Medical Sketches of the Expedition to Egypt, from India

by Sir James McGrigor

“On looking over the returns, and observing the proportional sickness of different periods, a periodical increase was very striking. The eight or ten days that followed the payment of the men, on the twenty-fourth of every month, regularly produced much sickness. The soldier’s pay in India, as in England, and perhaps every where else, allow him at times to indulge in excess. He is most amply supplied with meat and bread, and generally he has a portion of vegetables; but the allowance of spirits issued to him is too great. In the dry season it is a quarter of a pint daily, and in the rainy months it is double this quantity. As the price of arrack is low, the soldier very often procures as much as he can use; besides which, he has often access to farrey, or toddey, the fermented juice of the cocoa-nut tree. Some degree of intoxication and intemperance, in a corps in India, is perhaps unavoidable. Intemperance has hitherto always appeared as a principal cause of the diseases which have prevailed.

“The difference, in point of health, between the hot and the cold, the dry and the rainy, months is striking. For the last eighteen months, in the hot season, the men had much duty. They were daily marched two miles to the fort of Bombay; while there, they were much exposed to the sun on the garrison-duty; and, in the heat of the next day, were marched back to their barracks on the island of Colabah. Yet it appears, by the accompanying tables, that the hot months were the most healthy by far. If heat be very noxious, something in this instance obviated its effects. Was this exercise?

“The first year after the arrival of the 88th regiment, in India, they suffered considerably. During the month after that on which the monsoon set in, one hundred and forty, or more than one fourth of the corps, were ill of hepatitis or dysentery. In the second year of the regiment being in India, only seventy were admitted into the hospital in the course of the same month, and this number was not quite one tenth of the then strength of the corps. Here, then, we appear to have gained considerably by being one year inured to the climate.”

In Egypt I found that all the above-quoted remarks held good; in particular that relating to heat. Though the degree of it be very considerably increased, I believe that, unless combined with intemperance, or some other cause, it very rarely is the exciting cause of disease. At Kossier, and in crossing the desert, the degree of heat was very great, and both the officers and men, from Madras, as well as Bengal, complained that it was more insupportable than they had ever felt it in the hottest seasons. Yet, at the above period, the army enjoyed an uncommon degree of health, though they necessarily were much exposed to the sun: but their minds as well as their bodies were at this time exercised. Not only on crossing the desert, but for some time after we reached the Nile at Ghenné, we all thought that we were in the neighbourhood of a division of the French army, and the Indian army was for some time kept in the constant hopes of being engaged.

That simple moisture is noxious, the situation of the 61st regiment, in the Pharos, shewed; and that moist exhalations from marshes were active as causes of the diseases which prevailed, from the arrival of the army at Rhoda till their departure from El Hammed, the journal gives abundant proof.

We received still farther confirmation of the very great influence which intemperance has as a cause of disease. We had demonstration how very little spirits are required, in a hot climate, to enable the soldier to bear fatigue, and how necessary a regular diet is.

At Ghenné, and on the voyage down the Nile, (on account of the difficulty of at first conveying it across the desert,) the men had no spirits delivered out to them; and I am convinced that, from this, not only did they not suffer, but that it even contributed to the uncommon degree of health which they at this time enjoyed. From two germs, or boats, the soldiers one day strayed into a village, where the Arabs gave them as much of the spirit which they distil from the juice of the date-tree, as induced a kind of furious intoxication. It was remarked, that, for three months after, a considerable number of these men were in the hospitals.

On the causes of the plague I do not mean to dwell. I may just mention, that, after seeing the first cases which occurred in the Indian army, and attentively studying the histories of some of the cases which subsequently appeared, it struck me that there were many points of resemblance between this disease and the destructive fever of the West Indies, which, some years ago, I saw a good deal of in several of the islands there. I would by no means, however, have it implied that I consider the diseases as the same.

One of our medical gentlemen persevered in an opinion that the plague was not contagious. He made the first, and we sincerely hope the last, experiment of the kind to determine this question. Dr Whyte fell a victim to his own temerity.

Never were the effects of fear, in the treatment of diseases, more felt than at one period in the Indian army in Egypt. At the time the plague first broke out, (as shall be more particularly noticed hereafter,) the dread of the disease, particularly among the native troops, was a bar to every kind of treatment. They exclaimed that they were sent to the pest-houses merely to die; and some of them refused every kind of medicine or sustenance.