HMS Hydra - medical journal
HMS Hydra - medical journal


William Loney R.N.DocumentsMedical journals  

William Loney’s Medical journal ADM 101/186 covers that part of 1872 during which he served as Staff Surgeon in HMS Glasgow, the flagship of the Commander-in-Chief on the East Indies station


GENERAL REMARKS

Having given in last years Journal a general description of the ship's accommodation, ventilation etc, with remarks on the physical condition of the crew, and general economy and hygiene of the vessel, I have only to add here that an attempt was made at Bombay in May last to carry out the system of ventilation I recommended direct from screw alley to the poop, and was found to be impracticable.

I append a tracing [no longer present], showing how I proposed to carry a tube along the ships' side, when I found it impracticable to carry it directly upwards; but here again the Carpenter encountered difficulties, which completely stopped all further proceedings. However I must say that, on the whole, the bilge occasions very little annoyance, and, as the sick list shows, no injury to the health of the ship's company.

#

With the exception of Madras, there is no place of any importance on the Indian Station that the Glasgow has not visited during the period embraced by this Journal.

Leaving Trincomalie early in January we arrived at the Hooghly on the 17th and Admiral Cockburne having landed and taken up his residence at Government House Calcutta, intending to go overland to Bombay, and there to rejoin us, Lord Mayo, Viceroy of India, embarked for a tour on inspection to Burmah and the Andamans.

Three or four days after sailing from Trincomalie, Admiral Cockburne complained of feeling unwell, and was landed in a very bad state of health; but as I shall refer to his case farther on, in its proper place in the next section of my remarks, I may dismiss it for the present.

From the Hooghly we sailed for Rangoon, where we remained a week, and sailing from thence to Moulmein, staid there 2 days. Two days more sailing or steaming from Moulmein brought us to Port Blair, Andaman islands [first used by the British as a penal settlement in 1789; since 1858 as a penal colony for Indian separatists] where Lord Mayo met his death at the hands of a life convict on the evening of the 8 February.

He went on shore early that day, and inspected every part of the convict settlement, concluding with a visit to a high ground in one of the islands from whence a commanding view is obtained. Unhappily he remained on shore until dark, and had almost reached the place where the steam launch awaited him, when the assassin, rushing wildly past his attendants, struck him with a knife, inflicting two incised wounds, one on the left side of the chest superiorly, penetrating deeply, and a similar wound on the right side of the chest posteriorly. He was quite dead when the steam launch came alongside, and I believe he must have died immediately after been taken into the boat, or about ¼ an hour before the boat came alongside.

An inspection of the wounds externally, was all we were permitted to make, the ends of justice not requiring a complete examination.

On the 9th February the assassin was condemned to death, and on the 10th we got under weigh and steamed back to Calcutta with all dispatch.

Arriving at the mouth of the Hooghly on the 13th the body was transferred to the Daphne, and that vessel proceeded up river to Calcutta.

On her arrival, there was a funeral procession to Government House, where the body lay in state for some days.

The Daphne returning with the body to the mouth of the Hooghly on the 22nd, it was transferred to the Glasgow, and we proceeded direct to Trincomalie, and from thence - after a brief stay - to Bombay, where Lady Mayo and some members of her family embarked, and we proceeded to Suez, calling at Aden on the way agreably with orders received by telegraph from the Admiralty.

At Suez, the Enchantress, Admiralty yacht, waited our arrival, and having received the body of the late Viceroy of India, and embarked Lady Mayo, family and suite, proceeded at once to England.

The Glasgow remained 10 days at Suez, busily occupied in refitting, painting, cleaning flues after a long continuance of steaming, and in other duties; and having embarked Lord Northbrook, the new Viceroy of India, and staff, we sailed on the 8th April for Bombay, touching at Perim Island and Aden to give Lord Northbrook an opportunity of officially visiting those places.

Arriving at Bombay on the 26 April, we found the flying squadron, under the command of Admiral Beauchamp Seymour, lying there; and the several vessels of the squadron saluted the Viceroy's Flag as we streamed into harbour and otherwise cooperated in doing honor to the occasion.

At Bombay, our new Commander-in-Chief, Rear Admiral Arthur Cumming CB [with whom Loney had served in Emerald], awaited us, and immediately transferred his Flag from the Briton, where he had hoisted it temporarily, to the Glasgow, his proper flagship.

Here the crew were employed a fortnight in caulking, and other work; and on the 11th May we again sailed from Bombay, and arrived at Trincomalie on the 11th [this should be: 19th].

Some telegraphic correspondence with the senior officers in the Persian Gulf necessitating reference to the Admiralty, we were detained longer than we anticipated at that hot season of the year.

We were unable to leave before 17th June, when we sailed southward, arriving at Mauritius on the 3rd July. We remained seven weeks at Mauritius with great advantage to the health of the ship's company, who enjoyed their leave with all that zest, which a long continued service on the Indian coast, and in the Red Sea might be expected to engender.

From Mauritius we proceeded to Tamatave on the east coast of Madagascar, where we stayed only 24 hours. Tamatave is the principal port of Madagascar on the east coast of that island, and the place from whence Mauritius gets all the beef it requires. It is a miserable place, a mere collection of huts, with a dilapidated fort, which once was successful in defeating a continued attack of English and French men of war!

From Tamatave we proceeded to Zanzibar, and here it was sad to see the havoc which the cyclone of the 15th April preceding had produced [description]. Houses unroofed, sea walls washed away, acres of valuable clove plantations levelled to the ground. Coconut trees torn up from the roots, and the huge banyan and other trees uprooted or left mere poles with their branches torn off.

On the hands of a more energetic people the clove plantations might be restored in a few years, but the apathetic Arab character gives no promise of such a happy result for many years to come.

Having visited Zanzibar about the same time last year, I remarked how much cooler the climate was this year, and the entire absence of any complaint which could be in any way ascribed to the place.

This year, owing to the destructive effects of the cyclone, there was a great scarcity of fruit, and the men could not indulge as they did last year. They had now also the advantage of a twelve months' seasoning in a tropical climate, and to these circumstances may be ascribed the greater immunity from disease on this occasion. But much may also be due to the purifying effects of such a cyclone as that which swept over Zanzibar in April, and to the lowering of the temperature in 1872, as compared with the same period last year, and which may be ascribed to atmospherical changes consequent on the same.

Leaving Zanzibar on the 11th September, we arrived at Mahé, Seychelles on the 19th. The Seychelles group situated in mid ocean, about the 5th parallel of south latitude, enjoys a very healthy climate, the heat being tempered by the prevailing winds, at the different seasons of the year. Mahé (to which place our vessels resort) is beautifully situated, houses and huts well built, and streets clean and orderly, with good roads in every direction, affording excellent walks, which the men appeared to enjoy very much, for here, as at Mauritius, general leave was given. Seychelles is the sanatorium of the Mozambique cruisers. There is a small hospital at Mahé in charge of Dr Bro???, the colonial Surgeon, who, as surgeon and agent of naval sick quarters, received the sick from the cruisers.

At the period of our visit he had under his charge, Captain Jago of the "Briton", with a compound fracture of the right tibia, two men with chronic ulcers on the leg, and a Krooman [a native of eastern Liberia, skilled seamen who often served in British ships] with stricture of the urethra, all of whom we invalided, leaving captain Jago in his charge, but removing the others [Jago was to have been the naval advisor to the Frere mission (in early 1873, shortly after Dr Loney had left "Glasgow") to persuade the Sultan of Zanzibar to renounce the slave trade, but due to this accident, he was unable to do so].

Having refitted and coaled at Mahé, we sailed on the 5th October for Trincomalie, calling at Galle on the 18th.

We anchored for a few hours at Galle, and discharged our invalids to the barracks on shore to wait a passage in the first Peninsular & Oriental steamer to England; and on the 20th we anchored at Trincomalie.

The admiral having received unofficial information of my promotion, I prepared at once to deliver over charge to my successor as soon as the Commission & Appointment should arrive.

Through some mistake of the Post Master at Aden, the Commission & Appointment only reached Trincomalie on the 10th Nov. and next day I gave up charge to Dr More, the senior Assistant-Surgeon of the ship, who was appointed Acting, pending the arrival of a Staff Surgeon.

At the same time with the Commission and Appointment, I received an order to go by the first Peninsular & Oriental steamer from Galle, and left Trincomalie on the 12th in the Nassau. Arriving at Galle on the 14th, I took up my quarters at the Oriental Hotel, and on the 24th I embarked on board the "Travancore" [1889 tons; launched 1868; lost off Italy without loss of life in 1880] for Hong Kong, where I arrived on the 12th December, and from whence I am now writing. Having packed up everything in anticipation of an order (any moment) to move on, I have been unable to complete my Journal sooner.

Our visits to Burmah, Calcutta, Bombay and other places on the Indian coast were so brief, and the opportunity of observing so limited, I cannot pretend to offer any remarks of value on the physical or medical climate of the places visited.

Taking them in the order named, or, beginning with that beautiful group of islands we visited to the southward and eastward of Burmah, I may observe that, the beauty of the Andamans was so striking at first sight, I could but feel regret that they should be devoted to the exclusive use and benefit of the offscourings of Indian society, a regret which was heightened presently by the ever to be lamented death of Lord Mayo, by the hands of a Mussulman life convict.

At Moulmein and Rangoon there was one continued round of entertainment affording us an opportunity of seeing the Burmese under various circumstances, and receiving the most favourable impression of their characters and dispositions. Our boats' crews communicated freely with the shore without any illness resulting, those places being perfectly healthy.

The ship anchoring at Sandheads near Sagar at the mouth of the Hooghly, there was no general leave at Calcutta. But a good many men went there, on the occasion of Lord Mayo's funeral, performing very unusual onerous duties in transferring the body from the rough coffin in which it was placed at the Andamans to one made at Calcutta, marching in procession to and from Government House with the funeral cortege, and carrying the coffin in and out of Government House. They remained at Calcutta during the period from the 13th to the 22 February, but not a single case of illness resulted.

The Daphne, on the other hand, was less fortunate, for she lost a young officer - a sub-Lieutenant - had several men laid up with bowel complaint, and, her Commander, being seized with the same complaint, subsequently succumbed, and was buried at Madras.

At Bombay, as well as at Trincomalie, the ships were allowed to communicate very freely with the shore, but no illness resulted, although smallpox was prevalent at the former, and cases of continued fever were commonly heard of among the native born people at the latter place, especially at the period of our recent visit.

We took away one man from Bombay, infected with smallpox, a newly entered man - and landed him at Aden - placing him under the care of the military medical officer for treatment.

At Aden, Perim, and Suez, boat crews only communicated, and all these places seemed to be perfectly healthy.

The climate of the Red Sea (at the season we passed through it) was not so intolerable as I was led to expect. And although the heat throughout our Indian cruising was generally very considerable between decks, the crews generally, and the stokers in particular, continued in good health.

Prickly heat was experienced by very many, and it was a remarkable fact that men (myself included) who never experienced anything of the kind on the coast of Africa and other hot stations, were very much annoyed with it on the Indian station.

Passing from the Indian, to the southern division of the station, and inversing the order in which we visited the several places, I may observe that the Seychelles, the sanatorium of our Mozambique cruisers, are very charming islands, rich in coconuts, but richer still in a climate rendered perfectly health and agreeable to the European constitution by the prevailing winds which blow over and through them, one way or the other, all the year round. Granite rocks crop out of the very highest peaks, large boulders stud the shore line, and the invaluable coconut tree - the staple of the islands - is planted in every available spot. One island of the group, and only one, is remarkable for the production of that unique nut, the "Coco de Mere" [this should, of course, be "Coco de Mer"]

Zanzibar, situated near the African coast, is a very beautiful island, but proverbially inimicable to the European constitution. The town is built on a low promontory at its southern extremity; and, with the exception of the Sultan's palace, and a few houses occupied by his relatives or retainers, and 3 or 4 European persons, is a mere cluster of hovels, with narrow, tortuous and very dirty streets. With such construction, and such utter disregard of all sanitary laws, we cannot be surprised that it retains its unenviable notoriety. Nevertheless many Europeans have lived, and apparently in good health for many years in this very dirty place; in houses, although spacious enough, hemmed in on all sides by filthy hovels.

Our cruisers visit this place constantly and boats crews communicate on these occasions; but, as a matter of course, only privileged leave for the day, is ever given, and that very sparingly, to the ships company.

Of Madagascar I have very little to say, our cruisers visit places on its western coast occasionally, but we only visited Tamatave, a port on the north east side, and remained there only 24 hours. The coastline is admittedly unhealthy, but the high land in the interior is said to possess a salubrious climate. Europeans enjoy a good health at the principal town, about 8 or 10 days journey from Tamatave, as they do in England. And, as a proof, it may be stated, that the agents of the London Missionary Society have now permanently established themselves there.

Mauritius, where we remained 7 weeks, with great benefit to the health of the ship's company, has recovered from the shock of the fearfully destructive epidemic of fever with which it was visited in 1866-7. Occasional fever cases still present themselves, but no greater number than might reasonably be expected in its mixed population, amongst whom, sanitary arrangements are still far from perfect, and whose physical condition, in too many instances is the reverse of good.

In our own experience, feverish colds were very common, caused by variation of temperature, and yielding to generous diet with wine and porter. And in my short experience I had occasion to observe similar slight illnesses amongst persons on shore, ascribed to the continued fever producing character of the climate, and recourse had to quinine, where no such remedial measure was in the least necessary.

In all such, or similar illnesses amongst our men, I refrained altogether, on principle, from giving quinine and with perfectly good results, including them under the head of catarrh.

But a fever which carried off about 1 in 9 of the inhabitants, according to official accounts, 35,657 deaths down to the 31 July 1867, could not fail to inspire people with a dread of its recurrence, and hence their readiness to resort, on every occasion of illness of a feverish character to the only remedy found efficacious during the height of the epidemic.

Seeing it stated, on the highest authority that, "the rivers, the sole source of drinking water for the population are also the general lavatories for every purpose of all classes" - and taking into account the probable filtration and surface drainage of impurities from artificially manured land into these rivers, and their further pollution by a superabundant Indian and Colored population of uncleanly habits who have been permitted to locate themselves along their banks: - care was taken to ascertain, that the source of supply for the shipping was beyond the reach of all impurities, before any of it was taken on board the Glasgow. And having satisfied ourselves that the water pipes leading to a point near the harbourmasters office commenced at a height which ensured the purity of the supply, it was taken on board freely.

It is quite true (as anybody may see) that the rivers in the neighbourhood of Port Louis, and for miles inland, are used as lavatories, and that the town is supplied from sources thus openly polluted, but the supply from which ships can freely help themselves, comes from a proven source and may be used (as we used it) with perfect safety.

II

Before considering in regular sequence the diseases which have prevailed during the period, I may refer again, as I did last year, to the hospital or sick quarters at Trincomalie. Since last report I made further improvement by enclosing a piece of ground at the north side for garden purposes, and thus brought the passage leading from the public road to the hospital yard within the hospital compound, enlarging the yard and making the place look more cheerful, as well as making the rear of the hospital more secure from the intrusion of strangers. I also had a footpath made, leading to a large spreading banyan tree on a high ground outside the garden, and garden seats placed all round where the patients could sit down & have a commanding view of the ships in the harbour.

And this outlet I found was a very great advantage, for it had a quieting effect, and lessened the desire for the only other outlet - the public road - when in many cases much walking would only retard the cure.

I must also not omit to add that since last report, knives and crockery, suitable for a hospital, have been sent from England by order of the Director-General, with other articles indispensable for the proper management of the same. And it may be said that, although called by the more modest name of sick quarters, it has more the character of a hospital than it ever had.

Provision is now permanently made by Admiralty Authority for medical attendance on the storekeeper, the carpenter and 2 or 3 clerks, by the payment of 7/6 per diem to the principal military medical officer at Trincomalie so that there can be no excuse for these people applying for assistance to any naval medical officer at the hospital.

I. General Diseases, Section A.

Small Pox.

One case only during the period, The man, aged 29, with good marks of previous vaccination, was entered at Bombay on the 11th March, in the capacity of Warrant Officers Cook. He had never been previously employed in Her Majesty's service. On the same day Lady Mayo and family embarked and we sailed for Suez.

On the 19th, at the morning visit, 8½ a.m., he presented himself complaining of headache and pain in the back, where in the night before bad rigors. The face, body, and upper extremities were covered with a reddish, papular eruption. The throat was red and swollen, and the tongue coated, pulse full & about 96, bowels acting regularly.

For three weeks before joining he resided at Bombay, having been discharged from a ship in the merchant service.

The character of the eruption and the general symptoms exciting suspicion of an invasion of variola, I sent him on shore at Aden on our arrival, the day following, the 20th.

On the 16th April following, on our return from Suez, I learned that he had passed through one of the worst attacks of confluent small pox the principal army medical officer who attended him had ever seen. And the patient then covered with scales, and still in a weak state, I declined receiving him on board, and consequently he did not join us for some time afterwards.

Simple Continued Fever.

Nine cases recorded under this head, chiefly cases of febricula. The most noteworthy are recorded in this Journal, cases 29 & 30. The subject of the first case is one of the Carpenters Crew, a tall man, complexion a pale yellow, of irregular habits. He complained of bowel complaint on the passage from Trincomalie to Mauritius. The bowel complaint ceased, but irregular febrile symptoms continuing, I sent him to the Military Hospital at Mauritius on arrival, as I was sending a very bad case of diseased shoulder joint. This man rejoined cured after a few days treatment, but the case of diseased shoulder joint was left there for transmission to England.

The subject of the second case is a young Marine, fair complexion, very intelligent and as steady as a man of his age and with his temptations could be expected to be.

He was employed as a Wardroom Servant, and had charge of the wine cellar. In this case also there was disturbance of the bowels, but his illness commencing about the period of our sailing from Mauritius, the whole treatment was conducted on board, and he returned to his duty within a reasonable time. On discharging him the list I recommended his return to duty on deck, and he showed no signs of illness afterwards. In neither case can it be said there was anything climatic, or anything that could reflect upon the hygienic arrangements in the ship.

Ague.

Three cases are recorded, one a re-entry, at Trincomalie, both junior officers. They were sent from the ship to the sick quarters, but after continued careful observation, I could not see anything more than a general malaise. And consequently I did not find it necessary to resort to any specific treatment in either case.

Both officers remained at the sick quarters when I gave up charge.

II. General Diseases, section B

Rheumatism.

18 cases entered, 3 remaining from last year, 1 of the former and 1 of the latter invalided. Cases in journal 7 & 10.

8 were entered in the first quarter of the year, 6 in the second, and 4 in the third.

Referring to copies of my returns for these periods I cannot find that any special remarks were called for on the subject of these cases. The average days sickness show they were very insignificant; unconnected with climate, and in some instances, I am bound to say, looking very much like cases of malingering.

Syphilis.

11 cases of primary and 1 of tertiary returned. 2 of the former were contracted in the first quarter, and 2 in the second at Bombay. And 7 were contracted in the 3rd quarter at Mauritius.

The tertiary case was only on the list 5 days, but he was under treatment much longer. He was subsequently invalided for fracture. Case no. 36.

Phthisis pulmonalis

1 case remaining, Thos. Tall, 18, ???, the physical signs in this case were not very well marked, and at the period of my giving up charge he was at the sick quarters at Trincomalie. The treatment, generous diet, milk and cod liver oil. There was undoubted delicacy of lung structure, but nothing more could be said at that period.

III. Diseases of the Nervous System, and organs of the Special Senses.

Sunstroke.

3 cases recorded in the second quarter, 1 on the 22 May, and 2 on the 10 June at Trincomalie. The illness in each case was of very temporary duration, and due to imprudent exposure to sun after a meal; the stomach relieved, the feeling of illness soon passed away.

Paralysis.

1 remaining, 1 added, and 1 invalided in sick quarters. The case remaining from last quarter will be found recorded at no. 40 in my Journal for 1871, and notes at no. 4 in this Journal. It is a hopeless case.

The other, John Morey, aged 37, stoker, was on the list for 3 days only with paralysis of one hand, in January on the passage from Sagar to Rangoon.

Hemiplegia.

One case, no. 16 in journal, a hopeless case. Invalided.

Neuralgia.

7 cases in all. 1 in Lady quarter, 3 days on the list. 5 in Midsummer quarter, with an average days sickness of 5, and 1 in Michaelmas quarter, 3 days on the list. One appears to have been caused by syphilitic taint; one of two by bad teeth, and others were very doubtful; I mean it is very doubtful if there was any neuralgia at all.

Weak intellect.

The only case of this kind I have had to deal with, I invalided and recorded at no. 35 in the Journal.

Ophthalmia.

1 remaining from last year, 7 entered, and all remitted back to duty after an average of 15 days each under treatment. 4 entered in Lady quarter, 2 in Midsummer quarter, and 1 in Michaelmas quarter. Two of these were reentries of the man who was subsequently invalided for Cataract, and 2 were reentries of a Krooman who had a cataract in each eye, and who was discharged at Zanzibar, and the others were not important.

Cataract.

See case 32. Cataract resulting from a direct blow on the eye, sustained some months previously.

Disease of Ear.

1 remaining from last year, and 13 added. Of these 3 were invalided. Cases nos. 8, 15 and 19. And the others were remitted to duty. The latter were all cases of inflammation of the dermoid meatus, 2 of these at least recurring cases, and some of them frequent attendants in the sickbay for treatment when off the list.

Functional Disease of the Heart.

3 entries and 2 invalided. See cases 11 and 18.The subject of the latter was twice on the list which accounts for the 3 entries.

V. Diseases of the Circulatory System.

Varicose veins.

2 cases. 1 in Lady quarter, Wm. Trownson, aged 38, Blacksmith, 9 days on the sick list. This man wanted me to invalide him for a varicose state of the veins in his legs. I could not comply and he has not complained since. They were not very bad or I should have resorted to the radical cure by occlusion of the vessels.

The other, Edward Hall, aged 24, sto., I placed on the sick list on our return to Trincomalie from Mauritius for the purpose of resorting to the radical cure, which I pursued with considerable success at the sick quarters on shore. I left him at the sick quarters when I gave up charge, see case 42.

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

Bubo (symp.)

10 cases added, 1 remaining. 4 added during Lady quarter, 1 in Midsummer quarter and 5 in Michaelmas quarter.

The case remaining on the list when I gave up charge (Geo. Thorus, aged 20, a leading seaman) is one of those strumous cases where local treatment does very little good, the cure depending more , or altogether, on measures directed to the improvement of the general health, and where free incisions would be simply mischievous. He was 61 days under treatment when I gave up charge. A concise statement of his case is giver in this Journal, no. 39.

One case was only 3 days on the list, the others for periods varying from 18 to 39 days.

One case, I should observe was a reentry, (Thos. Girdwood, aged 27, capt. of the Sto???) so that in his case the days sickness from this complaint amounts on the whole, to 55 days.

W, Leuch, age 21, buglers ???, under treatment for 27 days, was discharged to his duty before the punctures were healed, believing, as experience justifies, that his cure would be promoted by moving about in the open air. His case resembles Thorus', small strumous suppurations quite distinct from one another. Added to which he was very lazy and indolent, and addicted in excess to smoking, which I felt it my duty to check.

VII. Diseases of the Respiratory System.

Taking the whole number of cases under this heading, the average sickness is a little over 7. There is a total of 58 cases of Catarrh. 7 in Lady quarter, 6 in Midsummer quarter, and 45 in Michaelmas quarter. The large augmentation in the last period being due to the variable temperature at Mauritius, after a long sojourn in the steady, uniform high temperature on the Indian coast. In some of the latter there was a good deal of feverish disturbance, but they were all purely and simply catarrhal, the average days sickness about 9, yielding in every case to generous diet with wine and porter.

There are 6 cases of bronchitis recorded - two of which only require notice. Franas Pint, Captains servant, a native of Goa - has 2 entries for the complaint and is now a confirmed asthmatic - see case 37 - he is a delicate man, but being a good, trustworthy servant, Captain Jones retains him most indulgently.

Henry Patourel, aged 42, cooper, has one entry for catarrh and one for this complaint. He is a seedy looking man, and was always presenting himself at the sickbay with chest complaints whenever he saw, of thought he saw, a prospect of an invaliding day. He tried hard to be left behind at the Cape, but was disappointed, for I did not send a single case to the Cape hospital. He was examined very carefully on more than one occasion without eliciting any information to justify his complains. He is one of those men who manage to serve much of their time between the hospital and the reserves, but he now bids fair to finish his commission in the Glasgow.

The case of pleurodynia is not of any moment, and the same may be said of one of the cases of haemoptysis, no. 38 in the journal. The other cases of this complaint are made up by the reentries of Joseph Wavell, sick berth steward, who was invalided, and whose history is given at no. 31 in the journal.

VIII. Diseases of the Digestive System.

The average days sickness under this head, cases of all kinds included, is only 5.

There were 25 cases of cynache, 12 in first quarter, 7 in second, 5 in third, and 1 in the broken period in the 4th quarter, with an average days sickness of something less than 5.

There were 36 cases of dyspepsia, 8 in first, 15 in second, 9 in third, and 4 in part of the 4th quarter, with an average days sickness, a little over 5.

There was 1 case of dysentery from last year, Arthur Triggle, 17, boy, whose history and treatment is fully recorded, no. 39, in last years Journal.

41 cases of diarrhoea are recorded. 17 in first, 16 in second & 4 in third & 4 in part of 4th quarter, with an average days sickness under 5.

15 cases of colic and constipation are returned. 7 in first, 6 in second, 1 in third, and 1 in broken 4th quarter, with an average days sickness under 4.

3 cases of haemorrhoids are recorded. One to hospital, whose case I must revert to presently. 1 is recorded in first quarter, 1 in third, and 1 in the last period, with an average days sickness a little over 5.

1 case of Peritonitis terminated fatally on the 5th day. The subject of it had been confined in the cells a little time before. Seen regularly twice a day, and made no complaint for some time afterwards. The cause of his illness was therefore of more recent date, an the case is remarkable for the absence of acute pain and tenderness, and others signs characteristic of peritoneal inflammations, and above all for the sudden & peculiar characteristics of his death, under circumstances which lead to the conclusion that embolism was the immediate cause. His case in no.14 in this Journal.

Ascites - one case - invalided. A very full history of this case will be found in my Journal for 1871, no. 25, followed up by a shorter statement in this Journal, no. 17. The case is not devoid of interest, and may, by this time, I fear, be completed. For remembering his state and condition when I invalided him at Bombay on the 9 March I cannon but think that he must have succumbed to the disease by this time.

The average loss by days sickness for the several diseases under this heading, as shown by the foregoing figures, is very small indeed; but on the other hand, 3 very important cases are included under it, - the peritoneal case which terminated fatally, - the ascites case which must so terminate sooner or later, if the fatal termination has not already arrived; and the case of haemorrhoids sent to hospital, to which I must now make special reference.

Admiral Cockburne was the subject of this case.

The Glasgow left Trincomalie on the 7th Jany last, the admiral being apparently in his usual health. On the 10th he casually referred to himself in the course of an official communication I had with him, and having taken a mild dose of medicine, he expressed himself "quite well" next day, and accepted an invitation to dinner in the wardroom.

On the 12th he sent for me before rising from bed and made known the existence of large, painful, external haemorrhoids, suitable treatment was adopted, and the recumbent position enjoined.

A few days subsequently he complained of deepseated pain with tenderness on pressure in the umbilical, and later in the right iliac regions for which small doses of Rx mercury with chalk and pulve. Ipecac. [powder of Ipecacuanha (illustrationExternal link from Köhler's Medizinal Pflanzen), a stomach mixture] and morphia were given, and hot fomentations with occasional turpentine stupes [poultices] resorted to, to relieve urgent symptoms.

On the 20th I accompanied him to Government House Calcutta, and gave him into the charge of Dr Fayrer the senior Surgeon of the College Hospital. Dr [Oliver] Barnett, Surgeon to the Viceroy, was present, and both he and Dr Fayrer were of opinion that an abscess existed in or near the cecum, but that there was no ulceration.

The deep dark fur which the tongue assumed, on the supervention of the abdominal symptoms, made me cautious about the case, and I was compelled to tell him my opinion to induce him to leave the ship on the 20th. But the diagnosis after consultation, by Drs Fayrer and Barnett, inspired him with so much confidence he evidently thought my fears groundless. For in taking leave of him on the morning of the 23rd there was an absence of cordiality and friendship in his manner. His parting words "you were quite right to look seriously on my case" implying, that I was quite right to guard myself, but entirely wrong as regarded his case, and he did not feel grateful to me for it. I could scarcely feel surprised although hurt with this farewell reception, for at this period the operation for the radical cure of the piles, was openly and confidently talked about as a measure to be put in practice at some future time.

My letter from the secretary, who was with him, received at Rangoon, the case appeared at one time to progress favorably, for it was arranged he should leave on the 12 February for Bombay. But appearances were most fallacious, for we were startled a few days later by a telegram to the Viceroy, received at Moulmien, as follows: "intestinal sloughing still going on, case serious," and on our arrival at Sandheads from the Andamans, we learned that he was dead.

On reading the telegram I saw there was no hope for him, and wrote from Moulmien requesting I might be furnished with the particulars of the case, and the result of the post mortum should he unfortunately be dead.

On my return to Calcutta Dr Fayrer kindly gave me full particulars in a long written statement, a copy of which I append to my case, but I regret to say there was no examination of the body after death.

IX and X, Diseases of the Urinary and Generative system.

There are only 15 cases recorded under this heading with an average sickness of 15 days. All of then returned to duty and there is no necessity to remark on any one specially.

2 of the Gonorrhoeal cases were contracted at Bombay, 5 at Mauritius, and 2 at Seychelles.

The average sickness was not high, because I did not think it necessary to keep a man on the sick list until the running had ceased. My practice was to discharge them to duty as soon as I felt that no evil could result from doing so, keeping them under treatment as out patients, and forbidding them the shore until they were cured.

At Bombay I was informed that it was quite impossible to put the Contagious Diseases Act in force successfully, for the simple reason that a woman found no difficulty in getting a man to claim her as his wife, who interposed and prevented examination.

At Mauritius on the other hand, I was informed by good authority that in that island, at all accounts, it would be perfectly possible to carry it out with complete success; and, as a matter of course, if possible at Mauritius, it would be equally so in Seychelles, but in neither place is the act in working order.

XI. Diseases of the Organs of Locomotion.

The number of cases under [this heading] is only 5, with an aggregate of 151 days, or about an average of 3 days sickness each [this is obviously incorrect; I assume '5' should be (about) '50'] .

Disease of the Bones.

Thomas May, o.s. [= ordinary seaman], aged 18, on the 3 May, at Bombay, sustained a severe injury from a fall from the upper deck on to the grating of the stoke hole, the head coming into contact with one of the bars, causing an extreme scalp wound over the left temple, and depression of the outer tabeculae of the bone. The head symptoms were singularly slight, but the would was 59 days healing, owing to the detachment of pieces of bone. This man was reentered for "Diseases of the Bones" on the 4th July following, the wound having partially reopened to give exit to one or two very small pieces of dead bone, and after 22 days treatment he was sent to duty perfectly cured.

Disease of the Joints.

George Davis, o.s. aged 21, was the subject of this compliant, and his case is fully given -no. 28 - in this Journal. The left shoulder and elbow joints were affected, especially the former. The disease commenced at Trincomalie, the immediate cause, a wrench of the shoulder joint in pulling in a boat. I sent him to the Military Hospital as Mauritius and he has gone home long since (I hope) in the Himalaya. His general health was improving when we left that island, giving hope that he would be able ultimately to undergo the operation of resection at the shoulder joint.

Of the periosteal and bursal cases it is not necessary to say more than that they were of an ordinary character and yielded to ordinary treatment.

XII & XIII. Diseases of the Cellular Tissue, and Cutaneous System.

There are a good many cases recorded under this heading, and the number of days sickness resulting is very considerable, but it will not be necessary to make any lengthened remarks, a few general observations will suffice.

Phlegmon and Abscess.

6 cases remained from last year with an average sickness this year, a little over 4 days each.

37 were added whose average sickness exceeded slightly 80 days each: a heavy average due to the difficulty on board shop of treating such cases, especially affecting the lower extremities.

6 remained on the list when I gave up charge, and one or two of them promised to be tedious cases.

Ulcer.

16 remained from last year whose average sickness this year amounted to 20 days each.

53 were added whose average sickness amounted to 18½ days each. 4 remained on the list, when I gave up charge, and were under treatment respectively 39, 10, 8 & 2 days each. The last one, I briefly adverted to in this Journal, no. 43, the case being such that, trifling as it looked, and originating as it did in a very slight cause, may nevertheless lead ultimately to his invaliding.

Carbuncle.

One case remaining from last year, a very bad carbuncle in the back of the neck, was altogether 48 days under treatment.

Urticaria.

A very simple case relieved by ordinary treatment.

Eczema.

4 cases but only 2 patients with 2 entries each. Thos. Kelly, 19 o.s. We did not find it necessary to exempt from duty after the 3 July last, but we were compelled to invalide Chas. Larthing, 19, ???, vide case 24 in this Journal.

Tinia.

The case remaining, from last year, was cured with the ordinary remedies. It was a very trifling case in a young officer. He was very few days on the list altogether.

Unclassed.

This section comprises only 9 cases "added", with an average sickness of 10 days, the two cases of Debility remaining from last year, being on the list - one of them 6 days, and the other one day only.

Debility.

There is very little to be said about cases of this kind, I was obliged to invalide five cases, numbered 9, 12, 20, 22 & 27 in this Journal. The subject of case no. 9 had 3 entries for debility in 1872, and he was one of two who remained on the list from last year. These cases are all, at the best, very unsatisfactory.

Tumor.

There was a case of encysted tumor on the dorsum penis in an officer, Mr Blackmore, Carpenter, I removed it with the knife at Trincomalie in May last.

Delirium Tremens.

This was a slight case. W. G. Batar - Admiral's Steward - on the list only 5 days. Dismissed the Service at Galle.

Wounds and Injuries.

10 cases remained from last year, and one, a fractured clavicle, is reported (no. 2) in this Journal.

196 cases were added, and an average sickness of 2389 days, or about an average of 12 days each is recorded against them. A small average days sickness for a group comprising all the wounds and injuries for the period.

Wounds.

119 cases added during the period with an average sickness of 1471 days, or an average a little over 12 days each. Several of these cases have been deemed worthy of special record, some of necessity for future reference.

Stephen Harding, a boy (case 12) lost a portion of the right index finger in a very singular manner. He was in the Head at an early hour on the morning of 1st January, at Trincomalie; and while closing his clasped knife, the finger was caught under the blade and a portion fairly amputated. I gave him a certificate and he remains in active service. He is now in the Columbine and no complaint made of inability to do his duty.

Jim Williams, a Krooman, was killed by another coloured man at Trincomalie on the 11 June (case 25). He was stabbed in 4 or 5 places in the chest with a clasp knife, one, penetrating the pericardium, transfixed the aorta, causing immediate death. The culprit was sentenced to penal servitude for 2 years at Ceylon.

Frederick Thornton, an ordy seaman, received a slight lacerated wound to the left index finger, near the palm, while cleaning the funnel casing. Inflammation setting in, extended up the palm of the hand, suppuration ensued, and free incisions were resorted to successfully, reducing the inflammation & stopping the suppuration - but although the joints were perfectly free, and the flexor tendon alright in its sheath, he could not (he alleged) flex the fingers, so I was ultimately compelled to invalide him.

Richard S Ruse, a leading seaman sustained a wound of the left little finger, a compound comminuted fracture, rendering amputation necessary at the first joint. Leaving Seychelles on the 5 Oct, he was attending forward on the main deck when the cable taking charge jammed his finger against the messenger. I gave him a certificate, and he remains in the ship (case 41).

John Drake, a boy, sustained a deep lacerated wound beneath the right great toe with a piece of glass or shell, while bathing at Trincomalie on the 24 May. It was very painful and very difficult to heal (case 44).

Charles Byles, ordy seaman, while on leave at Seychelles, on the road he walked with bare feet amongst some high grass, and standing on some broken glass inflicted a deep lacerated wound in the sole of the right foot. The wound bled very freely but was promptly plugged with lint & a pad of bandage applied by Dr B??? at the hospital on shore. I allowed the plugging to remain three days and no haemorrhage recurred on dressing the wound. It granulated rapidly and he resumed duty on the 36th day (case 45).

Fractures.

3 added. Average sickness 29 - the days sickness from case remaining from last year being excluded, he was invalided on the 6th day (2).

Sergeant Jurie R.M. fractured his left second toe on the 12th Feb, and was incapacitated from duty a fortnight; the other cases are recorded, 36, a fractured humerus, invalided, and 40, a fracture of radius remains, but is cured.

Dislocation.

Thos. Higgins R.M. dislocated his right shoulder at Mauritius on the 3 August, ??? it and he resumed duty on the 14th.

Sprains.

21 added - average days sickness less than 7 - some were very slight.

Contusion.

41 added. Excluding the case of Geo. Satchell who was 105 days on the list and ultimately invalided (case 33), the average days sickness for the remaining 40 is only a fraction over 9.

Burns and Scalds.

10 added. Days sickness, excluding the 2 cases from 1871, is a little over 13 days each.

Submersion and Drowning.

John Langler, R.M. accidentally drowned in Lat. 4.37 S. Long 84.11 E (case 26).



Top↑
Valid HTML 5.0