MEDICAL SKETCHES
OF THE
EXPEDITION TO EGYPT,
FROM INDIA.

BY JAMES M‘GREGOR, A.M.
Member of the Royal College of Surgeons, of London;
Surgeon to the Royal Regiment of Horse Guards;
and lately Superintending Surgeon to the Indian Army in Egypt.

LONDON:
PRINTED FOR JOHN MURRAY, 32, FLEET-STREET;
BELL AND BRADFUTE, EDINBURGH; AND
GILBERT AND HODGES, DUBLIN.
1804.

W. Marchant, Printer, 3, Greville-Street, Holborn.

TO
SIR LUCAS PEPYS, BART.
Physician General, &c. &c.
THOMAS KEATE, ESQ. F. R. S.
Surgeon General, &c. &c.
AND TO
FRANCIS KNIGHT, ESQ.
Inspector General of Hospitals, &c. &c.
The Members of the Army Medical Board,
THESE SKETCHES
are dedicated, with the utmost respect,
by their most obedient
and very humble servant,
JAMES M‘GREGOR.

CONTENTS.

ERRATA.

Transcriber’s Note: the above errata have been corrected, and in addition, those listed below. Where there were two spelling variants in use in equal measure (e.g. diarrhœa/diarrhæa; Signior Positti/Posetti), both are left as printed.

INTRODUCTION.

In consequence of orders, from the Court of Directors to the Government in India, it became my duty to give some account of the health of the troops employed on the late expedition from India to Egypt, and to describe the prevailing diseases.

The sources of information, to which I had recourse, were the reports made to me, and an extensive correspondence with the medical gentlemen of the army; particularly those employed in the pest-establishments. Besides these, to which my situation, at the head of the medical department of the army from India, gave me access, other sources of information, regarding the plague, were open to me, as a Member of the Board of Health in Egypt.

Some may think the present a very short, and many may think it an incomplete account; but, I trust, it will not be found incorrect. I have purposely avoided doubtful speculations and hypotheses. Anxious, above all things, to adhere closely to facts, and keep these unmixed with any notions of my own, I have, in most cases, published the extracts from letters to me, without altering a word of the correspondence.

Of the numerous imperfection of these Sketches, I am abundantly sensible. The life of a medical man in the army is at no time very favourable to literary pursuits; mine has been peculiarly unfavourable; and I have had little time or opportunity, since I first entered the army, to attend to the ornaments of diction. For the last fifteen years of my life; mostly spent in the East Indies, West Indies, or at the Cape of Good Hope; sometimes at sea, sometimes on land; my time has been occupied in a laborious attention to my duty in the army.

Some necessary avocations oblige me to dismiss this tract in a more imperfect form than it might have appeared in, perhaps with more leisure. As it is, it conveyed to government, in India, all the information which they required; and I must mention, that it comes before the public very nearly in the state in which I presented it as a report in India. From materials in my possession, I could have enlarged most parts of it, and rendered the whole more complete; but, when I drew up the following account in India, it never occurred to me, that my imperfect Memoir would be the only medical account of the Egyptian expedition. I expected, on my arrival in England, to have found complete histories of the climate and diseases of Egypt, during the time that it was occupied by the English, from some of the medical staff of the British army; several of whom were known to be fully equal to the task. If any of these gentlemen should hereafter give to the world the medical history of this renowned campaign, my Memoir may stand in some stead: it gives some facts and it will supply some information to which no one but myself had access.

At the present moment, I have not leisure to enlarge or alter it; and some friends, who have seen the manuscript, press its publication at the present time.

In the execution of my duty, during a long and perilous voyage, and alter the most fatiguing marches, I sometimes laboured under difficulties; but my duty was in every instance much facilitated, and it would be unjust in me not to mention it. I acknowledge my obligations to all the medical gentlemen of the Indian army, by whom I was most cordially and well seconded in all that I undertook.

From the nature of the prevailing diseases, the campaign in Egypt was, in a particular degree, a service of danger. To their regret, the Indian army arrived too late in Egypt to share in any other dangers than those arising from the diseases of the country; and here, the medical gentlemen had the post of honour. The zeal, attention, and perseverance, displayed, particularly by those employed in the plague-establishments, deserve every praise. Nothing can so powerfully incite the exertions of medical men, in such circumstances of danger, as the consciousness of co-operating with the best and most enlightened of mankind, for the alleviation of human misery. Intrepidity is more a military than a medical virtue; but seldom I believe has there been a greater display of it than among the medical officers, in Egypt, whose duty it became to reside in the pest-houses.[1]

There are two names which I cannot pass over with general praise. At a period of universal alarm, and of real danger, when the plague was committing the greatest ravages, two gentlemen stepped forward, and generously volunteered their services in the pest-houses. It so happened, too, that, from their acquirements, these two were the best calculated, of any in the army, to succeed in this dangerous duty. Dr Buchan had acquired a perfect knowledge of the disease in the former year; and while on duty at the pest-house, at Aboukir, had got the infection there, soon after the memorable landing of Sir Ralph Abercrombie. Mr Price had made the history of the plague his particular study, and, from his acquaintance with the oriental languages, was peculiarly calculated to be master of every thing relating to it. As will be seen hereafter, in the execution of his duty at El-Hammed, he, likewise, caught the infection. To the exertions of these two gentlemen, the service owes much; their country very much. I would fain hope, that from them, who are so able to do it, we may look for something like a history of the plague in Egypt.

Dr Shapter, who was for some time in charge of the medical department of the Indian army, and who succeeded Mr Young, as head of the medical staff of the English Army, deserves our thanks for his very ready accommodation on every occasion, and compliance with every request for assistance, and for many things, of which an army which had traversed an immense desert was necessarily destitute.

Thus far I have discharged debts which I felt that I owed. I must add a few words more, in explanation.

To some, it may appear that, in the following Sketches, I have given too large a space to the journal; and that I have been too copious in my extracts from letters. Both of these are, no doubt, to many, dry and uninteresting; but, as statements of facts, from which every one can form deductions for himself, as they stand, they appeared to me much more useful than any conjectures which I might hazard to advance. It is to be feared that, too often, facts and details are made to bend to preconceived opinions and theories.

On the causes of diseases, I have dwelt a shorter time than to some may have appeared necessary. But I thought that, while the general causes of the diseases of soldiers and sailors have been so ably handled by a Pringle and a Lind, a Cleghorn and a Huxam, a Blane and a Hunter—from me, little could be expected. All that appeared necessary for me to do, was, to assign the extraordinary causes—those incidental to the expedition, or peculiar to Egypt; those, in fine, which rendered the service treated of different from former services, either on the continent of Europe, or in tropical climates.

It will be observed, that the diseases which occurred in the Indian army were but few; and, except on the plague, I detain the reader but a short time on this part of my subject. A long description of the symptoms, or of the history, of dysentery, diarrhæa, hepatitis, or ophthalmia, appeared to me superfluous; when, besides the very clear and perfect nosological account of the illustrious Cullen, we have many complete histories of these diseases, in books which are in the hands of every person.

Finally: in justice to myself, and in extenuation of errors in these Sketches, I must mention, that, when they were preparing for the press, I laboured under many and very considerable disadvantages. I was on duty in a remote corner of the kingdom, and have been, necessarily from the same reason, at a distance from the press, since, and while the printing went on: circumstances which, I hope, will conciliate the indulgence of readers in general, and shield me from the severity of criticism.

MEDICAL SKETCHES, &c. &c.

PART I.

In complying with the orders of government in India, I have sincere pleasure in being able, from original documents, to present them with a correct account of the diseases and mortality which occurred in their army during the late expedition to Egypt. From the period of the first sailing of the expedition, and my appointment to the medical superintendance of it, I retained both the reports of the different medical gentlemen employed in it, and my own memorandums written on the spot. During the period in which Dr Shapter acted, and until I was re-appointed, I likewise kept states of the sick and mortality of the army, and thereafter, till the return and landing of every corps of the army at Calcutta, Madras, and Bombay, or at Ceylon.

The India government has ever been peculiarly anxious about every thing that related to the health of their troops, zealous in collecting any fact and circumstance touching the causes of diseases or the means of obviating them, and most liberal in every thing that regarded the health of the sick soldier.

During an uncommonly long voyage, in a march over extensive deserts, and in a country and climate described as the most inimical to the human race, the Indian army enjoyed a considerable degree of health, and suffered but a small mortality. The causes of this I shall attempt to develope: the investigation may be useful.

The prevention of disease is usually the province, and is mostly in the power, of the military officer; the cure lies with the medical: in the expedition to Egypt very much was done by both.

The medical officers deserve my grateful thanks, and I readily acknowledge my obligations to them. For every assistance in their power, I am under not fewer obligations to the military officers. In no army, perhaps, was the health of every soldier in it more the care of every officer, from the general downwards, than in the Indian army.

It would be doing violence to my feelings not to mention how much my duty was abridged by having such a commander-in-chief as General Baird. His military abilities are well known. His extreme attention to every thing which regarded the health and comfort of the soldier, I must mention, was a principal cause of the great degree of health enjoyed by the army.

To Brigadier-General Beresford the army owes very much likewise. It is not my business to say how much all were indebted to the man, who, under circumstances the most discouraging, led the advance over the desert. In my official capacity I cannot but notice how much the British army, as well as that from India, were indebted to him, as President of the Board of Health, and as Commandant of Alexandria. The excellent police established by him gave security to the army as well as to the inhabitants; and, more than any other circumstance, tended to the exclusion of the plague from Alexandria.

The route which we took from India to Egypt is remarkable for having been that by which, in the earliest ages, the commerce of Asia, its spices, its gums, its perfumes, and all the luxuries of the East, were conveyed to Tyre, Sidon, Carthage, Rome, Marseilles, and in a word to all the coasts of the Mediterranean, from Egypt, a country rendered extremely interesting by various recollections.—The situation of the army from India has accordingly excited no common share of interest.

It penetrated Egypt by a route over the desert of Thebes, a route unattempted by any army for perhaps two or three thousand years. Independently of late circumstances, Egypt and Arabia peculiarly interest every man of science, and more particularly medical men, from the occurrence of the plague, and the ophthalmia, or the disorder of the eyes, in Egypt.

On one account the situation of the Indian army in Egypt is not a little curious. It consisted of about eight thousand men; of which number about one-half were natives of India, and the other half Europeans. We have often seen the changes effected on a European habit by a removal to a tropical or to a warm climate, but not, till now, the changes in the constitution of an Asiatic army brought to a cold climate: for such were the bleak shores of the Mediterranean to the feeble Indian.

The following Sketches I have divided into three parts. The first gives the medical history, or rather the journal, of the expedition: in the second, after attempting to assign the causes of the diseases which prevailed, some modes of prevention are offered: and in the third there is some account of the diseases.

The first division of the army intended for the expedition to Egypt, under Colonel Murray, sailed from Bombay in January, 1801. Their voyage was rather a tedious one, and the small-pox and a remittent fever broke out among them. They touched for refreshments at Mocha and at Jedda, and on the 16th May, 1801, came to anchor in Kossier-bay; the prevailing winds in the Red Sea, at this time, rendering it impossible to get so far up as Suez.

The second division of troops, (originally intended for another service,) under Colonel Beresford, sailed from Point de Galle, in Ceylon, on the 19th February; and on the 19th May disembarked at Kossier.

The last division, under Colonel Ramsay, sailed from Trincomalée, in Ceylon. They were later of arriving at Kossier, and were not able to cross the desert before July.

At Kossier there is a fort and a town, if they deserve the name. They are built of mud, and the Arabs inhabit them only at the season when caravans arrive with the pilgrims for Mecca, and with corn for that and the other ports on the opposite Arabian coast.

Like every other place described by Mr Bruce, that we have seen, we found Kossier most accurately laid down by that traveller in lat. 26° 7″, and long. 34. 04.

Kossier is situated on the western coast of the Red Sea. Here, vessels for the expedition were daily arriving, and the troops in general landed in a very healthy condition. In one column of an annexed table, intended to show the diseases and mortality of the army, will be seen the strength of the different corps employed in that service.

JUNE, 1801.

At the beginning of this month we were in camp near the village of Kossier. Soon after the arrival of the troops at Kossier, all were attacked with a diarrhœa, occasioned by the water, which contained much sulphate of magnesia. At first it greatly debilitated the men; but, as they became used to it, the water ceased to affect the bowels. On the whole it appeared to have produced salutary effects, and the army was, for some time, uncommonly healthy.

On the 19th, the 88th, with two companies of the 80th regiment, under the command of Colonel Beresford, as the advance of the army, commenced the march across the desert. Having the digging of wells and other duties to perform, the advance did not reach the banks of the Nile until the next month. The rest of the army marched on the following days, the marches being always performed by night; and the army, with a very inconsiderable loss, reached the banks of the Nile in a very healthy state. The course which we took was nearly that travelled by Mr Bruce. For a considerable way after we left Kossier, the road had the strongest resemblance to the bed of a river. As we advanced from Kossier, the water became daily less salt, and less bitter. At Le Gita, and at Bir Amber, the two stations nearest to Ghenné, it was not much complained of.

The winds in Kossier camp, from nine to twelve o’clock, generally blew from the N. W. accompanied with torrents of sand.

On the march, a very hot suffocating wind from the W. set in about ten and continued till three o’clock. The thermometer at Kossier could not be attended to.

On the 29th, at Le Gita, in my tent, at three P. M. the mercury stood at 114°. In the soldiers tents it could not have been less than 118°. At six o’clock in the morning, in a well three feet deep, it was at 69°; and, after taking it out, it fell to 63°: but evaporation must have had a share in the reduction. In other places, on the march, the degree of heat must have been higher. Le Gita is not a situation favourable to the centration of heat: it is situated in a large open plain of many miles extent.

There was but little sickness in this month, and yet almost every exciting cause existed. The heat was intense. In the currents of dust, much of it went into the stomach and lungs, and occasioned nausea, which was likewise occasioned by the destructive hot wind. To this the Arabs and even the camels always turn their backs. The men were frequently exercised, and the duties of fatigue in India, usually done by black natives, were performed at Kossier by the soldiers. The fatigue on the march has perhaps never been exceeded in any army. Diarrhœa, and a few cases of ophthalmia, and nyctalopia, were the only diseases in the army. The native corps from Bombay were recovering from a fever, with which they landed. These corps were the last that crossed the desert.

JULY.

During almost the whole of this month, the army was encamped on the banks of the Nile, which now began to overflow its banks, near Ghenné. On the opposite bank are the magnificent ruins of Tentyra, or Dendira, and the fine temple of Isis. The situation of the army near Ghenné was very healthy. There was excellent water, and an abundant market of vegetables, of fruit, and of the best provisions. We prepared to move, and detachments of the army went up to Thebes, Luxor, and to the cataracts, to press all the boats. About the end of the month, the army began to move to Lower Egypt. The 10th regiment marched to Girgé, the capital of Upper Egypt, sixty miles below Ghenné.

On the 27th and following days, the rest of the army was embarked in boats. The wind at Ghenné was not regular from any quarter, and sand was blown from all quarters, particularly at the time of the springs. The thermometer had a wide range at Ghenné. In my marquee from 71° to 108°.

On the 20th, it rose to 110°. In the open air the heat was from 70° to 115°. There was more sickness than in the last month. There were several cases of hepatitis, particularly in the 10th regiment, and cases of dysentery were not unfrequent towards the end of the month. In the beginning a considerable number of cases of fever appeared, and not a few of ophthalmia and pneumonia: but all these soon did well, after being removed to a good hospital. The Catchief, the officer next in rank to the Bey, gave up his own house for an hospital, and General Baird likewise gave up his quarters to the sick.

AUGUST.

By the 12th of this month, the greater part of the army, after a navigation of the Nile, of nearly four hundred miles, arrived at Damietta, where we found one regiment of the English army, the 89th, and a general hospital, under charge of Dr Franks, the inspector. The troops at first were put into quarters there; but an encampment was afterwards formed on Rhoda, a small island made by the Nile, very nearly in the centre between Cairo and Ghiza. The Nilometer is on this island. As they landed, the troops were uncommonly healthy. Most of the hepatic and dysenteric sick had recovered on the passage, and the only disease with which they landed was slight fever, of which the cases were not numerous. This state of health continued but a very short time after the landing. In the course of the first week, most of the corps sent one-twelfth and some one-tenth of their strength to the hospital.

In three weeks, the sick of the army exceeded one thousand. A considerable number of ophthalmic cases appeared, but the prevailing disease was fever. In every corps it prevailed, and very few escaped it. In general it was of short duration, of two, three, or five, days at most, and rarely proved fatal. Ghiza appeared then to have been an unhealthy quarter, and the ground of the encampment was found to be swampy. We found the 89th regiment in garrison at this place, and so very sickly was that corps, that they could not muster fifty men on the parade. The sick of the army was sent into Ibrahim Bey fort, pleasantly situated on the bank of the river on the Cairo side. It had been occupied by the enemy as an hospital, and had been completely fitted up by them for the purpose. But it was neither (if accounts could be believed) a healthy nor a safe situation. A little before our arrival, the French had some cases of the plague in a ward of this hospital. On hearing this, every measure of precaution was taken, and the disease did not appear. It was remarked, that those sent to the hospital, ill of ophthalmia, dysentery, and hepatitis, rarely left it without an attack of the prevailing fever.

About the end of the month, preparations were making to embark the army for Rosetta, and not less than twelve hundred sick were embarked.

During the month the wind was most frequently from the N. The thermometer on the Nile, from the 1st to the 8th, was higher than we had found it at Ghenné. In the fort of Ibrahim Bey it moved from 80° 50″ to 90°. The sickness of the month was very considerable. Though we lost several men, yet the loss bore but a small proportion to the sickness that prevailed. Much of the sickness, and many of the deaths which subsequently occurred, we could trace to the situation near Cairo. Many cases of hepatitis did not appear, but of late many of dysentery; and, in some corps before quitting Cairo, ophthalmia prevailed very generally.

SEPTEMBER.

Early in this month, the greater part of the army was encamped in the neighbourhood of Rosetta. The 86th regiment and two companies of the 7th Bombay regiment went into garrison at Ghiza. Separate regimental hospitals were provided for every corps in Rosetta: but the number of sick appeared to be gaining ground, particularly the cases of ophthalmia, which disease was nearly confined to the 10th and 88th regiments. The number occurring in the artillery, 61st and 80th regiments, was inconsiderable; and the disease was very rarely seen among the Sepoys. Dysentery and hepatitis prevailed very generally in every corps; but the appearance of another disease occasioned the greatest alarm throughout the army.

On the morning of the 14th, I discovered a case of the plague in the hospital of the 88th regiment: Anthonio, one of the hospital-cooks, who had for thirty hours laboured under febrile symptoms, shewed me two buboes in his groins. He had no venereal appearance, and the fever was now attended with extreme irritability of the stomach. At the same time, I was shewn another hospital-servant, a Hallancore, who lay next to Anthonio. The Hallancore had been attacked in the night time, and, when I saw him, had much fever and pain in the axilla, though I could discover no swelling of the glands. As speedily as possible these two men, and six other hospital-servants, who slept in the same apartment, were removed to a house at the extremity of the town. A room was immediately allotted, in the hospital of the 88th regiment, for cases under observation.

To this every soldier, or follower, with febrile symptoms, was sent the instant that the symptoms were discovered. A minute examination was made, on the evening of the 14th, of all the men in the hospital, amounting then to one hundred and sixty-two, in order to discover whether any laboured under suspicious symptoms, but nothing was observed.

On the morning of the 15th, I discovered six men with fever, most of them had been attacked in the night-time; they were sent without delay into the observation-room, and most strictly guarded. By frequent observation, in the course of the day, I discovered buboes in one, and pain in the axillary and femoral glands of all the others: all were therefore sent to the pest-house, which was now established.

Early on the morning of the 16th, the cook and Hallancore, first attacked, died. It was found necessary in the course of the day to send nine more men into the observation-room, where the nitrous fumigation was very liberally used. After an emetic, I gave mercury very liberally to the whole nine; but the symptoms, on the morning of the 18th, were so unequivocal, that I sent them all to the pest-house.

Our situation now became very alarming. There were the clearest proofs of the hospital which the 88th regiment occupied being thoroughly infected, consisting of about fourteen or fifteen rooms, but all the cases had hitherto come only from three of the rooms. Lamps for the nitrous fumigation were kept constantly burning both in them and in the observation-room. A very large building was procured near Rosetta; and, with all possible haste, the men were moved to it.

No man left the old hospital till all his clothes were washed; his hair was cut short, and himself bathed. On coming to the outside walls of the new hospital, every man stripped himself naked and went into a warm bath before his reception into the hospital. He was then provided with new clothing and bedding; the clothing brought with him was received by a non-commissioned officer, who saw it repeatedly washed and baked, after which it was received into the hospital store-room. On the evening of the 18th, I sent four more men into the observation-room, and, on the 21st, three of them were sent into the pest-house. The other did well in the observation-room.

On the 23d, Littlejohn, a boy, was sent in the morning to the observation-room, having been attacked the night before with rigours. On the 25th, Egan, another suspicious case, was also sent there. In both of them a severe ptyalism was excited in less than forty-eight hours by mercury and nitric acid, and they afterwards did well.

On the 28th, Craig, with febrile symptoms, was sent from the new hospital to the observation-room of the old. His gums were speedily affected; but it was found necessary to send him to the pest-house. This was the only instance of the plague which appeared in the 88th regiment after their removal to the new hospital.

The six native followers, first sent off, had no symptoms of the disease for eight days after their arrival at the pest-house; but, on the 9th and 10th days after, all of them were attacked, and none survived the attack three days. Four more of the Indian servants, sent to the pest-house to attend the others, shared the same fate. The case of the Mukadum of the Dooli-bearers was the most rapid.

On the 17th, he was attacked about nine o’clock in the morning with rigours, and died before four o’clock. No instances of the plague appeared in any other corps of the army during this month. Though they attempted to conceal it, we discovered that some accidents (as they call it) had occurred about the beginning of September among the people of the town.

The weather still continued the same during this, as the whole of last, month. The same winds prevailed, without rain or anything remarkable. On the 15th, 16th, and 17th, it blew from the westward: after this, we had close calm weather.

After the 15th, the Nile at Rosetta began to recede. The general range of the thermometer, in a house in Rosetta, was from 73° to 83° 50´.

After the plague, the most formidable disease in the army, from its general prevalence, was ophthalmia. In the 10th and 88th regiment there were upwards of three hundred and fifty cases. The total number in the army exceeded six hundred. Dysentery and hepatitis prevailed very generally among all the European corps; and the mortality of the month was very considerable.

OCTOBER.

In the beginning of this month, the encampment was moved from one to five miles distance from Rosetta. The hospitals were gradually removed also from hence. As the men recovered they were sent to a convalescent camp, intermediate both to Rosetta and the general encampment, and precautions were taken to prevent the men from intermingling with the inhabitants of Rosetta.

Thatched regimental hospitals were built in the camp; and, though in the middle of a desert, the sick soldier had a warm, comfortable, and well-ventilated, apartment, and was liberally provided with every thing conducive to his recovery. Early in the month, the garrison of Damietta joined the army. The 86th regiment were healthy and suffered less from ophthalmia than any European corps of the army. About the end of the month, this corps was sent to Ghiza, and the detachments in garrison there were ordered to join their respective corps.

The temperature of the air became sensibly lower than in the former month, the extremes being from 69° 50´ to 80°. The medium was from 70° to 77°. The westerly was still the prevailing wind, and it often blew very fresh. The atmosphere, towards the end of the month, was very cloudy; and, though we had no rain during the month, it seemed often to threaten it. Owing to the very strict precautions taken, little plague occurred during the month.

From the time the sick of the 88th regiment were separated, and from regulations regarding cleanliness and fumigation being rigidly adhered to, the progress of the contagion was effectually suppressed in that regiment. The European corps still continued to suffer from hepatitis and dysentery, while the number of cases of ophthalmia, and the great degree of violence in which this disease was now seen, were really alarming.

During the month, a case of the plague appeared in the 61st regiment. He had been a patient in the regimental hospital in Rosetta, and caught the disease from straggling through the town. The only other case which occurred was a follower of the commissariate department.

NOVEMBER.

At the commencement of this month, the army was encamped at El Hammed. The sick were in the thatched buildings, and the mortality bore but a small proportion to the sickness. The 86th regiment were very healthy in Ghiza. The weather during the month was different from what we had experienced for a considerable time. The sky was constantly clouded, and it often blew strongly from the west. It rained on fifteen days, and the quantity of rain which fell during the month was considerable. On the 17th, there was much thunder and lightning. The dews were heavy, and there was generally a thick fog which lasted till eight or nine in the morning. The extreme ranges of the thermometer in my marquee were from 57° to 77°.

In the beginning of the month, the whole sick of the army amounted to one thousand three hundred and fifty, or more than one-fourth part of the whole strength of it. In the course of the month there appeared one hundred and seventy cases of intermittent fever, occasioned evidently by the effluvia from the low ground between the camp and the river, which retained the rain, and, before we moved, became a swamp.

On the 8th, we were again alarmed at the appearance of a case of the plague, in the department of the commissary of cattle, which was immediately put under quarantine. On the 12th, symptoms of the disease appeared in a Sepoy of the Bengal battalion, who was in the hospital of that corps. On the 13th, five more cases were discovered in the same hospital, which was ordered to be burnt, the sick having been removed into a large house near Rosetta, where the same precautions were used as with the 88th regiment, when the disease first broke out. After their removal, no case appeared in that battalion. On the 12th a case of small-pox was discovered in the hospital of the 10th regiment; and, in the course of two days more, four cases appeared in the same hospital. The first, a Portugueze servant, died. At the end of the month, the number of sick was reduced. In the weekly return from the 20th to the 26th, there were six hundred and thirty-two Europeans, and three hundred and eighty Sepoys, making a total of one thousand and twelve.

None of the tents kept the rain well out, which was often heavy. The sand, however, quickly absorbed it in most places. The fever was, in several instances, similar to a type, which we had been little used to, viz. the typhoid.

DECEMBER.

Early in this month part of the army marched to Alexandria; and, by the end of it, all the army, with the exception of the horse-artillery, 7th Bombay regiment, and the department of the commissary of cattle, was collected there. About the time that the first part of the army marched thither, detachments of the 26th dragoons, and of Hompesch’s mounted riflemen, joined us from the English army, and were quartered in Rosetta. The plague now gained on us.

On the 1st of the month, Corporal Francis, of the 88th regiment, who had been on the pest-house guard the day before, complained of slight febrile symptoms and giddiness. He had a vibex on the seat of the inguinal glands on one side, with some pain, but no swelling there. I shewed him to Mr Price, who was in charge of the pest-house, and he had no doubt of its being a case of the plague. Very soon after his admission into the pest-house, a bubo appeared in his groin, and his fever increased. Mercury was thrown in rapidly, his mouth became affected, and, the bubo suppurating, he recovered.

On the 15th, a private of the 8th light dragoons was shewn to me with a bubo in his groin and giddiness, but without quickness of pulse or any other febrile symptom. On being brought to Mr Price he was admitted into the pest-house, and the treatment and result in him were similar to those of Francis.

On the evening of the 15th, it being reported to me that a Sepoy had suddenly died of fever in the line of the 7th Bombay regiment, I examined the body, and found the inguinal glands swelled on both sides. About an hour after, Mr Grisdale, the surgeon, shewed me a case in the hospital of the same corps, which was evidently the plague, and which I instantly ordered to the pest-house.

In the course of the month 38 more cases of the same disease, most violent and rapid in their progress, appeared in the same regiment. Three died, either in the hospital or on the lines, before they could be conveyed to the pest-house, and one died in his way thither. One man of the 1st Bombay regiment died of the same disease, who had clearly got the contagion from the former corps, near which their hospital was situated.

The weather during the month was changeable; towards the end it was boisterous. The thermometer in tents was sometimes so low as 49°, and rarely rose above 70°. The sky was cloudy, but rain fell only once in eight days. In the beginning of the month there was a considerable number of cases of continued fever. There were fewer intermittents than in the last month. The number of cases of dysentery was decreasing.

Towards the end of the month there were many cases of catarrh, pneumia, and rheumatism. The diseases of the eyes were greatly on the decline. In the weekly return of the 3d are three hundred and twelve cases, whereas in that of the 31st there appear only ninety eight.

JANUARY, 1802.

With the exceptions already mentioned, all the army, during this month, was in Alexandria, where they attained a degree of health they never had at Rosetta. No case of the plague had been known at Alexandria when the Indian army arrived there; and the strictest precautions were taken to cut off the communication with Rosetta and the 7th regiment.

In the beginning of the month the weather was extremely boisterous: the wind, generally from the north and north west, was very high. For eleven days there was rain, and often very heavy. The thermometer was once below 60°, and never above 70°, in a house in the centre of the city. The number of sick was much smaller, but the mortality greater, than in any preceding month. On the 1st, Mr Price, who was in charge of the pest-house near Rosetta, was himself attacked with the disease, which with him proved very violent.

On the following day, three of six Arabs, who acted as in-servants to the pest-house near Rosetta, were also attacked.

On the 6th, a Sepoy of the 1st Bombay regiment died suddenly in the hospital of the corps at Alexandria; the sick of this corps having arrived from Rosetta but a few days before.

On the 7th, two cases of the plague, from the same regiment, were detected in the camp at Alexandria.

On the 8th, the 1st and 7th Bombay regiment marched to, and encamped at, Aboukir-bay, where a pest-establishment was placed for them.

On the 2d, symptoms of the plague were discovered on Dr Whyte, who the day before had inoculated himself, and he died on the 9th.

On the day following, a soldier of the 61st regiment, a servant of Colonel Barlow, Commandant of Rosetta, was sent into the pest-house there, now under the charge of Mr Grisdale and Mr Rice, with the plague.

On the 13th, two of six Arabs, out-servants at Rosetta, were attacked with the disease. Two men of the department marched the same road, and halted at the same stages, as the 7th regiment had done a week before.

On the 22d, two men of the 10th regiment, from a permanent guard on-board a vessel under quarantine, were sent into the pest-house at Alexandria. There occurred this month 72 cases of the plague in the Indian army, viz.

Continued fever prevailed in the army. It was the synocha of Cullen. Intermittents were still on the decline, as were likewise dysentery and hepatitis. Pneumonia and rheumatism prevailed but in a small degree.

FEBRUARY.

This was a very cold and wet month; yet the number of sick continued to decrease, except in the 1st and 7th regiments, in which corps the plague continued to rage. Throughout the month, the sky was cloudy; we had high winds, on 19 days it rained, and on some of these as heavily as in the monsoons in India. The thermometer moved between 55° and 63°. On the 13th, for the first time, the following cases of the plague were dismissed cured from the quarantine-hospital; viz. two Sepoys, one drum-major, and one woman, from the 7th regiment, and two Arab servants of the pest-house. At this period, too, six were dismissed from the pest into the quarantine-hospital.

Till this day no native of India, who had entered the pest-house, ever returned. But so much was the dread of the distemper now lessened, that a volunteer in-steward, for the pest-house at Aboukir, came forward from the 7th regiment.

On the 24th, the commissary’s clerk at Rosetta got the disease. Of five Europeans, whom we had left at Rosetta, two caught it and died. The disease here raged with the utmost violence.

On the 28th, Signior Positti, an Italian, came from Rosetta, and lodged at the house of Mr Fantouchi, the Swedish consul in Alexandria. It was discovered two days after that he had the plague, and he, with the surgeon attending him, was immediately sent to the Lazaretto. Signior Positti died on the day of his admission. Almost all the cases of plague, which subsequently appeared in Alexandria, could be traced to this case as a source.

The whole number of cases of plague, which occurred in the army during this month, was only twenty one. Fever appeared in all the reports. It was accompanied with the inflammatory diathesis, and it was in general slight.

Of hepatitis and dysentery, the number of cases was still less than in former months. Ulcers, which in the Indian army were hitherto very rarely seen, prevailed at this period. Of rheumatism and pneumonia there was an increase.

On the whole, in the course of the month, there was a decrease of sickness, and a considerable decrease of the mortality. On the 1st of the month there were seven hundred and five in the report; and on the 28th only three hundred and twelve, or about one in twenty-six.

MARCH.

The weather was milder than in February. The thermometer was gradually on the rise. During the month it never was lower than 50° nor higher than 69°. The wind was most frequently from the west, from which quarter it blew very strongly on the 13th, 14th, 15th, 16th, 19th, 20th, and 21st. It rained on 12 days; and on some of them, about the middle of the month, very heavily. The atmosphere was in general cloudy. On the 19th we had claps of loud thunder. But for the existence of the plague the army might be said to have been very healthy during the month; and, though this disease was more diffused through the country and in the army, yet more cases did not occur in the Indian army than in last month, and the mortality from this disease was much less considerable than formerly.

The garrison of Ghiza had been, for some time, the most healthy part of the army. During the present month the corps there presented long reports of sick. The small-pox broke out among the Sepoys there; and in the 86th regiment there was an immense number of venereal cases, several of which, from their standing, were inveterate.

The following is a list of the number sick of the plague in March.

The spreading of the diseases rendered it necessary to multiply our pest-establishments. In addition to those of Alexandria, Rosetta, and Aboukir, one was formed at Ghiza, and one at Rahamania, situated on an island at that part of the Nile where the canal of Alexandria formerly took its rise. Between Aboukir and Rosetta, a serjeant and twelve men, of the 26th dragoons, were stationed to prevent communication between Alexandria and Rosetta. Nine of these were attacked with the disease during this month. Within the walls of the pest side, or that part of the lazaretto appropriated for the reception of cases of plague, at Alexandria, a serjeant and twelve men were also posted as a guard to preserve order. Eleven of them caught the disease in the present, and the rest in the following, month. They were volunteers from the 10th, 61st, and 88th, regiments, and appear in the above list. The source of this disease appeared to be clearly in Signior Positti. Four of the Arab servants who attended him were seized; and the Board of Health obtained an order that no more soldiers should be sent on so dangerous a duty.

On the 2d, a deserter from the queen’s German regiment, taken up in Alexandria, was sent to the provost’s guard. He had only come to Alexandria a few minutes before he was discovered. He complained of being ill; and, on being visited by Mr Blackwell, inspecting surgeon of plague-cases to the Board of Health, it was found that his disease was the plague. He was immediately conveyed to the lazaretto, and all the prisoners at the provost’s guard were brought to the observation-ground, and the provost with his guard were sent to the quarantine-ground. The deserter died a few minutes after his arrival in the pest-house. His case was one of the most inveterate.

On the 14th, Broughman O’Neal, one of the prisoners sent from the provost’s guard, having symptoms of the plague, was sent by Mr Cloran, who was in charge of the observation-side, in to Mr Price, who was in charge of the pest-side, of the lazaretto. On the 17th a case of the plague was detected in the hospital of the regiment De Roll. The infection could not be traced; however the surgeon and the sick in the hospital were put under quarantine.

On the 19th a case was detected in the hospital of Dillon’s regiment, and the hospital of that corps was also put under quarantine. On the 16th, one of nine Lascars, attached to Major Falconer, deputy quarter-master general, was attacked with the plague at Rahamania. The major had only arrived there from Rosetta a few days before. Subsequently, the remaining eight Lascars, and two of the Major’s servants, caught the contagion, and every one of them died. On the 26th a private of De Roll’s regiment was sent from the observation to the pest side of the lazaretto; and, on the same day, a sailor, belonging to the agent of transports near Aboukir, was sent into the pest-house, as was also a man of the Royal Artillery from Aboukir-castle.

Of fever there occurred but a very few cases during the month, and the disease was a very mild one.

Of five cases of small-pox two died, both of which were natives of India. Of hepatitis and dysentery there appear fewer cases, and of the total number more than one half were from the 61st regiment; and all the severe cases were of that corps. Of ulcers the number still continued to be considerable and increasing.

APRIL.

At the commencement of this month affairs wore a very unfavourable aspect. The plague, which first appeared in Rosetta, and had hitherto, with little exception, been confined to that place, at the present period had travelled as far as Aboukir on the one side, and as far as Rahamania on the other side, of Alexandria; and we had information that most of the intermediate stages, betwixt us and these two places, were infected. With so much severity did the disease rage at Rosetta, that, at the end of last month, it was found necessary to withdraw the commandant and every person from it, and the inhabitants shut themselves up. From information received by the Board of Health, they likewise found it necessary to place all those coming from Cairo and Ghiza under quarantine.

It was well known, that, in Upper Egypt, the plague was making dreadful ravages among the Mamalouks. The few cases which occurred in Alexandria made every one alert there, and a very strict police was kept up in the town by the commandant and by the Scorbatchie.

The weather in the beginning of the month was variable. The thermometer rose a little. It was rarely so low as 60°, and only once as high as 71° 50″. We had much high wind on twelve days. It rained on fifteen days, but the quantity which fell was not so great as in the last month. The sky was cloudy throughout the month.

On the 20th there was much loud thunder.

On the 1st, sixty-four invalids, from the Indian army, were embarked for England. The greater part were cases of blindness.

Both Mr Price and Mr Rice, who dissected the body of Signior Positti in the lazaretto, had been ill ever since; and this day they were so ill that Dr Buchan was sent in to relieve Mr Price, and Mr Moss to relieve Mr Rice.

On the 3d, a case of the plague appeared at Ghiza on a private follower, and another case was detected in the hospital of the 26th Dragoons at Alexandria.

On the evening of the 14th, Mr O’Farrel, who had charge of the pest-house at Aboukir, was attacked with the disease. This day all the hospitals were moved out of town, and encamped under the walls of Alexandria.

On the 6th, a Jewess dropped down dead in the streets of the city, and it was discovered that she had been ill for four days of the plague. Her husband, who concealed it from the Board of Health, was bastinadoed; and afterwards was sent, with his whole family, into quarantine. On the same evening an Arab’s family reported that one of them was ill of the plague. The person affected was sent to the pest-side, and the rest of the family to the observation-ground, of the lazaretto.

On the 7th, Mr Dyson, who on the 4th went to Aboukir to relieve Mr O’Farrel, discovered bubo and symptoms of the plague in himself.

On the 10th, a serjeant of the 61st, who had had the disease last month, and who, after recovering, officiated as in-steward of the pest-house in Alexandria, was again attacked with the plague.

On the 11th Mr Angle died, being the fourteenth day of his disease. He, three weeks before, went to assist Dr Buchan in the lazaretto.

On the 14th, symptoms of the disease were first discovered on Mr Moss in the lazaretto. Of the Jew family sent to the observation-ground on the 6th, which amounted to seven persons, two were sent to-day to the pest-side.

On the 15th the husband of the jewess died in an observation-tent, having glandular swellings, which were not discovered till after his death. He did not appear to be ill. Mr Cloran was accustomed, once a day or oftener, to examine those under observation, but nothing was discovered to ail this man.

On the 16th, he discovered some symptoms of the disease in another of the same family, and sent him in to Dr Buchan.

On the 17th, a deserter from the 61st regiment, sent to the regimental guard-house, where he was discovered to have the plague, was sent to the lazaretto, and the guard, amounting to nineteen persons, into the observation-ground of the lazaretto. This man confessed that he had slept one night near the pest-house at Aboukir. On the 19th Mr Moss died. On the 24th the plague was discovered in another Jew family. The plague of the Indian army, during the month, was as follows, viz.

On the whole, it was a pleasing circumstance to see so little of the disease among the native corps, as, when it did occur, it proved so much more fatal to them. From my correspondence with different gentlemen in the pest-houses it appears, that, during the month, bubo was not so constant a symptom, and that carbuncles were now frequent.

At first this symptom was seen in no case. Excepting the 61st regiment, the army was in a very healthy state. Fever was equally mild as in last month. Opthalmia began again to appear. In the last return there were sixty cases, fifty of which were Europeans. Of seventy-one men with ulcers, sixty were Europeans. The total sick of the army, at the end of the month, did not exceed three hundred; and in this are included every ulcer, accident, or less serious complaint, which prevents a soldier from appearing on parade.

MAY.

At the commencement of this month the principal part of the army was still encamped at Alexandria. On the last day of April orders arrived from England to General Baird, to return with his army to India, and to detach the 10th, 61st, and 88th, regiments, which were placed on the British establishment.

On the 3d the Indian army began the march to Ghiza, where it remained encamped by the pyramids for some days, until water and the passage over the desert were reported to be ready. At length the march commenced with the sick.

We crossed the river, encamped at Boulac, set off from Cairo, and, passing the ruins of Heliopolis, made Birket El Hadje our first stage. Our marches over the desert of Suez, as in crossing the great desert, were all performed during the night, and we always encamped by sunrise in the morning. Luckily there had much rain fallen before we marched; and at one place in the middle of the desert, and again at Suez, we found large collections of rain-water, from which all were well supplied.

By the end of the month the whole corps, except the 7th Bombay regiment, had crossed the desert and arrived at Suez. Part of the army was encamped near the town of Suez, and part at Moses Wells, nine miles on the eastern side of the Red Sea. The march over the desert of Suez was performed with much greater ease than that over the desert of Thebes. The weather was cool and favourable, the hot winds were less felt, and we found abundance of good water provided at the different stations. At the time of our arrival we found Suez very healthy. Though the plague had travelled as far as Cairo and all the neighbouring villages, it had not reached Suez till the arrival of the army.

The women and children of the army, as well as some invalids, were here; and they, with the Lascars of the fleet, were under the medical charge of Dr Colquhoun and Mr Waring, whose reports had all along shewn a very great degree of health. The only disease was the tropical dysentery, and this was confined to the women and children, who were inactive. The Lascars, who were actively employed, were all very healthy. During the month, several cases of the plague were reported, but they were all very mild. On the 4th, a Sepoy of the 1st Bombay regiment, on duty with the pioneers in the desert, was attacked with the disease, and was the only man who died of it during the month. On inquiry afterwards, it was found that the Sepoy had got the infection from one of the interpreters, named Peter, and that Peter brought the disease from the Turks in Cairo. The case of the interpreter was so mild, that it was treated by Mr Dick as a venereal complaint. He took mercury to produce salivation, the bubo came to suppuration, and Peter recovered. As soon as the Sepoy died in the desert, every article belonging to him was burnt with the body. A perfect separation was effected, and every precaution taken in consequence. No other case appeared in this detachment.

On the 12th, another case appeared in the 7th regiment, now encamped at a village opposite Boulac. No plague could be discovered to have been in the village. The occurrence of this case, therefore, could be accounted for in no other way than that the seeds of the disease still lurked in this very unfortunate corps, and that they brought it from Aboukir with them. A pest-house was established under the charge of Dr Henderson at Boulac, and two other mild cases were admitted into it towards the end of the month.

On the 23d, the disease was discovered on a Madras tent-Lascar at Moses Wells. On the 26th it was discovered on a serjeant of the 86th regiment in crossing the desert. This was the last case which appeared previous to the embarkation of the army.

The weather, during the month, was uncommonly fine. The thermometer was greatly on the rise. During the month it was from 60° to 68°: at Alexandria from 60° to 78°: in the tents on the desert, and at Moses Wells, from 60° to 98°. The wind was generally from north to north-west. In the desert, and at Moses Wells, we had the dry suffocating wind that we found in the desert of Thebes, at Kossier, at the same time in the former year; and the atmosphere was generally cloudy. The army was very healthy.

Ophthalmia now, however, became a more frequent disease, particularly among the Europeans, and it might be said to be the only disease which prevailed.

JUNE.

On the 2d, the embarkation commenced, and by the 15th the whole army was embarked, and had sailed for the different presidencies, except the 7th regiment, which, on account of the plague still prevailing in it after the rest of the army had embarked, was ordered to remain two months. Most of the corps in the army embarked in the most healthy state. There was hardly a sick man, except a few cases of the venereal disease which had resisted mercury.

To conclude, never, perhaps, was there an army embarked for any service more healthy than the Indian army was when it re-embarked on its return from Egypt.

Previously to the arrival of the army from Egypt, in order to provide against the introduction of the plague into India, quarantines were established at the presidencies of Bombay, Bengal, and Madras, as well as at the island of Ceylon. The principal of these was at Butcher’s island, near Bombay, where there were pest and quarantine establishments, of which, on my arrival in June, I took the charge. At this period, letters from Dr Short, at Bagdad, and from Mr Milne, at Bassorah, described the plague as raging in Persia, and particularly at Ispahan and Bagdad: in consequence of this information every vessel, both from the Red Sea and Persian Gulf, was ordered to Butcher’s island.

As the ships arrived, the troops from the Red Sea were landed; but the artillery, 86th regiment, 1st Bombay regiment, and the commissariat department, were so uncommonly healthy, that I detained them but a very few days on the island.

The 7th Bombay regiment landed at Butcher’s island in August. As this was the corps in which the plague had principally prevailed, though they were not unhealthy, I judged it prudent to detain them a month. On my last inspection of them before they left the island, of a total of seven hundred, including Sepoys, their wives, and the public and private followers of the corps, I found only four sick, and these I believe were all catarrhs.

Dr Henderson, with the pest-establishment, and all those whom we had left at Suez, arrived at Butcher’s island on the 1st September. The convalescents from the plague, as well as the guard, and the pest-house servants, were, on their arrival, all of them very healthy; but I thought it safe to keep them in quarantine on the island till October, when, like all the others who had been in quarantine, they were provided with new clothing and sent over to Bombay.

The company’s packets from Bassorah, and the vessels which arrived from the Persian Gulf, had none of them the least suspicious appearance, and I found that their crews were all very healthy.

I had likewise the satisfaction to receive accounts from the medical gentlemen employed in the expedition, after their arrival at Calcutta, Madras, and Ceylon: their accounts were so late as November. In none of the corps did any death occur from the time of embarkation at Suez. The deaths which appear in the annexed table, in the 80th regiment, were men lost in the wreck of one of the transports.

END OF PART I.

PART II.

From my own observation, from accurate reports made to me, as well as from an extensive correspondence with the medical gentlemen of the Indian army in Egypt, I have presented a faithful, and I believe an accurate, narrative of the medical occurrences of the late campaign.

Perhaps it may be thought that I have descended to a great degree of minuteness: however, I conceive, that, from the facts stated, important and useful deductions may be made. I think it a matter of regret that such journals are not more frequently kept; with a little industry on the part of the profession they might always be so. Had such records been always faithfully kept, many practical points would not, as they now are, be involved in doubt and uncertainty. We should not now be so ignorant of some diseases, of the countries where we have so often made campaigns, or of which we have so long been in the possession.

Humble as the labours may seem, and confined as the abilities of an individual may be, were he only faithfully to relate observations made with care, to compare them with those of his contemporaries, and by these to correct the opinions of his predecessors, he would perform no mean service to his art.

I shall, in this part, advert to what appeared to be the principal causes of the diseases which prevailed. Previously to this it will be necessary to take notice of the state of the different corps, composing the army, as they landed at Kossier.

With the exception of the Sepoys from Bombay, every corps disembarked at Kossier in the most healthy state. Rarely, indeed, have troops on any expedition been landed in the degree of health in which the Indian army landed in Egypt.

There is little doubt that their situation on ship-board was the cause of the sickness which prevailed among the troops from Bombay. The Sepoys were but a short time encamped at Kossier when they began to recover; yet the situation there was by no means what we would recommend, or make choice of, for the recovery of health.

The army under General Baird was composed, as already observed, very nearly of one half Europeans, and of one half natives of India. We shall begin with the Europeans.

A detachment of the Royal Artillery came with Sir Home Popham from the Cape of Good Hope, where they had been stationed for nearly four years. The Honourable Company’s artillery, collected from the different presidencies in India, had all of them been a considerable time in that country. Of the artillery, the Bombay suffered the most; next to them the Royal; next the Madras; then the Bengal; and, least of all, the horse-artillery. The prevailing diseases were dysentery and hepatitis. At one period, indeed, fever prevailed among the Bombay artillery.

The troop of the 8th Light-Dragoons was landed in a very healthy state, and continued healthy throughout. The dragoons came from the Cape of Good Hope, where the regiment had been for five years. The only man they lost in Egypt was from hepatitis.

The 10th foot had been a short time at Madras and had been two years stationed in Calcutta, whence they were embarked for Egypt. At Calcutta this regiment was at first very unhealthy, and lost a number of men; but they landed in a most healthy state at Kossier. The 10th regiment, but for having lost their way, and making some prodigious marches across the greater desert, would have suffered less, perhaps, than any other corps. In consequence of this march, soon after they reached Ghenné, a number of cases of fever appeared, all of which terminated either in hepatitis or in dysentery. Half the sick of the army, on leaving Ghenné, was from the 10th regiment; and the diseases contracted by their march across the desert continued, at Rosetta, to croud their sick-reports for four months after.

The 61st regiment was, in several respects, the finest corps in the army. The men were all young and very healthy, and the regiment joined the army in a state of high order and discipline. They came from the Cape of Good Hope, where the body of the regiment had been for nearly three years. This regiment continued healthy till they were encamped at El Hammed, and they lost very few till they came to Alexandria. They were quartered in the Pharos, and the surgeon attributed much of the sickly state of the regiment to the situation of this quarter. The situation is indeed a very damp one, surrounded every where by the sea, except on the side of the mound which connects it with Alexandria. However, this corps had not yet lost those men which every corps loses on its arrival in a warm climate, and which, in some shape, seems necessary to their naturalisation to it. The diseases by which the 61st regiment suffered were dysentery and hepatitis; and, after their arrival in Alexandria, they were wont to lose, on an average, four men a week, for some time.

The 80th regiment came from Trincomalée, in Ceylon, a very unhealthy station, and where, during a five-years stay, they lost a very great number of men. This regiment was very healthy on landing. It was composed of what are usually termed old Indians; draughts from the 36th, 52d, 71st, and 72d, regiments, which had been sent home after a stay of fifteen or twenty years in India. The 80th suffered most of their loss after crossing the desert. At Ghiza, at El Hammed, and at Alexandria, they were the most healthy corps. However, there were many old men in this regiment who never recovered the fatigue of the march, nor the illness at Rhoda island, and who felt most severely the cold weather at Alexandria. A fact regarding this corps deserves mention. Mr Brown, who was in charge of it, informed me, that many men, who, at Trincomalée, were never free from liver-complaint, and were almost always in the hospital with this disease, never complained at Alexandria. This fact, on inquiry, I found held good in most other corps, and I had observed many instances of it in the 88th regiment.

The 86th regiment landed in a healthy state. This regiment had been six years in a warm climate. They came from Bombay, where they had been in garrison for the two last years. They continued very healthy till they were encamped at Rhoda island; there, and at El Hammed, they suffered much: subsequently, no corps in the army suffered less or lost fewer. The frequent movements of this corps contributed to their being in a more healthy state than some other corps were.

The 88th regiment had been about three years in a warm climate. They likewise came from Bombay. This regiment crossed the great desert with the loss of only one man. They were very healthy at Ghenné, and continued so till their arrival at Rhoda. The 88th was the first regiment from the Indian army that arrived at Ghiza, where they found the 89th regiment, and the ophthalmic hospital of the English army. In the course of the first week after their arrival at Ghiza, the 88th regiment sent one fourth of their strength into the hospital; all of them cases of fever or ophthalmia. At El Hammed, in proportion to the strength of this corps, ophthalmia prevailed more in it, and the regiment suffered more from it, than any other corps, except the 10th regiment. It will be remembered, too, that it was in the 88th regiment that the plague first broke out; and this regiment had more cases and more deaths from it than any other European corps. Mr Tonrey and myself, who attended these first cases, were among the few medical men who were exposed to the contagion and came in contact with the patients, and yet escaped the disease. The 88th regiment became at last one of the most healthy corps in the army. From the 1st December, 1801, to the 1st May, 1802, they only lost two men; of these, one was from the plague, and the other from sudden death, cause unknown.

With the exception of the two Bombay corps, all the native Indians lost fewer men than the European corps. After they marched from Kossier, and till the plague appeared in the two Bombay battalions, where it committed the greatest ravages, they were the two most healthy corps in the army.

The Bengal volunteer-battalion, composed of volunteers for the expedition to Egypt, from different regiments of Sepoys in Bengal, was a fine body of men, and they were mostly what are called old or made soldiers. They were in general very healthy, and during the campaign their loss was very inconsiderable. Though the plague at one time appeared in this corps, yet, by the system established throughout the army by this time, and by the active vigilance of the officers of the corps, the contagion was extinguished; and, though the plague prevailed in every other corps, it never subsequently visited this battalion.

The Artillery-Lascars were, on the whole, very healthy throughout the campaign. The few deaths which they had were from dysentery.

The 1st Bombay regiment, after recovering from the fever contracted on ship-board, continued healthy, and suffered few deaths but from the plague. It was remarked, that this corps effected the march across the desert of Thebes, as well as that over the isthmus of Suez, with less difficulty than any corps in the army. In general, we observed that the native troops endured this better than the European. It ought not to be forgotten, that, under Captain Mahoney, detachments from the native corps were employed, some time before the march of the army, in clearing the roads, digging wells, and on other duties of fatigue more harassing than any that fell to the lot of any other part of the army. Nevertheless, these men continued in a high state of health.

At the period when the plague attacked the 7th Bombay regiment, they were far from unhealthy. The prodigious loss of this corps, which appears in the annexed table, was at first from the fever which raged at sea, and subsequently from the plague, which continued to persecute this corps from December, when it broke out among them, till the whole army was embarked at Suez.

The pioneer-corps was uncommonly healthy till they came to El Hammed. Here they had much severe duty. They were employed in building the hospitals, and very often in cutting the reeds by the river-side, or in conveying them through marshes. A very considerable share of the intermittents that prevailed in the army was from this corps.

The departments (under which title are included about five hundred men employed by the commissaries of cattle, of provisions, and of stores, and by the quarter-master general) were, from beginning to end, more healthy and had fewer deaths than any one corps in the army. They lost none but from the plague; and, when this was discovered, such precautions were taken that the contagion was very speedily eradicated. The extraordinary health of this body of men, as well as their escape from the plague, though particularly exposed to the contagion, I could only attribute to the commissary of cattle, who had the greater part of them in his charge. Captain Burr was constantly among these men, and was most singularly attentive to every thing that regarded their internal economy.

I am decidedly of opinion, that in the peculiar soil and climate of Egypt we are to look for the principal causes of the diseases which prevailed the most in that country.

On grounds that appear not slight, we suspected that several of these diseases were propagated by contagion. But I have no intention of entering on the discussion of the theories of contagion; an obscure subject, and on which I do not presume to think that I could throw any new light. If ever the veil which covers it be removed, the late discoveries in chemistry bid fair to do it. The accurate knowledge which we have acquired of the composition of bodies, and in particular of the constituent parts of the atmosphere, have opened new fields of inquiry to the philosopher and to the physician. The successful application of these discoveries to the practice of physic by the Doctors Beddoes and Thornton, by Dr Rollo, Mr Cruickshank, Dr Wittman, and other eminent surgeons of the artillery, and more particularly by the philanthropic Mr Scott, of India, deserve the gratitude of the profession and of mankind at large. Hereafter, most probably, and when introduced into general practice, they will be looked upon as the greatest improvements that the healing art has received in modern days.

In respect to the soil and climate of Egypt, as giving rise to disease, they are of considerable variety. In a country of such extent, stretching from the tropic, on the one side, to the shores of the Mediterranean, on the other, this might be expected. If, in Lower Egypt, and on the bleak shores of the Mediterranean, we saw the diseases of Europe, and met with the inflammatory diathesis; in Upper Egypt, and as we approached the tropic, we met with the same diseases, and succeeded with the same treatment, as in the peninsula of India.

Perhaps no country is better known, or has been oftener described, than Egypt. I therefore presume that every thing regarding the climate and soil is generally known.

Upper Egypt, that is, the cultivated part of it, is a narrow stripe, laid out sometimes on one and sometimes on both sides of the Nile, which, in its course from Abyssinia till it passes Cairo, is on both sides enchained with a ridge of mountains.

Lower Egypt is, in general, a fine, rich, flat, country, interspersed in different places by branches of the Nile, and overflown by this river at a particular season; at which time the country is in the situation of Holland, or of the fenny counties of England.

The soil in most places is argillaceous or sandy, and in some calcareous; but every where there is a strong mixture of a salt: in most places there are incrustations of it to some depth. The quality of the atmosphere, and the proportions of its different constituent parts, I regret that I never had an opportunity of ascertaining.

The cultivated part of Egypt, particularly the Delta, is a very rich country; in fertility and luxuriance of soil yielding to none under the face of heaven. The art of husbandry is there but imperfectly known; and at their harvests there is a very great destruction of vegetable matter, from which hydrogene gas, or hydro-carbonate, is extricated in great quantities. Under similar circumstances, in America as well as in India, I have seen a bad fever of the intermittent or remittent type appear. But in Egypt, after the subsiding of the Nile, which in many places had covered a great extent of country, there is a great exhalation from the mud, and from the putrid animal and vegetable matters left behind. The effluvia of these substances, acting on the human body, will readily account for much disease. If we add to these the extreme filth of the inhabitants of Egypt, their poor diet, their narrow, close, and ill-ventilated, apartments, generally much crouded, with the extreme narrowness of their streets, and the bad police of their towns, we will not be astonished if a fever, at first intermittent or remittent, should have symptoms denominated malignant, superadded to the more ordinary symptoms of the disease. If an imported contagion should make its appearance at the same time, and under the above circumstances, we expect a most terrible disease.

The dry parching wind, which comes over the desert, and which at certain seasons blows in Egypt and in Arabia, is well known, and was often severely felt by the army on their march, both across the desert and the isthmus of Suez. The whirlwinds of sand roll with great impetuosity, are very troublesome, and insinuate fine sand and dust every where. It is hardly possible to keep the minute particles out of the eyes.

The dews, which fall in Egypt, I always heard were very heavy, and were a cause of the diseases of the country. I had occasion too, more than once, to hear the natives attribute much to them as the cause of their diseases; with what justice I will not pretend to decide. From some experiments which I made in India, on the Red Sea, and lastly in Egypt, I am inclined to think that they are equally heavy in the two former as in the latter quarter. After weighing it carefully, I took a piece of lint, twelve inches square, exposed it for a night to the dew, and, by weighing it in the morning again, ascertained the quantity which it had gained. I am aware that this is by no means a nice experiment, and that in the performance of it several particulars demand attention; but it is sufficient to our purpose, and I learned by it, that, in the island of Bombay, on the Red Sea, and in Lower Egypt, the quantity of dew which falls is nearly equal.

It ought to be mentioned, that, during the year we were in Egypt, the season was not the usual one. There was a greater overflow of the Nile. It rose higher on the Nilometer than it had done for several former years, and it was remarked to be much later in subsiding at Rosetta.

The fall of rain at Alexandria was greater than on former years; and, at Rosetta, the rains were in setting in later than usual. The season of the plague set in much earlier than usual.[2]

In general, the Thebaid, or Upper Egypt, is healthier than the Lower. Never were troops more healthy than the army when encamped near Ghenné.

Ghiza, the ancient Memphis, at the time the army disembarked there from Upper Egypt, we found to be a very unhealthy quarter. For a considerable time, and immediately before the arrival of the Indian army, it had been the station of large armies: alternately of Turks, Mamelukes, French, and English. From all these armies a number died at Ghiza, and there was much filth and noxious effluvia. We saw there enough of putrid animal matter to generate contagion. Whether this was or was not the cause of the fever which prevailed, I will not attempt to decide. One circumstance may be mentioned. We were here joined by a detachment of the 86th regiment under Colonel Lloyd, which, for some months before, had been doing duty with the Vizier’s army, which never was healthy. That the circumstances which existed at the time of our occupying Ghiza were the cause of the fever is manifest from this, that, subsequently to the army going to the coast, the garrison left in it found Ghiza a most healthy quarter. The same objections are to be made to Rhoda that are applicable to any marshy situation.

The 86th regiment found Damietta healthy, till the Turkish troops came down in great numbers from Cairo; but, at this period, the British troops were removed from it.

Rosetta is not a healthy quarter. It is one of the largest and worst-built towns in Egypt. There is hardly one street in it. There are only narrow dirty lanes, with high houses overhanging each other, and the passage frequently interrupted by houses in ruins. It is, on two sides, surrounded with swamps. The river is in the front, and behind, it is nearly encompassed with burying grounds.

The place of the encampment at El Hammed was an unhealthy spot. About half a mile in the rear of it there was a great extent of swampy ground; but there was no choice: it was necessary to encamp where there was water.

As a station for the army, Alexandria had every recommendation. It is built on a peninsula which formed the antient harbour, on a fine dry and open situation. Some squares, and several of its streets, are open and spacious; very unlike an African or Asiatic city. Its numerous mosques afforded us large and airy hospitals and barracks. In point of health, the inundation of the water from the lake Maadie was favourable. It insulated Alexandria; but the water was in motion, and at such a distance, that nothing was to be apprehended from exhalation. All the hospitals at first were within the walls of the modern city. The situation of the Pharos is well known to every one. I have said, that it was complained of as a quarter for troops, and with justice. The state of the 61st regiment shewed this. Subsequently to their being removed from it, they were encamped on the outside of the walls. From this period both the sickness and mortality in this corps disappeared. The 10th regiment found Fort Triangulaire a dry, spacious, and airy, barrack. In the fort they had the means of keeping the men constantly in their quarters; they were at some distance from Alexandria, and thus it was in their power to preserve a regular internal economy and prevent drunkenness. When the regiment came to take possession of this quarter they had a numerous sick-list: it decreased daily after they came here; and, finally, the 10th was as healthy as most other regiments. The barracks of the 80th regiment, and of the Bengal volunteer-battalion, were situated close to Fort Triangulaire; and they possessed all the same advantages, but that it was not so easy to confine the men to the barracks.

The barracks of the 88th regiment, at Fort Cretan, were dry and airy. Though in a different quarter they possessed nearly the same advantage as Fort Triangulaire, with the disadvantages of the quarters of the 80th regiment.

The horse-artillery and 8th dragoons were, along with the 26th dragoons, stationed at Damenhoure, which had every advantage of a country quarter. It was situated in a fine, open, cultivated, country. The station was thought so good, that at last we sent the sick of the army to this quarter; and old cases of dysentery and hepatitis, as well as some of fever, recovered here with astonishing rapidity. By the time of their arrival there was in many a great amendment. They were conveyed in waggons constructed for them, and made three days easy journey to Damenhoure.

In the difference of Upper Egypt in June, and El Hammed and Rosetta in December, is included perhaps more than change of season; there was change of climate and of heat from 108° to 49° of the thermometer. We have said that, in many instances, the causes of disease at El Hammed could be traced to the march across the desert and the encampment at Rhoda. Very much, however, was likewise to be attributed to the change of weather experienced in November and December.

In every part of the world, with change of season, some diseases pretty constantly make their appearance; but in no part is this so observable as in the countries under the tropics. In the West-Indian islands, as well as on the shores of India, I have repeatedly and uniformly observed the sick-list of European corps more than doubled by the third week after the setting in of the monsoon.[3] In these countries a very considerable increase of sick is likewise found to take place on the change from the rainy to the dry season. The change of season in Egypt had nearly an equal influence on the health of the army while there.

In a memoir, which, four years ago, I had occasion to present to the Military and Medical Boards at Bombay, on the state of health of the 88th regiment, and of detachments of the 75th, 77th, 84th, and 86th, regiments, under my care, one passage is so very closely applicable to the subject I am now on, that I will extract it. After pointing out the smaller proportion of sickness in different corps, and in proportion as they had been in India from one, two, three, to twenty, years, and the very great proportion of disease and mortality which the European bore to the native Indian corps, the memoir goes on:

“Though, perhaps, a residence for a certain length of time, or a naturalisation to the climate, be necessary, yet one reason may, with probability, be brought forward to account for the very great difference, in point of health, between European and Indian corps, viz. the great intemperance of the European in eating and drinking. A native of India is astonished, at first, to see the meals of animal food devoured, and the quantity of spirits drank, by Europeans. There can be little doubt, that the nearer we approach to the mode of living of the natives, the more nearly we shall attain their state of health.

“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.

I shall now advert to some of the principal measures of prevention of disease in general: some regulations regarding the plague are mentioned under the head of that disease.

Within the last thirty or forty years the improvements made in the means of preserving the health of seamen have been great. These had their rise from the great Captain Cooke; after him, very much was done by Dr Lind, of Haslar-hospital; since, by Dr Blane; and, more lately, by the present able physician to the fleet, Dr Trotter.

Under the eminent surgeon-general of the artillery, a very great deal has been done in the ordnance-department. Abroad, as well as at home, their hospitals and the medical department are in a state not unworthy of imitation.

Since the time of the Carthagena expedition, a good deal has been done in the army likewise. To the present commander-in-chief the army owes very much; and the Army Medical Board have, of late, corrected many abuses, and introduced much improvement into the medical department: but much remains to be done for the soldier, especially when embarked for service.

Often, during the late war, have we seen troops suffer much in transports; and, on one or two occasions, a confinement of two or three months on ship-board has crippled regiments, if not armies, and left them unfit for service.

At no time, I believe, have troops on any expedition been so long confined on ship-board as during that of which we are treating; and in none I believe, not even in the shortest, has there been a smaller loss of men.

This is to be ascribed entirely to the very liberal policy of the great character at the head of affairs in India, and to the gallant general selected to command on this expedition. It was the governor-general’s order, that every convenience and comfort, that might conduce to the health of the soldier, should be most amply provided. In consequence of this, a sufficiency of tonnage, and that calculated for a warm climate, was procured. Large, lofty, and roomy, ships were fitted up, and the greatest care was taken to embark only such as were in perfect health. The transports were liberally provided with every requisite or comfort for a long voyage: the quality of the water was particularly attended to. Besides a large stock of fresh provisions, vegetables of every kind were shipped. There was a large stock of potatoes, of onions, bread-fruit, pickled vegetables, of tea, rice, and pepper, which were regularly served out to all. Besides these, for the sick there was provided a large stock of wines, of fermented liquors, and of every other comfort.

To the very liberal manner in which the transports were fitted up, and to the regulations established in every transport of the fleet, which were rigorously enforced, is undoubtedly owing the very healthy state in which most corps remained, for half a year, on ship-board; and that, on landing, they were fit to march on any service.

At Bombay there was, at first, a scarcity of shipping. One ship sailed thence much crouded; and, in a three-weeks passage to Ceylon, those on-board suffered much: there occurred much sickness and several deaths. On their arrival at the island of Ceylon, Mr North immediately ordered two more vessels for the troops with which this vessel (the Minerva) was crouded. The good effects of this measure struck all: thereafter, during a three-months passage to Kossier, there died not a man in the Minerva.

The clothing of the Indian army conduced much, in our opinion, to their healthiness. They landed with their white cotton dresses, which were admirably adapted to the warm season in which we came to Egypt; favourable to cleanliness; and, by consequence, to the exclusion of pestilential contagion.

From the time of the army first landing at Kossier, in every situation where it could be done, bathing was enjoined throughout the army. In every corps it was regularly done under the inspection of a commissioned officer, and any neglect of cleanliness was most severely punished. In any country or climate, attention to cleanliness will be found a principal means of preserving the health of troops; but, in Egypt, where contagion was lurking in every corner, it became indispensably necessary.

In the cold season, and while we were in Lower Egypt, warm comfortable clothing and bedding were provided, not only for every soldier or Sepoy, but likewise for the women, children, and all the numerous followers of the army.

The simple diet of the Hindoo is well suited to a warm climate. It is seldom more than rice with aromatics, or clarified butter with a kind of pea, to which the luxury of a little salt-fish, of preserved tamarinds, or some fresh fruit, is occasionally added. As far as it could be done, the Europeans were made to conform to this diet; and we are convinced that it was with much advantage to them. The light wines of the Greek islands were issued to the Europeans in the warm season; but in the cold they got spirits.

In the cold season it was found necessary to make some change in the diet of the Sepoys. In the month of January they suffered so much from the severity of the weather, and a climate very unlike their own, that a portion of animal food, as well as of wine, was ordered to be issued to them.

The prejudices of country, religion, and of the different casts of Gentoos, were first overcome in the Bombay regiments. At length, the most austere yielded; and, finally, even the severe Brahmin, as well as the rigid Mussulman, gave way to the necessity imposed by their situation in a foreign country.

The length of time, which most corps had been in a warm climate, deserves to be mentioned, as a cause of the health of the Indian Army in Egypt, till attacked by the endemic diseases of the country. No corps in the army had been less than two years in a warm climate. During the late war, the value of the Cape of Good Hope, to us, was often felt and acknowledged in India. After being at this healthy settlement and there seasoned to a warm climate, the 80th, 84th, and 86th, regiments and the Scotch brigade, landed in India, in an effective state, never before witnessed with European troops in that country. This fact is not undeserving public consideration.

The fact cannot be too often repeated or too generally known, that nothing conduces more to the health of a corps, than the preserving a good internal economy in it. A good commanding officer has, in general, a healthy regiment. Every thing can be done in the prevention of disease; but, unfortunately, very often, little in the treatment when it supervenes.

One point remains still, and I know no fitter place to introduce it than here.

It has been mentioned, that liver complaints rarely recovered in Egypt, and, likewise, that cases of hepatitis and flux, which, in India, had long remained obstinate, here yielded of themselves and without medicine. This fact leads me to the suggestion of a measure, which, I conceive, would save many useful lives. It is, whenever a case of fever, dysentery, or liver complaint, in India, is obstinate, or continues for a long time on the reports, to send such cases to sea or to Europe.

It is a truth, well known to every medical man in India, that, after continuing ill of these disorders a certain time, soldiers or sailors never do well there. They linger, and are, at length, carried off, either by a suppuration in the liver or ulceration of the intestines. In India, when patients, whose situation in life permits them to take a voyage to Europe, are in this state, they never fail to take it, and, most commonly, are recovered by it; but there is no hope for the poor soldier or sailor there.

The same benefit might, however, be acquired for the soldier, and with little, or, perhaps, no, expense: it is not always necessary that the voyage be a long one, or, that the change of climate be to Britain. Were the cruisers of the company or the king’s ships, from time to time, to take on-board some of these chronic cases, for one cruise, the men would be frequently recovered by it, and, in many cases, they would soon be capable of doing duty on ship-board, where, in time of war, Europeans are very much wanted, but cannot be found in India. Whenever a voyage in India is not attended with complete success, a voyage to Europe still offers one chance for life. The prospect of this, by removing that despondency which, in chronic diseases is a never-failing attendant, and which we have too often found baffle every mode of treatment, would cheer the patient, and of itself do infinite good. Men of his Majesty’s regiments might be brought home, and attached to the recruiting companies there, whence able healthy men might be sent in exchange for them, while the invalid from India would at the same time recover his health in a country-quarter at home, and be equally useful as another man on the recruiting service.

Humanity, as well as policy, loudly calls for something to be done. From what I have seen, I fear that invalids and ineffective men are sometimes detained by far too long in India.

END OF PART II.

PART III.

OF THE DISEASES OF THE INDIAN ARMY IN EGYPT.

We have now arrived at the last part of these Sketches; where it is intended to offer some account of the diseases which we met with in Egypt.

The catalogue of military diseases is never extensive. If his peculiar way of life exposes the soldier more to some distempers, it entirely exempts him from many others. In an Indian army the diseases are even fewer than in any other; at the same time, that the practice of medicine is more simple. I am of opinion, that in India the practitioner goes on surer ground than in Europe, partly for the above reason, and partly from the causes of disease being less varied in that country. Though the diseases which occurred in the Indian army, when in Egypt, were not numerous, yet some of them were highly important, and on our arrival in Egypt were new to every one of the medical gentlemen, excepting Mr Bellars, of the 86th regiment, who had treated a few cases of the plague, which occurred in a detachment of that regiment acting with the Vizier’s army, and had himself suffered from the ophthalmia of Egypt.

I propose to include every thing that I have to offer on this part under two heads. Under the first, I shall notice two diseases which may be termed the endemics of Egypt, viz. the plague and the ophthalmia of that country.

Under the second, the other diseases which prevailed will be noticed. They are mostly tropical diseases; and with them the reader will not be long detained.

OF THE PLAGUE.

I begin with the plague; a disease of which accounts have been handed down to us from the earliest ages of history or of physic. The consideration of it is important, not only on account of its frequent and fatal occurrence, but, as being, perhaps, the most formidable disease that the art of physic has to encounter. On this subject, however, much will not be expected from me. Of no disease have we a more clear, accurate, and complete, history than of this, in Dr Russel’s work on the plague. In Egypt, we often had recourse to this work, and we readily acknowledge our obligations to the venerable and learned author.

Though since the time that Dr Russel gave his ample history of the plague in Syria, we have had several accounts of this disease as it appeared in other countries; yet much has not been added to our stock of information, and little of improvement has been made in the practice. The proper and well-timed use of mercury, and, perhaps still more, the application of the newly-discovered remedies analogous in their effects to the calces of that mineral, hold out a prospect of success the most encouraging.

In Europe, but more particularly in Britain, much of the dread, and much of the real danger, that attended the most fatal diseases in this country are now done away, by the late improvements in medicine, and in chemistry.

The time was, when fever, when it broke out in different parts of England, proved little less fatal to whole villages and towns than the plague does in the countries where it resides. From the improved practice of the treatment of fever, but more from our knowledge of the means of destroying contagion and preventing its spreading, the mortality from this class of diseases is now comparatively small.

The small-pox, that plague which once carried off so great a proportion of the population of Europe, now bids fair to be expunged from the catalogue of diseases.

May we not indulge a hope, that, as the intercourse of civilized Europe, with the countries of which the plague is now the scourge, becomes more regular and intimate, we may be enabled to extend to them our discoveries and improvements, and so direct them to the means of divesting the plague of its terrors, and reducing the mortality from it to the scale of that of fever and the small-pox in Europe?

Egypt has been called the cradle of the sciences. From this we acknowledge, that the arts were derived to Greece, and subsequently to every part of the world. It would surely be the noblest gratification, if in return, at this period, Europe, by extending her benefits and improvements to Egypt and to Greece, could free them from the most cruel scourge of countries, once the most civilized and polished in the world. It would in some measure compensate and console them for the low state of degradation into which they have fallen.

All that I have to say of the plague will tend to diminish the dread which has hitherto been entertained of it.

A formidable disease undoubtedly it is; but, when we hear how much of the population of Persia, Arabia, Turkey, Syria, Egypt, and Barbary, is now and then swept off, all must not be laid to the account of the plague, as if its ravages admitted of no remedy. The experience of the French and English, in Egypt, will now convince Europe, that much of the vast mortality, in the above countries, is to be ascribed to the gross ignorance in which they are immersed.

Were typhus, our jail or hospital fever, to be imported into a town of Egypt, we can hardly conceive how it could ever be eradicated by the natives. Whenever the small-pox does appear in that country, it proves a dreadfully-destructive disease. The structure of their houses and plans of their streets are calculated for the production of disease, and the preservation and concentration of contagion.

It is a matter of no little consolation to us, that we know the means, not only of excluding the plague from our own country, but that, when our armies are stationed in the countries where the disease is endemic, we can arrest the progress of the contagion, and with certainty eradicate it.

The plague made its first appearance, in the army from India, in the middle of September, 1801. From its early appearance the natives were very much alarmed, and prophesied a dreadful season of plague. They have observed, that, when it breaks out before December, they have always a generally-prevailing and a very destructive disease.

The number of cases which appeared in the Indian army, from the 15th of September, 1801, to the 15th of June, 1802, is seen in an accompanying table.