Medical Sketches of the Expedition to Egypt, from India

by Sir James McGrigor

From my case-books and notes, while in the West Indies, I have thrown, under a few heads, a brief extract of the result of my observations, which I shall here insert. From the similitude which I think I can trace, this is not foreign to the principal subject of these Sketches; and, as the result of close observation, unattached to any theory, they may, perhaps, be not without interest or use.

1st. In Barbadoes, both in the end of 1795, and in the beginning of 1796, the only disease which prevailed was typhus. The 88th regiment was healthy at St Lucia, and continued pretty healthy at Grenada for three months after their arrival there, or as long as they remained to the windward side of the island. This was likewise the case with the 10th, 25th, and other regiments. It was only after our return to St George’s and to Richmond Hill, after we had communication with the 68th regiment, and the general hospitals, where the yellow fever had for many months prevailed, that it appeared in the 38th, and in the other corps.

2d. Before the appearance of this fever in the 88th, as well as in other corps, dysentery and intermittents prevailed most.

3d. On the 12th of July, 1796, a detachment of the 88th regiment was embarked at Grenada, in the Betsy transport, for England. We embarked one hundred and forty, and I was most particularly careful not to take any man on board with the slightest appearance of illness. Every precaution which regarded cleanliness, ventilation, or fumigation, was adopted. The remains of the 8th, 10th, 25th, and other regiments, were at the same time embarked, at Grenada, for England.

4th. From the time we sailed from Grenada, on the 19th of July to the 5th of August, seven days after we sailed from Tortola, (where we had touched for water) no case of this fever appeared in the Betsy. The other corps, which left Grenada along with us, had not been so fortunate. The 8th, 10th, and 25th regiments, all of them suffered severely on the passage from Grenada to Tortola; the 8th particularly. This corps, besides the loss of many non-commissioned officers, in this short passage, lost every officer on board, except the surgeon in second, and major and captain Armstrong; and these two gentlemen were ill of the yellow fever on coming into Tortola. I was requested to go on board to visit them, but the request was opposed by all the officers on board the Betsy, as well those of the ship as by the officers of the 88th regiment on board. So very much were all impressed with an opinion of the fatally infectious nature of this fever, that they remonstrated with me, and told me, that the ship and the regiment were now perfectly free from this fever; but that, by my going to see the 8th, I should certainly bring the fever into the Betsy. However, a second message having come for me to visit captain and major Armstrong, I instantly accompanied the messenger on board. From seeing the state of their transport, I immediately ordered major and captain Armstrong on shore, and accompanied them to the hotel. Here we found that the prejudices in the Betsy transport prevailed in the island of Tortola. The doors of the hotel were shut against the yellow fever, and it required a very forcible remonstrance to persuade them to admit these two officers, who, however, both of them, died the next day in the hotel.

5th. The state of the other corps, after sailing from Tortola, I am unacquainted with. When lying at Tortola, on the 29th and 30th of July, the Betsy communicated with the transports which had the 8th and 10th regiments on board. On the 6th of August, the first case of the yellow fever appeared on board the Betsy; from which period to the 12th of September, 1796, every person almost was once, and a great many on board twice, attacked with this fever. Of one hundred and forty people on board the Betsy, the captain of the ship, eighteen soldiers, and one woman, died in this period. It should, however, be mentioned, that, of the soldiers, several were old and worn-out invalids. During the passage from Tortola to England, our convoy, the Hebe frigate, suffered even more than the Betsy. When sent for on board, by Captain Scott, I found that he had not only lost many seamen and marines, but several officers, and two medical gentlemen.

6th. On the fleet, from Grenada, anchoring at Tortola, the yellow fever was unknown there; thereafter, I have heard, that it prevailed generally, and committed great havoc.

7th. Those labouring under dysentery, ague, &c. were those first seized with this fever.

8th. [Symptoms.]—The attack was first with extreme debility, affection of the head, and frequently the appearance of drunkenness. Next, the abdomen was complained of, and the biliary system appeared to be a principal seat of the disease. The yellowness, though not a constant, was a generally attending symptom. The eyes first appeared of a watery suffusion; they next were observed to be blood-shot; and, in a short time after, yellow; from the eye, the yellowness quickly spread over all the body, and the patient in a little time had the appearance of one highly jaundiced. Sometimes the yellow colour of the body continued for some time after the patient got well, and purgatives brought off yellow stools, while the urine was at the same time yellowish. The irritability of the stomach, and what is called the black vomiting, were pretty constant attending symptoms. The state of the pulse varied in the course of the disease; there was at first, almost always, a firm and strong pulse, with so much re-action, as would lead a stranger to the disease to blood-letting and the anti-phlogistic regimen. The bowels were, in general, very unequal; there was either a looseness or costiveness, though most frequently the latter.

9th. The duration of the disease was, in different cases, and in different situations, very different. In Grenada, when it first broke out, it generally ran its course from twenty-four, thirty-six, to forty-eight hours, in the hospitals. Soon after we sailed from Grenada, cases terminated in three days: thereafter, and as we approached the higher latitudes, and before we reached Ireland, cases were drawn out to ten, twelve, and fifteen days.