GENERAL REMARKS

At the period coincident with the termination of my last Fair Journal we were occupied surveying the coast between Hanglip & Quoin points, and continued to be employed upon this duty until the 8^th of January, the date of our return to Simons Bay. In February we were employed one day on "towing" H.M. Ship Hastings out of the bay on her way to England from India; and from the 23^rd of March to the 19^th of April inclusive we were employed a second time this year upon the coast survey. On the 18^th of May we steamed out of Simons Bay "en route" for Mauritius; and from this date until our return to Simons Bay again on the 4^th of August (with the exception of a fortnight at Mauritius) the steam was always up; although we occasionally banked up the fires and disconnected when favoured by the winds. From the 12^th of Octb^r to the 24^th Nov^r we were again absent from Simons Bay, searching in vain for the "Marion Shoal", surveying off Cape Agulhas & the adjoining coast, and in conveying troops from Algoa Bay to the Cape as detailed in my return for the period. And in Dec^r we steamed across to Gordon Bay and back the same day with Commodore Talbot and his family on board. An analysis of the foregoing brief sketch of the duties which occupied us during the 12 months now terminated shows 68 days, surveying; 1 day, "towing" Hastings; 79 days, cruise to Mauritius and back; 12 days, trooping; and 1 day, Gordon Bay and back; making a total of 161 days sea duty. Add to this 204 days at moorings in Simons Bay and we have the total number of days for the period, viz. 365. This analysis shows a great variety of duty compared with the former year. It also exhibits a considerable amount of sea duty; nearly one half of the period having being passed at sea under steam. During all our surveying operations the steam was never down. There was very little boat work, the duty being nearly all done from the vessels deck as she steamed slowly off and on the land, a distance of 5 or 6 miles, and in parallel lines 1 mile, and 1½ miles apart. While during the whole course of our cruise to Mauritius, & back through the Mozambique Channel, the steam was up - with the exception already stated of a fortnight at Mauritius. At Bourbon, Johanna, Mayotta, Mozambique, Delagoa Bay, Natal & other places where we touched, the steam was never allowed to go down; our stay in each place being brief, the fires were banked up instead. From the foregoing summary it will be observed, too, that the change of climate was very considerable. And it will be my duty to show, amongst other things as we proceed, what influence it had upon the health of the crew; and the great disparity which diseases of an adventitious nature bear to those that may be rightly attributed to climatorial causes.

Par:-2.- A comparison with the result of the first years experience exhibits a decrease of 115 in the total no. of cases; but in the total days sickness we do not find so great a disparity. For while the total days sickness in each "case" in 1852 was less than 7 days; it exceeded 9 days in the average of this year. As a correction for this decrease in the apparent no. of cases, it must be stated that there were 20 more victualled in 1852 than in 1853, And to estimate more fairly on the other hand the disparity in the total days sickness, it must be remembered that we sent many more to the hospital in 1852, after short illnesses, which our long cruises this year, & other circumstances prevented. In 1852, the average no. victualled was 135, & the total no. of cases 321; showing an average of more than 2 entries for each individual. While in 1853 the no. vict^d were 130, and the total no. of cases 206, showing only a little more than 1 entry for each individual. But what shows more particularly in favour of this year is the greatly diminished nos. of rheumatic cases, and of those diseases affecting the bronchial & gastro-intestinal mucus membrane. After reviewing very minutely the movements of the ship for the two years, and comparing one with the other, I am unable to find any sufficient cause of a climatorial character to account for the difference in the nos. of entries for the diseases alluded to. I am, therefore, compelled to ascribe the great decrease this year to a more perfect adaptation to the diet and discipline of a ship; and to admitted changes which men's constitutions undergo fitting them to resist those common deranging influences of climate. Allowance ought certainly to be made in all comparative estimates of this nature, for the invaliding, deaths and exchanges of "mauvais sujets" which may have taken place in the 1^st year. And credit might be taken in the 2^nd, for the greater attention paid, on the whole, to hygiene, and the removal of the galley range from the lower deck. But giving all these circumstances their due weight, much would still remain in favour of the present year (1853) to be ascribed to the causes herein before enumerated. In the first year we had a fair no. of rheumatic, catarrhal, & diarrhoal cases, while this last season we had not a single case at a time when the "Meander" lying close to us, had numbers laid up with influenza.

Par:-3.- In the cases of phlegmons [boils and carbuncles], and contusions [bruises], the same favourable reduction in nos. is apparent, and for precisely the same reasons, viz.: - a more perfect adaptation to the diet and discipline of a ship &c. But in injuries of greater moment, such as wounds, fractures and sprains, the same amount of reduction is not, for obvious reasons, observed. While in the maladies resulting from vicious indulgence, a still closer approximation to the nos. of those diseases recorded last year, is found to exist. Under the later head may be classed the venereal cases, the cases of vigilium cum tremore, and a very large proportion of the dyspeptic cases. The syphilitic cases are not near so numerous as one might expect, but I make no doubt that many cases of gonorrhoea are contracted, & cured sooner or later without coming to my knowledge. Indeed a case of syphilis (20) was only brought to light accidentally at the inspection for long service men held after the issueing of the new regulations. The first case of vig. c. tremore occurred at Mauritius in June. The subject of it - the marine mentioned in former reports of mine - having so little power to resist the temptation to drink. I recommended his leave should be stopped; but the advice was not acted upon, and a fresh attack was the result. His great strength of constitution, however, carries him as yet through these repeated illnesses. In Aug^t and Sept^r after our return to Simons Bay, three Blue Jackets [sailors] & this same marine were under treatment for the disease. And in Nov^r & Dec^r, after our return from our last surveying & trooping excursion - two of the Blue Jackets before alluded to, and the Sarg^t of Marines were put under treatment for the same. From this brief resumé it will be seen that it confines its attacks within a small circle. But I regret to say that habits of intemperance in harbour are far more general than this fact would seem to indicate, for, as I have said, the large majority of the dyspeptic cases are to be attributed to the deranging influences of causes similar to those which occasioned the more alarming affections of the nervous system Having recorded only 1 case of vig. c. tremore in the Journal (1), I ought to state here that in other instances where a loaded tongue & head symptoms existed, with other symptoms of disorder of the prins via purgatives of calomel & comp. powders of jalap, followed by infusion of senna, were made to proceed the exhibition of opiates, either simply or combined with the ammonis sesqicart. in camphor mixture. Spirits were never systematically resorted to as stimulants; and as the cases of each never went beyond the first stage of the disease properly denominated "Delirium c. tremore", I have used the term "vigilium" instead.

Par:-4.- The loss by death and invaliding this year was small; viz: - one man, Robert Hext, Stoker, ae. [age] 33, killed on the 28^th of Feb^r while assisting in turning the wheels, in Simons Bay. And another man, Samuel Deane, S.O. Cook , ae. 25, who was invalided from the Hospital at the Cape, for bronchitis, on the 29^th of April. Both cases are so fully detailed at nos. 5 & 3 respectively that any further reference to them would be a mere waste of space. The same might be said of the 11 hospital cases, with one or two exceptions. The case of sprain (2) I have shown to have been in a great measure, if not altogether, a case of skulking. It must, however, be noted, that a vast change has taken place in his appearance since then. His hair is turning grey, and he looks much older that he really is; but he has not been on the list. The cases of wound & fractures are noted with sufficient minuteness; and I don't see that anything need be added to those of scrofula [enlargement and degeneration of lymphatic glands] and nephritis [inflammation of the kidneys]. But the case of vig. c. tremore and bubo [swelling in groin] call for some remarks. The first was necessarily concise from the short time he continued under our care; and the treatment adopted was different from that which in most of the other cases was deemed advisable. A loaded, or a foul tongue, and breath tainted, or exhaling a foul odour rendering calomel & the compound powder of jalap with Infusion of senna requisite in the first instance. And by thus getting rid of depraved secretions, &c, and relieving the feeling of oppression, & headache attendant upon such a state of things; prepare the way for the more beneficial operation of sedatives. For irritability of stomach in these cases, I have found the following a never failing remedy.

Two of the buboes recorded; 1 from gleet [slime, phlegm], was only on the list 4, and the other from cold, 3 days. The two others are the entry and reentry of the man who is still under treatment, vide 16. Our space will not admit of a detailed statement of this case to exhibit the endless phases it has assumed since his return to the ship from the hospital. A strict attention to measures calculated to promote the general health, has, however, at last succeeded, with local treatment of a palliative nature to bring the groin into a comparatively healthy state. The healing process is now going on slowly, but steadily; and I hope e'er long to be rid of this tedious case. I cannot but feel still that a puncture in a depending part would have been far preferable to an opening made by potassa fusa [caustic potash (potassium hydroxide)?].

Par:-5.- Only two cases of fever are recorded this year, of an ephemeral character, & attributable in some measure to irregular habits. It is however proper to state that, at the period of their occurrence, in the first quarter of the period, warm night winds were experienced coming over the land from the southward to the moorings in Simons Bay, and occasioning a remarkable degree of enervation in several persons, myself among the number, and evincing debilitating properties not to be accounted for by its intrinsic heat. The 5 epileptic cases arise from the repeated entries of the same individual, vide 6. Since the 26^th June, the date of the last fit, he has not had any recurrence of the disease. But from the 15^th to the 20^th of Sept^r we find him under treatment for vigil. c. tremore, and the presumption therefore, is that, the epileptic seizures had their origin in causes entirely under his own control; and that the opinion I formed of the case in the first instance was perfectly correct. I may also fairly attribute his exemption from fits since June, to a closer attention to the measures of precaution. I had repeatedly inculcated against obstipation [severe constipation] and dyspeptic derangements generally. Of the catarrhal, diarrhoal, & rheumatic cases, arising commonly from changes of weather &c only one of the latter is recorded (10), - the others being very commonplace, & of short duration, no notice has been taken of them. The gout recurs in our Chief Engineer - is hereditary - and manifests itself always in the right foot, preceded & accompanied at times with much general derangement. The herpes [viral infection of mouth ("cold sores") or genitals] is recorded at no. 8; but as the erysipelas [streptococcal (bacterial) infection resulting in oedema - accumulation of water fluid in the tissue] is not recorded, I may observe that it is a recurring idiopathic affection of the lower extremity in a man whose case will be found in my former Journal at no. 40. The subject of the case of anasarca [swelling] (21) has more recently been taking the gum guaici [Guaiacum sp; trees and schrums native to West Indies and tropical America] with the squills [sea onion] and digitalis [fox-glove]; and for some days past the ex. colch. acet. [extract of Colchicum automnale (= meadow saffron)?]. By these means the signs and symptoms of the disease both local and general have been got rid of; and by a continuance of the latter remedy a little longer, a recurrence will, I hope, be prevented. The Gunner, ae. 35; and a Quarter Master, ae. 38; have both been successfully treated for tonia[?], by gradually increasing doses of the sp. tereb. [terebintha = turpentine oil?] from 1 dram to ½ ounce. The first was under treatment in Nov ’52 for the same. A mid[shipman], ae. 18, subject to constipation, & derangement of the b^s, and who had been on the ’list’ for acarides [thread-worm], was attacked with hysterical convulsions on the 29^th of Dec^r. For some days preceding he had been taking medicine for a gonorrhoa, and to the disorder of the stomach and b^s resulting from the use of the medicine, &c, I attributed the seizure. The paroxysms recurred with much violence for 2 or 3 days, but then yielded to free purging. 197 s.b. The term dyspepsia is one of such extensiveness, comprising cases whose causes & treatment are more various even than the habits of body of the individuals in whom is occurs, that I may well be excused entering upon the subject in these remarks. I shall, therefore, conclude this paragraph, and devote the next concluding one to a consideration of the principal surgical cases not noticed hitherto.

Par:-6.- Although the ulcers were sufficiently numerous, and their cure, on the whole, tedious enough to cause considerable reduction in the effective strength of the crew, there were none possessing any peculiarity worthy of commemoration. The same might be said of the cases of abscess, with the exception of two recorded at no. 7 & 13 respectively. Case 13 is "returned" under the head phlegmone; and its no. in the sick-book is therefore placed against phlegmone also in the synopsis. While under this latter are included furunculi [boils] & such like, as well as the cases which are properly denominated phlegmones. Many cases of these diseases, especially the two first, owed their origin to slight accidents received in the ordinary course of duty. But the effective strength was still more considerably effected by accidental injuries such as wounds, fractures, sprains, contusions, burns & scalds. Yet none of these cases, I may say, had any peculiarity to recommend them for insertion in preference to those we have recorded. The two cases of spasmodic stricture, 15 & 17, entailed considerable trouble upon us. The suffering was so acute, & most frequently at night time, that we were called up repeatedly to administer to their relief. About 10 weeks after the discharge of one, he was entered again for nephritis (17), with the same amount of suffering, but with well marked inflammation of the kidneys supperadded. The man's habits are decidedly intemperate, although in this instance the attack could only be attributed to the sudden setting in of damp, cold weather on our return voyage from Mauritius. The nature & degree of the syphilitic cases, & the treatment pursued, are very fully exhibited by the cases we have recorded at 9, 19 & 20, respectively. No 9 also shows a bubo complication & the principles upon which it was treated. The case in respect of this contrasts very favourably with that of the man Rowe (16), who has been incapacitated from duty for 6 months, & is still on the list with the groin unhealed. In Rowe’s case, too, the suppuration was more complete, and the case altogether a more favourable one for treatment by puncture, instead of the caustic potass with which it was opened in the Hospital.

H.M. Steam Sloop Hydra
Mozambique Channel
23^rd of January 1854.

W^m Loney M.D., Surgeon.