Produced by The Online Distributed Proofreading Team at http://www.pgdp.net (This file was produced from images generously made available by The Internet Archive) MEDICAL SKETCHES OF THE _EXPEDITION TO EGYPT_, FROM INDIA. BY JAMES MâGREGOR, A.M. Member of the Royal College of Surgeons, of London; Surgeon to the Royal Regiment of Horse Guards; and lately Superintending Surgeon to the Indian Army in Egypt. LONDON: PRINTED FOR JOHN MURRAY, 32, FLEET-STREET; BELL AND BRADFUTE, EDINBURGH; AND GILBERT AND HODGES, DUBLIN. 1804. _W. Marchant, Printer, 3, Greville-Street, Holborn._ TO SIR LUCAS PEPYS, BART. Physician General, &c. &c. THOMAS KEATE, ESQ. F. R. S. Surgeon General, &c. &c. AND TO FRANCIS KNIGHT, ESQ. Inspector General of Hospitals, &c. &c. THE MEMBERS OF THE ARMY MEDICAL BOARD, THESE SKETCHES are dedicated, with the utmost respect, by their most obedient and very humble servant, JAMES MâGREGOR. CONTENTS. INTRODUCTION v-xv PART I. _Journal of the Indian Expedition to Egypt_ 1-55 PART II. _Of the Causes of the Diseases which prevailed in the Indian Army_ 56-97 PART III. _Of the Diseases of the Indian Army in Egypt_ 99 FIRST, THE ENDEMIC DISEASES OF EGYPT. _Of the Plague_ 100-146 _Of the Ophthalmia of Egypt_ 146-159 _General Remarks on the Diseases_ 160-161 SECONDLY, OF THE OTHER DISEASES OF THE INDIAN ARMY. _Fever_ 162-170 _Hepatitis_ 171-180 _Dysentery_ 181-192 _Pneumonia and Rheumatism_ 193-194 _Small-Pox_ 195-197 _DiarrhÅa_ 198 _Scurvy_ 199 _Syphilis_ 200-201 _The Guinea-Worm_ 202-217 _Ulcers_ 218 _Tetanus_ 219-222 _General Remarks on the Yellow Fever, and the Resemblance which this Disease bears to the Plague_ 223-238 TABLE I. _The Points of Resemblance between the Plague and the Yellow Fever._ TABLE II. _State of the Diseases and Deaths in the Indian Army._ ERRATA. Page 6, line 17, for _time_ read _service_. â 9, â 6, for _Ghenna_ read _GhennÃ©_. â 15, â 3, from bottom, for _Ghiza_ read _Damietta_. â 23, â 1, _et passim_, for _Thiza_ read _Ghiza_. â 26, last line, for _typhaid_ read _typhoid_. â 47, â 11, for _prevent_ read _prevents_. â 48, â 7, for _Hepiopolis_ read _Heliopolis_. â 48, â 7, for _B El Hadje_ read _Birket El Hadje_. â 50, â 12, dele _the_. â 73, â 14, for _the matter_ read _it_. â 73, â 15, for _quantity_ read _piece_. â 83, â 12, dele _where_. â 86, â 12, for _gums_ read _germs_. â 94, â 4, for _inspired_ read _imposed_. â 101, â 3, from bottom, for _prevent_ read _preventing_. â 103, â 4, from bottom, for _goal_ read _jail_. â 122, â 12, from bottom, for _appears_ read _appear_. â 128, â 6, from bottom, for _viluces_ read _vibices_. â 129, â 5, after _often_ a _comma_. â 129, â 6, after _perceptible_ a _comma_. â 133, â 13, for _patient_ read _patients_. â 137, â 9, dele the first _as_. â 151, â 11, after _flowed_ insert _down_. â 166, â 5, for _healthiness_ read _unhealthiness_. â 171, â 7, for _decubities_ read _decubitus_. â 190, â 8, from bottom, note, for _instantly_ read _constantly_. â 191, â 10, for _man_ read _men_. Transcriberâs Note: the above errata have been corrected, and in addition, those listed below. Where there were two spelling variants in use in equal measure (e.g. diarrhÅa/diarrhÃ¦a; Signior Positti/Posetti), both are left as printed. Page 22 âconside-derableâ changed to âconsiderableâ (mortality of the month was very considerable). 23 âfumegationâ changed to âfumigationâ (regarding cleanliness and fumigation). 44 âOâFarrolâ changed to âOâFarrelâ (Mr OâFarrel, who had charge of the pest-house). 45 âOâFarrolâ changed to âOâFarrelâ (went to Aboukir to relieve Mr OâFarrel). 98 âmedidicineâ changed to âmedicineâ (the practice of medidicine is more simple). 99 âoccuredâ changed to âoccurredâ (cases of the plague, which occurred). 103 âdiminshâ changed to âdiminishâ (will tend to diminish). 113 âfomâ changed to âfromâ (some matter from the bubo). 117 âmedecineâ changed to âmedicineâ (he could not get him to swallow any medicine). 117 âinflamationâ changed to âinflammationâ (I discovered some inflammation of the glands). 122 âprevostâsâ changed to âprovostâsâ (The provostâs guard and his prisoners). 126 âabcessâ changed to âabscessâ (an abscess, of the size of a pigeonâs egg). 130 âsuccededâ changed to âsucceededâ (that he had never succeeded in exciting sweating). 136 âmedecineâ changed to âmedicineâ (a morsel of food nor any medicine). 137 âspungingâ changed to âspongingâ (washing their patients with vinegar and sponging them with it). 138 âpossesionâ changed to âpossessionâ and âinfalliableâ changed to âinfallibleâ (I am in possession of an infallible remedy). 139 âveneralâ changed to âvenerealâ (an old venereal complaint). 145 ânitrieâ changed to ânitricâ (When our stock of nitric was at length exhausted). 153 âcamphirâ changed to âcamphorâ (a weak solution of sugar of lead, or of camphor). 158 âmedecineâ changed to âmedicineâ (Mr Paton, previously to embracing the military profession, had studied medicine). 160 âGENERAL REMARKS ON THE DISEASES.â Heading added. 161 âconvalecentsâ changed to âconvalescentsâ (convalescents would frequently suffer a relapse). 223 âGENERAL REMARKS ON THE YELLOW FEVER, AND THE RESEMBLANCE WHICH THIS DISEASE BEARS TO THE PLAGUE.â Heading added. Footnote 5 duplicated word âdownâ removed (On being brought down to Rosetta). INTRODUCTION. In consequence of orders, from the Court of Directors to the Government in India, it became my duty to give some account of the health of the troops employed on the late expedition from India to Egypt, and to describe the prevailing diseases. The sources of information, to which I had recourse, were the reports made to me, and an extensive correspondence with the medical gentlemen of the army; particularly those employed in the pest-establishments. Besides these, to which my situation, at the head of the medical department of the army from India, gave me access, other sources of information, regarding the plague, were open to me, as a Member of the Board of Health in Egypt. Some may think the present a very short, and many may think it an incomplete account; but, I trust, it will not be found incorrect. I have purposely avoided doubtful speculations and hypotheses. Anxious, above all things, to adhere closely to facts, and keep these unmixed with any notions of my own, I have, in most cases, published the extracts from letters to me, without altering a word of the correspondence. Of the numerous imperfection of these Sketches, I am abundantly sensible. The life of a medical man in the army is at no time very favourable to literary pursuits; mine has been peculiarly unfavourable; and I have had little time or opportunity, since I first entered the army, to attend to the ornaments of diction. For the last fifteen years of my life; mostly spent in the East Indies, West Indies, or at the Cape of Good Hope; sometimes at sea, sometimes on land; my time has been occupied in a laborious attention to my duty in the army. Some necessary avocations oblige me to dismiss this tract in a more imperfect form than it might have appeared in, perhaps with more leisure. As it is, it conveyed to government, in India, all the information which they required; and I must mention, that it comes before the public very nearly in the state in which I presented it as a report in India. From materials in my possession, I could have enlarged most parts of it, and rendered the whole more complete; but, when I drew up the following account in India, it never occurred to me, that my imperfect Memoir would be the only medical account of the Egyptian expedition. I expected, on my arrival in England, to have found complete histories of the climate and diseases of Egypt, during the time that it was occupied by the English, from some of the medical staff of the British army; several of whom were known to be fully equal to the task. If any of these gentlemen should hereafter give to the world the medical history of this renowned campaign, my Memoir may stand in some stead: it gives some facts and it will supply some information to which no one but myself had access. At the present moment, I have not leisure to enlarge or alter it; and some friends, who have seen the manuscript, press its publication at the present time. In the execution of my duty, during a long and perilous voyage, and alter the most fatiguing marches, I sometimes laboured under difficulties; but my duty was in every instance much facilitated, and it would be unjust in me not to mention it. I acknowledge my obligations to all the medical gentlemen of the Indian army, by whom I was most cordially and well seconded in all that I undertook. From the nature of the prevailing diseases, the campaign in Egypt was, in a particular degree, a service of danger. To their regret, the Indian army arrived too late in Egypt to share in any other dangers than those arising from the diseases of the country; and here, the medical gentlemen had the post of honour. The zeal, attention, and perseverance, displayed, particularly by those employed in the plague-establishments, deserve every praise. Nothing can so powerfully incite the exertions of medical men, in such circumstances of danger, as the consciousness of co-operating with the best and most enlightened of mankind, for the alleviation of human misery. Intrepidity is more a military than a medical virtue; but seldom I believe has there been a greater display of it than among the medical officers, in Egypt, whose duty it became to reside in the pest-houses.[1] There are two names which I cannot pass over with general praise. At a period of universal alarm, and of real danger, when the plague was committing the greatest ravages, two gentlemen stepped forward, and generously volunteered their services in the pest-houses. It so happened, too, that, from their acquirements, these two were the best calculated, of any in the army, to succeed in this dangerous duty. Dr Buchan had acquired a perfect knowledge of the disease in the former year; and while on duty at the pest-house, at Aboukir, had got the infection there, soon after the memorable landing of Sir Ralph Abercrombie. Mr Price had made the history of the plague his particular study, and, from his acquaintance with the oriental languages, was peculiarly calculated to be master of every thing relating to it. As will be seen hereafter, in the execution of his duty at El-Hammed, he, likewise, caught the infection. To the exertions of these two gentlemen, the service owes much; their country very much. I would fain hope, that from them, who are so able to do it, we may look for something like a history of the plague in Egypt. Dr Shapter, who was for some time in charge of the medical department of the Indian army, and who succeeded Mr Young, as head of the medical staff of the English Army, deserves our thanks for his very ready accommodation on every occasion, and compliance with every request for assistance, and for many things, of which an army which had traversed an immense desert was necessarily destitute. Thus far I have discharged debts which I felt that I owed. I must add a few words more, in explanation. To some, it may appear that, in the following Sketches, I have given too large a space to the journal; and that I have been too copious in my extracts from letters. Both of these are, no doubt, to many, dry and uninteresting; but, as statements of facts, from which every one can form deductions for himself, as they stand, they appeared to me much more useful than any conjectures which I might hazard to advance. It is to be feared that, too often, facts and details are made to bend to preconceived opinions and theories. On the causes of diseases, I have dwelt a shorter time than to some may have appeared necessary. But I thought that, while the general causes of the diseases of soldiers and sailors have been so ably handled by a Pringle and a Lind, a Cleghorn and a Huxam, a Blane and a Hunterâfrom me, little could be expected. All that appeared necessary for me to do, was, to assign the extraordinary causesâthose incidental to the expedition, or peculiar to Egypt; those, in fine, which rendered the service treated of different from former services, either on the continent of Europe, or in tropical climates. It will be observed, that the diseases which occurred in the Indian army were but few; and, except on the plague, I detain the reader but a short time on this part of my subject. A long description of the symptoms, or of the history, of dysentery, diarrhÃ¦a, hepatitis, or ophthalmia, appeared to me superfluous; when, besides the very clear and perfect nosological account of the illustrious Cullen, we have many complete histories of these diseases, in books which are in the hands of every person. Finally: in justice to myself, and in extenuation of errors in these Sketches, I must mention, that, when they were preparing for the press, I laboured under many and very considerable disadvantages. I was on duty in a remote corner of the kingdom, and have been, necessarily from the same reason, at a distance from the press, since, and while the printing went on: circumstances which, I hope, will conciliate the indulgence of readers in general, and shield me from the severity of criticism. _MEDICAL SKETCHES, &c. &c._ PART I. In complying with the orders of government in India, I have sincere pleasure in being able, from original documents, to present them with a correct account of the diseases and mortality which occurred in their army during the late expedition to Egypt. From the period of the first sailing of the expedition, and my appointment to the medical superintendance of it, I retained both the reports of the different medical gentlemen employed in it, and my own memorandums written on the spot. During the period in which Dr Shapter acted, and until I was re-appointed, I likewise kept states of the sick and mortality of the army, and thereafter, till the return and landing of every corps of the army at Calcutta, Madras, and Bombay, or at Ceylon. The India government has ever been peculiarly anxious about every thing that related to the health of their troops, zealous in collecting any fact and circumstance touching the causes of diseases or the means of obviating them, and most liberal in every thing that regarded the health of the sick soldier. During an uncommonly long voyage, in a march over extensive deserts, and in a country and climate described as the most inimical to the human race, the Indian army enjoyed a considerable degree of health, and suffered but a small mortality. The causes of this I shall attempt to develope: the investigation may be useful. The prevention of disease is usually the province, and is mostly in the power, of the military officer; the cure lies with the medical: in the expedition to Egypt very much was done by both. The medical officers deserve my grateful thanks, and I readily acknowledge my obligations to them. For every assistance in their power, I am under not fewer obligations to the military officers. In no army, perhaps, was the health of every soldier in it more the care of every officer, from the general downwards, than in the Indian army. It would be doing violence to my feelings not to mention how much my duty was abridged by having such a commander-in-chief as General Baird. His military abilities are well known. His extreme attention to every thing which regarded the health and comfort of the soldier, I must mention, was a principal cause of the great degree of health enjoyed by the army. To Brigadier-General Beresford the army owes very much likewise. It is not my business to say how much all were indebted to the man, who, under circumstances the most discouraging, led the advance over the desert. In my official capacity I cannot but notice how much the British army, as well as that from India, were indebted to him, as President of the Board of Health, and as Commandant of Alexandria. The excellent police established by him gave security to the army as well as to the inhabitants; and, more than any other circumstance, tended to the exclusion of the plague from Alexandria. The route which we took from India to Egypt is remarkable for having been that by which, in the earliest ages, the commerce of Asia, its spices, its gums, its perfumes, and all the luxuries of the East, were conveyed to Tyre, Sidon, Carthage, Rome, Marseilles, and in a word to all the coasts of the Mediterranean, from Egypt, a country rendered extremely interesting by various recollections.âThe situation of the army from India has accordingly excited no common share of interest. It penetrated Egypt by a route over the desert of Thebes, a route unattempted by any army for perhaps two or three thousand years. Independently of late circumstances, Egypt and Arabia peculiarly interest every man of science, and more particularly medical men, from the occurrence of the plague, and the ophthalmia, or the disorder of the eyes, in Egypt. On one account the situation of the Indian army in Egypt is not a little curious. It consisted of about eight thousand men; of which number about one-half were natives of India, and the other half Europeans. We have often seen the changes effected on a European habit by a removal to a tropical or to a warm climate, but not, till now, the changes in the constitution of an Asiatic army brought to a cold climate: for such were the bleak shores of the Mediterranean to the feeble Indian. The following Sketches I have divided into three parts. The first gives the medical history, or rather the journal, of the expedition: in the second, after attempting to assign the causes of the diseases which prevailed, some modes of prevention are offered: and in the third there is some account of the diseases. The first division of the army intended for the expedition to Egypt, under Colonel Murray, sailed from Bombay in January, 1801. Their voyage was rather a tedious one, and the small-pox and a remittent fever broke out among them. They touched for refreshments at Mocha and at Jedda, and on the 16th May, 1801, came to anchor in Kossier-bay; the prevailing winds in the Red Sea, at this time, rendering it impossible to get so far up as Suez. The second division of troops, (originally intended for another service,) under Colonel Beresford, sailed from Point de Galle, in Ceylon, on the 19th February; and on the 19th May disembarked at Kossier. The last division, under Colonel Ramsay, sailed from TrincomalÃ©e, in Ceylon. They were later of arriving at Kossier, and were not able to cross the desert before July. At Kossier there is a fort and a town, if they deserve the name. They are built of mud, and the Arabs inhabit them only at the season when caravans arrive with the pilgrims for Mecca, and with corn for that and the other ports on the opposite Arabian coast. Like every other place described by Mr Bruce, that we have seen, we found Kossier most accurately laid down by that traveller in lat. 26Â° 7â³, and long. 34. 04. Kossier is situated on the western coast of the Red Sea. Here, vessels for the expedition were daily arriving, and the troops in general landed in a very healthy condition. In one column of an annexed table, intended to show the diseases and mortality of the army, will be seen the strength of the different corps employed in that service. JUNE, 1801. At the beginning of this month we were in camp near the village of Kossier. Soon after the arrival of the troops at Kossier, all were attacked with a diarrhÅa, occasioned by the water, which contained much sulphate of magnesia. At first it greatly debilitated the men; but, as they became used to it, the water ceased to affect the bowels. On the whole it appeared to have produced salutary effects, and the army was, for some time, uncommonly healthy. On the 19th, the 88th, with two companies of the 80th regiment, under the command of Colonel Beresford, as the advance of the army, commenced the march across the desert. Having the digging of wells and other duties to perform, the advance did not reach the banks of the Nile until the next month. The rest of the army marched on the following days, the marches being always performed by night; and the army, with a very inconsiderable loss, reached the banks of the Nile in a very healthy state. The course which we took was nearly that travelled by Mr Bruce. For a considerable way after we left Kossier, the road had the strongest resemblance to the bed of a river. As we advanced from Kossier, the water became daily less salt, and less bitter. At Le Gita, and at Bir Amber, the two stations nearest to GhennÃ©, it was not much complained of. The winds in Kossier camp, from nine to twelve oâclock, generally blew from the N. W. accompanied with torrents of sand. On the march, a very hot suffocating wind from the W. set in about ten and continued till three oâclock. The thermometer at Kossier could not be attended to. On the 29th, at Le Gita, in my tent, at three P. M. the mercury stood at 114Â°. In the soldiers tents it could not have been less than 118Â°. At six oâclock in the morning, in a well three feet deep, it was at 69Â°; and, after taking it out, it fell to 63Â°: but evaporation must have had a share in the reduction. In other places, on the march, the degree of heat must have been higher. Le Gita is not a situation favourable to the centration of heat: it is situated in a large open plain of many miles extent. There was but little sickness in this month, and yet almost every exciting cause existed. The heat was intense. In the currents of dust, much of it went into the stomach and lungs, and occasioned nausea, which was likewise occasioned by the destructive hot wind. To this the Arabs and even the camels always turn their backs. The men were frequently exercised, and the duties of fatigue in India, usually done by black natives, were performed at Kossier by the soldiers. The fatigue on the march has perhaps never been exceeded in any army. DiarrhÅa, and a few cases of ophthalmia, and nyctalopia, were the only diseases in the army. The native corps from Bombay were recovering from a fever, with which they landed. These corps were the last that crossed the desert. JULY. During almost the whole of this month, the army was encamped on the banks of the Nile, which now began to overflow its banks, near GhennÃ©. On the opposite bank are the magnificent ruins of Tentyra, or Dendira, and the fine temple of Isis. The situation of the army near GhennÃ© was very healthy. There was excellent water, and an abundant market of vegetables, of fruit, and of the best provisions. We prepared to move, and detachments of the army went up to Thebes, Luxor, and to the cataracts, to press all the boats. About the end of the month, the army began to move to Lower Egypt. The 10th regiment marched to GirgÃ©, the capital of Upper Egypt, sixty miles below GhennÃ©. On the 27th and following days, the rest of the army was embarked in boats. The wind at GhennÃ© was not regular from any quarter, and sand was blown from all quarters, particularly at the time of the springs. The thermometer had a wide range at GhennÃ©. In my marquee from 71Â° to 108Â°. On the 20th, it rose to 110Â°. In the open air the heat was from 70Â° to 115Â°. There was more sickness than in the last month. There were several cases of hepatitis, particularly in the 10th regiment, and cases of dysentery were not unfrequent towards the end of the month. In the beginning a considerable number of cases of fever appeared, and not a few of ophthalmia and pneumonia: but all these soon did well, after being removed to a good hospital. The Catchief, the officer next in rank to the Bey, gave up his own house for an hospital, and General Baird likewise gave up his quarters to the sick. AUGUST. By the 12th of this month, the greater part of the army, after a navigation of the Nile, of nearly four hundred miles, arrived at Damietta, where we found one regiment of the English army, the 89th, and a general hospital, under charge of Dr Franks, the inspector. The troops at first were put into quarters there; but an encampment was afterwards formed on Rhoda, a small island made by the Nile, very nearly in the centre between Cairo and Ghiza. The Nilometer is on this island. As they landed, the troops were uncommonly healthy. Most of the hepatic and dysenteric sick had recovered on the passage, and the only disease with which they landed was slight fever, of which the cases were not numerous. This state of health continued but a very short time after the landing. In the course of the first week, most of the corps sent one-twelfth and some one-tenth of their strength to the hospital. In three weeks, the sick of the army exceeded one thousand. A considerable number of ophthalmic cases appeared, but the prevailing disease was fever. In every corps it prevailed, and very few escaped it. In general it was of short duration, of two, three, or five, days at most, and rarely proved fatal. Ghiza appeared then to have been an unhealthy quarter, and the ground of the encampment was found to be swampy. We found the 89th regiment in garrison at this place, and so very sickly was that corps, that they could not muster fifty men on the parade. The sick of the army was sent into Ibrahim Bey fort, pleasantly situated on the bank of the river on the Cairo side. It had been occupied by the enemy as an hospital, and had been completely fitted up by them for the purpose. But it was neither (if accounts could be believed) a healthy nor a safe situation. A little before our arrival, the French had some cases of the plague in a ward of this hospital. On hearing this, every measure of precaution was taken, and the disease did not appear. It was remarked, that those sent to the hospital, ill of ophthalmia, dysentery, and hepatitis, rarely left it without an attack of the prevailing fever. About the end of the month, preparations were making to embark the army for Rosetta, and not less than twelve hundred sick were embarked. During the month the wind was most frequently from the N. The thermometer on the Nile, from the 1st to the 8th, was higher than we had found it at GhennÃ©. In the fort of Ibrahim Bey it moved from 80Â° 50â³ to 90Â°. The sickness of the month was very considerable. Though we lost several men, yet the loss bore but a small proportion to the sickness that prevailed. Much of the sickness, and many of the deaths which subsequently occurred, we could trace to the situation near Cairo. Many cases of hepatitis did not appear, but of late many of dysentery; and, in some corps before quitting Cairo, ophthalmia prevailed very generally. SEPTEMBER. Early in this month, the greater part of the army was encamped in the neighbourhood of Rosetta. The 86th regiment and two companies of the 7th Bombay regiment went into garrison at Ghiza. Separate regimental hospitals were provided for every corps in Rosetta: but the number of sick appeared to be gaining ground, particularly the cases of ophthalmia, which disease was nearly confined to the 10th and 88th regiments. The number occurring in the artillery, 61st and 80th regiments, was inconsiderable; and the disease was very rarely seen among the Sepoys. Dysentery and hepatitis prevailed very generally in every corps; but the appearance of another disease occasioned the greatest alarm throughout the army. On the morning of the 14th, I discovered a case of the plague in the hospital of the 88th regiment: Anthonio, one of the hospital-cooks, who had for thirty hours laboured under febrile symptoms, shewed me two buboes in his groins. He had no venereal appearance, and the fever was now attended with extreme irritability of the stomach. At the same time, I was shewn another hospital-servant, a Hallancore, who lay next to Anthonio. The Hallancore had been attacked in the night time, and, when I saw him, had much fever and pain in the axilla, though I could discover no swelling of the glands. As speedily as possible these two men, and six other hospital-servants, who slept in the same apartment, were removed to a house at the extremity of the town. A room was immediately allotted, in the hospital of the 88th regiment, for cases under observation. To this every soldier, or follower, with febrile symptoms, was sent the instant that the symptoms were discovered. A minute examination was made, on the evening of the 14th, of all the men in the hospital, amounting then to one hundred and sixty-two, in order to discover whether any laboured under suspicious symptoms, but nothing was observed. On the morning of the 15th, I discovered six men with fever, most of them had been attacked in the night-time; they were sent without delay into the observation-room, and most strictly guarded. By frequent observation, in the course of the day, I discovered buboes in one, and pain in the axillary and femoral glands of all the others: all were therefore sent to the pest-house, which was now established. Early on the morning of the 16th, the cook and Hallancore, first attacked, died. It was found necessary in the course of the day to send nine more men into the observation-room, where the nitrous fumigation was very liberally used. After an emetic, I gave mercury very liberally to the whole nine; but the symptoms, on the morning of the 18th, were so unequivocal, that I sent them all to the pest-house. Our situation now became very alarming. There were the clearest proofs of the hospital which the 88th regiment occupied being thoroughly infected, consisting of about fourteen or fifteen rooms, but all the cases had hitherto come only from three of the rooms. Lamps for the nitrous fumigation were kept constantly burning both in them and in the observation-room. A very large building was procured near Rosetta; and, with all possible haste, the men were moved to it. No man left the old hospital till all his clothes were washed; his hair was cut short, and himself bathed. On coming to the outside walls of the new hospital, every man stripped himself naked and went into a warm bath before his reception into the hospital. He was then provided with new clothing and bedding; the clothing brought with him was received by a non-commissioned officer, who saw it repeatedly washed and baked, after which it was received into the hospital store-room. On the evening of the 18th, I sent four more men into the observation-room, and, on the 21st, three of them were sent into the pest-house. The other did well in the observation-room. On the 23d, Littlejohn, a boy, was sent in the morning to the observation-room, having been attacked the night before with rigours. On the 25th, Egan, another suspicious case, was also sent there. In both of them a severe ptyalism was excited in less than forty-eight hours by mercury and nitric acid, and they afterwards did well. On the 28th, Craig, with febrile symptoms, was sent from the new hospital to the observation-room of the old. His gums were speedily affected; but it was found necessary to send him to the pest-house. This was the only instance of the plague which appeared in the 88th regiment after their removal to the new hospital. The six native followers, first sent off, had no symptoms of the disease for eight days after their arrival at the pest-house; but, on the 9th and 10th days after, all of them were attacked, and none survived the attack three days. Four more of the Indian servants, sent to the pest-house to attend the others, shared the same fate. The case of the Mukadum of the Dooli-bearers was the most rapid. On the 17th, he was attacked about nine oâclock in the morning with rigours, and died before four oâclock. No instances of the plague appeared in any other corps of the army during this month. Though they attempted to conceal it, we discovered that some _accidents_ (as they call it) had occurred about the beginning of September among the people of the town. The weather still continued the same during this, as the whole of last, month. The same winds prevailed, without rain or anything remarkable. On the 15th, 16th, and 17th, it blew from the westward: after this, we had close calm weather. After the 15th, the Nile at Rosetta began to recede. The general range of the thermometer, in a house in Rosetta, was from 73Â° to 83Â° 50Â´. After the plague, the most formidable disease in the army, from its general prevalence, was ophthalmia. In the 10th and 88th regiment there were upwards of three hundred and fifty cases. The total number in the army exceeded six hundred. Dysentery and hepatitis prevailed very generally among all the European corps; and the mortality of the month was very considerable. OCTOBER. In the beginning of this month, the encampment was moved from one to five miles distance from Rosetta. The hospitals were gradually removed also from hence. As the men recovered they were sent to a convalescent camp, intermediate both to Rosetta and the general encampment, and precautions were taken to prevent the men from intermingling with the inhabitants of Rosetta. Thatched regimental hospitals were built in the camp; and, though in the middle of a desert, the sick soldier had a warm, comfortable, and well-ventilated, apartment, and was liberally provided with every thing conducive to his recovery. Early in the month, the garrison of Damietta joined the army. The 86th regiment were healthy and suffered less from ophthalmia than any European corps of the army. About the end of the month, this corps was sent to Ghiza, and the detachments in garrison there were ordered to join their respective corps. The temperature of the air became sensibly lower than in the former month, the extremes being from 69Â° 50Â´ to 80Â°. The medium was from 70Â° to 77Â°. The westerly was still the prevailing wind, and it often blew very fresh. The atmosphere, towards the end of the month, was very cloudy; and, though we had no rain during the month, it seemed often to threaten it. Owing to the very strict precautions taken, little plague occurred during the month. From the time the sick of the 88th regiment were separated, and from regulations regarding cleanliness and fumigation being rigidly adhered to, the progress of the contagion was effectually suppressed in that regiment. The European corps still continued to suffer from hepatitis and dysentery, while the number of cases of ophthalmia, and the great degree of violence in which this disease was now seen, were really alarming. During the month, a case of the plague appeared in the 61st regiment. He had been a patient in the regimental hospital in Rosetta, and caught the disease from straggling through the town. The only other case which occurred was a follower of the commissariate department. NOVEMBER. At the commencement of this month, the army was encamped at El Hammed. The sick were in the thatched buildings, and the mortality bore but a small proportion to the sickness. The 86th regiment were very healthy in Ghiza. The weather during the month was different from what we had experienced for a considerable time. The sky was constantly clouded, and it often blew strongly from the west. It rained on fifteen days, and the quantity of rain which fell during the month was considerable. On the 17th, there was much thunder and lightning. The dews were heavy, and there was generally a thick fog which lasted till eight or nine in the morning. The extreme ranges of the thermometer in my marquee were from 57Â° to 77Â°. In the beginning of the month, the whole sick of the army amounted to one thousand three hundred and fifty, or more than one-fourth part of the whole strength of it. In the course of the month there appeared one hundred and seventy cases of intermittent fever, occasioned evidently by the effluvia from the low ground between the camp and the river, which retained the rain, and, before we moved, became a swamp. On the 8th, we were again alarmed at the appearance of a case of the plague, in the department of the commissary of cattle, which was immediately put under quarantine. On the 12th, symptoms of the disease appeared in a Sepoy of the Bengal battalion, who was in the hospital of that corps. On the 13th, five more cases were discovered in the same hospital, which was ordered to be burnt, the sick having been removed into a large house near Rosetta, where the same precautions were used as with the 88th regiment, when the disease first broke out. After their removal, no case appeared in that battalion. On the 12th a case of small-pox was discovered in the hospital of the 10th regiment; and, in the course of two days more, four cases appeared in the same hospital. The first, a Portugueze servant, died. At the end of the month, the number of sick was reduced. In the weekly return from the 20th to the 26th, there were six hundred and thirty-two Europeans, and three hundred and eighty Sepoys, making a total of one thousand and twelve. None of the tents kept the rain well out, which was often heavy. The sand, however, quickly absorbed it in most places. The fever was, in several instances, similar to a type, which we had been little used to, viz. the typhoid. DECEMBER. Early in this month part of the army marched to Alexandria; and, by the end of it, all the army, with the exception of the horse-artillery, 7th Bombay regiment, and the department of the commissary of cattle, was collected there. About the time that the first part of the army marched thither, detachments of the 26th dragoons, and of Hompeschâs mounted riflemen, joined us from the English army, and were quartered in Rosetta. The plague now gained on us. On the 1st of the month, Corporal Francis, of the 88th regiment, who had been on the pest-house guard the day before, complained of slight febrile symptoms and giddiness. He had a vibex on the seat of the inguinal glands on one side, with some pain, but no swelling there. I shewed him to Mr Price, who was in charge of the pest-house, and he had no doubt of its being a case of the plague. Very soon after his admission into the pest-house, a bubo appeared in his groin, and his fever increased. Mercury was thrown in rapidly, his mouth became affected, and, the bubo suppurating, he recovered. On the 15th, a private of the 8th light dragoons was shewn to me with a bubo in his groin and giddiness, but without quickness of pulse or any other febrile symptom. On being brought to Mr Price he was admitted into the pest-house, and the treatment and result in him were similar to those of Francis. On the evening of the 15th, it being reported to me that a Sepoy had suddenly died of fever in the line of the 7th Bombay regiment, I examined the body, and found the inguinal glands swelled on both sides. About an hour after, Mr Grisdale, the surgeon, shewed me a case in the hospital of the same corps, which was evidently the plague, and which I instantly ordered to the pest-house. In the course of the month 38 more cases of the same disease, most violent and rapid in their progress, appeared in the same regiment. Three died, either in the hospital or on the lines, before they could be conveyed to the pest-house, and one died in his way thither. One man of the 1st Bombay regiment died of the same disease, who had clearly got the contagion from the former corps, near which their hospital was situated. The weather during the month was changeable; towards the end it was boisterous. The thermometer in tents was sometimes so low as 49Â°, and rarely rose above 70Â°. The sky was cloudy, but rain fell only once in eight days. In the beginning of the month there was a considerable number of cases of continued fever. There were fewer intermittents than in the last month. The number of cases of dysentery was decreasing. Towards the end of the month there were many cases of catarrh, pneumia, and rheumatism. The diseases of the eyes were greatly on the decline. In the weekly return of the 3d are three hundred and twelve cases, whereas in that of the 31st there appear only ninety eight. JANUARY, 1802. With the exceptions already mentioned, all the army, during this month, was in Alexandria, where they attained a degree of health they never had at Rosetta. No case of the plague had been known at Alexandria when the Indian army arrived there; and the strictest precautions were taken to cut off the communication with Rosetta and the 7th regiment. In the beginning of the month the weather was extremely boisterous: the wind, generally from the north and north west, was very high. For eleven days there was rain, and often very heavy. The thermometer was once below 60Â°, and never above 70Â°, in a house in the centre of the city. The number of sick was much smaller, but the mortality greater, than in any preceding month. On the 1st, Mr Price, who was in charge of the pest-house near Rosetta, was himself attacked with the disease, which with him proved very violent. On the following day, three of six Arabs, who acted as in-servants to the pest-house near Rosetta, were also attacked. On the 6th, a Sepoy of the 1st Bombay regiment died suddenly in the hospital of the corps at Alexandria; the sick of this corps having arrived from Rosetta but a few days before. On the 7th, two cases of the plague, from the same regiment, were detected in the camp at Alexandria. On the 8th, the 1st and 7th Bombay regiment marched to, and encamped at, Aboukir-bay, where a pest-establishment was placed for them. On the 2d, symptoms of the plague were discovered on Dr Whyte, who the day before had inoculated himself, and he died on the 9th. On the day following, a soldier of the 61st regiment, a servant of Colonel Barlow, Commandant of Rosetta, was sent into the pest-house there, now under the charge of Mr Grisdale and Mr Rice, with the plague. On the 13th, two of six Arabs, out-servants at Rosetta, were attacked with the disease. Two men of the department marched the same road, and halted at the same stages, as the 7th regiment had done a week before. On the 22d, two men of the 10th regiment, from a permanent guard on-board a vessel under quarantine, were sent into the pest-house at Alexandria. There occurred this month 72 cases of the plague in the Indian army, viz. 2 Officers, Dr Whyte and Mr Price. 2 Cases in the 10th regiment. 1 61st ditto. 22 1st Bombay regiment. 30 7th ditto. 4 department of the com. of cattle. 1 Pioneer-corps. 10 Arab servants. -- Total 72 -- Continued fever prevailed in the army. It was the synocha of Cullen. Intermittents were still on the decline, as were likewise dysentery and hepatitis. Pneumonia and rheumatism prevailed but in a small degree. FEBRUARY. This was a very cold and wet month; yet the number of sick continued to decrease, except in the 1st and 7th regiments, in which corps the plague continued to rage. Throughout the month, the sky was cloudy; we had high winds, on 19 days it rained, and on some of these as heavily as in the monsoons in India. The thermometer moved between 55Â° and 63Â°. On the 13th, for the first time, the following cases of the plague were dismissed cured from the quarantine-hospital; viz. two Sepoys, one drum-major, and one woman, from the 7th regiment, and two Arab servants of the pest-house. At this period, too, six were dismissed from the pest into the quarantine-hospital. Till this day no native of India, who had entered the pest-house, ever returned. But so much was the dread of the distemper now lessened, that a volunteer in-steward, for the pest-house at Aboukir, came forward from the 7th regiment. On the 24th, the commissaryâs clerk at Rosetta got the disease. Of five Europeans, whom we had left at Rosetta, two caught it and died. The disease here raged with the utmost violence. On the 28th, Signior Positti, an Italian, came from Rosetta, and lodged at the house of Mr Fantouchi, the Swedish consul in Alexandria. It was discovered two days after that he had the plague, and he, with the surgeon attending him, was immediately sent to the Lazaretto. Signior Positti died on the day of his admission. Almost all the cases of plague, which subsequently appeared in Alexandria, could be traced to this case as a source. The whole number of cases of plague, which occurred in the army during this month, was only twenty one. Fever appeared in all the reports. It was accompanied with the inflammatory diathesis, and it was in general slight. Of hepatitis and dysentery, the number of cases was still less than in former months. Ulcers, which in the Indian army were hitherto very rarely seen, prevailed at this period. Of rheumatism and pneumonia there was an increase. On the whole, in the course of the month, there was a decrease of sickness, and a considerable decrease of the mortality. On the 1st of the month there were seven hundred and five in the report; and on the 28th only three hundred and twelve, or about one in twenty-six. MARCH. The weather was milder than in February. The thermometer was gradually on the rise. During the month it never was lower than 50Â° nor higher than 69Â°. The wind was most frequently from the west, from which quarter it blew very strongly on the 13th, 14th, 15th, 16th, 19th, 20th, and 21st. It rained on 12 days; and on some of them, about the middle of the month, very heavily. The atmosphere was in general cloudy. On the 19th we had claps of loud thunder. But for the existence of the plague the army might be said to have been very healthy during the month; and, though this disease was more diffused through the country and in the army, yet more cases did not occur in the Indian army than in last month, and the mortality from this disease was much less considerable than formerly. The garrison of Ghiza had been, for some time, the most healthy part of the army. During the present month the corps there presented long reports of sick. The small-pox broke out among the Sepoys there; and in the 86th regiment there was an immense number of venereal cases, several of which, from their standing, were inveterate. The following is a list of the number sick of the plague in March. Royal Artillery 1 â Navy 1 26th dragoons 9 10th regiment 2 61st regiment 7 88th regiment 2 1st Bombay regiment 1 7th ditto 8 The Departments 3 Foreign corps 3 Strangers 2 Arab servants 7 -- Total 46 -- The spreading of the diseases rendered it necessary to multiply our pest-establishments. In addition to those of Alexandria, Rosetta, and Aboukir, one was formed at Ghiza, and one at Rahamania, situated on an island at that part of the Nile where the canal of Alexandria formerly took its rise. Between Aboukir and Rosetta, a serjeant and twelve men, of the 26th dragoons, were stationed to prevent communication between Alexandria and Rosetta. Nine of these were attacked with the disease during this month. Within the walls of the pest side, or that part of the lazaretto appropriated for the reception of cases of plague, at Alexandria, a serjeant and twelve men were also posted as a guard to preserve order. Eleven of them caught the disease in
{'title': 'Medical Sketches of the Expedition to Egypt, from India by Sir James McGrigor', 'source': 'Project Gutenberg', 'lang': 'en'}