| Description | Page 2: 11 April
Notes that at the commencement of this month, the Army remained in cantonments, 'though preparations were very like preparations for a move'. He has sent inspecting officers to every division of the Army and every corps was inspected monthly. Also comments on satisfactory reports received from Dr. Forbes, Mr. Robb and others.
Page 3: records that 4,825 patients were admitted into regimental hospitals and 693 into general hospitals for the month of April. Compares figures with same month for previous year, noting marked decrease in number (11,920 patients were admitted into general hospitals). Notes different types of cases admitted into all the hospitals as of 20 April, including: 1,776 cases of continued fever, 917 cases of intermittent fever, 238 cases of typhus fever, 228 cases of rheumatism and 367 cases of ulcers.
Page 8: 6 April
A circular order of this date has been sent to the divisions prohibiting anyone but a medical officer from making up medicines and issuing instructions relating to the care of convalescents, particularly in relation to their diet as 'sudden changes of diet [are] noticed as among the chief causes of relapse'.
Page 16: 20 April
Notes orders to take charge of all the sick and wounded prisoners of war, previously under care of Portuguese government.
Pages 18-30: provides details of reports from the different hospital stations.
Lisbon: 456 admissions, 52 of which were cases of continued fever (Mr. Guthrie notes that these were mild cases and responded well to cathartics and febrifuge medicines).
Santarem: 124 admissions, including 30 cases of intermittent fever and 11 cases of rheumatism: 'the admissions have all been from detachments or from barracks. Intermittent the prevailing disease is very resistant. He has had some cases of phlegmon accompanied with erythema, as likewise some severe cases of Erysipelas'.
Castello Branco: 29 admissions, 4 of which were cases of dysentery.
Vizeu: 'On this station a very important change in point of health has taken place'; notes that simple continued fever, followed by typhus, intermittent fever, pneumonia, hepatitis, dysentery and diarrhoea have been prevalent. Also notes symptoms of fever: heat of skin, full pulse and white tongue.
Pages 32, 34 and 36: report of Cavalry Division. 245 cases were admitted during the month, 61 of these were continued fever, 53 intermittent fever and 26 were cases of rheumatism. 'The greater prevalence of [Intermittent] Fever in this over the former month he ascribes to the variable state of the weather; he discovered that men employed in fields to look after their sickly horses in very many instances have lain down and fallen asleep, exposed to a powerful sun and consequently considerable exhalation from damp and marshy grounds…The special causes assigned for Intermittent will account for the great prevalence of Rheumatism'. Notes report by Mr. Caldwell that 'frequent intoxication was a predisposing cause to all the diseases which prevailed' in the 13th Dragoons and Mr. Griffiths thinks that the prevalence of dysentery in the 15th Dragoons was a result of the 'stimulus of wine and spirits and the irritation produced by a profuse quantity of acid fruit; both cheap and readily come at by the soldier. He treated it successfully by the early use of the lancet, followed by giving a solution of sulphate of soda with occasional doses of Antimonials and Calomel'. Also notes information from reports of the 18th, 'the most healthy corps of the brigade', and the German regiments.
Pages 36 and 38: 1st Division, with separate reports from Mr. Nixon on the Guards at Oporto and Mr. [Dunk?] for the other mainly German corps.
Pages 38 and 40: 2nd Division. Dr. Ferguson states that there were 144 cases of simple continued fever, 129 cases of intermittent fever, 36 cases of remittent fever, 3 cases of typhus and 16 cases of pneumonia. Dr. Ferguson notes that the continued fever has generally yielded to the ordinary antiphlogistic remedies 'without long confinement'. Notes that ophthalmia has made its appearance in the 39th and 71st regiments but the disease yielded to the cooling treatment.
3rd Division. There were 499 admissions, nearly half of the previous month. The most common diseases were continued and intermittent fever, 158 and 133 cases being admitted respectively.
Page 42: Discusses use of cold affusions and diaphoretics in treatment of continued fevers, the prevalence of intermittent fever in the 45th and 74th regiments (which yielded to evacuation, attention to the digestive organs and to bark), and notes reports from the 5th, 45th, 74th and 83rd regiments.
Page 44: Reports of 87th and 88th regiments.
4th Division. Mr. Lindsay reports that there were 535 admissions as follows:
Continued fever: 181
Intermittent fever: 120
Remittent fever: 16
Typhus: 9
Pneumonia: 13
Rheumatism: 20
Hepatitis: 2
Ophthalmia: 11
Catarrh: 4
Diarrhoea: 21
Phthisis Pulmonalis: 1
The intermittent and continued fevers were attended with considerable vascular action and frequently with topical determination to the important viscera and sometimes with diarrhoea.
Page 46: Venesection was practised in the cases of low fever in the 7th and 53rd Regiments: 'it not infrequently cut short the disease at once and arrested the danger of topical determination'. Also notes other methods used by Mr. Lindsay. Refers to the problem of intoxication which has increased the sick of the 4th Regiment as well as that of other Divisions: 'In one case, cholera morbus was directly induced by heavy drinking. The case proved fatal and dissection showed marks of high inflammation throughout the whole of the abdominal viscera'. List different types of diseases treated among the 107 cases admitted by Mr. Williamson of the Fusiliers.
Page 48: Continues summary of report by Mr. Williamson and comments on the 23rd Regiment (where continued fever was the prevailing disease, the treatment used being venesection and sometimes mercury) and the 27th and 40th Regiments.
Page 50: Comments on report on the 48th Regiment and the 5th Division. In the latter, 386 patients were admitted during the month, including 172 cases of continued fever, 67 cases of intermittent fever and 27 cases of typhus.
Page 52: Report by Dr. Gordon of the 4th Regiment. 'Worms were met with not uncommonly and in cases where fever appeared to be the idiopathic disease. The long round worm was frequently voided by the mouth to the great horror of the patient. The tape worm was mostly voided by stool and generally dead and in pieces. The evacuation of these particularly when it happened by the mouth was always preceded by restlessness, great uneasiness about the praecordia, gripping pains about the navel and severe pains of the loins, slimy dysenteric stools with tenseness generally accompanied these symptoms' [continues on page 54].
Page 54: 'After expelling the worms downwards or upwards he ordered bitter and tonic medicines with a nutritious diet...'. Also notes advantages gained in frequently altering the diet of patients suffering from dysentery and that the bathing of the regiment three times a week in a nearby river has contributed to their recovery. Notes reports of the 9th and 38th Regiments, the latter admitting 63 patients in the course of the month.
Page 56: In the 38th, slight febrile attacks continue to appear and there have been relapses among the convalescents: 'these cases yielded to the early application of an emetic and purgation and to the cold affusion'. In the some of the 158 cases of continued fever treated in the 47th Regiment, there was 'yellowness of the body, which commenced in the eye; excruciating pain of the feet and toes frequently occurred, in 3 cases it terminated in mortification, the toes sloughing'. Also refers to report of the 59th Regiment.
Page 58: 6th Division. 418 cases were admitted, 150 less than the previous month:
Continued fever: 191 (60 died)
Remittent fever: 13
Typhus: 17 (10 died)
Dysentery: 5
Diarrhoea: 14
Rheumatism: 6
Pneumonia: 16
Ophthalmia: 5
Note of reports from 11th and 32nd Regiments.
Page 60: 30th Regiment. In the treatment of continued fever, both purgation and cold affusion were tried, with preference given to the latter. Refers to reports of 42nd (Mr. McLaughlin noting use of emetics, brisk purgation, followed by diaphoretic mixtures in treatment of fever), 53rd, 61st and 75th Regiments and 7th Division.
Page 62: In the 7th Division, 927 cases were treated in total. 28 patients died, 565 were discharged and of 334 remaining under treatment, 177 are convalescent with only 54 confined to bed. The total admissions were 429 with continued and intermittent fevers the most common disease. Report of the 82nd Regiment.
Page 64: Light Division. 191 cases were admitted during the month, 88 being cases of continued fever, 81 cases of intermittent fever and 10 cases of pneumonia. Pneumonia has occurred mainly in the drafts received from England. 'Of 250 sent to the 39th, the greater part had been in Walcheren and suffered by the prevalent fever there: most of the men suffered an attack on coming out to the Peninsula'. Refers to report of the 43rd Regiment. |