| Orders. Windward and Leeward Command. ARMY MEDICAL DEPARTMENT. IV. ON THE HEALTH OF THE TROOPS SERVING IN THE WEST INDIES. Section I. Sickness and Mortality. I. WINDWARD AND LEEWARD COMMAND. 1. WHITE TROOPS. The Force employed in this Command has remained the same as in 1860, consisting of Royal Artillery, the service companies of the 1st Battalion 21st, and two companies of the 14th Regiment detached from Jamaica. The average strength of the white troops during the year was 1,259, the admissions into hospital were 1,374, and the deaths 7, of which 3 occurred in and 3 out of hospital, and 1 among 'the invalids sent to England. numbers give the ratio of 1,091 admissions into hospital and 5.55 deaths per These 1,000 of the mean strength, the former being exactly the same as the average of the two preceding years, and the latter under half that average, but identical with the ratio in 1860. The following Table shows the influence of the different classes of diseases in producing these rates of sickness and mortality. A detailed return of the diseases in 1861 will be found in Abstract No. XV. of Appendix. 1234 Class I. Miasmatic Diseases. Dietic 4 Parasitic Class II. Diathetic Diseases. 684. 91 50 3 :::: :::: 5433 72.3 39.7 2.4 4.9 2 2 14.3 1.59 2 Circulatory 5 3.9 3 Respiratory 30.2 4 Digestive 75.4 1.59 5 Urinary 6 Reproductive 7 Locomotive 8 Integumentary Class IV. 4 Diseases of Nutrition 7 183 20.6 5.5 145.3 348 ⚫40 .. 1 125 1 3 1 Diseases. On examining this Table it will be observed, that while the total admissions Windward in 1861 correspond exactly with the average of the two preceding years, there and Leeward is a considerable difference in the various classes. Thus, there has been an Command. increase in miasmatic and dietic diseases which has been compensated by a reduction in the amount of venereal and diseases of the integumentary system. The difference in the mortality has been chiefly in miasmatic diseases. MIASMATIC DISEASES.-On subdividing these, as usual, into smaller groups the following results are obtained : Admitted. Rheumatism Although small-pox prevailed as an epidemic at Trinidad during the first six months of the year, no cases of it occurred among the soldiers. During the second half of the year measles became epidemic at Barbadoes and Trinidad among the civil population, but there were only two admissions in each of these islands among the white troops. There has been during the year a marked increase in the amount of paroxysmal fevers and a decrease in continued fevers. The increase was entirely confined to St. Lucia and British Guiana. At the former it may have been perhaps merely an irregularity attributable to the small amount of the force employed; at the latter, it arose from special circumstances which deserve notice. On the 26th of May, yellow fever broke out among the civil population at George Town, but chiefly confined to the shipping and the lower orders of Portuguese. As a precautionary measure, on the 3rd of June the detachment of the 21st Regiment was moved by rail from George Town to Belfield, distant about seventeen miles, and was there put under canvas. During the first sixteen days after its arrival there seven cases of yellow fever occurred, all of which recovered, and the disease then ceased among the troops. The disease continued, however, to prevail in George Town and its vicinity till towards the end of December, and, in consequence, the authorities did not consider it advisable that the troops should return from Belfield till the 18th of January, 1862. At Belfield the tents were pitched on a sandy ridge, about 1,000 yards from the sea. The surrounding country is low, flat, and marshy, being at high water several feet below the level of the sea, from the irruption of which it is protected by dykes and sluices: As might have been anticipated, among troops encamped in such a situation, intermittent fevers prevailed to a great extent, but of a mild type, none of the cases having terminated fatally. The locality selected was the most eligible that could be found within reach of George Town; and the result, so far as regards the immunity from yellow fever, was satisfactory; but it may be a question whether, under similar circumstances, it would not be advisable to remove the European troops entirely from the colony, unless there were military or political reasons to prevent such a measure. Between the 26th of May and 31st of December, there were 767 cases of yellow fever treated in the Seamen's Hospital at George Town, of which 92 died; 56 cases in the Colonial Hospital, of which 15 died; and it was stated that about 120 cases, with 18 deaths, occurred in private practice. We have no information, as to the numbers living of each of the classes among whom these cases occurred, but the intensity of the disease is shown by the high rate Died. Admitted. Died. Windward of mortality, which was about 1 death in 8 cases among the seamen, 1 in 4 in and Leeward the Colonial Hospital, and 1 in 6 in private practice. Command. In the end of August a few cases of yellow fever, but of a mild type, occurred among the civil population of New Amsterdam, Berbice, and the sailors on the Berbice River; but the disease did not prevail as an epidemic, and only 4 deaths by it were recorded. Diarrhea was much more prevalent than usual during the year, at all the stations except British Guiana. Ophthalmia also gave rise to an increased number of admissions. DIETIC DISEASES have been greatly above the average of the two preceding years, the excess being entirely in cases of intemperance (ebriositas) at Barbadoes. It is probable that the reduction already noticed in the amount of continued fever may be due to cases arising from intemperance, which were formerly returned as continued fever, now appearing under their proper head. The admissions by Delirium Tremens were 13, being exactly the same as in the preceding year. The other classes of diseases do not seem to require comment. The admissions and deaths at each of the subordinate stations in the Command will be found detailed in Abstract No. XV. of Appendix, from which the following summary has been prepared. 1.3 110.6 3.8 :: : 180.8 : 57.9 : 52.4 6.6 974 5 2 54 978 6 10 61079.8 8.88 1778.3 6.6 1034 6 6 40 857 1 5 101401 5 41 36 1122 9 9.97 This Table shows the sickness to have been below the average in Barbadoes and Trinidad, and above it in St. Lucia and British Guiana, in the latter to a :::: :: Died. Very great extent. The excess in both was confined to the class of miasmatic Windward diseases, and in Demerara was caused entirely by the prevalence of inter- and Leeward mittent fever, attributable, as already stated, to the marshy locality in which Command. it was necessary to encamp the troops for upwards of seven months. The mortality in all the stations was extremely low-lower, indeed, in Barbadoes and British Guiana than among the Infantry serving in the United Kingdom. II. BLACK TROOPS. The black troops employed in this Command consisted, as formerly, of the head-quarters of one of the West India Regiments and a corps of Military Labourers. In the beginning of June, the head-quarters of the 1st West India Regiment arrived from Nassau N.P., to replace the 3rd West India Regiment sent to Jamaica. The average strength of the black troops throughout the year was 1,007; the admissions into hospital among them were 852 and the deaths 21, all in hospital; being in the annual ratio of 846, and 20-85 per 1.000 of the mean strength. These results show a very considerable reduction in the sickness, compared with the average of the two preceding years, but merely a trifling difference in the mortality. The diseases which occurred during the year will be found detailed in Abstract No. XVI. of Appendix, from which and previous Reports the following Table has been compiled : : Windward Command. It will be seen from this Table that the decrease in the sickness has been and Leeward chiefly in venereal and in diseases of the respiratory and integumentary systems. There has been an increase in miasmatic diseases, and both the admissions and deaths by tubercular diseases have been doubled. MIASMATIC DISEASES.-On subdividing this class in the usual manner, the following results are obtained. Eruptive Fevers have amounted to double the average of the two preceding years, but have in no instance proved fatal. We have already stated that small-pox prevailed in an epidemic form at Trinidad, and measles, both there and at Barbadoes, among the civil population. Of the former 8, and of the latter disease 46 cases occurred among the black troops. Paroxysmal and Continued Fevers and Ophthalmia were less prevalent than before, while there was an increase in the admissions by the other subordinate groups of this class. TUBERCULAR DISEASES have given rise to rather more than twice the average of the admissions during the two preceding years, and to nearly twice the average of the deaths; but the ratio corresponds closely with that of 1860, so that, whatever may have been the cause of the increase in that year, it appears to have continued in operation in 1861. VIOLENT DEATHS. -The only one returned in this class was that of a private of the 3rd West India Regiment, who committed suicide with his rifle. CORPORAL PUNISHMENT.-The proportion of admissions into hospital in consequence of the infliction of this punishment was exactly half the average of the two preceding years. The following Table, prepared from No. XVI. of Appendix, shows the relative influence of the various classes of diseases among the black troops at the different stations. |