| Description | Some pages are either blank or are incomplete containing, for example, only the date or the name of a division as a heading with no information added below. Where this is the case, no cataloguing was deemed necessary.
Flyleaf: list of hospital stations and medical officers in charge including those attached to Cavalry Division.
October
Page 1: During journey to Ciudad, Celerico and other places the sick were exposed to severe weather; this led to simple continued fever and intermittents degenerating into typhus and dysenteries assuming 'so malignant a character as to baffle the skill of the medical officer, the cases frequently proving fatal within a few days...'.
Page 2: Comments on weather, noting poor conditions, and remarks on drop in temperature.
Page 3: In order to satisfy the urgent requests of the army for medical aid and in particular to prevent sick men being sent to the rear unaccompanied by a medical officer, Mr. Grant was directed to...
Page 5: Hospitals at Madrid and Talavera ordered to be broken up.
Page 9: Summarises reports from the various hospital stations.
Lisbon: 599 men were treated in total; [venereal?] disease, followed by intermittent and continued fever was most common affliction; 207 men were discharged and 14 died.
Santarem: Notes Dr. Buchan's reply to his query as to why phthisis pulmonales was less frequent in Portugal than in England: the cases in which the lungs have been found ulcerated have in general been complicated with other diseases or occurring from wounds; he had not seen what is termed a constitutional phthisis pulmonales.
Page 10: Dr. Buchan reports that in the month 250 men were admitted from Abrantes, the majority suffering from intermittent fever 'or the consequences of this disease' and he relates their symptoms. Reports diseases among the inhabitants, noting that intermittent and remittent fever prevailed (of the former the quotidian type was prevalent). The rains and cold weather has led to sore throats and 'affections' of the chest. Lists number and types of cases admitted to hospital.
Page 11: Comments further on report from Santarem, noting prevalence of intermittent and remittent fever among inhabitants. Refers to report by Mr. Paddock on prevailing diseases, including chronic cases sent from Abrantes. Also notes case of acute dysentery treated by use of lancet. Comparisons made by Paddock, who previously was a practitioner in the West Indies, of fevers occurring during the month with the bilious remittent found there.
Abrantes: Dr. Somers notes unhealthy location of Abrantes [continues on pages 13 and 15] and problems of supply and quality of water.
Page 17: Summarises reports from Alto da Chau [Alter de Chao] and Castello Branco. In both stations, intermittent and continued fevers and dysentery have been the prevailing diseases [continues on page 19].
Page 19: Report from Coimbra, where the most prevalent disease was 'the sudden exhibition of gangrene among the wounded'. Provides detailed description of symptoms of gangrene [continues on page 21], noting treatment of tonics and stimulants.
Page 23: 'I issued orders to all the Divisions to establish general hospitals, to get good Douro wine, rice and salt from the Commissariat _ , to repair hospital cantonments'.
Page 25: Dr. Erly in report from Francisco hospital notes that admissions for month are mainly from Celerico, the barracks, detachments passing by Coimbra to join the army, cases from the convalescent hospital at St. Clara and _ . The prevailing diseases being dysentery, intermittents, remittents and visceral complaints.
Page 31: Celerico
Mr. Burrows reports that many sick have been received from Ciudad Rodrigo and he has many acute severe diseases accounting for a great proportion of mortality. 'The heavy rain and bad weather which the sick met with in their progress from Ciudad greatly aggravated the diseases' and many cases of gangrene were received from here. In the convalescent hospitals many cases of intermittent fever have relapsed: 'from the situation of this hospital the men are exposed to the heat of the sun which excited the return of the disease'. Intermittent fever had been very persistent among the inhabitants and 6 people died from this disease. Mr. Powell states that dysentery and typhus were the most fatal diseases of the month.
Page 33: Ciudad Rodrigo
635 patients remained in hospital in addition to the 555 cases admitted for the month. Of the 1,190 patients treated, 395 were transferred to Celerico and 244 recovered. 98 patients died, 33 from continued fever. 2 of the fatalities were prisoners of war, 2 were soldiers wives and 4 were Portuguese bullock drivers. Notes prevalence of gangrene among wounded: 'The gangrene was usually preceded by attacks of fever either remittent or intermittent: the sufferers frequently attributed its origin to the jolting of the bullock carts on the road between Salamanca and Ciudad…Staff Surgeon Bruff treated this disease with but a moderate portion of success. The local application which appeared to answer best was composed of equal parts of [Peruvian] bark and charcoal joined with a sixth part of powdered nitre, applied twice a day to the sloughs, taking care always as the sores cleaned to cover the healthy and tender granulations with dry lint and to apply the [continues on page 35].
Page 35: powder only to the most foul and diseased parts of the sores. By this means the sloughs were soon thrown off the surface, brought to a healthy state with a well conditioned purulent discharge'. Notes effect of bad weather on patients and comparison of Dr. Neal of stump cases sent home from Walcheren to the hospitals at Deal with those sent from Salamanca to Ciudad Rodrigo: 'In the Deal hospital, the moment a wounded man was attacked with the fever, his wounds began to slough. In Ciudad the blistered surface in fever cases assured the sloughing appearance'.
Page 37: Report from Salamanca.
Page 41: Burgos
The 1st Division had been involved in the siege of Burgos and had been affected by fatigue and cold weather. In the 2nd Division, 256 cases of continued fever, 135 cases of remittent fever and 535 cases of intermittent fever had been admitted. Though the admission of these fevers was less than in September, 'they have been attended with more severe and urgent symptoms and many proved fatal. In the Continued and Intermittent type there was great irritability of stomach, determination to the head, bilious redundance, accompanied with delirium and in some occasions with coma and in the cases where the disease terminated fatally, the progress of the disease was rapid in most instances, seldom running a course of more than 5 or 6 days'. Notes that the extreme nature of these attacks was due to 'the increased morbid effects of miasma' and the alteration of heat and wet and coldness during the nights.
Page 43: Report from 4th Division.
November
Page 51: Dr. Dickson reports that he sent 556 men from Salamanca to the rear on the 1st November and 889 men on the 2nd November.
Page 65: Report from Lisbon.
Page 67: Abrantes
Dr. Somers reports that during the previous month the prevailing diseases have been obstinate intermittents, remittents 'degenerated into low continued fever' and chronic dysenteries. Since the arrival of the cold and wet weather the cases of dysentery 'of a long standing were rapidly swept off, sometimes in a few hours' [continues on page 69].
Page 69: Notes efforts to prevent this happening by providing flannel clothing and warm, comfortable bedding in the hospital. 'Sometimes and when the hospitals were far from the ports and when the means of transport were difficult as at Vizeu, Celerico, Salamanca we had not these advantages and no doubt Dysenteric sick would suffer [proportion?]'. Also discusses postmortem examinations carried out on these cases: '...in almost every instance...the colon from the arch downwards and the rectum more especially were throughout in an ulcerated sloughing state, the liver and spleen in general...enlarged and verging to supperation'. Dr. Somers comments that the lancet would have been of benefit in these cases and recommends use of bloodletting in early stages of dysentery. Notes treatment used by Dr. Somers at Cape of Good Hope [continues on page 71].
Page 71: Notes use of warm bath to help relieve pain when attended with tenesmus and other treatment administered. Report from Mr. Goodrich.
Alto da Chao: Mr. Porter reports that the prevailing diseases have been intermittent and continuous fever together with dysentery, with same diseases affecting the inhabitants of the village.
Page 73: Mr. McCaul reports that intermittents, mostly of the quotidian type, were the most prevalent.
Castello Branco: 92 patients were admitted. Of these, 27 were cases of continued fever, 22 cases of intermittent fever and 22 cases of dysentery. Out of 281 cases treated in total, 14 died, 7 from chronic dysentery arising from continued or intermittent fever or from repeated attacks of these diseases.
Page 75: Coimbra
The prevailing diseases have been intermittents and dysenteries with a few cases of remittent fever and a large number of visceral affections. Since the last report, the hospital gangrene has mostly disappeared but agues are very prevalent due to the rainy weather. The admissions were primarily from Celerico, the barracks and a few cases of relapse from the convalescent hospital. Discusses specific cases of intermittent and remittent fever, the latter experiencing a considerable swelling of the tongue with some degree of inflammation [continues on page 77].
Page 77: Continues report of case affected with swelling of the tongue and notes that he had similar case in Bombay. Also lists the different types of disease that led to deaths of patients and refers to report from the College of Arts where the wounded Fench soldiers were sent.
Page 79: Ciudad Rodrigo: Dr. Neal reports that 46 patients died from dysentery, 29 from wounds (the majority from hospital gangrene) and 17 from typhus. Notes that men admitted with dysentery were those who having recovered from continued or remittent fever during the summer months returned to their duties in the field where they were generally attacked with dyspepsia, diarrhoea and other gastric affections with the onset of the rains. These usually led to serious attacks of dysentery 'which in debilitated subjects frequently proved fatal'. |