ^^ Lagos is an island surrounded on 
all sides by the waters coming from a large lagoon, the * Crudu 
Water.' It is low, flat, thickly wooded, about two and a half miles 
long, and one and a half miles broad, and contains on an average 
about 40,000 inhabitants, nearly all of whom are natives. In reality 
there are two towns on the island, one, built on the west side, 
inhabited by Europeans, the houses, being of brick (which the 
natives make in the interior), are two storeys high. The lower 
storeys are never occupied, being principally used for store-rooms, 
9cQ. The northern, or north-eastern part of the island is inhabited 

by 



• Surgeon R. R. Siccama. t Assistant Surgeon A. Gorham, m.d. 

384. s 4 



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Wert Coast 

of Africa 

and Oap« of 

Good Hope 

Station. 

Claas I. 
Sect. A. 



204 MEDICAL STATISTICAL BETUBKS OP THE WEST COAST 

by natives, who live in huta, of a variety of shapes, built of mud 
with palm leaves. There are a few European houses in this quarter 
built upon ipiles driven into the mud, the place being very swampy. 
The inhabitants of these houses are generalljr very sickly. The 
remainder of the island is thickly wooded, havi^ a few scattered 
villages throughout, in which fisneimen live. European comforts 
and even luxuries can be obtained here. 

*' During the rainy season Lagoa Bar is very dangerous to open 
boats crossing it, as tnere is a very heavy surf and tbe bar is con- 
stantly shifting. It is also infested with sharks, and whole boats' 
crews are often taken down by them when capsized, as they often 
are. 

" The Marina, to which all the European houses face, is very low. 
During spring tides large tracts of this road are inundated ; a thick 
muddv deposit is left exhaling the most offensive odours. This 
deposit is a very fertile source of malaria when exposed to con- 
ditions favourable to its elimination. Another source is derived 
from the refuse thrown along the banks by the natives. This is 
continually kept alive, as it were by tidal influence — a very disa^ee- 
able odour resulting from the combined emanations of the ddbns of 
floating islands and the smell of rotten fish, or of fish badly cured 
which the natives expose for sale during the day. This generally 
arises about sunset, and is most offensive to the senses of passers-by, 
in some causing faintness and giddiness, and in others exciting 
vomiting. The sanitary laws are good, but the native police take 
little or no trouble to enforce them. 

** Below the southernmost extremity of the island is a place called 
** The Beach," a narrow strip of sand, jutting out for about 200 or 
300 yards, separating the lagoon from the sea, on which are a num- 
ber of pools called " Alligator Ponds," filled with vegetable, and 
often animal matter in a high state of decomposition. Scattered 
about this beach the debris of floating objects are in great profusion, 
also evolving their quota of malaria. The ship has to pass quite 
close to this place when crossing or recrossing the bar ; and the 
wind generally blowing from this quarter between the hours of 
10 a.m. and 4 p.m. carries malaria with it, to the full influence of 
which the men are exposed when the ship is coming down the 
lagoon. 

" Another and equally fertile source of malaria lies in the low 
swampy ground opposite the island, filled with tropical vegetation of 
every description. The sea breeze blowing from the S. W. between 
the hours above-mentioned, wafts the emanations from both these 
sources up to Lagos, and meeting with their kindred there, renders 
the place eminently fertile as regards mephitic vapours. 

** Fish is caught in the lagoon. Oysters are also to be procured 
from two sources, one from beds, the other from mangrove trees. 
The latter are not eat^n, as, to a certain extent, they are poisonous. 

*•' The seasons in Lagos are, January, February, and March, dry; 
April, May, June, and July, wet ; August and September, dry ; 
October and November, wet ; December, generally dry. The har- 
mattan months are December and January, when dense fogs arise 
in the morning and obscure the land until about 7h. a.m., when the 

whole 



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OF AFRICA AND CAPE OF GOOD HOPE STATION. 



205 



whole slowly lifts as a great curtain and exposes the surrounding 
objects. Little or no dew falls, and the wind is perfectly dry. The 
place is then moderately healthy. Until the settingin of the rainy 
season, fevers of a light character prevail. 

" The tornado season sets in the same time as the wet. During the 
first six weeks of the wet season, during a tornado, the wind howls and 
whistles through the rigging, the canvas awnings flap ; a current of 
cold air rushes through the ship ; a light semi-circular arch forms in 
the heavens, a strange contrast to the dark threatening aspect of the 
sky; the black clouds seem as if pregnant with thunder, and 
strangely lit up by vivid flashes of lightning of extraordinary hues, 
from the bright white forked to the sulphureous smelling purple, the 
rumbling of the distant thunder gradually drawing nearer until at 
last it bursts with a fury as if the heavens were rent asunder, at the 
same time that the sky is illuminated as if on fire from the con- 
tinuous flashes of lightning which last for several seconds and some- 
times as long as a minute. These proclaim the coming on of the 
cyclones of West Africa. This state of matters terminates in rain, 
which comes down in torrents. When this ceases the atmosphere is 
left beautifully clear and cool. 

** During this time the person who has resided in the Tropics for 
any length of time, shakes and shivers, his countenance contracts, 
his skin shrivels, nails turn blue, teeth chatter, he is swathed in 
woollen and flannel, to that extent that it might be supposed he was 
residing in the Arctic Herons. Even people who come straight 
out from England about this time, feel most uncomfortable, but they 
usually prefer it to the sweltering wasting heat of the dry season. 
Fevers, dysentery, and rheumatism, prevail during this period.'' 

"I have often remarked that those serving m this ship in 

Lagos lagoon are unable to serve with advantage in a sea-going 
ship, their constitutions as it were adapting themselves to the 
malarial atmosphere of that locality. The sea-breeze, instead of 
having an invigorating effect upon them, tends to depress their 
vital energies ; orings on a certain amount of debility, and renders 
them liable to fever, or what is more likely, dyspepsia and debility. 
This is an every day occurrence in this ship, and amongst the 
European merchants on shore, one journey over the bar being quite 
sufiScient to bring on one or other of the above-mentioned diseases, 
in fact the ship's company were, as a rule, comparatively healthy 
until we made a trip over the bar. After that, some two or three 
men were invariably found ailing in the morning.*' 

There were eight cases of remittent fever in the Vindictive, the 
store ship permanently stationed at Jellah Coffee. They presented 
no features of peculiar interest. The medical officer* says that in 
the treatment of this form of fever he found small doses of quinine 
often repeated, more efficacious than the large doses recommended 
by some, and less likely to produce headache. Also that if given 
undissolved it was better tolerated by the stomach. 

In 



West Coast 

of Africa 

and Cape of 

Good Hope 

Station. 

Class I. 
Sect. A. 



384. 



* Assistant Surgeon Wm. J Rankin, m.d. 



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206 MEDICAL STATISTICAL RETUBNS OF THE WEST COAST 



West Coast 

of Africa 

and Cape of 

Good Hope 

Station. 

cia«ri. 

Sect. A. 



In the Sirius there were eighteen cases of remittent fever, all of 
which occurred in the Christmas quarter of the year, and were 
attributable to exposure at Lagos, and at St. Pauls de Loanda. The 
Surgeon* of the vessel says that he classed them all as remittent 
fever, as they were a special climatic disease quite different from 
the continued fevers of England. He says ; " Quinine is the 
remedy in which 1 have the greatest confidence in the treatment of 
these coast fevers, and I have, I may say, trusted to it almost ex- 
clusively, but like every other good thing it may be abused. It 
was not pushed so far in any as in the first cases which were so 
tedious, and I have no hesitation in acknowledging my belief that 
they owe their protraction, in some degree at least, to the injudicious 

persistence in its administration." " Vomiting took place 

m one or two cases (especially those lately exposed to the sun), 
before they came under treatment, but it has not occurred in any 
case during treatment where it did not follow a large dose of quinine, 
or quinine too long persisted in, and was evidently caused by it. 
In tlie last two outbreaks of fever I have never given a larger dose 
than five grains, and have not repeated it oftener than three times 
in the twenty-four hours, and as soon as the acute fever has subsided 
have not given more than one five-grain dose, and the cases have 
been much more tractable, and the average day's sickness less." 

" Almost, if not all, complained during convalescence of giddiness 
and fluttering in the chest on first turning out of hammock or stand- 
ing up. I do not think these symptoms are improved by quinine. 
Others also after the subsidence of all acute symptoms have a sen- 
sation of an occasional succession of momentary chill and heats, 
ending in perspiration. I am growing cautious of quinine as a specific 
for these symptoms." 



n. General Diseases. —Section B,— Constitutional Group. 

Class II. Under this head 267 cases of various forms of disease were entered 

Sect. B. on the sick-list, of which nineteen were invalided, and one proved 

fatal. The fatal case was one of rheumatism, occurring in the person 

of a Krooman. 

Rheummtism, — Of this disease 209 cases were entered on the sick-' 
list, which is in the ratio of 120'8 per 1,000 of force, being an 
increase, compared with the preceding year, equal to 8-8 per 1,000. 
The average duration of each case was between sixteen and seven- 
teen days. The majority of these cases resulted as sequelse of 
remittent fever. The medical officer of the Lynx, in whicm vessel 
there were thirty-nine cases during the year, says : *^ A large pro- 
portion of these cases occurred after fever, especially in middle-aged 
men. Indeed, nearlv every man over twenty-five who had an attack 
of fever, subsequently suffered from rheumatism. In no instance 
was there any swelling of the joints, but the patients complained of 

constant 



Surgeon Martin Magill, m.d. 



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OP AFRICA AND CAPE OF GOOI> HOPE 8TATI0K. 



207 



constant gnawing pains^ generally most severe in the knees. The 
hips and muscles of the uiigh were also commonly affected. There 
was generally a nightly exacerbation, occurring at about the same 
time as the ^brile one formerly did, but accompanied by no febrile 
symptoms. Tonics, with sarsaparilla and iodide of potassium, were 
the remedies chiefly used, most of the men being a good deal debili- 
tated from the effects of the Niger Expedition. Change of air, diet, 
&c., and removal from a crowded lower deck on our arrival at 
Ascension, did much more for them than any medicines." 

Syphilis, Primary and Secondary. — There were thirty-seven cases 
of prmiary, and seven of secondary syphilis on the sick-list during 
the year, which give very much in the same ratio as those of the 
preceding year. The surgeon of the Rattlesnake remarks, with 
reference to the prevalence of venereal diseases at Cape Town, and 
Simon's Bay that : " The Contagious Diseases Act was carried out 
very strictly in both places, but it could, of course, be more so in the 
latter place (Simon's Town), both on account of its limited extent, and 
isolated position, almost all the prostitutes being known to the police, 
and any newcomer being soon discovered. In the reports furnished to 
the commodore by the staff surgeon of the Naval Hospital and by 
the district surgeon, a great decrease is shown since the working of 
the Act, especially in syphilis, which cannot be concealed, but not 
so much in gonorrhoea, as the district surgeon informed me that every 
means were taken by many of the women to deceive him in pre- 
paring themselves for examination, and of course some might 
escape." 

Of Sierra Leone, he observes : " Syphilis is very rife, I hear, 
among the population, especially simple chancre. Gonorrhoea is 
common also. The Contagious Diseases Act, however, could not 
be made to work either here, or any place down the coast. There 
are several reasons for this. First, tne people generally go to native 
doctors, and use native medicines ; then, it would be impossible to 
find out, or register women, as most of the negro population are 
loose in their habits ; and again, power to carry out the Act could 
not be given to the native police, as they would use it as an engine 
to carry out their own private ends instigated by revenge or pique, 
or for the mere pleasure of annoyance. I hear that when the black 
soldiers get this disease they generally are discharged afterwards, 
as they become unfit for the service." 



West Coast 

of Africa 

and Cape of 

Good Hope 

Station. 

Class n. 
Sect B. 



m Difieases of the Nervous System and Organs of the 
SpedaL Senses. 

Eighty*six cases of various forms of disease belonging to this class 
were under treatment during the year, of which sixteen were in- 
valided. No mortality was occasioned by them. The most pre- 
valent affisctions were neuralgia, doubtless of malarial origin, and 
diseases of the eye. 



Class ni. 



384. 



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208 MEDICAL STATISTICAL RETURNS OP THE WEST COAST 



West Coast 

of AfricA 

and Cape of 

Good Hope 

Station. 

Class IV. 



IV. Diseases of the Circulatory System. 

Only eight cases appear under this head ; viz., four of functional 
disease of the heart, three of organic disease, and one of phlebitis ; 
and of these three were invalided, and three proved fatal. 

The case of phlebitis was complicated with pneumonia. It oc- 
curred in the person of a Krooman of the Jaseur, who was placed 
on the sick-list on the 30th of April, at Kabenda, complaining of 

feneral pains in his limbs and muscles, with slight feverishness. 
he pains by degrees began to settle and grow more intense in the 
left axilla, where the vein felt tender, and in the shoulder, about 
the scapular deltoid and pectoral muscles. About the 2nd of May 
the shoulder began to swell considerably, and on the 3rd the super- 
ficial veins were much distended, when the pain was somewhat 
relieved. The report of the medical officer* goes on to state that 
" The arm was now swollen down to near the orbicular ligament, the 
hand remaining its natural size. A series of incisions were made 
along the back and outside of the arm, but neither blood nor serum 
escaped in any quantity, although fomentations were used to en- 
courage their discharge. Fomentations, and afterwards evaporating 
lotions, containing iodine, were tried, with no beneficial results. 
The most satisfactory treatment appeared to consist in the application 
of iodine unguents and liniments, under a rather tight bandage, 
which rapidly promoted absorption when the acute symptoms were 
passed. Shortly after the arm began to swell he was attacked with 

{meumonia of the right lung, which afterwards extended to the 
ower lobe of the left lung. The treatment for the most part 
consisted of laxatives, and, when the fever was high, small doses 
(l-8th of a grain) of tartarised antimony. On the 24th the pneu- 
monia was greatly improved, and respiratory murmur had returned 
in the lower lobes, especially of the right lung. The rusty viscid 
sputa have disappeared for many days, and the arm is now nearly 
its normal size ; out he complains that it feels " heavy " on his using 
it ; the superficial veins have diminished in size considerably, and 
there is no longer pain nor tenderness in the axilla. About the 
end of the month the left leg began to swell and be affected, in an 
exactly similar manner to uie arm of the same side. He has all 
along been kept quiet in a cot, and it has been necessary to expend 
a considerable amount of stimulants, &c. on him, such as wine, oeef 
tea, &c., he was so weak, with a sinking pulse and furred tongue. 
Indeed for a considerable period he had more than two-thirds of a 
bottle of wine daily, and with marked benefit The leg improved 
more rapidly than the arm, the same treatment being employed in 
both, and about the middle of the month there was no trace of any 
disease of the lungs, and both leg and arm were natural in size, the 
superficial veins still continuing considerably enlarged, compared 
with their usual size. He was just able to use the arm and leg at 

the 



* AMiBtant Soigeon John R. Burke, mj>. 



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OF AFBICA AND CAPE OP GOOD HOPE STATION. 



209 



West Coast 

of Africa 

and Gape of 

Good Hope 

Station. 

Class IV. 



the commencement of the following month, and was perfectly con- 
valcHcent ; but, as the ship was goin^ to Sierra Leone to discharge 
her Kroomen, it was thought advisable to keep him on the list until 
her arrival there, to prevent die possibility of any relapse occurring 
from exposure or over-exertion before he landed." 

V. and VL Diseases cxf the Absorbent System and 
DncUess Glands. 

Thirty-eight cases appear under this head> of which thirty-seven ClaMesV. 
were sympathetic bubo> and the thirty-eighth was a case of enlarge- ^^^ '^ 
ment of the cervical glands. These affections were the result of 
debility from climatic cachexia. 

Vn. Diseases of the Bespiratory System. 

Under this head 188 cases of catarrh^ four of hsemoptysis, four of Class VII. 
asthma, and twenty-nine of inflammatory disease of the lungs were 
entered on the sick-list ; and of these, three were invalided and one 
proved fatal. Each case of catarrh was, on an average, between 
five and six days under treatment ; each case of haemoptysis a little 
over ten days, each case of asthma about eight days, and each case 
of inflammatory disease between twenty-five and twenty-six days. 

The fatal case was one of pneumonia. It occurred in the person 
of a Ejrooman of the Seringapatam, who died in the Royal Naval 
Hospital, Simon's Bay. Little information is given in connection 
witbit. 

VnL Diseases of the Digestive System, 

Four hundred and eighty-five cases of -various forms of disease Class VIII. 
were entered on the sick-list under this head, of which five were 
invalided and four proved fatal. Dyspepsia and diarrhoea were the 
most prevalent affections ; 186 cases of the former and 132 of the 
latter were under treatment. The average duration of each case 
of both forms of disease was between six and seven days. 

Dysentery was by no means so prevalent as during the preceding 
year, the difference between the ratio of the two years being equal 
to 18*9 per 1,000. There was a very great difference in the death- 
rate, however, for whereas, in 1868, of fifty-four cases entered on 
the sick-list only one proved fatal; during the present year, of 
twentv-one cases four terminated fatalljr. Two of these occurred in 
the Flora, at Ascension, where the disease is wont to be epidemic 
during certain seasons ; one in the Lynx, and one in the Rattlesnake. 

The case in the Lvnx occurred in the River Niger, in the person 
of the asfflstant sick-berth attendant, who had been twice on the list 
before with debility, since the vessel entered the river. The me- 
dical oflicer says : ** On the present occasion he was ordered to keep 
his himimock, and bitter tonics were prescribed. For some time 
previously he had been taking iron (he was placed on the sick-list 
on the 28th of August). On the morning of the 31st he said that 
for some time he had been suffering from diarrhoea, with bloody stools, 

384. and - 



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StatioD* 

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210 MEDICAL BTATI8TICAL BETUBNS OF THE WEST COAST 

and for two days had passed nearly pure bloody A mustard poultice 
was applied to the epieastium, a full dose of opium given^ and^ half 
an hour afterwards^ thirty grains of ipecacuan powder. During 
the day several doses of astringents were given in combination with 
diffusible stimulants, as the patient was much exhausted. At 
about six in the evening the diari'hoea seemed to be checked. Soon 
after this he fell asleep, and did not wake up until half-past four 
the next morning. Tne diarrhoea then returned with great severity. 
The motions were bloodless, but had nearly the rice-water appear- 
ance of cholera. Stimulants and astringents were ^iven, but he 
never rallied, and died at half-past nine on the morning of the let 
September." 

The fatal case in connection with the Rattlesnake occurred in the 
person of a seaman who had been sent to Ascension Hospital during 
the previous year, labouring under svphilitic cachexia. In order to 

S've him the benfit of a cooler climate, he was sent up to the 
fountain Hospital, where he contracted dysentery, which ter- 
minated fatally on the 6th of January. 

There were no points of interest in connection with the fatal case 
in the Flora. 



Classes EX. 
and Z. 



IX. and X. Diseases of the TTrinary and Generative Systems. 

Under this head 143 cases of various forms of disease were entered 
on the sick-list, all, with the exception of ten cases, being either gononv 
hoea or orchitis, chiefly of gonorrhoeal origin. The average duration 
of each case of gonorrhosa was a little over nineteen days, and of each 
case of orchitis almost precisely the same. By far the greatest 
number of cases of gonorrhoea occurred in the Rattlesnake. They 
were, in some cases, of a very virulent character, sometimes aocom^ 
panied with haemorrhage, in addition to the other symptoms, and 
lasting for three or four weeks. In the most severe cases, which 
constituted about one-third of the whole number, emetics and pur- 
gatives, and subsequently antimonials, were employed to combat the 
acute symptoms, after which injections of permanganate of potass 
occasionally seemed to do good. 



Class XI. 



XL Diseases of the Organs of Locomotion. 

Thirteen cases of various affections of the bones and joints oc- 
curred under this head, of which two were invalided. One of these 
was a case of periostitis of the tibia of a chronic character, and, as 
far as could be ascertained, unconnected with any syphilitic taint. 
There was little or nothing of an interesting character in connection 
with the other cases. Generally, as might be expected £rom the 
nature of the part affected, they were of a somewhat tedious cha- 
racter, the average duration of each case b^ng over twenty-four 
days. 



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OF AFBICA AND CAPE OF GOOD HOP£ STATION. 211 

West Coast 

Xn. and Xm. DiBeases of the Cellular Tissue and and Ca^f 
Cutaneous System. Good Hope 

Station. 

Boila, abscesses, and ulcers were almost the only aflfections entered 

on the BickJist under this head. The loss of service occasioned by ^l^vw 
them was very great, seventeen or eighteen men being daily inca- ^^ Alll. 
pacitated by them. Of the total number, two of abscess, six of 
ulcer, and one of skin disease, were invalided, and two cases of 
abscess terminated fatally. Psoas abscess was the cause of death in 
one instance ; the other was a more complicated case. It occurred 
in the person of a seaman of the Rattlesnake, who was placed on the 
sick-list on the 9th of June at the Cape of Good Hope. On the 
previous day he had walked from Wynberg to Simon's Town, a dis- 
tance of fourteen miles, and at 1 a.m. he complained of acute pain 
in the left knee and ankle, increased on motion of the limb. There 
was no swelling ; the pulse was tolerably quiet. On tho following 
day great pain was complained of on the inner side of the thigh and 
at the knee ; the skin was hot, the tongue furred, the pulse 120, and 
he was very restless. In this condition he was discharged to the 
Naval Hospital at Simon's Town. While there his symptoms 
varied very much ; occasionally the pain in the groin and inside of 
the thigh was intense, and prevented sleep ; at other times there was 
little or no pain, only stiffness. He appears to have been allowed 
to move about On the 2dth of June it was noted that there was 
constantly a hectic flush on his cheek, and that he looked ill ; the 
pain in the leg was a little less severe ; his appetite was indifferent, 
and the pulse at 96. On the 2nd of Julj^ the leg was very stiff 
and groin painful ; appetite good ; functions normal. On the 
3rd, ** acute pain disappeared ; only feels stiff about leg." 4 th. 
Sudden pain in knee yesterday causing him to fall when walking, 
epistaxis. 9th, Easier ; left thigh and leg very much swollen ; 
foot oedematous, losing flesh; looks ill; pulse 120; slept fairly; 
appetite indifferent; bowels confined for three days. On the 
20th the foot was punctured with a needle in several i>lacej?, and 
oozing of serum took place, and continued for some time. The 
abdomen now began to swell, and bed sores were established. On 
the 23rd the dorsum of the foot was inclined to sloueh ; on the 
following day diarrhoea set in. On the 25 th a large axillary abscess 
of twenty-four hours' formation was laid open, and three pints of 
pus discnarged. On the 27th he sank exhausted.. 

The following report of the post-mortem examination of the body 
is by the medicid officer* in charge of the hospital ; from his notes the 
above abridged history of tho case has been taken. " Body. — 
Greatly emaciated ; left thisjh inverted, and greatly swollen, and 
le^ cedematous, with vesications of thigh, and sloughing appearance 
oidorsum of left foot ; lungs healthy ; the right side of tne heart 
presented thinned walls ; an abnormal quantity of fatty deposit in its 
structure ; a fibrous deposit on right and left auricles. Liver large, 

light 



* Staff Surgeon John Bernard. 
384. 



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212 MEDICAL STATISTICAL RETDKNS OF THE WEST COAST 

ofAfrica* ^^^^^ coloured, and of a nutmeff appearance on slicing, together 
and Cape of With a greasy feeling of the wnole organ. About the sigmoid 
Good Hope flexure of the colon there seemed ei^idence of inflammatory action 
Station. and suppuration, together with a glueing together of the adjacent 
Classes XII. structures, and appearance of attempted formation of a sac. The 
and ZIII. * dissection caused a rupture of the thin walls, instantaneous collapse 
of the intestine( descending colon), great stench, and the disclosure 
of a large unhealthy purulent mass in which seemed embedded 
the psoas and iliacus muscles, left large bloodvessels and nerves. 
Left iliac fossa filled with dark coloured putrid pus. On cutting 
down the femoral sheath, the vein seemed distended with coagulated 
blood. No trace between the axillary abscess and these diseased 
structures could be discovered, and it is therefore to be presumed 
that the collection of pus in the axillary space was caused by absorp- 
tion and subsequent deposit there." 

TTnoIassed Diseases, 

Under this head fifty-nine cases of debility, chiefly arising from 
climatic causes, two of delirium tremens, and three of alcoholic 
poisoning, were entered on the sick-list. Of these, twenty-one of 
the cases of debility were invalided. One case of delirium tremens 
occurred in the person of a private Marine, the other in a petty 
oflicer. 

Wounds and Injuries. 

A man sustained a fatal fracture of the skull by falling from aloft. 

Two men were drowned, one while in the act of diving, the other 
by falling overboard. 

A man was suffocated by the impaction of food in the larynx, 
probably introduced while in the act of vomiting when drunk. 

The total number of deaths was eighteen, which is in the ratio of 
10*4 per 1,000 of force, being a reduction compared with the pre- 
ceding year equal to 2'6 per 1,000. 

Invaliding* 

Under General Diseases, section A., twenty-two persons were in- 
valided, viz., twenty-one for the scquelas of continued and periodic 
fever, and one for erysipelas; and under Section B., ten persons 
were invalided for rheumatism ; one for gout ; two for secondary 
syphilis, and six for consumption. Sixteen persons were invalided 
for diseases of the nervous system, and organs of the special senses ; 
three for diseases of the circulatory system ; one for bubo ; three 
for diseases of the respiratory system; five for diseases of the 
digestive system; six for diseases of the urinary and generative 
systems; two for diseases of the organs of locomotion; nine for 
diseases of the cellular tissue and cutaneous system ; twenty-one for 
unclassed diseases ; and five for wounds and injuries of various kinds. 
The total number of persons invalided was 1 IS, which is in the 
ratio of 64*7 per 1,000 of force, being a decrease, compared with the 
preceding year, equal to 19*5 per 1,000. 



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OP AFRICA AND CAPE OF GOOD HOPE STATION. 



213 



Table, No. 1. 

Showihg the Number of Cases of aU Disbases and Injuiues, and the Number 
Intaudeo and Deai), with the Ratio per 1,000 of Force. 



DISEASE OB INJURY. 



CMes. 



Nuiber. 



Ratio 

per 

1,000 

of 
Force. 



Inralidad. 



Nvmbcr. 



lUtio 

P« 
1,000 

of 
Force. 



Dead. 



Nninbcr. 



Ratio 

P« 
1,000 

of 
Force. 



I. General Diieaaei, Section A.: 

Simple coDtinaed Fever - 

Ague 

Bemittent Fever - 
Mainps- . . . . 
Erysipelas . - . . 

n. General DiaeaaeSySectionB. 
Rheumatism - - . , 
Gout - - - - 

Phthisis Puhnomilis 
Dropsy - - - - 



m. 



Diseases of the V ervons Sys- 
tem, and Organs of uie 
Special Senses: 
Apoplexy - - - - 
Suustroke - - - - 
Paralysis - - - - 
Vertigo - - - - - 
Epilepsy - - . . 
Gonyulsioiis - - - . 
Neuralgia • . . . 
Insanity • . . - 
Diseases of the Eye 
Diseases of the 1^ 
Diseases of the Nose 



17. Diseases of the Circulatory 
System: 

Disease of the f Functional 
Heart -(Organic - 
Phlebitis . . . - 



384. 



124 

21 

190 

1 

2 



209 
2 
37 
7 
8 
4 



3 
4 
5 
6 
1 

18 
5 

33 
8 
1 



4 
3 
1 



71-6 

12-1 

116- 

•6 

M 



120-8 
M 
21-3 
4- 
4-6 
2-3 



M 
1-7 
2-3 
2-8 
3-4 
•6 

10-4 
2-8 

19- 
4-0 
•5 



2-3 

1-7 

•5 



1 

2 

18 



10 

1 

2 
6 



•6 

11 

104 



5-7 
•5 

11 
3-4 



•5 
11 
T7 



M 

3-4 

•5 

•5 



11 
•5 



17 



1-7 



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214 



MEDICAL STAtlSTICAL BETURNS OP tflE WfiST COAST 



Table, No. 1. — Showing the Number of Cases of all Diseases, kc^^ontinuetL 



DISEASE OR INJURY. 



v. ft TI. Siseasetf of the Absorb- 
ent System and Suctless 
Olanois: 

Bubo {Sytnp,) - - - 
Glandular Diseases 



VII. Diseases of the Bespiratory 
System: 



Catarrh - - - - 
Hsemoptysis - - - 
Asthma - - - - 
Other Diseases of the Lungs 



VIII. Diseases of the Digestive 
System: 

C^'nanche - - - - 
Diseases of the Mouth, Teeth, 

&c. - - - - - 
Dyspepsia - - - - 
Dysentery - - - - 
Diarrhoea - - - - 
Colic and Constipation - 
Haemorrhoids - - - 

Hernia - - - - - 
Worms - - - - - 
Other Diseases of the Stomach, 

Intestines, &c. - - - 
Diseases of the Liver, Spleen, 

&c. 



IX. ft X. Diseases of the Urinary 
and Oenerative Systems : 

Diseases of the Kidneys - 
Diseases of the Bladder - 

Gonorrhoea - - - - 

Diseases of the Organs of Gre- 

neration - - - - 

Stricture - - - - 

Varicocele - - - - 

Orchitis . - - - 



Caaes. 



noaber* 



37 

1 



188 

4 

4 

29 



48 



3 
1 

94 

1 

4 

2 

38 



Rfttio 
per 

1/XM> 
of 

Force. 



21-3 
•5 



108-6 

2-3 

2-3 

lG-7 



27-7 



4 


2-3 


186 


107-5 


21 


121 


132 


76-3 


68 


33-6 


11 


6-3 


3 


1-7 


4 


2-3 


11 


6-3 


7 


4- 



1-7 

5 

54-3 

•5 

2-3 

11 

21-9 



iDTslided. 



Ktttnber. 



3 

1 
1 



Ratio 

P« 
1,000 

of 
Force. 



Dead. 



Niioiber. 



2-3 



1-7 
•5 
•5 



Ratio 

per 
1,000 

of 
Force. 



2-3 



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OF AFRICA AND CAPE OP GOOD HOPE STATION. 



215 



Tablb^ No. 1.— Showing the Number of Cases of all Diseases, &c. — continued. 




Cases. 


Invalided. 


Dead. 


DISEASE OR INJURY. 




Ratio 

per 
1,000 

of 
Force. 




Ratio 

per 
1,000 

of 
Force. 




Ratio 

1,000 

of 
Force. 




Number. 


Number. 


Number. 


XI. IHseaAes of the Organs of 
Locomotion: 














Diseases of the Bones, Joints, &c. 


13 


76 


2 


1-1 


— 


— 


Xn. ft Xlll. Diseases of the 
Cellular Tissue and Cuta- 














Fhlegmon and Abscess - 


453 


261-8 


2 


11 


2 


11 


Ulcer 


120 


69-3 


6 


3-4 


■— 


— 


Erythema - - - - 


1 


•5 


— 


— 


— 


— 


Diseases of the Skin 


18 


10-4 


1 


•5 


— 


— 


Scabies - - - - 


1 


•5 


— 


— 


— 


— 


Unclassed: 














DebiUty - . . - 


59 


341 


21 


12-1 


— 


— 


Delirium Tremens - - - 


2 


M 


— 


— 


— 


— 


Poisoning - - - - 


3 


1-7 


— 


— 


— 


— 


Wounds and Iiyories : 














Wounds, Injuries, &c. - 


499 


288-1 


5 


2-8 


1 


•5 


Bums and Scalds - - - 


25 


14-4 


— 


— 


— 


— 


Submersion and Drowning - 


2 


1 




- 


2 


11 


Asphyxia * . . - 


2,795 


- 


- 


- 


1 


•5 


Totals - - - 


1,615-6 


112 


64-7 


18 


10-4 



384. 



t2 



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216 



MEDICAL STATISTICAL RETURNS OP THE WEST COAST 



Table, No. 2. 

Showing the Number of Days' Sickness from each Disease and from Injuries, the 
Average Number of Men Sick Daily, with the Ratio per 1,000 of Force. 





Namber of Days' Sicknen 


Avenge Namber of 
Mea Sick Daily. 


DISEASE OR INJURY. 


f 




\ 




Ratio 




OnBotrd. 


In HospiUl. 


Total. 


Number. 


1.000 of 
Force. 


I. General Diseases, Section A. : 












Simple continued Fever - 


857 


44 


901 


2-4 


1-3 


Ague 


187 


50 


237 


•6 


•3 


Remittent Fever - - - 


2,387 


1,581 


3,968 


10-8 


6-2 


Mumps - - - - - 


13 




13 


— 


— 


Erysipelas - - - - 


6 


"■ 


6 


-"~ 


— 


n. Oeneral Diseases, Section B. : 












Rheumatism - - - - 


1,842 


1,612 


3,454 


9*4 


5-4 


Gout 


4 


8 


12 


_^ 




syphHi^ -{ISZy: : 


901 


461 


1,362 


8-7 


21 


253 


262 


515 


1*4 


•8 


Phthisis Pulmonalis 


188 


257 


445 


1-2 


•6 


Dropsy - - - - - 


12 


" 


12 






III. Diseases of the Henrons Sys- 
tem, and Organs of the 






















Special Senses: 












Apoplexy - . - - 


6 


44 


50 


•1 





Sunstroke - - - 


23 


13 


36 


— 


««» 


Paralysis .... 


40 


40 


80 


•2 


•1 


Vertigo - - - - - 


13 


- 


13 







Epilepsy . . - - 


146 


46 


102 


•5 


•2 


Convulsions - - - - 





— 


9 


_- 




Neuralgia . - - - 


124 


- 


124 


•3 


•1 


Insanity .... 


14 


100 


114 


•3 


•1 


Diseases of the Eye 
Diseases of the Elar 


249 


343 


592 


1-6 


•9 


105 


«. 


105 


•2 


•1 


Diseases of the Nose 


— 


23 


23 






lY. Diseases of the Circulatory 
System: 

Disease of the (Functional - 
Heart -1 Organic 












85 


20 


105 


•2 


•1 


46 


108 


154 


•4 


•2 


Phlebitis . - - . 


80 


— 


80 


•2 


•1 



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OP AFBIGA AND CAPE OP GOOD HOPE STATION. 



217 



Tablb, No. 2. — Showing the Number of Days' Sickness from each Disease, &c. — cent*'. 



DISEASE OR INJURY. 



T. ft TI. Diieases of the Absorb- 
ent System and Ductless 
Olanos: 

Bubo (/^►wp.) - - - 
Glandular Diseases 



Vn. Diseases of the Sespiratory 
System : 



Catarrh . - - - 
Hemq)tysi8 - - - 
Asthma ... 

Other Diseases of the Lungs 



Tm. Diseases of the Digestive 
System: 

Cynanche - - - - 
fi^seases of the Month, Teeth, 

&C. - - - - - 
Dyspepsia - - - - 
Dysentery - - - - 
Diarrhcea . - - - 
Colic and Constipation - 
Hnmorrhoids . - . 

Hernia - - - - - 
Worms - - - - - 
Other Diseases of the Stomach, 

Intestines, &c. . - - 
Diseases of Liver, Spleen, &c. - 



□LAX. Diseases of the Vrinary 
and Oeneratiye Systems : 

Diseases of the Kidneys - 
Diseases of the Bladder - 
Gonorrhoea - - - • 
Diseases of the Oigans of Ge- 
neration - - - - 
Stricture . - - - 
Varicocele - - - - 
Orchitis . - - - 

384, 



Nninber of Days* Sieknett 



On Board. 



619 
44 



1,038 

42 

14 

282 



2G4 

10 

1,163 

269 

604 

230 

77 

59 

39 

70 
84 



26 

6 

1,583 

6 

128 

10 

599 



In Hotpital. 



Total. 



T3 



218 
60 



17 

466 



51 



43 

377 

201 

11 

26 

3 



30 
69 



57 
232 

146 
134 



737 
94 



1,044 

42 

31 

748 



315 

10 

1,196 

646 

865 

250 

ia3 

02 
39 

100 
143 



Average Number of 
Meo Sick Daily. 



Number. 



2-8 
•1 



3-2 
1-7 
2-3 
•6 
•2 
•1 
•1 

•2 
•3 



83 

6 

1,815 

6 

274 

10 

733 



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218 



MEDICAL STATISTICAL KETUBN8 OP THE WEST COAST 



TablE) No. 2. — Showing the Number of Daya* Sickness from each DiseasOi kc.-^coni^. 





NnnberofDayt'Sicknett 


Men Sick DaU^ 


DISEASE OR INJURY, 


/ 








Ratio 


' 


OnBovd. 


InHo^taL 


Total. 


Number. 


1,000 of 
Force. 


XI. Diseases of the Organs of 
Locomotion: 












Diseases of the Bones, Joints, 
&c. 


260 


54 


314 


•8 


•4 


XII. & Xm. Diseases of the 
Cellnlar Tissue and Cuta- 
neous System: 












Phlegmon and Abscess - 


3,697 


481 


4,178 


11-4 


6-6 


Ulcer 


1,889 


350 


2,239 


61 


3-5 


£r}^hema - - - - 


10 


- 


10 




— 


Diseases of the Skin 


281 


89 


370 


1- 


•5 


Scabids 


17 


23 


40 


•1 


— 


Unolassed: 












DebiUty ... - 


S77 


624 


1,001 


2-7 


1-5 


Ddirnm Tremens ... 


3 


10 


13 


— 


— 


Poisoning . . - - 


6 


- 


5 


— 


— 


Wounds and Iiy uries : 












Wounds, Injuries, &c. - 


4,721 


888 


5,609 


15-8 


8-8 


Bums and Scalds - . - 


265 


78 


343 


•9 


•5 


Submersion and Drowning - 


r 


2 


3 


— 


— 


Totals - - - 


26,341 


9,738 


36,079 


98-8 


571 



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OP AFBIGA AND CAPE OP GOOD HOPE STATION. 



219 



Table, No. 3. 

Showikg the Number Invaudbd from each Ship on the Wbst Coast of Africa and 

Cape of Good Hope Station. 























i 
1 


! 


J 




1 


1 


i 

> 


1 


I. Oeneral Diseases, Section A. : 

Simple continued Fever 

Ague 

Remittent Fever - 
Erysipelas - - , - 

n. Oeneral Diseases, Section B. : 

Rheumatism - - - - 
Gout ----- 
Syphilis, Secondary 
Phthisis 

TTT. Diseases of the Hervons Sys- 
tem, and Organs of the Spe- 
cial Senses: 

^nS«' : : "- : 

Epilepsy - . - . 
Inflanity - - . - 
Diseases of the Eye 
Diseases of the Ear 
Diseases of the Nose 

« 

IV. Diseases of the Circulatory 

System: 
Disease of the / Functional 
Heart -(Organic - 

V. ft TI. Diseases of the Absorh- 

ent System and Ductless 
Glands: 

Bnho (Symp,) 


1 
1 


3 

1 

1 


1 

1 
1 




1 
1 

1 


1 


11 
1 


1 

1 

1 

1 
1 


2 

1 


1 
1 


1 

3 

1 


1 

1 
1 


I 

"* 
2 

I 
1 

1 

1 

1 

1 


2 

1 
2 

I 


1 


1 


J 

2 

18 

1 

10 

1 
2 
6 

1 
2 
3 
2 
6 
1 
1 

2 
1 

1 



384. 



I 4 



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220 



MEDICAL STATISTICAL H£TUHN8 OF THE WEST COAST 



Table, No. 3.— Showing the Number InvaHded from each Ship, &e.-'<mtinued. 




CAUSE OF INVALIDING. 


J 


I 




li 


J 


1 


1^ 


1 
I 


1 


• 


. 


1 


} 


t 




VIL Diseases of the Respiratory 
System: 

Heemoptysis - - - . 
Asthma - • . . . 
Other Diseases of the Lungs - 

Vni. Diseases of the Digestive 
System: 

Dysentery - . - - 
Hernia - - - - - 

IX. & X. Diseases of the Urinary 
and Generative Systems : 

Diseases of the Kidneys - 
Stricture - - - - 
Varicocele - . - . 
Orchitis 

XI. Diseases of the Organs of Lo- 

comotion : 

Diseases of the Bones, Joints, 
&c. - - - . . 

XII. & XIII. Diseases of the Cel- 

Inlar Tissue and Cutaneous 
System : 

Abscess - - - - - 

Ulcer 

Diseases of the Skin 

ITnclassed: 

Debility 

Wonnds and Iiyuries: 

Wounds, Injuries, &c. - 


1 
2 


1 
1 

1 

2 

1 


1 


1 
1 


1 
1 


1 


I 

1 
1 

1 

2 


1 
6 


1 

1 
1 
I 


- 


5 


1 
1 

1 


1 

1 
• 
8 

2 


1 
2 


1 - 


- 1 

- 1 

- 1 

- 4 

- 1 

- 1 

- 3 

- 1 

- 1 

- 2 

~ 2 

- 6 

- 1 

I 21 

- 5 


Totam - - - 


5 


11 


4 


2 


5 


2 


18 


11 


7 


2ilO 

i 


6 


16 


9 


2 1 


I 112 



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OP APBICA AND CAPE OF GOOD HOPE STATION. 



221 



TAfiLB^ No. 4. 

SsoifiNo the Number of Deaths in each Ship employed on the Wbst Coast op Africa 

and Capb of Good Hope Station. 



CAUSE OF DEATH. 



1 General Diseaies, Beefion A. : 
Remittent Feyer 



IL General Diseases, Seetion B. 
Rheumatism ... 



I 



S 



17. Diseases of the Cireolatory System : 
Disease of the Heart, Organic 
Pericarditis - - - . 



Vn. Diseases of the Respiratory System : 
Diseases of the Lungs - . . . 



YIIL Diseases of the Digestive System: 
Dysentery --.--. 



Xn. and Xni. Diseases of the Cellular 
Tissue and Cutaneous System: 
Abscess ------ 



Wounds and Iq uries : 

Wounds - - - - 
Submennon and Drowning - 
Asphyxia - - - - 

TOTAU 



1 

1 I 



1 



•I 



< 

s 



18 



^ 



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222 



MEDICAL STATISTICAL RETURNS OF THE WEST COAST 



TaBLBi No. 6. 

Showing the Number of Cases of all Diseases and Injuries in the Ships 



DISEASE OR INJURY. 



i 



B 
& 



I 



O 



I. General Diseases, Section A. : 

Simple continued Fever 
Agne . - - - - 
Remittent Fever - - - 
Mumps - - - - 
Erysipelas - - - - 



II. General Diseases, Section B. : 

Rheumatism - ^ - - - 
Gout 

sypj^^" {£a.y : : : : 

Phthisis Pulmonalis - - - - 
Dropsy ------ 

IIL Diseases of the Nervous System and 
Organs of the Special Senses : 
Apoplexy 



Sunstroke - 

Paralysis 

Vertigo 

Epilepsy 

Convulsions 

Neuralgia - 

Insanity 

Diseases of the Eye 

Diseases of the Ear 

Diseases of the Nose 



lY. Diseases of the Circulatory System: 

Disease of f Functional - - - 
the Heart, \Organic - - . - 
Phlehitis (Disease of Veins) 

V. & VI. Diseases of the Absorbent Sys- 
tem and Dnctless Glands : 
Buho (^SJKWW.) - - - - - 
Glandular Diseases - . . - 

Til. Diseases oftheSespiratory System: 
Catarrh ------ 

Hsmoptysis - - - - - 

Asthma ------ 

Lungs- ------ 



40 
2 



19 
5 



2 
52 



i 


- 


I 


- 


1 


- 





_ 


1 


_ 


7 


2 


- 


2 


1 


— 


2 




1 


_ 



2 
3 



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OF AFRICA AND CAPE OP GOOP HOPE STATION. 



223 



--••-- Table, No. 6. 
employed on the West Coast of Africa and Cape of Good Hope Station. 





































a 

H4 


1 


J 


1 


i 


1 


1 


1 


1 


«5 


) 


• 



•c 


1 


> 


< 

1 






6 


2 


3 


2fi 


22 


1 


11 


10 


5 


1 




1 




124 




— 


1 


. 


— 


— 


1 


1 


6 


_ 


3 


_ 


_ 


_ 


_ 


21 




1 


2 


- 


44 


6 


5 


14 
1 


42 


- 


- 


- 


18 


- 


8 


199 

1 
2 




- 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 




- 


8 


3 


39 


6 


4 


14 


5 


12 


37 


7 


1 


2 


8 


209 

2 




- 


1 


- 


1 


3 


1 


2 


- 


3 

1 
1 


12 


2 


1 


- 


- 


37 
7 
8 




"" 


_ 


_ 


_ 


2 


3 


_ 


1 


_ 


_ 




_ 






^ 


























4 




1 


- 


~ 


1 

1 


- 


2 


1 
1 
1 


- 


~ 


1 
1 
2 

1 
6 
1 

2 

1 


- 


1 


"" 


- 


2 
3 
4 
5 
6 
1 

18 
5 

33 
8 
1 




- 


- 


- 


3 


- 


2 
3 


- 


1 


1 


- 


1 


- 


- 




- 


2 
3 


"" 


4 


1 


3 


2 


1 


2 


1 


- 




- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 




- 


1 
1 
1 


- 


"" 


- 


— 


- 


- 


- 


1 




~~ 


— 


- 


4 
3 
1 




^ 


1 


1 


1 


7 


1 


4 


- 


6 


3 
1 


- 


- 


- 


- 


37 

1 




- 


13 


3 


21 

1 


11 


10 


31 


2 


6 


28 

1 


4 


7 


2 


11 


188 
4 




- 


- 


- 


1 


- 


5 


2 


1 


1 


6 


4 

1 


1 


- 


2 


4 
29 



384. 



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224 



MEDICAL STATISTICAL RETURNS OF THE WEST COAST 



Table, No. 6. — Showing the Number of Cases of all Diseases and Injuries in the Ships 



DISEASE OR INJURY. 



s 

Q 



I 






I 



Vni. Diseases of the Digestive System : 

Cynanche ------ 

Diseases of Mouth, Teeth, &c. 
Dyspepsia ------ 

Dysentery ------ 

Diarrhoea ------ 

Colic and Constipation - - . 
HsDiorrhoids - - - - - 

Hernia ------ 

Worms ------ 

Other Diseases of Stomach, Intestines, &c. 
Diseases of Liver^ Spleen, &c. 



IX. & X. Diseases of the ITrinary and 

Generative Systems : 

Diseases of the Kidneys - - - 

Diseases of the Bladder - - - 

Gonorrhoea ------ 

Disease of the Organs of Generation 
Stricture ..---. 
Varicocele ------ 

Orchitis ------ 

XI. Diseases of the Oi^^ans of Locomotion : 

Diseases of the Bones, Joints, &c. 

Xn. & Xni. Diseases of the Cellular 
Tissue and Cutaneous System : 
Phlegmon and Abscess . . - 

Ulcer 

Erythema ------ 

Diseasesof the Skin . - - . 
Scabies ------ 

Unclassed: 

Debility 

Delirium Tremens - - - - 
Poisoning by Alcohol - - - - 



5 

2 

22 



16 
5 
1 



61 
9 



Wounds and Injuries : 

Wounds, &c. - - - 
Bums and Scalds 
Submersion and Drowning - 



37 
1 



Totals - 



217 



43 



20 

11 

17 

3 



31 
2 

1 



40 
3 
1 



17 
5 



32 

8 



23 
3 



227 



201 



1 

6 

19 
2 



27 
3 



17 
2 



106 



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OF AFBICA AND CAFE OF GOOD HOPE STATION. 



225 





employed on 


the West Coast of Africa and Cape of Good Hope 


i Station — continued. 
























B 












»-4 


1 


s 




s 


1 


1 


• 


1 


! 


1 

1 


1 


1 

J 




1 








1 

2 
6 


2 




4 


3 




1 


26 










48 

4 

186 




2 


2 


13 


9 


4 


7 


18 


18 


17 


4 


6 


1 


16 




. 


« 


. 


5 


. 


1 




2 


1 




_ 


_ 


- 


.. 


21 




1 


4 


4 


7 


7 


9 


9 


4 


4 


6 


2 


3 


1 


. 


132 




— 


8 


2 


3 


3 


2 


3 


10 


1 


6 


1 


3 


1 


- 


58 




- 


: 


1 


2 


- 


- 


1 


1 


1 


1 


3 


1 


- 


- 


11 
3 




: 


1 


: 


: 


1 


1 


1 


1 


: 


1 


1 


: 


— 


: 


4 
11 






1 




2 












2 










7 




- 


*" 


1 


1 
1 


5 


7 


8 


- 


1 

2 


38 


4 


1 
1 


- 


8 


3 

1 
94 
1 
4 
2 
38 




- 


- 


I 


1 
2 
2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 




- 


3 


- 


1 


3 


1 


2 


4 


10 


2 


- 


- 


3 




- 


1 


- 


- 


- 


1 


4 


1 


1 


- 


- 


- 


- 


- 


13 




1 


]2 


11 


22 


30 


32 


34 


3 


14 


76 


C 


15 


7 


11 


453 




- 


2 


1 


6 


6 


3 


3 


6 


4 


51 

1 
3 

1 


2 


3 


1 


3 


120 

1 

18 

1 




1 


3 


2 


2 


1 


1 


3 


- 


- 


- 


- 


- 


- 




- 


- 


- 


29 


8 

1 


1 


1 
2 


7 


2 


3 


- 


6 


- 


- 


59 
2 
3 




3 


21 


10 


12 


32 


30 


46 


6 


16 


126 


10 


19 


2 


19 


499 








1 


1 


2 


3 


^ 


"~ 


1 


5 


1 


2 


- 


~ 


25 
2 




10 


94 


61 


232 


166 


158 


204 


131 


111 


486 


56 


91 


19 


89 


2,795 



384. 



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Google 



226 



MEDICAL STATlBtlCAL RETURNS OF THE WEST COAST 



Tabl^, No. 6. 

Suowiifo the Names of the Ships ^ the Average ComplementSi dec.; the Number of 

Men Sick Daily in each Ship ; 



P. O. Paid dff. 



C. CommiMioned. 



Hate, &c. 


NAMES 

of 
SHIPS. 


Where , 


When 
Commissioned. 


Number 

of 
Guns. 


Tonnage. 


Horse 
Power. 




Sixth Rate - 


DaDJie - 


- S.C. 


Portsmouth 


28 Nov. 1867 


6 


1,287 


S. 350 






Rattlesnake - 


- 


Devonport - 


9 Sept. 1867 


17 


1,705 


S. 400 






Sinus 


- 


Portsmouth 


23 July 1869 


6 


1,268 


8. 350 




Sloop - 


Peterel - 


- 


Devonport - 


2 June 1866 


3 


669 


S. 150 




GuA Veuel - 


Fly . . 


- 


Devonport - 


14 Dec. 1868 


4 


464 


SS.120 






Growler - 


- C. 


Devonport - 


29 June 1869 


4 


464 


SS. 120 






Jaaeur - 


-S.C. 


Sheemesa - 


26 Aug. 1867 


5 


427 


S. 80 






Lee . - 


- S.C. 


SheemeSB - 


10 June 1867 


5 


431 


S. 80 






Lynx 


- 


Devonport - 


14 Dec. 1868 


4 


464 


SS. 120 






Myrmidon 


- 


Chatham • 


29 Oct. 1867 


4 


697 


S. 200 






Pandora - 


- 


Portsmouth 


17 March 1868 


5 


426 


8. 80 






Plover - 


- 


Woolwich . 


25 Sept. 1867 


3 


663 


S. 160 






Speedwell 


-s.c. 


Woolwich - 


24 July 1867 


5 


428 


S. 80 




Steam Vessel 


Pioneer - 


. 


River Congo 


7 June 1866 


_ 


142 


P. 34 






Investigator - 


-P.O. 


Lagos 


15 Aug. 1866 


2 


149 


P. 34 




Beoeifiog Ship - 


SeringapBtam - 


. D. 


C. G. Hope 


1 April 1867 


- 


1,152 


- 




Store Ship - 


Dromeddry - 


-P.O. 


Ascension - 


1 July 1867 


2 


654 


S. 100 






Flora 


- 


Ascension - ^ 


1 Jan. 1869 


10 


1,634 


- 






Industry - 


-S.C. 


Woolwich - 


25 April 1$66 


2 


638 


S. 80 






Vindictive 


- 


JeHahCofiee 


1 April 1867 


2 


1,758 


- 





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OF AFBICA AND CAPE OF GOOD HOPE STATION. 



227 



Table, No. 6. 



the Total Number of Days' Sickness on Board ', the Average Number of 
and the Number Discharged to Hospital. 







S. C. Station changed. 




D. Returns Defective. 






Period. 


Com- 
plements. 


Avwsge 
Com- 
plements 
corrected 
for Time« 


Number 

of 

Casi^of 

Disease and 

Injury. 


Number of 

Days» 

Sickness 

on Board. 


Average 
Number of 
Men Sick 

Daily 
for Twelve 

Months. 


Ratio 

per 1,000 

of Average 

Force of 

each Ship. 


Number 
Discharged 

to 
Hospital. 




1 Jaa.to30Stpt. 


205 


150 


217 


2,119 


6-8 


38-6 


5 




Year 


820 


320 


485 


44^63 


13-5 


'411 


26 




1 Oct to ai Deo. 


225 


60 


91 


818 


2-2 


36*6 


— 




Year - . 


115 


115 


204 


1,700 


4*6 


40- 


11 




Yaw 


86 


85 


201 


2|250 


6*1 


71-7 


8 




1 Jolf toSlDee. 


80 


40 


106 


1,067 


2-9 


72-5 


14 




1 J«li.toa0 8tpi. 


70 


50 


94 


866 


23 


46* 


5 




lJaii.to31March 


75 


20 


51 


406 


11 


55- 


4 




Year - - 


70 


70 


232 


1,602 


43 


61-4 


67 




Year . - 


100 


100 


166 


1,661 


4-5 


46- 


13 




Ytar 


75 


76 


158 


1,690 


4-6 


61-3 


12 




Ymr 


90 


90 


111 


1,473 


4- 


44-4 


11 




lJaa.to3]March 


80 


20 


19 


250 


•6 


30- 


— 




Year - - 


40 


40 


181 


974 


2*6 


65- 


4 




1 Jan. to 82 Feb. 


40 


5 


10 


85 


•2 


40- 


1 




Year - - 


120 


60 


« 
56 


361 


•9 


15. 


9 




lJan.to24April 


75 


26 


43 


613 


1-6 


64- 


9 




Year - - 


280 


280 


227 


1,517 


41 


14*6 


40 




] AprUtoSlDw. 


85 


60 


102 


915 


2-6 


41-6 


7 




Year . . 


65 


65 


89 


1,051 


2-8 


43' 


— 



384. 



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228 MEDICAL STATISTICAL RETURNS 



EAST INDIA STATION. 



East India The squadron on this station in 1869 comprised twelve v^sels. 
Station. yjg^^ two, of the fourth-rate ; one, of the sixth-rate ; four sloops ; 
two gun-vessels ; and three troop-ships. The returns from eight of 
these vessels were for the whole year, and for the remainder for 
periods varying from three to nine months. The mean force cor- 
rected for time was 2,300, and the total number of cases of disease 
and injury entered on the sick-list 4,277, which is in the ratio of 
1859*5 per 1,000, being a decrease compared with the preceding jrear 
equal to 2188 per 1,000. Of these 129 were invalided, and tmrty- 
one died, the former being in the ratio of 56*, and the latter of 13*4 
per 1,000. Compared wim the preceding year, there was a decrease 
m the invaliding rate to the extent of 21*7, but an increase in the 
ratio of mortality equal to 1*6 per 1,000. During the preceding 
year, the ratios of cases entered on the sick-list, and of invaliding, 
were exceptionally high, owing to the exposure of the crews of the 
vessels employed in the Bed Sea, in connection with the Abyssinian 
Expedition. 

The average number of men daily sick from Class I., General 
Diseases, Section A., was in the ratio of 4*5 per 1,000 ; and from 
Section B., 8*6. From diseases of the nervous system, and organs 
of the special senses, the average daily ratio was "8 per 1,000 ; from 
diseases of the circulatory system, *6 ; of the absorbent system 
and ductless glands, 1*4 ; of the respiratory system, 2*2 ; of die 
digestive system, 6-3 ; of the urinary and generative systems, 2*2 ; 
of the cellular tissue and cutaneous system, 11*3; fromundassed 
diseases, 1*1 ; and from wounds and injuries of various kinds, 8*9. 
The total average number of men sick daily was 119*7, which is in 
the ratio of 52* per 1,000, being a reduction compared with the 
preceding year equal to 13*9 per 1,000. 

L General Diseases.— Section A., or Febrile Oroup. 

Class I. Under this head, 517 cases of various forms of disease were 

Sect A. entered on the sick-list, viz., thirteen of small-pox, two of vaccinia, 
seven of measles, eight of enteric fever, 293 of simple continued 
fever, seventy-two of ague, ninety-nine of remittent fever, two of 
cholera, fourteen of influenza, one of mumps, and six of erysipelas ; 
and of diese, two of enteric fever, one of ague, and eleven of remittent 
fever were invalided ; and two of cholera proved fatal. 

Small" 



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EAST INDIA. STATIOT^. 




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OF THE EAST INDIA STATION. 229 

Small-pox. — Of the thirteen cases of small-pox which were East India 
entered on the sick-list in the squadron during the year, six occurred Station. 

in the Forte, three in the Jumna, two in the Octavia, and two in 

the Star. Class I. 

Sect A. 

In the Forte, the first case occurred in the person of a seaman, 
who presented himself on the 2nd of April, the day after leaving 
Bombay, with a well-marked varioloid eruption. The surgeon* of 
the vessel says : " He had slept on shore in a low public-house about 
a fortnight previously. He had very good vaccination marks on 
both arms. He was placed under a screen in the fore part of the 
main deck, and a sentry had orders that he should be kept perfectly 
isolated. The case proved to be an extremely mild one, the rash 
not passing beyond the vesicular stage. He was discharged to 
duty. The screen, bedding, clothes, &c.,were all carefully washed, 
and steeped in a solution of carbolic acid. No other case occurred 
till the 3rd of May, a fortnight after leaving Muscat, where many 
of the men landed, and where there was much communication 
between the native Arabs and the ship. The man had frequently 
been on shore at Muscat, and had gone to the crowded bazaar for 
the purpose of buying provisions. In this part of Arabia, small- 
pox is always prevalent. 

" Soon after a mess-servant had an attack of the disease. He had 
not been on shore at Muscat, but had a good deal of intercourse 
with natives who came on board selling fowls, eggs, vegetables, &c. 
On the 6th of May a boy and a leading seaman showed well- 
marked symptoms of the disease. They had landed at Muscat. Two 
days afterwards an ordinary seaman was attacked. He had been 
on the list suffering from chronic diarrhoea for a considerable time 
previously. All six had remarkably good vaccination cicatrices, 
and in all the disease was of a very mild character. Indeed, in 
three, the eruption was so modified, that they might be entered 
under the heading of varicella. 

. " The men affected with the disease were kept perfectly isolated. 
The commodore ordered a large portion of the poop to be screened 
off for their reception. Marines who had had small-pox were placed 
as sentries, and prevented any intercourse between the sick men 
and the rest of the ship's company. To these precautions may be 
attributed the immunity from the further spead of the disease. 

*^ Before we left Bombay, vaccine lymph was procured, and 
attempts were made to re-vaccinate the younger men and the boys. 
They were, however, unsuccessful. Nearly all had good vaccina- 
tion marks." 

There were three cases of small-pox in the Jumna, all occurring 
at Bombay, in the persons of native stokers. There was no diffi- 
culty in tracing the origin of the disease in these cases as the men 
had daily leave on shore, where small-pox was prevalent. 

In the Octavia, there were two cases of small-pox, with reference 

to 

♦ Surgeon J. W. S. Meiklejohn, m.d. 
384. U 



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230 » MEDICAL STATISTICAL BET0RN8 

Em* India ^ which the surgeon* of the vessel makes the following observa 
Btatton. tions : — " The occurrence of two cases of emall-pox on board during 

the first week of March caused considerable alarm, but their prompt 

Class I. removal to hospital sufficed to prevent any spread of the contagion 
Sect A. on board. It was thought advisable, however, at the same time, to 
have all persons on board having unsatisfactory marks of vaccina- 
tion, or unprotected by previous attacks of the disease, re-vacci- 
nated, and within forty-eight hours of the first case of variola show- 
ing itself, thirty-eight persons were vaccinated from a native child 
sent off by the superintendent of vaccination in Bombay, and of 
those, twenty-nine * took' well, one so well, indeed, that ne had to 
be placed on the sick-list for five days ; his arm becoming veiy 
much inflamed, and a roseolar eruption appearing all over his 
body, with slight feverishness. 

"The occurrence of this threatening of small-pox on board, 
within a few days of the corresponding time of the year at which 
the epidemic broke out on board at the same place in 1866, is per- 
haps worthy of note, as corroborative of the fact, which is, I believe, 
proved by statistics, that small-pox is more apt to attack Europeans 
at Bombav in early spring than at any other season of the year. I 
regret to have to add, that it was found necessary to leave both the 
ca«es attacked in hospital, as one was sfill seriously ill, and the 
other had not got beyond all risk of conveying infection, when the 
ship had to leave Bombay. Both cases would, however, I trust, 
ultimately do well, as they were both modified by vaccination, 
although one was a confluent case. Neither of them was in the 
ship during the epidemic of 1866 ; but both joined at comparativelv 
recent dates. All those cases of vaccination that were successful, 
were also new entries in the ship." 

There were two cases of small-pox in the Star. One occurred 
in the person of a seaman, who doubtless contracted the disease on 
board, there being some cases among a number of captured slaves. 
Fortunately this was the only case that occurred amongst the ship's 
company, and it was of a modified character. The surgeonf 
observes: "I had little fear for the ship's company, as all were 
vaccinated, and had passed unharmed, with one exception, through 
a severe epidemic of the disease which occurred amongst a number 
of slaves on board in the previous year," 

In the other case which occurred in this vessel, the disease pre- 
sented itself in the person of a native Tamil of Ceylon, who had con- 
tracted it at Bombay. 

Measles,— Of the seven cases of this form of eruptive fever 
entered on the sick-list, two occurred in the Euphrates, and five in 
the Jumna, They were of little importance, and the infection was 
evidently brought on board the vessels by the children of the 
soldiers embarked in these troop ships. 

Enteric 



• Surgeon Do\^le M. Shaw, 
t Surgeon W. R. Bennett, u n. 



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* Surgeon S. A. Willis, j4.d. 
384. U 2 



Stfct A. 



OF THE EAST INDIA STATION. 231 

Enteric Fever. — Eight cases of this dangerous form of fever Sa«^ India 
appear ia the returas from the squadron, of which seven occurred Sfcatioa. 
in the Jumna, and one in the Nymphe. With respect to the " — 
former vessel but little information is ^iven with reference to the 2^ J* 
disease, and no suggestion offered as to its probable origin ; and no 
information whatever is given in connection with the case in the 
Nymphe. From the nosological tables, it may be gathered that 
each case of this disease was on an average about three weeks under 
treatment. 

Simple Continued Fever. — Two hundred and ninety-three cases 
of simple continued fever were under treatment during the year, all 
of which were discharged to duty. The average duration of each 
case on the sick-list was precisely six days. Of the total number of 
cases, 134 occurred in the Jumna, the majority of them were of a 
trivial character, but a few severe cases occurred chiefly amongst 
the native stokers. The disease was considered to be caused by 
sudden changes of climate to which the men were exposed on the 
passage between Suez and Bombay. 

In the Euphrates, in which there were fifty-five cases of simple 
continued fever, the surgeon* remarks on the difficulty he encoun- 
tered in classifying the various forms of fever that came under 
observation. He says, " Careful attempts were made to classify 
those cases of fever, as they were divided into fifty-five of simple con- 
tinued fever, twenty of intermittent fever, and twenty of remittent 
fever ; but in many instances it was difficult to decide to which class 
some of the cases should be assigned. A strong presumption was 
entertained that they were all intimately connected with each other 
in their etiology. Frequently it happened that after some slight 
sun exposure, a person would suffer headache, congestion of the eyes 
and face, and general disturbance of the system for two or three 
days, and then all would pass off, and he would be quite well. 
Apparently from the same cause, fever of an irregular intermittent 
character, of longer duration, and periodic in its exacerbations 
would ensue ; and again a fever would commence, in no way dis- 
tinguishable at the outset from the other two, yet at the end of six 
or eight days, so far from there being any amendment, there would 
be an aggravation of the symptoms generally, and they would prove 
intractable and unamenable to treatment, and it would be clearly 
evident that the symptoms were those of remitted fever of a severe 
type ; in some few instances there were severe well-marked typhoid 
symptoms. It is noticeable in the returns for the year, how nearly 
the same number of cases of simple continued fever occurred in each 
quarter ; whereas of either ague or remittent fever, there were none 
in the first quarter, thirty m the second and tliird quarters, and 
ten in the fourth quarter, proving how directly those diseases were 
caused by the climate of Bombay, and that it was sufficiently 
powerful to produce ten cases in the quarter after the ship had left 
that place and resumed her trooping." 

Remittent 



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232 MEDIGAIi STATISTICAL KETURN8 

East India Remittent fever. — There were ninety-nine cases of this form of 
StatioD. fever on the sick-list during the year, of which eleven were inva- 
^ I lided. The average duration of each case was about thirteen days. 
8e^ A ^ ^^® Cossack, the vessel in which the largest number of cases 
• occurred (fifty-two), the disease is said to have been characterised 

by greater or less severity of symptoms, according to the extent of 
solar or malarial exposure. The medical oflScer* observes, " These 
symptoms, as they became more or less developed, constituted either 
febricula or remittent fever, according to their intensity. By far 
the greater number of cases that appear in these returns, originated 
through exposure to the sun. The attack generally commenced 
the same dav that the man had been either walking or working in 
the sun, and was ushered in with severe headache ; a feeling of 
chilliness ; a hot dry skin ; thirst ; with or without vomiting ; 
bowels usually confined ; urine scanty and high coloured ; and the 
tongue thickly coated with a brownish fur. These symptoms lasted 
till 4h. or 5h. a. m., when there was an abatement of the fever, and 
the skin became moist. About 3h. p. ra. an exacerbation occurred, 
which was in due course followed by the remission, about the same 
time as the former. These phenomena lasted from three to ten or 
fourteen days. The treatment, as a rule, consisted in giving from 
six to ten grains of calomel, applying a sinapism over the epigas- 
trium, and allowing the patients as many effervescing draughts as 
they chose to drink. After there had been free action of the bowels, 
a mixture of chlorate of potass and dilute hydrochloric acid was 
given every four hours ; and lastly, when the tongue conunenced to 
clean, the mixture was changed for quinine, in five or ten grain 
doses, three times daily; at the same time one or two glasses of 
wine, and some good soup were found beneficial in hastening con- 
valescence. 

*^ While the ship was at Zanzibar, and some time after leaving that 
localitv, fever of a more decidedly remittent type prevailed, accom- 
panied in a few instances with typhoid symptoms, and troublesome 
diarrhoea, and hepatic complication. These occurrences were pro- 
bably owing to the emanations arising from mephitic deposits on the 
beach facing Zanzibar. The fever generally left the patient in 
an excessively weakly condition, convalescence was teoious, and 
even when he was discharged to duty he became a martyr to dys- 
pepsia and constipation. 

" In two instances only have I had an opportunity of tracing this 
fever to direct malarious agency. A sub-lieutenant, and a midship- 
man slept on shore at Pomoney (Johanna), and bathed on the 
following morning before the sun was up, in a pond supplied by 
a stream which came from the jungle. Nine days afterwards the 
sub-lieutenant was seized with vomiting and other symptoms of 
remittent fever ; and on the tenth day the midshipman was also 
attacked. The sub-lieutenant was eighteen days, and the midship- 
man fifteen days on the list" 

Cholera 



• Surgeon Frederic Piercy. 

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Sect A. 



OP THE EAST INDIA STATION. 233 

Cholera. — Two cases of thb malignant disease occurred in the East India 
squadron, both of which proved fatal. One occurred in the Dryad, Station , 
the other in the Malabar. r I 

The fallowing report in connection with the case occurring in the ^^ a. 
Dryad is by the medical officer * of that vessel. " A fatal case of 
cholera occurred this year. There were two cases under treatment, 
but only one belonged to the ship's company. The other does not 
appear in the returns. The following are the particulars of the 
fatal case. 

"...'. aet. 46. Sick-berth attendant. An old Marine. 
Married, Suffered from a severe attack of dysentery in the early 
part of 1869. Looked prematurely old and worn; zealous; of an 
anxious disposition ; temperate ; led a steady regular life ; served 
his time for a pension. 

*^ At 4h. p. m. on the 5th of December, on the passage from Zan- 
zibar to Bombay, I was sent for to see this patient. On my arrival 
I found him lying on deck, under the forecastle, in a state of 
extreme prostration. The extremities were icy cold ; the whole 
of the body bathed in a cold clammy perspiration. Pulse not 
perceptible at the wrist, and the heart's action hurried, feeble, and 
indistmct. He had severe cramps in all his limbs and fingers, and 
his voice was feeble and scarcely audible. He complained of head- 
ache and pains all over. He was suffering from vomiting and 
purging, and in fact from all the symptoms of Asiatic cholera. He 
did not complain much of thirst, nor of any feeling of coldness. The 
trunk, although much reduced in temperature, was far from pre- 
senting to the touch the same morbid degree of coldness as the 
extremities. 

" On inquiry I discovered that the attack had suddenly set in two 
and a-half hours previously, but owing to gross ignorance or extreme 
neglect on the part of the persons about him, no. notice had been 
taken of his condition till four o'clock, my hour for visiting the sick. 
The attack was not preceded either by premonitory diarrhoea or any 
other symptom of ill health. 

" He was at once put into a cot, under a screen, on the starboard 
side of the forecastle, and frictions with oil assiduously applied to 
the limbs, by two petty officers told off for the purpose. Turpentine 
stupes were applied to the stomach, and warmth to the feet, giving 
him at the same time stimulant draughts containing tincture of 
ginger and aromatic spirits of ammonia, while barley water was 
being prepared for drinK, to which was added ten grains of chlorate 
of potass to the ounce. 

" In this way a little heat was restored ; the cramps in the legs 
became less severe, and by eight o'clock were entirely confined to 
the arms and fingers, but the pulse did not rally. He had only 
vomited once or twice since I saw him, and the watery discharges 
from the bowels were neither urgent nor painful, the evacuations 
escamng without any effort. 

** Warm flannel bandages applied along the whole length of the 

lege 

• Sarg^n D. O'Connor, m.d. 
384. U3 



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234 MEDICAL STATISTICAL BETtRKS 

East India legs seemed to have a most beneficial effect in arresting the cramps ; 
Statiod. but this advantage was at once followed by increase of pain in the 
7" stomach, and cramps along the muscles of the abdomen. The pain 

2~* ?• resisted chlorodyne in effervescing draughts, with warm fomenta- 
Bect. A. ^j^j^g ^ ^g abdomen, but the cramps ceased. The breathing had 
now become more anxious and hurried, and he complained of heat 
and oppression, although a cool breeze from an adjoining port circu- 
lated freely round him. In this condition, with some slight variation, 
depending on the strength or feebleness of the voice, he lingered till 
7h. 40'. a. m. of the 6th, when he suddenly expired, apparently from 
sheer exhaustion. There was scarcelv any lividity of the body. The 
eyes were particularly bright, and full of expression, and his intellect 
clear to the last moment. 

*' This attack was very sudden, and ran a very rapid course. The 
collapse seems to have come on very early, and continued with for- 
midaole obstinacy. It must have been comparatively independent 
of the discharges by the stomach and bowels, which seemed to me 
by far the least alarming feature of the disease, either in quantity 
or frequency. 

** In this case no regular plan of treatment was pursued. The early 
and extreme collapse admitted of no delay, and the rapid tendency 
to death by asthenia had to be combatted in dealing with symptoms 
that led more prominently in that direction. This consisted in 
endeavourihg to restore the heat of the body, and to improve the 
condition of the pulse by means of stimulants and essence of 
beef internally, and warm embrocations locally, all of which 
ultimately proved unavailing against a most virulent disease sud- 
denly seizing upon a constitution already very much worn aiid 
enfeebled. 

** The disease was in all likelihood contracted from a young Negro 
boy, who had come on board the ship at Zanzibar on the 29th of 
November, the evening preceding our departure from Bombay. 
This boy fell sick with cholera on the 2nd of December, when we 
had been three days at sea. His was also a very severe attack. 
Collapse set in early, with intense coldness of the extremities and 
total absence of pulse at the wrist. Great restlessness and pains all 
over, and especially in the region of the heart, to which he constantly 
referred severe pain. In this case there were no cramps, but the 
purging and vomiting Were incessant. His condition had been for 
some days very critical, but he ultimately recovered. It was during 
his attendance on this boy that the deceased was attacked. 

" For a few days preceding our departure from Zanzibar there 
was a rumour that cholera had made its appearance on shore, and 
was committing dreadful havoc amongst the native population, 
causing as many as from thirty to forty deaths daily. Tne rumour 
was well known to the medical men on shore, but up to the time of 
my inquiry no case had come under their actual notice. 

*^ It was well known for a long time that cholera was raging with 
fatal effect at Pangany, a town of some importance on the opposite 
coast of the mainland of Africa. There appears to be some trade 
carried on between that town and Zanzibar, and constant communi- 
cation takes place between them. This being the case it does not 

speak 



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09 THS EAST INDIA STATION. 235 

speak badly for the contagious nature of cholera that the disease fiatt India 
had not extended to this place up to a few days before our de- Station, 
parture, more especially when we remember the dirty habits of ' 1 
Africans and Arabs, and their utter disregard of all hygienic and S^i* 
sanitary laws. ^^'^ 

" No leave was granted to the ship's company, either special or 
privileged, during our stay at Zanzibar, and deceased never landed 
there. It must be noticed, however, that a constant communication 
had been kept up with the shore by officers, stewards, cooks, ser- 
vants, and in various other ways, since up to the time of the ru- 
moured outbreak of cholera, the town was said to be remarkably 
healthy, except^ perhaps, some few cases of remittent fever which 
is endemic here. No one can well imagine any place more favour- 
able to the spread of disease, on the occasion of an epidemic, than is 
tiie town of Zanzibar. There it would find a congenial soil in the 
bosom of filtfi and in the perfect freedom from the wholesome restric- 
tion of any sanitary law. For the better understanding of its con- 
dition, I will endeavour to give a brief outline of the place, although 
a moment's glance at any chart of it will afford better information 
than can be conveyed by verbal description. 

" Zanzibar is situated on a narrow tongue of land running N.E. and 
S. W., and at flood tides nearly surrounded by water. At low water 
extensive marshes are left exposed in the rear of tlie town and a 
filthy beach of considerable extent discloses itself on its seaward 
side. These places are the general receptacles of human excre- 
ment and all the filth and abomination of a thickly populated and 
densely crowded town, so that on all sides it is surrounded by sources 
calculated to generate and foster disease. 

" During our stay, however, the direction of the winds tended 
to remove or neutralize these malarial emanations from the swamps 
in the rear, while they favoured the smells and emanations from the 
beach» being blown right into the town ; the dwellings of the foreign 
residents on the beach having to bear the brunt of this offensive 
and intolerable nuisance, especially in the neighbourhood of tJie 
English Mission, where even a momentary respite cannot be ob- 
tained from this everlasting nuisance. This arises from a large 
portion of the beach in this locality being beyond the reach of tidal 
wash. 

" During our stay at Zanzibar the ship's company enjoyed excellent 
health. There is at Zanzibar an hospital established by the superiors 
of the Catholic Mission in that town, and attended by a French naval 
surgeon. It is rather small, but clean and in good order. Patients 
of every nationality are received there, so far as the accommodation 
will admit, and meet with every care and attention. 

** But to return from this digression to the question of cholera. It 
may be very naturally asked, how has it happened that this very fatal 
and undoubtedly Contagious disease has limited itself to only two 
cases on board this ship? Can it be the prompt measures adopted at 
the first outbreak of the disease ; immediately separating the iatient 
from the ship's company, and the unsparing use of disinfectants 
during the illness of the patient, and after his death ; taking care 
that none but the special attendants should approach the screen, till 

384. u 4 the 



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236 MEDICAL STATISTICAL EETURNS 

East India the body as well as the bedding and foul clothes of the deceased 
Station. were consigned to the deep, a few hours after death ? 
' 1 " In these precautions I admit I have great confidence ; but it must 

s f*A ^^* ^^ forgotten that segregation on board ship is a matter of much 
diflSculty under the most favourable circumstances, and in small 
vessels of war of the Dryad class, a thing next to impossible, sup- 
posing always the disease to possess strong contagious properties 
like small-pox, measles, or typhus fever. The weather during the 
whole of the passage was most favourable to health ; a cool breeze 
circulated freely through the ship, while the sea was sufficiently 
calm to admit of the ports being kept constantly open. The 
humidity of the atmosphere was, however, as calculated to favour 
the extension of disease as the opposite condition is known to retard 
if not altogether prevent its spread. 

" In the present instance, although the precautions adopted were 
attended with the most satisfactory results, yet it is difficult, to believe 
that these measures could of themselves have so suddenly arrested so 
rapid and so formidable a disease, and that it may not have ceased 
of its own accord. One cannot help noticing that however fatal 
its seizures may be when it appears on board ship, how com- 
paratively few they are, notwithstanding the crowding and the other 
disadvantages. Two or three cases in a very short space of time 
occur ; they have a rapid and fatal termination, and the disease sud- 
denly disappears, perhaps never to return again, having as it were 
exhausted its virulence m its first violent outbreak. This may not 
invariably be so, but it appears to be usually the case as noticed in 
the records of its outbreak on board ships on this station of late 
years. The contagious nature of the poison, or whatever it may be, 
would appear to require constant transfer from one person to 
another, failing which it would seem to become inert. 

" In the cases on board this ship, the period of incubation would 
seem to be very short. The probability in the one case, and the 
almost certainty in the other, would seem to point to a period of four 
days, if not less. The Negro boy fell ill on the 2nd of December, the 
fourth day after his arrival on board. Supposing that in this case 
the poison had been imbibed on the 29th of November, this would 
make the period of incubation exactlv four days. The presumption, 
however, seems to be in favour of a later date. A boy belonging to 
the English Mission, and no doubt not at liberty to stray about at 
lar^e would be less likely to get exposed to infection ; but even 
taking the mean of the time, it would still be four days. The sick- 
berth attendant did not come in contact with this boy until the 2nd 
of December, when he commenced his attendance upon him, and 
fell sick himself on the 5th of December, or the fourth day of his 
attendance. There is little doubt that he contracted the disease 
from the Negro boy, although the proof cannot be reduced to ab- 
solute certainty ; but occurring in the person of one who had been 
in Qpnstant attendance on a cholera patient and on him only, looks 
at least more than a mere coincidence, and indeed almost to a cer- 
tainty favours this view, and is in keeping with the usual habits of 
cholera. 

*^ Assuming, therefore, that in thes^ cases of the Dryad we had the 

^eual 



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OF THE EAST INDIA STATION, 237 

usaal manifestations of cholera^ and taking other instances of the ^^^ India 

disease into consideration^ it may fairly be stated that the period of S tation , 

incubation is not long, although it would be an interesting question Class I, 

to ^rove what that may be, or whether it has any precise or regular Sect A. 
period at all, as it is a question that bears, to some extent, on qua- 
rantine and infection.'' 

At a subsequent period the same officer forwai'ded the following 
interesting report on the epidemic of cholera which made its appear- 
ance at Zanzibar in 1869 : — 

*^ On the occasion of a recent visit (Jidy 1870) to Zanzibar, I 
took the opportunity of making some inquiries relative to the history 
and progress of the late epidemic of cholera, which had been com- 
mitting great havoc in that island between the latter end of No- 
vember 1869 and June 1870. 

" As I am not aware that any report of it has been sent* to the 
Medical Director General, I beg to forward a resume of the result 
of these inquiries for his information. 

" I may mention at the outset that in December 1869, shortly 
after leaving Zanzibar for Bombay, two cases of cholera occurred on 
board this ship, one of which proved fatal ; a report of this was 
immediately forwarded on reaching Bombay. 

^* Until my late visit to Zanzibar, I was entirely ignorant of the 
course and progress of the epidemic, in consequence of the imper- 
fect means of postal communication with that island, both from 
Bombay and other parts of the station ; cruising for the suppression 
of slavery being entirely suspended this season, probably from ap- 
prehension of nsk to the squadron from infected dhows, prevented 
still further occasional opportunities of communicating by means of 
ships of war. 

" On the 9th June 1870, we left Trincomalee for Zanzibar. Having 
occasion to communicate with the senior officer, we touched at Sey 
chelles, where we arrived on the 3rd of July : finding that he was 
away on a cruise, and his return being daily expectea, we awaited 
his arrival before venturing to proceed directly to Zanzibar. 

" Seychelles is at all times a very enjoyable place, but at this 
season of the year especially, the climate is excellent, and the weather 
cool and bracing. During our stay f eleven days) we found it an 
agreeable refreshing change, especially after a singularly rough 
passage, of twenty-five days of damp, squally, disa^eeable weather. 

" The authorities at Seychelles were rigorously enforcing the 
quarantine laws on all vessels arriving from the Mozambique and 
other suspected ports, and a Portuguese vessel of war, which had 
recently arrived from the Mozambique with passengers and mails 
for the French homeward-bound packet, having had a fatal case of 
cholera on the passage, was at once placed in quarantine, and not 
even allowed to discharge her mails to the Messagerie. 

"The Cossack arrived on the 20th of July and was put in quaran- 
tine in the outer roads, having communicated with Zanzibar, where 
the disease was known to be prevalent iip to a recent date. She was, 
however, admitted to pratique after a £ew days, having satisfied the 
commissioner that no recent outbreak had occurred at Zanzibar ; and 
having communicated and discharged our supernumeraries, we 

384, resumed 



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238 MEDICAL STATISTICAL RETUBKS 

East India resumed our voyage on the 9th of July and arrived at Zanzibar on 
Station. the 24th of that month. 

Class I. *^ Cholera had now entirely ceased here, and no case of it had been 

Sect A. known to occur since June last. The opposite coast of the main 
land of Africa, between Cape Delgado on the south, and Brava on 
the north, where the epidemic also proved very fatal, had been re- 
ported quite free from the disease. It was still lingering at Brava. 
Much farther north it may have extended through the agency 
of dhows resuming the coast trade on the return of the south-westerly 
monsoon. No recent information had reached Zanzibar. 

" The latest news from the Mozambique reports the disease still 
prevalent in that city, and in many of the coast villages in the 
Portuguese dominions. Early in January 1870 cholera had visited 
Johanna and the Comoro Islands, but no late information had been 
received at Zanzibar as to their present condition, nor was it known 
whether the disease had extended to Madagascar. 

*^ Nos Beh and Mayotta had escaped, and no case of it had oc- 
curred at Seychelles. It is deserving of notice here that these 
places were placed under quarantine regulations at the first out- 
break of cholera at Zanzibar, and that the Mozambique, where 
similar restrictions were enforced, escaped until May, some six 
months after its first appearance on the coast ; and there is good 
reason to believe that this check was owing to the same precautions 
which have secured for Seychelles, Nos Beh and Mayotta, entire 
immunity from cholera. 

^^ With the panic-stricken people of Zanzibar the late epidemic 
had been the all-absorbing topic. It was estimated by the natives 
that as many as 30,000 persons were carried off in the town of Zan- 
zibar alone. Since there is no census taken of the population, and 
no record of deaths kept, I am inclined to think that Dr. Kirk's es- 
timate of ten to fourteen thousand is more correct. It is by him 
that these remarks were mainly furnished, and they may therefore 
be considered as pretty correct. 

*^ The first outbreak was attended with the greatest numbers 
attacked, and with the greatest mortality, as many as three and four 
hundred persons beinff carried off daily in the early part of Decem- 
ber 1869; after this tlie numbers began to fluctuate, increase, dimi- 
nish, intermit, decline, and finally to cease altogether in June 1870. 
It was equally, if not more virulent amongst the shipping in the 
harbour ; some vessels were forced to put back into Zanzibar, having 
lost more than half their crews within a few days after leaving port. 
This fatality amongst the mercantile shipping occurred at a later 
period, and when the disease began to decline on shore. 

*^ The poorer classes suffered most. The slaves and necro popu- 
lation were almost the sole sufferers at first ; a little later uie poorer 
Arabs, and later still the richer Arabs and Europeans. It had been 
remarked that the purer the African type, and the lower in the 
scale of civilisation, the greater aptitude did they seem to possess for 
catching the contagion, the greater severity did it show, and the 
more fatal did it prove. Recent arrivals (and this remark applies to 
Europeans as well as to natives) were noticed to be especially liable 
to the disease. Persons shifting quarters or otherwise attempting 

to 



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Ot THS BASt IlfBIA STATION. 239 

to fly from the disease showed ftlso a remarkable susceptibility to EaBt Itidia 
the contagion of cholera. Station. 

** The epidemic had also severely smitten the opposite coast of the 

mainland, and although there are no means of forming even a rough Claii I. 
estimate of the number of deaths^ yet from the circumstance that ®^* ^ 
twenty-eight fatal cases occurred in the establishment of the Ca- 
tholic Mission at Bagamayo ; and considering that great care and 
attention is bestowed upon these, we may imagine the mortality 
amongst the poverty-stricken population along the coast villages 
between Cape Delgaido and Brava^ deprived of the necessaries, not 
to say the comforts of life. 

" To any person acquainted with the town of Zanzibar, it can be 
no cause of surprise that cholera or any other infectious disease 
should prove very destructive, after having once entered it. It is 
especially the abode of vice and filth, and the hotbed of disease* 
Its streets are narrow and dirty, and reeking with the stench of 
human excrements, which are generally deposited at the doors, and 
around their dwellings. The exhalation from animal and vegetable 
matter, decomposing and seething under the burning heat of a 
tropical sun, and giving off volumes of poisonous gases, pollutes the 
atmosphere far and wide, and supplies suitable food and fuel for the 
pestilence. 

'^ The water obtained from any part of the island is said to be 
bad, and to possess purging qualities; that obtained from the 
wells in the town is highly brackish* I cannot say that I have 
tested or eveu tasted this water, but from what 1 have learnt, 
as well as from the situation of the town, on a low flat spit, in high 
tides almost entirely surrounded bv water, and that its surface is 
composed of sand situated on a coral foundation, I cannot but think 
that whatever freshness this water may possess is in a great measure 
derived from occasional rainfalls, and from the refuse water brought 
from distant parts of the islands by Europeans and rich natives, 
after having done the work of flushing latrmes and sewage, as well 
as other cleansing and domestic offices. The wells and cesspools lie, 
in many instances, side by side^ and the fluid contents of the latter 
can have no difficulty in finding their way into the former without 
undergoing any very refined process of filtration. The streatn 
waters are said to contain salts of lime, and to throw down a thick 
white precipitate on standing ; their purging qualities are probably 
due to the presence of decomposed organic matter, which the luxu- 
riant growths of l^e island and their rapid decay under the influence 
of moisture and a high temperature must abundantly supply to it. 

" No public interest is taken in the sanitary condition of the 
town ; no municipal precatitions against the advent of disease \ no 
means adopted to relieve the sufferings of sickness or the distress of 
poverty. There are no burial regulations *, the dead are buried at 
their very doors ; the interment Is deep or superficial, as the case 
may be, or perhaps no burial at all is effected, as in the late epidemic, 
when bodies were in many instances left to rot on the beach. The 
garments of the deceased "were generally sold at the bazaar shortly 
after their removal from the body> and thus the seeds of the disease 
were scattered broadcast oter the island. It is hard to admire an 

384. administration 



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240 MEDICAL STATISTICAL BETUEN8 

East India administration which permits such revolting scenes^ and yet there 
Station. appears not the least prospect of improvement. 
^ J " The English consul, in the interest of the English and forei^ 

Beet* a! residents, set apart the gaol as a hospital during the height of the 
cholera, and many Europeans and foreigners from the snipping in 
the harbour were treated in this building. The hospital of the 
Catholic Mission also aflPorded shelter and treatment to many per- 
sons of all classes during the epidemic. 

" A scourge so formidable, and attended with such heavy loss of 
life, very naturally suggests an inquiry into its history and progress; 
whence did it come; by what road did it travel; where was its 
primary focus ; had it been imported, or was it of purely African 
growth? 

" These were the questions to which I sought answers, and to 
which my inquiries were principally directed. 

^^ As in many other outoreaks, the origin and history of the pre- 
sent epidemic are very obscure. A great deal of this depends on 
the remote region which it has invaded, as well as upon the want of 
precise information from the people inhabiting these distant countries, 
by whom it was known to have been conveyed in the first instance 
to the coast. 

*^ Dr. Kirk, an old African traveller, and a man well acquainted 
with the south-east portion pf that continent, and thoroughly con- 
versant with the mode of life and habits of the people of these parts, 
states that the disease had in the first instance reached Zanzibar 
from Pangany, and that it had been introduced into the latter place 
from the interior of Africa. 

'^As early as the month of September 1869 some very fatal 
disease had been known to exist in the Masai country (a country 
lying south-west of the Gallas) in the interior, where it had been 
committing great havoc long before it reached the coast. 

" The first case known on the coast happened, as before noticed, 
at Pangany. This town is situated on the mainland opposite to, but 
a little to the north of the island of Zanzibar, and is the terminus of 
a great caravan route to the ivory and trading countries in the 
interior, and it was by this road that cholera had been conveyed to 
Pangany. 

^* The first case known in the island of Zanzibar occurred in a 
small village on the north-west coast of the island, opposite Pangany, 
and where dhows, trading between this latter place and Zanzibar, 
usually anchor. The next appearance of the disease happened in 
the town of Zanzibar ; next, the disease broke out at Mombas, north 
of Pangany, on the mainland ; after this, the disease became general, 
attacking the various towns and villages on the coast along the 
south till it reached Quiloa, where it lingered for some time before 
invading the Mozambique and the Portuguese dominions. 

" Dr. Kirk has no doubt that this epidemic reached the coast 
from the interior, and that it in every instance followed in the 
path of human intercourse and in the wake of trade. He also states 
that it was carried back again into the interior by another great 
caravan route, beginning at Bagamayo and traversing the tJmjam- 
neri. The rout^ thus traversed Jies parallel tp, but considerably to 

the 



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OF THE EAST INDIA STATION. 241 

the southward of the Pangany route. He states that it made no East India 
headway at first against the north-east monsoon, having got no Station. 

farther north than flie village of Lamo on the coast ; but this he ' ' 

attributes, not to the winds, but to the suspension during tiiis period ? *? \ 
of dhow trade from the south : for, on the return of the south-west ^^ 
monsoon, it extended northward along the seaboard of the Sultan's 
dominions as far as Mukdeesha, about two degrees northward of the 
line, ihe farthest point north from which any information has reached 
Zanzibar. 

** Now we have traced the epidemic to the Masai country in the 
interior of Africa, but how it got there it is much more difficult to 
find out. Was it introduced from India direct, or by the Red Sea, 
or did it get there, as some think, from the West Coast of Africa by 
land, or was it conveyed thither in ships round the Cape? To 
these questions there appears to be. at present no means of returning 
a decisive answer. Its advent from tne Gambia overland i^pears 
to be against all probability, especially when we consider the geo- 
graphical relations of these two places ; one in the extreme north- 
west, the other in the extreme south-east part of the great African 
continent; separated from each other by lofty mountain ranges, 
burning ascents, impenetrable forests, wide lakes, and rapid rivers ; 
a country devoid oi roads and of every facility of human intercourse, 
it is difficult to imagine that it has be^n conveyed over that vast 
area of country. Its passage hj the Cape is not more probable, and 
directly opposed to what is positively known of its prevalence in the 
interior of Africa previous to its appearance on the east coast, or 
at Zanzibar, a circumstance not easily understood, on the suppo- 
sition that it was introduced by this road. 

** Cholera had no doubt existed at Hyderabad and extended to 
Kurrachee towards the end of '69, following the course of the Indus, 
and from this port it might have been conveyed to the south-east 
coast and to Zanzibar. 

" Yet since it had been known to have existed in the Masai country 
as early as September '69, and at a season when the south-west mon- 
soon puts a* stop to all intercourse between Kurrachee and the 
African ports on this coast. On the supposition that this was the 
route taken by the epidemic, it must have been introduced previous 
to the commencement of the south-west monsoon, and the difficulty 
would still remain how to explain the immunity of the coast through 
which it must have travelled in getting to the interior. 

" Arabs and eastern merchants trading with Abyssinia by the Red 
Sea may have conveyed the disease into the Galla country, and thus 
to the neighbouring country of the Masai. The objection to this is 
that I am not aware that the disease did exist in any of the Abys- 
sinian ports in '68, nor had I heard of its prevalence there in '69, 
although I had some opportunities of hearing, had it existed, being 
then for some months m Bombay. 

*^ It can be seen therefore that neither of these routes satisfactorily 
explain the introduction of cholera into the Masai country, in fact that 
they are almost entirely opposed to such a view. The only question 
we have to consider, therefore, is its origin, ^^de novo,** in the interior 
of Africa ; from what I can gather my own ideas are in favour of 
this presTunption* 

384, '' Nq 



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242 HJCDICAL STATISTXGAI4 1EISTU9KS 

£ft8i India " No doubt the majority of medical men at the present day main- 

Station. ^i^ ^^^1 every outbreak of cholera^ in whatever portion of the globe 

p. J it may appear, can be easily traced and connected, link by link, 

S^ A ^^*^ some outbreak in its " endemic home" (as it is called) iii India; 

' * some men going so far as to consider Lower Bengal as the only 

endemic area and home of cholera. 

*' There are no doubt many good reasons for this view of the 
question, and some evidence to support it. It must be admitted 
also that this doctrine is far from being established with certainty, 
and so long as any doubt remains, and remain it certainly does, the 
probability of its origin, " de novo^^ cannot oppose any principle of 
nosology, nor involve any medical heresy. Very little is really 
known of the physical features of the interior of the vast continent 
of Africa ; still less of its geological or meteorological condition, and 
absolutely nothing of the historv of its nosology. These are factors 
that all must admit play an important part in the outbreak and 
spread of cholera, and these are points that must not be forgotten 
in the question of regarding Bengal as the only source and home 
of cholera. 

^* In the accounts of the outbreak of cholera on the West Coast 
in 1868, it is supposed to have been introduced there from Morocco 
through the agency of caravans, and the general impression seems 
to be m favour of connecting it with the great outbreak in Alexandria 
in 1865, 

" In a number of the ^ Lancet,' dated the 21st of August 1869, the 
following remark is made, which appears to me to have some bearing 
on the question of its origin * de novo.* The paper states : ^ It is 
remarkable that on the Gambia as on the Senegal, the epidemic, 
according to our present and fairly trustworthy information, appeared 
first inland,* 

'^ It is also noticed that the disease advanced to seaward, and yet 
but little stress is laid on this fact, and indeed seenns to be entirely 
ignored in deference to the old time-honoured custom of connecting 
every outbreak of cholera with its home in the East; fhe difficulty, 
too, of crossing the desert from Morocco, will be readily admitted, 
even by the most strenuous advocates of contagion. 

" Of the contagious nature of cholera and its rapid spread through 
the medium of human intercourse, there appears to pe much less 
doubt, as well as that its progress has been checked, and in some 
instances entirely stopped wherever sanitary and strict quarantine 
regulations have been vigorously enforced, as in the case of Seychelles, 
Nos Beh, and Mayotta, already noticed, as well as th^ prevalence 
of the disease, apparently when such precautions have been neglected. 
A practitioner at Zanzibar inforfned me that the late epidemic here 
aflTorded peculiar opportunities of observing the bigh^ contagious 
nature of cholera. The population, composed of a mixture of 
various castes and races of various customs and habits of life, 
some highly social and keeping up a very intimate intercourse 
amongst tliemselves, as well as with forei^ers, payiog constant 
visits to their sick friends and attending tbeir wakes and funerals ; 
others, such as the Banyans, whose rqles^ both ia reference to their 
own and other castes, enforce the utmost seclusion, 

** Amongst 



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OF;rHB EA8T INDIA STATIC V. 243 

** Amongst the former^ cholera committed great havoc, whilst the East India 
latter enjoyed a very remarkable immunity from the epidemic. Station . 

" It was remarked that the Banyans used the town water almost daMTl. 
exclusively, and thus it was thought that water could have little geot. A* 
or no share as a medium for propagating the disease. The state- 
ment appears certainly remarkable, and should it prove correct, the 
immumty which the fianyans enjoyed can only be accounted for on 
the supposition that exclusiveness in caste implies exclusiveness in 
dwellings ; the use of water, and all minor particulars ; and that the 
wells are less likely to be contaminated with infected dejecta, or 
perhaps these people, being in better circumstances, are better 
in health also, and thus better able to resist the action of contagion ; 
for this immunity in the better classes was a subject of general 
remark. Although the dwellings of the Banyans are not models of 
cleanliness, yet their social habits tend materially to protect them 
from the contagion of infectious diseases ; at meals they use the 
leaves of trees mstead of dishes, casting the leaves and fragments of 
their food to the cattle after they have finished, and thus lessening 
or entirely removing the chance of infection. There are some 
reasons for the beliei that water plays some part in extending and 
intensifying the spread of cholera, and the water of this island is 
generally allowed to possess purging qualities. A gentleman here 
who has peculiar opportunities of observing its effects on large 
numbers of young negroes, confirms this statement. He makes the 
remark also that they suffer from looseness of the bowels, on chang- 
ing to a dietary to which they are unaccustomed, showing a great 
irntabilitv of Uie bowels of these races at Zanzibar. 

** At Zanzibar the general features and symptoms of cholera are 
familiar to all, and in this respect there have been unhappily but 
too many facilities for study and observation ; their enuhieration at 
second hand would, however, be of no practical value here. It may 
be worth noticing however, in passing, that cramps were not com- 
mon amongst the negro and Asiatic races who had suffered from 
cholera, whilst in the case of six Europeans, on the contrary, severe 
cramps and spasms affecting the trunk and extremities, proved the most 
d'lstressing symptoms, and in these cases also suppression of urine 
and delirium were very general, related to each other, perhaps, as 
cause and effect. I have heard from a medical practitioner that 
large numbers of round worms were voided by the sufferers ftom 
cholera. This he regarded merely as a coincidence, and noticed the 
fact simply to show the large number of persons who suffer from 
worms, and who continue, notwithstanding, in good health, and in 
the total ignorance of their existence. 

** I could collect no evidence as to the use of alcoholic stimulants ; 
this arose principally from the poverty of those who suffered most 
from the disease, and who consequently could afford no such luxury, 
and partly to the objection of a great many to its use on the grounds 
of caste and religion; and partly also to the circumstance of their being 
ill-borne in consequence of the great irritability of the stomach 
which affected a large proportion of cases. He states, however, 
that so far as his experience went, he was disposed to consider the 
use of stimulants and wine advantageous^ on the whole ; while the 

384. use 



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244 MEDICAL STATISTICAL BETUBN8 

use of carbolic acid (in glycerine, I think he said,) he considers 
Station ^^^^'j beneficial ; for besides the physiological action in allaying 

* the irritability of the stomach, he imagines it possesses some chemi- 

(i|jm J cal action in neutralizing the poison of cholera, whatever that may be. 
Sect. A. ^^ ^^ states that fully one-half of the cases treated in the building 

before referred to, proved fatal, but it must be remembered that 
nearly all arrived there in a state of collapse after the favourable 
moment for treatment had passed by. In a large majority of the 
natives collapse set in early, almost the first symptom, and such 
cases generally proved fatal. 

" Such are the chief gleanings gathered in this inquiry, and the 
report is forwarded in the hope that it may supply any deficiency 
of official information arising from the difficulty that has for some 
time existed of holding direct communication with the island of 
Zanzibar." 

The fatal case of cholera in the Malabar occurred in the person 
of an officer who it is said must have contracted the disease at 
Bombay, where it was prevailing at the time, although not in an 
epidemic form. He was a bad subject for any such affection as 
cholera, having for some years suffered from dyspepsia, the most 
distressing symptoms of which were vomiting ana diarrhcDa. On 
the 9th of April he went on shore, and came off in the evening to 
dinner; he retired to bed about 10 p.m. ; in the middle and morn- 
ing watches he was heard vomiting, a common thing with him ; he 
made no complaint. The surgeon* says : — " I saw him of my own 
accord about 8h. a.m. on the 10th ; he complained of vomitinff and 
purging, and looked drawn. I ordered him a pint bottle of cnam- 
pagne ; he took some of it, but vomited the whole or most of it. When 
seen again by me, between 9h.30' and lOh. a.m., he had most decided 
symptoms of Asiatic cholera. The choleraic aspect and voice were 
apparent ; cramps were felt ; rice-water stools passed ; vomiting was 
frequent; the skin was bluish, cold, and clammy ; the pulse was 
feeble, and the urine suppressed." He was removed from his cabin 
to the Seaman's Hospital, and placed in a warm bath at a tempera- 
ture of 102* for five minutes ; he had less cramps when taken out ; 
every effort was made to stimulate the vital powers, but without 
effect; collapse set in; the pulse became almost imperceptible; 
there was occasional wandering delirium ; the urine was entirely 
suppressed ; the breathing became much laboured, and he died at 
7h.30' a.m. of the 12th without any apparent symptom of pain. 

II GFeneral Diseases.— Section B.| Constitutioiial Group. 



Class II. 
Sect B. 



Under this head 444 cases of various forms of disease were entered 
on the sick-list, of which thirty-three were invalided and one proved 
fatal. 

Rheumatism. — There was a considerable increase in the ratio of 
cases of this disease compared with the preceding year, but the in-^ 

validing 

* Surgeon Thomas Oolan, m.d. 



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OF THE EAST INDIA STATION. 245 

Taliding rate was lower, and it caused no mortality. Two hundred ^*i°^'* 

and twenty-tJiree cases altogether were under treatment, of which Stataon. 

twelve were invalided. The average duration of each case on the q^^^ jj 

sick-list was about eleven days. The vessels which had the largest g^^ j ' 
number of cases of this affection were the Forte, the Jumna, and the 
Malabar. 

In the Forte there were thirty-nine cases of rheumatism, and of 
these twenty-nine were discharged to duty, four were sent to 
hospital, three were invalided, and three were under treatment at 
the end of the year. They were nearly all chronic cases, and some 
of them resisted all treatment. A few were undoubtedly of a 
syphilitic origin. 

^ In the Jumna, in which there were also thirty-nine cases of this 
disease, some of them were complicated with pericarditis, for 
which reason two of them had to be invalided. The greater ten- 
dency to heart complication in these cases was considered to be due 
to the high temperature of the Red Sea, in which the vessel was so 
much employed. 

There were thirty-seven cases of rheumatism in the Malabar, the 

Seat majority of which were placed on the sick-list in Bombay 
arbour. The medical officer says that the damp air of that 
locality, during the months the monsoon blows, is unfavourable to 
persons liable to the chronic form of the disease, and tends to induce 
acute attacks in healthy persons. 

Syphilis, Primary and Secondary, — One hundred and thirty-nine 
cases of primary syphilis and forty -nine of secondary syphilis were 
entered on the sick-Bst during the twelve months, of which one case 
of primary and eight of the secondary form of liie disease were in- 
vakded. Compared with the preceding year there was a consider- 
able increase in the ratio of cases of the former disease, but that of 
secondary syphilis was much lower. The invaliding rate for both 
diseases combined was much higher than in 1868. The vessels in 
which the largest number of entries on the sick-list from these affec- 
tions occurred were the Daphne, the Forte, the Jumna, the Nymphe, 
and the Octavia. 

In the Daphne there were seventeen cases of primary^ and four 
of secondary syphilis. Hardly any information whatever is given in 
connection with them. # 

In the Forte there were eighteen cases of primary syphilis and ten 
of secondary. Two of the cases of primary dbease appear, however, 
to have been contracted at Simon's Town. Of the remainder, five 
were contracted at Bombay during the Midsummer quarter : nine at 
the Seychelles Islands during the Michaelmas quarter; and two at 
Suez during the Christmas quarter. They were all discharged to 
duty. The surgeon says that both at Bombay and the Seychelles 
venereal diseases were extremely prevalent, but that at Simon's 
Town the Contagious Diseases Act was in operation, and probably 
to that circumstance might be attributed that such a small number 
of cases appeared there, as the men were freqmently on shore on 

384. X leave. 



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346 UEJ>lCAJb 6TATISXICAL BSTUBNS 

EmI India leave. At Bombay^ he sa^s^ the proetitutes have lately been placed 
SUtion. under the surveillance of the police, but that at the Seychelles 
Islands it would be scarcely practicable to introduce an Act of the 
kind, BO general is the immorality that prevails. With respect to 
the cases of secondary disease, he observes, that in all, the primary 
disease was contracted either at Portsmouth or Plymouth before the 
men joined the ship. 

In the Jumna, in which there were twenty-two cases of primary 
and seven of secondary syphilis, the former disease was contracted 
chiefly at Bombay and Suez. At the latter place some amount of 
sanitary control is said to be exercised over the jNrostitutes, but at 
Bombay, so far as the medical officer could ascertain, a public register 
only is kept for the purpose of taxation, which of course as many 
as can, evade. 

There were twenty-one cases of primary syphilis, and three of 
secondary syphilis in the Nymphe, concerning which the medical 
officer* observes : — " There has oeen a great increase in the number 
of syphilitic cases this year, caused by the infection of the town of 
Mahe, Seychelles, by Her Majesty's ship Octavia and a French 

auadron, after the termination of the Abyssinian Expedition, 
ost of the leave given to the crew of the ifymphe in 1869 was 
passed at this place, and, in 1868, previous to the arrival of 
the Octavia and the Frenchmen, free leave had also been given, 
without a single venereal case resulting." 

There were fifteen cases of primary and eight of secondary 
syphilis in the Octavia, but no mformation is given in connection 
with them. 

nL DiseaBOS of fhe Nenrous System and Oi^fanB of the 
Special Senses. 

Class III. ^^® hundred and twentv-five cases of various forms of disease 
were entered on the sick-lst under this head, of which ten were 
invalided and five proved fatal. Of these latter, two resulted from 
apoplexy and three from sunstroke. One of the cases of apoplexy 
and all the cases of sunstroke appear in the returns from the Forte. 
In that vessel the apoplectic seizure occurred in the person of an 
officer on the voyage from Simon's Bay to Trincomalee. He was 
of vvy intemperate habits, and had been on duty in the engine- 
room, the vessel being under steam. On coming off watch he com- 
f)lained of " nervous excitement." Though he spoke quite col- 
ectedly, he had evidentiy been indulging in spirituous liquors a 
short time prevousljr ; the pulse was much accelerated, and there 
was great heat of skm. A cnlorodyne draught was given him, and 
he went to bed. At llh. p.m. he was seized with strong convul- 
sions, and immediately afterwards fell into a state of profound coma. 
The breathing was stertorous ; the pulse at the wrist scarcely per- 

ceptiole ; 



* Surgeon John Noble. 



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OF TBJfi |U8T 11S(J>U^ STATIOir* 347 

capilble ; the carotid arteries throbbing viplently ; tl^e pupila much ^^ ^4fa 
contracted, and there was pungent heat of skin. Two hours frfter- w*tio^ 
wards be expired. Qiggg m. 

On post-mortem examination of the body> the head only was exa- 
mined. The longitudinal sinus was gorged with blood, which after 
death, flowed from the nostrils. The arachnoid was thick(sne4, and 
morbidly adherent in scTeral places to the dura mater and to the 
BurfJEice of the cerebral hemispKeres by lymphy deposits. Both 
die cerebrum and cerebellum were in a state of ramollissement. 
There was no increased amount of fluid in the ventricles. Besides 
these signs of old standing meninffea} and cerebral disease, the 
brain generally was highly congested. On slicing the cerebral sub- 
stance, die cut ends of the vessels appeared as numerous red points. 
There was no trace of a clot. 

Sunstroke. — There were twenty cases altogeliier of this aflfection 
in the squadron, of which, as has been already said, three proved 
fatal. Three cases occurred in the Cossack, soon after her arrival 
on the station. They were of a very trivial character, and required 
litde or no treatment. 

In the Dryad there were six cases of sunstroke. Four of these 
occurred during the Midsummer quarter, while the vessel was em- 
ployed on the Arabian coast. One of these was of a rather e^evere 
character, and resulted in the invaliding of the subject of it. 

Hiere were tiiree cases of sunstroke in the Euphrates. They 
occurred when die vessel was in the dry dock at Bombay. One^ of 
diem was ofgreat severity, and result^ in die subject oi it bein^ 
invalided. iSe medical officer reports diat die man *^ was seized 
widi sunstroke on die afternoon of tlie 4th of May, at Bombay, 
while coming off* in the boat from the dockyard, where diey had be«i 
at work ail day ; the rfiip was Aen in dry dock, and the weadier was 
exceedingly hot.. He continued in a state of stupor and partial 
insensibUity for twelve hours. Frecjuent cold afi^on of iced water 
over the head afforded him great rehef, and was the only means of 
restoring him to full consciousness. For several di^ys afterwards he 
suffered from severe headadie, and much disturbance of the senso- 
rium, vertigo, insomnia, and occamonid nausea and vomiting. He 
also, in the course of trealanent, compliuned of severe nocturnal 
piuns of the left leg, knee, and foot, apparendjr of a neuralgic cha- 
racter, and these pains continued to afflict him to the last. He 
lost flesh, and became anaemic; it was evident that his nervous 
system was so impaired that nothing but change of dimate could 
restore it." 

There were six cases of sunstroke in the Forte, three of which 
proved fatal. With respect to five of these, the surgeon says, 
" During our stay at Aden in June, where the temperature was 
excessively high, five men were attacked with coiq) de sokil. They 
had all been on diore on leave. One man was found lying dead on 
the road. The post-mortem examination showed that the lun^ 
were h^hly congested, and the right cavities of the heart gorged 

384. X 2 with 



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^48 MEDICAIi STATISTICAL KETUENS 

East India with blood. He was a very powerful, healtlnr man. He had been 

SUtion. drinldng, as a small quantity of spirits was found in his stomach. 

— — Another man was found on the beach in a state of insensibility. He 

GlaM ni. ^ed in about an hour after he was brought on board. Death was by 

syncope. 

" Of the remaining three cases, two were subsequently invalided 
for climatic debility, and the third, a Marine, still remains in the 

ship, and now enjoys very good health On the 3rd of 

October, during our voyage up the Red Sea, there was another 
death from sunstroke. The symptoms „ were precisely similar to 
those observed in the men who died at Aden." 

There was a single case of sunstroke in the Jumna. Although 
the man made a rapid recovery, his symptoms were very severe and 
alarming. While under an awning at work on deck, he was attacked 
with vertigo and faintness, and fell down. The sun was powerful 
at the time, and the awning was thin. His face was pale and the 
features pinched. There was loss of temperature, and a weak, flut- 
tering pulse. He was a healthv man, and very abstemious. Am*- 
monia and brandy were given hun, and he recovered in two days, but 
he suffered for some time from a feeling of weakness in the limbs, 
h e result of loss of muscular power. 

There was a single case of sunstroke in the Malabar, and it was 
of a trivial character. 

Encephalitis. — A single case of this disease appears in the returns 
from the Daphne. It occurred in the person of a petty officer, and 
was the result of his being seriously injured on the 1st of June by 
the falling of a sail-tackle block from aloft, the block striking him 
on the upper and left side of the head. He fell senseless, but reco- 
vered in about half an hour. * 

During the first few days the prominent symptoms were giddiness 
and sharp shooting pain in the head. There was no paralysis. 
The pain each day became duller ; the patient slept a good deal, 
but constantly started from his sleep, and was at times delirious. 
The sense of hearing was lost in the left ear. Cold was applied to 
the head, and, purgatives having been freely administered, calomel, 
in two-ffrain doses every third hour, was ordered, until a slight effect 
was produced on the gums. Two grains were continued at bedtime 
for ten days subsequently. On the 1st of July a blister was applied 
to the back part of the head, and repeated at intervals with apparent 
benefit. 

On the 16th of August he requested to be allowed to try a little 
light duty, but on the 17th he came back complaining of much pain 
in the head. He was put on the list, a purgative draught given him, 
and a blister applied. Cold also was applied to the head. On tlie 
18th he had an epileptic seizure, the convulsions being very severe, 
and their duration nearly twelve minutes. On the 19th deUriiun 
ensued. He slept much, but constantly started out of his sleep, and 
looked round in an excited manner. Calomel was again adminis- 
tered, and under its influence he improved, partial paralysis of the 
left leg remaining, with loss of hearing in the left ear, and giddiness. 

The 



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OP THE EAST INDIA STATION. 



249 



The medical officer,* from whose notes the foregoing abridgement 
of the case has been made, says: " On the 15 th o£ September Ae 
temperature of both legs was noted. Sound leg, thermometer laid 
on upper and inner part of thigh, and retained for thirty minutes, 
97° ; ditto, left leg, 92^ On the 16th, temperature of right leg, 96**; 
of left, 9 P. September 30th ; he improves in health ; leg gets 
more power ; sense of hearing improves. As there was little pro- 
bability of his being fit for further service on this station, he was 
brought forward for survey, and invalided on the 14th of October." 

17. Diseases of the Circulatory System. 

^ Thirty-eight cases of various forms of disease were entered on the 
siek-list under this head, and of these, eleven were invalided and six 
proved fatal. There was a considerable reduction in the ratios of 
cases and of invaliding, compared with the preceding year; but 
the death-rate was much higher. Of the fatal cases, five were 
the result of oi^aiiic disease of the heart, and the sixth of rheumatic 
pericarditis. This occurred in the person of a Krooman of the 
Cossack, who, on the 2nd of September, was placed on the sick-list 
for rheumatic pains in the shoulders and loins. On the same day 
he attempted suicide by jumping overboard, but he was rescued by 
the other Kroomen. Nothing of importance occurred thereafter 
until the night of the 4th of September, when he was suddenljr 
seized with pain in the left side, accompanied with dyspnoea. His 
face was bathed with large drops of perspiration ; the skin cold ; the 
pulse rapid and small ; and the sounds of the heart scarcely audible. 
Despite the treatment to which he was subjected, the dyspnoea rapidly 
became more urgent, accompanied with an intermittent pulse, and 
at 12 h. (midnight) he died convulsed. The following report of the 
post-mortem examination of the body is by the surffeonf of the ship: 
— " Body, well nourished, with good muscular developement. Bi^or 
mortis well marked. On removing the sternum after cutting 
through to the costal cartilages, the pericardium was found disteudea 
with fluid of a light straw colour, measuring twenty ounces. The 
heart itself was enlarged, bled freely when cut into, and its muscular 
substance was friable, and easily broken down by the finger. Both 
mitral and tricuspid valvea were thickened, but their surfaces were 
unencumbered with lymph deposits. The lungs were pale in colour, 
but free from disease. The liver and spleen both enlarged. The 
kidneys were healthy, as were also the remaining viscera. Death 
was probably caused by metastasis, suddenly followed by rapid 
effusion into the pericardium.^' 

V. & VI. Diseases of the Absorbent System and Ductless 

Glands. 

Fifty-seven cases of sympathetic bubo appear under this head, 
probably the result of climatic cachexia. The average duration of 
each case was over three weeks. 



East India 
Station. 

Class m. 



Class IV. 



Classes 
V. A.VI. 



^Acting Surgeon Wm. K. Dillon. 
384. x3 



f Surgeon Frederick Piercy. 



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250 MEDIOAIi STATISTICAL EBTUBKS 

£aitIndlA 

^^^^ Vlt Diseases of the Respiratory System. 

CUuM Vn. Under thiB head 269 cases of disease were entered on the ack- 
list^ 237 of which were of a simple catarrhal character, each case 
averaging in duration five days. 

A fatal case of pneumonia occurred in the person of a petty oflScer 
of the Jumna, a worn-out man, prematurely old from long service, 
and in all probability from intemperate habits. He had no rallying 
power, ana sunk from sheer exhaustion. 

Vm. Diseases of the Digestive System. 

C]!as8 Vin tJnder this head, no fewer than 995 cases of various forms of 
disease were entered on the sick-list, including 227 of dyspepsia, 
fifty-three of dysentery, and 456 of diarrhoea. Of the total niunber 
of cases, nineteen were invalided, and eight proved fatal. 

Dysentery and Diarrhoea. — The vessels in which the largest num- 
ber of cases of these affections occurred were the Daphne, the Forte, 
^e Jumna, and the Star. 

There were twelve cases of dysentery and thirty-four of diarrho&a 
in the Daphne, and of these, three of dysentery proved fatal. They 
occurred chiefly in the montiis of July and August, when the vessel 
was in the vicinity of the Mozambique Channel ; and of the fatal 
cases, one occurred in the person of a seaman who was convalescing 
from a long and severe attack of fever, and another in a worn-out 
old native mterpreter. 

In the Forte there was one case of dysentery and seventy-six of 
diarrhoea. The former disease occurred m the person of a bandsman, 
when the vessel was at Suez, at a time when diarrhoea was vefy 
prevalent amongst the ship's company. It was in fact originally a 
simple attack of diarrhoea, but dysenteric symptoms supervened, 
with much fever and frequent muco sanguineous stools. Under 
the influence of large doses of ipecacuan he made a good recovery. 

With respect to the cases of diarrhoea, the surgeon says :— ** There 
were seventy-six cases of diarrhoea, all of which were discharged to 
duty. Of these, nine occurred in the Lady quarter, five m the 
Miasummer, twenty in the Michaelmas, and forty in the Christmas 
quarter. During our stay at Suez (from the 16th of October to the 
2nd of December), diarrhoea prevailed to a very great extent. 
Although no more than forty were placed on the sick-list, nearly 
every one in the ship suffered more or less from bowel complidnto. 
The prevalence of the complaint probably arose firom two causes ; 
1st, uie comparatively low temperature, especially at night, which 
was experienced there ; and, 2ndly, the use of the water which was 
procured from the fresh water canal, and contained much organic 
impurities. We were in dock for some time, and then it was of 
course impossible to condense water. To remedy the ill effects of 

the 



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OF THE EAST INDIA STATION. 851 

the water from the canal^ that intended for drinking was bmled in Cast India 
the coppers and filtered. This plan is followed by Sie English in- StoU^, 
habitants of Suez. The results of this were very beneficial, and the ^ f iy y Vin. 
niunber of cases of diarrhoea decreased. As soon as practicable 
distilled water was used. The average duration of sickness was 
about five days." 

There were thirty cases of dysentery and 101 of diarrhoea in the 
Junma. One case of dysentery proved fatal. The surgeon speaks 
favourably of the influence of ipecacuan in these afiections, which 
he considers to have been mainly attributable to hepatic derange- 
ments. 

There was a single case of dysentery and fifty-eight of diarrhoea 
in the Star. The former was placed on the sick-list on the last day 
of the year. Although not very severe it ultimately necessitated 
the invaliding of the subject of it. The cases of diarrhoea were for 
the most part of a trivial character, and depended chiefly on errors 
of diet and hepatic derangement. 

There were two fatal cases of bowel afiection in the Cossack, one 
of dysentery, the other of diarrhoea. In the latter instance the 
disease was complicated with ascites. It occurred in the person of 
a Ejrooman, who w^ placed on the sick-list on the 7th of October 
for diarrhoea, for which he was subjected to the usual treatment in 
such cases. On the 14th he complained of pain at the umbilicus, 
and the abdomen appeared to be swollen. The tongue was dean 
but glassy, the skm hot and dry, and the appetite good. Jalap 
purges and diuretics were administered with apparent advantage, 
the abdomen decreasing in size, and the patient expressing himself 
as feeling better. In this condition he was discha%ed to sick 
quarters at Mahe in the Seychelles Islands, where he died on the 
19th of November. On post-mortem examination of the body, the 
intestines were found glued together by old adhesion, the residt of 
a former attack of pentonitis. 

The fatal case of dysentery occurred in the person of an officer 
of a weakly constitution, who was placed on the sick-list on the 18th 
of August, at Trincomalee, with dysenteric diarrhoea of a very severe 
character, accompanied with much febrile disturbance. He became 
reduced to such a state of debility and emaciation, that it was deemed 
advisable to have him removed from the station as soon as possible. 
With this view he was invalided and sent on to Madras to catch the 
English steamer. At Madras his symptoms became so aggravated, 
that he was conveyed to the General Hospital there, where he died 
on the 2nd of September. 

A fatal case of diarrhoea appears in the Returns from the Malabar. 
It was of a somewhat peculiar and complicated character, and its 
history is best given in the following report and remarks, by the 
surgeon of the vessel. The patient, an officer, **.... a fat 
and nervous man was placed on the sick-list on the 14th of March, 
when the ship was lying in the harbour of Bombay. He came on 
board on the 12th, from leave, feeling unwell on that and on the 

384. X 4 following 



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252 



MEDICAL STATISTICAL BETUBNS 



East India 
Station. 

Class Tm. 



Classes DL 
and X. 



following day. During the night of the 13th; and morning of the 
14th; he was violently pureed; and administered to himself^ without 
medical advice; two half-drachm doses of chlorodynC; after which 
the purging stopped. When seen by me at 8 h. a. m. of the 14th, 
he complained oi severe vomiting; and much abdominal uneasiness. 
About 10 h. a. m. he was removed to the Seamen's Hospital. He 
had most severe cramps in the limbS; and vomited. Opiates and 
brandy, with iced water; and the application of synapismS; and tins 
containing hot water, to the affected partS; seemed to remove the 
vomiting; but the cramps recurred from time to time. 

*^ On the 15th the patient appeared restless and feverish; and 
there was considerable muscular tremor of the arms. Weak brandy 
and water; beef tea; and an opiate at night were given. Next day 
he appeared more composed; and slept at intervals. He partook of 
some food; and had an opiate at mght. On the 16th he appeared 
to be doing fairly; and gave no cause for uneasiness. Took wine; 
arrowroot; &c. 

** On the 18th; muscular tremor and loss of power in the voluntary 
muscles were, apparent; and though some vomiting occurred; the 
bowels were rather confined. An aperient was ffiven in the evening. 
During the night there were two motions. Next day there was 
actual palsy of the armS; so much sO; that in the evening a tumbler 
could not be held; but fell from the hands. However; some sago 
and beef tea were taken in the course of the day. 

** On the 20th; the aspect of affairs looked very bad towards eve- 
ning. The limbs were very powerless, and there was a frightened 
appearance about the patient. The case was a very curious one, as 
nothing like it had appeared on board before; and there was no de- 
lirium tremens. Between 10 h. and 11 h. p. m.;the mind wandered, 
the pulse bJlt very fast, the legs seemed utterly powerless, and Ae 
arms nearly so. The breathing was hurried. At llh. the head 
was shaved, and iced water appued to it ; but all was of no avail, 
for death took place at 12 h. 20 a. m. of the 21st 

^^ I am at a loss to account for this case. It is worthy of remark, 
that this o£Scer slept for two hours on shore, on fla^tones under 
a verandah.^ What is called the * Land Wind' was blowing, and it 
is a belief, in Bombay, that that wind sometimes causes paralysis, 
by its effects on the body. When I was serving in the Beagle in 
1861 and 1862, on the coast of Ceylon, I have heard of horses be- 
coming paralysed, or what was called ' land-struck' by the wind at 
night. 1 have seen a case, lately, of paralysis of the legs, and one 
side of the abdomen, said to have been caused by this wind. I know 
of no treatment for the affection." 

IX. and X. Diseases of the Urinary and Oeneratiye 

Systems. 

Under this head 121 cases of various forms of disease appear in 
the Rehirn, of which six were invalided. Very few of the cases 
were of any importance. SeveDtyK)ne cases of gonorrhoea were 
under treatment, the average duration of each case being nineteen 



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OF THE EAST IKDIA STATION. 253 

XI. Diseases of the Organs of LoeomotioiL 

Nine cases af various affections of the bones and joints were 
entered on the sick-list, all of which were discharged to duty. The 
average duration of each case was between nine and ten days. 



East India 
Station. 

Class XI. 



XII and XTTT. Diseases of the Cellular and 
Cutaneous System. 

Of 868 cases of various forms of disease entered on the sick-list Classes XII. 
under diis head, 547 were cases of boils and abscesses, and 286 and Xm 
ulcers. The average duration of each case of boil and abscess was 
eight days ; and of each case of ulcer, somewhat over seventeen 
days. Of the total number of cases there were invalided, two for 
ulcer and one for obstinate chronic eczema, which had resisted long- 
continued treatment. 

Unclassed Diseases. 

Under this head seventy-six cases of debility, one of lead poison- 
ing, and six of delirium tremens, were entered on the sick-list, and 
of these, twenty-two cases of debility, or more strictly speaking, 
perhaps, climatic cachexia, were invalided. 

Of the cases of delirium tremens two occurred in the persons of 
commissioned officers ; two in Marines ; one in a stoker ; and in one 
case the rating has not been given. 

Wpnnds and Injuries. 

A man was killed by falling down the fore hatchway of his ship, 
a distance of about eight feet. His death was almost immediate, 
and was sum>osed to have resulted from either dislocation or fracture 
of one of the cervical vertebrae. A man was killed in action with 
some Arab dhows; a gunshot wound divided the femoral artery, 
and he bled to death; the nature of the injury was not ascer- 
tiuned, it being dark at the time, there being no medical officer 
in the boat, and the commanding officer being himself severely 
wounded. Death resulted from a severe scald of the abdominal 
walls, in the person of a petty officer, who, while lifting a mess 
kettle full of boiling water from the galley, slipped and fell, 
receiving the contents of the kettie over his abdomen, back, and 
thighs. He sank in twelve hours. 

Five men were drowned; two by falling overboard; two in 
attempting to land in a surf; and one in attempting to swim off to 
his ship. 

The total number of deaths was thirty-one, which is in the ratio 
of 13*4 per 1,000 of force, being an increase, compared with the pre- 
ceding year, equal to 1*6 per 1,000. 

384. 



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264 MEDICAL STATISTICAL BETUBNS 

East India _ ,. • , 

Station. Iiiyalided* 

Under General Diaeasee, Section A,, fourteen persons were iu- 
yalided; viz., two for enteric fever ; one for ague ; and eleven for 
remittent fever. Under Section B., thirty-three persons were in- 
valided, of which twelve were for rheumatism ; one for primanr 
syphilis ; eight for secondary syphilis ; and twelve for phthisis pul- 
monalis. Ten persons were invalided for disease of the nervous 
system and organs of the special senses ; eleven for diseases of the 
circulatoiT system ; five tor diseases of the respiratory system ; 
nineteen for diseases of the digestive system ; six tor diseases of the 
urinary and generative systems ; three for diseases of the cellular 
tissue and cutaneous system ; twenty-two for unclassed diseases ; 
and six for wounds and injuries of various kinds. 

The total number invalided was 129, which is in the ratio of 56* 
per 1,000 of force being a decrease, compared with the preceding 
year, equal to 21*7 per 1,000. 



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OF THE EAST IKBIA STATION, 



255 



Tablb^ No. 1. 

Showing the Number of Cases of all Diseases and Injuries, and the Number Invalided 
and Dead^ with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



L Oeneral Diseases, Seotion A. : 

Small-pox - - - - 

Vaocima - . - . 

Measles . - - - - 
Enteric Fever 
Simple continued Fever - 

Ague 

Remittent Fever - 

Cholera- - - - . 

Influenza . . . . 

Mumps - - - - . 

Erysipelas - - - . 

n. Oeneral Diseases, Section B* 

Ilheamatism - - - . 
Gout - - . - 

Syphilis -{l^nZy: : 

Scrofula . - - 
Phthisis Pnlmonalb 

SCUTT}' - - - - 

Dropsy - - - - 



m. Diseases of fhe Vervous Sys- 
tem and Organs of tno 
Special Senses : 



CiMt. 



Apoplexy 

Sunstroke 

Paralysis 

Vertigo - - - 

Epileps;^ 

Neuralgia 

Encephalitb - 

Diseases of the Bye 

Diseases of the Bar - 

384. 



Number. 



13 

2 

7 

8 

293 

72 

99 
2 

14 
1 
6 



223 

1 

139 

49 

7 

21 

2 

2 



2 

20 
2 
1 
6 

30 
1 

36 

27 



Ratio 
per 

1»000 
of 

F6rce. 



66 
•8 
3* 
3-4 
127-3 
31*3 
43- 
•8 
6- 

•4 
26 



96-9 

•4 

60-4 

21-3 

8- 

91 

•8 

•8 



Invalided. 



Number. 



•8 

8-6 

•8 

•4 

2-6 

13' 

•4 
16-6 
11-7 



1 
11 



12 

1 
8 

12 



1 
3 

1 



Ratio 

P« 
1,000 

of 
Force. 



•4 
47 



5-2 

•4 
3*4 

6-2 



17 

•4 

1-3 

•4 



Dead. 



Namber. 



Ratio 

per 

1»000 

of 
Force. 



2 
3 



;-8 

1-3 



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256 



MEDICAL STATISTICAL BETUBKS 



Table, No. 1.— Showing the Number of Cases of all Diseases, &c — continued. 



DISEASE OR INJURY. 



Cues. 



Namber. 



Ratio 

P« 

1,000 

of 
Force. 



Invalided. 



Number. 



Ratio 
per 

1,000 
of 

Force. 



Dei^ 



Namber. 



Ratio 

per 
1,000 

of 
Force. 



IV. Diseases of fhe Circulatory 
System: 

Disease of the f Functional 
Heart -\Organic - 
Varicose Veins - - - 



Y. ft TI.I)iseases of the Absorb- 
ent System and Ductless 
Glands: 



Bubo (<^pO 



YLL Diseases of the Bespiratory 
, System: 

Catarrh - - - - - 

UflBinoptysis - - - - 

Asthma - - - - - 

Other diseases of the Lungs - 



Tin. Diseases of the Digestive 
System: 

Cynanche - - - - 
Diseases of the Mouth, Teeth, 

&c. 

Dyspepsia , - - - 
Dysentery - - - - 
Diarrhoea - - - - 
Colic and Constipation - 
Haemorrhoids . - . 

Hernia - - - - - 
Worms - - - - - 
Other Diseases of the Stomach, 

Intestines, &c. - . - 
Diseases of the Liver, Spleen, 

&c. - - 



IX. ft X.' Diseases of the Urinary 
and Generative Systems : 

Diseases of the Kidneys - 
Diseases of the Bladder - 
Gonorrhoea - - - - 



18 

14 

C 



57 



237 

2 

1 

29 



78 

6 

227 

53 

456 

91 

16 

3 

26 

8 

36 



2 

1 
71 



7-8 

6- 

2-6 



24-7 



103- 
•8 
•4 
12-6 



33-9 

2-6 

08-6 

23- 

198-2 

39-5 

6-9 

1-3 

11-3 

1-3 

15-6 



•8 

•4 

80*8 



3 
2 



2 
4 



•8 

3-4 

•4 



1-8 
•8 



•8 
17 



2-6 



21 
•8 



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OF THE EAST INDIA STATION. 



257 



Table, No. 1. — Showing the Number of Cases of all Diseases, &c. — continued. 



DISEASE OR INJURY. 



DL ft X. Diseases of the Uri- 
nary and Generative 
Systems— coM/mtieii. 

Diseases of the Oi^gans of Gene- 
ration . . . . 
Stricture - . . . 
Varicocele - - - - 
Orchitis- - - - - 

ZI Diseases of the Organs of 
Loeomotion : 

Disesses of the Bones, Joints, 
&c. - - - - . 

Xn. ft Xm. Diseases of the 
Cellnlar Tissne and Cnta- 
neons System: 

Phlegmon and Abscess - 

Ulcer 

Erythema - - - - 
Diseases of the Skin 



Vnelassed: 



Debility 
Lead Poisoning 
Delirinm Tremens 



Wounds and Lynries : 

Wounds, Injuries, &c. 
Bums and Scalds - 
Submersion and Drowning 

Totals - - 



Gue0. 



Number. 



3 
13 



647 

286 

6 

20 



76 

1 
6 



6d3 

52 

6 



4,277 



Ratio 
per 

1,000 
of 

Fofce. 



1-3 

6-6 

•8 

12-6 



3-9 



Invalided. 



Number. 



237-8 

124-3 

2-6 

12-6 



33- 

•4 
2-6 



301-3 

22-6 

2-6 



1,860-6 



2 
1 



22 



Ratio 

P« 
1,000 

of 
Force. 



120 



1-7 
•4 



Dead. 



Number. 



Ratio 

per 

1,000 

of 
Force. 



0-6 



2-6 



66- 



•8 

•4 

21 



31 



13-4 



384. 



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258 



MBDICiX 8TATI0TIOAL BBTURNS 



Table, No. 2. 

Showing the Number of Days' Sickkess from each Diseabe and from Ivjvbivs, the 
Ayerage Number of Men Sick Daily, with the Ratio per 1^000 of Force. 



DISEASE OR INJURY. 



Number of Days* Siduieas 



Oo Board. 



In HoqpitaL 



Total. 



Average Number of 
Maa Sick Paily. 



Number. 



Ratio 

1,000 of 
Foree. 



I General Diseases, Section A. 

Small-pox 

Vaccinia - - - 
Measles - - . . 
Scarlet Fever 
Enteric Fever 
Simple continued Fever 
Ague - - - - 
RCTiittent Fever - 
Cholera- - . - 
Influenza ... 
Mamps - - . - 
Erysipelas 

n. Oefteral Diseases, Sectioii B. 

Rheumatism - • - 
Gout - . - . 

^ X Secondary 

Scrofula ... 

Phthisis Puhnonalis 
Scurvy - - - - 
JJiopsy - - - - 



m. Diseases ef the Nervous 
System and Oi:^:ans of the 
Special SensesT 

Apoplexy .... 
Sunstroke - . . . 
Paralysis - - . . 
Vertigo - - . - - 
Epilepsy - - . . 
Neuralgia .... 
EncephEditis - - - . 
Diseases of the Eye 
Diseases of the Ear 



228 

19 

73 

16 

164 

1,758 

696 

1,276 

8 

74 

8 

60 



2,396 

5 

3,529 

731 

169 

402 

33 

6 



2 

149 

56 

1 

69 

179 

58 

326 

225 



17 
21 

59 
97* 

67 



34 



228 

19 

73 

33 

1«4 

1,758 

717 

1,276 

S 

8 
71 



•6 

•4 
4-8 
1-9 
3-4 

•1 



2,455 


6-7 


5 


— 


3,626 


9-9 


731 


2- 


159 


•4 


469 


1-2 


33 


._ 


6 


— 




• 


2 


, 


183 


•5 


66 
1 


•1 


69 


•1 


179 


•4 


58 


•1 


326 


•8 


225 


•6 



•1 

2- 

•8 
1-4 



2-9 

4-3 
•8 
•1 
•5 



•3 
•2 



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OF THB BAST IKDIA STATIOIT. 



269 



Tajblb, No. 2.— Showing the Number of Days' Sickaess from each Disease, &c.— con^. 



DISEASE OB INJURY. 



Nnmber •£ Days' Sickness 



OaBoud. 



In Hospital. 



Total. 



Average Number of 
Men Sick Daily. 



Number. 



Ratio 

per 

1,000 of 

Force. 



IV. Diseases of the Circulatory 
System: 

Disease of the f Fanciional - 

Heart -\Oigaiiic- 
Varicose Veins - - - 



y. ft TI. Diseases of the Absorb- 
ent System and Ductless 
Glands: 



Bubo (Slytnp,) 



VII. Diseases of the Kespiratory 
System: 

Catarrh - - - - - 

Hsmoptysis - - - - 

Asthma - - - - - 

Other Diseases of the Lungs - 

Vm. Diseases of the Digestive 
System: 

Oynanche . - - - 
Diseases of the Mouth, Teeth^ 

&c. - - - - - 
Dyspepsia - - - - 
Dysentery - - - - 
Diarrhoea . - - - 
Colic and Constipation - 
Hemorrhoids - - - 
Hernia - - - - - 
Worms - - - - - 
Other Diseases of the Stomach, 

Intestines, &c. - 
Diseases oi the iHTer^ o|>KNMiy 

&c. " - • . 

384. 



212 

74 



1,160 



1,186 
43 

4 
797 



479 

66 
1,072 
577 
2,213 
422 
109 
141 
139 

44 

529 



34 



87 



23 



132 
43 
35 



403 
212 

74 



1,247 



1,186 

43 

4 

820 



479 



1,204 
577 

2,256 
422 
144 
141 
139 

44 

529 



11 
•5 
•2 



3-4 



3-2 
•1 

2-2 



1-3 

•1 

3-2 

1-5 

61 

11 

•3 

•3 

•3 

•1 

1-4 



•4 
•2 



1-4 



1*3 
•9 



1-3 
•6 

2-6 
•4 
•1 
•1 
•1 



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i60 



MEDICAL STATISTICAL BETUBN8 



Table, No. 2,— Showing the Number of Days' Sickness from each Disease, &c.—cofU^' 




Number of Days' Sickness 


Men Sick Daily. 


DISEASE OR INJURY. 










Ratio 




On Board. 


In Hospital. 


Total. 


Number. 


l,^of 
FOTce. 


IX.4rX. Diseases of the XTrinary 
and Generative Systems : 










• 


Diseases of tiie Kidneys 
Diseases of the Bladder 
Gonorrhoea - - - - 
Diseases of the Organs of 
Generation . - - 
Stricture - - - - 
Varicocele - - - - 
Orchitis .... 


121 

5 

1,350 

62 

174 

41 

404 


26 


121 

5 

1,350 

62 
200 

41 
404 


•8 

3-6 

•1 

•5 

•1 

11 


•1 
1-5 

•4 


XI. Diseases of the Organs of 
Locomotion : . 












Diseases of the Bones, Joints, 
&c. 


88 


- 


88 


•2 


— 


Xli. & Xin. Diseases of the 
Cellnlar Tissue and Cuta- 
neous System : 












Phlegmon and Abscess - 
Ulcer - - . - 
Erythema - - - - 
Diseases of the Skin 


4,427 

4,845 

45 

289 


105 


4,427 

4,960 

45 

289 


121 

13-5 

•1 

•7 


5-2 
5-8 

•3 


XJnclassed: 






■ 






Debility - - . - 
Lead Poisoning - - - 
Delirium Tremens 


993 
25 
75 


10 
17* 


1,003 
25 
92 


27 
•2 


* 11 


Wounds and:'Iiyurie8 : 












Wounds, Iniuries, &c. - 
Burns and Scalds - - - 
Submersion and Drowning - 


6,903 

532 

3 


172 


7,075 

532 

3 


19-3 
1-4 


8*3 
•6 


Totals - - - 


42,719 


990 


43,709 


1197 


62* 



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OP THE EAST INDIA STATION. 



261 



Tablb, No. 3. 

Showing the Number Invalided from each Ship employed on the 
East India Station. 



CAUSE 

or 

INVALIDING. 



I. General Diseases, Section A. : 
Eateric Fever - - - 
Agne ^ . - - - 
Remittent Fever 



n. General Diseases, Section B. 
Rheumatism 

{Primary - 
Secondary - - 
Phthisis - - - - 



m. Diseases of the Henrons 

System and Organs of 

the Special Senses : 

Encephalitis - - - 

Sunstroke - - - - 



Epilepsy - - - - 
Disease of the Eye 
Disease of the Ear 

IV. Diseases of the Circnlatory 
System: 
Disease of f ^uncUonal 
the Heart\orgaDio - 
Pericarditis - . - 
Varicose Veins - - - 



VII. Diseaaes of the Bespira- 
tory System: 
Hemoptysis - - - 
Other Diseases of the Lungs 

384. 



1 
Y 



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262 



MEDICAL STATISTICAL BBTDUKS 



Table^ No. 3. — Showing the Number Invalided from each Ship, &c. — continued. 



CAUSE 

or 

INVALIDING. 


1 


1 


1 


1 


i 

i 


1 


»-» 


1 

3 


£ 


1 


1 


VIU. Diseaias of the Dlgeftive 
System: 

Dysentery - - - . 

Hemorrhoids 

Hernia - - - - 

Other Diseases of the Sto- 
mach, &c. - - - 

Diseases of the Liver, &c - 

IX. & X. Biseaaes of the ITri- 
nary and Generative 
Syat^na: 
Disease of the Kidneys 

Stricture - - - . 

Orchitis .... 

XII. & XIII. Diseases of the 
Cellular Tissue and Cu- 
taneons System: 

Ulcer 

Diseases of the Skin - 

XTnclaased: 

Debility - - - - 

Wounds and Injuries : 
Wounds and Injuries - 


1 


1 
1 
1 

1 


1 
1 

2 

1 

1 
2 


1 

m 
1 

1 

2 


I 

1 
1 

3 


1 

1 

11 

1 
"28 


• 1 
2 

1 

1 
26 


1 
1 

4 

2 

1 


2 

1 


1 

2 


2 
4 
2 
2 

o 

7 

1 
4 

1 

2 

1 

22 
6 


Total - - - 


2 


6 


ifi 


6 


23 


19 


4 


129 



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OF THE EAST INDIA STATION. 



263 



Table, No. 4. 
Showing the Number of Deaths in each Ship employed on the East India Station* 



CAUSE OF DEATH. 



I. Oeiieral Diseases, Section A. : 
Cholera - - - - - 

n. General Diseases, Section B.: 
Phthisis 



ni. Diseases of tiie Hervoos 
System and Organs of tiie 
Special Senses : 



M 

J 



Apoplexy 
Sunstroke 



IV. Diseases of the Circnlatory 
System: 

Disesse of the Heart, Organic - 
Pericarditis - - - - 



TIL Diseases of the Bespiratory 
System: 
Pneumonia - - - - 



Vni. Diseases of the Digestive 
System: 
Dysentery - . - - 
Diarrhoea ^ - - - 
Disease of the Liver 



Wounds and Injuries : 

Wounds and Injuries 
Bums and Scalos - 
Drowned - - - 

Total - 






I 



I u 



i 



J 



1 - 



1 1 

3 



2 
3 



6 

I 



31 



384. 



^2 



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264 



M£DICAL STATISTICAL BETUKNS 



Tablb^ No. 6, - 
Showing the Number of Cases of all Diseases and Injuries 



DISEASE OR INJURY. 



Q 






I. General Diseases, Section A. : 

Sraall-pox - - - - 
Vaccinia .... 
Measles • - . - 
Enteric Fever - - - 
Simple Continued Fever 
Ague - - . . - 
Remittent Fever ... 
Ciiolera .... 
Influenza .... 
Mumps .... 
Erysipelas . - - - 



II. 



General Diseases, Section B. 
Rheumatism ... 
Gout 

syp"'"- {LcSSy : : 

Scrofula - . - 
Phthisis Fulmonalis 

Scurvy - . - - 

Dropsy , - . - 



III. Diseases of the Hervons System and 
Organs of the Special Senses : 
Apoplexy ...... 

Sunstroke .----- 

Paralysis .----- 

Vertigo .-.--. 
Epilepsy ---.-. 
Neuralgia --.--. 
Encephalitis - - - . - 

Diseases of the Eye - 
Diseases of the Ear - - . . 

IT. Diseases of the Circolatory System: 

Disease of the/ Functional - - - 

Heart i.Organic . - - 

Varicose Veins - - - - - 



T. & VI. Diseases of the Absorbent 
System and Ductless Glands : 
Bubo (Symp.) - - - - - 

TIL Diseases of the Besprratory System: 
Catarrh •----. 
Haemoptysis 

Asthma •-.-•-• 
Other Diseases of the Longs 



4 
1 
4 



16 

1 
1 



52 



]0 

7 
3 



1 
1 
S 



12 

1 



10 

17 

4 



15 
6 



20 
7 
9 
1 



16 

8 

1 



14 



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OF THB EAST INDIA STATION. 



265 



384. 



- Tabi^ No. 6. 
in the Ships employed on the East India Station. 



t3 





& 


»^ 


1 


?; 


.a 


i 




t5 




6 


3 






2 

1 




2 


13 
2 

7 




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- 


7 


» 


1 


- 


- 


- 


8 




8 


134 


18 


31 


5 


1 


9 


293 




6 


8 


12 


2 


1 


4 


12 


72 




- 


10 


2 


- 


- 


- 


2 


99 




«- 


«. 


1 


« 


.. 


w 


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2 




- 


14 




- 


- 


- 


- 


14 




— 


— 


. 


-. 


— 


— 


1 


1 




~ 


— 


I 


- 


1 


— 


- 


6 




39 


39 


37 


7 


6 


9 


17 


223 




— 


~ 


. 


-. 


— 


^ 


•• 


1 




18 


22 





21 


16 


7 


8 


139 




10 


7 


3 


3 


8 


3 


- 


49 




— 


«. 


. 


M 


mm 


. 


. 


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30 




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4 


11 


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4 


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. 


7 


36 




1 


7 


1 


1 


— 


2 


4 


27 




1 


5 


2 


1 


1 




1 


18 




4 


4 


- 


- 


- 


- 


- 


14 




1 


"■ 


"■ 


"■ 


" 


' ^ 


" 


6 




2 


15 


6 


6 


2 


6 


9 


67 




60 


69 


21 


12 


6 


4 


39 


237 




- 


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- . 


- 


- 


1 


2 




mm 


mm 


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. 


1 


- 


— 


1 




- 


9 


- 


- 


7 


- 


1 


29 



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266 



MEDICAL 8TATI8TlCiX BETUfiKS 



Tabi^, No. 5. — Showing the Number of Cases of all Diseases and 



DISEASE OR INJURY. 



m 



a 

I 



-s 



Vm. Diseases of the Digestive System : 

Cynanche 

IHseases of the Mouth, Teeth, &c. 
Dyspepsia -----. 

Dysentery ------ 

Diarrhoea ------ 

Colic and Constipation - . . . 
Hemorrhoids . . . . . 

Hernia -....- 

Worms -----. 

Other Diseases of the Stomach, Intes- 
tines, &c. - - - - , 

Diseases of the Liver, Spleen, &c. 

IX. & X. Diseases of the XTrinary and 
Generative Systems: 
Diseases of the Kidneys - - 
Diseases of the Bladder - - «, 
Gonorrhoea -----. 
Diseases of the Organs of Generation - 
Stricture - - ' - 
Varicocele -----. 
Orchitis ----- ^ 



XI. Diseases of the Organs of Loeomotion : 
Diseases of the Bones, Joints, &c - 

XII. ft Xin. Diseases of the Cellnlar 
Tissue and Cutaneous System : 

Phlegmon and Abscess - - - . 

Ulcer 

Erythema 

Diseases of the Skin - . . . 



TTnolassed: 

Debility 

Lead Poisoning - 

Delirium Tremens 



Wounds and Injuries : 

Wounds, &c. 
Bums and Scalds 
Submersion and Drowning 



Total 



6 

3 

20 

3 



3d 
6 



88 
2 



154 



3 
2 

12 
1 

38 
7 
5 
1 
1 



] 

1 
10 

1 

2 



35 

29 

1 

5 



GO 
3 

1 



329 



17 

12 

34 

8 



1 

18 
2 
3 



36 
38 



63 
2 



312 



15 
5 

11 
6 



37 
39 



52 
3 

2 



279 



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OF TUB £A8T INDIA STATIOK. 



267 





Injuries in the Shipi employed on the East India Station— cimrtitt«f. 






1 


•-» 


• 


Nymphe. 


1 


^ 


1 


1 




9 


11 


13 


7 


11 


3 


8 


78 




— 


— 


2 


. 


. 


1 


«. 


6 




46 


87 


9 


2 


19 


9 


28 


227 




1 


80 


. 


. 


., 


» 


1 


59 




76 


101 


39 


13 


19 


14 


58 


456 




8 


15 


«0 


2 


« 


8 


5 


91 




1 


6 


1 


- 


2 


- 


1 


16 




•» 


>. 


. 


1 


« 


mm 


. 


3 




1 


1 


- 


- 


23 


- 


- 


26 




. 


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2 


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^ 


3 




1 


15 





■ 


1 


3 




3a 




« 


«. ^ 


. 


« 






2 

1 




4 


10 2 
2 
2 


6 


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3 


4 


1 

71 
3 

13 

2 

29 




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3 


1 


- 


- 


2 




4 


3 


1 


2 


3 


- 


- 


1 


- 


- 


- 


- 


9 




164 


38 


18 


49 


15 


47 


50 


547 




39 


11 


9 


14 


12 


36 


30 


286 




«. 


1 


. 


. 


a 


1 


• 


6 




1 


5 


3 


1 


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7 


29 




17 


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23 


8 


3 




11 


70 




— 


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•- 


•. 


— 


1 




1 


■■ 


*■ 


" 


" 


■ 


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6 




103 


54 


34 


51 


42 


62 


79 


698 




9 


9 


2 


7 


1 


3 


7 


52 




2 


- 


- 




- 


- 


1 


6 




65 


726 


308 


255 


215 


230 


423 


4,277 



384. 



t4 



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268 



MEDICAL STATIgTICAL BKTUBN8 



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JO 8M«3 JO jaqamfii 



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China 
Station. 



eot A. 



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268 



MEDICAL STATISTICAL BETVBNS 



i 


paSiVi{3siQ jaqamm 


« 00 


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00 »o "* 1 


e< •* 


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|o aMOj aSsjaAy 
JO 000*1 •»<Iop«H 


k 3 


s 


ini 


V f 

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to 00 ^ 

^ 5 S 


imber of Days' Sicki 
rged to Hospital. 


•«l»aopi aA(9iix 
joj ifwa si^IS »9W 
jo jsqion^ aSsiaAy 


|2 


09 


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M r* 00 S 


ss 


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if 


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;o8awoi«^«l«>nN 


2 2 

3 « 




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Ss 


i§i 




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i8 


s 1 S g 


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i§i' 




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ss 


© 

55 


S S S S 

*.« ^14 »i4 Pi4 


s s 


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1 1 t 

in 


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erofMen Sic 




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12 Jane 1867 
3 May 1867 

13 June 1867 
2 Not. 1865 




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Ships; the 
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the Names of the 
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OF THE CHINA STATION. 269 



CHINA STATION. 



The squadron on the China Station in 1869 comprised twenty- CMn& 
three Vessels ; viz., one iron-clad ; one second rate ; one sixth rate ; Station. 

five sloops ; nine gun vessels ; two steam vessels ; two surveying 

vessels ; one troop ship ; and one receiving ship permanently sta- 
tioned at Hong Kong; oesides these, there were eight small gunboats, 
from which the returns are defective. The returns from sixteen of the 
vessels are for the whole year, and from the remainder for periods 
varying from three to nine months. The total force corrected for time 
was 3^750 ; but in estimating the ratio of cases entered on the sick-list 
it is necessary to make a deduction from the force equal to the crews 
of the small gunboats^ from which the returns were defective, and for 
this purpose therefore the force will be considered as 3,480 ; the 
total force, however, is taken for the invaliding and death rates, 
the returns under those heads being complete. The total number 
of cases of disease and injury entered on the sick-list was 5,242, 
which is in the ratio of 1,506 "3 per 1,000 offeree, being a reduction, 
compared with the preceding year, equal to 80* per 1,000. Of these, 
188 were invalided, and fifty-one proved fatal, the former being in 
the ratio of 50*1, and the latter of 13*6 per 1,000. Compared with 
1868, there was a reduction in the invaliding rate to the extent of 
15' per 1,000, and an increase in the ratio of mortality equal to 
•6 per 1,000. 

The average daily number sick from General Diseases, Section A., 
or Febrile &roup, was in the ratio of 4*7 per 1,000; and from 
Section B., or Constitutional Group, 17'1 ; from diseases of the 
nervous system and organs of the special senses, 1*1 ; of the circu- 
latory system, '3 : of the absorbent system and ductless glands, 2-4 ; 
of the respiratory system, 2*6 ; of the diffestive system, 5*3 ; of the 
urinary and generative systems, 4*4 ; of tne organs of locomotion, '5 ; 
of the cellular tissue, and cutaneous system, 12* ; from unclassed 
diseases, 1*3; and from wounds and injuries of various kinds, 6*7. 
The average number of men sick daily was 231*4, which is in the 
ratio of 61*7 per 1,000 of force, being an increase, compared with 
the preceding year, equal to 3*8 per 1,000. 

L General Diseases.— Section A.^ or Febrile Group. 

Under this head 505 cases of various forms of disease were entered Class I. 
on the sick-list, viz., forty of small-pox ; nine of typhus fever; two Sect A. 
of enteric fever ; 315 of simple continued fever; seventy-seven pf 

384, ague ; 



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270 MEDICAL STATISTICAL BETURNS 

China ague ; fifty-two of remittent fever ; six of mumps ; and four of 
Station, erysipelas. Of these, three of simple continued fever ; eight of 

ague ; and six of remittent fever, were invalided ; and four of small- 

C1*M !• pox ; one of typhus fever ; one of enteric fever ; one of simple 
Sect A. continued fever ; one of ague ; and one of remittent fever proved 
fatal. 

SmalUPox. — Forty cases of this form of eruptive fever were under 
treatment, of which four terminated fatally. The average duration 
of each case on board ship and in hospital was between nineteen and 
twenty days. The vessels in which the disease made its appearance 
were the Icarus, the Leven, the Salamis, and the Zebra. 

There were eleven oases of small-pox in the Icarus. They 
occurred in the month of November, at Shanghai. Two of them 
proved fatal, but the rest were modified in character. They were 
all at once removed to the General Hospital on shore. The medical 
oflficer* says : " The disease first made its appearance in the per- 
son of a Marine who had been on duty on shore as orderly, and 
was turned over to this ship from Her Majesty's ship Zebra, 
previous to her departure for Japan ; and I am rather inclined to 
think that it was n*om her that the disease was contracted. All the 
cases presented the same symptoms — rigors, pain in the head and 
loins, nausea, and rapid pulse. In all the cases marks of vaccination 
were borne. The average period of the primary fever was two days, 
and as a rule the eruption appeared on the face. As regards the 

{precautionary measures taken against this epidemic, leave was stopped 
or some time ; all the holds and lockers fore and aft in the snip 
cleared, thoroughly cleansed, whitewashed, and chloride of zinc and 
carbolic acid freelv used. The ship's company were all mustered 
for inspection of their vaccination marks. Any doubtful ones I re- 
vaccinated, but in only one or two cases was it successful. Up to 
the close of this journal there were no signs of any more cases. 
The disease has been very prevalent on shore during this winter, 
especially among the natives, so much so that Europeans have been 
cautioned and warned from going into the native town." In the two 
fatal cases, although both bore vaccination cicatrices, in one they 
were not satisfactory. In the other, however, not only were the 
marks good, but he had been successfully re- vaccinated subsequent 
to his entry in the service. In this case there must have been a 
singular proneness to the disease. 

There were four cases of small-pox in the Leven, one of which 
proved fataL The returns from this vessel are imperfect, and no 
information has been obtained in connection with these cases. 

In the Salamis there was a single case of small-pox. It occurred 
in the month of December at Foochow, and was very modified. 
Whether the man had been previously vaccinated or not, is not 
stated. 

There 

♦ Acting Sui*g;eon C. Gregory Wodeworth. 

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OF THE CHINA flTATION. 271 

There were twentj-four cases of small-pox in the Zebra. Of China 
these^ one, a single isolated case, occurred in the month of June at Station. 
Shanghai, in the person of a Marine. He had good vaccination ^: — j 
cicatrix on each arm ; the case proved mild and recovery rapid. No gel^JL 
other case appeared until the month of November, when on the 
evening of the daj the vessel left Shanghai for Japan (2nd of 
NoveinberV one of the crew was found suffering from headache, and 
lumbar pains, with febrile disturbance and nausea ; there was slight 
drowsiness, and the skin was hot and dr^ ; there were no rigors. 
He was at once separated from the rest of the ship's company. The 
medical officer* of the ship says: " I may as well mention here that 
he, as well as each of the other cases subsequently attacked, had a 
fair vaccine cicatrix on the arm. Next morning a papular eruption 
appeared upon the forehead, soon becoming pustular, and extending 
over the face, arms, and chest. A second man showed premonitory 

rptoms on the evening of the 5th, and another on the 8th. These 
e cases proved to be of the confluent form of the disease. I 
ascertained that these men had, when on leave at Shanghai, on the 
21st, 24th, and 27th of October, frequented a low brothel In the 
American Settlement (Hong-que). Iney denied all knowledge of 
there having been any sick persons in the place, though this is the 
only origin to which 1 could trace the disease. Three milder cases 
occurred on the 9th, I4th, and 15th. These last men had also been 
on shore at Shanghai, when special leave had been given in October, 
and general leave on the 23rd of that month. On the vessel arriving 
at E!ob£, Hiogo, I sent the above six cases of variola to the temporary 
sick quarters at that port, and they were all doing well on the 16th 
of November, when the Zebra proceeded to Yokohama, arriving 
there on the night of the 18th, by which time no less than fourteen 
additional cases had appeared. As soon as proper accommodation 
had been prepared on shore, thev were sent to the hospital, as also 
a mild case which appeared on the 21st. The disease decreased in 
intensity from the flrst outbreak. All possible precautions were 
taken to prevent the extension of the contagion. There was one 
case from the gunroom, one only from a Marine mess, and the 
remainder from the seamen's messes in average proportion." 

Typhus Fever. — There were nine cases of this serious form of 
fever, of which one proved fatal, ^ach case was, on an average, 
between twenty-six and twenty-seven days under treatment. 

In the Argus there were two cases of typhus fever. They 
occurred during the Lady quarter of the vear, and the disease was 
contracted at x okohama, where general leave was given. No in- 
formation of any value is given in connection with them. 

There was a single case of what Is classed as typhus fever in the 
Icarus. It appears, however, to hayja been more of^ the enteric cha- 
racter. It occurred at Yokohama, in the Lady quarter of the year, 
in the person of an officer who had been ailing for some days before 

he 

* Suigeon J. W Leahy. 
384. 



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272 MEDICAL STATISTICAL RETURNS 

Stetion ^^ presented himself for treatment, fancying that he had merely 
_, ' caught a cold. In this case the symptoms were of much severity ; 
ClaM I. delirium and hiccough set in early, and a dark eruption presented 
Sect. A. itself over the chest and abdomen. He was discharged to the Naval 
Hospital at Yokohama where he made a good recoverv. The 
medical officer* of the ship says : — '* From the colour of tne rash, 
and the early period at which delirium set in, I have entered this as 
a case of typhus fever, although it is only right to add that after his 
admission to hospital there was irritability of the bowels and trouble- 
some diarrhoea; but this does not shake my opinion, as the enteric 
symptoms may have been the result of purgatives which were given, 
and not of specific origin. He was sent to sick quarters on the fore- 
noon of the 24th of March, his bedding and ^ear being sent with 
him ; the cabin scrubbed out and sprinkled with chloride of zinc, 
the scuttle kept out, and no one allowed to occupy it for some 
time." 

The medical officerf in charge of sick quarters at Yokohama 
reports the case as one of enteric fever, and sajrs that the rose- 
coloured eruption was well marked, and appeared m several crops. 

There were six cases of typhus fever in the Ocean, one of which 
proved fatal. The following report in connection with these cases 
is by the surgeonj of the vessel : — " Typhus fever, which had been 
prevalent on shore, both in the foreign settlement and amongst the 
native population, as is usual during the early months of the year in 
this place, first appeared in this ship while she was lying at the 
anchorage inside the island of Oosima, situated almost at the entrance 
of the Kii Channel, and during her stay of three days there, 
on her passage to Hiogo, in the inland sea of Japan. Save some of 
the officers who landed for sporting purposes, none of the ship's 
company were allowed to go on shore, as the anchorage is situated 
far outside all treaty limits. The first case, a healthy young or- 
dinary seaman who had been on general leave about twelve or 
fourteen days previous to the ship's departure from Yokohama, 
and had passed the night in a native house, was placed on the 
sick-list on the lOth of March complaining of flying pains about 
both upper extremities, especially troublesome in the left elbow- 
joint, sore-throat accompamed with difficult deglutition, and, ver- 
tigo, which had existed more or less for the last three months, 
coming on early in the morning when he first turns out, lasting for 
about fifteen minutes, and then disappearing for the rest of the dav ; 
no loss of appetite ; pulse 80, full ; Dowels regular ; no thirst. For 
these symptoms, pulv. ipecac. 3j, followed by a purge of calomel and 
jalap, was given, and sinapisms applied to the elbow-joint and throat, 
and he was placed in bed. On the Ilth the throat symptoms had 
disappeared ; the pain had shifted from the elbow to the shoulder- 
joint, the pulse was quick, 90, and bounding ; the tongue covered 
with a thick creamv coat, wiA papillsB projecting through ; con- 
junctivae injected ; skin burning hot, and persistency of the vertigo, 

so 

^ Surgeon R. J. M. Morris, f Surgeon John Dunwoodie. 

X Surgeon John Korie. 



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OF THE CHINA STATION. 273 

80 that he was unable to sit up. He complained of great thirst and China 
sleepleesness. On the 14th a diffused rubeoloid rash made its Station. 

appearance on the abdomen, chest, back, and upper extremiti^ ' 

but in a few hours faded, leaving the genend surface thickly speckled ^J^ ^* 
with dusky purple petediial spots. DiflSculty of swallowing re- ^®^ ^ 
turned ; dea&ess came on ; a short, troublesome cough set in ; the 
tongue became dry and parched, slight subsultus tendinum ; 
increase of the stupor, with frequent and incoherent mutterings, 
constipation, retention of urine, hot scalp, and head and neck suffused 
with a vivid coppery blush. On the 18th advantage was taken of 
an hospital which had been erected near the seashore, for the ad- 
mission of small-pox cases, to land this man ; at the same time, a 
stoker, who had been placed on the sick-list on the 14th of March, in 
a cachectic condition, u-om the presence of constitutional syphilis, and 
complaining of catarrhal symptoms, with oedema of the lower extre- 
mities, but who was also evidentiy infected with the typhus poison, and 
also a seaman evidentiy in the same condition, and an assistant pay- 
master, were removed on shore, an assistant surgeon of the ship placed 
in charge, and nurses appointed. In the case of the stoker, the erup- 
tion, very scanty however, appeared on the 19th, five days after his 
admission on the sick-list. In the third case admitted, which proved 
fatal, it appeared two days afterwards, and was very copious ; and, 
in the fourth, the assistant paymaster, who was placed on the sick-list 
on the 17 th, it was observed on the 21st, was not very distinct in cha- 
racter, and almost looked like a miliary eruption. After this date no 
more cases occurred until after the return of the ship, on the 2nd of 
April to Yokohama when, on the 22nd of that month, one of the 
men who had nursed the first patient was placed on the sick-list, and 
on the 25th discharged to the ^aval Hospital, the eruption having 
appeared on the previous ni^ht; and, on the 23rd, the sixth and last 
case was placed on the sick-ust, and discharged also on the 25th to 
hospitaL The first man seized, it is supposed, conveyed the infection 
on board, as three out of the remaining five had not been on shore 
for weeks, and two had onlv been on leave for a few hours, had only 
entered a European grog-shop where they had spent about an hour 
drinkinff, and then returned to the ship between 9h. and lOh. p.m. 
The omy two men in the same mess were the first man and his 
nurse. 

'^ Early and extreme prostration of strength, deafness, muscular 
pains, with disturbance of the mental functions, and cough, occurred 
in aU. Only in one case did the delirium become violent, and 
general convulsions occur, and that was in the fatal case, and then 
only for about twenty-four hours before death. The crisis occurred 
about the fifteenth day, and then all made a rapid recovery Avithout 
any untoward symptom, saving the stoker, wno, as has been pre- 
viously stated, was suffering from syphilitic cachexia when symp- 
toms of typhus infection declared themselves. He required a pro- 
longed administration of iron, cod liver oil, and iodide of potassium 
to fit him for duty. All have been extremely healthy since. 

" Immediately the character of tiie disease was observed in the 
ship the patients were placed in separate screened places on the main 
deck, and iJl the necessary and known precautions taken to prevent 

384, tiio 



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274 MEDICAL STATISTICAL RETURNS 

China the extension of the infection, and after they were landed on the 18th 
S tation . ^f March, they were placed in rooms with the windows wide open, 
IjT"^ ibd left so with fires constantly burning day and night ; were well 
■eot A.' covered with warm clothing, as chilly days occasionally occurred, 
and active, healthy, intelligent trustworthy nurses appointed. Car- 
bolic acid was kept constantly in the urinary and fcecal utensils ; the 
discharges removed as soon as passed ; extreme cleanliness of the 
persons of the sick obtained by daily ablution with soap and warm 
water : carbolic acid frequently sprinkled about the noors and on 
the bedding, and an improved and most nourishing diet supplied to 
the attendants who, I teel, by their care and complete attention to 
the orders given by the medical oflScers, contributed most import- 
antly to the fortunate results obtained. 

" The treatment consisted in the administration of an emetic 
followed by a purge, and then effervescing salines; shaving the 
head, and applying cold lotion to moderate cerebrd excitement; 
sinapisms to the chest when pulmonary symptoms appeared ; con- 
stant attention to the state of the bladder ; enemata of soap and 
water if the bowels were not relieved daily ; hot-water bottles when 
the temperature of the lower extremities tell, as it did occasionallj ; 
and an application, when necessary, of a strong solution of camphor 
in alcohol to the integuments over the sacrum and trochanters. 
For a diet: milk, egg-flip, strong beef tea, and rice stewed in 
it; wine, brandy, &c., increased or diminished in quantity ac- 
cording to the volume and rapidity of the pulse, in general a 
fair indicator of the patient's condition and requirements in this 
disease." 

Enteric Fever. — Two cases only of this form of fever appear in 
the returns from the squadron, ana their severity may in some mea- 
sure be estimated by tne fact that the average duration of each case 
on board ship and in hospital was over 171 days. Both cases oc- 
curred in the Ocean. 

On Table I V., a fatal case of this disease appears in connection 
with the Rodney. It occurred in the person of a leading seaman, 
who was placed on the sick-list on the 19th of December 1868, com- 
plaining of diarrhoea. He was a man of very meagre frame and 
delicate physique. Under the treatment to which he was subjected 
he appeared to do well for a time, but low symptoms set in ; the 
tongue became dry and brown ; small rose-colourea papulae appeared 
on the trunk ; the stools were composed of thin reddish fseculence ; 
and the vital powers were much prostrated. 

On the 4th of January 1869, he was sent to the general hospital 
at Shanghai. On the 9th, the disease became much aggravated, and 
on the lOtii, he died. 

Simple Continued Fever. — There were 315 cases of this form of 
fever under treatment during the year, of which three were in- 
valided and one proved fatal. The average duration of each case 
on board ship and in hospital was about thirteen days. The vessels 
in which the largest number of cases occurred were the Avon, the 
Princess Charlotte, the Bodney, and the Zebra. 

In 



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OF THE CHINA STATION. 276 

In the Avon there were twenty-six cases of this form of fever ; ChiD» 
of these twenty-two were contracted during the months of May, Station. 
Jane^ and July, either at Labuan or Balabac. They were con-, -"-^ 
sidered, in all cases, to be attributable to the same causes ; viz,, ex- Class I, 
posure to the heat of the sun, and wet. The symptoms were almost ^^^ ^* 
precisely identical in each case, and were characterised by intense 
headache, vomiting, flushed face, increased temperature, and ac- 
celerated pulse. 

In the Princess Charlotte there were fifly-five cases of simple 
continued fever. They appear to have been for the most part of a 
very trivial character ; but very little information is given in con- 
nection with them. 

'ITiere were 134 cases of simple continued fever in the Rodney, 
concerning which the staff surgeon* observes : — '* The majority oc^ 
curred in the Michaelmas and Midsummer quarters, seventy-three 
in the former and twenty-nine in the latter. Those contracted in 
the months of July and August, when the ship was lying at Yoko- 
hama, and during the passage to Hong Kong, were purely of an 
ephemeral character, and yielded quickly to laxatives and diapho- 
retics; but in September, at Hong Kong, and subsequently, partly 
owing to the climate, but more to the number .of worn-out men 
drafted into the Rodney from ships paid out of commission on the 
station, the symptoms assumed a mixed character, in some resembling 
those of affue, in others those of remittent fever, and were frequently 
followed by great prostration of physical and mental powers.'' 
. . . . ^^ Three casea^ the subjects being men paid off from the 
Starlingi which had been employed on the coast oi Borneo, were, in 
particular, oi such a mixed character that it was difficult to class 
them, assuming, at the commencement of the attack, the con- 
tinued type, and that of the remittent towards the close. They 
yielded to mercurial purgatives, diaphoretics, and quinine. One 
case, occurring in the person of a man who had been previouslv 
treated on the sick-list for catarrh and rheumatic pains of a syphi- 
litic character, and whose constitutional powers were comparatively 
broken down, quickly assumed u very low form, accompanied bv 
daily progressive emaciation ; furred, dry, brown tongue ; harsh 
skin, and great prostration. He was sent to Yokohama sick quarters, 
and there left on the sailing of the ship for England, his state being 
such as was likely to prove fatal during the voyage. Another case, 
placed on the sick-list at Nagasaki on the 1st of April, proved very 
tedious, from relapses on the slightest exposure to cold. His symp- 
toms at die first were of a highly febrile nature, marked by great 
heat of skin, quick pulse, throbbing of temples, and furred tongue. 
These yielded in about six days to the action of purgatives and dia- 

S heretics, the crisis being marked by profuse sweating, followed by 
ebility. As above mentioned, on the slightest exposure relapses 
occurred, the symptoms of which gradually assumed a modified form 
under the influence of quinine." 

In 

« Staff Surgeon Gtoige BiniM Hill. 
384. 



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276 MEDICAL STATISTICAL BETUBNS 

China In the Zebra there were thirty-one cases of simple continued fever 

Station. mostly of an ephememl character. They occurred principally during 

-jT"*"- the' summer; the common symptoms were headache^ aoceleratea 

Seet*iL P"^®^ anorexia, dark furred tongue, and rigors occurring at irregular 

intervals. There were no marked intermissions. 

The fatal case of simple continued fever occurred in the person of 
an officer's servant of the Perseus, a delicate-looking youth of spare 
build, who had recently, joined the ship. The case, as may be judged 
by its termination, was of great severity ; presenting, in many 
respects, the characteristic symptoms of true typhus. 

Ague and Remittent Fever. — Seventy-seven cases of ague and 
fifty-two of remittent fever were entered on the sick-list, and there 
was one death from each form of disease. The fatal cases occurred in 
small gun-boats, and no information has been obtained in connection 
with them. 

The Avon, the Elk, and the Rifleman were the vessels in which 
the largest number of cases of these fevers appeared, and in all they 
were attributable to exposure to malarious influences, while the 
vessels were employed among the islands of the East Indian Archi- 
pelago. The average duration of each case of ague was a little over 
ten days, and of ea(m case of remittent fever fourteen days. 

Mumps. — Of six cases of this painful affection five occurred in the 
Ocean. The surgeon says : — *^ The disease, which was of the simple 
form, appeared in the last week of May, and continued during the 
month of June, the last case being placed on the sick-list on the 22nd 
of that month. Three of the patients were nineteen years of age, 
one twenty-seven, and the other thirty^three. It occurred ' spo* 
radically,' from cold conjoined with humidity, for in this month, 
generally, the hot, rainy season of Japan sets in ; but this year the 
temperature was much below the usually observed height, and 
nortnerly instead of south-westerly had been the prevailing winds 
for some weeks. Both parotid glands were affected ; in one case 
the sub-maxillary also ; in another, metastasis occurred to the testes. 
The symptomatic fever was slight, and suppuration did not occun" 

n. General Diseases, Section B., or Constitutional Groups 

Class II. Seven hundred and eighty-six cases of various forms of disease 

Sect B. were entered on the sick-list under this head, of which fifty-nine 

were invalided and eight terminated fatally. Seven of the deaths 

were from pidmonary consumption. 

Rheumatism, — Of this troublesome disease 252 cases were placed 
on the sick-list, which is in the ratio of 72-4 per 1,000 offorce. 
This is a reduction, compared with the preceding year, equal to 11*7 
per 1,000. 

In the Rodney, in which there were fifty-one cases of rheumatism, 
the staff surgeon observes :— " The majority of cases of thig disease 

occurred 



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OF THE CHINA STATION. 277 

occurred in the Lady and spring quarters^ during which the greatest 
alternations of temperature were experienced. Of the fifty-one q?^* 

entered, only five or six were of the acute character ; the remainder ^' 

comprised Uiose suftering from lumbago and temporary pains of a Clasi II 
rheumatic character, affecting the joints and other portions of the Sect B. 
body. The greater number were primary attacks ; but six appear 
on tiie list several times, some on three, others on four occasions. 
Of the eleven sent to hospital, two were ultimately invalided ; one 
of them, whose symptoms were of a syphilitic character, and another 
who suffered from arthritis and effusion into the right knee joint, 
were surveyed at Hong Kong, and return in their ship to England. 

** In one case, that of a petty officer, a thin, spare, wiry man, the 
disease resulted from gonorrhoea, and proved very intractable; the 
pain, of a sub-acute nature, was confined on the first occasion to the 
bones and tendinous structures of the inside of the left foot, and was 
accompanied by little swelling ; but on the second occasion, a month 
subsequently, the wrists, knees, and both ankles were implicated ; his 
general health was also impaired, and he looked thin and emaciated. 
On his first entry on the bst, alkalies, colchicum, and blisters proved 
successful in eighteen days ; but, in the second attack, those means, 
combined with tonics, gave no relief, and he was sent to Hong Kong 
Hospital on the 2nd of September, with a hope that he might be 
brought forward for survey ; but to this he strongly objected, and, 
as the ship was going home, his whim was gratified. He returned 
to the ship on the 22nd of the same month, his svmptoms having 
undergone little alteration. He still remains on the list, and is slowly 
improving under the use of ferruginous tonics, nourishment, and 
stimulants, and I think ere long he may be discharged to duty. 

" In all the acute cases the heart was unaffected ; but the febrile 
symptoms were severe, accompanied a8 usual with sour perspiration, 
and urine of high specific gravity, loaded with lithates and urates. 

" The treatment adopted consisted in clearing out the primse viae, 
followed by a scruple of Dover's powder, the exhibition of large 
doses of some of the salts of potash, generally the acetate, either 
alone or combined with mindererus spirit, or the nitrate, with tinct. 
colch., continued until an alkaline effect was produced on the urine. 
Circular blisters, followed by large emollient cataplasms, were in- 
variably attended by the most oeneficial results, even when no 
internal medicines were used. Metastases were of frequent occur- 
rence after the use of blistering, and were generally a sure indication 
that the disease was about to subside. 

" In two cases subsequent debility proved of a lingering and tedious 
natare, requiring the offices of the coOk rather than of the medical 
man." 

Syphilis^ Primary and Secondary. — There were 318 cases of pri- 
mary syphilis, and 165 of secondary syphilis on the sick-list durmg 
the year, and of these, three of primary and twenty of secondary 
syphilis were invalided. The duration of each case of the former 
^sease was thirty-nine days, and of each case of the latter, a little 
over thirty-five days. About fifty men were, on an average, daily 
incapacitated for service from these diseases alone. 

384. Z The 



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378 MEDICAL STATISTICAL BET^BNS 

China The vessels in which syphilitic diseases were most numerous. 

Statical. ^^^.^ ^j^^ Qcean, the Pearl, the Rodney, and the Princess Charlotte, 

Class IL In the Ocean there were seventy cases of primary syphilis, and 
feot, B. forty-seven of secondary. The surgeon, speaking of these two forms 
of disease, remarks that " In addition to six cases remaining under 
treatment from last Annual Report, 117 new ones were added to 
the sick-list, almost all of whom were infected in Japan, principally 
at Yokohama, and thirty-two were discharged for hospital treatment. 
This does not include an almost equal number who were treated 
as out-patients for simple uncomplicated soft sores on the genitals. 
This was an increase of nineteen over the total number of the vear 
1868, but then it must be remembered that no leave had been 
given to the ship's company in its first quarter, whilst the ship was 
stationed at the then newly opened port of Hiogo. Undoubtedly 
the appointment of a medical officer for special service, in 
connection with the Lock Hospital, at Yokohama, the head- 
quarters of the Japan squadron, must have tended to mitigate 
the ravages of this fell disorder amongst the officers and men of the 
Navjr employed on this part of the station ; but despite all the pre- 
cautions adopted, much yet remains to be done ere the port can be 
declared even moderately free from infection. As it is, I consider 
it now, after having been for many months under supervision, the 
most infected, and exhibiting the worst form of the disease I have yet 
seen in the East. The ship s company have been carefully examined 
on board, previous to the monthly leave giving. A separate list of 
those suffering from gonorrhoea is kept for police purposes, and the 
men whose names appear on it are not allowed to visit the shore till 
cured. Every infected patient on presenting himself for treatment 
is questioned, and on affirming his knowledge of the locality, and 
woman with whom he had associated, is immediately sent to the 
Yoshiwarra (the public bagnio) in charge of a ship's corporal, to 
point her out, that she may be immediately placed under observa- 
tion and treatment. 

The '* sores " were of the three usually described forms, the one 
that is soft throughout its whole course chiefly prevailing, and were 
situated in all parts of the penis, both externally and internally, 
but principally in the cervix or fossa. The inguinal glands on one 
or both sides were frequently involved, and they generally suppu- 
rated. Asa rule, the sores were seen at too late a period for the 
successful use of escharotics. Calomel dusted on the sores, with an 
after dressing of dry lint once in the twenty-four hours, was found 
the most successful local application ; and if the sore proved a little 
obstinate, it was coaxed into a good condition by the administration, 
thrice daily, for seventy-two hours, never longer, of a powder com- 

Eosed of pulv. doveri gr. v., hydrarg. c. creta, gr. ij. Suppurating 
uboes were treated by the carbolic acid plan of opening and 
dressing, by the seton, and by free incision, and with about equal 
success. 

The constitutional manifestations followed at most uncertain 
intervals of time, and were almost of every known variety, affecting 
the various viscera, giving rise to epilepsy, paralysis, tuberculosis, 

ultimAtely 



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OF THE CHINA STATION. 279 

ultimately terminating in phthisis. Cachexia was not at all un- China 
common^ and was most intractable^ requiring months of hospital Station. 

treatment, and occasionally leading to invaliding. Psoriasis was 

the most common of the eruptive forms. The most useful remedy i^^ ?* 
in such cases was found to be the following draught, given thrice *^ 
daily, with a full and nourishing diet, Liq. hydrarg. oichlor. ji., 
potass, iodid., gr. v., tr. opii. min. v., aquse ^iss. Ulcers on the 
tnmk or extremities soon got well under the daily application of 
upguentum calomelanos." 

In the Pearl there were twenty-three cases of primary and 
twenty-nine of secondary syphilis. With regard to the prevalence 
of syphilis at Yokohama, the medical officer* observes, " I do not 
think that this disease is so virulent as heretofore, nor are the cases 
so numerous. Since the system of examination of the prostitutes 
has been organised, many women, who otherwise would have con- 
taminated the community, are now confined to the Lock Hospital, 
and are kept there till cured. 

" The regular prostitutes are all under the care of the Japanese 
Government, and are obliged to live in a particular portion of the 
town, surrounded by deep ditches, and only accessible by boats, or 
by a bridge. When these unfortunates wish to go outside to visit 
tneir friends, they are provided with a * fuda ' or pass, which con- 
sists of a small piece of wood, on which is written me name of the 
woman, and the number of the house she is going to visit. The 
average number of women in this public brothel during the last 
year was 1,020, and each woman was examined once a week. 

** In addition to these regular women, the owners of low grog-* 
shops, and cafes have, up to this time, harboured girls to tempt the 
half-drunken soldier or sailor. When few men were on leave, 
they prowled about the streets of the settlement, soliciting the 
passers-by. 

** Dr. Newton, R. N., to whom I am indebted for the foregoing 
information,^ has at last persuaded the local authorities to put a stop 
to this vagrant prostitution, and now any woman who is found 
wandering about the streets at night without a fuda, is arrested and 
sent to the Lock Hospital for examination. The beneficial result 
of this proceeding was proved by the discovery of twenty diseased 
women, out of forty arrests, in one night only. From this time we 
may expect a considerable decrease in the number of cases." 

In the Rodney there were eighty-four cases of primary and four- 
teen of secondary syphilis, in reference to which the stafi" surgeon 
observes, ** There were eighty-seven cases of primary syphilis 
treated during the period, oi which three remained from the pre- 
ceding year. Sixty-nine were discharged to duty, fourteen sent to 
hospital, and four are still under treatment. Nine contracted the 
disease at Shanghai towards the end of last year and the beginning 
of January; twenty-eight at Nagasaki, in February and March; 
one at Bjob6, in April; twenty-two at Yokohama, in June and 

July; 

• Acting-Surgeon Bradley Gregory. 
384. z2 



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280 MEDICAL BTATISTICAIi BETUBNS 

China July ; eight at Hong Kong, in September ; and twelve at Singa- 
Station. pore, in November. Of those contracted at Shanghai, three proved 
' hospital patients, and were discharged to Melville ; one resulted in 
g^ J extensive phagedena ; one was followed by suppurating bubo ; 
and in the third numerous hard, horny chancres were seated around 
the corona, and bathed in fetid pus from a phymosed state of pre- 
puce. In none of these did secondary symptoms make thetr ap- 
pearance. 

" During the time the ship was anchored at Hong Kong, general 
leave was given, and the result, as judged by the admission of only 
eight cases of syphilis on the sick-list m such a large vessel as the 
Rodney, speaks well for the surveillance exercised over prostitution 
in this place. The character of the sores was also very different 
from that observed in the northern part of China or Japan, par- 
taking more of the nature of supeHicial abrasions than that of spe- 
cific mcers. 

" Nagasaki forms an unfavourable contrast in this respect when 
compared with Hong Kong as above-mentioned. No sanitary 
measures have as yet been instituted to stop the ravages of the 
social evil. As the sources of infection are numerous from the 
crews of foreign ships, and as no remedial measures, or at least 
very imperfect ones, are adopted by the native doctors, the disease 
is seen here in all its varied forms, and its spread is daily increasing. 
Could compulsory supervision be adopted here, as at Yokohama and 
other places, I need not remark how great the benefits would be to 
all classes. Of the twenty* eight cases recorded as contracted at 
this port, four were followed by suppurating bubo ; two were of a 
sloughing nature ; and one sent to hospital at Yokohama was of a 
phagedenic character. The subject of the latter was a seaman, aged 
38, a man prematurely old, and whose constitution was broken down 
by intemperate habits. About three weeks after infection, he pre- 
sented himself with a soft, circular, sloughing svphilitic ulcer, 
situated on the left side of the body of the penis, if otwithstanding 
the measures adopted, the sore spread to such an extent that he was 
obliged to be sent to the hospital at Yokohama, fearing that the 
character of the sore might taint ulcers in its vicinity, although 
strict segregation was observed. His case began to improve m 
about ten days after admission to sick quarters, and quickly healed. 
But secondary symptoms, in the form of an extensive roseolar erup- 
tion, soon appeared on the chest, arms, and legs, and ultimately 
yielded to the use of mercury and iodide of potassium. The primary 
sore was of such a nature as to preclude the use of mercury, and 
hence, in my opinion, the occurrence of constitutional effects. 

*^ In the majority of these cases the sores were of a soft, super- 
ficial, spreading nature, free from hardness or surrounding interstitial 
deposition, and amenable to mercurial fumigation, the internal use of 
this mineral carried to slight ptyalism, and the local application in 
the first place of escharotics, as acid, nitric, fort, followed by black 
wash, sol. cupri. sulph., or some other astringent and stimulating 
application. 

** The character of the sores was no doubt altered or modified in 
accordimce with the constitution of the patients, or by the number 

of 



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OP THE CHINA STATION. 281 

of prior attacks ; those affected for the first time having sores pos- China 
sessed of a more specific character than those who had previously Station, 
experienced the disease. ■ 

** A great deal has been said and written of late as to the treatment g^g/ p ' 
of the various kinds of syphilis, and therefore I feel very diffident in 
hazarding; a remark on this point, where so many different opinions 
prevail, but I am perfectly convinced, in my own mind, that all 
suspicious sores should be attacked by gentle mercurialism of con* 
sidcrable duration, as being the only means of preventing the occur- 
rence of constitutional symptoms. Where this system has been 
properly carried out and followed up by the use of iodide of potash 
and decoction of sarsaparilla, the cases in my own experience are 
yery rare in which secondaries occurred. 

" The character of the disease at Yokohama was much milder than 
on the former occasion when the ship visited this port. Only four 
cases proved tedious under treatment on account of the occurrence of 
suppurating bubo. One of these was subsequently invalided at 
Hong Kong for syphilitic cachexia, associated with a livid coloured 
eruption. 

" Those contracted at Hong Kong were, as on a former occasion, 
of a simple nature ; but, from being frequently accompanied by 
gonorrhopa, the discharge of which acted as a poison to the sores, 
their cure was in some instances rendered tedious. 

** The majority of the cases inspected at Singapore were of a pha- 
gedenic and sloughing character, and did not m general make their 
appearance for three or four weeks after intercourse ; the subject of 
the worst of these was a Marine whose general health was much de- 
bilitated ; on presenting himself the ulceration had embraced the 
whole of the superior surface of the glans, and was rapidly spread- 
ing. By improving the patient's weakened state by tonics, stimu- 
lants, and nourishing diet, and bjr the topical application of strong 
nitric acid, foUowecf by mercurial fumigation, the parts rapidly 
healed, and he was discharged to duty in twenty-four days. 

" Of those remaining under treatment, one is likely to prove 
tedious. The subject of the disease is an officer, a roDust, clear, 
florid complexioned young man, of a scrofulous diathesis. He 
entered the list on the 7th of December with a superficial sloughing 
ulcer about the size of a sixpence, situated on tne corona glandis^ 
accompanied with bubo and gonorrlioea. By the free application of 
strong nitric acid, and the internal use of mineral acios, followed 
subsequently by gentle ptyalism and fumigation, the sore healed and 
the swelling of the glanas of the groin disappeared. He was about 
1o be discharged from the sick-list when a small sore made its apjpear- 
ance in the urethra, about half an inch from the orifice ; tnis at 
present has a very unhealthy appearance, and, situated as it is, the 
urine irritates it, and I am afraia it may ultimateljr prove serious. 

** Of the fourteen cases of secondary syphilis, nine were primary 
entries, and three were remissions ; one of the latter appears three 
timesj^ another twice, and a third three times. The first on the list 
was a petty officer sent to hospital for sloughing sores, in the end of 
last year ; his primary disease did not admit of the use of mercury, 
and in March he was attacked with rbeiuni^tism, and a copious 

384. z 3 copper 



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MEDIOAL STATISTICAL BETUBNS 

China oopper coloured eruption, which yielded to the use of iodide of 
S tation . mercury and iodide of potass, 

t Ti^„ jj " One patient, an able-seaman, by his own statement had not had 

Sect B * primary syphilis for years, only an attack of gonorrhoea. In this 
case there was a thick pustular eruption over the chest and extre- 
mities, and ultimately the face, wnich was ushered in by some 
febrile symptoms, and his general health was impaired, lie was 
discharged to sick quarters at Yokohama, and rejoined on the 
24th of July, on the snip being ordered home ; he was now treated 
with tonics of quinine and iron, under which he improved very much, 
but on the ship reaching Hong Kong he was temporarily sent to the 
Melville Hospital Ship, where he remained dunng the refitting of 
the Rodney until her departure on the 23rd of September from the 
station, when he was again admitted on the list for two days. 

" A gunner of the Royal Marine Artillery, lately paid off from 
the Icarus, proved a subject for invaliding. His general health was 
much impaired from syphilitic cachexia ; a copious papular eruption 
covered the chest and extremities ; the lower limbs were much 
swollen and oedematous, and there was persistent ophthalmia, accom- 
panied by slight iritis on the right side. He is now an invalid on 
board. 

*' Another Marine, late of the Cormorant, paid off, suffered from 
an extensive eruption of rupia on both legs and feet, which from 
time to time took an ulcerative action, accompanied by oedema ; he 
was pale and cachectic, and had suffered from primary disease about 
four years previously ; he improved under tonics and nourishing 
diet, followed by iod. potass, in small doses, but he is still under 
treatment. 

" One case, received from the Princess Charlotte, and lately em- 
ployed in the Marine Guard on board the Melville, was anected 
with an eczematous ulceration of a verv troublesome and persistent 
nature, situated around the feet and ankles. Another belonging to 
the Rodney had impetigo of the legs, the sequel of a recent attack of 
primary disease ; the remainder mostly comprised rheumatic affec- 
tions which, from their histories, were considered syphilitic, and were 
treated accordingly." 

In the Princess Charlotte, in which there were seventeen cases of 
primary and twelve of secondary syphilis, the majority of the primary 
cases were examples of the simple soft sore or chancroid, most of 
them followed by bubo, which usuallv suppurated, and was the 
cause of their long detention on the sick-list. The cases of second- 
ary syphilis were mostly of long standing, the primary disease, it is 
said, having usually been contracted in Englana. 

There wre eight cases of primary and eleven of secondary syphilis 
in the Cormorant, all attributable to infection in Japan, With re- 
ference to some of these cases the medical officer* observes : — 
" Primary syphilis has of late much diminished in Yokohama since 
the institution of the Lock Hospital, and the inspection of women in 
that 

* Assistant, Surgeon Charles L. Ridont. 



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OP THE CHINA STATION. 283 

that place, as well as the strenuous exertions that have from time to China 
time been made to suppress vagrant prostitution. The cases that Sti^tion. 

E resented themselves were not of so severe a nature as formerly, 
eing much more amenable to treatment. One case out of three was Class H. 
followed by constitutional symptoms, but all were accompanied by ^^^^ ^' 
suppurating buboes. One of the most effectual methods of treatment 
of chancres, especially when accompanied by hardness, is found to 
be that of fumigating the part affected with calomel vapour (gr. xv.) 
once a day, and the speedy healing of the sores was sometimes quite 
surprising. Chloride of zinc lotion made by adding one drachm of 
Sir William Burnett's disinfecting fluid to sixteen ounces of water, 
acts extremely well when the sore is entirely soft. 

** The cases of secondary syphilis were examples of long standing 
disease in broken-down constitutions, usually of a severe type, consist- 
ing of obstinate ulceration, nodes, and rheumatic pains. Iodide of po- 
tassium combined with generous diet, cod liver oil, quinine, iron, and 
port wine was the treatment usually adopted. On this station, I have 
oflen observed that syphilis runs a particularly rapid course, passing 
in a short time to advanced stages. This is probably caused by the 
depressing nature of the climate, which renders the system less able 
to withstand the effects of the poison." 

Purpura. — Two cases of this disease in a mild form were entered 
on the sick-list, and both were discharged to duty. In Table 
IV., however, a fatal case appears in connection with the Ocean. 
It occurred in the person of a petty officer who was sent to 
Yokohama Hospital as a case of dyspepsia, but in whom spots of 

Eurpura had made their appearance on the legs. On admission to 
ospital he is reported to have been a man of Lirge frame, but much 
reduced in flesh and strength. He complained of debility, dyspnoea, 
cough, loss of appetite, and a constant sinking feeling; the skin was 
sallow, dry, and dusky ; the conjunctivae tinged yellow ; the tongue 
coated with a deep yellowish fur, and the pulse 76. On the lower 
extremities, and on other parts of the body there was an eruption of 
purpura; there was considerable difficulty of breathing, slight dul- 
ness on percussion over the whole chest, and the respiratory murmur 
was indistinct, but there was no crepitation. He stated that he 
had been for the most of his life in the merchant service, on hot 
stations, and particularly on the Coast of Africa. 

His symptoms gradually increased in severity, the ankles became 
oedematous ; several large ^^ blotches " of purpura appeared on the 
feet ; those on the body became more vivid ; the ^ums were spongy, 
and bled on pressure, and the urine and stools were very dark 
coloured. With increased difficultv of breathing, cough set in, and 
there was a good deal of oozing of blood from the gums, mouth, and 
throat ; the cough became more troublesome, and the expectoration 
consisted of frothy mucus and blood ; oozing of blood became more 
profuse ; oedema extended to the thighs ; the nurpuric spots began 
to assume a yellow tinge, and he was gradually becoming weaker. 
He remained conscious to the last, but ** wandered " occasionally a 
Uttle during the night ; he ultimately sank three weeks after his 
admission to hospital. 

384. z 4 The 



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284 MEDICAL STATISTICAL RETUBNS 

China The following report of the appearance on post mortem examina- 

Station . ^ion of the body is by the surgeon in charge of the hospital: — 
p, -• " Thighs and legs cedematous ; body and legs covered with pur- 
gfff p • puric blotches and spots. On opening the chest both pleuras were 
found to be about half filled with very dark bloody serum ; the 
lungs were gorged with blood, but in other respects healthy ; the 
pericardium contained a considerable quantity of bloody fluid, and 
the heart was large and flabby with dilated cavities, but no valvular 
disease existed ; tne inner surface of the stomach and intestines was 
mottled with purpuric spots, and the latter contained a quantity of 
dark-coloured semi-fluid faeces, and was a good deal distended by gas ; 
the liver was much smaller than natural, and had a hobnailed appear- 
ance externally ; when cut into it had a distinct nutmeg appearance ; 
on the upper surface of the right lobe was a mark like a cicatrix ; the 
kidneys were very large and gorged with blood." 



Class III. 



m. Diseases of the Nervous System, and Organs of the 
Special Senses. 

Under this head 124 cases of various forms of disease were entered 
on the sick-list, of which, sixteen were invalided, and nine proved 
fatal. The deaths were, five from apoplexy ; one from sun-stroke ; 
two from paralysis ; and one from epilepsy. 

Apoplexy, — There was a fatal case of apoplexy in one of the gun- 
boats, and one in the Leven. From the defective nature oi the 
returns from these vessels, no information has been obtained in con- 
nection with them. 

In the Ocean, a private of the Roval Marine Artillery, a man of 
most intemperate habits, and who only on the forenoon of his death 
had been removed from his post as sentry for being drunk, died 
suddenly of apoplexjr. On being removed from his post, he was 
placed as a prisoner m the after cockpit, and on becoming quite sober 
was released from arrest and allowed to return to his mess. While 
sitting there playing cards with a messmate at 8 h. 10 p.m., he sud- 
denly fell from ofl^ the form on which he was sitting, to the deck. The 
surgeon says : " I was summoned immediately, and found him Iving 
on his left side, partially supportinff the upper part of the trunk on 
his left arm, which was semiflexed beneath it; the head was thrown 
back ; the eyes wide open, and pupils dilated ; the mouth wide 
open, with froth oozing irom it; the head and neck of a livid hue ; 
the body warm ; jpulseless, and with cessation of the heart's action 
He was dead." On post-mortem examination, the principal appear- 
ances connected with the fatal result were, congestion of the super- 
ficial and deep cerebral veins ; great serous effusion into both 
ventricles; and excessive engorgement of both choroid plexuses. 
The medical officer observes : " He had been under treatment 
occasionally for dyspeptic symptoms, following a debauch, and a few 

mino^r 



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OP THE CHINA STATION, 285 

minor surgical diseases^ but otherwise had enjoyed good health. No china 

doubt the original cause of the present fatal attack was his intemperate Station, 

habits^ which producing gastric irritation induced cerebral irrita- 

tion, which is, 1 believe, acknowledged to be one of the most frequent Class III. 
causes of apoplexy." 

There was a fatal case of apoplexy in the Perseus. It was con- 
sidered to be attributable to insolation. The subject of it, a petty 
officer, was seized at 2 h. a.m. of the 11th of April, at Manilla, with 
what appeared to be an epileptic fit, the symptoms being quite 
characteristic of that disease. At 3 h. a.m. the fit passed off, when 
he complained of a gnawing pain in his bowels, ana made frequent 
attempts at vomiting. On tne following day the bowels had not 
acted, and he compmned of headache and thirst The skin was hot 
and perspiring, and the tongue coated thickly with a yellow fur. 
He answered questions very slowly, apparently from defective 
memory. A blister was applied to the nape, and a purgative of 
jalap and croton oil administered, which acted freely, and all his 
symptoms improved much« On the 1 5th a saline rhubarb mixture 
was prescribed, which had the effect of keeping his bowels open. 
The tongue became cleaner, and after this, with the exception of 
slight headache, he had no bad symptoms. He had passed some 
round worms during the treatment to which he was subjected, but 
none had appeared for some days. On the evening of the 22nd he 
was seen at 8 h. p.m., when, with the exception of slight headache, 
he reported himself quite well. On the morning of the 23rd he was 
found dead In his hammock. The report of the post-mortem examina- 
tion as given by the surgeon* of the ship is as follows : ** Rigor 
mortis present. Body, that of a well-formed muscular man, about 
five feet six inches in height. A mark of an old scalp wound was 
the first thing noticed, at the back of the head, over the junction of 
the left parietal and occipital bones. On reflecting the posterior 
flap of the scalp, no corresponding injury was however found. 
Bemoving the dura mater, the vessels of the pia mater were found 
to be very much distended, presenting a highly congested character. 
On the removal of the brain, a number ot small black clots were 
found at its base, particularly on the lower surface of the cerebellum, 
and surrounding tne pons varolii, and the upper part of the medulla 
and cord, the substance of the brain having a normal appearance ; also 
In both lateral, and the third and fourth ventricles there was no excess 
of serous fluid." The other organs were healthy. The medical 
officer remarks in this case that ^^ although at the post-mortem 
examination there was found to be an entire absence of that con- 
gested condition of the lungs which appears almost invariably to 
occur in cases of insolation, arising from the direct solar rays, yet 
the condition of the membranes, as well as of the base of the brain, 
and upper portions of the spinal cord, and the unusually fluid con- 
dition of the blood, were such as to leave little doubt in my own 
mind that this was a case which I can only designate as heat apoplexy, 

arising 

* Surgeon Astley Cooper. 



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886 MEDICAL STATISTICAL BETUBNS 

China ariaing from the effect of an ill-ventilated and vitiated condition of 
Station. the atmosphere acting on a person overheated by the high range of 
^flu m temperature, and fatigues ot the day. 

Two similar cases to the foregoing occurred on board about the 
same time, in which the subjects of them were found in a state of 
insensibility, but by timely mterference and removal to the upper 
deck, where they were exposed as freely as possible to the air, 
they rallied before suflScient time had elapsed for the insensibility 
to pass into a condition of coma. With the view of remedying this 
state of affairs I recommended, as far as was practicable, the spreading 
of awnings and of side awnings at night, to enable the majority of 
the men to sleep on the upper deck, thereby relieving the over- 
crowding below, and giving individually a much larger space for 
breathing purposes. I need not state that this plan was followed 
by happy results." 

A fatal case of apoplexy occurred at Shanghai in the person of an 
officer of the Zebra in the month of July, and on one of the hottest 
days experienced at that place, the temperature in the shade being 
98". The attack was remarkably sudden, and death occurred in less 
than an hour. On examination after death, about three pints of 
dark-coloured blood escaped from the skull on removing the cal varium. 
This was traced to a ruptured branch of the middle meningeal 
artery ; the blood had been lodged between the brain and dura mata, 
separating them completely all round the head. 

IV. DiseaseB of the Circulatory System. 

Class IV, Twenty-three cases of various forms of disease were entered on 
the sick-list under this head, of which, twelve were invalided, and 
one, a case of aneurism of the aorta, proved fatal. It occurred in 
the person of a Marine of the Ocean, a well built powerfully made 
man, but of intemperate habits, who after partaking of his dinner 
with his usual avidity, was walking along the main deck about 
lh.3(y p.m. of the 25th of December, when in the act of talking with 
one of nis messmates, suddenly experienced a sense of choking, and 
requested the man to whom he was speaking to support him. He 
was immediately carried into the sick bay, and when medical assist- 
ance arrived about three minutes later, he was in a state of insensi- 
bility, and had just vomited some undigested food which had an odour 
of rum. The surface was warm, and there was some jierspiration 
on the forehead | the pulse could not be felt, and respiration was 
almost imperceptible ; a slight vapour, just enough to slightly dim 
a poUshea metal surface, escaping from the mouth, and soon all 
thoracic and abdominal respiration ceased. The pupils immediately 
became dilated; the eyes insensible to the touch; and the hearts 
action, which could barely be felt, was the only indication of vitality. 
This however, soon ceased, and he died about 2 h. p.m. 

On the following day the body was examined, when, '^ on raising 
the sternum, the pericardium was observed to be enormously 
distended, and on opening the sac, a quantity of sanguineous fluid, 
about fourteen ounces, escaped, leaving a large clot surrounding the 
heart. The heart itself was normal in si£e,l)ut exhibited signs of 

f ktty 



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OF THE 0HI19A STATION. 287 

fatty degeneration ; the valves were healthy, and the cavities empty. China 
On examining the arch of the aorta, a distinct fissure of a quarter Station. 
of an inch in length, was observed on the posterior surface of its ~^ 
ascending portion, about an inch above its origin from the left ^8** ^v. 
ventricle. Fatty degeneration of the coats of the vessel extended 
for some distance, but no atheromatous or calcareous deposits could 
be detected. There was but a very slight dilatation of the vessel, 
and a thinning of its walls only in and about the site of the 
rupture, to the extent of a third part of the calibre of the vessel. 
The absence of a sac of any size would full^ account for the 
freedom of the deceased from all symptoms of its existence whilst 
he was alive. The remaining contents of the thoracic and abdo- 
minal cavities were healthy." 

A strong, healthy-looking able seaman of the Princess Charlotte 
was invalided for aneurism of the abdominal aorta. He had been 
undergoing punishment in prison, one part of which consisted in 
what IS termed *^ shot drill,^ and to this cause the disease was at- 
tributed. He was discharged to the Melville hospital ship at Hong 
Kong, from which the following brief statement ot his case has been 
forwarded by the Deputy Inspector General* : — ....** He 
had been previously under treatmentfor about a fortnight, complain- 
ing chiefly of vertigo, headache, and debility, without any apparent 
cause, until a small pulsating tumour was found to exist in the ab- 
domen, close to the umbilicus. During the patient's stay in hospital ^ 
the tumour increased both in size and strength of pulsation ; but the * 
general health somewhat improved. He had never complained of 
abdominal pulsation until on examination it was observed, and the 
medical officerf of his ship seemed inclined to attribute its origin to 
* hard labour ' at shot drill, the man being at the time a prisoner in 
the naval gaol." 

V, and yi. Diseases of the Absorbent Sjrstem and Dnotless 

Glands, 

One hundred and sixteen cases of sympathetic bubo were entered on Classes V. 
the sick-list during the year, the average duration of each case being and VI. 
between twenty-eight and twenty-mne days. There can be little 
doubt that in the majority of these cases the disease was attributable 
to general constitutional impairment from climatic causes. 

Vn. Diseases of the Respiratory System. 

Under this head 378 cases of various forms of disease were entered Class Vll. 
on the sick-list, of which seven were invalided and two proved fatal. 
Of the total number, 344 were cases of ordinary catarrh, the average 
duration of each case being about eight days. The fatal events re- 
sulted, in one instance, from haemoptysis, and in the other from 
pneumonia. 



384, 



•Deputy Inspector General Robert Pottinger. 
t A3si6tant Surgeon Robert Neltoii. 



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288 MEDICAL STATISTICAL RETURNS 

China pneumonia. The case of haemoptysis should more properly have 

Station. been classed under phthisis, for which disease the subject of the 

Class Vn. attack had been invalided at Yokohama, and, three hours before his 

death had embarked on board a contract mail steamer for a passage 

to England. The attack was sudden and violent, and he died in a 

few minutes. 

The case of pneumonia occurred in the person of an officer's servant. 
It is reported to have been of the asthenic type, and its unfortunate 
result to have been mainly attributable to loss of valuable time, 
occasioned by the patient not reporting himself until he had been 
for two or three days labouring under the disease. The treatment 
from the outset was directed to support the strength, and to obviate 
the marked tendency to sinking, which the symptoms and aspect of 
the man plainly suggested. Wine and brandy, m small quantities, 
were frequently and steadily administered, as were also ammonia, 
sether, beef tea, jelly, and other light nourishment, but without avail, 
and he expired seven days after being admitted to the sick-list. 

Catarrh. — In the Ocean and the Rodney, in which vessels the 
largest numbers of cases of this affection were entered on the sick- 
list, some of the attacks were of considerable severity. The staff- 
surgeon of the latter vessel observes : — ^^ Under this heading are 
comprised all cases suffering from febrile colds, in whom there was 
cough, unattended by abnormal physical sounds, coryza, and such- 
•like symptoms." . . . . " The majority were simple cases 
which soon returned to dut^; but some were complicated with 
rheumatic affections, some with cynanche, and others with slight 
chronic pleuritis, which somewhat lengthened their duration on the 
list" 

In the Ocean (he surgeon reports that the greatest number of 
cases were placed on the sick-list in the first quarter and the least 
in the second quarter of the year. ** No new symptoms worthy of 
record appeared. Occasionally the stress of the disease fell on the 
trachea and bronchial tubes, or on the mucous membrane of the ali- 
mentary canal, when confinement to bed and a little prolonged 
treatment were required. Of three cases discharged to hospital, 
two presented such obscure symptoms that they were sent for closer 
and more minute observation. In the third case haemoptysis ap- 
peared, and was considered to be dependent on hepatic congestion, 
the result of occasional fits of intemperance. All returned to duty." 



Vm. Diseases of the Digestiye System. 

Class TIIL Under this head, 815 cases of various forms of disease were 
entered on the sick-list, of which thirty-one were invalided and 
seven proved fatal. The majority of the cases were different varieties 
of dyspepsia and diarrhoea, 230 cases of the former having been ad- 
mitted to the list, and 368 of the latter. The dyspeptic cases were 
in some instances due to the debilitating effects of climate, but in 
th^ majority to dietetic irregularities. 

Dysentery 



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OP THE CHINA STATION. 289 

Dysentery and Diarrhcea. — Twenty-four cases of dysentery and china 
368 of diarrhoea were entered on the sick-list during the year ; but Station. 

several cases of the latter disease became dysenteric and proved fatal. 

Each case of dysentery was, on an average, twenty-seven days under Class VIII . 
treatment on board ship and in hospital, and each case of diarrhoea 
between nine and ten. The vessels in which these diseases prevailed 
in largest numbers were the Adventure, the Hornet, the Ocean, 
the Perseus, the Princess Charlotte, and the Rodney. 

There were three cases of dysentery and fifteen of diarrhoea in 
the Adventure. Very little information is given with regard to 
these cases ; but they appear, for the most part, to have been of a 
mild character. The majority of the cases of diarrhoea were con- 
sidered attributable to atmospheric causes, as they generally occurred 
in the cool of the morning, and relapses were common at fiiat time. 

In the Hornet there were seven cases of dysentery and three of 
diarrhoea. They were for the most part contracted in the River 
Min. The medical officer* remarks : — " The river off Pagoda Island 
is a mile in breadth, with a rise and fall of seventeen feet. They 
had had a very hot summer here, the thermometer averaging 93* in 
the shade at noon. Djrsentery is the prevailing disease here just 
now, the merchant shipping suffering in a marked degree. Precau- 
tions were taken to guard the crew as much as possible from this 
disease ; no leave was granted ; the eating of unripe fruit was for- 
bidden ; no work in the sun was permitted during the heat of the 
day ; and those men who slept on deck were made to sling their 
hammocks some distance from the deck, and to keep under the awn- 
ings. The drinking water is got by contract from a spring in the 
neighbourhood ; but the coolies, to spare themselves trouble, some- 
times draw it from the river. To obviate this, a petty officer was 
sent in charge of the tank. It seems to be fair drinking water, but 
soft, and in appearance free from animal and vegetable impurities. 
Notwithstanding the above measures, several cases with marked 
symptoms of dysentery came under treatment. The first appeared 
on the second day of our arrival in port ; the last was placea under 
treatment on the 20th of September." 

In the Ocean there were one case of dysentery and twenty-three 
of diarrhoea. ITie former disease occurred in the person of a young 
officer, who had, forty-eight hours previous to his application for 
treatment, been witii a messmate snooting in paddy-fields all day 
under a hot sun, and, to slake his thirst, had freely and repeatedly 
drank of the apparently pure-looking water draining from them. 
•* He had, not many months before, been under treatment for con- 
stitutional syphilis, followed by typhoid fever, and hence may have 
been more predisposed to the attack than his companion, a stout, 
healthy youth, wno was only seized witii diarrhoea. The attack was 
in the acute form, and was'treated by occasional doses of 01. ricini, 
to prevent the lodgment of scybalse ; a pill, composed of morph. 

hydrochfor. 



^ Assistant Sorgeon J. B. Drew. 
384. 



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290 MEDICAID STATISTICAL BETUBNS 

China hydrocjhlor. gr. i, pil. hydrarg. gr. iss., pulv. ipecac gr. iij, every 

^ ^*^° * third hour ; opiate eneinata, sinapisms, stupes, and hot cataplasms to 

CI VTTT ^^^ abdomen : and a diet composed of farinaceous food, weak broths^ 

*** and milk. A speedy convalescence ensued, imattended by any 

symptoms of the chronic form of the disorder." 

Of the diarrhoea which prevailed in the vessel, the surgeon re- 
marks, that it mostly occurred in the Michaelmas quarter of the 
year, when the annual temperature is at its highest range, and the 
greatest quantity of rain falls. Some of the cases depended upon 
an acrid or increased secretion of bile occurring in those who had 
been intemperate. Some of them proved protracted, and were 
occasionally accompanied by rather urgent symptoms. 

There were seven cases of dysentery and seventeen of diarrhcBa 
in the Perseus. Six of the cases of dysentery and eleven of diarrhoea 
occurred during the midsummer quarter oi the year. The former 
disease appears, from its protracted character, to have been of con- 
siderable severity, but no mformation whatever is given in connection 
with either form of disease. 

In the Princess Charlotte there were fifty cases of diarrhoea and 
one of dysentery, but no information is given in connection with 
them. Several of the cases of diarrhoea appear to have assumed 
dysenteric characters, as it will be perceived, on reference to 
Table IV., that three deaths from dysentery appear in oonneotion 
with that vessel. 

In the Bodney, in which there were one case of dysentery and 
ninety-five of diarrhoea, the staff surgeon reports, that the dysenteric 
case occurred in the chronic form in the person of a worn-out man. 
a Maltese bandsman, who was invalided on account of the weakened 
state of his general health. 

With respect to the diarrhoea, he observes, ** Fifteen cases of this 
disease occurred in the Lady quarter, ten in the Midsummer, thirty- 
six in the Michaelmas, and thirty-four in the Christmas quarters. 
It thus appears that the affection prevailed most during the warm 
weather, gradually diminished as the more temperate regions were 
encountered, and a^ain slightly increased when the cold southerly 
winds were experienced as the ship neared the Cape. Besides 
climatic influences, the disease was in many instances caused by sudden 
changes in diet, such as occur frequently in the service when crews 
pass from fresh to that of a long-continued salt diet. This disease 
Ibrms a fourteenth of all the cases treated during the period, with an 
average duration of seven days, and consisted principally of the 
congestive form of the disease which required, in the first instance, 
free unloading of the digestive organs, both glandular and intestinal, 
by the exhibition of hydragogue cathartics, combined with calomel, 
and followed by some of me usual anodyne and astringent medi- 
cines, as ipecacuan with opium, Dover's powder, acetate of lead, 
with opium, &c. ; rest enjoined, low diet strictly observed, and 
fomentations applied to the abdomen should pain be present. This 
treatment has always, in my hands, been attendea with perfect 
success. In the practice of others I have often witnessed tne bad 

results 



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OF THE CHINA STATION. S91 

results of astringents used in the early stages of this disease, wHh- China 
out haying previously prepared the system by the early use of Stetio*. 
cathartics. ^ 

Other Diseases of the Stomach and Bowels. — A fatal case of ob" 
etruction of the bowels occurred in the person of a Marine, of the 
Ocean, who had been sent to the sick quarters, at Yokohama, in 
November 1868, labouring under primary and secondary syphilis. 
On the 13th of January 1869 he was seized with severe bilious 
vomiting, accompanied by pain, and tenderness over the region of 
the stomach. He vomited a large basinful of dark green fluid, 
with ^eenish flocculi floating in it. On the following day, vomitinff 
of a smiilar kind occurred, and the abdomen became distended and 
tympanitic. As no discharge from the bowels took place, enemata 
were exhibited, but they came away without bringing any faeces 
with them. On the 18th and following days the vomited matters 
were stercoraceous. On the 20th he vomited an immense quantity 
of feculent matter, and on the 21st he died. 

The report of the post-mortem examination, by the medical officer 
in charge of sick quarters, is as follows: ** The body was much 
emaciated, and the remains of a syphilitic eruption were present on 
the trunk and limbs. Belly distended and tympanitic. The thoracic 
vicera were healthy. On opening the cavity of the abdomen, a con- 
siderable quantity of fetid gas escaped. The stomach was normal 
in appearance ; the upper part of the small intestines was much dis- 
tenaed with gas, and contained also a large quantity of light yellow 
coloured fluid fadces. At a point in the ileum, about three feet from 
its junction with the colon, there was a sudden constriction of its 
calibre, with inflammatory thickening of it« coats, rendering them 
rigid in a sharply curved position, and nearly obliterating the cavitv 
01 the bowel. From this point to the caecum the bowel was much 
contracted, admitting with difficulty the blade of the blunt-pointed 
scissors. The colon also was somewhat contracted throughout its 
whole length. On opening the intestines it was found that the con- 
stricted part was about the calibre of a goose-quill, and it was caused 
by an exudation of lymph at the site of an old ulcer in one of Peyer's 
patches. Throughout the whole length of the bowel these patches 
showed traces of inflammation and ulceration at some previous date, 
leading me to infer that he must at some period have suflered from 
a severe attack of enteric fever. The liver and other organs were 
healthy." 

IZ. and X. Diseases of the Urinary and Generative 

Systems. 

Under this head 326 cases of various forms of disease were entered Glasses IZ. 
on the sick-list, of which seven were invalided. The number of cases and X 
of gonorrhoea was 178, and of orchitis 120; the averj^e duration 
of each case of the former disease being about twenty oays, and of 
the latter a little over eighteen days. Most of the cases classed as 
orchitis were due to gonorrhoeal irritation, 

384. 



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292 



MEDICAL STATISTICAL BETUBNS 



Chuia 
Station. 

Class XI. 



XI. Diseases of the Organs of Locomotion. 

Thirty cases of different forms of diseases of the bones and joints 
were entered on the sick-list during the year, and of these, three 
were invalided. Of the latter, one was considered unfit for service, 
from partial anchylosis of the metacarpo-phalangeal joint of the rin^ 
finger of the left hand, which had followed a contused and lacerated 
wound of the adjacent soft parts ; and another had very slight mo- 
bility of the left elbow-joint, the result of inflammation of the part 
in a strumous boy. The third case of invaliding occurred in one of 
the gunboats, and little or no information is given in connection 
with it 



Xn. and Xni. Diseases of the Cellular Tissue and Cutaneous 

System. 

Classes XII. Under this head 1,315 cases of various forms of disease were 
and Xin. entered on the sick-list, of which five were invalided and one proved 
fatal. Almost all the affections (1,252) were boils, abscesses, and 
ulcers ; the average duration of each case of boil and abscess being 
about nine days, and of each case of ulcer between twenty-three 
and twenty-four days. 

The fatal case occurred in the person of a seaman of the Adven- 
ture, who was discharged to the sick quarters, at Yokohama, with 
a sloughing ulcer over the metatarso-phalangeal joint of the great 
toe. The ulcer healed, but he gradually sank and died from 
anaemia. He took nourishment freely, and did not lose very much 
flesh. On examining the internal organs after death, disease of the 
spleen and left kidney was found, and all the viscera were extremely 
pale and ansemic. The opinion of the medical oflScer in charge of 
the sick quarters was that the case was one of leucocythemia. 

Vnclassed Diseases. 

Under this head appear ninety cases of debility, doubless from 
climatic causes, of which twenty-three were invalided ; fourteen of 
delirium tremens, of which one was invalided ; and two of poison- 
ing, of which one was invalided, and one proved fatal. 

Delirium Tremens. — Of this disease four cases occurred in the 
persons of petty oflScers ; two, in able seamen ; one, in one of the 
carpenter's crew ; four, in Marines ; two, in bandsmen, and in one 
instance the rating has not been ascertained. 

Poisoning. — The fatal case of alcoholic poisoning occurred in the 

Eerson of a healthy young ordinary seaman of the Ocean, at Yoko- 
ama. He had been on shore on twenty-four hours' leave, and came 
on board, at the expiry of the time, intoxicated. He had been 
drinking heavily, while on shore, a cheap spirit manufactured there^ 
and sold under the name of " Old Tom." He had, apparently, 
recovered, in so far, from his debauch, but next day he complabed 

to 



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OF THE CHINA STATION. 293 

to his messmates of headache and loss of appetite, which he attri- China 
buted im his fit of drunkenness. He had gone to bed as usual on Station. 
the following evening, but in the morning, not *^ turning out" with 
the rest of the ship's company, he was spoken to, but only replied 
by a groan. Five minutes later, a man who was passing noticed a 
sudden pallor overspread his features, and called the medical officer, 
who found that the man had just died. He was of most intemperate 
habits, it appeared, and invariably got drunk when he went on 
shore. 

The principal post-mortem appearances are; excessively contracted 
stomach, the peritoneum covering the anterior surface and lower 
curvature of which was inflamed. It was found to contain nearly 
two ounces of a thin sanguineous-coloured fluid, probably the result 
of exudation. The mucous coat was inflamed and thrown into 
numerous longitudinal plaits, excessively rugose, and covered with 
a thick tenacious mucus. All other organs appeared healthy. 

Wounds and Ii\jiiries. 

One man who fell from aloft died from the effect of internal 
injuries. 

Twelve men were drowned ; of these seven fell overboard, four 
were found drowned, and the circumstances under which one man 
was drowned have not been ascertained. 

The total number of deaths in the squadron %as fifty-one, which 
is in the ratio of 13*6 per 1,000 offeree, being an increase, compared 
with the preceding year, equal to '6 per 1,000. 

Invalided. 

Under General Diseases, Section A, seventeen persons were 
invalided, viz., three for simple continued fever, eight for ague, and 
six for remittent fever. Under Section B. fifty-nine were invalided, 
of which ten were for rheumatism ; three for primary syphilis ; 
twenty for secondary syphilis; three for scrofula; and twenty - 
three for phthisis pulmonalis. Sixteen persons were invalided for 
diseases of the nervous system and organs of the special senses ; 
twelve for diseases of the circulatory svstem ; seven tor diseases of 
the respiratory system ; thirty-one U)r diseases of the digestive 
svstem ; seven for diseases of the urinary and generative systems ; 
three for diseases of the organs of locomotion ; five for diseases of 
the cellular tissue and cutaneous system ; twenty-five for unclassed 
diseases, and six for wounds and injuries of various kinds. The 
total number invalided was 188, which is in the ratio of 50*1 per 
1,000, being a reduction, compared with the preceding year, equal to 
15- per 1,000. 



384, A A 

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MEDICAL STATISTICAL BETUKNS 



Table, No. I. 

Showing the Number of Cases of all Disbisbs and Injuues, and the Number 
Invalided and Dead, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



General Diseases, Section A. 
SmaU-Pox ^ 
Typhus Fever 
Enteric Fever 
Simple Continued Fever 
Ague - - - - 
Bemlttent Fever - 
Mumps - - - - 
Erysipelas 



II. General Diseases, Section B. 
Rheumatism - • . , 
Gout - . . . . 
_/ Primary - 
" iSecondttry - 



Syphilis 

Scrofula 

Phthisis Pulmonalis 

Purpura 

Dropsy - - . 



in. Diseases of the Vervons 

System, and Organs of 
e Special Senses: 
Apoplexy - - - - 
Sunstroke - . . . 
Paralysis - - . . 
Vertigo - - - - - 
Epilepsy - - - . 
Neuralgia .... 
Insanity «... 

Hysteria - - . . 
Diseases of the Eye 
Diseases of the Ear 
Piseases of the Nose 



CaMt. 



Number. 



40 

9 

2 

815 

6 
4 



252 

11 

318 

165 

9 

18 

2 

11 



5 
21 
7 
3 
9 
17 
1 
1 

57 
2 

1 



Ratio 

f^ 
1,000 

of 
Force. 



11-4 

2-5 

•6 

90-5 

221 

14-9 

1-7- 

11 



72-4 

31 

91-4 

47-4 

2-5 

5-1 

•5 

3-1 



Invalided. 



1-4 

6- 

2- 

•8 
2-5 
4-8 

•2 

•2 
16-3 
••5 

•2 



Number. 



10 

3 

20 

3 

23 



1 
2 

5 
3 

2 



Ratio 

1^ 
1,000 

of 
Force. 



Dead. 



•8 
21 
1-6 



.2-6 

•8 
6-3 

•8 
01 



•2 
•5 

1-3 
•8 
•5 

•8 



Number. 



Ratio 
per 

1,000 
of 

Force. 



•2 
•2 
•2 
•2 
•2 



1-8 
•2 



1-3 
•5 
•2 



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OT THE CHINA STATION. 



295 



Tablb, No. 1.— Showing the Number of Gases of all Diseases, kc-^continued. 




Cams. 


In?a 


lided. 
Ratio 


Dead. 


DISEASE OR INJURY. 




Ratio 






Ratio 






per 




per 




per 




Noober. 


1,000 

of 
Force. 


Number. 


1,000 

of 
Force. 


Number. 


1,000 

of 
Force. 


lY. Diseases of the Cironlatory 














System: 














Disease of the ( Functional 
Heart -I Organic - 


17 


4-8 


4 


1- 


.— 


— 


S 


•8 


3 


•8 


— 


— 


Anenrism - - - - 


1 


•2 


1 


•2 


1 


•2 


Varicose Veins - - - 


2 


•5 


4 


1- 






V. ft VI. Diseases of the Absorb- 














ent System and Dnetless 
Glands: 














Bubo(/Symp.) - - . 


116 


33-3 

# 


~~~ 


*— 


~ 




yil. Diseases of the Bespiratory 














System: 














Diseases of the Larynx - 


1 


•2 


— 


— 


— 


— 


Catarrh - - - - »• 


844 


98-8 


— 


— 


— 


— 


Hemoptysia - - - - 
Other Diseases of the Lungs - 


6 


1-4 


1 


•2 


1 


•2 


28 


8- 


6 


1-6 


1 


•2 


VllL Diseases of the Digestive 














System: 














Cjnanche - - - - 


87 


26- 


— 


— . 


— 


— 


Diseases of the Mouth, Teeth, 














&c. 


6 


1-4 


— 


— # 


— 


— 


Dyspepsia . - - . 


230 


66- 


7 


1-8 


— 


— 


Dysentery • - • - 


34 


6-8 


6 


1-6 


4 


1- 


Diarrhoea - - . - 


368 


105-7 


9 


2-4 


— 


— 


Colic and Constipation - 


39 


11-2 


— 


— 


— 


— 


HsBinorrhoids - - - 


21 


6- 


1 


•2 


— 


— 


Hernia - - - - - 


6 


1-7 


3 


•8 


— 


— 


Worms - - - - - 


6 


17 


— . 


— 


— 


— 


Other Diseases of the Stomach, 














Intestines, &c. - - - 


8 


2-2 


1 


•2 


3 


•8 


Diseases of the Liver, Spleen, 
&c. 


2? 


6- 


4 


1- 


— 


— 



384. 



A A 2 



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296 



MEDICAL STATISTICAL RETURNS 



Table, No. 1.— Showing the Number of Cases of all Diseases, &c. — continued. 



DISEASE OR INJURY. 



IX. ftX. Diseases of the TTrinary 
and Oenerative Systems : 

Diseases of the Kidneys - 
Gonorrhoea - - - . 
Diseases of the Organs of Ge- 
neration - - - - 
Stricture - - - - 
Orchitis . - - - 

XI. Diseases of the Organs of 
Looomotion: 
Diseases of the Bones, Joints, kc. 



Xn. & XIII. Diseases of the 
Cellular Tissue and Cnta- 
neons System: 

Phlegmon and Abscess - 

Ulcer 

Erythema . - - - 

Diseases of the Skin 

Scabies - - - ^ . 

ITnolassed: 

Debility .... 

Deliriam Tremens - . - 
Poisoning - - - • - 

Wonnds and Iiy nries : 

Wounds, Injuries, &c. - 
Bums and Scalds ... 
Submersion and Drowning 

Totals - - - 



Ctiei. 



Number. 



6 
178 

7 

15 

120 



do 



940 

312 

2 

41 

20 



90 

14 

2 



673 
35 
10 



5,242 



Ratio 

per 
1,000 

of 
Force. 



1-7 
611 

2- 

4-3 

34-4 



8-6 



270-1 

89-6 

•5 

11-7 

6-7 



25-8 
4- 
•5 



193-3 
10- 
2-8 



1,506-3 



Invalided. 



Namber. 



23 
1 
1 



188 



Ratio 
per 

1,000 
of 

Force. 



Dead. 



Number. 



61 
•2 
•2 



1-6 



501 



1 
12 



51 



Ratio 

per 
1,000 

of 
Force. 



•2 
3-2 



13-6 



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OF THE CHINA STATION. 



297 



TlBLE, No. 2. 

Showing the Number of Days' Sickness from each Disbasb and from Injuries, the 
Average Number of Men Sick Daily, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



L Oeneral Diseases, Section A. : 

Small-Pox - - - 

Typhus Fever 

Enteric Fever - 

Simple continued Fever - 

Ague - - - - 

Remittent Fever - 

Mumps - - - - . 

Erysipelas - - - . 



n. Oeneral Diseases, Section B. 

Rheumatism . - - • 

Gout 

f Primary 

"\Secondary - 

Scrofula - - - . 
Phthisis PulmonaUs 

Purpura - - . . 

Dropsy - - - - - 



Syphilis 



in. Diseases of the Vervons 

System, and Organs of 
the Special Senses: 

Apoplexy . . - - 

Sunstroke - - - 

Paralysis . - - - 

Vertigo - - - - - 

Epilepsy - - - - 

Neuralgia - - - - 
Insanity .... 

Hysteria - - - - 
Diseases of the Eye 
Diseases of the Ear 
Diseases of the Nose 

384, 



Number of Days' Sickness 



On Board. 



181 
128 

38 

2,544 

529 

534 

47 



2,385 

71 

6,442 

2,635 

184 

457 

18 

50 



20 

147 

49 

16 

184 

140 

5 

1 

C89 

17 

1 

▲ ▲3 



In Hospital. 



595 
109 
305 
1,535 
246 
240 

18 



1,610 

5,981 

3,158 

102 

893 

46 



38 
328 

15 

48 

107 

101 

4 

268 

22 
6 



Average Number of 
Men Sick Daily. 



Total. 



776 

237 

343 

4,079 

776 

774 

47 

87 



3,996 

71 

12,423 

5,793 

236 

1,350 

13 

96 



20 
185 
377 

31 
232 
256 
106 
5 
957 

39 
7 



Number. 



21 

•6 

•9 

111 

21 

21 

•1 

•2 



10-9 
•1 

34' 

15-8 

•6 

3-6 



•6 
•7 
•2 

2-6 
•1 



Ratio 

per 

1,000 of 

Force. 



•5 
•1 

•2 

2-9 

•5 

•5 



2-9 

9' 

42 
•1 
•9 



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298 



MEDICAL STATISTICAL RETURNS 



Table, No. 2.— Showing the Number of Days' Sickness from each Disease, &c.— conK 











Average Namber of 




Number of Days* SickneM 


Men Sick Daily. 


DISEASE OR INJURY. 


' 








Ratio 




On Board. 


In Hoepital. 


Total. 


Number. 


per 

1,000 of 

Force. 


IV. Diseases of the Circulatory 












System: 


• 










Disease of the f Functional - 
Heart -\Organic 


177 
34 


353 

44 
13 


530 
34 
45 
20 


1*4 
•1 


•3 


Aneurism - - - - 
Varicose Veins - - . 


1 

7 




"~" 


V. & VI. Diseases of the Absorb- 












ent System and Ductless 
Glands: 












Bnho (iS^p,) 


2,095 


595 


3,290 


9- 


2-4 


VII. Diseases of the Bespiratory 
System : 












Diseases of the Larytix - 


37 


15 


52 


•1 


— 


Catarrh 


2,478 


356 


2,834 


7-7 


2- 


Haemoptysis - - - - 
Other Diseasefl of the Lungs - 


25 


72 


97 


•2 


— 


509 


371 


880 


2*4 


•6 


VIII. Diseases of the Digestive 
System: 












Cynanche - . - - 


542 


5 


547 


1-4 


•3 


Diseases of the Mouth, Teeth, 












&c. 


78 


74 


152 


•4 


•1 


Dyspepsia - . - - 


1,699 


186 


1,884 


61 


1-3 


Dysentery - - - - 


375 


273 


648 


1-7 


•4 


Diarrhoea - - - - 


2^4 


1,131 


3,465 


9-4 


2-5 


Colic and Constipation - 


193 


29 


222 


•6 


•1 


Haemorrhoids - - - 


157 


106 


263 


•7 


•1 


Hernia - - - - - 


49 


10 


69 


•1 





Worms - - - - - 


33 


«. 


33 


— . 


_— 


Other Diseases of the Stomach, 












Intestines, &c. ... 


107 


160 


267 


•7 


•1 


Diseases of the Liver, Spleen, 












&c. 


243 


383 


626 


1-7 


■* 



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6^ THE CHIwi STA-tkON. 



299 



Table, No. 2. — Showing the Number of Days' Sickness from each Disease, &c. — cont^. 




Nnmbei- of Days* Sickness 


Average Number of 
Men Sick Daily. 


DISEASE OR INJURY, 










Ratio 




On Board. 


In Hospital. 


Total. 


Namber. 


per 
1,000 of 
Force. 


VLAX. Diseases of the ITrinary 
and Generative Systems : 












Diseases of the Kidneys - 
Gonorrhoea - - - - 
Diseases of the Organs of Ge- 
neration - - - - 
Stricture .... 
Orchitis - - - - 


42 
3,129 

90 

70 

1,644 


23 
364 

288 
196 
549 


65 
3,493 

378 

2G6 

2,193 


•1 
9-5 

1- 

•7 
6- 


2-5 

•2 

•1 

1-6 


XI. Diseases of th^ OrgiLns of 
Locomotion : 












Diseases of the Bones, Joints, 
&c. 


605 


321 


826 


2'i 


•5 


XTT. ft Xnl. Diseases ^f the 
Cellnlar Tisine and Cuta- 
neons System: 


• 










Phl^poion and Abscess - 

Ulcer 

Er^-thema - - - - 

Diseases of the Skin 

Scabies 


7,785 
5,455 

673 
194 


715 
1,891 

88 


i 8,500 

7,346 

7 

761 

194 


23-2 
201 

2- 
•5 


61 
5-3 

•5 
•1 


XTnclassed: 












Debility ... - 
Delirium Tremens - 
Poisoning - - - - 


810 

116 

3 


908 
106 


1,718 

222 
3 


4-7 
•6 


1-2 
•1 


Wonnds and Iiynries : 












Wounds, Injuries, &r. - 
Bums and ocalds - « - 
Submersion and Drowning - 


7,199 

431 

' 8 


1,699 


8,798 

440 

8 


24-1 
1-2 


6-4 
•3 


Totals - - - 


57,469 


27,007 


84,476 


231-4 


^1-7 



384. 



▲ a4 



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300 



MEDICAL. STATISTICAL RETURNS 



tjiXLE, No. 8. - 

Showing the Number Invalidbd from each Ship 



CAUSE OF INVALIDING. 



I. General Diseases, Section A. : 

Ck)ntinued Fever - 
Ague 



Remittent Fever - 



II. General Diseases, Section B. : 
Rheumatism . - - - 



Scrofula 
Phthisis 



III. Diseases of tiie Nervous 
System, and Organs of tiie 
Special Senses: 



Sunstroke 

Paralysis 

Epilepsy 

I^leuralgia 

Insanity 

Diseases of the Eye 



17. Diseases of tiie Circulatory 
System: 
Disease of the r Functional 
Heart -tOiTjanic • 
Aneurism » - . . 
Varicose Veins - - . 



VII. Diseases of the Eespiratory 
System: 
Hsmoptysis - . - . 
Other Diseases of (he Lungs - 



I 

< 



> 
< 



1 



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OP THE CHINA STATION. 



301 



•» Table, No. 8. 
employed on the China Station. 



I 



J 



2 
3 
3 



1 



a 

I 



S 



asi. 



.1 



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303 



MfiDICAL BTAl'lfiXrOAL HETUBNS 



Table, No. 3. — Showing the Number Invalided from each Ship^ &c. — continued. 



CAUSE OF INVALIDING. 



VIII. Diseases of the Digestiye 

System: 
Dyspepsia - - - - 
Dysentery - - - - 
Djarrhoea - *. - - 
Hemorrhoids - - - - 
Hernia - - - - - 
Fistula in Ano ... 
Diseases of the Lirer, Spleen, 

&c 



IX. ft Z. Diseases of the tlrinary 
and OeneratiTe Systems : 

Diseases of the Kidneys - 
Gonorrhoea - - - - 
Stricture .... 
Urinary Abscess - - - 



XI. Diseases of the Origans of 
looomotioii : 

Diseases of the Bones^ Joinis, 
&c. - - - . - 



XII. ft Xltl. Diseases of the Cel- 
lular Tissue and Cntaneons 
System: 

Abscess - - - - - 

Ulcer 

Diseases of the Skin 



I 



Vnolassed: 

Debility - 

Delirium Tremens - 
Poisoning by Lead - 



Wounds and bjnrws : 

Wounds, Injuries, &c. 

Totals 



& 



12 



S 



I 

9 



41 



Digitized by 



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OJP THE CHIKA STATIOIT. 



303 







Table, 


No. 


3.--Showiiig the Number Invalided from each Ship, &C'-contiuued. 






i 


i 


Leven. 
Midge. 




1 


1 
& ' 1 


j 




A 




1 


1 


•5 


J 


1 




1 


1 


1 


^ 


1 
1 

2 

1 
2 

1 


1 
1 


1 


8 

4 

1 
1 

I 

2 

1 

1 


i •* 
1 


1 
~ 
1 


1 
I 
1 

1 " 

■A 

2 

4 
1 




1 

- 


2 

1 

_ 


1 


7 
6 
9 

1 
3 
1 

4 

4 
1 
1 
1 

3 

2 
2 

1 

23 
I 

1 

G 




3 


2 


1 


2 

1 


12 


11 


3 1 28 


3 


9 


34 


r 


5 


4 


18a 



384. 



Digitized by 



Google 



304 



MEDICAL STATISTICAL RETURNS 



TablB; No. 4. 
Showing the Number of Dbathb in each Ship employed on the China Station. 



CAUSE OF DEATH. 


1 

< 


< 


1 




I. General Biseases, Section A. : 

Small Pox - . - . 
Typhus Fever - - - 
Enteric Fever - - - 
Continued Fever - - - 
Intermittent Fever - - . - 
Remittent Fever - - - 

II. General Diseases, Section B. : 

Phthisis 

Purpura - - - - 

III. Diseases of the Hervons 
System and Organs of the 
Special Senses: 

Apoplexy - - - - 

Sunstroke - •. - - 

Paralysis - - - - 

Epilepsy . - . - 

IV. Diseases of the Circulatory 

System: 
Aneurism . - - - 

VII. Diseases of the Eespiratory 
System: 
HfiBmoptysis - - - - 

Pneumonia - - - - 


" 1 
1 


1 


1 

1 


1 

1 
1 

1 


2 
1 


1 
1 


1 

1 

1 
1 

1 
1 


1 


1 
1 


1 


- 


1 
4 

1 


1 



4 

1 
1 
1 
1 
1 



6 
1 



Digitized by 



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OF THE CHINA STATION. 



305 



Tablk, No. 4. -Showing the Number of Deaths in 


each Ship, 


&c.- 


-co 


ntim 


ted. 




CAUSE OF DEATH. 


i 

1 


i 

< 


1 


o 




J 


i 


^ 


1 


II 


j 


, 


J 


1 


Vm. Diseases of the Digestive 
System: 

Dysentery - - - - 
Other Diseases of the Stomach 

Xn. ft XIII. Diseases of the 
Cellular Tissue and Cuta- 
neous System: 

Ulcer 

Vnelassed: 

Alcoholic Poisoning 

Wounds and Injuries : 

Wounds, &c. .... 
Submersion and Drowning - 


1 


1 

> 


1 


3 


2 


- 


1 

1 
2 


- 


- 


3 

1 

1 


1 


1 
2 


1 


4 
3 

1 

1 

1 
12 


• 
Total • - - 


1 


2 


3 


7 


6 


2 


10 


1 


2 


6 


1 


9 


2 


51 



984. 



Digitized by 



Google 



306 



MEDICAL STATI«TIOAIi BETUBNS 



Table, No, d, - 
Showing the Number of Casbs of all Diseases and 



PISEASE OR INJURY. 






i 



I. General Diseases, Section A. : 

Small Pox . - - - 
Typhus Fever ... 
Enteric Fever - - - 
* Simple conthiued Fever 
Ague - . - - - 
Remittent Fever - - - 
Mumps - - 
Erysipelas - - 

II. General Diseases, Section B. : 

Rheumatbm . - - 
Gout 

Scrofula - - - - 
Phthisis Pulmonalis 

Purpura - - - 

Dropsy . . . - 



11 
1 

6 

9 



13 

6 

4 



III. Diseases of the Hervons System and 
Organs of the Special Senses : 
Apoplexy 



Sunstroke - 
Paralysis 
Vertigo 
Epilepsjr 
Neuralgia - 
Insanity 
Hysteria 

Diseases of the Eye 
Diseases of the Ear 
Diseases of the Nose 



3 I 



17. Diseases of the Circulatory Sjrttem: 
Disease of r Functional - - - 
the Heart, \Organic - - - - 

Aneurism ------ 

Varicose Veins - - - - - 



T. ft TI. Diseases of the Absorbent Sys- 
tem and Ductless Glands : 
Bubo (Symp,) - - - - - 



26 
11 



19 

11 
3 



1 
1 
51 



18 

1 



Digitized by 



Google 



W THK emJffA STAWOW. 



SffT 



- Table, No. 6. 
Injubibs k the Ships employed on the China Station. 







































M 


1 


i 


1 


J 


:i 




ll 


1 


1 


^ 


1 


1 


1 


1 


1 




11 


4 




















1 






24 


40 




1 


— 


- 


- 


6 
2 


— 


- 


- 


- 


- 


— 


: 


- 


- 


- 


9 

2 




9 


2 


1 


3 


— 


4 


6 


56 


. 


4 


134 


1 


1 


10 


81 


315 




1 


1 


— 


7 


4 


2 


7 


1 


17 


2 


3 


3 


— 


-, 


7 


77 




— 


_ 


- 


2 


6 


— 




- 


d 


1 


2 


2 


7 


• 


1 


52 
6 




"• 


— 


— 


-~ 


I 


"~ 


- 


"" 


— 


1 


~ 


—' 


"~ 


1 


"~ 


4 




15 


4 




3 


19 


20 


3 


25 


1 


8 


51 


14 


4 


10 


7 


252 




» 


1 


. 


. 


_ 


— 


2 


« 


- 


1 


4 


— 


- 


- 


- 


11 




9 


1 


4 


3 


70 


23 


6 


17 


1 


9 


84 


10 


12 


16 


12 


318 




7 




- 


1 


47 


29 


6 


12 


1 


8 


14 


— 


1 


5 


5 


165 








_ 


«. 


2 


3 


_ 


. 


_ 


_ 


2 


_ 


— 


— 


1 


9 




. 


^ 


« 


— 




— 


- 


3 


mm 


. 


8 


2 


- 


- 


2 


18 




1 


_ 


•. 


_ 




-. 


_ 


. 


— 


_ 


-. 


^ 


^ 


- 


~ 


2 




' 


"~ 


"" 


~' 




" 


~ 


" 


1 


' 


10 










11 






1 


























1 


5 




_ 


_ 


. 


_ 




_ 


!• 


I 


- 


— 


U 


- 


- 


- 


7 


21 




1 


— 


1 


. 




- 


- 


1 


- 


- 


- 


- 


- 


- 


- 


7 






_ 


. 


_ 




— 


» 


— 


- 


~ 


3 


— 


- 


— 


«. 


3 




1 


» 


-. 


„ 




- 


» 


1 


1 


1 


- 


- 


~ 


«. 


- 


9 




4 


- 


" 


"~ 




1 


*" 


1 


: 


1 


1 


- 


- 


1 


1 


17 

1 
1 




- 


- 


- 


- 


• 


8 


3 

1 


2 


1 


3 


13 


1 


2 


6 


1 
1 


57 
2 

1 




1 


- 


- 


- 


I 


1 


- 


1 
3 

1 


1 


1 


1 


- 


- 


- 


4 


17 
3 

1 
2 




8 


1 


3 


1 


7 


6 


3 


6 


- 


5 


30 


4 


2 


4 


10 


116 



384. 



Digitized by 



Google 



308 



MEDICAL STATISTICAL BETUBNS 



Table, No. 5. — Showing the Number of Cages of all Diseases and 



DISEASE OR INJURY. 



Vn. Diseases of the Bespiratory System : 
Diseases of the Larynx - - - 
Catarrli -.--.- 
Ilsimoptysis - - - . - 
Other Diseases of the Lungs 

vlil. Diseases of the Digestive System : 
Cynanche ------ 

Diseases of Mouth, Teeth, &c. 
Dyspepsia ------ 

Dysentery ------ 

Diarrhoea ------ 

Colic and Constipation ... 
Hemorrhoids . . - . . 
Hernia -----. 

Worms -----. 

Other Diseases of Stomach, Intestines, &c. 
Diseases of Liver, Spleen, &c. 

IX. ft X. Diseases of the Urinary and 
Generative Systems : 
Diseases of the Kioney s - - . 
Gonorrhcsa ------ 

Diseases of the Organs of Greneration - 
Stricture -----. 

Orchitis ------ 



10 



XI. Diseases of the Organs of Locomotion : 

Diseases of the Bones, Joints, &c. - 

XII. ft Xni. Diseases of the Cellnlar 

Tissue and Cutaneous Sjrstem : 
Phlegmon and Abscess . . . 

Ulcer 

Erythema ------ 

Diseases of the Skin - - - - 

Scabies ------ 



Vnolassed : 
Debility 

Delirium Tremens 
Poisoning - 






10 



Wounds and Iiynries : 
Wounds, &c. 
Bums and Scalds 
Submersion and Drowning 



Totals - - 



35 16 
3 - 



176 



5 

1 

10 



19 25 
8 24 



113 126 



10 



12 
1 

21 
2 
2 



20 



35 13 
1 



223 



1 
3 



31 
3 



16 



12 
3 



108 



i 



1 
11 

4 
1 



40 



14 



165 112 



I 



11 
3 



56 



Digitized by 



Google 



OF THE CHINA STATION. 



309 





Inji 


iries in the Ships employed on 


the China 


Station — contintied. 










i 

8 

1-^ 


J 


1 


1 


1 


1 


£ 


II 


1 


1 


PS 


.s 


1 

CO 


i 


^ 


1 




22 


5 


- 


1 


67 


38 


6 


19 


- 


4 


95 


10 


4 


14 


6 


I 
344 




— 


— 


— 


— 


1 


. 


. 


— 


1 


1 


. 


_ 


». 


_ 


. 


5 




2 


- 


— 


1 


1 


2 


2 


2 




5 


7 


- 


- 


1 


3 


28 




4 


_ 


. 


2 


8 


7 


3 


7 


_ 


14 


18 


3 


1 


_ 


7 


87 




« 


■- 


*• 


«- 


2 


» 


* 


. 


1 


*. 


wm 


_ 


_- 


_ 


. 


5 




10 


8 


• 


3 


47 


1 


3 


21 


2 


14 


42 


11 


5 


4 


6 


230 




- 


- 


- 


- 


1 


~ 


7 


1 


- 


- 


1 




— 


2 


- 


24 




6 


5 


- 


13 


23 


8 


17 


50 


1 


16 


95 


14 


3 


12 


15 


368 




* 


— 


— 


1 


- 


6 


3 


4 


5 


6 


7 


1 


_ 


_ 


1 


39 




1 


- 


- 


- 


2 


3 


- 


- 


- 


1 


4 


4 


1 


- 


1 


21 




— 


— 


— 


- 


1 


- 


— 


— 


— 


— 


3 


— 


— 


— 


— 


6 




— 


~ 


— 


— 


•» 


. 


. 


1 


- 


- 


2 


_ 


« 


_ 


_ 


a 




1 


- 


- 


- 


1 


. 


. 


1 


. 


- 


I 


_ 


. 


1 


2 


8 




"" 


"* 


*" 


"" 


2 


1 


1 


4 


•~ 


"* 


5 


— 


"■ 


5 


■• 


21 












1 


1 




1 






1 






1 




6 




10 


3 


1 


2 


11 


7 


3 


12 


3 


36 


20 


15 


5 


12 


9 


178 




« 


— 


a. 


«. 


2 


_ 


~~ 


4 


— 


— 


— 


. 


^ 


_ 


— 


7 




. 


1 


— 


— 


1 


1 


2 


- 


- 


- 


7 


« 


1 


1 


- 


15 




4 


2 


3 


1 


19 


5 


2 


6 


2 


3 


22 


6 


2 


7 


9 

* 


120 




1 


2 


- 


1 


6 


2 


- 


- 


- 


6 


5 


- 


- 


1 


- 


30 




34 


5 







116 


51 


38 


59 


3 


34 


319 


16 


27 


38 


15 


910 




6 


3 


2 


4 


82 


3 


10 


22 


7 


25 

1 


79 

1 


8 


8 


3 


2 


312 
2 




2 


. 


«. 


^ 


. 4 


. 


1 


4 


1 


6 


10 


„ 


_ 


- 


. 


41 






- 


- 


- 


3 


1 


-- 


5 


— 


- 


3 


- 


- 


2 


- 


20 




4 


1 




6 


8 


3 


2 


14 


^^ 


_ 




3 


_ 


4 


4 


90 




« 


. 


«. 


_ 


2 


1 


. 


2 


~* 


— 


8 


_ 


— 


— 


. 


14 




- 


- 


- 


- 


(a)l 


- 


- 


— 




- 


ib)l 


- 


- 


— 


- 


2 




22 


6 


2 


3 


122 


39 


20 


28 


6 


41 


179 


10 


14 


16 


16 


673 






2 


«. 


. 


6 


- 


2 


3 


4 


— 


8 


_ 


- 


1 


- 


35 




2 


- 


- 


- 


2 


- 


— 


- 


1 


1 


3 


- 


- 


— 


1 


10 




200 


53 


17 


63 


721 


272 158 

1 


398 


69 


258 


1,323 


139 


100 


178 


212 


5,242 



(a) Alcohol. 



384. 



Bb 



(fi) Lead. 



Digitized by 



Google 



310 



MEDICAL STATISTICAL BETUBK8 



Tablb, No. 6. 



Showiwq the Names of the Ships; the Average Complements, &c. j the Number of 

Men Sick Dailj, in each Ship ; 



P. o. Paid off. 



Rate^&e. 


NAMES 

of 
SHIPS. 


Where 
Commissioned. 


When 


Number 

of 
Guns. 


Tonnage. 


Herte 
Power. 




Iron Clad - - 


Ocean - 


a • • 


Devonport - 


80 July 1866 


24 


4,047 


& 1,000 




Second lUie 


Rodney - 


- 


SbeemeM - 


21 Jan. 1867 


72 


2,770 


S. 000 




Sixtli Rate - 


Pearl - 


- 


Portsmouth 


5 Biay 1866 


17 


1,469 


S. 400 




Sloop - . 


Argue - 


. 


Hong Kong 


23 Jan. 1866 


6 


981 


P. 300 






Icarus - 


- 


Sheemeas - 


28 Feb. 1866 


3 


680 


a 160 






Perseus - 


- 


Hong Kong 


23 Jan. 1866 


16 


956 


S. 200 






Rinaldo - 


. 


Portsmouth 


1 Nov. 1866 


7 


961 


S. 200 






Zebra - 


" 


Woolwich - 


13 Feb. 1867 


7 


961 


& 200 




Gun Ve»el - - 


Algerioe. 


• . . 


Hong Kong 


IJuly 1868 


3 


299 


S. 80 






Aton 


- 


Portsmonth 


21 April 1868 


4 


467 


8.S.120 






Cormorant 


. 


Hong Kong 


23 Jan. 1866 


4 


695 


S. 200 






Dwarf - 


- 


Woolwich . 


18 April 1868 


4 


465 


S.S. 120 






Elk 


— • « 


Portsmonth 


5 Dec. 1868 


4 


465 


S.S. 120 






Hornet - 


- 


Portsmouth 


9 Dec. 1868 


4 


464 


S.S. 120 






I even - 


- D. 


Ilong Kong 


25 May 1867 


3 


300 


8. 80 






Midgo - 


- 




19 Feb. 1869 


4 


464 


S.S. 120 






Slaney - 


• •• • 


Hong Kung 


1 July 1868 


3 


801 


8. 80 




Steam Vewel 


Manilla - 


- -P.O. 


Shanghai • 


1 Feb. 1866 


_ 


296 


S. 70 






Salamis - 


• 


Portsmouth 


1 Jan. 1866 


2 


835 


P. 260 




Sarrcyiog Veewl - 


Rifleman 


- . P. 0. 


Hong Kong 


31 March 1866 


4 


486 


S. 100 






Sylria - 


- D. 


Woolwich - 


12 Oct 1866 


5 


696 


S. 160 




Troop Ship • 


Adventure 


- - - 


Hong Kong 


28 May 1867 


2 


1,704 


S. 400 




Reeeiviog Sbip • 


Priocesi Charlotte - 


Hong Kong 


1 Jan. 1866 


12 


2,443 


- 





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OP THE CHINA STATION. 



311 



Tablb^ No. 6. 



Cases; the Total Number of Days' Sickness on Board j the Average Number of 
and the Number Discharged to Hospital. 



D. Retoms defective. 





Period. 


Average 
Com- 
plements. 


Average 
Com- 
plements 
corrected 
for Time. 


Number of 
Cases of 

Disease and 
Injury. 


Number of 

Days* 

Sickness on 

Board. 


Aveiage 

Number of Men 

Sick Daily for 

Twelve 

Months. 


Ratio per 
1,000 of 
Average 
Force of 

each Ship. 


Number 
Diwsharged 

to 
Hospital. 




Year 


660 


660 


721 


10,595 


29- 


43*9 


73 




Year - - 


765 


765 


1,323 


14,368 


39-3 


51-3 


88 




Year - - 


275 


275 


272 


2,624 


71 


25-8 


40 




1 Jan. to 30 Jnne 


160 


80 


126 


970 


2-6 


32-5 


15 




Year 


130 


130 


200 


2,428 


6-6 


50-7 


28 




1 Jan. to 30 June 


185 


90 


158 


1,439 


3-9 


43-3 


9 




Year 


180 


180 


258 


3,849 


10*6 


58*3 


12 




Year 


200 


200 


212 


2,203 • 


6' 


30- 


57 




Year - . 


50 


50 


113 


1,203 


3-2 


64* 


14 




Year 


65 


65 


223 


2,036 


5-5 


84-6 


28 




Year 


90 


90 


108 


885 


2«4 


26-6 


15 




Year - - 


70 


70 


165 


1,318 


3-6 


61-4 


6 




20 April to 31 Dec. 


70 


45 


112 


1,026 


2-8 


62-2 


- 




1 July to 31 Dec. 


76 


35 


58 


649 


1-7 


48*5 


6 




Year 


50 


45 


53 


636 


1-4 


31-1 


7 




1 Oct. to 31 Deo. 


80 


20 


63 


267 


•7 


36- 


15 




Year 


50 


50 


100 


1,425 


39 


78- 


4 




1 Jan. to 15 June 


50 


25 


17 


315 


•8 


32* 


4 




Year - - 


80 


80 


139 


1,576 


4-3 


53-7 


22 




1 Jan. to 24 Aug. 


90 


60 


G9 


664 


1-8 


30- 


14 




Year 


110 


100 


178 


2,562 


7- 


70- 


23 




Year 


145 


145 


176 


1,745 


4-7 


32*4 


16 




Year 


220 


220 


398 


3,107 


8-5 


38*6 


42 



384. 



BB 2 



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312 MEDICAL STATISTICAL EETUENS 



AUSTRALIAN STATION. 



AuBtralian Xhe squadron on this station during the year 1869 comprised 
Station. four vessels, viz., two of the sixth rate, and two sloops. The returns 
from each of the vessels were for the whole year. The mean force, 
corrected for time, was 760, and the total number of cases of disease 
and injury entered on the sick-list 1,425, which is in the ratio of 
1875- per 1,000 offeree, being an increase, compared with the pre- 
ceding year, equal to 291*8 per 1,000. Of these, twenty-five were 
invalided and seven proved fatal, the ratio of the former being 32*8 
and the latter 9*2 per 1,000. Compared with the previous year 
there was an increase in the invaliding rate to the extent of 2*4 per 
1,000, but there was a reduction in the ratio of mortality equal to 
•4 per 1,000. 

The average daily loss of service from General Diseases, Section 
A., was in the ratio of 1* per 1,000, and from Section B. 7*8. From 
diseases of the nervous system and organs of the special senses, the 
average daily sick-rate was 2'5 ; from diseases of the circulatory 
system, '1 ; of tfie absorbent system and ductless glands, '1 ; of the 
respiratory system, 4*3 ; of the digestive system, 4*5 ; of the urinary 
and generative systems, 2*2 ; of the cellular tissue and cutaneous 
sysfem, 14'6 ; from unclassed diseases, I'l ; and from wounds and 
injuries of various kinds, 13*4. The average number of men sick 
daily was 42'5, which is in the ratio of 55*9 per 1,000, being an in- 
crease, compared with the previous year, equal to 4*3 i)er 1,000. 

I. General Diseases.— Section A., or Febrile Oroup. 

jj*^ ^' Under this head thirty-four cases of various forms of disease were 

^•^'^* entered on the sick-list, viz., six of enteric fever; twelve of simple 
continued fever ; four of ague ; eleven of remittent fever; and one 
case of erysipelas ; and of these one case of enteric fever proved fatal. 
The average duration of each case of enteric fever, on board ship 
and in hospital, was about nine days, so that, with one exception, 
they cannot have been of great severity ; of each case of continued 
fever a little over eleven days ; of eacn case of ague a little over 
four days : of each case of remittent fever about eighteen days ; 
and the case of erysipelas was thirty-one days under treatment. 

Enteric Fever. — In the Blanche there were four cases of this 
form of fever, all apparently exceedingly mild. The surgeon* says, 
^^ "The 

* Sqi^geon Gerald Molloy. 

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OF THE AUSTRALIAN STATION, 313 

" The four cases of this disease occuiTed at WeUington soon after AuBtralian 
our arrival from Sydney, on the Ist of October. Only one was of Station, 
any importance, having rose-coloured spots and a tendency to 
diarrhoea. The other three cases occurred at the same time and pre- ^^ ^' 
sented the same symptoms, viz., vomiting, purging, and a loaded °®^*' ^' 
tongue, but an emetic given at once seemed to check its further 
progress. I have no doubt these cases were caused by the use of 
impure water, which at that time was obtained from a stream that 
runs at the back of the town, in which people bathe and wash 
clothes, and into which drains open. Latterly the supply has been 
obtained from the Government tank, which is supplied by a stream 
running direct into it from the hills. Since then there has not been 
another case.'' 

There were two cases of enteric fever in the Rosario, but the 
returns from this ship are so defective, that but little information is 
to be obtained in connection with them. One of them proved fatal, 
and in that instance the man was placed on the sick-list on the 10th 
of August complaining of headache and loss of appetite. The skin 
was hot and dry, and the tongue furred. These symptoms increased 
until the 25th, when partial delirium set in ; the skin became mottled, 
the tongue red at the edges, there was tenderness of the abdomen, 
diarrhcea, and all the symptoms of enteric fever. In this condition 
he was discharged to the Military Hospital at Sydnev, where he 
died on the 29th, the nineteenth day after seizure. Enteric fever 
was prevalent in Sydney at the time, owing, it is said, to the con- 
tinued drv weather and consequent want of water to flush the 
sewers, which were very offensive. 

Simple Continued Fever, — Of this form of fever twelve cases were 
entered on the sick-list, eleven of which occurred in the Blanche and 
one in the Virago. No information is given in connection with the 
cases occurring m the Blanche, but they appear to have been mild ; 
Ae case in the Virago was only of one aay's duration. 

Remittent Fever. — Eleven cases of remittent fever occurred in 
the squadron during the year, all of them in the Virago. The sur- 
geon* of the vessel makes the following observations m connection 
with them : "In making a few remarks on the occurrence of 
diseases met with and treated during the year, the febrile class 
stand in the first rank of importance, and deserve the first attention. 
We may dismiss the single case of simple continued fever, and an 
old case of ague, and remark only on the remittent, malarial type 
of fever. During the latter part of 1868 the malady had shown 
itself among the crew, and six men had been attacked on the voyage 
north to llew Guinea, and the return voyage through the same 
seas was productive of a greater amount. It was singular that in 
the first voyage made by the ship through the same parts of the 
Coral Sea, — ^inside the Great Barrier reef, and along the coast of 

the 



* Surgeon Alexander Oroebie, m.d. 
384. B B 3 



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314 MEDICAL STATISTICAL RETUBNS 

AaBiralian the mainland as far as Cape York, in the end of 1867 and beginning 
Station. of 1868, during the same season and exposed to the same external 
— conditions, only a single case of remittent fever should have occurred. 
uT A I^ossibly the fine robust health of a crew recently arrived from 
Boot A. England withstood the malarial poison,, or the season may have 
been an anti-febrile one. For here, as in all malarious localities, 
where endemic fevers are engendered, the production and concen- 
tration of miasmata may vary from year to year, depending upon 
conditions but little understood, but apparent in their effects to all. 
The wide-spread disease of one year may be followed by the entire 
exemption of the one following. That this coast has been generally 
considered free from malaria, and held to be very healthy, may per- 
haps be owing to the circumstance last noted — may have been visited 
in a non-malarious season or year. Our experience contradicts the 
assertion that it is a healthy coast, and proves indubitably by facts, 
that unhealthy seasons occur here, as in all places within or near 
the tropics where the conditions exist for the production of malarin. 
Surely where there are large tracts of mangrove swamps, long 
reaches of low wooded land, miles of sandy grass-covered coast, 
high wooded hills and ridges, with narrow close ravines and low 
valleys, with rivers all but swamps or waterholes for six months of 
the year, all sweltering under a not sun, with abundance of decRV* 
ing vegetation everywhere, and when the tides retire to leave the 
muddy shores fermenting in the heat; where all these various 
tracts are exposed for nearly four months of the year to frequent 
rains — these conditions must produce malaria — have produced it at 
all times, and will continue to produce it, for all the necessaries are 
here, and the laws of Nature are immutable. There can be no 
denial, however, of the small production of malaria in proportion to 
the conditions capable of generating it Nowhere in the world are 
these conditions so abundant, and yet there can be seen in Northern 
Queensland, towns placed in localities which in the West Indies 
would be utterly uninhabitable by white men. No attention seems 
to have been given to the sanitary conditions of the locality where 
they were founded, and large swamps seem to have attracted the 
first settlers. Of these, fort Denison, Cardwell, and Gladstone 
are well-known instances, and yet I am not aware that they suffer 
from remittent fevers to any great extent, though I have learned that 
a season seldom passes without a few cases of what the natives call 
* low fever ' being met with. The climate also of Cape York has 
been lately extolled by some who have resided there for a time, but 
the experience gained in this ship is the adverse of considering it a 
healthy place, at least in the season (hot, rainy), in which for two 
successive years it was visited. The inconveniences of the first 
visit can well be recalled, and the great trials we all underwent in 
the second, are looked back on with disgust by all. Among the 
white troopers there was not to be found a single man in good 
or even passable health who had resided for any length of time in 
the township of Somerset. AH were anaemic, debilitated, and in- 
capable of hard day's work, and several showed a scorbutic tendency. 
It is true that the stay of the ship either time was comparatively 
short, but there is the strongest conviction that we would have suf- 
fered 



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OP THE AUSTRALIAN STATION. 315 

fered severely had tbe period been lengthened. It must be taken into Anstralian 
account, too, that we were exceptionally placed. The anchorage was Station, 
within 300 yards of the shore, in the pass between the Island of Albany 
and Somerset, and was protected iii a measure from the prevailing ^^^ ^' 
breeze ; the N. W. monsoon and the rainy season had just begun ; ^^^ ^' 
the temperature ranged from 88** to 90® Fahr. in the shade, and the 
frequent rains necessitated the sloping of the awnings, rendering 
the air below decks very hot and oppi*essive. Such an unhappy 
combination of circumstances told sneedily on the health of the 
crew ; debilitv was apparent in all who came under medical treat- 
ment, and although the crew had previously been receding from the 
healthy standard, here they rapidly deteriorated. I have never 
seen men so reduced in outward condition, in so short a time, for 
they seemed to melt away during the twenty-six days of our stay ; 
directly we left, improvement quickly ensued. 

" The tendency to disease of a periodic type continued for some 
time after the arrival of the vessel in New Zealand, induced or 
augmented by her stay at Oladstone ; here she remained for two 
days (from the 12th to the 14th of April), while coaling in a creek 
bounded extensively by mangrove swamps, which the recession of 
the tide left dry and exposed. This exposure was followed by three 
cases of fever, one of dysentery, and two of diarrhoea, all showing 
periodic tendency. 

" The number of remittent fever cases amounted to eleven ; they 
were all of a mild type, generally well marked, and showing distinct 
remissions ; some were ill defined, and irregular in the symptoms ; 
and one was lengthened, almost continuous. Seizure was often 
acute, and remission usually took place in the early morning, and 
continued till late in the afternoon, when the daily exacerbation 
began, and extended till morning. In a few however there were 
two exacerbations, one in the morning, the other in the evening, and 
in a case or two, scarcely discernible alterations in these respects. 
Indeed, it was sometimes difficult to discriminate between the ill- 
marked forms of fever and the cases of debility and dyspepsia 
which occurred at the same time. These cases of fever diffcrea in 
no rpspect from those met with, and so frequent in malarious 
countries in various parts of the world. Quinine was the remedy 
used ; usually in large doses, of from ten to fifteen grains, and 
repeated once or twice during the remission. This quick^ mitigated 
the exacerbation, and sometimes cut the disease short after the first 
or second day. Cinchonism was kept up by diminished doses for 
three or four days, and then discontinued to allow of the advance of 
convi^escence.** 

IL Gtoneral Diseases.— Section B., or Constitutional Group. 

Under this head 104 cases of various forms of disease were entered Class 11. 
on the sick-list, of which, ten were invalided and one proved fatal. Scot. B. 
Almost all the invaliding was occasioned by rheumatism and 
pulmonary consumption. 

Ah$umaiism. — Of this disease there were sixty-five cases, which- 
is in ike ratio of 85*5 per 1,000 of force, being a reduction, compared 
384. B B 4 with 



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316 MEDICAL STATISTICAL BETUEN8 

Ansfcraliiiii with the previous year, equal to 24*9 per 1,000. The average 

Station. duration of each case was a little over fifteen days. Five persons 

^ Zj were invalided for it, but the returns from the station give very 

g^ J little information connected with the disease, 

St/philis, Primary and Secondaiy. — Fourteen cases of primary 
svphilis and fifteen of secondary syphilis were under treatment during 
the year, the average duration of each case of the former disease 
being about twenty-six days, and of the latter, twenty-seven days. 

There was not a case of either form of syphilitic disease in the 
Blanche during the year. 

In the Challenger there were eight cases of primary and four of 
secondary syphilis. Most of this disease was contracted at Mel- 
bourne during the Lady quarter of the year. The staff surgeon* 
observes : *' The number of cases added to the sick-list, as well as 
the days' sickness, is considerably in excess of that of the previous 
quarter. This circumstance is mainly owing to the very severe 
form of venereal complaints contracted during our short stav at 
Melbourne in the latter end of the month of December 1868. These 
syphilitic complaints were more severe in character than any I have 
previously witnessed on the Australian Station, in several instances 
being followed by buboes and very obstinate and protracted 
secondary symptoms. On our arrival at Wellington, one of the 
venereal patients was so seriouslv ill that it was deemed necessary 
to send him on shore to the Civil Hospital, where he remained till 
the 13th of March, when he rejoined the ship. His health had 
improved greatly, but it was necessary to continue him on the sick- 
list for some time." 

There were two cases of primary and one of secondary syphilis 
in the Kosario. The former disease was contracted at Sydney, and 
the latter was a sequela of (me of the cases. 

In the Virago thera were four cases of primary and ten of 
secondary syphdis. The surgeon observes : *^ Primary syphilis was 
met with four times, in three of which the ulcer was diagnosed at 
the time, or subsequently, as belonging to the infecting (hard, non- 
suppurating), and one to the soft suppurating variety. The three 
former were followed by constitutional symptoms. Of the ten cases 
of secondary syphilis, three presented no history or trace of primary 
disease, five followed primary at various intervals, and two consisted 
of relapsing symptoms, which had appeared at various times ; for a 
period of three years in one ; and two or three times within three 
months in the other. Six presented condylomata, anal or scrotal, 
with induration of the inguinal and cervical glands, and with scaly 
psoriatic eruptions ; one, falling-off of the hair, with discoloration 
of the integument ; one, iritis ; one, psoriaris guttata ; and one an 
eruption oi lichen. The period occupied in the treatment varied 
from a fortnight to two months on the sick-list, though it was con- 
tinued as long as the eruption remained, when the patient was 

discharged 



Staflf Surgeon Alex. Watson, m.d. 



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OP THE AUSTRALIAN STATION, 317 

discharged from the list to light duty ; as long, sometimes, as four Auatralian 
months. The bichloride of mercury was the remedy employed, in Statiou. 
doses of an eighth or a sixth of a grain, twice and then thrice a day, (Jiags II. 
in solution, and in no case was ptyalism induced, though digestive Sect B. 
disorder sometimes followed. Improvement slowly but surely took 
place, and the cachectic appearance of constitutional syphilis was 
slowly displaced by a better and healthier, though paler hue. Iodide 
of potassium, with carbonate of ammonia and tartarised iron, occa- 
sionally displaced, and always succeeded the mercurial, with great 
and abiding benefit." 

m. Diseases of the Nervous System and Qi^ans of the 
Special Senses. 

Forty-two^ cases of various forms of disease appear under this Class III. 
head, of which six were invalided and two proved fatal. Of the 
fatal cases, one was the result of apoplexy, the other of paralysis. 

Apoplexy. — The only case of apoplexy in the squadron occurred 
in the person of a stoker of the Challenger, and proved fatal. An 
epitome of its history is thus given by me surgeon* of the vessel: 
*^ A case of apoplexy in a stoker occurred during this visit to 
Sydney (13th December 1869). He had been to the " Head" at 
2h. p. m*, the sun at the time being very hot ; he was ordered to leave 
it, by the officer of the watch. Ho did not move for some time, and 
when he did was unable to adjust his clothes. He had been on the 
sick-list frequently in this ship, suffering from syphilitic nodes and 
irregularity of the bowels. He had a famting fit when taken to the 
sick bay. His face was pale ; pulse slow, but full ; when he came 
to, he complained of pain in the head and cervical vertebrae. He 
expressed himself as much better after this, but on the morning of 
the 15th of December, suddenly hb breathing was heard to become 
stertorous (he had been talking to his attendant an hour before\ 
and he was found to be totally insensible. Toward the close of life 
(he never rallied nor became conscious) his breathing became ob- 
structed with mucus, and he moaned frequently. The pulse rose to 
112. A post-mortem examination of the body showed rupture of 
the basilar artery, with effusion of blood on the pons varolii and base 
of the cerebellum, a clot resting on about the origin of the ninth pair 
of nerves. There was a small clot in the tube of the basilar artery, 
in front of the rupture, of a pale yellow colour, which seemed to be 
fi brine; but the artery was thin in its walls, and it (the clot) seemed a 
portion of the wall of the arterj^ that had been, as it were, doubled 
back on itself, and then coated with fibrinous deposit from the blood." 

Diseaies of the Eye. — ^Eleven cases of affections of the eyes were 
under treatment ; four in the Blanche, and seven in the Virago. Of 
those in the Blanche, three were cases of simple ophthalmia ; the 
fourth, a case of choroiditis. Of the cases in the Y irago, the sur- 
geon 



* Surgeon Daniel flnucane, m.d. 
384. 



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318 



MEDICAL STATISTICAL BETUBNS 



Australian g^on obseiTes : " The ophthalmic cases were, with perhaDs one ex- 
Station, ception, referable to inflammation of the conjunctiva, ana occurred 
in the month of March, at Port Denison, in Queensland, where the 

Class III. ship remained from the 11th of February to the 17th of March, and 
where leave was given. The disease was endemic there at the time. 
It is usually called " the sandy blight" by the people, and prevails 
during the hottest time of tlie year ; and also, as far as I have 
observed, chooses weak antemic subjects, much below the standard 
of health. With us the disorder was slight, and never proceeded 
beyond the catarrhal stage, never became purulent. A strong solu- 
tion of alum was found to be the best local collyrium." 



IV. Diseases of the Circulatory System. 

Class IV. Under this head there were only three cases of functional derange- 
ment of the heart. They were of no consequence. The average 
duration of each case was fifteen days. 

V. and VI. Diseases of the Absorbent System and 
Ductless Olands. 



Classes 
V. and VI. 



Class VII. 



This group was only represented by three cases of sympathetic 
bubo. The average duration of each case was a little over sixteen 
days. 

Vn. Diseases of the Bespiratory System. 

One hundred and ninety-nine cases of various forms of disease 
were entered on the sick-list under this head, 187 of which were 
examples of ordinary catarrh. The average duration of each case of 
catarrh was between five and six days. Apart from the number 
of days the men were incapacitated for duty, the loss to the service 
from these affections was limited to the invaliding of one man for 
asthma. 



Vni. Diseases of the Digestive System. 

Class Vin. Under this head 256 cases of disease were entered on the sick-list, 
of which two were invalided. Of the total number, 144 were cases 
of diarrhoea of greater or less severity. They appear, however, to 
have been of trifling importance, as the medical officers make little 
or no allusion to them ; and the average duration of each case was only 
three or four days. In the Blanche, in which there were twenty 
cases, the majority ef them occurred in the beginning of October, 
when the vessel was lyinc in Wellington Harbour, and they were 
supposed to be owing to the use of impure drinking water. 

The other diseases which appear in this class do not call for any 
comments. 



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OF THB AUSTBALIAK STATION, 



319 



DL and X. Diseases of the Urinary and Generative Systems, station. 

Forty-four cases of various forms of disease appear under this Classes IX. 
head, of which thirty-four were cases of gonorrhoea. Each case of ^^^ ^* 
this disease averaged twelve davs on the sick-list. No loss of service 
by invaliding or death occurred from this class of diseases. 

All the cases of orchitis were of that form designated epididymitis, 
being the result of gOKorrhoeal irritation. 



XI. Diseases of the Qi^ans of Locomotion. 

Only one case appears on Table I. under this head ; but two are 
returned as invalided. The apparent discrepancy arises from one 
of the men having been entered on the sick-list under a different 
heading. The case referred to above was one of synovitis of the 
riffht knee*joint, occurring in a Marine who had been injured by 
falling from a height of eight or nine feet, while cleaning a window 
in barracks. He was repeatedly under treatment for chronic swelling 
and effusion into the joint, and, as it became apparent that he would 
never be fit for the active duties of the corps to which he belonged, 
he was brought before a board of surveymg officers and invalided 
from the service. 



Class XI. 



and XIII. 



Xn. and Xin. Diseases of the Cellular Tissue and 
Cutaneous System. 

Three hundred and forty-eight cases were entered on the sick-list ^^;^4m^* 
under this head, of which 341 were cases of phlegmon and abscess, 
and ulcer. One case of ulcer was invalidea. The subject of it, a 
seaman of tbe Rosario, had for nearly a year been under observa- 
tion and treatment for varicose ulceration of the extremities, which 
had resisted every effort to effect its cure. That was indeed the 
only case of any importance in this class of diseases. Each case of 
phlegmon and abscess was, on an average, between eight and nine 
days under treatment; and each case of ulcer rather over eighteen 
days. 

XJnclassed Diseases. 

Only ten cases appear under this head, of which two of debility 
were invalided. 

Delirium Tremens. — Of the two cases of this disease entered on 
the sick-list, one occurred in a leading seaman, the other in an able 
seaman. 

Poisoning. — One case of alcoholic poisoning occurred in the person 
of a seaman of the Challenger. It was of a mild character. 



384. 



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320 MEDICAL STATISTICAL RETUEKS 

AuBtraiiftn Wouiids and Injuries. 

Station. ^ 

With the exception of two cases of drowning and one of suicide, 

there were no fatal casualties during the year. The man who com - 
mitted suicide jiunped overboard and was drowned ; and of the 
other two cases, one was found drowned and the other fell overboard. 
The total number of deaths in the force was seven, which is in the 
ratio of 9*2 per 1,000, being a reduction, compared with the pre- 
ceding year, equal to '4 per 1,000. 

Invalided. 

From General Diseases, Section B., ten persons were invalided ; 
viz., five for rheumatism ; one for scrofula ; and one for phthisis pul- 
monalis ; six for disease of the nervous system and organs of the 
special senses ; one for diseases of the respiratory system ; two for 
diseases of the digestive system ; two for diseases of the organs of 
locomotion ; one lor diseases of the cellular tissue and cutaneous 
system ; two for unclassed diseases ; and one for wounds and injuries. 
The total number invalided was twenty-five, which is in the ratio of 
32*8 per 1,000, being an increase, compared with the preceding 
year, equal to 2*4 per 1,000. 



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OP THE AUSTRALIAN STATION. 



321 



Table^ No. 1. 

Showing the Number of Cases of all Diseases and InjurieS| and the Number Invalided 
and Dead, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



L Cteneral Diseases, Section A. : 

Enteric Fever 
Simple Continued Fever 
Ague - - - - 
Ilemittent Fever - 
Erysipelas - - - 



II. General Diseases, Section B* : 

Rheumatissi - - - - 
Gout 

Tumour, Cystic - - - 
Scrofula - . - - 
Phthisis Pulmooalis 



Ctiet. 



Nomber. 



IIL Diseases of tiie Hervoos Sys- 
tem and Organs of the 
Special Senses : 

Apoplexy - - - - 

Sunstroke - , - - 

Paralysis . . - - 

Vertigo - - - - - 

Epilepsy , . . - 

Neuiiilgia - - - - 

Insanity . . _ - 
Diseases of the Eye 

Diaeuses of the Ear - - - 



lY. Diseases of the Circnlatory 
System: 

Disease of the 
Heart 

384. 



^^JFuncUonal - 



6 
12 

4 
11 

1 



65 
1 

14 

15 

1 

2 

6 



1 

10 

2 
6 
4 
3 
11 
6 



Ratio 
per 

1,000 
of 

Force. 



7-8 
157 

5-2 
14*4 

1-3 



85-5 
1-3 
18*4 
197 
18 
2-6 
7-8 



Invmlided. 



1-3 
131 

2-6 
7-8 
5-2 
39 
14*4 
6-5 



3-9 



Number. 



1 

4 



Rmtio 
per 

1,000 
of 

Force. 



Dewl. 



Number. 



6-5 



1-3 
5-2 



R«tb 

per 

1,000 

of 
Force. 



1-3 



1-3 



1-3 
2-6 
1-3 
1-3- 
1-3 



13 
1-3 



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322 



MEDICAL STATISTICAL BBTtTRKS 



Table, No. 1. — Showing the Number of Cases of all Diseases, &c. — continued. 




Cases. 


Invalided. 


Dead. 


DISEASE OR INJURY. 




Ratio 
per 




Ratio 
per 




Ratio 
per 




Number. 


1,000 

of 
Force. 


Nvmber. 


1,000 

of 
Force. 


Number. 


1,000 

of 
Force. 


V. ft VI. Diseases of the Absorb- 
ent System and Ductless 
Glands: 














Bubo (i^^mp.) 


3 


30 


• — 


~~" 




■ 


Vii. Diseases of the Bespiratory 
System: 














Catarrh 

Hasmoptysis - - - - 
Asthma - - - - - 
Other Diseases of the Lungs - 


107 
1 
3 
8 


246- 
1-3 
3-9 
10-6 


1 


1-3 


— 


— 


YIIL Diseases of the Digestive 
System: 














Cynanche - - - - 
Dyspepsia - - - - 
Dysentery - - . - 
Diarrhoea - - . - 
Colic and Constipation - 
Haemorrhoids * - - - 

Hernia 

Other Diseases of the Stomach, 
Intestines, &c. - 


62 

65 

3 

114 

23 

3 

1 

6 


68-4 

72-3 

3D 

160- 

CO-2 

3-9 

1-3 

6-6 


1 

1 


1-3 

1-3 


— 


i 


IX. ftX. Diseases of the Urinary 
and Oeneratiye Systems : 














Disease of the Kidneys - 
Diseases of the Bladder - 
Oonorrhcoa - - - - 
Stricture - - . . 
Orchitis - - . - 


1 
3 

34 
2 

14 


1-3 
3-9 

44-7 
2-6 

18-4 


— 


— 


— 


— 


XI. Diseases of the Organs of 
Locomotion : 














DiseMes of tlie Bones, Joints, 
&c. - - - - - 


1 


1-3 


2 


2-6 


— 


— 



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OP THE AUSTBAIilAN STATION. 



323 



Table, No. 1.— Showing the Number of Cases of all Diseases, &c. 


— continued. 




Cues. 


Invalided. 


Dead. 


DISEASE OR INJURY. 


Number. 


Ratio 
per 

1,000 
of 

Force 


Number. 


Ratio 
per 
1,000 

of 
Force. 


Number. 


Ratio 

P« 
l/WO 

of 
Force. 


Xir. ft XIII. Diseases of fhe 
CeUular Tissue and Cuta- 
neous System: 














Phlegmon and Abscess - 


231 


3030 


— 


— 


— 


— 


Ulcer 


110 


1447 


1 


1-3 


— 


— 


Erythema .... 


3 


3-9 


— 


— 


— 


— 


Diseases of the Skhi 


4 


5-2 


— 


— 


— 


— 


ITnclassed: 














Debility .... 


7 


»-2 


2 


2-6 


— 


— 


Delirium Tremens - - - 


2 


2-6 


— 


— 


— 


— 


Foisonmg - - . - 


1 


1-3 


— 


— 


— 


— 


Wounds and Injuries : 














Wounds, Injuries, &c. 


357 


460-7 


1 


1-3 


— 


— 


Burns and Scalds - 


10 


131 


— 


— 


— 


— 


Submersion and Drowning 


4 


6-2 


- 


- 


2 


2-6 


Suicide 


- 


- 


- 


• 


1 


1-3 


Totals - - - 


1,426 


1,875- 


25 


32-8 


7 


9-2 



384. 



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324 



MEDICAL STATISTICAL RETURNS 



TablE; No. 2. 

Showing the Number of Days' Sickness from each Disease and from Injdbies, the 
Average Number of Men Sick Daily, with the Ratio per 1,000 of Force. 





Number of Day»' Sickness 


Average Number of 
Men Sick Daily. ^ 


DISEASE OR INJURY. 










Ratio 




On Board. 


In HoapiUk 


Total. 


Number. 


per 

1,000 of 

Force. 


I. General Diseases, Section A. : 












Enteric Fever . - - 
Simple Continued Fever 

Ague 

Remittent Fever a - - 
Erysipelas - - . - 


49 
82 
17 
197 
31 


4 
5] 


53 
133 

17 
197 

31 


•I 
•3 

•5 


•1 
•3 

•6 


II. General Diseases, Section B. : 












Rheumatism - - - - 
Gout 

«yp^"«{£;3^ : : 

Tumour, Csytic 

Scrofula . « - - 

Fhthisis Pidmonalis 


758 
9 

3C6 

409 

3 

50 

208 


226 
283 


984 
9 

366 

409 

3 

50 

491 


2-6 

1- 
11 

•1 
1-3 


3-4 

1-2 
1-4 

•1 
1-7 


III. Diseases of the Nervous 
System and Organs of the 
Special Senses: 












Apoplexy - - - - 
Sunstroke . - - - 

Vertigo 

Epilepsy . - - - 
Neuralgia - - - - 
Insanity . - - . 
Diseases of the Eye 
Diseases of the Ear 


5 
36 
102 
152 
119 
112 
199 
U3 


107" 


5 
36 
102 
259 
119 
112 

ie9 

93 


•2 
•7 
•3 
•3 
•5 
•2 


•2 
•9 
•3 

? 

"2 


IV. Diseases of the Circulatory 
System: 












Disease of the Heart, Func- 
tional. 


45 


• • 


45 


•1 


•1 



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OF THE AUSTRALIAN STATION. 



325 



Table, No. 2.— Showing the Number of Days' Sickness from each Disease, &c.— conA 



DISEASE OR INJURY. 



V. & YI. Diseases of fhe Absorb- 
ent System and Ductless 
Olands: 

Bubo (JSymp.) - - - 



VII. Diseases of the Bespiratory 
System : 



Namber of Days' Sickneu 



On Board. 



Catarrh - - 
HsmoptyBis - 
Asthma - - - - 
Other Diseases of the Lungs - 



Vin. Diseases^of the Digestive 
System: 

Cynanche - - - - 

Dyspepsia - - - - 

Dysentery - - - - 

Diarrhoea - - - - 

Colic and Constipation - 

Haemorrhoids - - - 

Hernia - - - - - 
Other Diseases of the Stomach, 

Intestines, &c, - - - 



IX. &X. Diseases of the Urinary 
and Oenerative Systems : 

Diseases of the Kidneys 
Diseases of the Bladder 
Gonorrhcea - ' - - - 
Stricture « - - - 
Orchitis - - - - 



XI. Diseases of the Organs of 
Locomotion : 
Diseases of the Bones, Joints, 
&c. 



384. 



40 



1,071 

5 

30 

146 



375 
297 

75 
612 
102 

11 
1 

44 



3 

40 
409 

45 
209 



31 



In Hospital. 



Co 



Total. 



Avei-age Number of 
Men Sick Daily. 



Namber. 



22 



20 



49 



1,071 

5 

30 

168 



375 
317 

75 
612 
102 

11 
1 

44 



3 
40 

409 
45 

209 



31 



2*9 
'4 



1- 
•8 
•2 

1-4 
•2 



•1 

11 

•1 

•5 



Ratio 

per 

1,000 of 

Force. 



3-8 
•5 



1-2 
1- 

•3 
1-8 

•2 



•1 

1-4 

•1 

•6 



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326 



HBDIOAL STATISTICAL BETUBN6 



Table, No. 2^— Showing the Number of Days' Sickness from each Disease, bo.—contd. 





Number of Days* Sickness 


Arerage Number of 
Men Sick Daily. 


DISRA8E OR IKJURY. 


r 

On Board. 


In Hospital. 


Total. 


Kumbo*. 


Ratio 

Ij^of 
Force. 


XII. & XIII. Diseases of the 
CeUnlar Tissae and Cnta- 
neons System : 

. Phlegmon and Abscess - 

Ulcer 

Erythema - - - - 

Diseases of the Skin - 

Unbiassed: 

Debility - - - - 
Delirium Tremens 
Poisoning - - - - 

Wounds and Injuries : 

Wounds, Injuries, &c. - 
Burns and Scalds - - - 
Submersion and Drowning 


1,960 

2,002 

CO 

82 

340 
9 
2 

3,620 

143 

4 


27 
25 

149 


1,987 

2,027 

39 

82 

340 
9 
2 

3,678 

143 

4 


5-4 

•1 
•2 

•9 

10- 
•3 


71 

72 

•1 

•2 

11 

131 
•8 


Totals - - - 


14,013 


914 


15,627 


42*5 


55*9 



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OF THE AU8TBALIAN STATION. 



327 



Taulb, No. 8. 
Showing tbe Number Invalided from each Ship on the Australia Station. 



CAUSE OP INVALIDING. 



% 

3 



6 



e 






n. Cteneral Diieases, Seotion B. 
Rheumatism - - . . 
Scrofula - - . . 
Phthisia 



m. Dueases of the Vervons System, and 
Organs of 1^ Special Senses: 



Vertigo - 
Epilepsy 
Neuralgia 
Tusanity - 
Choroiditis 



Vn. Diseases of the Bespiratory System: 
Asthma ------ 

Vm. Diseases of the Digestive System : 



Dyspepsia 
Sea Sickness 



XI. Diseases of the Organs of Locomotion : 
Diseases of Bones, Joints, &c. - 

Zn. A Zm. Diseases of the Cellular 
Tissue and Cntaneons System : 

Ulcer 



Unclassed : 

Debility ■ 



Wounds and Iquries : 
Wound . 



Total 



384. 



C O 2 



14 



26 



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328 



MEDICAL STATISTICAL BETUBNS 



Tablb^ No. 4. 
Showing the Number of DsATBti in each Ship employed on the Austrauan Station. 



CAUSB OF DEATH. 



I. General Diieaaes, Seetion A. : 
Enteric Fever - • - 



IL General Diieaees, Seetion B.: 
Pbthisu .... 



m. Disease! of the Venrons System and 
Organs of the Special Senses : 



Apoplexy 
Paralysis 



1 



Wonnds and Injuries: 
Drowned - 
Saicide 



Total - - 



1 
(a)l 



(a) By ilrowoing. 



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OF THE AUSTBALIAK STATION. 



329 



TABhB, No. 5. 

Showing the Number of Cases of all Diseases and Injuries in the Ships employed 

on the Australian Station. 



disease or injury. 



I. General Diseases, Seetion A. : 
Enteric Fever - - - 
Simple Continued Fever 

Ague 

Remittent Fever - - - 
Erysipelas - - - - 



n. Oeneral Diseases, Seetion B. : 

Rheumatism . . - . • 
Gout 

s^p'^" {?^Sy : : : : 

Tumour Cystic - - - - - 

Scrofula ------ 

Phthisis Pulmonalis . - . - 

m. Diseases oftheNervons System and 
Organs of the Speeial Senses : 
Apoplexy ------ 

SunstroKe -.-.-- 

Vertigo 

Epilepsy ------ 

Neuralgia ------ 

Insanity ------ 

Diseases of the Eye .... 

Dtsesses of the Ear . - . . 



lY . Diseases of the Cironlatory System : 
Disease of the Heart, Functional - 

y. ft VI. Diseases of the Absorbent Sys- 
tem and Dnetless Glands : 
Bubo(Symp.) - - . . 

Vn. Diseases of the Respiratory System: 
Catarrh -..-.. 
Hnmopfysis . . . . - 
Asthma -...-. 
Other Diseases of the Lungs, &c. - 

384, 



I 



4 

11 

2 



12 



21 

1 
C 9 S 



42 

8 
4 

1 



5 
3 
3 



81 

1 
1 

4 



6 

1 
2 

1 



10 



& 



1 

1 

11 



4 
10 

2 
2 



46 

2 
3 



I 



6 
12 

4 
11 

1 



65 

1 

14 

15 

1 
2 
6 



1 
10 
2 
6 
4 
3 
11 
5 



187 
1 
3 
8 



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330 



MEDICAL STATISTICAL BETUBNS 



Table^ No. 5. — Showing the Number of Cases of all Diseases, &c. — continued. 



DISEASE OR INJURY. 



& 

a 



ft 



VIII. Diseases of the Digestive System : 



Cynanche -----. 

Dyspepsia ----- ^ 

V Dysentery - ^ - - - . 
Diarrhoea ------ 

Colic and Constipation - - - 
Hemorrhoids - - - - - 

Hernia ------ 

Other Diseases of the Stomachy &c. 

IX. ft X. Diseases of the Urinary and 

Oenerative Systems : 

Diseases of the Kidneys - . . 

Diseases of the Bladder ... 

Gonorrhoea ------ 

Stricture -----. 

Orchitis -----. 

XI. Diseases of the Organs of Looomotion : 
Diseases of the Bones .... 

Xn. ft XIII. Diseases of the Cellular 
Tissue and Cutaneous System: 

Phlegmon and Abscess - . . 

Ulcer 

Erythema - - - 

Diseasesof the Skin . - - - 

Vnolassed : 



Debility . 
Alcoholic Poisoning 
Delirium Tremens 



Wounds and Iquries : 

Wounds, &c. - - 
Bams and Scalds 
Submersion and Drowning - 



Totals - 



ID 
5 



20 
2 



47 
28 

1 



00 
5 
2 



285 



14 
16 
1 
40 
14 



1 

3 

15 

11 



90 

83 

2 

1 



129 



540 



2 
SS 

35 
6 
3 



11 
1 



10 

1 



02 
2 



295 



17 
2 
2 

19 

1 



36 
39 



70 
3 



305 



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OF THE AUSTRALIAN STATION. 



331 



o 



384. 



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POOO^t Jado!|»H 



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napj jo jaquiii^ ASwaAy 



*pj«oti no 
•SMiiIdi^ ,«X«Q JO jaqomi^ 



•Xinfuf pov anMiQ 
JO SMVQ JO jaqimijii 



■9uea»|clui03 oJNjaAy 



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to . 

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^ a 

S5 « 



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1 

CO 

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332 MEDICAL STATISTICAL BETUKN8 



IRREGULAR FORCE. 



Irregular Thebe were fifty-six vessels in the Irregular Force during the 

Force. year 1869 ; viz., ten of the fourth rate ; thirteen of the sixth rate ; 
five sloops; twelve gun-vessels; one steam-vessel; seven troop- 
ships ; two store ships ; five unclassed ships ; and one floating dock, 
for service at Bermuda. The returns from ten of the vessels only, 
were for the whole year ; from the remainder they were for periods 
varying from & few days to over eleven months. The mean force 
corrected for time was 7,450, and the total number of cases of disease 
and injury entered on the sick-list 10,024, which is in the ratio of 
1345*5 per 1,000 of force, being an increase compared with the pre- 
ceding year, but only to the extent of 3*9 per 1,000 ; of these 199 
were invalided, and sixty proved fatal, the former being in the ratio of 
26*7, and the latter of 8* per 1,000. Compared with 1868 there was 
an increase in the invaliding rate to the extent of 3*6, and in the 
death rate of -5 per 1,000. 

The average daily loss of service from General Diseases, Section A., 
Febrile Group, was in the ratio of 1*7 per 1,000 ; from Section B., 
or Constitutional Group, 11*3; from diseases of the nervous sys- 
tem, and organs of the special senses, 1*2 ; from diseases of the circu- 
latory system, *4 ; of the absorbent system, and ductless glands, '8 ; 
of the respiratory system, 3*6 ; of the digestive system, 3*4 ; of the 
urinary and generative systems, 3*6 ; of the organs of locomotion, 
*4 ; of the cellular tissue and cutaneous system, 10*6 ; from un- 
classed diseases, *5 ; and from wounds and injuries of various kinds, 
5*7. The average number of men sick daily was 3486, which is in 
the ratio of 46*7 per 1,000 of force, being a decrease compared with 
the preceding year, equal to 8*6 per 1,000. 

L Oeneral Diseases.— Section A., or Febrile Group. 

Qlgjig l^ Under this head, 362 cases of various forms of disease were entered 
g00^ j^ on the sick-list, ei^ht of which proved fatal. They occasioned no loss 
to the service by invaliding. Of the total number, two were cases 
of vaccinia; two of scarlet fever; eight of measles; six of enteric 
fever; 221 of simple continued fever; twelve of yellow fever; 
thirty-one of ague; fortv-six of remittent fever; one of cholera; ten 
of mumps ; eight of influenza ; and fifteen of erysipelas. 

Scarlet Fever. — A single case of this form of fever occurred in 
the person of a boy of the Cossack, who appears to have contracted 

the 



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OP THE IRREGULAB FORCE. 333 

the disease at Trincomalie^ where it was prevalent at the time. The Irregular 
case was of some severity, but he ultimately did well. Force. 

There was a case of scarlet fever in the Simoom. It occurred in the Class I. 
person of an officer of the ship who had contracted the disease when Sect A. 
on leave, at his residence at Southsea, where that form of fever was 
prevalent at the time, and some members of his family had been 
suffering from it. He was not allowed to come on board the ship, 
but was treated on shore, and afterwards granted leave so as 
to ensure, as far as possible, that he should not bring the infection 
on board with him. 

Measles. — There were eight cases of this form of eruptive fever in 
the Force during the twelve months, viz., two in the Liffcy ; two 
in the Liverpool ; two in the Oronles ; one in the Revenge; and one 
in the Serapis. 

With repcard to Table II, in reference to this Force, it is neces- 
sary to explain that the days' sickness therein allotted to the cases 
of disease is not to be considered as the sickness resulting from 
these cases, but must rather be regarded as tlie balance of days' 
sickness not accounted for on other stations, but which must 
be taken in order that the Total Force may be complete. 

Enteric Fever. — Single cases of this form of fever occurred in the 
Donegal, Endymion, Espoir, and Megaera. In the Liffey there 
were two eases. The case in the Espoir proved fatal. It occurred 
in the person of a warrant officer who was placed on the sick-list on 
the 20tn of November, when the vessel was at sea, on her passage 
to Bermuda. He had been ailing, he said,tbr four days previously ; 
he complained of severe headache, pains in his bones, and general 
weakness. Severe vomiting set in on the 23rd, which continued 
with only slight intermissions until the 2nd of December, when he 
was discharged to Bermuda Hospital. On the 30th of November the 
characteristic eruption of enteric fever presented itself over the ab- 
domen. He had at this time much thirst, anorexia, and sleeplessness, 
aggravated by a severe cough, with expectoration of sputa tinged with 
blood. *^ On his admission into hospital," the Deputy inspector 
General* says, " he chiefly complained of weakness and general 
malaise. The pulse was 104, small and weak ; skin acting ; tongue 
very foul ; bowels confined for several days; abdomen soft and 
flaccid : no spots observable ; cannot retain anything upon his 
stomach. During the period of his treatment in hospital, his stools, 
on his bowels being first moved by a mild cathartic, were dark, 
watery, and tinged with bile ; afterwards they assumed more of a 
date colour, and were generally scanty. The more prominent 
symptoms were those of the lung complication ; pain in the side ; 
cough; expectoration tenacious, and tinged red. Temperature 
varied from lOl'^'C to 103**. Towards the end he got delirious ; ab- 
domen 



* Deputy Inq^eotor General Thomas Kelson, m.d. 
384. 



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334 MEDICAL STATISTICAL RETURNS 

JmffoilMX domen highly tympanitic and painful on pressure; pulse failing. 
^^^ He gradually sank, and died at 5h. 26 p,ra of the 19th of December. 
Q^jg^ I^ ^ " Autopsy, fifteen hours after death. — Body, emaciated; cadaveric 
Sect. JL rigidity. Right hmg, eighteen ounces ; crepitant, floated ; slightly 
congested. Left lung, twelve ounces ; bright red colour, and con- 
gested ; blood -red serum exuding from cut surface. Pleura healthy, 
no fluid. Hearty ten ounces, flabby and pale ; clots in both ventricles; 
right ventricle dilated. Abdomen. On penetrating the peritoneum 
a Targe quantity of fetid gas escaped. Jreritoneum smooth, contain- 
ing a small quantity of pus, free in the cavity. Liver, three pounds, 
and healthy. Intestines, The whole of the small intestine highly 
congested ; leashes of vessels running from the mesentery to the 
bowels; perforation existed about two and a half feet from the 
ileo-ccBcal valve, and the whole of the intestine was of a port wine 
colour. The whole of the ileum and the ileo-coecal valve were one 
mass of ulceration, covered with dark ragged sloughs; Peyers patches 
were completely ulcerated, the ulcers varying from the size of a pea to 
that of a shilling, of irregulur shape, and with sharp bright coloured 
edges, with yellow slougns separating, and it was m an ulcer in this 
state in which the perforation occurred ; mesenteric glands enlarged 
and infiltrated ; other organs healthy." 

Simple Continued Fevei\ — There is little or nothing to be said in 
connection with the cases of this tvpe of fever which were entered on 
the sick-list. There were altogether 221 cases, which were tolerably 
equally distributed over the Force. They caused no loss to the 
service either by invaliding or death. 

Yellow Fever. — Twelve cases of this fatal form of fever occurred 
in the force, of which five proved fatal. There were single cases in 
the Barrosa and Lapwing, three in the Malacca, and seven in the 
Bacoon. 

The history of the case in the Barrosa is thus given by the 
surgeon* of the ship:—" One case of yellow fever, which ended 
fatally, occurred in a boy eighteen years of age, soon after leaving 
Rio de Janeiro. The patient in this case was one of the cutter's 
crew, and went to the shore in his boat, on the evening of the 23rd 
of August, and while the boat was at the landing place at Rio, he 
ran away, evidently with the intention of deserting, for it afterwards 
turned out that he went round to the harbour where the merchant 
shipping lie, and spent the night on board a brig. As those 
particulars were not obtained until after the disease had made its 
appearance, and when we were at sea, it was impossible to find out 
whether the fever had actually prevailed in the brig on board of 
which he slept, or not ; but while at Rio I was told that a few cases 
were occurring now and then among the merchant seamen, and that 
two cases, one of which ended fatally, had been sent from the 
Egmont to the hospital on shore for treatment. The boy was 

picked 

• Sorgeon William Anderson (a). >^^^ 



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OF THE IBBE'lULAB FOBCE. 335 

picked up and brought off to the ship on the following day^ the 24th; Irregnlar 
and on the morning he presented himself with symptoms of the disease. Force. 
When the nature of the disease was ascertained he was removed from Z, 1 
the sick bay in which he had had his hammock, and shiftedinto a cot o^J* f' 
which; as we were at this time under sail, was hung over the engine- 
room grating and enclosed by a canvas screen, the only means 
of separation from the ship's company that could be adopted. The 
place is airy, with a large hatchway overhead, which could be opened 
or closed as required, with a free current of air from the engine- 
room and stoke-hold below. Three volunteers were told off to look 
after him in turn, night and day, and in the performance of this duty 
they were most careful and watchfuL A solution of carbolic acid 
was kept frequently sprinkled about inside the screen and on the 
deck round it outside. It was also freely used in the vessels 
in which he vomited, and in the urinals and night stools. ^ 

** In the ti*eatment, I chiefly depended upon moselle, brandy, and 
e£fervescing draucrhts, with smapisms to tne epigastrium to relieve 
the vomiting ; while, at the same time, he was supported by beef 
tea, arrowroot, and anv nourishment he could take. I tried carbolic 
acid in the hope that it would alter the secretions of the stomach, 
and perhaps relieve the vomiting, and it appeared for a short time 
to act satistactorilv, but, as the result proved, it was only for a short 
time. I should, however, from what 1 observed in this case, be in- 
clined to try it again in another, earlier in the disease, should I have 
an opportunity of treating one. No post-mortem examination was 
made owing to the inconvenience of performing it in a ship of this 
class. Fortunately for us wo were running south at the time, and 
daily getting into a colder temperature, and the disease, I am happy 
to say, did not spread. (While at Rio the temperature was 74® in 
the shade, and on the 4th of September, when approaching Monte 
Video, it was 64^) One of the midshipmen, however, was put on 
the sick-list three days after this patient died, with symptoms of 
fever which appeared to take on the remittent type. There was in 
this case slight delirium and other peculiar symptoms which led me 
to believe, tnat had he remained in a warm latitude, they would have 
developed themselves into yellow fever. The gun-room is immediately 
opposite the engine-room hatchway where the patient was enclosed. 
One of the attendants also was under treatment for a few days with 
febricula, but the symptoms were of a very mild nature." 

The history of the case which occurred in the Lapwing is also 
instructive. It is thus given by the medical oflScer* of tne ship : 
** The ship left Port Royal on the 13th of September for Nassau, 
touching at Inaqua on the 16th, where a stay of only a few hours 
was maae, and arriving at Nassau on the 20th. Soon after our 
arrival it was ascertained that an epidemic of yellow fever was 
prevalent on shore during the Midsummer qua rter, and since ; four 
of the officers of a detachment of the 2nd West India Regiment, 
and several of the civil population, having succumbed to the malady. 

Precautions 

* Assistant ^nrgeon Denis 0. Mc Carthy. 
384. 



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336 MEDICAL STATISTICAL RETURNS 

Irregular Precautions to prevent the spread of the disease to the ship were 
^^'*^' accordingly adopted. Leave was withheld from the ship's companj, 
CijB^gg I. none save the officers and stewards being allowed to land. I am 
Sect. A. informed hj a resident practitioner that the island was perfectly 
healthy until the arrival of the Eclipse in July, when the first case 
occurred, which terminated fatally, the subject being her command- 
ing officer, who died on shore after a brief iUness. 

*^ A case of mild ephemera was entered on the sick-list on the 
20th, the day after our arrival ; the patient, a Marine, was dis- 
charged to duty on the third day. A case which has been returned 
as remittent, on account of its not presenting features of such gravity 
as to warrant the classing it under the head of the more malignant 
disease, occurred on the 27th, in the person of a petty officer, who 
had been employed in the dockyard. When he came on board he 
was 6uffi}ring from acute frontal headache, nausea, epigastric 
tenderness, and rachialgia. The eyes were suffused and deeply 
injected, the skin dry and parched, and there was pyrexia. This 
case terminated favourably, and was discharged on the seventh 
day. 

*^ Notwithstanding the unsatisfactory state of the bilgesj which 
at times smelled most offensively, despite of all endeavours to render 
them clean and inodorous by repeated cleaning and the liberal 
and unrestricted use of carbolic acid, the sanitary condition of the 
ship continued excellent. No other case of fever occurred until 
the 14th of October; for three days previous to that date the sick- 
list was blank. Since our arrival at Nassau the weather had been 
fine, the thermometer ranged from 76** to 84" Fahrenheit; baro- 

io. in. 

were meter averaged from 29' 90 to 30*20; and the prevailing winds 
E. and N. E. 

" On the morning of the above named day, an officer felt unwell. 
He complained of rachialgia, deep^ seated pain of the orbits and 
frontal smuses, nausea, and epigastric uneasiness. The conjunctivae 
were deeply injected, the skin was dry and burninff, the tongue 
loaded in the centre, red at the tip and edges. Ihe pulse 96 , 
slow and full. Traces of albumen in the urine were noticed on the 
evening of the 15th; next day it was more copious; the tongue 
resembled raw beef in appearance, and slight hoemorrhage from the 
gums was observed ; hiccough and suppression of urine set in on 
the fourth day. He was removed to sick quarters on the 18th at 
noon, where he expired at 3h. 30 p.m. on the following dav, during a 
violent attack of hoemorrhage from the stomach and bowels, the 
intellect remaining unimpaired almost to the last moment. 

" As to the origin of tne disease there cannot be a doubt that it 
was contracted on shore on the 9th of October, when the officer 
landed. From the commencement of the attack every precaution 
was adopted to prevent its spread. The patient was placed in a cot 
on deck, aft, beneath a screen, and isolated as completely as possible, 
none but the sick attendants being permitted to approach him. 

*' On the 20th another case of fever occurred. The patient, a 
corporal of the Boyal Marine artillery, was attacked in the evening 
with vomiting, bacK and Jinab pains, frontal headache and epigastric 
tenderness. The skin was dry and pungent, and the eyes yellowish 

and 



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OP THE IRREGULAB FORCE, 337 

and injected. I may observe that while the case of the officer has irregular 
been entered and reported as a case of yellow fever, that of the Force. 

corporal appears as remittent fever. They were, however, I am 

now inclined to believe, identical in their origin, symptoms, and Class I. 
course ; and differing in no respect, except their termination, the ^^^ ^ 
Marine being convalescent on the fourth day and able to resume 
light duty on the 26th of October. No other case I am happy to 
say occurred, except one of primary fever, which from its mildness 
and short duration I have classed under the head of febricula. 

" Until the end of October yellow fever continued to occur in 
sporadic cases, when on the approach of the cool season, it. subsided 
altogether in Nassau." 

During the time the Malacca was in the Irregular Force, three 
cases of yellow fever occurred on board, one of which, in the person 
of an officer, proved fatal on the sixth day. The djsease was con- 
tracted at Rio de Janeiro, which place the vessel touched at on the 
homeward voyage, and where yellow fever prevailed at the time. 
There were no points of special interest in the case, excepting per- 
haps the fact that none oi the persons affected had been out of the 
ship while she lay in Rio Harbour. 

There were seven cases of yellow fever in the Racoon, of which 
one proved fatal. The history of this outbreak is very interesting, 
and IS thus given by the surgeon* of the ship : " Under this head 
it will be observed that seven cases were placed on the sick-list, of 
whom one, a young officer, died. The ship having lain at Port 
Royal, Jam^ca, from the 25th of November to the 7th of December, 
left that day for Port-au-Prince. The patient was seized on the 8th 
with an'acute febrile paroxysm. There were no rigors, but the seve- 
rity of the usual symptoms was most marked ; the lumbar and rachitic 
pam, headache, constipation, &c. I had him placed in a cot and 
isolated at once, and on the following day (the 9th) I expressed a 
decided opinion as to the nature of tne attack. The captain's main 
deck fore, and after cabins, were fortunately available lor a quaran- 
tine hospital, and were handed over to me for that purpose, and the 
patient was placed there immediately. The heat oi skin was 104*5, 
and albumen commenced to show itself in the urine already. The 
head symptoms were most distressing, but great relief was afforded 
by the simple but most efficacious plan oi applying one leech to 
the internal nares by a tube. By this means it was thought the 
ethmoidal vessels would be directly relieved, and the subsequent 
bleeding from the leech would be equivalent to natural epistaxis. 
Immense relief was afforded without much depletion by this local 
measure. But the virulence of the attack was very great. Black 
vomit appeared on the 10th, and subsequently melasnic stools. The 
hyposulpnites were administered with the usual remedies; the 
current symptoms being narrowly watched. The distress of the 
stomach, bismuth, with coimter irritation, seemed to allay. Lime 
water and milk, soda water and milk, champagne, &c., had but 
transitory eflect. Turpentine as an enema afforded relief; and I 
found in the restless and watchful delirium that a few minims of 

chloroform 



* Sargwn Pierce Maoafielcl. b.a., m.d* 
384, 



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Sect A. 



338 MEDICAL STATISTICAL BETURNS 

Irrogniar chloroform inhaled were grateful^ but of course could only be a{q)lied 
Foroe. before any tendency to coma appeared. He succumbedj however, 

r ~ despite every effort, and died on the sixth day. 

2i^ I* The accession of the disease to the six others who were seized is 

remarkable as a clear proof, as far as it goes, of the oontagiouA 

nature of the fever. 

I. The officer, who died as above. 

II. An able seaman. The man was on the sick-list with 
ulcer for three days during the period of the officer's illness, 
and was discharged to duty on the 11th of December. The 
sore was daily dressed by myself or the assistant surgeon during 
this period. He returned on the 13 th of December with febrile 
symptoms, and on the 15th showed albuminous urine, &a 
The form of this fever changed its type only when we had got 
north to a temperature of 40**. 

III. An able seaman ; showed symptoms on the 16 tb* He 
was one of the galley's crew, and unavoidably came in contact 
with an attendant on the officer, who was one of the same boat's 
crew, and accidently pulled at the funeral that da^. In this 
patient there was severe fever. Tube casts and epithelium in 
the urine, observed bv the microscope. Albumen ; severe 
gastric svmptoms ; no black vomit. 

IV. One of the sailmaker's crew; showed decided febrile 
symptoms on the 17th at sea. He had been constantly at work 
in the gangway, the passage leading to the outer cabin- door, 
and had passed closely from time to time. The symptoms, aa 
of yellow fever, became more marked on the 22nd and 23rd. 

V. An ordinary seaman ; a weakly lad, who had a febrile 
attack since the 8thof December, and was progressing favourably, 
showed suspicious symptoms on the 16th, when it was evident 
that the fever had seized him. On the 18th the urine waa 
albuminous, with tube casts, and black vomit appeared on the 
same day. This recurred but once subsequently, and the 
prominent symptoms abated only as the north was approached ; 
even tlien the convalescence was most unsatisfactory and pro- 
tracted, the tongue, &c showing how much the prinue viae 
were at fault. 

VI. One of the carpenter's crew ; was engaged under my 
immediate superintendance in placing the body of the officer 
in the coffin on the 15th, during which operation, despite all 
precautions, a most intolerable letor emanated from it. TTie 
first symptoms appeared in him on the 19th. He is slowly 
recovering. The stomach was much affected, but there was no 
black vomit. 

VII. A carpenter's mate ; was employed on the same duty 
with the preceding, and complained of febrile disturbance on 
the 18th. It was not, however, until after an incubation of six 
or eight days that specific symptoms appeared. 

** In these cases there can be traced with very little doubt the cer* 
tain transmission by contagion. Until those that presented febrilo 
symptoms in the first instance were marked with subsequent specific 
ones, as evidenced in the urine by microscopic observation, &c., they 
were not, although otherwise uoliated, placed in the quarantine cabin. 

The 



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OF TEE IBBEGULAB FORCE. 339 

The urine in all was affected to a greater or less extent, diminishlog Irregular 
as the cold increased and the kidneys acted better. There was J^^' 
evidence of a most determined struggle between patient and disease* (Jlaas L 
which latter I fully believe to have been overcome mainly, if not g^^ j^ 
entirely, by the rapid change of climate or temperature, die high 
blood-temperature being reduced. There were other cases exhibit- 
ing febrile paroxysms of a mild form during the progress north, 
accompanied by constipation, rachitic and lumbar pains, headache, 
lethargy and prostration, and most of these in people having more 
or less connection with the infected. 

'^ The utmost precaution was adopted in disinfecting continuously, 
by means of very large quantities of carbolic acid, and more par- 
ticularly by the periodical use of sulphurous acid fumes in adjoining 
cabins, to which and back again patients were removed with cots, as 
necessary. The bedding and clothing were destroyed, and the 
decks and latrines had solution of carbolic acid employed freely on 
and in them. 

** After the sixth or seventh day, specific treatment was changed 
for that which best antagonised the current symptoms ; and on the 
30th of December, the day of our arrival at Halifax, the patients 
were landed and lodged in the quarantine shed of the sick quarters 
of the dockyard. 

" As to the origin of this sickness, there can be little if any doubt 
that it sprung from Her Majesty's ship Aboukir, at Port Royal, 
Jamaica. It prevailed in that ship while we were there, from 
the 26th of November to the 7th of December, during which 
time two deaths from yellow fever occurred at the Royiu Naval 
Hospital, in the persons of men from that ship. The surgeon was 
in hospital with yellow fever, and the assistant-surgeon of the Dart 
being also ill ana on sick leave, I received orders to take medical 
charge of both these ships, there being no medical officer in them. 
During this time they were visited twice daily, either by myself or 
the assistant-surgeon; and on the 5th of December I convejred 
what appeared to oe a doubtful case from the Aboukir to the hospital. 
On the 6th, there was a marine exhibiting suspicious symptoms ; 
but on the 7th we left for Port-au-Prince. Besides these circum- 
stances, there was free intercourse, as to visiting, &c., between this 
ship and the Aboukir. The Dart and the town were healthy ; but 
there were three deaths in the garrison during this time, the first 
occurring on the day of our arrival.'* ....'* This appears to 
be a summary of the history of the attack in the present instance, as 
connected with Port Royal. The poison had made itself a nidus in 
the ship, and would undoubtedly have germinated and propagated 
itself rapidly had it still continued to find good soil, which the 
approach northward to the frost disorganised and destroyed." 

Cholera. — A fatal case of this malignant disease occurred in the 
person of a boy of the Galatea, at Calcutta, who presented himself 
at 8.30, a.m. of the 26th of December, complaining of diarrhcea 
and vomiting, which had come on during the night. The medical 
officer* says: — *^ A draught, containing sulphuric acid and chloro- 

dyne, 



* Additional Surgeon William Labdon Powell. 
384. 



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340 MEDICAL STATISTICAL RETUBNS 

Irregular dyne, was administered ; this had the effect of staying the vomiting ; 
Force. but at 9h. 30 a.m. he was brought into the sick-bay in a state ap- 
dasTL P^oapl^ing collapse. He was at once put to bed, hot water tins 
Seot^A. ?PP^^®d to the feet and calves, and the draught repeated, followed 
in a few minutes by two ounces of port wine. From this time he 
gradually became worse, all the symptoms of cholera becoming fully 
developed, and he died at 3h. 5 p.m. At Calcutta, at all seasons of 
the year, there are sporadic cases of cholera ; and in this particular 
instance the disease could not be traced to any special exciting 
cause, but may have been provoked by over indulgence on Christmas- 
day. The patient had had no communication with the shore, nor 
had he drank any of the river wat^r." 

n. Oeneral Diseases— Section B^ or Constitational Ghroup. 

Class II. Under this head 1,031 cases of various forms of disease were 

Sect. B. entered on the sick-list, of which sixty-three were invalided and 

eight proved fatal. Rheumatism and primary and secondary syphilis 

were the most numerous affections. 

Primary and Secondary Syphilis. — The vessels in which these 
diseases wero most prevalent were the Bristol, the Donegal, the 
Galatea, the Juno, the Scylla, and the Serapis. 

In the Bristol, in which there were seventeen cases of primary 
syphilis and nine of secondary syphilis, most of the disease was con- 
tracted in English ports, in the Donegal the primary disease was 
contracted at Liverpool, where she was stationed. In the Galatea, 
in which there were thirty-seven cases of primary and eleven of 
secondary syphilis, most of the disease was contracted in China and 
Japan. Witn reference to the former country the staff-surgeon* 
observes : — " During our stay at Hong Kong I had an opportunity 
of visiting several public institutions, and my attention was par- 
ticularly directed t) the great decrease in the number of venereal 
complaints, when contrasted with former experience whilst serving 
on that station some twelve years previously, wlien syphilitic com- 
plaints formed one of the greatest scourges that naval medical 
officers had to contend with. On visiting ller Majesty's hospital 
ship Melville, I ascertained that cases of this disease were of rare 
occurrence, and chiefly contributed by ships on arrival ; but there 
being only a small naval force now employed in the south of China, 
the decrease was partly accounted for. On instituting further in- 
quiry on the subject, I ascertained that the Contagious Diseases 
Act had for several years past been rigidly enforced by the colonial 
surgeon, who has devoted a good deal of attention to the mitigation 
of this evil. The population of Hong Kong has increased very 
rapidly during the past ten years ; the harbour is still much fre- 
quented by shipping from various parts of the world, and a consider- 
able military force is still maintained; yet there is a marked de- 
crease of venereal complaints. There is a strict surveillance by the 
police of the houses occupied by prostitutes, and the periodic exa- 
mination of this class of people appears to be associated with no 

moral 

• Btaif Surgeon Alexander Watson, m,d. 

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OF THE IBBEGULAB FOBCE. 



341 



moral degradation. The principal part of the expense attending 
the maintaining the hospital establishment devolves on the owners or 
keepers of the tenements occupied by this class of people, so tliat 
they become equally interested in submitting early any cases requir- 
ing treatment. On attending at one of the periodical examinations, 
I was much impressed with the eflSciency of the instruments used 
by the medical officer, and, I believe, invented b^^ himself, with 
which upwards of ninety cases were thoroughly inspected (without any 
apparent inconvenience to patient or operator) in less than an hour." 

In the Juno there were seventeen cases of primary and eleven of 
secondary syphilis ; of these two cases of pnmaiy and four of se- 
condary disease occurred amongst supernumeraries, taking a passage 
in the ship. In connection with the remainder, the surgeon* makes 
the following observations : — 

" Fifteen cases of primary and seven of secondary syphilis have 
been under treatment. The former, which show 474 days' sick- 
ness, were all discharged to duty, and give an average of 31*6 
days' treatment for each case. Of the latter, with 320 days' sickness, 
an average of 45 '6 days' treatment, five were discharged cured and 
two sent to hospital. 

" With respect to the secondary svphilis, the large number of days' 
sickness on board was occasioned by one case, which made a pro- 
tracted recovery from sinuses and fistulous openings forming in the 
left groin over an indolent bubo ; without this case the average 
number of days under treatment is twenty-five. 

** The following Tables will show the difierent places where the 
disease was contracted. 

Tabls I. — Cases of PaiiiARY and Secondaet Syphilis. 



Irregular 
Force. 

Class II. 
Sect B. 





II 


1 


Rate. 


Dinene. 


Date 
Contracted. 


Where 
Contracted. 


Sute when 
•een. 


How 
Discharged. 


Remark!. 




( 1 


19 


0.8. - 


8ypbilis, Primary • 


4 January 


Portraouth 


Soft sore on sulcus Cured. 






2 


27 


C. A. G. 


«• 


.. - 


20 „ 


fi 


Soft sore on sulcus Cured, 
and glands. 




l»t 

Quarter. 


3 


27 


C. Mate 




^ 


18 M 


,, 


Soft sore on sulcus Cured. 




< 


24 


Barber - 


» 


Secondary 


21 Dec. - 
18G6: 


n 


Bubo right side 
ofgroin. 


Cured. 






5 


23 


A. B. - 


n 


n 


December 

18C8: 


n 


Nodes OB shins - 


RelieTcd. 






6 


25 


W. O. 
Cook. 


n 


»» 


December 


n 


Bubo right groin 


Cured. 




2Dd 

Quarter 


f' 


23 


G.Mate 


't 


Primary - 


4 April - 


Cape Of 
Good Hope 


Soft sore • • 


Cured. 
Hospital, 




l« 


18 


Off. . 


»» 


Secondary 


Not sure - 


China 


Bubo left groin - 


Japan. 






/ 9 


32 


M. 




Primary - 


16 July - 


Yokohama 


Soft sore - 


Cured. 






10 


19 


0.8. - 






16 n - 


^ 


Soft sore - 


Cured. 






11 


19 


Off. - 




Secondary 


Not sure - 


China 


Bubo left groin - 


Cured 


Re-entry. 




12 


22 


A.B. - 


jj 


Primary - 


16 July - 


Yokohama 


Soft sore - 


Cured. 






13 


19 


O.8. - 






20 „ - 


^ 


Soft sore - 


Cured. 




3rd 
Quarter. 


14 
15 


20 
19 


A.B. - 
0.8. - 


** 


n 


20 » - 
22Augu«t 


n 

Hongkong 


Soft sore and 

bubo. 
Soft sore and 

gonorrhoea 


Cured. 
Cured - 


During treatment 
coppery blotched. 




10 


23 


A. B. . 


.» 


n 


22 n ' 


i» 


Soft sore with a 
white surface. 


Cured - 


Had secondary 
coppery blotches. 




17 


21 


M 


w 


» ' 


20 July - 


Yokohama 


Soft sore - 


Cured. 






/18 


21 


o.s. - 




t, 


25 August 


Hongkong 


Soft sore - 


Cured. 




J.U 


19 


20 


M. 


^ 




14 Sept. - 


Singapore 


Soft sore - 


Cured. 




^ i / ao 


24 


Off. 






14 n - 




Soft soro - 


Cured. 




Quarter. \ ff 


28 


A. B. - 


»t 


Secondary 


Not sure • 


PorUmouth 


Nodes . - 


RelieTed - 


Re-entry. 


VM 


19 


O.S. - 


" 


14 Sept. - 


Hongkong 


Coppery eruption 
and rheumatism. 


HospiUl. 
HuUr. 


Re-entry, second- 
ary eruption. 








• Surgeon D. Wilson 


884, 






Di> 


















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342 MEDICAL STATISTICAL RETURNS 

Table 9. — Abstract of Cases showing the nombers contracted at each plaoe. 



Place. 


Dueaw. 


Number 
ofCkMa. 


Dieeate. 


Namber 
ofCaaei. 


Totals* 


Portnnouth ... 
Cape of Good Hope • 
Hongkong ... 
Yokohama - - . 
Singapore . . « 


Syphilid Primary - 
ft ff ' 


3 
1 

a 

6 
2 


Syphilii, Secondary - 
>t t» - 


4 

a 





" It will be observed that the greatest number were diseased daring 
the third quarter of the year at Hongkong and Yokohama. 

" Of the seven who contracted the disease at Portsmouth, four 
had the secondary form of the disease, two followed by buboes, and 
two by nodes on the shins. 

" Of the six who contracted the primary disease at Hongkong, 
three were entered for the secondary symptoms ; besides two others, 
numbered 15 and 16, suffered from coppery eruption whilst under 
treatment for the primary sores. The cases in Table 1, numbered 
8 and 11, 15 and 22, appear as re-entries. 

"Of the six who contracted the primary disease at Yoko- 
hama, it is remarkable to observe that none were followed by 
secondary svmptoms. By expressing my surprise at no secondary 
affection following the inoculation from the disease contracted at 
Yokohama, I must say there were no indications in the appearance 
of the sores to warrant one to expect any secondary affection ; but 
from the wreck one sees of so many people suffering from disease 
contracted in Japan, I almost expected to find every one diseased to 
be ultimately constitutionally affected, 

" By my own observation Hongkong is still a hot-bed of venereal 
disease, and of the very worst kind. At Hongkong the police regu- 
lations for prostitutes are insufficient, and in most cases cannot be 
carried out against the women who are diseased. The system of 
having a set of brothels kept apart for the use of the Chinese por- 
tion of the inhabitants, and another for the Europeans, which is 
supposed to be cleaner and under stricter regulation of the police, is 
bad. By this double brothel management, the men who are granted 
leave of absence in the colony for the first time are as often £und to 
have contracted the disease in the one brothel as the other. With 
the strictest police regulations it is impossible to prevent such irre- 
gularities occurring as above mentioned ; and further, the women 
who find themselves diseased can easily leave the colony by passing 
over to the mainland of China, where they can often carry on their 
infamous traffic without interference from the European police 
authorities. 

*' At Yokohama and other Japanese seaport towns opened for 
foreign trade, such as Nagasaki and Hiogo, where we touched on 
the passage, venereal disease is very rife, notwithstanding the ref- 
lations emorced by the Japanese authorities to prevent the specific 
disease from spreading. At Nagasaki no law had been introduced 

to 



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OF THE IBRBOtTLAB FORCE. 343 

to authorise the periodical inspection of prostitutes, and as far as I Inogalar 
oould learn no place had been established where they could treat ^^'^^ 
the women who were known to suffer from venereal disease. -^ ni tt 
believe I am stating under the number when I say about one-third g^ b* 
of the prostitutes are diseased who live in the town and keep them- * 

selves apart for the use of sailors. The Europeans qf the place are 
not exposed to such risks of contracting disease as visitors, because 
they spend their lives more after the Eastern fashion with their 
concubines. 

^^ At Hiogo, the Japanese authorities have established a regular 
brothel-palace, which is completely inclosed by palings to separate 
it from the rest of the town, and is governed by rules and statutes, 
the same as are in force at Yokohama. This place is fast rising into 
importance, and such an establishment as the one above referred to 
may prevent venereal disease from committing such havoc amongst 
the Europeans who may visit the port, as has nitherto been the case 
with the places opened for traffic with foreigners." 

In the Scylla there were eighteen cases of primary, and seven of 
secondary syphilis. All the primary disease was contracted in Eng- 
land, with the exception of one case attributable to contagion at 
Monte Video. 

There were twenty-one cases of primary, and six of secondanr sy- 
philis in the Serapis. As a means oi ascertaining the existence oi, and 
as much as possible checking the progress of disease, the surgeon* 
has a favourable opinion of the periodical examination of the ship's 
company. He says " General inspections of the men have been 
made, and I have reason to believe much benefit arises from the 
efficient performance of this duty. The certain knowledge that 
before gomg on leave, or coming into harbour, they must submit to 
examination, causes the men to apply as soon as they suspect any- 
thing to be the matter with them, and I incline to the opinion that 
these examinations are not offensive to the men. Only one man 
within two years has objected, and when examined he was found to 
be labouring under gonorrhoea." 



in. Diseases of the Nervous System and Organs of the 
Special Senses. 

Under this head 255 cases of various forms of disease were (j\g^ ni. 
entered on the sick-list, of which, twenty-six were invalided, and 
three proved fatal 

Apoplexy. — Of two cases of this disease which occurred in the 
Force, both proved^fataJ. One of the cases occurred in the person 

of 



• Surgeon John Breakey, m.d. 
384. D D 2 



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344 MEDICAL STATISTICAL RETURNS 

Lregular of a petty officer of the Juno, at Hon^ Kong. Three days before 
Force. his death he had been on leave, and evidently had indulged freely 

in spirituous liquor. On the day of the fatal seizure he had been 

Class III. ailing, but thought that a good night's rest would put him to rights. 
About midnight, however, he was heard to be breathing heavily in 
his hammock, §nd found to be quite unconscious. His breathing 
was laboured and stertorous (32 in the minute), the pulse 86, and 
weak ; and the left pupil slightly contracted. The stools had been 
j^assed involuntarily in his hammock, and he was in a state of pro- 
found coma. He only lived about two hours after being first seen. 
He had been a remarkably steady man, and it was thought that the 
sudden change in his habits had induced fatal congestion of the brain 
and nervous system. 

The other fatal case occurred in the person of a Marine of the 
Serapis, who was found dead in a brothel in Portsmouth. Post- 
mortem examination showed extensive extravasation of blood at the 
base of the brain. 

A fatal case of encephalitis occurred on board the Egmont in the 
person of a boy, one of the crew of the Boxer. No information has 
been furnished in connection with this case. 



IV. Diseases of the Circulatory System. 

Class IV. Forty-eight cases of different forms of disease were entered on 
the sick— list under this head, of which twenty-eight were invalided, 
and six proved fatal. Four of the deaths resulted from organic dis- 
ease of the heart, and two from pericarditis. 



V. & VI. Diseases of the Absorbent System and Ductless 

Olands. 

Classes V. There were seventy-three cases of sympathetic bubo, and two of 
and VI. other forms of glandular disease under treatment during the year, 
but they were of no importance, and call for no observations. 



VII. Diseases of the Respiratory System. 

Class VII. Under this heading 1,218 cases of various forms of disease were 
entered on the sick-fist, of which, nine were invalided, and seven 
terminated fatally. Of the total number, 1,091 were cases of com- 
mon catarrh. One death was from haemoptysis, and the remainder 
from different forms of inflammatory disease. 



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OP THE'IRBEGULAB FORCE. 345 



Vm. Diseases of the Digestive System^ 



Irregular 
Force. 



Under this head 1,525 cases of various forms of disease were Class VIII. 
entered on the sick-list, the most numerous affections being sore- 
throat, dyspepsia, and diarrhoea. Of the total number, twenty -two 
were invalided, and eight proved fatal. Of the deaths, two were 
from dysentery, two from diarrhcca, and four from abscess of the 
liver. There was nothing of a special character in connection with 
these diseases. 

Dysentery and Diarrhoea. — In passing through the tropics, and in 
changing from salt to fresh diet, the crews of the vessels composing 
the fl ving squadron suffered, although by no means to a great extent, 
from Dowel affections. The staff surgeon* of the Liverpool, in which 
vessel three cases of dysentery, and fifty-six of diarrhoea were en- 
tered on the sick-list, observes that " the greatest number of cases 
during any week occurred while at Rio, and at Monte Video. The 
colicky pains were severe, and vomiting was a frequent accompani- 
ment. Whenever there is a change of diet from salt meat to fresh, 
with vegetables, and water from the shore, there invariably occur, 
more or less, diarrhoeal cases ; more numerous where the extremes 
of temperature are great, be they high or low. When catarrh is 
prevalent, the intestmes are frequently affected, instead of the 
bronchial mucous membrane. In China, as in many other places, 
river water will, no doubt, produce it, and there condensed water 
should always be used, or wherever there is any reason to suppoae 
that any putrid animal matter has percolated into the place of 
supply." 

With respect to the cases of dysentery which came under notice, 
he remarks, ".only three cases of this disease have been under treat- 
ment, and they did well. One case occurred six days after our 
arrival at the Cape of Good Hope ; the second case three days after 
leaving the Cape; and the third at Sydney. They were not 
mild cases ; the stools were bloody mucus, upwards of twelve during 
the twenty-four hours, with some tormina, but not much tenesmus ; 
no constant nor fixed pain in any part of the abdomen, nor was there 
any unequivocal fever. I have given the greatest consideration to 
the treatment of this disease, in China, where I attended the Mili- 
tary Hospital, in Ceylon, at the Mauritius and elsewhere, and con- 
sidered, Mter having fairly tried large and small doses of calomel 
and opium, with or without venesection, that there is no drug in 
the British Pharmacopoeia equal to ipecacuanha. 

" I consider that the treatment should be commenced with a small 
dose of .castor oil (siv.), with laudanum (jss.), where there is a 

furred 



Staff Surgeon W. Mc. E. Saunders, m.d. 
384. D D 3 



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346 



MEBICAL STATISTICAL BETITBKS 



Lregolar 
Popoe. 



furred tongue, or any reason to suppose that some indigestible 
matter remains In the stomach or intestines. In about two hours 
subsequently the ipecacuanha is to be conmienced with, four grains 
Class YXXl. with half a grain of opium every two hours, and a large sinapism is 
to be applied to the abdomen within six hours. The diet must be 
a farinaceous one, with plenty of barley or congee water for drink, 
into which thirty grains of pot. tart. acid, have been put, as also some 
burnt biscuit or toast In about three days it is generalljr safe to 
give thrice daily a cupful of lukewarm panada, with port wine, and 
one pint of chicken broth during the twenty-four hours. 

** If the patient comes under treatment when the premonitory 
symptoms of the disorder are present, when the bowels are first dis- 
ordered, and he complains of chills followed by slight flushes, with 
coldness of the bacK and loins, he should be put into a hot bath 
(105**) and be kept in it until he becomes rather faint, or until a 
copious rush of sweat, or both, are induced, unless dangerous deter- 
mination to the brain should occur. The profuse sweating should 
be encouraged for six or eight hours, and at the eimiration of this 
period should there not be unequivocal yielding ol all the urgent 
symptoms, if the pains are great and attended with much tenesmus, 
put him into a hot bath for the second time ; and, if robust and ple- 
thoric, with a full pulse and hot skin, a few leeches (eight to ten) 
around the margin of the anus, will generally afibrd considerable 
relief, but the oozing from their bites must be arrested before any 
fomentations are applied, except to the abdomen. 

^^ Should the tongue be found yellow, with nausea and scalding, 
and yellow or greenish stools, the ipecacuanha had better be given 
in larger doses (ten grains) so as to produce vomiting, which will 
prevent the acrid bile from irritating tiie bowels when passing over 
the inflamed parts. Purgatives of a drastic nature, — ^too often given 
with the view of removing scybalous matters, must be avoided, and 
half an ounce of castor oil should be considered the only safe one ; 
althouffh in those exceptional cases where the stools are like orange 
pulp, we pulv. jalap, co. in 3j doses, has certainly been beneficial 

** There will very probably be found some tender spot in the 
course of the colon on the third or fourth day. A blister two or 
three inches square should be applied there. 

" The above plan of treatment having been steadily persevered in 
for a few days, the inflammatory condition of the intestinal canal 
will be found to yield gradually, and make way for returning health 
from the sixth to the tenth day. 

** It is of consequence to remember that there are two stages ; 
1st, the inflammatory ; and, 2nd, the ulcerative ; and of course it is 
of the utmost importance to prevent the second stage by cutting 
short the first. 

** If the mucous, gelatinous, or slimy stools are merely streaked 
with blood, we may consider this appearance as an indication that 
the blood has exuded from the inflamed or excoriated capillaries 
supplying the mucous surface, without any sensible rupture or solu- 
tion of continuity in the part affected. Blood is occasionally 

evacuated 



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OF THE IBBBOULAB FOBCE. 



347 



Irregular 
Force. 

Class YIII. 



evacuated in very large quantities^ and distinct from the other matters ; 
it then flows from the lower parts of the large intestines. When 
consisting of coagula^ and dark grumous clots intensely mixed with 
the discharges^ it then proceeds from the upper part of the colon 
and ccecom. The first may or may not proceed trom an ulcerated 
party but when it presents the yenous cnaracter, and occasionally 
a dark muddy appearance mixed intimately with watery, feculent, 
and offensive dejections, it is characteristic of ulceration. 

" When the dysenteric stools have been stopped, and there is sub- 
sequent constipation, prescribe two grains of powdered rhubarb 
every three hours, carefully avoiding any stronger medicine. 

** JDuring convalescence from dysentery, the diet must be most 
careful, and, if possible, night air, rain, fogs, wet feet, &c., 
avoided/' 

The staff surgeon* of the Phoebe, another vessel of the flying 
squadron, in which there were one case of dysentery and twelve of 
diarrhcea, says, with respect to the latter affection, that ^' the 
exciting cause in some appeared to be a change of water, as many 
occurred immediately this took place, the condensed water beins so 
pure compared with that obtained at the various places at whicm it 
was procured. Change from condensed water to that obtained 
from the shore I have frequently -observed upon other occasions 
produce attacks of diarrhoea.'* 

IX. and X. Diaeases of fhe Urinary and Oenerative 

Syatema. 

Under this head 501 cases of various forms of disease were under Classes IX. 
treatment, of which twelve were invalided. The majority of the and X. 
cases were gonorrhoea dnd orchitis, the latter mainly of gonorrhoeal 
origin. None of the diseases under this head call for any comments. 



XI. Siseaaes of fho OtgBSkA of Locomotion. 

There were forty-three cases of various forms of disease of the Class XI. 
bones, joints, &c. under treatment, of which six were invalided. 
Synovitis was the commonest affection* 



TTT. and Xm. Diaeasea of fhe Cellular Tiasue and 
Cutaneona System. 

Under this head 2,562 cases of various forms of disease were entered Classes XII. 
on the sick-list, two-tiiirds of which were boils and abscesses, and the and Xm. 

majority 



884. 



* Btftff Bnigeon John Ward. 
D D 4 



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348 MEDICAL STATISTICAL BETUBNS 

Irregular majority of the remainder, ulcers. Boils and abscesses were very corn- 
Force, jjjqh and caused considerable loss of service in the flying squadron. 
" They were attributed by the medical officers generally, to ^e cachectic 
iJ^nr ' ^^^i*^^^ engendered in the men by the prolonged use of salt meat 
and AIII. ^j^|.^ ^^j Ijy numerous climatic changes. The staflF surgeon of the 
Liverpool also thinks that the custom of frequently wetting the deck 
on which the men mess, is very liable to induce these troublesome 
and painful affections. 

niicla4s»ed Diseases. 

One hundred and one cases appear under tiiis head, of which 
ninety-one were debility resulting, as a rule, from climatic cachexia; 
seven were cases of delirium tremens ; and three of poisoning, one 
by alcohol, one by lead, and one was a case of fish poisoning. 

Delirium Tremens. — Of the seven cases of delirium tremens, one 
occurred in the person of an officer ; four in able-seamen ; one in a 
mess-servant ; and the rating in one case is not known. 

Wounds and Injuries. 

Under this head there were 2,179 cases of wounds and other in- 
juries, 114 cases of bums and scalds, and thirteen cases of submersion 
and drowning. Of these twelve persons were invalided for the 
results of injuries; six died from the effects of injuries; four from 
scalds or bums ; and ten were drowned. 

Of the fatal injuries, four men sustained fatal fracture of the 
skull, three by falling from aloft, and one by a blow from a block. 
One man sustained fatal internal injuries by falling from aloft, and 
one fell from a staircase to the pavement and was killed. 

Four persons were scalded to death by the explosion of a boiler. 

Ten persons were drowned, nine by falling overboard, and one 
by being capsized in a boat. 

The total number of deaths was sixty, which is in the ratio of 
8- per 1,000, being an increase compared with the precedini?. vear 
equal to '5 per 1,000. ^ 



Invalided. 




nervous 



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OF THE IBBEGULAB FOBCE. 349 

nervous Byetem and organs of the special senses ; twenty-eight for irregnlar 
diseases of the circulatory system ; nine for diseases of the respiratory Force, 
system ; twenty-two for diseases of the digestive system ; twelve for — 

mseases of the urinary and generative systems ; six for diseases of 
the organs of locomotion; mne for diseases of the cellular tissue and 
cutaneous system ; twelve for unclassed diseases ; and twelve for 
wounds and injuries of various kinds. The total number invalided 
was 199, which is in the ratio of 26*7 per 1,000, being an increase 
compared with the preceding year equal to 3'6 per 1,000. 



384. 

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350 



MEDICAL STATISTICAL BETUBKS 



Table, No. 1. 

Showing the Number of Cases of all Diseases and Injubibs, and the Number 
Invalided and Dead, with the Ratio per I|000 of Force. 





CMe«. 


iDTilidad. 


D«mL 


DISEASE OB INJUBY. 




Batio 
per 




Ratio 
per 




Batio 




Number. 


1,000 

of 
Force. 


Number. 


1,000 

of 
Force. 


Number. 


1,000 

of 
Force. 


I. Oeneral Diseases, Seetion A. : 














Vaccinia - . - - 


2 


•2 


._ 


_ 


_ 


— 


Scarlet Fever - 


2 


•2 











— 


Measles 


8 


1- 











— 


Enteric Fever - . - 


6 


•8 


^ 


. 


1 


•1 


Simple Continued Fever 


221 


29-6 


__ 





«_ 


— 


Yellow Fever 


12 


1-6 


_ 


« 


5 


•6 


Ague 


31 


41 


__ 


, - 


__ 





Remittent Fever - - - 


46 


6-1 


__ 


__ 


__ 


^^ 


Cholera 


1 


•1 


— 


-, 


1 


' I 


Pyoemia - - - - 
Mumps - - - - 


- 


- 


. 


. 


1 


•1 


10 


1-3 





.^ 


«. 


— 


Influenza - - - - 


8 


1- 


__ 


_ 








Erysipelas - - - - 


15 


2- 


— 


— 


— 


— 


II. General Diseases, Section B.: 














Rheumatism - . . . 


493 


661 


13 


1-7 


1 


•1 


Gout 


14 


1-8 










^y^^^^ -{£:=y: : 


316 
151 


42-4 
20-2 


11 


1-4 


— 


— 


Scrofula - - . . 


6 


•8 


2 


•2 


_^ 





Phthisis Pulmonalis 


46 


6- 


35 


46 


7 


•9 


Purpura - - - - 


1 


•1 










Scurvy - ... 


1 


•1 


^^ 


^__ 


,„^ 


^_ 


Dropsy - - - - - 


4 


•5 


2 


•2 


— 


— 


III. Diseases of the Kervons 














System, and Oigans of 














the Special Senses: 














Apoplexy - - - - 


2 


•2 


1 


•1 


2 


•2 


Sunstroke - - . - 


2 


•2 


_«. 








Paralysis . . - - 


11 


1-4 


4 


•5 


.^ 


, , 


Vertigo 


13 


1-7 


1 


•1 


^_^ 


^__ 


Epilepsy .... 
Neuralgia - - - . 


18 


2-4 


6 


•8 








52 


6-9 


1 


•1 


^_^ 


^^^ 


Insanity . - . - 


8 


1- 


2 


•2 








Other Diseases of the Brain - 


3 


•4 


1 


•1 


1 


•1 


Hjrsteria . - . . 


1 


•1 










Diseases of the Eye 


111 


14-8 


10 


1-3 





. 


Diseases of the Ear 


32 


4-2 


. 




— . 




Diseases of the Nose 


2 


•2 


— 


— 


— 


— 



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OV THE IBBSOUI^AR FOBOB. 



351 



Table, No. 1, — Showing the Number of Cases of all Diseases^ &c continued. 



DISEASE OR INJURY. 



IV. Diseases of the Cirenlatory 
System: 

Disease of the f Functional 
Heart -(Organic - 
Pericarditis - - - - 
Aneurism .... 
Varicose Veins ... 



V. ft VI. Diseases of the Absorb- 
ent System and Ductless 
Glands: 

Bubo (Sytnp,) . - . 

Glandular Diseases 



Vn. Diseases of the Sespiratory 
System: 

Diseases of the Larynx - 

Catarrh - . - - - 

Hfcmoptysis - - - - 

Asthma- - . - . 

Other Diseases of the Lungs - 



Vm. Diseases of the Digestive 
System: 

C|^nanche - - - - 
Diseases of the Mouth, Teeth, 

&c. 

Dyspepsia . - - . 
Dysentery * - - - 
Diarrhoea . . . . 
Colic and Constipation - 
Hasmorrhoids - . - 
Hernia ..... 
Worms - - - . . 
Other Diseases of the Stomach, 

Intestines, &c. - 
Diseases of the Liver - 

384. 



CaiM. 



Number. 



25 
17 

2 
4 



73 
2 



6 
1,091 


20 
93 



313 

8 

405 

18 

544 

101 

28 

15 

37 

22 
86 



Ratio 

per 

1,000 

of 
Force. 



3-3 
2-2 

•2 
•5 



9-7 
•2 



•6 

146-4 

1-2 

2-6 

12-4 



42- 

•4 
54-3 

2-4 
73- 
135 

3-7 

2- 

4-9 

2-9 
4-8 



Invalided. 



Number. 



8 
16 

3 

1 



4 
6 



Ratio 

per 
1,000 

of 
Force. 



1- 
21 

•4 
•1 



•5 
•6 



Dead. 



Number. 



Ratio 

per 
1,000 

of 
Force. 



•5 

•2 



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352 



MEDICAL STATISTICAL BETUBNS 



Tablb, No. 1. — Showing the Number of Cases of all Diseases, &c. — continued. 




Coses. 


Invalided. 


Dead. 


DISEASE OR INJURY. 




Ratio 




Ratio 




Ratio 
1,000 




Number. 


per 
1,000 


Number. 


per 
1,000 


Number. 






of 




of 




of 






Force. 




Force. 




Force. 


IX. ft X. Diseases of the Urinary 














and Oeneratiye Systems : 














Diseases of the Kidneys - 


20 


2-0 


4 


•5 


.. 


-^ 


Diseases of the Bladder - 


2 


•2 


^__ 


__ 








Gonorrhoea - - - - 


294 


39-4 


_^ 


««. 


— 


.. 


Stricture - - - - 


32 


4-2 


4 


•5 





— 


Varicocele - - - - 


2 


•2 


1 


•1 


— 


— 


Orchitis . - . - 


148 


191 


.^ 





... 


— 


Diseases of the Organs of Ge- 










' 




neration - - - - 


8 


1- 


3 


•4 


— 


% — 


XI. Diseases of the Organs of 














Loeomotion: 














Diseases of the Bones, Joints, &c. 


43 


6-7 


6 


•8 


— — 


— 


XII. ft Xni. Diseases of the 














Cellular Tissue and Cnta- 














neons System: 














Phlegmon and Abscess - 


1,974 


264-9 


3 


•4 


— 


— 


Ulcer 


448 


601 


6 


•8 


— 


— 


Erythema - - - . 


15 


2- 


— 


— 


— 


— 


Carbnnclo - - - - 


3 


•4 








..- 


— 


Scabies - - - • - 


49 


6-6 


— . 








. — , 


Other Diseases of the Skin - 


73 


9-7 


— 


— 


— 


— 


Unelassed: 














Debility . - . - 


91 


12-2 


11 


1-4 


— _. 


_ 


Delirium Tremens - - - 


7 


•9 


1 


•1 


_ 


__ 


Poisoning - .- 


3 


•4 




— 


— 


— 


Wonnds and Injuries : 














Wounds, Iniuries, &c. - 
Bums and Scalds - - - 


2,179 


292-4 


12 


1-6 


6 


•8 


114 


16-3 


. 


_ 


4 


•6 


Submersion and Drowning - 


13 


1-7 


- 


- 


10 


13 


Totals - - - 


10,024 


1,345-6 


199 


267 


60 


8- 



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OF THE IBREGULAU FORCE. 



353 



Table, No. 2. 

Showing the Number of Days' Sickness from each Disease and from Injuries, the 
Average Number of Men Sick Daily, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



I. Oeneral Diseases, Section A. : 

Small-Pox - - - - 

Vaccinia - . - - 

Scarlet Fever . - - 

Measles- - - - . 
Influenza - - 

Enteric Fever - - - - 
Simple continued Fever - 

Yellow Fever - - - 

Ague 

Remittent Fever - - - 

Chotera - - - - - 

HoopiDg Cough - - - 

Mumps . . . . - 

Erysipelas - - - - 

n. General Diseases, Section B. : 
Rheumatism - - - - 
Gout ----- 

Epithelioma - - - - 

Scrofula - - - . 
Phthisis Puli]|}onalis 

Purpura r - • - 

Dropsy - . - - - 

Scurvy - - - - - 

m. Diseases of the Kervous 

System, and Organs of 

the Special Senses: 

Apoplexy - . - - 

Sunstroke - - - 

Vertigo 

Paralysis . - - - 
Diseases of the Nervous Sy sem 
Epilepsy - - - - 
Neuralgia - - - - 
Insanity - - - . 

Other Diseases of the Brain - 
Ophthalmia - - - - 
Diseases of the Ear 
Diseases of the Nose 

384. 



Number of Days' Sickness 



On Board. 



15 

38 

63 

63 

53 

1,678 

194 

344 

384 

1 

60 
261 



5,998 

93 

7,368 

3,443 

84 

1,102 

4 

49 

21 



16 
55 

215 
8 

113 

506 

58 

21 

1,179 

259 



In Hospital, 



45 



1,690 

7 

1-29 

746 

77 
25 

32 

20 
247 



2,833 

40 

6,899 

2,260 

11 

196 

2,578 

11 

140 



5 

25 

80 

273 

15 

114 

105 

238 

223 

686 

86 

26 



Total. 



45 

15 

38 

1,743 

70 

182 

2,423 

194 

421 

409 

1 

3-2 

89 

506 



6 

41 

135 

488 

23 

227 

611 

296 

244 

1,804 

345 

315 



Digitized by 



Average Number of 
Men Sick Daily. 



Number. 



•1 
4-7 

•1 

•4 
&6 

•5 
11 
11 



•2 
1-3 



8,831 


241 


133 


•3 


13,267 


36-3 


5,703 


16-6 


11 





280 


•7 


3,680 


10- 


15 


— 


189 


•5 


21 


— 



1-3 

•6 
1-6 
•8 
•G 
5-1 
•9 
•8 



Google 



354 



MSDIOAL STATISTICAL BSTUBNS 



Table, No. 2.— Showing the Number of Days' Sickness from each Disease, &c — cofO^. 



DISEASE OR INJURY. 



IV. Diseases of the Circniatory 
System : 

Disease ofthe J Functional 
Heart -(.Oiganic - 
Aneurism - - - 
Varicose Veins 



V. ft VI. Diseases of the Absorb- 
ent System and Ductless 
Glands: 

Bubo(/S^.) 
Glandular Diseases 



VII. Diseases of the Bespiratory 
System: 

Diseases of the Larynx - 
Catarrh - - 

HflBraoptysis - - - - 
Asthma . - - - 

Other Diseases of tho Lungs - 



VIII. Diseases of the Digestiye 
System: 

Cynanche - - - - 
Diseases of the Mouth, Teeth, 

&C- - - - - - 

Dyspepsia - - - - 

Dysentery - - - - 

Diarrhoea - - - - 

Colic and Constipation - 

Hsemorrhoids . - - 

Hernia - - - - - 

Worms - - - - - 

Other Diseases of the Stomach, 

Intestines, &c. . - - 
Diseases of the liver 



Number of Dajrs* Sickness 



On Board. 



264 

267 

123 

89 



1,834 
17 



48 

5^41 

136 

233 

1,602 



1,994 

38 
2,084 
409 
2,592 
416 
239 
137 
148 
224 

702 



In Hospital. 



442 
61 
86 



617 
38 



25 
292 
170 

78 
1,774 



410 



271 



Total. 



790 
709 
184 
125 



2,351 
55 



73 

6,233 
306 
311 

3,376 



2,404 



973 



5 


43 


•1 


349 


2,433 


6-6 


205 


614 


1-6 


162 


2,754 


7-6 


28 


444 


1-2 


39 


278 


•7 


27 


164 


•4 


_ 


148 


•4 


433 


657 


1-8 



Arenge Number of 
Men Sick Dail/. 



Number. 



21 

1-9 

•5 

•3 



6-4 
•1 



•2 

17- 

•8 

•8 

9-2 



6-5 



2-6 



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OP THE IBBEGULAB FOBCE. 



355 



Table, No. 2. — Showing the Number of Days' Sickness from each Disease, kc.—cont^. 




Number of Days* Sickness 


Average Number of 
Men Sick Daily. 


DISEASE OR INJURY. 


r 








Ratio 


, 


On Board. 


In Hospital. 


Total. 


Number. 


per 
1,000 of 
Force. 


ELftX. Diseases of fheTTrinary 












and Oeneratiye Systems : 












Diseases of the Kidneys, &C, - 


305 


350 


655 


1-7 


•2 


Diseases of the Bladder - 


30 


30 


66 


•1 


— 


Gonorrhoea - - - - 


4,709 


990 


5,699 


16-6 


2- 


Diseases of the Oigans of Ge- 
neration . . . - 


275 


167 


432 


M 


•1 


Stricture - - - - 


284 


568 


842 


2-3 


•3 


Varicocele . - « . 


2 


23 


26 


— 


— . 


Oitjliitis .... 


2,212 


550 


2,762 


7-5 


1- 


XI. Diseases of the Organs of 












Loeomotion: 












Diseases of the Bones, Joints, 












&c. - . - '. ' 


654 


610 


1,264 


8-4 


•4 


XII. ft Xm. Diseases of the 












Cellular Tissue and Cuta- 












. neous System: 












Phlegmon and Abscess - 


15,941 


951 


16,892 


46-2 


6-2 


Ulcer 


7,448 


2,089 


10,437 


28-5 


3-8 


Carbuncle - - - - 




15 


15 


— 


—^ 


£r}'thema - - - - 


148 


36 


184 


•5 


— 


Scabies - - - - - 


497 


150 


647 


1-7 


•2 


Other Diseases of the Skin - 


718 


h^ 


1,284 


3-5 


•4 


Unolassed: 












Debility . - - - 


004 


658 


1,562 


4-2 


•5 


Delirium Tremens - - - 


23 


1G4 


187 


•5 


— 


Poisoning . - - - 


33 


57 


90 


•2 


"~~ 


Wounds and Injuries : 












Wounds, Imuries, Sec. - 
Bums and Scalds - - - 


11,520 


3,087 


14,616 


40- 


6-3 


1,161 


102 


1,263 


3-4 


•4 


Submersion and Drowning - 


10 


1* 


21 


— 


— 


Totals - - - 


90,404 


36,858 


127,262 


348-6 


467 



384. 



Digitized by 



Google 



356 



MEDICAL STATISTICAL BETUBKS 



Table, No, 3. - 
Showing tbe Number Invalided from each - 



CAUSE 



INVALIDING. 



1 1. General DiieuM, Section D. : 
Rbeamatism . . . 
Syphiiif, SecontUry - 
ScroftaU - - - - 
PhthUia . . . . 
Dropay . . - - 



III. Diacaiet of the Nerroua Syitem and 
Ornns of the Special Sensea) 
Apoplezj 
Paralyaii 



Paralyais - 

Vertigo 

Epilepay - 

Neuralgia - 

Insanity 

Diiease of the Brain 

Diaeasea of the Eyea 



IV. Diieaws of the Circulatory System 
Disease of ( Fonctional 
tbe Heart (Organic - • - 
Anenriam - . - . - 
Varicose Veins . . . - 



VII. Diseases of the Respiratory System : 
Aphonia - . - - - 
Hscmoptysis - - - - 
Other Diseases of the Longs 

VIII Diseases of the Digestive System : 
Disease of the Mouth, &c • 
Dyspepsia - . - . - 
Dysentery - - - - - 

Diarritosa - - - - - 

Colic ------ 

Hamorrhoida . - - - 
Hernia • - - - - 

Other Diseases of the Stomach - 
Diseases of the Utrer, &c. - 

IX. & X. Diseases of the Urinary and 
Generative Systems : 
Diseases of the Kidneys 
Stricture - - - - - 
Varicocele - - - - - 
Other Diseases of the Organs of 
Generation . - . - 

XI. Diseases of the Organs of Loco- 
motion: 
Diseases of the Bones, Joints, Ace. 

XII. & XIII. Diseases of the Cellular 
Tissue and Cutaneous System : 
Phlegmon and Abscess 
Ulcer -.-..- 



Unclassed : 

Debility 
Delirium Tremens 

Wounds and Injuries: 

Wounds - • 



Total 



2 3 






m 
m 
B 



II 



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OF THE IRBEGULAR FOECE. 



357 



Table, No. 3. 
Ship employed in the Irregular Force. 





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1 


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1 




1 


1 


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T 

r 

1 


1 


1 

„ 

1 


1 
1 


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1 
I 

2 


2 
3 

1 


2 

I 
1 

1 

7 


1 

2 

2 

1 

1 
2 

I 

1 

1 
2 


1 

2 

2 

1 
8 

1 

1 


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T 
I 

1 
2 

8 

I 


2 

1 

2 

1 


2 

1 

2 


1 


I 


1 

1 


- 


I 


1 

I 


18 
11 

2 
86 

2 

4 
1 
6 

2 

10 

8 
16 
8 

1 

2 

6 

1 
1 
1 
1 

1 
7 
4 
5 

4 

4 
1 

a 

6 

8 

6 

11 

1 

12 




3 


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1 


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3 


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2 


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384. 



E E 



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358 



MEDICAL STATISTICAL BETUBN8 



Table, No, 4. - 
Showinq the Number of Deaths in each 



CAUSB 

of 
DEATH. 



I 



I 

5 



I. Genertl Diseases. Section A. 

Enteric Fever 
Yellow Ferer 
Cholera - - - 
Pyoemia - - - 



II. General Diseases. Section B. : 

Bheumatism 

Phthisis - - . . 



III. Diseases of the Nervous System 
and Organs of the Special 
Senses: 
Apoplexy - - - - 
Disease of the Brain 



IV. Diseases of the Circulatory Sys- 
tem : 



Organic Disease of the Heart 
Pericarditis • - - 



VII. Diseases of the Bespiratory 
System: 

Hiemoptysis - - - - 
Other Diseases of the Lungs - 



YIII. Diseases of the Digestive Sys- 
tem: 



Dysentery - - - 
Diarrhoea - - • 
Diseases of the Liver, &e. 



Wounds and Injuries t 

Wounds, Itc. 
Bums and Scaldi - 
Submersion and Drowning 



Total - - 



1 - 



1 3 



Digitized by 



Google 



OF THB IBBEGULAB FOBCE. 



359 



- Tablb, No. 4. 
Ship employed in the Jrrbovlab Force. 





■1 


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2 


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1 

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1 
1 


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1 


2 


1 


4 


1 


1 


1 


1 
5 

1 
1 

1 
7 

2 
1 

4 
2 

1 

6 

2 
2 
4 

6 

4 
10 




I 


6 


1 


3 


1 


8 


2 


2 


6 


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1 


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1 


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Fr 



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360 



Show]( - 



DISEASE OR IMJUBT. 



L G«B«al DiMSMf, SmUod ▲. : 



VMcioia - 
Scarlet PcTOT 



BntorlcFcTer - - 
SimpU Continued Ferer 
Yellow Fever 

Ague - " " • 
Remittent Ferer - 

Cholen - - • 

Xumpa - - - 

Influenu - - • 

Erjtipelw - - - 



n. Qenenl ©!•««•» Section B.: 



Rhenmatlfln 
Ch>ut - - - 

Scrofula - 
Phthiiis PulnumuliB 
Purpura 
Scurvy - 
Drop^ 



III. Dlitaeei of the Nerroui BjtUm and 
OrgaM of the Special SenM : 



▲poplenr - - • - 

Sunstroke - • • • 

Psralytit . - - • 

Tertifo - - . - 

Epiiw - - " : 

Neuralgia ' ' I I 
<^tf SlMiMt of the Brain 



BysUTia ^ ^ 

DiMaKaofdiaEye - 

DlMiteaoftbeBar - 

DiMaMtoftheNoM - 



IV. Diieaaef of the (Srculitafy Syrtem: 

_. f Fuiictional 
DiieaM of the Heart |()^^le . 



Aneurlfm 
Varicose Veini 



T. ft VI. BiMMH of the Abwrbent 
«ndDucUeMOl*nda: 

Biibo (5yiiw.) 
Glandular DUaaaes - 



Digitized by 



Google 



361 



384. 



10 

1 



JO 



JPOBCE. 

T7~ 



I 

3 



9 
14 



IS 
1 

9 
6 



4*3 
14 I 
810 
Ifil I 

e. 



DI8EA8B OR iNJtmT. 



I. Oeneral DisaMa^ SMtlob A.i 
S I Vaceioia. 

8 I Heulea. 

I BDterlc Feir«r. 

•?i 5f pie OonUnned Farar. 

I« I Yellow F^Tar. 

81 Ague. 

40 I Bemmltteiit Ferer. 

1 I Cholera. 
10 Mampa. 

8 IbflttaoM. 

19 fiyaJpalu. 



II. Oenaral Dlaaataa, Saetlon B.: 

Bhawatlaa. 

Oottt. 

6 Scrofula. 

48 PhthMa PttteaoaaUa. 

1 Purpura. 

1 Scarry. 

4 Dropajr. 



in. DIaaaaaa oT tba Vts^mm 9jmtm t 

Organs of the Speelal Sanaaa: 

Apoplaxj. 

Sunstroka. 

PanUyala. 

Vertigo. 

BpUeptj. 

Naunilgia. 

lOMDitJ. 

Other IMaaaaaa of tha Bnta« 
HTsteria. 

DIaaaaaa of ftbtB^. 
DiMueaoftheEar. 
Dliaaias of Um Noaa. 



S 

s 
11 

18 
20 

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8 
8 
I 
111 
89 
I 



95 
17 
9 

4 



T8 
9 



IV. DIfeaiaaoftbaGIiMlator7Syatani: 

O^Jalfi"*!!™— •ofthaHa.rt. 

▲neuriimi. 

Varicoaa Valna. 



y. ft YL Dlsaacaa of tba Abaorbaat Syatan 
and Dvetlaia Ghudi: 



Bnbo(i 



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X BBTUBNS 



CB in the 


Ships emplojed in the Irregular Force — continued 


• 


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- 


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87 


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116 


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6 


80 


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76 






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as 


sa 


4 


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148 


88 


71 


8 


6 


134 


7 


7 


147 


4 


188 






I 


a 


1 


6 


- 


11 


8 


9 


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- 


6 


3 




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9 






- 


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101 1 


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338 


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100 


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651 


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363 



Table, , Force — continued. 



4 « 

4 



I 



IS 
S 



10 

J7 

9 
Id 

% 
S 



10 

4 

1 

S 
1 



18 
10 



14 



58 



108 



88 
8 

1 



87 



S81 



88 

8 



18 

1 
8 
6 

1 



10 

1 



16 



84 

8 
1 



888 







46 



6 

1,001 

9 

20 

03 



813 
3 

405 
18 

844 

101 
88 
15 
37 
92 
86 



80 

3 

204 

92 

2 

143 

8 



43 



1,074 

448 

15 

3 

49 

73 



DISEASE OB INJURY. 



VII. DlMaseforiheBetpimtorySyitem; 
DiMawt of the Larrnx. 
Catarrh. 
HsBmoptytii. 
Asthma. 
Other Dieeaies of the Liingi. 



VIII 



8,170 

1 j 114 

13 



DiseaMf of the Digestire Syitcm: 
C^nanche. 

Diseases of the Moatb, Teeth, ftc: 
Dyspepsia. 
Djsentery. 
Diarrhoea. 

Colic and Constipation. 
Hflsmorrholds. 
Hernia. 
Worms. 

Other Diseases of the Stomach, &c. 
Diseases of the Liver, Spleen, Ac. 



IX. & X. Diseasei of the Urinarr and 
Generative Systems: 

Diseases of the Kidneys. 
Diseases of the Bladder. 
Gonorrhopa. 
Stricture. 
\ arlcoeele. 
Orchitis. 

Diseases of the Organs of Genera- 
tion. 



XL Diseases of the Organs of Locomotion. 
Diseases of the Bones, Joints, ftc 



XII. * XIIL Diseases of the Cellalar 
Tissue and (.'uuneous System: 

Phlegmon and Abscess. 

Ulcer. 

Erythema. 

Carbuncle. 

Scabies. 

Other Diseaaes of the Skin. 



Unclassed: 



DebUitj. 

Delirium Tremens. 
Poisoning. 



Wounds and Injuries: 



Wounds, &c. 
Burns and Scalds. 
Submersion and Drowning. 

. Total. 



384. 



Digitized by 



Google 



364 



MEDICAL STATISTICAL EETUBNS 



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OT THE IBBEOULAB FORCE. 



365 



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366 MEDICAL STATISTICAL BETUBKS 



TOTAL FORCE. 



Total Force. The total force in the service afloat, corrected for time, in the 
— year 1869, was 48,820 ; and the total number of cases of disease and 
injury entered on the sick list 59,326, which is in the ratio of 1,221*9 
per 1,000, being a decrease compared with the preceding year equal 
to 30*5 per 1,000. In consequence of the defective nature of some 
returns from a few vessels, it has been necessary, in estimating the 
ratio of cases, to make a reduction from the Total Force to the extent 
of 270, and for that purpose, therefore, the force is taken as 48,550. 
The total mean force, however, is taken in estimating the invaliding 
and death rates, the returns in connection with which are complete. 
The average number of men sick daily was 2,256*4, which is in the 
ratio of 46*2 per 1,000, being a reduction, compared with the pre- 
ceding year, equal to 2' per 1,000. The total number of persons 
invalided was 1,574, which is in the ratio of 32'2 per 1,000, and the 
total number of deaths was 484, which is in the ratio of 9*9 per 
1,000. Compared with the preceding year there was a reduction in 
the invaliding rate to the extent of 2* per 1,000, but an increase in 
the ratio of mortality equal to l* per 1,000. This increase was 
entirely attributable to the destructive influence of yellow fever in 
the West Indies. From disease alone the death-rate was 7'3 per 
1,000. Had it not been from the fatal exposure of certain vessels 
to the jrellow fever poison, it would have been only 6*2, which 
would have been below the ratio of mortality of 1868 to the extent 
of '3 per 1,000. 

The number of cases of disease and injury per man on the Home 
Station was '9; Mediterranean, 1*4; North America and West Indies, 
1*4; South East Coast of America, 1*5; Pacific, 1'4; West Coast 
of Africa and Cape of Grood Hope, 1*6; East Indies, 1*8; China, 
1*5 ; Australia, 1*8; and in the Irregular Force, 1*3. The average 
number of cases per man in the Total Force was 1*2, being precisely 
the same as in the previous year. 

The lowest sick-rate was on the Home Station, and the highest on 
the China Station. The ratio per 1,000 of men sick daily on the 
Home Station was 38*3 ; on the Mediterranean, 53* ; North America 
and the West Indies, 51*6; South East Coast of America, 44'; 
Pacific, 68-2 ; West Coast of Africa and Cape of Good Hope, 57-1 ; 

East 



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OP THE TOTAL FORCE. 367 

East Indies, 52* ; China, 61*7 ; Australia, 55*9 ; and in the Irregular Total Foree. 
Force, 46*7. The average sick-rate of the Total Force was 46*2 per — 
1,000, which is a reduction, compared with the preceding year, equal 
to 2* per 1,000. 

Compared with the preceding year, the greatest reduction in the 
invaliding rate was on the East Indies Station, where it was equal 
to 217 per 1,000. This is readily accounted for by the fact that in 
1868 the squadron on that station suffered severely from exposure 
in the Bed Sea, in connection with the Abyssinian Expedition, and 
that an unusual amount of invaliding occurred in consequence. 
There was also a great reduction in the ratio of invaliding on the 
West Coast of Africa and Cape of Good Hope Station. It would 
perhaps be premature to attrioute this to the amalgamation of the 
two stations, which occurred during this year. The reduction was 
very great, however, being to the extent of 19*5 per 1,000. Com- 
pared with the preceding year, there was an increase in the invaliding 
rate on the Home, Mediterranean, South East Coast of America, 
and Australian Stations, and in the Irregular Force; on all the 
remaining stations the rate was lower. The invaliding rate .on the 
Home Station was 25*6 per 1,000; on the Mediterranean, 39*5; 
North America and West Indies, 34*2; South East Coast of America, 
20*4 ; Pacific, 25*3 ; West Coast of Africa and Cape of Good Hope 
Station, 64-7 ; East Indies, 56* ; China, 50*1 ; Australia, 32-8 ; and 
in the Irregular Force, 26 7. The total number invalided was 
1,574, which is in the ratio of 32*2 per 1,000, being a decrease, com- 
pared with the preceding year, equal to 2* per 1,000. 

Compared with the preceding year, there was an increase in 
the ratio of mortality on the ISorth America and West Indies, 
South East Coast of America, Pacific, East Indies, and China 
Stations, and in the Irregular Force. The largest increase was 
on the North America and West Indies Station, where it was 
as much as 14*2 per 1,000. The ratio of mortality on the Home 
Station from disease alone was 5*1 per 1,000; from violence, 1*8: 
on the Mediterranean Station, from disease, 4*2; from violence, 
3*7: North America and West Indies, from disease, 197; from 
violence, 3*7: South East Coast of America, from disease, 19*3; 
from violence, 2*1 : Pacific, from disease, 9*4; from violence, 3*4: 
West Coast of Africa and Cape of Good Hope, from disease, 8*; 
from violence, 2*3 : East Indies, from disease, 10* ; from violence, 
3*4 : China, from disease, 10*1 ; from violence 3*4: Australia, from 
disease, 5*2; from violence, 3*9: and in the In*egular Force, from 
disease, 5*3; from violence, 2*6. The total death-rate from disease 
alone was 7*3, and from violence, 2*5. In 1868, the death-rate from 
disease alone was 6'5, and from violence, 2*4. 

The total number of deaths was 484, of which 358 were from 
disease, and 126 from violence. The total death-rate was 9'9 per 
1,000, which is an increase, compared with the preceding year, equal 
to 1* per 1,000. 

384. H H 2 Compared 



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368 



MBDICAL BTATI8TICAL RETURNS 



Total Foxoe. Compared with the preceding year, there was a reduction in the 
— - death-rate on the Home Station equal to '6 per 1,000; in the 
Mediterranean, to '7 ; West Coast of Africa and Cape of Gt)od 
Hope, to 2 '8 ; and on the Australian Station, to -4. There was an 
increase on the North American and West Indies Station, of 14*2 
per 1,000; on the South East Coast of America, of 6'; Pacific, of 
4-8 ; East Indies, of 1*6; China, of -6 ; and in the Irregular Force, 
of -5. 

The following Tahle shows the ratio per 1,000 of mean force of 
all cases of disease and injury placed on the sick-list, and of mor^ 
tality from the various classes of disease on the different station : — 



CLASS OP mSEASB. 


HOMK. 


MsDiTia- 

aAMEAN. 


NomTB 

AMxaicAX 

and 

Wbst 

Indus. 


SOVTH 

East 

Coast 

of 

America. 


Pacific 


J 


iS 


1 


1 


J 


i 


J 


1 


1 


1 


I. General Diseawt, Section A. s 

Bniptire Perera - - • - . 
Continued Peren - - - - 
Periodic Peren - • - - . 
Other DiwaMs ..... 


16- 
10-9 

6-3 

4- 


•3 
*1 


7-3 
3Q- 
191 
66-9 


•7 


1*7 
i74-6 
14*8 
4* 


•2 

14*8 

•5 

•5 


9-6 
90- 
116*3 

21 


4*3 
I* 


9*8 
80- 
7*2 
*4 


*8 
•4 


II. General DiteaM^ Section B. ; 

Rheumatism ..... 

^"^ -dSHSry : : : 

Phthitie ...... 

Other Diseases • - - . . 


48- 

421 

12*8 

6-6 

3-6 


•9 
*1 


63-9 

88-6 

9*8 

4*6 

2-2 


1* 


79-4 
351 
24* 
4*5 

*8 


*8 


66-6 
6-4 
7*5 
21 
1* 


1* 
21 


84*5 

75-9 

42*4 

3*8 

1*7 


1*7 


III. Diseases of the Nenrons System, &e. 


24-7 


•6 


18*6 


•2 


31-7 


*2 


40*8 


3*2 


30-4 


•8 


lY. Diseases of the Cireolatory System 


9-8 


*9 


4* 


•5 


131 


*5 


4*3 


- 


7*7 


1-2 


y. & VI. Diseases of the Absorbent System and 
Ductless Glands . . . - 


6-2 


. 


6*2 




18-5 


« 


9*6 


. 


15^ 


• 


VII. Diseases of the Respiratory System 


130*1 


1*1 


1241 


1* 


135*7 


M 


196*7 


3*2 


191-4 


17 


VIII. Diseases of the DigtstiTe System • 


114*6 


•3 


193*9 


*5 


216*8 


- 


353*7 


- 


272-5 


1*2 


IX. & X. Diseases of the Urinary and Gene- 
ratire Systems • . - - 


69*3 


•2 


17*8 


« 


58*2 


„ 


15* 


. 


63*9 


*4 


XI. Diseases of the Organs of Locomotion - 


4*3 


- 


5*5 


- 


4*8 


- 


7*5 


- 


5*5 


- 


XII. & XIU. Diseases of the CeUolar Tissne, 
&c. 


204*3 


- 


422*1 


•2 


374*5 


« 


298*9 


- 


319-7 


•4 


Unclassed 


8* 


- 


16-8 


- 


31*4 


•5 


13*9 


- 


12*4 


•4 


Wounda and Injuries •••.«- 


190*6 


1*8 


351*3 


3*7 


264-2 


3*7 


264*5 


2-1 


279*3 


8*4 





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OP THE TOTAL FOBCE. 



369 



CLASS OF DISEASE. 



I. Genertl DueaMi, Section A.: 
Bntptire Fevers - 
Continned Ferera 
Periodie Feren - 
Other Diwawi - 



II. General Dinuet, Section B. : 

Rbeumatinn . . . . . 

^y^ -{IS, : : : 

Phthins .-.-.. 
Other Diteuet • . - . . 

III. Diaeaaes of the Nervona System, &c. • 

IV. Diseuea of the Oroilatory System 

V. & VI. Diaeaaea of the Absorbent Syatem 

and Ductleaa Olanda . . - 

VIT. Diaeaaei of the Reapiratory Syatem 

VIII. Diaeaaes of the Digeative Syatem 

IX. h X. Diaeases of the Urinary and Gene- 

rative Syatema • - • . 

XL Diaeaaea of the Organs of Locomotion - 

XI L k XIII. Diaeaaea of the Cellubr riasne, 
&c. •>•-•• - 

Undaaaed - • • ^ • « * 

Wounda and lojoriea - • . • • 



WnrCoA 

of 

Atmlxca 



Cape of 
Gooo HoPB. 



kSiT 



J 



71-6 

1271 

1-7 



120-8 

21*3 

4- 

4-6 
3-4 

49-7 

4'6 

21*9 
ISO- 
280*3 

82-6 
7*6 

342-7 
36*9 
304* 



EiaT 

ISDIEB, 



China. 



J 



1-7 



1*7 

•6 
2*3 



1*1 



2*3 



13- 

127-3 

74-3 

10* 



96-9 
60-4 
21*3 

91 

5*2 

64*3 
16*5 

24-7 
116*9 
432*6 

52*6 
3*9 

377*3 
36* 
326*5 3-4 



I 



14*6 
90*5 
37* 
2-8 



72*4 

91*4 

47*4 

5*1 

9*4 

35*6 

6*6 

33*3 
108-6 
234-1 

93*6 
8-6 

377-8 

80*4 

206-3 



AUSTAAUA. 



I 



7-8 1-3 
15*7 
19*7 

1*3 



Irbiqulaji. 



J 



I 



2 

2 

3*7 



85*5 

18*4 

-19*7. 

7-8 

5*2 

55*2 

3*9 

3*9 
261*8 
336*8 

71- 
1*3 

457*8 
13*1 



1*3 



26 



2-4 
31*2 
10*3 

4*5 



66-1 

42*4 

20*2 

6* 

3*4 

34*2 

6*4 

10* 
163*4 
204*2 

67*2 
5*7 

343*8 
13*5 



•1 
*9 

•4 

•8 



488*1 3-9 1309-5 



2*6 



L General Diseases.— Section A., or Febrile Group. 

Under this head 4,020 cases of various forms of disease were 
entered on the sick-list, of which seventy were invalided and 108 
proved fatal. Upwards of one-half of the mortality was caused by 
yellow fever. Nearly one-half of the total number of cases came 
under the head of simple continued fever. 

Eruptive Pevers^CsBes of eruptive fevers were met with on all 
the stations (with the exception of the West Coast of Africa and 
Cape of Good Hope), and in the Irregular Force. 

Of eighty-two cases of small-pox, forty occurred on the China 
l^tation, where, as a rule, the disease prevails epidemically during 
the winter months of the year. 

384, 1 1 The 



Class 
Sect 



I. 

A. 



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9iQ MEDIC41. WATIWlCAIi BOTURNS 

Total Force. The remaining cases occurred on the Home^ Mediterranean^ 
Pacific, and East Indies Stations. 

Scarlet fever was almost altogether confined to the Home Station. 
Two cases occurred in the Irregular Force. 

Measles was extensively epidemic in one vessel on the Home 
Station. Cases also oeeurred in the Mediterranean, North Ameri- 
can and West Indies, and East Indies Station, and in the Irregular 
Forco. 

Cases of tvphus fever were n^et with on the Home, Mediter- 
ranean, South East Coast of America, and China Station* On 
the latter station the disease has latterly become prevalent in Japan^ 
and nearly one<-half of the total number of cases m the Foroe, were 
the result of infection at Yokohama. 

Enteric fever was met with in the squadrons on the Home, Medi- 
terranean, South East Coast of America, Pacific, East Indies, China» 
and Australian Stations, and in the Irregular Force* It is endemic 
at Malta and probably at most of the seaports on the Mediterra- 
nean Station, at Valparaiso on the Pacific Station, and in Farm 
Cove at Sydney, on the Australian Station. 

Continued Fevers. — Simple continued fever was present on all 
the stations to a greater or less extent, and in the Irregular Force. 
The largest nupiber of cases occurred on the North America and 
West Indies, apd on the China Stations. 

Yellow fever was epidemic in the West Indies and caused much 
mortality. It also prevailed on the South East Coast of America 
Station, at Rio de Janeiro, and several cases occurred in the vessel 
permanently stationed there. Cases also occurred in the Irregular 
Force, in vessels having intercourse with infected ports. 

A single case of relapsing fever occurred on the Home Station. 

Periodic Fevers, — Cases of ague occurred on all the stations and 
in the Irregular Force. The largest number of cases was on the 
Home Station where the disease was prevalent at Sheerness. In the 
Mediterranean squadron it chiefly occurs in the vessels employed in 
the River Danube. On the South East Coast of America Station, 
where a large numlj^r of cases occurred, the disease was attributable 
to exposure to the malarious influences of the River Paraguay, 
where one or two vessels were stationed during the year, 

Remittent fever occurred in the squadrons on all the stations and 
in the Irregular Force. It was, as might be expected, most pre- 
valent on the West Coast of Africa and Cape of Good Hope 
Station. 

Other Diseases, — Of eight cases of cholera which presented 
themselves in the force, three occurred on the Home Station ; one 
on the North American and West Indies Station ; one on the South 
East Coast of America ; two on the East Indies Station, and one in 
the Irregular Force. 

Three 



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OF THE TOTAL FOEOB. 



371 



Three cages of hooping cough occurred on the Hon^e Station* TqM ForPft 

Cases of erysipelas occurred on all the stations (with the excep- """"^ 

tion of North America and the West Indies), and in the Irregular 

Force, They were most numerous on the Home Station. 

A single case of pyaemia occurred on the North America ^n4 
West Indies Station. 

Mumps occurred on several of the stations, but not to any extent. 

There were altogether 251 cases of influenza, and of these 108 

cases occurred on the Mediterranean Station, the remidnder on the 

Home, South East Coast of America, and East Indies Stations, wad 

in the Irregular Force. 



n. General Diseases, Section B., or ConstitatioiLal Ghroup. 

Rheumatism. — Of this disease 3,095 oases were entered on the 
sick-list, which is in the ratio of 63*7 per 1,000 of force, being a 
decrease compared with the preceding year equal to 9*7 per 1,000. 
The average duration of each case was about seventeen days, and 
144 men were on an average daily rendered ineffective by it. 

The following Table shows the comparative prevalence of the 
diseases on the different stations during 1868 and 1869. 



Stations. 



Home - 

Mediterranean 

North America and West Indies . - - 
South East Coast of America - - - - 

Pacific 

West Coast of Africa and Cape of Good Hope 
East Indies - . ^ - - - - 
China --^-..-- 
Aostralia -.--*.- 
Irr^nlar -.-.--- 



Rhbumatisv, 


1868. 


1869. 


51' 


48- 


96-8 


68-9 


92- 


70*4 


51-4 


M'Q 


104-7 


84-6 


112- 


120*8 


88* 


96-9 


84-1 


72-4 


110-4 


86-6 


90-5 


661 



It will be observed that as heretofore the disease was most pre- 
valent on the Pacific, West Coast of Africa and Cape of Good 
Hope^ East Indies^ and China Stations. 

Syphilis^ Primary and Secondary. ~0i the primary form of this 
disease 2,215 cases were nnder treatment, and 900 cases of secondary, 
the former being in the ratio of 45-6 and the latter of 18*5 per 
1,000. Compared with the preceding year there was a reduction 
in the primary disease to the extent of 1-4, and in the secondary to 
that of -1 per 1,000. On the Home Station there was an increase 

384. 112 in 



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372 MEDICAL STATISTICAL BETUBN8 

Total Fdrcd. ^ ^^ J^atio of primary syphilis compared with the previous year to 

— the extent of 5* per 1,000. Probably some amount of this increase 

Class 11. may be referred to the numerous obstacles that have been thrown 

Sect B. in the way of the efficient working of the Contagious Diseases Act. 

There was a great increase in the ratio of cases of syphilitic disease 

on the Pacific Station consequent upon more extensive intercourse 

with Valparaiso, which is a perfect hot bed of disease, no system 

of surveillance whatever being in existence there. There was a 

reduction to the extent of 9*1 per 1,000 of syphilitic disease on 

the China Station, due, doubtless, in great measure to the preventive 

system adopted at Hong Kong, and at Yokohama in Japan. 

Phthisis Pulmonalis. — Two hundred and sixtv five cases of this 
form of disease were entered on the sick-list, which is in the ratio of 
5'4 per 1,000. This is slightly under the ratio of the preceding 
year. 

III. Diseases of the Nervous System and Organs of the 
Special Senses. 

Class in. Under this 1,473 cases of various forms of disease were entered 
on the sick-list, of which 193 were invalided, and thirty-nine proved 
fatal. Twenty-five persons were invalided for paralysis ; fifty-two 
for epilepsy ; twenty-six for insanity, and fifty for various affections 
of the eyes. Fourteen deaths were caused by apoplexy and four- 
teen by various forms of disease of the brain, Tnere were four 
deaths from sunstroke. 

IV. Diseases of the Circulatory System. 

Class IV. Four hundred and twenty-one cases of disease were entered under 
this head, of which 183 were invalided, and forty-three proved 
fatal. Fifty-one persons were invalided for functional disease of 
the heart ; ninety-five for organic disease ; six for aneurism, and 
thirty-one for varicose veins. Of the deaths thirty-four were caused 
by organic disease of the heart, and nine by aneurism. 

V. and VI. Diseases of the Absorbent System and 
Ductless Glands. 

Classes ^^ ^^^ cases of glandular disease entered on the sick-list, 544 

V. and VI. w^^® sympathetic buboes. They were of a tedious character, and 
in this way caused considerable loss of service. The average dura- 
tion of each case was about twenty-eiffht days, and forty-one men 
were on an average daily incapacitated by them. There was no 
mortality under this head, but three men were invalided for glandu- 
lar diseases^ 



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OF THE TOTAL FOBCE. 373 



Vn. Diseases of the Bespiratory System. 



Total Force. 



Altogether 6,763 cases of various forms of diseases of this class Class VII. 
were entered on the sick-list, of which sixty-nine were invalided and 
fifty-one proved fatal. The mortality from inflammatory affections of 
the lungs was nearly double that of the previous year. The largest 
ratio of cases of this class of disease was on- the Australian Station, 
and the smallest on the China Station. The highest ratio of mor- 
tality was on the South East Coast of America, the lowest (with 
the exception of the Australian Station, on which there was no 
mortality from this disease) on the East Indies Station. Of the 
total number of cases, 5,957 were examples of common catarrh. 



Vni. Diseases of the Digestive System. 

Of 9,099 cases of various forms of disease entered under this Class VIII. 
head, 173 were invalided, and thirty-nine terminated fatally. Of 
187 cases of dysentery, seventeen proved fatal. In 1868, seventeen 
only proved fatal, out of 267 cases; while of 163 cases in 1867, 
twenty-three proved fatal. This merely indicates the varying 
severity of the disease in different years. 

There were 246 cases of disease of the liver, of which twenty-six 
were invalided and nine proved fatal, chiefly from the formation of 
abscess. 

The stations on which diseases of this class showed the highest 
ratios were the East Indies, the South East Coast of America, the 
Australian, the West Coast of Africa and Cape of Good Hope, and 
the Pacific Stations. The lowest ratio was on the Home Station. 

IX. and X. Diseases of the Urinary and Generative Systems. 

The total number of cases of disease entered under this head was Classes IX. 
3,012, of which eighty-eight were invalided and seven proved fatal. andZ. 
Of the total number, 1,845 were cases of gonorrhoea, from which 
disease ninety-six were daily incapacitated for duty. Each case 
was, on an average, about nineteen days under treatment. Of the 
deaths^ six were from disease of the kidneys, and one from extra- 
vasation of urine the result of stricture. 

The highest ratio of cases of this class of diseases was on the 
China Station, the lowest on the South East Coast of America. 

XL Diseases of the Oi^ans of Locomotion. 

There were 252 cases of various forms of diseases of the bones Class XI. 
and joints during the twelve months, of which forty-one were 
invalided. These affections, as a rule, were of an obstinate cha- 
racter, the average duration of each case being thirty days. 

384. 113 



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374 MEDIC Ali STATISTICAL BBTUBNS 

ToMFot<oe. 

XH and Xm. Diseases of the CeUular Tissue and 
Cutaneous System. 

Claatei XII V^^et this head 14,213 cases of various forms of disease were 
and Zni. ' sntered on the sick-list/ of which 9,966 were boils or abscesses, and 
3,302 ulcers. Of tlie total number of cases, ninety-one were in-* 
valided and seven proved fatal. Two hundred and forty*eight 
men were didly incapacitated for duty by boils or abscesses^ and 196 
by ulcers. 

Of the invaliding cases seventeen were abscesses; sixty-six 
ulcers ; and eight chronic skin disease. Five cases of psoas abscess, 
one of ulcer> and one of oarbunclei proved fatal. 



Vnclassed Diseases. 

Under this head appear 641 cases of debility, chieflv dependent 
on climatic causes ; eignty-five of delirium tremens ; ana thirty-four 
of Doisoning, mostly alcoholic. Of these 151 cases of debility, four 
of aelirium tremens, and two of poisoning were invalided ; and two 
of debility, one of delirium tremens, and one of poisoning proved 
fatal. 



Wounds and Iiguries. 

There were 11,490 cases of wounds and injuries of various kinds, 
of which seventv-four were invalided and thirty- nine proved fatal. 
The majority of the fatal cases were the result of falls from aloft. 
Of eighty-four cases of submersion entered on the sick-list, seventy- 
five were drowned. 

The average number of men sick daily from General Diseases, 
Section A., or febrile group, was 139*5 ; from Section B., 524-3, 
more than one-half being affected with syphilis; from diseases of the 
nervous system and organs of the special senses, 72*2 ; of the cir- 
culatory system, 32*4 ; of the absorbent system and ductless glands, 
42-6 ; of the respiratory system, 164-5 ; of the digestive system, 
181-3 ; of the urinary and generative systems, 167-8 ; of the organs 
of locomotion, 20-4 ; of the cellular tissue and cutaneous system, 
486-2 ; from^ unclassed diseases, 39*7 ; and from wounds and injuries 
of various kinds, 361-5. The total average number of men daily on 
the sick-list for various forms of disease and injury was 2256*4, 
which is in the ratio of 46-2 per 1,000, being a decrease compared 
with the preceding year equal to 2- per 1,000. 

The 



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OF TSfi TOTAL FORCE. 



8^6 



The following Table showfl the ratio per 1,000 of fotco of cases Total Forcfe. 
entered on the sick-list, of invaliding and of mortality on the different - - 

BtationB during the year :-^ 



SVATIOKS. 


tUdo per 1,000 

of Force of 

Cases placed on 

Sick^Ist 


Ratio 
per 1,000 of 

Force 
Invalided. 


Ratio 
per 1»000 of 
Force Dead. 


Home m ^ m m 
Mediterranean . • * 
North America and We8t\ 

Indies - . - -j 
Sonth-East Coast of America 
Pacific - . - - 
West Coast of Africa and\ 

Cape of Good Hope -J 
East Indies ... 
China - . - - 
Australia - • . • 
Irregular - . - - 


900- 
1427*9 

1488*6 

1607*6 
1464*6 

1616*6 

1869*6 
1606-8 
1876- 
1846-6 


25*6 
89*6 

34*2 

20-4 
26-3 

64-7 

66* 
60*1 
82*8 
26*7 


6*9 
8- 

28*4 

21*6 
12*8 

10-4 

18-4 

18-6 

9*2 

8- 



The following Table shows the increase and decrease in the ratios 
of cases, inyaliaingB, and deaths in 1869, as compared with the pre- 
ceding year :— 















8i 
















• 


X 


J 




•si 














1 


S 


ii 


Ii 


1 


3» 

1 


1 


■1 


< 


1 


»4 

1 












1 
Imckkasi 










Cases - - . 


8- 


64*8 


62-2 


"■ 


- 


- 


- 


- 


291-8 


3-9 


- 


InTaUdings 


3-7 


12-7 


- 


•1 




- 


- 


- 


2-4 


3-4 


- 


Deaths - - - 


- 


- 


14-2 


6- 


4*8 


- 


1-6 


•6 


- 


•6 


!• 












DflcaxASK. 










Cases . . - 


- 


- 


- 


11-9 


199*9 


248-1 


218-8 


66* 


- 


- 


30-6 


Invalidings 


- 


- 


4-6 


- 


12*2 


19-6 


21-7 


16- 




- 


2' 


Deaths . - . 


•6 


•7 


- 


- 


- 


2-6 


— 


- 


•4 


- 


- 



Summary. — The total force, corrected for time, in 1869 was 
48,820, and the average number of men sick daily 2,256, which is 
in the ratio of 46*2 per 1,000. In 1868, the ratio was 48-2. 

There were 59,326 cases of disease and injury under trealment 
during the year, which is in the ratio of 1221*9 per 1,000, being a 
decrease compared with the preceding year equal to 30*5 per 1,000. 

384. 1 1 4 Each 



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376 MEDICAL STATISTICAL BETUBNS 

Total Force. Each case waa on an average 13*8 days under treatment, and the 

: total number of days' sicuiess divided amongst the Total Force 

gives an average of 16*6 days' sickness to each man. In 1868, the 
average was 17*6 days. 

The total number invalided was 1,574, being in the ratio of 32*2 
per 1,000, which is a decrease compared with the preceding year 
equal to 2* per 1,000. 

The total number of deaths was 484, which is in the ratio of 9*9 
per 1,000, being an increase compared with the preceding year equal 
to 1* per 1,000. The death-rate from disease alone was 7*3 per 
1,000. In 1868 it was 6*5. 



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OV THE TOTAL FORGB. 



377 



Table, No. 1. 

Showing the Number of Cases of all Diseases and Injuries, and the Number Invalided 
and Dead, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



I. General Diseaaes, Seotion A. : 

Small Pox - - - 

Vaccinia , - - . 

Scarlet Fever 

Measles- . - . . 

Typhus Fever 

&teric Fever 

Simple Continued Fever 

Vellow Fever 

Ague - -, . . 

Remittent Fever - 

Cholera ... 

Diphtheria ^ - • 

ReiajNung Fever • 

Hooping Cough 

Erysipelas - - - 

""ramia , - - 



lumps - - - - - 
Influenxa «... 

n. General Diseases, Section B*: 

Rheumatism « - - - 
Gout - - - 

Tumour, Cystic - 

Scrofula - . - . 
Phthisis Pnlmonalis 

Epithelioma . • - - 

Purpura and Ano&mia - 

Dropsy - - - - - 

Diabetes • . . . 

Scurry - , - - - 

in. Diseases ef the Venroos Sys- 
tem and Organs of the 
Speoial Senses : 
Apoplexy - - - - 
Sunstroke • • - • 
Paralysis - - - • 
Vertigo 



Caws. 



Namber. 



82 

6 

26 

824 

20 

47 

2,007 

118 

474 

611 

8 

1 
8 

112 

1 

29 

251 



3,095 

87 

2,215 

900 

2 

43 

265 

2 

6 

33 



Insanity 



17 
87 
62 
60 
121 
247 
51 



Ratio 

per 
1,000 

of 
Force. 



1-6 
•1 
'6 

6-6 

'4 

•9 

41*3 

2-4 

9-7 

10-5 

•1 



2-3 

•6 
51 



68-7 

1-7 

45*6 

18-5 

•8 

6*4 



•1 

•6 



1-7 

1- 

1*2 

2-4 

6* 

1- 



Invalided. 



Nomher. 



2 
9 

19 
37 



112 

2 

13 

74 

18 
207 

1 

4 

1 



2 

2 

26 

6 



Ratio 

Pw 
1,000 

of 
Force. 



2-2 

•2 
1-5 

•3 
4-2 



Dead. 



Namber. 



4 
15 

8 
57 

1 
6 
5 

1 



3 

1 



51 

1 



14 

4 
6 



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37S 



MEDICAL MATISTICAL BSTUBKS 



Table, No. 1. — Showing the Number of Cases of all Diseases, &c. — continued. 



DISEASE OR INJURY. 



III. Diseases of theHenrousSys- 
tein/.&c.— •con'iwtt^^'. 

Diseases of the Brain 
Diseases of the Nei'vous System 
Diseases of the Eye 
Diseases of the Ear - - - 
Diseases of the Nose 



IV. Diseases of fhe Circulatory 

System: 
Disease of the^ Functional 

Heart -/Organic 
Aneuiism - - - - 
Varicose Veins - - - 

V. ft VI. Diseases of the Absorb- 

ent System and Ductless 
Glands: 

Glandular Diseases 

VII. Diseases of the Bespiratory 
System: 

Diseases of the Laiynx - 

Catarrh - - - - - 

Bffimoptysis - - - - 

Asthma - - - - - 

Other Diseases of the Lungs - 

Vni. Diseases of the Digestive 
Systdin: 
Cynanche - - - - 
Diseases of the Mouth, Teeth, 

&c. 

Dyspepsia • - - - 
Dysentery - - *. - 
Diarrhoea - - - - 
Colic and Constipation - 
Hsemorrhoids * - - 

Hernia - - - - - 
Worms - - - - - 
Other Diseases of the Stomach, 

Intestines, &c. - - - 
Diseases of the Liver 



Gates. 



Number. 



14 

17 

611 

176 

20 



248 

107 

12 

54 



644 
16 



43 

5,967 

62 

39 

662 



1,881 

46 
2,368 
187 
8,204 
624 
105 
116 
152 

110 
246 



Ratio 
per 

1,000 
of 

Force. 



•2 

•3 

12-5 

3-6 

•4 



5*1 
2*2 

1-1 



11-2 
•3 



•3 

122*6 

1*2 

•8 

13-6 



38-7 

•9 

48-7 

3-8 

65-9 

12*8 

3-3 

2*8 

81 

2*2 
5- 



Invalided. 



Number. 



6 

2 

60 

16 

2 



51 

96 

6 

31 



3 

2 

14 

2 

48 



4 
22 
21 
13 

1 

4 

58 



23 
26 



Ratio 

Pw 
1,000 

of 
Force. 



1- 

1-9 
•1 
•6 



Dead. 



Number. 



14 
1 



Ratio 

per 
1,000 

of 
Force. 



34 
9 



11 



3 
48 



1 

17 
5 



7 
9 



•3 
•1 



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01* THU 1?6TAL FORCE. 



arr 



TablB| No. 1. — Showing the Number of Cases of all Diseases^ &c. — continued. 





Caae«. 


Invalided. 


Dead. 


DISEASE OR INJURY. 




Ratio 
per 




Ratio 




Ratio 
per 




Number. 


1,000 
of 


Nofflber. 


1,000 
of 


Number. 


1,000 
of 






Force. 




Force. 




Force. 


IX ftX. SiseasM of the Urinary 














and Generative Systems : 














DIfleasc of the Kidneys - 
Diseases of the Bladder - 


08 


2- 


28 


•5 


6 


•1 


do 


•6 


4 


— 


— . 


— 


Diseases of the Organs of Ge- 














neration - - . . 


39 


•8 


16 


•3 


— 


-» 


Gonorrhoea - - - . 


1,845 


88- 


1 


— 


— 





Stricture - - . . 


180 


3-7 


22 


•4 


1 





Variococele . - - - 


27 


•5 


12 


•2 


— 


— 


Orchitis .... 


793 


16-3 


6 


•1 


— 


— 


XI Diseases of the Organs of 














locomotion: 














Diseases of the Bones, Joints, 














&o. 


262 


5-1 


41 


•8 


""" 


— 


Zn. ft Xm. Diseases of the 














Oellular Tissue and Cuta- 














neous System: 














PUej^on and Abscess - 


9,960 


206-2 


17 


•3 


5 


•1 


Ulcer 


3,302 


68- 


m 


1-3 


1 


— 


Erythema - - . - 


70 


1-4 


— 


— 


— 


— i. 


Diseases of the Skin 


566 


11-6 


8 


•1 


— 


— 


Carbuncle . - - - 


4 


- 


- 


- 


1 


— 


Scabies 


305 


6-2 


— 


*~ 


"~" 


"""• 


Trnolassed: 














DebiHty - . - - 


641 


13-2 


161 


8- 


2 


..^ 


Delirium Tremens - 


85 


17 


4 


• 


1 


— 


Poisonhig . . . - 


34 


•7 


2 


*■ 


' 


"■• 


Wounds and Ixguries : 














Wounds, Iniaries, &C. 
Bums and Scalds - 


11,490 


236-6 


74 


1« 


89 


•7 


527 


lO-S 


— 


— 


5 


•1 


Hanp:ing .... 
Suicide - - - - - 


1 
1 


— ■ 


— 


"^" 


5 


^ 


Asphyxia - - - - 
Submersion and Drowning -< 


84 


"i-7 


~ 


^ 


1 
75 


1-5 


Not stated - - - - 


- 


— 


*• 


"- 


1 


""• 


TOTAIS - ^ - 


59,326 


1,221*9 


1,574 


32-2 


484 


9-9 



384. 



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360 



MEDICAL STATISTICAL RETURNS 



OS 

•S 

•s 



M 
o 
HI 

QD 

P 

I 



•5 

• •^ CO 

S .2 

d "^ 



!f. 






s 

i 



& 



O 

m 

CO 












m 



1. 






I 




•|!-si 



I 



s. 






1 2-8 I 



111: 



ll^ll 



Ills" 

55 oao ^ 



Hm 



I 



14 



sS's 



r 



o 

H 



eo 



5 i 



S 9 



9 

00 



o 

CI 



9 ra o> 






eo 



s. 
s 



s 



s 






0? 



O r* 

eo 



? s 












eo 7< 



00 






3 



0« 



op 

O 



A 
«« 



CO 



1^ A 






9 

s 



I 



§ 



■o 
of 



s 



8. 



00 

S 



I 

a 






1 


i 


1: 





i a s I 



- 2 



9 5? 9* 
«-« o >^ 
•* rf> •* 






2 

00 



? 



00 



s 



e4 j< ^ c« 






I i S i n I 
5* 3* 5 sf sf s* 



00 



I 

•o 






P-T ?? « "W' 



s 



s. 



»o «-« 



3 



s 

of 



s 



I 



cf 



o o o o o 
ef oo^eo tC 




II' ' 



ttta 



■I 1 ! 



I 



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OF THE TOTAL FORCE* 



381 



I 

■i 
I 



I 

CO 



§ 






jf Ǥ 

1 

S 

3 

i 



J 



•5 

o 

I 



384. 



1^-* 



llv 



'^iS 



8. 



<8| 



Jlii 



5- I*. 



MA 



m 






ii 



» ^ 









U 









o 

H 

CO 



to OD 






s s s 



s 



•M t* 









09 



IP 



99 W to 



T 9» 



0> A 






:: s s 






1* T 



op 
e« 

09 



s 



00 M 



00 (O 

6% e* 



00 
09 



1^ 
9 



09 



s 



O <D r* 



S 2 = - 



8 S 



i 
1 ■» 

« 1 



J 



I 



•8 



I 

^1 



k4 



I 






I 



Digitized by 



Google 



Mi 



MEDICAL STATISTICAL RETURNS 



TablB; No. 4. 

Showing the Number of Days' Sickness from each Disease and from iNJURiBd^ the 

Average Number of Men Sick Daily, with the Ratio per 1,000 of Force. 



DISEASE OR INJURY. 



Number of Dayt* Stdmeit 



On Board. 



In Hospital. 



Total. 



Avvrage Number ^f 
Men Sick Daily. 



Number. 



Ratio 

1,000 of 
Foroe. 



I. General Diseases, Section A. : 

Small-Pox - - ' - 
Vaccinia - - - . 
Scarlet Fever 

Measles - - - - 

Typhus Fever 
Imteric Fever 
Relapsing Fever - 
Simple Continued Fever 
Yellow Fever 

Ague 

Remittent Fever - 
Cholera - - . - 

Diptheria - - . - 
Hooping Cough 
Mumps - - - - - 
Influenza . . . . 
Eiysipelas - - • - 
Pyoemia - - - - 

II. General Diseases, Section B. : 

Rheumatism - - - . 
Gout 

Tumour, Csytic - - - 

Scrofula . . . - 

Phthims Pulmonalis 

Epithelioma • - . - 

Purpura and Anaemia - 

Dropsy - - - - - 

Scurry - - - - - 



III. Diseases of the Henrons 
System and Oi^^ans of the 
8^ial Senses: 



Apoplexy 

Sunstroke 

Paralysis 

Vertigo - 

Epileps;^ 

Neuralgia 

Insanity 



1,544 

65 

161 

426 

344 

526 

4 

14,385 

850 

3,828 

6,952 

12 



21 

263 

1,732 

1,821 

8 



31,633 

796 

44,016 

16,863 

16 

826 

4,754 

70 

78 

228 

54 



30 
775 
586 
360 
1,401 
1,995 
440 



984 

34 

8,724 

180 

1,317 

7,772 

1,206 

892 

2,348 

2 

162 

101 

790 

1,587 



20,969 

207 

37,882 

16,796 

1,206 

14,303 

57 

54 

736 



95 
292 

1,870 
463 

1,043 
635 

1,634 



2,528 

55 

195 

9,150 

524 

1,843 

4 

22,107 

2,065 

4,720 

9,300 

12 

2 

183 

364 

2,522 

2^908 

8 



52.602 

1,003 

81,898 

33,659 

16 

2,031 

19,057 

136 

132 

964 

54 



6-9 

•5 
25- 
1-4 

5- 

60-5 

12-9 
25-4 



•5 

•9 
6-9 
7-0 



1441 

2-7 

224-3 

92-2 

5-5 

p2'2 

•3 

•3 

9,-6 

•1 



134 


3 


1,067 


2-9 


2,456 


6-7 


823 


2-2 


2,444 


60 


2.630 


72 


^074 


5-6 



•5 

•1 

1-2 
•1 
•2 
•5 



2-9 

4-5 
1-8 



Digitized by 



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OP THE TOTAL FOBCE, 



383 



Tablb, No. i.'v^Showing the Number of Days' SioknesB from eaoh Disease, Scc^eont^. 



DISEASE OR INJURY. 



Number of Days* Sickness 



OnBoAni. 



In Hospita]. 



TOLAL. 



Average Number of 
Men Sick Daily. 



Number. 



m. Diseases of the Henrous Sys- 

tem, ^. — continued. 
Other Diseases of the Brain, &:c. 
Diseases of the Neryous System 
Diseases of the Eye 
Diseases of the Ear 
Diseases of the Nose 



IV. Diseases of the Oirculatory 

System: 

Disease of the f Functional 
Heart \Organic - 
Aneurism - - - - 
Varicose Veins - - - 

V. & VI. Diseases of the Absorb- 

ent System and Ductless 

Olanas: 
Bubo (S^mp.) 
Glandular Diseases - 



Vn. Diseases of the Bespiratory 
System; 
Diseases of the Larynx - 

Catarrh - - - - - 

Hsmoptysis - - - - 

Asthma - - - - - 

Other Diseases of the Lungs - 

VIII. Diseases of the Digestive 
System: 
Cynanche . - - - 
Diseases of the Mouth, Teeth, 

&c. - - ^ - - 
Dyspepsia - - - - 
Dysentery - - - 
Diarrhoea - - . - 
Colic and Constipation - 
Hemorrhoids - - - - 

Uemia 

Worms - - - - - 
Other Diseases of the Stomach, 

Intestines. &c. - - - 
Diseases of the Liver, Spleen, &c. 

384. 



173 

07 

6,694 

1,567 

351 



2,631 

1,417 

367 

608 



11,526 
210 



372 

34,108 

518 

424 

9,056 



11,478 

364 

12,281 

2,611 

16,190 

2,564 

1,469 

994 

693 

1,090 
3,368 



1,000 
81 

4,157 
635 
172 



3,582 

2,397 

377 

500 



3,696 
242 



281 
2,223 
1,002 

183 
11,992 



1,970 



1,173 

178 

10,851 

2,202 

623 



6,213 

3,814 

734 

1,108 



15,121 
462 



653 

36,331 

1,520 

607 
21,048 



13,448 



100 


464 


2,530 


14,811 


1,966 


4,577 


2,376 


17,565 


282 


2,846 


476 


1,945 


194 


1,188 


- 


693 


2,412 


3,602 


2,031 


6,399 



3-2 
•4 

29-7 
6- 
1-4 



17- 
10-4 

2- 

3- 



41-4 
1-2 



1-7 

99-5 

41 

1-6 

67*6 



36-8 

1-2 

40-6 

12-6 

48-1 

7-7 

5-3 

3-2 

1-8 

9-6 
147 



Digitized by 



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384 



MEDICAL STATISTICAL RETURNS 



Tablb, No. 4.— Showing the Number of Days' Sickness from each Diflease, &c—contf. 



DISEASE OR INJURY. 



IX. & X. Diseases of fhe Tlrinary 
and Aeneratiye Systems : 

Diseases of the Kidneys - 
Diseases of the Bladder - 
Cronorrhcea - - - - 
Diseases of the Organs of Gene- 
ration - - - - - 
Stricture - - - - 
Varicocele - - - - 
Orchitis - - - - 

XI. Diseases of the Organs of 

Locomotion : i 

Diseases of the Bones, Joints, kc, 

XII. & Xm. Diseases of the 
Cellnlar Tissue and Cuta- 
neous System: 

Phlegmon and Abscess - 

Ulcer 

Erythema . . - - 
Diseases of the Skin 
Carbnncle - . . - 
Scabies - - - - - 



XJnclassed: 

Debility - 

Delirium Tremens - 
Poisoning - - - 

Wounds, Ixguries, ftc. : 

Wounds, iDJuries, &c. - 

Burns and Scalds - 

Hanging 

Suicide - - - - 

Submernon and Drowning 



Totals 



6,220 
424 
229 



104,795 

6,419 

6 

G 

46 



569,589 



On Board. 


In Hospital. 


1,069 


1,931 


178 


313 


28,898 


6,140 


684 


1,209 


1,719 


4,054 


480 


87 


10,442 


4,211 


3,619 


3,936 


82,729 


7,902 


52,522 


19,235 


692 


185 


7,001 


3,381 


74 


78 


2,940 


813 



6,498 
881 
299 



21,092 
604 



56 



Total. 



264,002 



3,000 

491 

35,038 

1,843 

5,778 

567 

14,653 



7,455 



90,631 
71,757 

877 
10,382 

152 
3,753 



12,727 

1,305 

528 



125,887 

6,023 

5 

6 

102 



823,591 



Average Nomber of 
Men Sick Daily. 



Nnmber. 



8Si 

1-3 

95-9 

5- 
15-8 

1- 
40- 



20-4 



248-3 

196-6 

2-4 

28-4 

•4 

10'2 



34-8 
3-5 
1*4 



344-8 
16-5 



Raao 

ptr 

1,000 of 

Force* 



'1 

1-9 

•1 
•3 



5* 
4- 



•6 
•2 



2256-4 



46-2 



Digitized by 



Google 



OF THE TOTAL FORCE. 



385 



Tablb, No. 5. 
Showing the Number Inyaaideoi on the several Stations. 



CAUSE OF INVALIDING. 


W 


a 


'i 

1 

* 

J 
1 

i 


• 


1 


I. General Diseases, Section A. : 

Enteric Fever . - , 
Simple Continued Feve? - 
Agile . - - - - 
Remittent Fever - - - 
Inflaenza . - - - 
Erj'sipelae - . - . 

II. General Diseases, Section B. 

Gout 

Scrofula ^ . - • 
Phthisis Pulmonalis 
Dropsy - . - - - 
Diabetes .... 
Purpura and Ansmia - 

III. Diseases of the Henrous 
System and Organs of the 
Special Senses : 

Apoplexy - - - - 
Sunstroke . - . - 
Paralysb .... 
Vertigo - - . - - 
Epaep83r .... 
Neuralgia - - - . 
Insanitv . . - - 
Other Diseases of the Brain, &c. 
Diseases of the Nervous System 
Diseases of the Eye 
Diseases of the Ear 
Diseases of the Nose 


% 

I 

26 
1 
5 

16 
6 

89 
1 

1 

15 
19 

13 

1 

16 

12 

1 


6 

1 
1 

17 

1 

7 

2 

20 

1 
1 

1 
3 

1 

1 

4 


1 

13 

1 
6 
2 
7 

1 
2 
6 

3 

1 
3 
2 


1 
1 

1 

1 
1 


1 

6 

2 

4 

2 

10 

1 
4 

2 

1 

3 


2 
18 

1 

10 

1 

2 

6 

_ 

1 
2 
3 
2 

6 

1 
1 


1 
11 

12 

1 
8 

12 

1 
4 

1 

3 

1 


8 
6 

10 

3 
20 

3 
23 

1 
2 

5 
3 
2 

3 


5 

1 
4 

1 
2 
1 
1 

1 


18 

11 
2 

9^ 
2 

1 

4 

1 
6 
1 
2 
1 

10 


2 
9 
19 
87 
1 
2 

112 

2 

13 

74 

18 

207 

4 

1 
1 

2 
2 

6 
52 

5 
26 

5 

2 
60 
16 

2 



384. 



Kk 



Digitized by 



Google 



Digitized by 



Google 



OP THE TOTAL FORCE. 



387 



Table^ No. 6.— Showing the Number Inyalided on the several StBLtions - continuecL 



CAUSE OF DEATH. 


1 


1 




3, 
II 


J 


West Coast of 
Africa and Cspe 
of Good Hope. 


i 

1 


i 


< 


t-i 


1 


Vill. Diseases of the Organs of 
Locomotion : 

Diseases of the Bones, JointS; &c. 


19 


9 






^ 


2 




3 


2 


6 


41 


Xn. A Zm. Diseases of the 
CeUnlar Tissue and Cuta- 
neous System: 
Phlegmon and Abscess - 


2 


4 


4 






2 




2 




3 


17 


Ulcer - - - . - 


40 


3 


5 


- 


1 


C 


2 


2 


1 


G 


66 


DiaeaseioftbeSkiii 


3 


2 


- 


- 


- 


1 


1 


1 


- 


- 


8 


TJnclassed: 

DebiUty 


18 


30 


18 


4 


2 


21 


22 


23 


2 


11 


151 


Delirium Tremens 


2 


"" 


- 


- 


- 


- 


- 


1 


- 


1 


4 


Poisoning . . . - 


1 




- 


- 


- 


- 


- 


1 


- 




2 


Wounds and Injuries : 

W^ounds, Injuries^ &c. - 


25 


4 


10 


8 


2 


5 


6 


6 


1 


12 


74 


Total • - - 


5C6 


157 


120 


19 


59 


112 


129 


188 


25 


199 


1,574 



384. 



Ll 



Digitized by 



Google 



388 



MEDICAIi STATISTICAL EBTUEN8 



TABLBy No. 6. 

Showing the Number of Deaths on the seyeral Stations. 



CAUSE OF DEATH. 


& 

1 
1 
6 
2 

1 

1 
o 

1 
22 
1 
1 
2 

• 

2 

1 

10 

12 
8 


s 

• 

e 
'-% 

3 

4 

1 
2 


s 

ti 

1 

4 

48 
2 

o 
8 

1 
2 


o 

Is 

II 

• 

2 
2 

4 
1 

1 
2 

1 

1 

1 


2 

1 

4 

2 
3 


S 


1 


L General Diseases, Section A. : 

Small-Pox - - - - 
Scarlet Fever - - - 
Typhus Fever - - - 
Enteric Fever - - .- 
Simple Continued Fever 

Ague 

Yellow Fever 
Remittent Fever 
Cholera - - - - 
Fysmia - . - - 
Diphtheria - - - - 
Erysipelas - - - - 

n. General Diseases, Section B.: 

Rheamatism ... 
Syphilis, Secondary - 
Phthisis - . - - 
Epithelioma . - . 
Purpura - - - - 
Dropsy - - - - 

m. Diseases of the Kervous 
System and Organs of 
the Special Senses: 

Apoplexy - - - - 
Sunstroke - . - - 
Paralysis . - - - 
Epilepsy - - - 
Other Diseases of the Brain. 

&c. 

Diseases of the Nervous Sys- 
tem . . - - 

17. Diseases of theCircnlatory 
System: 

Disease of the Heart, Organic 
Aneurism • - ' - 


3 

1 

3 


2 

1 

2 
3 

6 


4 

1 
1 
1 
1 

1 

7 

1 

5 

1 
2 

1 

I 


1 
, 1 

1 


1 

i 

1 

7 

2 

1 

6 


5 

1 
4 

16 
8 
1 

67 
6 
5 
3 
1 
2 

3 

1 

61 

1 

t 

14 
4 
5 

1 

14 

1 

34 
9 


1-3 

•2 

11 

4-1 

2-2 

•2 

1.V9 

1-6 

1-3 

•8 

•2 

•5 

•8 
•2 
14-2 
•2 
•6 

3-9 
11 

'1 

8*9 

•2 

9-4 
2-6 


_ 


1- 
•2 
•8 

3- 

1-6 

•2 

11-7 

1-2 

1- 
•6 
•2 
•4 

•6 
•2 
10'5 
•2 
•4 
•4 

28 
•8 

1- 
•2 

2-8 

•2 

7- 
1-8 



Digitized by 



Google 



or THE TOTAL FOBOE. 



389 



Table, No. 6.— Showing the Number of Deaths 


on the seyeral Stations — continued. 


CAUSE OF DEATH. 


1 


s 


1 

1 


1 

1^ 


J 


"86 


1 


, 


9 
< 


f 


1 




ll 


ll 


Vn. Diseases of fhe Bespira- 
tory Syrtem: 
Haemoptysis - . - 
Other Diseases of the Longs 

VIII. Diseases ofthe Digestive 
System: 

Dyspepsia - - . - 
Dysentery - - . - 
Diarrhosa - . . - 
Other Diseases of the Sto- 
mach, &c. - - - 
Diseases of the Liver, &c. - 

IX. &X. Diseases of the ITri- 

nary and Oenerative 

Systems: 
Diseases of the Kidneys 
Stricture - - - - 

Xn. A Xm. Disee«es of the 
Cellular [Tissue and Cu- 
taneous Syrtem: 
Phlegmon and Abscess 

Ulcer 

Carbuncle - - - ^ 

ITnolassed: 

DebiHty .... 
Delirium Tremens 
Poisoning - - - - 

Wounds and Iquries : 

Wounds - - - - 
Bums and Scalds 
Asphyxia - . - - 
Submersion and Drowninir - 
Suicide - - - - 
Kot stated .... 


1 
24 

1 
1 
1 

1 
8 

5 
1 

1 
1 

17 

22 

1 


4 
2 

1 

4 

9 
2 


4 

2 

8 

9 
1 


8 

1 
1 


4 

1 

1 
1 

1 
1 

1 

4 

8 
1 


1 

4 

2 

1 

1 
2 


1 

5 
2 

1 

2 
1 

6 


1 
1 

4 
8 

1 

1 

1 
12 


2 

1 


1 
6 

2 
2 

4 

6 
4 

10 


8 
48 

1 
17 

7 

9 

6 

1 

6 

1 
1 

2 

1 
1 

39 
5 

1 

75 

5 

1 


•8 
18-4 

•2 
4-7 

1-8 

1-9 

2-5 

1-6 
•2 

1-3 
•2 
•2 

•5 
•2 
•2 


30-9 

3-9 

•7 

50-6 

3-9 

•7 


•6 
9-9 

•2 
3-6 
1- 

1-4 
1-8 

1-2 
•2 

1- 
•2 
•2 

:i 

•2 

8- 
1- 

•2 
16-4 
1- 

•2 


Total - - - 


163 |d2 


82 


20 


30 


18 


31 


51 


7 


60 


484 


- 


- 


- 



384. 



ll2 



Digitized by 



Google 



Digitized 



by Google 



[ 391 ] 



I I^ D E X 

TO SHIPS AND STATIONS, 



WITH 



LIST OF MEDICAL OFFICERS. 
186 9. 



384. I. L 3 



Digitized by 



Google 



Digitized by 



Google 



[ .393 ] 



I If D E X 

TO SHIPS AND STATIONS, 

WITH 

LIST OF MEDICAL OFFICERS. 
18G9. 



iV.5.— Where the Names of two or more Surgeons appear in one Ship, it is to be understood 
that these officers were serving in the vessel during different periods of the year ; or, in some 
instances, that a Surgeon was borne in lieu of an Assistant Surgeon. When As9i>tant Surgeons 
only appear, it is to be understood that thej were in charge. 





Stations. 


Pbriod. 


Nakes of Mbdioal Officbbs. 


Ships. 












staff Surgeons and 
Surgeons. 


Assistant Surgeons 


Abonkir 


North America 
and West Indies. 


Year - - 


J. Coogau; P. W. 
Rolston. 


A. Robertson, mj>. 


Achilles 


Home 


8 July to 31 Dec. 


J. C. Ingles - 

P. M. Roe ; E. A. 


W. D. Wodsworth. 


Adventure - 


China 


Year 


E. Wheeler, m.d. 








Hudson (Acting) ; 










C. A. Lees, m.d. 




Agincourt - 


Home 


Year - - 


T. J. Haran; W, E. 
O'Brien. 


T. W. Hughes; J. 
8tewart,B.A. ;G.G. 
Both well; G. K 
Farr; W.J.Inman. 


Algerine 


China 


Year 


- 


R. V. MacCarthy. 


Antelope 


Mediterranean - 


Year 


- - - - 


J. S. Levis, M.D. 


Arethusa 


Irregular 


1 to 7 Jan. 


H. Harkan - - 


D. R. Alcock. 


Argus - 


China 
Irregular 


1 Jan. to 30 June 
1 July to 3 Dec. 


R. H Can-oil. 




Ariadne 


Irregular 


1 Jan, to 8 June 


J. B. Holman, m.d. 
(S.S.); H. Hadlow 
(inlieuofA.S.). 


R. S. P. Griffiths. 


Asia - 


Home 


Year - - 


C.Forbes, M.D. (S,S.); 
F.M.IUyner(S.S.); 
C. Morton (in lieu 
ofA.S.). 


C. R.Enright; C. C* 
Mitcbinson. 


Avon - 


China 


Year 


" " ■ 


E. J.Sharood, mj>.; 
W. A. O'Connor^ 


Barracoata - 


North America 
and Webi; Indies. 


Year - - 


R C. P. Lawrcnson - 


w'j.Wey. 


Barrosa 


Irregular 


9 June to 31 Deo. 


W, Anderson (a) 


R. Turner. 


Basilisk 


Irregular 


1 Jan. to 13 Apr. 


T, J. Wilson - 


E. W. Leet, 


Beacon - 


South £a8t Coast 
of America. 


Year - - 




J. T. Comerford,]rj>. 


384. 




ll4 


I 








Digitized by VJ 


.ooqIc 



394 



INDEX. 



Shits. 



Stations. 



Pebiod. 



Names of Medical Ovfiobbs. 



Staff Sargeons and 

Sui^ODS. 



Assistant Sui^geons. 



Bellerophon - 

Bermudft Float- 
ing Dork. 
Black Prince - 



Blanche 
Boscawen 

Boxer - 

Brilliant 
Bibk - 
Bristol - 

Britannia 



Bullfinch - 

Buzzard 

Cadmus 
Caledonia 

Cambridge - 



Cameleon 
Caradoc 
Castor - 
Challenger 

Chanticleer 

Chary bd is 
Cockatrice 
Cormorant 

Cossack 
Cracker 

Crocodile 
Cruiser 

Dafdalns 

Danae - 



Daphne 



Home 

Irregular 

Home 



Australia - 
Home 

Irregular - 
Pacific 
Home 
Irregular - 
Irregular - 

Home 



Irregular - 
East Indies 
Homo 

Irrefjular - 
Mediterranean 



Home 



Pacific 

Mediterranean 
Home 
Australia - 



Year 

leJunetodlJuly 

Year 



Year 

Year - - 

1 Jan. to SO June 
1 July to 31 Dec. 
Year . - 
1 to 19 Jan. 
Year - - 



-Year 



1 Jan. to 31 Mar. 
1 Apr, to 31 Dec. 
Year - - 

23 Apr. to 8 June 
Year 



Year 



Year 

1 Jan. to 9 Juno 

Year 

Year 



Pacific 

Pacific 

Mediterranean - 
China 

East Indies 
South East Coast 

of America. 
Irregular - 
Mediterranean - 

Home 

West Coast of 

Africa and Cape. 

Irregular - 

East Indies 



Year 

Year 
Year 
Year 



1 July to 31 Dec, 
Year - - 



Year 
Year 

Year 

1 Jan. to 30 Sept. 

1 Oct. to 31 Dec. 
Year 



N. Littleton 



G. Duncan, h.d. 

(S.S.); W. G. J. 

Ayre. 
G. Molloy 
H. Slade ; J. G, T, 

Forbes. 



J. Christie, m.d. 
W. D. Smyth, m-d. - 
A.Irwin^ A.Rattray, 

MD. 

A. W. W. Babington 
CS.S.) ; J. Caldwell 
(inlieuof A.S). 



W. Anderson (a) 

J. G. T. Forbes; J. 

Buckley (in lieu of 

A.S.) ; J. Cotton, 

M.D. (S.S,). 

M. Walling, m.d. - 



F. A. Brice 

L. J. Monteith (&S.) 

A.Watson,MD.(S.S.); 

D. Finncane, M.D. 

R. Humphrys : M, 

Rodgers, m.d. 
J. C. Messer, m.d, - 



L. Lucas - 
F. Piercy 



J. Flanagan 

A. M'Bride, m.d. 



H. Fdmonds^ m.d. 

(S.S.). 
J. F. Mitchell ; R. R. \j. H. Houston. 

Siccama. 



E. T. Mortimer ; W. 
E. Dillon (Acting). 



A. Groodall, M.D. ; W, 

H. Putsey. 
E. Olive. 

G. V. Hart, b.a^ 



J. C. Bailey. 

E. T. Lloyd ;T. Con- 

R. Potter, M.B. 



M. 0. Hurlstone. 
G. Macleaii,M.A.,M.D. 
T. H. Knott. 



J. Allen. 

W. M. Power. 

R. Turner. 

J. Pringle, m.d.; B. 

Ninnia, m j>. ; A. G. 

Delmege, m.d, 

E. "Wheeler, m.d. ; 

W. Galloway, m.d. ; 

W.Grant, M.D. ; J. 

H, Martiu. 
A. W.Winn. 
R. Hay, m.d. 

H.N. Maclaurin,M.D., 
M.A.; L Waugb, 

B.A., M.B. 

T. Bolster. 

T. Cann, m.d. 

A.L Bolton, a A., M.B. 

C. L. Ridout (in 

charge). 
T. L. Homer. 
A. Turnbull, m.d. 

G. Curtis. 

W. H. Stewart, m.b. 



Digitized by 



Google 



I N D B X. 



395 



Ships. 



Btations. 



Pbriod. 



Nasies of Medical Officers. 



Staff Surgeons and 
Surgeons. 



Assistant Surgeons. 



Dart - . . 
Dasher - 
Dauntless 

Dee » - 

Defence 

Donegal 

Doris - 

Dromedary - 

Dryad - 
Duke of Wel- 
lington. 
Duncan 



Durham 
Dwarf - 

Eagle - 
Eclipse - 

Egmont 

Elk - 

Endymion 

Enterprise 
Euphrates 
Excellent 



Espoir - 
Favorite 

Fisgard 



Flirt - 
Flora - 



384. 



North America 
and West Indies. 
Home 

Home 

Home 
Home 

North America 
and West Indies. 
Home 
Irregular - 

North America 
and West Indies. 

West Const of 
Africa and Cape. 

East Indies 

Home 

Home 



Home 
China 

Home 

North America 

and West Indies. 
South Eabt Coast 

of America. 
Irregular - 
China 

Mediterranean - 
Irre/jular - 
Mediterranean -« 
East Indies 
Home 



Irregular - ^ - 
North America 
and West Indies. 
Home 



Elome 

West Coast of 
Africa and Cape. 



Year 

Year 

Year 

28 Oct. to 31 Dec. 
1 Jan. to 31 Mar. 
1 Apr. to 31 Dec. 

1 Jan. to 30 June 
25 Nov. to 31 Dec. 

1 Jan. to 16 June 

1 Jan. to 24 Apr. 

Year - - 
Year 

Year - - 



Year 
Year 

Year 
Year 

Year 

1 Jan. to 10 Apr. 
20 Apr. to 31 Dec. 

1 Jan. to 21 May 

22 May to 31 Dec 

Year 

Year 

Year 



8 Oct. to 8 Dec. - 
1 Jan. to 25 Aug. 

Year 



Year 
Year 



R.D.Pritchard(S.S.) 
F. F. Morgan - 



C. F. A. Courtney ; 

J. B. Holroan, m.d. 

(S.S.) 
J. E. Dyas 



D. O'Connor, m.d. 
W.T.Wilson (S.S.); 

F. W. Blake, »f .d. 
J. Thomson (c), mj>. 

(S.S.) ; F. W. Davis 

(in lieu of A.S.) ; J. 

W.Reid,ju.D.(S.S.); 

II. Trevan, m.d. 

(S.S.) 
C. M'Shane (S.S.) 



A. Murray (S.S.) 
R. L. B. Head ; W. 

F. C. Bartlett. 
T. McCarthy - 



A. Fisher, m.d. 

P. W. Wallace, M.D. 
S. A. Willis, M.I). - 
J. Henderson, mj>. 
(S.S.). 






W. Edncy 

C.K.Ord,M.D.(S.S.); 
A. Robertson (in lieu 
ofA.S.); J.D.Mac- 
donald, MJ>.^ F.B.8. 

A. S. Pratt; J.Mur- 
phy ; W. J. Eames. 



M. A. Harte ; W. H. 

Charles worth. 
J. S. Barry ; W. S. 

Fisher, b.a., m.b. 
Geo. .Murdoch, m.b. ; 

A. Colquhoun. 
W. Johnston, m.d. 
W. H.Charleswortb. 



J. B. Isaac; R. At- 
kinson ; G. Mar* 

doch. M.B. 

G. V. Wright, M.D. ; 

T. Corny. 
T. St. J. Gierke, m.d. 



C. Maclean, m.b. ; D. 

R.Alco3k;G.KeU. 
A. Mitchell, m.d. ; T. 

Milne, m.d. 



W. Reid, M.D. 

M. U. Greany, mjd. 
T. N. W. Colahan. 

A. Mitchell, m.d. ; R. 
J. Sweetnam ; R. 
Grant, m.a., m.b. 

J.Trimble; J. Dun- 
lop, M.D. 

R. B. O'Toole. 

J. N. Stone ; R. A. 

Mowll,M.D. ; T.St. 

J. Gierke, m.d. 
J. Crawford. 
A. Scott, M.A., M.B. 

E. B. Broster ; H. D. 
Stanistreet. 



S. Sweetnam. 

T. D'A. Bromlow, 
M.D. ;T.C.HickeY, 
M.B. ; P. O'fc. 
D'Oyle; C. Mac- 
lean, M.B. 



Digitized by 



Google 



396 



1 K D X X. 



Sbips. 



Fly - 
Forte . 

Fox - 
Galatea 

Ganges - 



Gladiator 
Greyhound - 

Growler 

Hector - 

Helicon 

Hercules 

Hibemia 
Himalaya 
Hornet - 

Icarus - 

Implacable - 
Impregnable - 

Inconstant • 
Indus - 



Industry 
Investigator 

Jackal - 
Jaseur - 

Jason 



Stations. 



West Coast of 
Africa and Cape. 
East Indies 



Home 
Irregular - 



Home 



Irregular - 
>outh East Coast 

of America. 
West Coast of 

Africa and Cape. 

Home 
Home 
Home 



Mediterraneaii - Y'ear 



Period. 



Year 
Year 

Year 
Year 

Year 



20Aug.to31Dec. 
I Jan. toll Sept. 

IJuly to311)ec. 

Year 

Year - - 

Year 



Irregular 
Irregular - 
China 

China 

Home 
Home 



Home 
Home 



. I Year 
. I 1 Jan. to SO June 
1 July to 81 Dec. 

Year - - 

Year 

Year - - 



12 Aug. to 31 Dec 
. ^ Year 



West Coast of 
Africa and Cape. 

West Coast of 
Africa and Cape 

Home 

West Coast of 

Africa and Cape. 

Mediterranean - 

North America 

and West Indies. 



1 April to 31 Dec. 
1 Jan. to 22 Feb. 

Year - - 

I Jan. to 30 Sept. 

1 Oct. to 31 Dec. 
Year - - 



Names op Medical Oficsbs. 



Staff Surgeons and 
Suigeoiis. 



J. W. S. Meiklejohn, 

M.D. 



J. Young, 1I.D. (S.S.) ; 
W. L. Powell (in 
lieu of A.S); A, 
Watson, H.D. (as.) 

S. S. D. Wells ; F. 
McAree (in lieu of 
A.a); W. S. Roche 
(inheuof A.S.) 

J. Thomson. 

A. Collins, M.B. 



R. C. Scott (S.S.) 



R. Irvine 

F. Negus (S.S.) 
T. B. Purchas - 



R. J. McMurris; C.G 
Wodsworth( Acting), 
F. Y. Toms - 
W. B. Fegen (S.S.) ; 
S. Wade. 

D. McEwan, m.d. 

S.Bowden,ii.D.(aa) 



W. H. Lloyd, M.D. 



Asdstant Suigeons. 



E. W. Doyle. 

W.E.Dillon; P. a 
Warren ; 11. a 
Smart, m.d. 

E.OHve; J.D.Smith, 
ifj>. 

W. H. Symes, m.b. 



W. H. Goode, M3. ; 
M. Trevan. 



C. R. Enright 



A. G. Bain. 

R. Turner; J. A. 

Hatch. 
J. McK. HoUings- 

worth. 
W. P. Clapp ; St. L. 

Mullen, M D. 
H. A. Close. 

B. H. McCurdy. 
J. B. Drew. 

^. A. Hudson. 

J. Whitaker, m.d. 
J. Dunlop, M.D. ; J. 

Crawford; J.Trim- 
ble. 
A. McDonald, if.D. ; 

M. F. Byan. 
G. W. L. Harrison ; 

G. A. Campbell; 

M. F. Moylan; A. 

S. Crowdy ; A. V. 

Sniyth. 
W. Redmond. 

P. O'C. D'Oyle. 

T. L. Bickford ; M. 

O. Hurlstone. 
J. R. Burke, Ma>. ; 

T. D'A. Bromlow, 

M.D. 

J. L. Whitney. 



Digitized by 



Google 



INDEX. 



M7 



Ships. 



Jumna - 
Juno - 



Lapwing 
Lee 

Leven - 

Liberty 
Liffey - 

Linnet - 

Lion 

LiTerpool 
Lord Warden 

Lynx - 

Malabar 
Malacca 

Manilla 

Marines, Falk- 
land Isles. 

Marines^ San 
Juan. 

Martin - 

Meiiusa 

Megssra 

Mersey - 

Midge - 
Minotaur 

Movarch 



Mullet - 

Mutine 
Myrmidon 



Statioks. 



East Indies 
Irregular - 

Hone 

North Amerca 

and West Indices. 
West Coast o* 

A^rit-a and Cape. 
Irregular - 
Mediterranean - 
China 

Home 
Irregular - 

South Ea>t Ooa-t 

of America. 
Irreguhir - 
Home 

[ Irregular - 

Mediterranean - 



West Coast of 
Africa and Cape. 
East Indies 
Pacific 
Irregular - 

Ciina 

South East Coast 

of America. 
Pacific 



Pi BIOD. 



Year 
Year 



1 J]in to 30 Juno 
1 July lo 31 Dec. 

I Jan. to 31 Mar. 

lApriltoSOJune. 
1 Jul.> to 31 Die. 
Year 



Year - - 

Year 

! Jan. ♦o 3 1 Mar. 

1 April to 3 July. 
1 Jan, to 1 Nov. 

8 May to 31 Dec. 

Year 



Year 

Year 

1 Jan. to 30 June 

1 July to 27 Aug. 

1 Jan. to 15 June 
Year 



Names of Medioal Offtcbbs. 



Stafi^ Surgeons ami 
SuigeoLB. 



L. H. J. Hayne, m.d. 
D. Wilson; P. M 
Roe. 



W. G, Hill 



W. TeFer 



Home 
Home 
Irregular 
Home 

Irregular 

China 

Home 



Home 



- Year 

. Year 

- Year 

- Year 
-Year 

.' 19 Feb. to no Sept. 

- 1 Oct. to 31 Dec. 
. Year 



i W. Mc K. Saundtrs, 

H.Trevan,M.D.(S.S.); 
E. H. Evans (iu 
lieuofA.a);J.W. 
Reid, M.D. (aa) 



T. Colan, M.D. 
W. H. Cruice 



I W. F. MacClinton, 

I M.B. 



J. Jack (S.a) - 



H. Gjmlett, m.d. 
I (S.S.) 



Assistiint Surgeons. 



I 



13Mayto31Dec. W.FaHken,M.D.(S.«.) 



North America 
and West Indie:*. 

Irregular - - ! 

West Coast of i 
Africa and Cape.' 



Year -----. 

1 Jan. to 30 Mar. J. Mart»n, m.d. 
Year - - R. R. Sccau a ; J. F. 

Mitchell. 



384. 



G. B. Beale, mj>. 

J. H. Penberthy, 
H.D. ; £. A. Hud- 
son. 

D. McCarthy. 

T. H. Atkinson. 



H.D.Stanisirect;:E. 

J. Sharoody v.i). 
W. Anderson (b), 
G. H. Madeley;W. 

H. Goode, M.B. 
A. M*Donald, m.d. 



R. Grant, m.a. m.b. ; 

G. Monteathy m.d. 
J. Bradley ; F. 

Buckle, M.D. 
T. Browne, mj>. 



W. P. M. Boyle. 

R. L. Bett. 
a liamfield. 



C. G. Wodsworth. 



I. Hanbury. 

J. Mulvany, m.d. 
J. A . Mac Donald, m.d. 
R. G. Bird. 
F. F. Flynn, m.b. ; 

E. W. Leet. 
S. Terry. 

C. Strickland ; J. B. 

Nicoll, m.d. ; J. 

Wilson. 
A. B. Johnson ; W. 

Galloway; m.d. ; C. 

F. K. Murray, mj). 
P. Burgess, m.b. 

W. Grant, M J). 



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Google 



398 



INDEX. 



Bbjpb. 



Nankin 

Narcissus 

Nassau - 

Nerens - 
Newport 
Niobe - 

Northumber- 
land. 
Nymphe 

Oberon - 

Ocean - 

Octayia 

Orontos 

Orwell - 

Pallas - - 
Pandora 

Peari - 
Pembroke 

Penelope 

Perseus - 
Peterel - 
Philomel 
Phoebe - 

Pioneer 

Plover - 

President 
Prince Consort 

Princess Char- 
lotte. 
Pysche - 



STATIONS. 



Home 



South East Coast 

of America. 
South East Coast 

of America. 
Pacific 

Mediterranean - 
North America 

and West Indies. 
Home 

East Indies 

South East Coast 

of America. 
China 

East Indies 
Irregular - 
Irregular - 

Home 

Home 

West Coast of 
Africa and Cape. 
China 

Home 



Home 



China 
IiTegular - 
Cape and West 

Coast of Africa. 
North America 

and West Indies. 
North America 

and West Indies. 
Irregular - 
West Coast of 

Africa and Cape. 
West Coast of 

Africa and Cape 
Home 
Mediterranean - 

China 
Mediterranean - 



Pbriod. 



Year 

1 Jan. to 17 July 
I Jan. to 12 Aug. 



Year 
Year 
Year 

Year 



Year 

1 Jan. to 20 July 

Year 

1 Jan. to 31 Mar. 
1 April to 22 July 
9 Jan. to 31 Dec. 

Year 

1 Jan. to Oct. 
Year 



Year 
Year 

Year 



1 Jan. to 30 June 
IJulyloiaOct. 
Year 

Year - - 

] Jan. to 30 June 

1 July to 31 Dec. 
Year 

Year 

Year 
Year 

Year 

Year 



Naues of Medical Officbrs. 



Staff Surgeons and 
Surgeons. 



T. R. Pickthoru 
(S.S.); A. B. Mes- 
ser, M .D. 

J. EUiott CS S.) 

S. Campbell, v.d. 



W. F. C. Bnrtlett; 

R. L. B. Head. 
S. Clift . 

J. Noble. 



J. Rorie - 
D. M. Shaw 
R. Edwardes 

R. Creighton 



E. Waller, ii.d. ; B. 

Gregory (Acting). 
T. Seccombe, m.d. 

(aS.);T.J.Haran. 

W.E.O'Brien;T. Sec- 
combe, MJ). (S.S.) ; 
R. W. Beaumont 
(S8.). 

A. Cooper 

J. N. J. 0:Malley. 



J. Ward (S.S.) 



H. M. Speer (8.S.). 
G. Mason, m j>. 



Assistant Surgeons. 



J. S. Dobbyn ; J. H. 
Martin. 



Geo. Mair, m.a.,m.d. 
R. Cannon. 



E. Mulcahy; G. B. 
Murray. 



A. A. Mullin. 

S. Kellett; J. Mc- 
Carthy. 

II. N. M. Sedgwick ; 
M. F. Ryan. 

F. Buckle, M.D. ; A. 
G. Robertson, m.b. 

J. Lambert ; A. Mit- 
chell, M.D. 

A. G. Colquhoun. 

N. T. Connolly. 



E. V. Da M6ric. 

J. ^\ hyte, if.B. ; T. 

Redfeni, m.d.; J. 

Stewart, m.b. 
G. G. Bothwell ; T. 

Red fern, mj). 



J. Craw, M.D. 



J. G. Claike. 

D. McN. Johnstoi, 
MJ>. ; F. McCle- 
ment, m.d. 

A. Gorham, m.d. 



V. Duke. 



W. McMahon, m.d. ; 
J. K. Convay, m.d. 
W. J. Thomason. 

T. Warden, mj>. 



Digitized by 



Google 







INDEX* 


399 




Station'. 


Period. 


Nambs op Medical Officers. 


Ships. 












Staff Surgeons and 
Surgeons. 


Assistant Smgeons. 


Pylades 


Pacific 

Sonth East Coast 
of America. 


lJan.to30Sept. 
1 Oct. to 31 Dec. 


J. Fisher - - - 


J Shields. 


Racoon 


Irregular - 
Mediterranean - 


Year - - 


P. Mansfield, m.d. • 


J. Wilson; S. Sexton. 


Rapid - 


Year . - 


G. W. J. Sutherland, 


C. G. Langdon. 


Rattlesnake 


West Coast of 
Africa and Cape. 


Year - - 


Iff.A. 

J. S. Adama - 


J. M. Hunter; P. 
O'C. D'Oyle. 


Reindeer 


Pacific 


Year 


E.Dann,M.D. (Acting). 




Resistance - 


Homo 


lJulyto3lDec. 


C. F. A. Courtney - 


J. B. Isaac ; J. Rod- 


Revenge 


Home 


IJon.toll Mar. 


W.Crawford; J.Cot- 


gers. 
J . E. Saunder8on,B.A., 




Irregular - 


21 Apr. to 27 Sept. 


ton, M.D. (S.S.) ; J. 


M.D.;B.Ninnb,M.D.; 




Irregular - 


16Nov.to31Dec. 


G. T. Forbes; J. 
Buckley (in lieu of 
A.S.) ; D. L. Mor. 
gan, M.D. (S.S.) ; J. 
'J\ U. Bremner,M.D. 


A. Delmege, mj). ; 
J. Pringle, M.D. ; J. 
Kodgers; J. B. Ni- 
C0II.M.D.; R. S.P. 








Griffiths ; M. Tre- 








(S.S.). 


van ; E. T. Lloyd. 


Rifleman 


China 


1 July to Sn Aug. 




W. A. O'Connor, mj>. 


Rinaldo 


China 


Year - - 


W. G. Ridings 


R. Beamish, h.a^ujs. 


Ringdove 


Irregular - 


iJan.todlMar. 


• . - . 


J. Parker. 




Pacific - 


1 April to 31 Dec. 
22 Nov. to 31 Dec. 


• . . • 


A. Brend. 


Rocket - 


Irregular - 


. - • • 


W. J. Morier, m.b. 


Rodnej 


China 


Year - . 


G.B.Hill (S.S.); H. 
Fegan, mj>. (in lieu 
of A.S.); L. Lucas 


J. A. Gaven ; C. L. 
Ridout. 
















(additional). 




Rosario 


Australia - 


Year - - 


T. Roche 




Roynl Ade- 


Home 


Year . - 


A. Adams (S.S.) 


G. Price, M.D. 


laide. 










Royal Alfred 


North America 


Year 


D. L. Morgan, m.d. 


J. Rodgers: J. B. 




and West Indies. 




(S.S.); R. C. P. 
Lawrenson (in lieu 
of A.S.); W. L. 
Gordon, m.d. (S.S.). 


Nicoll,M.D.;R.S.P. 
Griffiths. 


Boyal George 


Homo 


Year - - 


H. Loney (S,S.); A. 
J. Ireland, m.d. (in 


R. Atkinson. 
















lieu of AS.) 




Royal Oak - 


Mediterranean - 


Year 


W.H.Clarke - - 


T. Browne, M.D.: H. 
S. Trail ; W. C. J. 


















Holmes ;T.T.Ri- 










ordan. 


Royalist 


North America 
and West Indies. 


Year - - 


C. H. Slaughter 


J. W. Fisher, m.d. 


St. Gooi^e - 


Home 


lJan.to30June 


P. Digan, m.d. (S.S.) 


W. D. Wodsworth. 


St. Vincent - 


Home 


Year - -" 


W. Hoggan (S.S.) - 


W. J. Morier, m.b. ; 
J. S. Dobbyn. 


Salamis. 


China 


Year 


.... 


W. Fetherstonhaugh. 


Satellite 


Pacific . 

• 


Year 


W.D.Longfield( Act- 
ing) ; R. Eustace. 
J.-T. Gabriel. 


E. Meade. 


Scoipion 


Home 


Year 




Scont - 


Irregular - 


I Jan. to 6 May 


W. Carmichael, m.d. 




Scylla . . 


Irregular - 


15 Apr. to 31 Dec. 


C. Keenan 


J. Whyte, M.B. 


Benlark 


Home 


Year - - 


- - - . 


J. C. Dunlopj R. 




1 




Hay, MJ>. 


384. 




1 







Digitized by 



Google 



400 



I N D E X» 



Ships. 



Serapb 
Seringapatam 

Serpent 

Sheerness Re- 
senre. 



Simoom 
Sirius - 



Slanej-- 

Sparrowhawk 

Speedwell 



Spider - 
Spitefal 

Squirrel 

Star - 
Sylvia - 

Tamar - 
Teazer - 

Terrible. 

Terror - 

Thistle - 
Topaze 



Trafalgar - 
Trincomalee- 



Trinculo 



Stations. 



Period. 



Irregular - 

West Coast of 
Africa and Cape. 

China 
Irregular - 

Home 



Irregular - 
Irregular - 
West Coast of 
Africa and Cape. 

China 

Pacific 

West Coast of 

Africa and Cape, 
South £ast Coast 

of America. 

South East Coaat 
of Ameiica. 

East Indies 
Irregular - 

Home 

East Indies 
China 



Irregular - 
Irregular - 

Home 
Irregular - 

North America 
and West Indies. 

Irregular - 
Paomc 
Irr^^lar - 

Home 
Home 



Mediterranean 



Year 

Year 



1 Jan. to 31 Mar. 
I Apr. to 10 Aug. 

Year 



Year 

28Julyto30Sept 
1 Oct. to 31 Dec. 



Year 
Year 
1 Jan. to 31 Mar. 

1 Apr. to 31 Dec. 



1 Jan. to 1 May 

lJan.to30June 
1 July to 23 Sept. 

Year 

Year 
Year 



15Sept.to3lDec. 
23 Nov. to 31 Dec. 

1 Jan. to 10 May 
1*2 June to 31 Dec, 

Year 



18 Oct. to 22 Nov 
1 Jan. to 30 June 
1 July to 1 Sept. 

1 Jan, to 20 Nov. 
Year - - 



Year 



Names op Medical Oppioers. 



Staff Surgeons and 
Surgeons. 



J. Breakey, m.d. 



A. MuUan (Actins: 
Surgeon and Sur- 
geon). 

J. Lilbume, m.d. 
(S.S.) ; R. Mungle 
(in Ueu of A.S.) ; 
F. McAree (in Ueu 
of A.S.). 

A. McKenno, m.d. - 
M. Magill 



P. Comrie. 



D« Hilaton, m d. 



W. R. Bennett, m.d. 

F. U. Moore ; E. V. 
de M6rl€ (Acting). 

G. F. Banks - 



W.Fasken,M.D.(S.S.) 
W. Richardson 

J. L. Palmer - 



T. J. Breen (S.S.) - 

J. I. Crawford, m.d. 

(as.) ; A. Irwin. 



Assistant Surgeons. 



A G. Bain ; E. W. 

Colenaan, mjo. 
R. J. Sweetnam ; 

P. O'C. D'Oyle. 



W. Graham. 



B. L. Moss, m.d. 
J. C. Dunlop. 



W. K. Ryall. 
W. B. Fletcher. 



fl. S. Lauder. 



J. F. Parr ; A. Scott, 

M.A., M.B. 

R. V. MacCarthy(in 
charge). 

J. F. Parr. 
J. S, Barry. 

J. A. Hatch. 

G. W. L. Harrison. 

J. Halpin; W. J. 
Wey. 

J. S. Barry, 

C. B. Greenfield, m.b. 



W. Y, Paton, m.b. 



W. Yarde, m.d. 



Digitized by 



Google 



INDEX. 



401 





Stations. 


Period. 


Names of Medical Officers. 


Ships. 


Staff Surgeons and 
Surgeons. 


Assistant Suigeons. 


Urgent 


Irregalar - 


1 Jan. to 20 Aug. 


F. H. Blaxall, m.d. 
(S.S.) 


G. Kell. 


Valiant 


Home 


Year - - 


C.D.Shephard(S.S.); 
G. V. McDono^h, 
M d. (in lieu of A.S.) ; 
W. Smith, M.D. 
(S.S.) 




Valorous 


Irregular - 


12 to 31 Dec. - 


T.G.Wilson . - 


T. O'SuUivan, m.d. 


Vcatal . . 


North America 
and West Indies. 


Year 


C. McConaghy (act- 
ing); A.Robertson, 
M.D. (acting). 


M. U. Greany, m d. 
(in chaige). 


Victoria and 
Albert. 


Home 


Year - - 


J. M. Minter, m.d. 
(Dep. Insp. Gen.) 




Victory 
Vindictive - 


Home 

West Coast of 
Africa and Cape. 


1 Jan. to 28 Feb. 


F. M. Rayner (S.S.) 


A. G. Robertson, m.b. ; 

W. C. J. Holmes. 
J. Robertson ; W. 

J. Rankin, m.d. 


Virago - 


Australia - 


Year 


A.Crosbie, M.D. 




Warrior 


Home 


Year 


J. C. Walsh (8.S.); 
W. J.Hamilton.M.D. 
(in lieu of A.S. ). 


R. A. Mowll, M.D. 


Winchester - 


Home * 


Year 


W. Ross, M.D. (S.S.) ; 
W. Lawrance (aS). 




Wizard 


Mediterranean - 


Year 


- 


D. Maclver, md. 


Zealous 


Pacific . 


Year - - 


J. Cockin rS.S.) - 


J. Simpson, m.d. ; A. 
Brend. 


Zebra - 


China 


Year 


J.W.Leahy - - 


C. L. Ridout. 



384. 



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Google 



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APPENDIX. 



384. M M 

/Google 



Digitized by^ 



Digitized by 



Google 



[ 1 ] 



MEDICAL AND SURGICAL REPORTS 

For the Year 1869, 

OP THE 

MARINE DIVISIONS 

AT 

Fort Cumberland andEASTNEY. 
Portsmouth (Forton). 
Plymouth, and 
Chatham. 



384, 



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Google 



APPENDIX. 



MEDICAL AND SURGICAL REPOBT 

OF THE 

ROYAL MARINE ARTILLERY DIVISION 

AT 

EASTNEY BARRACKS AND FORT CUMBERLAND, 

Between the Ist January and the Slst December 1B69« 
By Staff Surgeon J. Jenkinb, o.b., m.d. 





.1". 




i 








a 




|l 


■1 


g 




« 




1. 




II 


t 


1 


2 


y 


. 1 


^1 




u 


1 


s 


a 


1 


i\ 


'1 


I. Qenenl DiMUM, Sec- 


Measles .... 




2 


2 










tionA. 


Scarlet Fever ... 


_ 


1 




1 


_ 


- 


« 




Enteric Fever - - . 


1 


2 


^ 


3 


- 


- 


- 




Simple Continued Fever - 




8 


6 


3 


- 


- 


^ 




Ague • . . . 


_ 


2 




2 


- 


- 


_ 




Cholera .... 


« 


2 


1 


_ 


- 


1 


« 




Erysipelas . . . 


__ 


1 




1 


- 


- 


- 


II. General DiMuet, Sec- 


Rheumatiim - - . 


2 


97 


71 


24 


I 


- 


3 


tion B. 


Gout .... 


I 


3 


3 




- 


- 


J 




Syphilis, Primary - 


3 


159 


97 


56 


- 


~ 


9 




Syphilis, Secondsry - 




38 


16 


18 


1 




5 




Hsmoptysis ... 


3 


1 


2 


2 


- 


- 






Phthisis Pulmonalis - 




22 


6 


16 


i 


- 






Parotitis ... 


1 


1 


2 




- 


- 






Purpura - . . 


I 


1 


2 


- 


- 


- 


I 


lU. DiieiMt of tbe Ner- 


Apoplexy 


„ 


1 


^ 


I 


- 


- 


„ 




Paralysis ... 


«. 


6 


8 




2 


- 


- 


nut of tbe Special 
Seneei. 


Convulsions from Drink . 


_ 


1 


1 


« 


- 


- 


- 


]^n^ I r I 


[ 


5 
10 


3 

7 


2 


3 

1 


"* 


- 




Vertigo . . . - 


u 


8 


7 


1 


- 


— 


_ 




Insanity .... 


_ 


2 




2 


- 


"- 


_ 




Syncope. 


.. 


2 


2 


- 


- 


— 


"" 




Fistula Lachrymalis • 


„ 


2 


2 


_ 


- 


- 


1 




Ophthalmia ... 


« 


23 


19 


2 


2 


- 


« 




Cataract. 


_ 








1 


- 


_ 




Diseases of the Ear . 


_ 


9 


6 


1 


2 


- 


_ 




Diseases of the Nose - 


- 


3 


3 




- 


- 


- 


IV. DiMMei of the Circu- 


Diseases of fFunctional - 
the Heart \Organic 




31 


16 


13 




- 


_ 


latory Syitem. 


« 


42 


15 


26 


1 


- 


_ 




Aneurism ... 


_ 


4 


_ 


3 


_ 


I 


_ 




Varicose Veins 


- 


1 3 


2 


1 


- 


- 




y. & VI. Dineaefl of tlie 


Bubo (Swmp.) 


_ 


8 


3 


3 


_ 


- 


2 


Absorbent System and 


Adenitis- '^ 1 . . 


_ 


3 


3 




^ 


- 




Ductlesi Glands. 


















VII. Diseases of tbe Re^ 


Catarrh - . . - 


8 


163 


162 


6 


_ 


_ 


3 


spiratory System. 


Bronchitis ... 




19 


17 


2 


_ 


_ 






Asthma .... 


„ 


4 


2 


1 


1 


- 


_ 




Pneumonia - - - 


: 


! 2 


! 1 


1 


_ 


. 


_ 




Aphonia ... 


1 - 


i 1 


1 - 




1 


- 


- 



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APPENDIX. 



Mbdical and Surgical Report of the Royal Marine AvtiWeryykc,-- continued. 



VIII. DiKtMt of the Di- 
ftttife Sjrttem. 



IX. Ic X. Diteaies of the 

Urinarjr and Genera- 
tire 8y Items. 



XI. Oiaeaiit of the Organs 
of Loeotnotion. 



XII. k XIII. Diseases of 
the Cellular I'issoe and 
Cutaneoas System. 



Uni 



Wounds and Injuries 



Cynanehe 

Icterus * . - 

Mekana - - - 

Dyspepsia 

Dyspepsia e potQ 

Dysentery 

Diarrhoea 

Colic and Constipation 

Hiemorrhoids - 

Condylomata Ani 

Hernia . 

Worms - - - 

Ptyalism . - 

Hepatitis 

FSatula in Ano 

Prolapsus Ani - 

Bright'fl Disease 

Incontinence of Urine 

Oonorrhcea 

Balanitis 

Hematuria 

Strictute 

Varicocele 

Orchitis - - - 

Hydrocele 

Diseaees of the Bones # 
Diseases of the Joists 
Diaeaees of the Burse 
Fibro-cellular Tumour 

Phlegmon and Abscess 
Ulcer - 

Other Skin Diseases 
Scabies . . - 



DebiUty - 
Sea-sidcness - 
Delirium Tremens - 

Wounds - - - 

Fractures 

Dislocations - 

Sprains . - - 

Contusions 

Bums and Scalds • 

SobmersioB and Drowning 

Abrasions 

Total - - 



•3 1 
•3 5 



47 



60 

11 

I 

71 

32 

3 

59 

16 

3 

3 

8 

8 

15 

4 
2 

1 
2 
224 
I 
1 
6 
2 
19 
1 

3 

1 
10 



187 
fl7 
31 
33 

14 

1 

82 
8 
7 

46 

70 
1 
1 

12 



1»760 



66 

4 

73 

30 

1 

61 

15 

1 

3 

8 
1 
9 
3 

I 



2 

139 
1 

1 
2 

16 



139 
50 
26 
31 

14 



79 

4 

6 

41 

67 

2 

13 



l,S82 






90 
I 



846 






I 



.9 
I. 



36 



41 



884. 



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Google 



APPENDIX. 



Cases of all Men Dead or Invalided • 



Service 

in 
Yetrt. 


Com- 
ptnyto 
which 
belong- 
ing. 


Cun, 


Age. 


Quality. 


Cauie of Death or 
Invaliding. 


Date 

(^ Death 

or 
Invaliding. 


Whither 
Discharged. 


Date 

of 

Discharge. 




17 
9 


16 
17 


Ciw 1 

,. 2 


40 
31 


Gunner - 
.» 


Aneurism • . . 
Cholera - - - 


30 Jan. . 
11 March 


Dead - 


30 Jan. . 
11 March 




8 
6 


12 
6 

18 
9 


., 3 
„ 6 


26 
32 
28 
29 


„ 


Drowning - . . 

Syphilis, Secondary 
Hernia 


10 July . 

26 Dec. - 
8 Jan. - 
8 Jan. - 


Invalided 


10 July - 

26 Dec. - 

19 Jan. - 

2 March 




11 


1 


,. 7 


32 


.. 


Deafiiess . 


5 Feb. . 


9t 


16 Feb. - 




12 
1 


17 
18 


„ 9 


31 
26 




Ulcer - 

Hernia . - - 


5 Feb. - 

6 March 


ft 


16 Feb. - 
16 March 




12 
2 

18 


6 

6 

12 


„ 10 

V *2 


31 
20 
32 


»» 
„ 


Bursitis ... 
Phthisis - 


6 March 
9 April - 
7May . 


»> 

,» 


16 Bfaich 
20 April - 
18 May - 




4 


11 


M 13 


22 


», 


Epilepsy . - . 


7 May . 


,, 


18 May - 




Oft 


14 


n 14 


27 


.. - 


Dislocation ... 


7May - 


.» 


18 May - 




2 

«ft 


2 
6 


^ 16 
M 16 


22 
25 


.» 


Hernia . - . 
Gunshot wound - 


4 June - 
9 July - 


,» 


15 June - 
20 July - 




7 
4 
3 


6 

9 

11 


o 17 
„ 18 
» 19 


25 
34 
28 




Paralysis ... 

Cataract 

Paralysis . 


9 July - 
9 July . 
9 July - 


,» 
„ 


20 July - 
20 July . 
20 July - 




2 
10 


6 
9 


« 20 

n 21 


21 

31 




Ophthalmia ... 
Fracture ... 


9 July - 
9 July - 




20 July - 
20 July . 




i 


2 

10 
11 


..22 
.,23 
., 24 


21 
25 
23 


.t 


EpUepsy - . 
Cardiac disease, syphilitic 
Rheumatism 


9 July . 
9 July - 
9 July - 




20 July - 
20 July - 
20 July . 




6 


8 


,.26 


29 


Bombardier 


Neura%ia - . . 


6 Aug. . 


1, 


18 Aug. . 




0* 
5 


16 
8 


.,26 
„27 


23 
24 


Gunner • 


Ophthalmia - 

Aphonia ... 


6 Aug. - 
3Sept.- 




18 Aug. . 
14 Sept. - 




10 


3 

6 

16 

15 


„28 
.,29 
„30 
.. 31 


21 
30 
26 
30 


„ 
„ 


Disease of ear 

Asthma 

Hernia ... 

Disease of bone • 


3 Sept. - 
3 Sept. . 
3 Sept. . 
3 Sept. - 


», 

„ 


14 Sept.. 
14 Sept. - 
14 Sept. - 
14Sq>t.. 




6 


6 


n 32 


27 


„ 


Hernia ... 


8 Oct. . 


„ 


20 Oct. . 




10 


11 


.,83 


29 


„ 


Hernia 


8 Oct. . 


,* 


30 Oct, - 




2 
2« 


6 
16 


,.34 
..35 


21 
21 




Varicocele - - 
8ea-sickness 


8 Oct. - 
8 Oct. - 




27 Oct. - 
20 Oct. . 




6ft 


3 


,.36 


21 


Bugler . 


Hernia 


6 Nov. - 


», 


17 Nov. . 




10 


6 


.,37 


28 


Gunner - 


Ulcer. . - 


5 Nov. - 


., 


17 Nov. - 




2ft 
15 


15 
H 


..38 
„39 


30 
33 


.« 

,» 


Hernia ... 


5 Nov. . 
3Dec.- 


», 
,» 


17 Nov. - 
15 Dec. - 





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APPENDIX. 



during the Period of this Return. 



State if Inytlided from a 

Foreign Station, 

tlie Place, Date, &c., and 

Remarks. 



Not invalided 



Not invalided before • 
4th Angnat 1868, Rattle- 
tnake. Cape of Good Hdpe» 
Not invalided before - 



30th November 1867, Cale- 
donia, Mediterranean Station. 
21st December 1 868, Ocean, 

China. 
Never bvalided before 



22nd December 1 668, Chal. 

lenger, New Zealand 
Never invalided before 

8th April 1869, Edipw, North 

America and West Indies. 
Never invalided before 



1st February 1869, H. M. 8. 

Peterel, Cape of Good Hope. 

12th June 1868, Argu», 

Cape of Good Hope. 
Never invalided before 



5th May 1869, Spiteliil, Bast 

India Station. 
4th October 1869, North- 

nmberland, Channel Sqnad< 

ron. 
Never invalided before 



REMARKS. 



Aneurtim of arch of aorta, burst whilst running. Lived twelve hours. 

Severe vomiting, rice-water evacuations, cramps, collapse, and death. 

Drowned accidentally whilst bathing at barracks; went down suddenly ; cramp ? 

Much vomiting, hepatic tenderness. Death from coma on sixth day. 

Syphilitic cachexia. 

Femoral hernia of left side from injury by the service ; also heemoptysis and phthisis. 

Total deafness of left ear and considerable deafness of right ear. Said to hav* been 

caused by broadside firing. 
Varicose ulcer of right leg; constitutional. 
Injury received in and by service at head quarters, 26th January 1869. Oblique 

inguinal hernia. 
Disease of phalangeal bones of right great toe, resulting from a bunion. 
Had three well marked ** fits " in two days. No previous history of the disease. 
A very chronic case, long under treatment in Haslar Hospital. 

Had no return of ** fits " at head quarters. 

Lameness of left arm following dislocation of clavicle. Injury received by a fall down 

stairs in barracks, 22nd January 1 869. 
Oblique inguinal hernia, occasioned by service at head qtiarters, II ih May 1869. 
Wound of back received in action, 29th July 1868. Is unable to stand erect. 

Partial paralysis of left side, affecting organs of speech, arm, and leg. 

Cataract of right eye. 

General paralysis following concussion of the brain. 

Defective vision following ophthalmia. 

Lameness, foUowing fracture of right thigh occasioned by the service. Fell from a 
scaffolding at bairacks. 

Found to be suffering from organic disease of heart when examined for embarkation. 
Invalided home for secondary syphilis and cachexia. 

Invalided home for loss of memory and neuralgia. 

Defective vision of both eyes. 

Has sufiercd from loss of voice for fourteen monlhf . Chloroform and galvanism tried 

without success. 
Otitis of both sides in a syphilitic constitution. 
Chronic bronchitis with frequent attacks of spasmodic asthma. 
Double inguinal hernia, said to be congenital. 
Necrosis of clavicle, with permanent enlargement of the bone, causing lameness of 

right arm. 
Oblique inguinal hernia. Injured by service on board Topose, in the Pacific, 24th 

July 1867. 
Oblique inguinal hernia. Injured by service in Pallas, Mediterranean Station, 19th 

April 1869. 
Varicooele of lef^ side. 
Was a supernumerary in H. M. S. SpitefUl. Persistent and irremediable sca-sickiiesi. 

Oblique inguinal hernia, diseov^Uhl when a patient with syphilis. 

A large clcatrilE on left leg, said to have been caused by an Injury received in Achilles^ 

1st ItibrUary 1867. 
Fracture of both bones of right leg and resulting lameness. Not received on duty. 
Oblique inguinal hernia of left side discovered ) no assignable cause. 



384. 



a3 



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APPENDIX. 



Classification of Disbasbb for 1869. 


Class and Nature of Disease. 


Number of 
Cases. 


Number per 
1,000 Men. 


Class I. General Diseases, Section A. - 


. 


. 


19 


12-2 


„ II. „ „ B. - 


- 


- 


334 


2150 


„ III. Diseases of the Nervous System 


- 


- 


7S 


47-0 


„ IV. „ Circulatory „ - 


- 


m ^ 


80 


51-5 


„ V.&VI. „ Absorbent „ - 


- 


- 


11 


7-0 


„ VII. „ Respiratory „ - 


- 


- 


197 


126-7 


„ VIII. ,, Digestive „ - 


- 


- 


305 


196-2 


„ IX. & X. „ Urinary, &c. „ - 


- 


- 


260 


167-8 


„ XI. „ Locomotive „ - 


- 


- 


15 


9-6 


„ XII. & XIII. Diseases of the Cellular System, 


fcc. 


268 


174-4 


Unclasscd 


• 


- 


16 


10»S 


Wounds and Injuries 


Total 


- - - 


229 


144-6 




1,807 


1162*8 


Mean Daily Force 


- 1,664< 















Table showing Number of Men Borne, Entered, Discharged, &c. during this Period. 



Average daily number of all i^anks 
Number of men embarked during the year - 
„ disembarked „ - - 

discharged (for all reasons) 
entered as recruits or volunteers 
who are married 



}9 



1,554 
605 
417 
264 
25 
762 



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APPENDIX. 

REPOKT ON THE HEALTH 

OF THE 

ARTILLERY DIVISION OF ROYAL MARINES, 

For the Year 1869. 
By StaiF Surgeon J. JenkinS; m.d., c.b. 



Number of men 
embarked and 
disembark^. 



Difficulty of 
obtaining accu* 
rate statisticfl. 



Im this annual Return from the corps it may not be inopportune to glance Introductory. 
I^eneranv at its medical history, past and present ; the relations which it may bear, 
in a meoical point of view, to tne army and nayy ; and also to inquire into any 
special injuries or diseases to whidi it may be liable as a separate body. 

For this purpose, the medical returns of previous years have been carefully 
gone over, several statistical tables compiled, and the hygienic condition of the 
barraoks and neighbourhood inquired into, with a view to determine in what de- 
gree it may have favoured or prejudiced health. But in estimating the health - 
rate of the division, or in comparing it with the army and navy, the constant 
change in iUi personnel^ owing to the departure of healthy men for embarkation, 
and the return of men from all parts of the world, who have disembarked, some 
with broken-down constitutions, and others with health impaired or enfeebled, 
the result of either dimate or disease, or both combined, must not be forgotten. 

During the year, 605 men, all in good health, left head-quarters for service at 
sea ; and 417 disembarked. To the latter, furlough (for periods varying accord- 
ing to the length of their absence from England) is usually granted ; and, that 
their holiday is not always spent in the most rational manner, we have the 
strongest proof in the many dyspeptic, nervous, and other complaints which 
appear on the sick-list after it is over and work commences. This casual, but 
iri^ently recurring, increase to the sick-rate must not be lost sight of, and its 
true cause recognis^. It is, therefore, to be premised that, in the investigation 
of the origin and history of disease, a great difficulty exists in a corps suph as 
this: 

Firstly.— In tracing the cause of disease, as much of it is contracted abroad, 
and no ^^ medical history sheet " has hitherto existed in the corps. 

Secondly, a larae proportion of cases are sent to the Royal Naval Hos- 
pital at Haslar, wnere men may either die or be invalided, without further 
particulars being available for a Return like the present. 

In the early part of 1 865 the Royal Marine Artillery corps (previously quartered 
at Fort Cumberland, Forton Barracks, and Portsmouth) was removed into the 
new, roacious, and magnificent barracks at Eastney, about two aud a half miles 
east ot Portsmouth. The men's quarters consist of two long blocks of brick 
buildings, three storeys in height, and built parallel to each other, at the respective 
distances of five and seven hundred yards from the sea on a gravelly soil. 
These blocks extend in a direction nearly east and west, and have their frontage 
and main entrances looking southwards or seaward. 

The Southern Block is occupied hj unmarried men, and contains the barrack' Barraek-roomi . 
rooms proper, these being thirty-six in number, and having accommodation for 
1,000 men } rarely more, however, than one-half the number of these rooms is 
occupied. 

Each room contains an average of twenty-eight men, and is of the following 
dimenskms : 

Length, 55 feet ; width, 21 feet ; height, 13 feet ; giving to each man 5361 Cubic loace. 
cubicfeet of air. (55 x 21 X 13 = 15,015 ~ 28 = 536). *^ 

384. a4 ' The 



Locatioaof 
corpi. 



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« 



APPENDIX. 



Appendix. The number of snperficial feet or flooring space per man is 41i square feet 

thus : (55 X 21|= 1165 r 28 = 41 J). The quantity of air is somewhat under that 

Saperficial allowed by army regulation, which is 600 cubic feet. The bedding and furniture, 

space. together with the bodies of the men, have also to be subtracted, which, allowing 

ten cubic feet for the former and four for the latter, leaves for each man, when 
the room is fuUy occupied, 522^ cubic feet of air. In comparison with other 
well-conditioned and healthy dwellings, this appears to be ample where such a 
sufficient means of ventilation exists as is now employed in all permanent 
barracks. 

Windows. On each side of the rooms there are four windows, measuring iu total breadth 

(on each side) sixteen feet, or xfather more than one -fourth of the wall space. 

Fireplaees. The fireplaces are large and open, two in number in each room, and placed at 

nearly opposite angles. 

Married The Northern Block of building is principally occupied by married men and 

quarters. their families, and for this purpose it is divided into numerous small rooms, the 

average dimensions of which are 16 X 16x13 feet, containing 3,228 cubic feet of 
air, but from this must be subtracted a sometimes large, but greatly varying 
Dormitories for <unount for furniture and the bodies of occupants. These latter range from two to 
children. ^^ ^^ number, but in the case of children over five years of a^e large and roomy 

dormitories are provided on the upper floor of the building. The average 
number of occupants in the small rooms is under four, and, even with a consi- 
derable deduction being made for furniture, they cannot be considered as over 
crowded. 

Ventilation. The ventilation of the barrack rooms is carried on by means of three wooden 

shafts in each room, of quadrilateral form, about a square foot in size at the 
ends, and which extend at equal intervals across the ceiling. These shafts open 
directly into the external air by means of intervals in the brickwork, and com- 
municate with the .'iir in the rooms by numerous circular openings about one inch 
in diameter (about 100 of these perforations exist in each shaft). 

Waterclosots, urinals, and lavatories are attached to each room and situated 
on the stair hmding ; all have an abundant supply of good water, and are fitted 
with patent taps and valvular apparatus. The basins and pans ore constructed 
of enamelled metal. They are however seldom used, and the waterdosets never 
(except in cases of emergency). The latrines, urinals, &c. in constant use are 
situated under a large gli^-covered shed (used for drill) immediately behind the 
building, and communicate directly with a well-trapped drain running direct to 
the sea. 

An abundant supply of water keeps up a continual " flushing " of the 
urinals, &c. 

Cleanliness of tho rooms is maintained by thoroughly scrubbing the floors 
twice a week. The stairs and passages are cleaned daily. All the rooms, &c. 
are whitewashed annually. 

Besides the men who live in barracks, a large number of married men live in 
the small hoases which exist in the villages of Eastney and Mitton, their 
dwellings varying in distance from the barracks from fifty yards to one mile, and 
it is " a consummation devoutly to be wished " that the same sanitary laws which 
regulate a barrack-room could be extended to them. A few mav bo models of 
cleanliness, neatness, and order, but too many are the abodes of wretchedness, 
filth, and concomitant disease, and the description of them given by Assistant 
Surgeon Robertson, in last yearns " Health of the Navy " still, unfortunately, 
remains true. 

Enteric fever is rarely absent from these dwellinffs, and such diseases as 
measles and scarlet fever, when once introduced, find a locality but too congenial 
to their further propagation. Facts are not wanting to prove that married men 
living out of barracks frequently import these diseases within their walls, and thai 
they do so in a less degree than might even be expected, is no doubt due to the 
circumstances that they are less at home than their ynve^ and families, that they 

are 



Waterdosets, 



Cleanliness. 



Men not llring 
in barracks. 



Sarroondiog 
district a 
sooroe of infec- 
tion. 



Zymotic 
disease. 



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APPENDIX. 9 

are not so obnoxious to zymotic disease as children ; and, in the case of enteric Appendix, 
fever, it is just probable, as has been suggested, that they owe their comparative 
immunity from it to drinking beer insteiui of water. 

During Miehaelmas quarter an epidemic of scarlet fever, and during Christmas 
quarter one of measles, prevailed (of the latter disease no fewer than sixty-nin€ 
cases occurred amongst women and children), yet only one married man con- 
tracted either disease ; and of the cases of enteric fever (noted in this year's 
return as the last of an epidemic of the previous year) only one of the men 
attacked lived out of barracks. 

In studying the hygienic conditions surroimding individuab, the circum- Hygienic con- 
stances influencing health may be divided into two classes. ditions which 

influence 
(1.) The essential and natural conditions of life common to all men ; health, 
as diet, air, water, soil, &c. 

(2.) Conditions peculiar to men following particular employments, or 
forming special social bodies, such as soldiers, seamen, &c. 

Under the first heading, I have briefly shown that the body with which 
we are concerned (whilst on shore) has on ample supply of fresh air, is well 
lodged, provided with all the necessaries, and not a few of the luxuries of 
life, and is generally speaking in a most favourable sanitary condition. The 
diet is that common to all British troops at home, and the means of recreation 
afforded the men is not, I believe, excelled either at home or abroad. 



There remain, however, certain circumstances which tend to increase the 
returns under the various classes of disease, and which depend upon causes 
spoken of under the second head, or those which, par eooceHence^ operate 
upon the men as soldiers in contradistinction to men employed in civil life. 

But, before enumerating those special causes of disease, it may be well to 
note that no true comparision can be drawn between the prevalence of dis- 
ease in the army and iiiat amongst civilians, except it may be in those cases 
which have a fatal termination. For, from the very nature of the soldier's 
duties, a much higher standard of health is required of him than of any other 
class, nor can he be indisposed for a single day without figuring on the health 
returns. It is, indeed, probable, that of the cases in the present return, three- 
fourths at least would never have appeared in any return of diseases in civil life, 
and of the thirty-five cases ^ invalided, a very large proportion are still able 
to follow some other occupation. The facility, too, witn which men can com- 
mand medical attendance, no doubt increases the returns, as in minor cases of 
catarrh, diarrhoea, &c., many men would probably continue at duty in preference 
to walking a mile to see the "doctor." The temptation to escape some dis- 
agreeable duty, or some awarded punishment, is likewise a fertile source of 
exaggerated ailments. 

By referring to the nosological table, it will be observed that the diseases 
showing the greatest number of admissions and loss to the service by death or 
invaliding are classed under wounds, &c., diseases of the circulatory system, and 
diseases of the enthetic class. 

These may be considered under the following headings, presuming that each 
acts as a principal cause in producing the above diseases respectively. 



Peculiarities in 
diseases of ma< 
rines in their 
capacity of 
soldiers. 



A high standard 
of healtn re- 
quired as com- 
pared with 
other occupa- 
tions. 



(1.) Labour. 



(2.) Dress. 



(3.) Prostitution. 



Labour. — The amount of work performed by the Royal Marine Artillery Duties of the 
Corps is considerably greater than by infantry regiments, and probably more than corps, 
that by either ^e Cavalry or Boyai Artillery. The drill comprises that of light 
inf antay, field artillery, and naval guns, which latter is now of a particularly 
heavy nature, owing to tiie greatly increased size of the ordnance used in the 

" service 



• Including those invalided from Haslar, 126 men were inTalided from the oorpi daring 
the year. (5«e Table III.) 

384. 



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10 



APPBNDIX. 



Xp ftMJix . a tenrioe afloat.** Modem guns, however, are becoming somewhat more manage- 
able in working, from the greater amount of mechanical api^anoes (toothed 
wheels, leyers, &c.) used in moving them at driU, and thns reancinff the use of 
the " handspiKe," a frequent source of *' rupture" among seamen and marines. 

Drill. About four htmdred men are employed at drill daily for about fire hours, the 

summer routine beginning at 6.30 a.m., and the winter routine at 8.80 a.m. For 
fifteen or eighteen months after joining the corps, a recruit has daily to underi^ 
tbiB ^' drudgery " of his profession, when, if found sufficiently trained, he is 

Employment, "passed" and drafted for service on board ship. A large number of noen 
in the ccnrps have, however, some other employment besides that of a soldier. 
Almost every trade is represented, and where practicable a man is ^ employed.*' 
Tailors, carpenters, plumbers, briddavers, masons, &c» are all refffesentedf as 
well as the lighter occupations of clerk, printer, &c. Well conducted man find 
occupations as officers* servants, coacnmen, grooms, and occasionally nurses. 
It will thus be seen that, probably more so than in any other body of 
fighting men, does the dvil element of labour prevail, and whether adding 
to health, or increasing disease, this must undoubtedly modi^ those diseases 
which may be peculiar to, or excessive in, more purely military bodies as regards 
occupation. 



Injuries re- 
ceived on duty. 



Exposure to 
severe weather 
avoided. 



Under Labour may be classed all those diseases to which it may give rise either 
ftom the peculiarity of its nature or excess in its amount, and with the former 
may be classed all those injuries (many of minor surgical importance) received at 
gun drill, which show a large number of admissions and a considerable loss to 
the daily strength of the corps, and it will be seen by looking to the oomparative 
table for the last four years that the numbers fluctuate very largely, depending 
greatly upon the number of recruits at daily drill,' as these represent by far the 
most numerous of this class of cases. 

The casualties of most frequent occurrence are oontusioni and lacerations 
of the fingers by being jammed in blocks, and of the feet and toes lyy being 
crushed under sun trucks. Three men were invalided during the year for 
injuries received on duty, one for lameness resulting from fracture of the 
femur caused by falMng from a scaffolding at Eastney, and two for oblique 
inguinal hernia occasioned at gun driU ; three other oases of hernia occurred at 
headquarters during the year, probably received on duty, but they could not be 
so distinctly traced to their origin. 

Whilst at drill the men are rarely and never avoidably exposed to inclement 
weather. All field-battery drill is subject to a " general order " of weather per> 
mitting. Infantry drill is performed in a commodious glass shed, and naval 
guns are worked in large wooden batteries built to represent the gun-deoks of a 
ship. The only unavoidable exposure to inclement weather is that undergone 
on sentry duty, each man keeping two hours' watch at a time, and eight hours* 
watch in twenty-four. Men employed on guard duty are out of l^, on an 
average, one night in five. 

During severe weather sentries are relieved every hour. This duty donbtieas 
gives rise to numerous cases of catarrh, and in winter to more severe affections 
of the respiratory organs. The guard-rooms are generally kept at a high tem- 
perature, and the alternation of heat and cold, with frequent lying down in wet 
clothes must be prejudicial in a high degree. 

Besides drill and guard-keeping, general parades, marching out, and *^ field 
days " entail occasional heavy work upon the men. It has been calculated that 
a fully equipped soldier who marches ten miles, performs as much work as is 
usually done oy a day labourer in ten hours, and as the former, in this case, does 
his work in about three hours, it will appear of no light character, nor do I 
think that such periods of great exertion, short as they are, are at all counter- 
balanced in their detrimental tendencies by the long hours of inactivity and 
indolence, which usually follow. It is, however, under the next head that I 
would briefly refer to diseases entailed by these duties. 

Much disease Dre««.— That the dress of the soldier is a fruitful source of diseaae there can 
is produced by be little doubt, and is, I believe, but a too plainly demonstrable truth ; and 
drMs, &c. much 



Marching, &c. 



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APPENDIX. 



11 



muoh interMfc, amounting afanost to " agitation " has been aroused on this sub- 
jeet, eeeing that it is amenable to tiie fi^t principle of cure, vis., to remove the 
cause. This is, however, but very indirectly under the control of the medical 
denurtment. 

That much good has been done of late* years in this direction is undoubted, 
and I need but dte one instance in support of my statement, vis., the change 
in the construction of the " stock," a froqnent cause of disease of the cervical and 
submaxillary glands, and, in scrofulous subjects, giving rise to chronic absceeses 
of intractable nature, not only causing much permanent loss to the service by 
invaliding, but producing most unsightly, painful, and troublesome disease, now 
happily of the rarest occurrence. 

It has been acknowledged by the most competent authorities that the equipment 
of the soldier in times of peace neither fits him to endure greater ^tigue in 
timee of war, nor is the burden which he now carries any fitting preparation 
for the duties which he has then to perform, and those who have seen a party 
of marines sent on shore to ^ bum and destroy *' the village of some saucy 
Chinese mandarin or the barracoon of some slave dealer on the coast of Africa, 
will see but little preparation for such a duty in the matter of drees. 

" When war comes with its rude touch," says Dr. Parkes, " everything which 
is not useful disappears ; what can be easiest borne is soon found out. The 
arts of the tailor and the orders of the martinet are alike disregarded, and 
men instinctively return to what is most simple and useful," and wose of this 
corps who have seen active service can abundantly testify its truth. 

The dress of the Roval Marine Artillery is similar to that of the Royal Ar- 
tillery, and somewhat neavier than in the infantry. The following table shows 
the weights carried on the march : 

Lh8. 



kppmi&x. 



Personal clothing on body 11 

Knapsack, containing spare kit, and greatcoat with straps 19 

Forage cap and canteen (carried on knapsack) ... 2 

Haversack (carried in knapsack when not in use) 

Rifle (Snider) 8 

Sword bayonet and scabbard 2 

Ball and earlridge pouches, belt, frog, &c. - - - 3 15 

Total - - - 48 1 




8 

8 
15 
8 



Dre88ofthe 
oorpi. 

Weights carried 
by men OB 
parade or 
march, &c. 



With the above, a blanket (four pounds), water, and three days' provisions 
(eight pounds), would be carried on a long march in active service, making in all 
60 pounds, without allowing for ammunition, which might vary in weight from 
one to six pounds. 

Granting the necessity for carrying this weight, perhaps less may be said of Tightneas in 
the dress than of the manner in which it is worn. Everything, in the first place, dress, belts, &c. 
is tight, tight in the extreme ; the collar is tight round the neck, the tunic is but- 
toned tightly across the chest, the trousers arc tight round the waist and they are 
tight in the perinesum and vicinity of the scrotum. In addition to this pressure, 
acting unequally on the superficial venous circulation and compressing the 
pectorahs, latissimus dorsi, and other muscles of respiration, are the knapsack 
straps paadng under the armpits, and again compressing the free edge of the 
pectortJ muscle and the deltoid, two of the most powerful in moving the arm. 

It is not then surprising that we find not only diseases of the heart, both Diseases of 
functional and organic, but also an excess of other diseases of the circulatory circulatory 

system, syttem. 



jVo/«. — j^g the corps of Royal Marines was raised in some degree to fbrm a connecting 
link between the soldier and sailor, he may nt least have some claim to the free and easy 
dress held so essential for the latter. 

384. 



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12 



APPENDIX. 



Appendix. 



Greatest per- 
manent loss of 
serrioe arises 
from cardiac 
disease. 

Mechanical 
origin of this 
disease. 



Epilepsy. 



** Irritable 
heart." 



Prophylactic 
measures. 



ajTsteiD) Buch as anearisni) varicoee veins, varicocele and hsBmonlioids, which 
may doubtless, in large proportion, be attributed to compression by clothing 
either in a direct or indirect manner. 

During the year, seventy-seven cases of heart disease or aneurism were under 
treatment ; of these, forty were sent to hospital ; one was invalided, and one died ; 
but on tracing the hospital cases we find that no fewer than thirty-seven were 
invalided, makmg a total loss to the service, from these diseases alone, of thirty- 
eight men or 22-45 per 1,000 of mean force. It will be seen, on reference to 
Table HI., that nearly one-third of all cases invalided from the service suffered 
from disease of the heart. Of a total of eleven cases of death occurring in the 
year (including those in Haslar), one-third arose from the same cause, showing a 
ratio of 2'57 per 1,000 of force. 

It will thus be seen that diseases of the heart occupy the most prominent 
position of those which give rise to permanent loss of service either from death 
or invaliding, and considering that a man enters the service in the prime 
of life and, presumably, unaJEected by disease of any kind, we are, in the 
absence of other special cause connected with his profession as a soldier, driven 
by a process of exclusion to place the vast excess of his mortality and invaliding 
from heart disease to the influence of his dress. That many of these cases have 
a mechanical origin is, I think, easily demonstrated. The tight-fitting trousers 
which, during the breakfast or dinner meal, have been unbuttoned at the waist, 
can only be re-buttoned by forcibly compressing tiie abdomen and pushing the 
stomach and diaphragm upwards into the cavity of the thorax, whilst the tight- 
fitting tunic, with its powerful ally, ihe belt, unites to resist the invasion by 
preventing the thorax from expanding upwards or laterally. The consequences 
are, the lungs are compressed and circulation through them impeded, the heart 
becomes sur-charged and labours to clear itself, as its tumultuous and irregular 
action testifies, and the pain, palpitation, dyspnosa, vertigo, and Minting which 
ensue afterwards. That it is also a cause of epilepsy is not improbable, from 
the fact that the first seizure, in the cases which have come under notice, has 
generally taken place when the man was on parade or fully accoutred. 

In an endeavour to classify cardiac affections, it would be difficult to distinguish 
between cases of an organic nature and those of palpitation only, owing, not 
only to difficulty of accurate diagnosis, but also to tne fact that a iarge number 
are invalided from hospital ; but, in treating of loss of service from this cause 
in a medico-military point of view, the clinical aspect of the cases may be thrown 
aside, as the patient is equally unfitted for service, whether he may suffer from 
organic lesion or persistent violence of action. 

In cases of " irritable heart/* where palpitation is excessive on slight exertion, a 
few days' rest in bed, a purgative, and perhaps a few doses of digitalis^ are usually 



' weU," 



found to ally all urgent symptoms ; the patient then expresses 1 
and is, so to speak, discharged cured ; but again and again does his name appear on 
the records of the infirmary to be as often re-fitted for work, till, after a useless 
expense to the country and a long score of sickness, he is finally invalided and 
lost sight of ; and this latter fact ought to be borne in mind in all statistics 
of heart disease, comparing its frequency in civil and military communities, 
as discharged soldiers belong to the former. 

It IS, I fear, to prophylactic measures alone that we can look for any diminu • 
tion in this class of disease. A higher standard of physique, a less severe and 
more graduated ti'aining of the youiig recruit, and, above all, a total chance in 
the style of dress, ai-e amongst the cluef desiderata. Efforts already made nave 
iiot been without fruit, the old rigid strangulating stock has disappeared, the 
cumbersome knapsack has given way to one at least less so, and men in this 

corps. 



Noie. — It may be a subject worthy of inquiry, how much the numerous cases of jaundice 
owe their origin to compression of the liver by the tunic and waistbelt 

During the year eleven cases occurred, two of which proved iktal. This is a number 
equivalent to that in the home ** service afloat " for previous three jears. 



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APPENDIX, 13 

oorps, and I believe in others, are allowed to wear a light serge or dock jacket, Appendix. 

whilst at gnn diill and fatigue daty, instead of the buttoned- up " shell." But 

yet much remains to be done before the soldier can be freed from those tram- 
mels which so literally bind him, and before he can, like o^er hardworking men, 
be said to " strip to his work.** 

At the date of this return the new valise is under trial here, as in various Line f^^ ^g^ 
regiments, and appears to be a step in the right direction. It removes much of « vaiite." 
the compression from the deltoid and pectoral muscles, and placing, as it does, 
the principal portion of the weight on the upper part of the sacrum, throws it 
below the man's centre of gravi^r, thus adding to his stability , and obviating the 
necessity of the forward stoop necessary to counterbalance the knapsack. The 
men seem to approve of it (no mean test of the comparative ease with which it 
is carried), although it is said to possess the disadvantage of keeping the loins too 
warm. 

In Table IV. a summary of cases of heart diseases which were invalided is 
given. It is worthy of note that although men enter the corps at eighteen years 
of age, and manv buglers and drummers still younger, no case has been invcdided 
under the age ox twenty, showing that the disease is not very rapidly developed. 

So far as can be ascertained from the hospital records, five only of the thirty- 
six cases of cardiac disease were of an organic nature, and on subtracting them 
from the whole, we find an average of 4i?j years as the period of sei*vice of men 
invalided for palpitation alone. 

ProstUution, — ^With this heading as a cause, may be included all those diseases 
arising from impure sexual intercourse ; from a simple abrasion of the mucous 
membrance of the penis to constitutional syphilis in the most severe degree. 
As a source of disease, it may now be considered as amongst those having some 
peculiarity in its operation among naval and military bodies, since the " Con- 
tagious Diseases A^t ** was made specially applicable to garrison and seaport 
towns. 

In Table V. a comparison is shown between army, navy, and marine artillery, Syphilis and 
and although the cases shown as occurring in the latter body appear in great gonorrhoBa in 
excess, it must be borne in mind: (1.) That it is permanently stationed in a army, navy, and 
town surpassed bvnone in Europe in the flagrancy of its prostitution ; (2.) That n>*rine corps, 
the mean strength of the corps (1,554) has been represented by upwards of 2,000 
individuals ; and, (3.) That secondary sjrphilis is imported from all parts of the 
world. 

In comparison with the " service afloat," it may be remarked that as a man Effects of the 
has no opportunity of propagating his disease at sea he is not unf requently Contagioos 
allowed to continue at auty whilst under treatment for a simple sore or mild Diseases Act. 
gonorrhoea, and is consequently not shown in the returns of sickness. Almost 
without exception have the men in this corps been placed on the sick-list or under 
treatment in the infirmary for the most trivial ^' contagious disease," and as these 
cases may show in what degree legislation has modified the disease, it may be 
useful to note the changes which have occurred during its working. 

Gonorrhoea has not diminished. The number of cases has averaged 141 
per 1,000 of mean force yearly since 1866, and has not shown any marked 
diminution or increase in any one year. The disease is generally of a subacute 
character ; cases complicated with chordee or severe ardor urin» are not frequent ; 
bubo is an exceedingly rare complication, and orchitis occurs comparatiyely 
seldom. These latter complications doubtless owe their rarity to the detection 
of the disease in its early stage, and the immediate enjoinment of rest. 

Syphilis (Primary), in which we include every primary venereal sore, has 
undergone a marked diminution in frequ