THE Medico-Chirurgical Review, No. LXV. [NO. 25 OF A DECENNIAL SERIES.] APRIL 1, To JULY 1, 1840. STATISTICAL REPORTS ON THE SICKNESS, MORTALITY, and InVALIDING AMONG THE TROOPS IN WESTERN AFRICA, ST. HELENA, THE CAPE OF GOOD HOPE, AND THE MAURITIUS. Prared from the Records of the Army Medical Department an War-Office Returns. 1840. OUR readers will of course remember the particularity with which we noticed the official documents, relating to the health of our troops in the West Indies, and our North American colonies. Such statistical records have a wider bearing than the military force on which they have been founded, and affect not only our ideas of the salubrity of particular quarters of the globe, but the very principles of medicine itself. On this account, we seize the present opportunity of recurring to a subject of such interest to the whole profession, and of carrying on our notice of these statistical reports, which, much to its credit, are emanating from the War-Office. Major Tulloch informs us, in his usual brief Introduction, that, in the present volume, are submitted the following Reports and relative Appendices: I. On the Sickness, Mortality, and Invaliding among the Troops serving on the Western Coast of Africa. II. On the Sickness, Mortality, and Invaliding among those serving in St. Helena. III. On the Sickness, Mortality, and Invaliding among those serving at the Cape of Good Hope. IV. On the Sickness, Mortality, and Invaliding among those serving at the Mauritius. With these would have been included a similar Report on the Health of the Troops in the Australian Colonies, but so many of the detachments there have been under the charge of civil practitioners, who do not furnish returns to the Army Medical Department, that the necessary information in regard to the prevailing diseases, cannot at present be procured. This defect, however, may yet be supplied; and in the meantime, the extreme salubrity of the climate may be stimated from the circumstance, that on the average of 20 years from 1817 to 1836 inclusive, the mortality did not exceed 14 per thousand of the force annually, whereof more than a fifth part arose from violent or accidental deaths, principally attributable to the nature of the duties on which the troops were employed. Thus the mortality from No. 81. 1 disease alone could have amounted to little more than one per cent. annually, being lower than in any other colony, except the eastern provinces of the Cape of Good Hope, to which the climate of Australia is in many respects similar. We are glad to observe a warmer acknowledgment of medical services, in the construction of these Reports. Such courtesy is becoming as well as due. The gentleman to whom Major Tulloch expresses his obligations are, Deputy Inspector General Marshall and Staff Assistant Surgeon Balfour. I. ON THE SICKNESS AND MORTALITY AMONG THE TROOPS ON THE The British settlements in Western Africa are scattered over a line of coast which, from St. Mary's on the Gambia to Accra, is nearly 1600 miles in extent, and consequently presents considerable diversity in climate, soil, surface, and geological structure. Unfortunately all spots agree in thistheir deadly influence upon European life. The Report opens indeed with a significant comment on the pestilential character of these fatal shores-it mutilates even statistic documents. "It is to be regretted that on this coast, where the baneful effects of climate on the European constitution exhibit themselves in their most concentrated form, and where it would have been of the utmost importance to trace the diseases of each station with the same minuteness as in previous Reports, the materials are neither so ample as those from other colonies, nor admit always of the same arrangement as has been hitherto adopted. The unceasing occupation of their professional duties in so unhealthy a climate left medical officers little time for making the proper distinction between the diseases of white and black troops; and their death has frequently prevented information from being obtained at those periods when the mortality was at its greatest height, and when an accurate statement of the particular circumstances under which it occurred would have been most interesting and useful." Vos o quibus integer ævi Sanguis, ait, solidæque suo stant robore vires; On the cession of Goree and Senegal to the French, the only stations occupied by the British troops on the coast were Sierra Leone, Gambia, and the Isles de Loss: but in 1821 the settlements of Cape Coast Castle and Accra, with their dependencies, having been transferred to the British Government by the African Company, were formed into another Command, of which it will be necessary to investigate the sickness and mortality separately. A. Sierra Leone Command. Major Tulloch offers a brief account of the localities of the stations of Sierra Leone, the Isles de Loss, and Gambia. The peninsula of Sierra Leone comprehends a tract of land extending about 18 miles from north to south, and 12 from east to west, consisting principally of a range of conical mountains from 2000 to 3000 feet in height, surrounded by a belt of level ground from one to five miles in breadth, to which have recently been added the Banana Islands and some minor acquisitions of territory. From the north to the south-east the whole country adjoining the peninsula is intersected by numerous creeks and rivers, which overflowing during the rainy season, form extensive swamps in every direction. Indeed, it may be stated generally, that the whole coast from Senegal to Sierra Leone, a distance of above 700 miles, is exceedingly low, being not more than a few feet above the ocean; that the rivers with which it is intersected are sluggish in their course, and flooded during the rains, when the mud they deposit, and the moisture they supply, give birth to an interminable wilderness of forest and brushwood, among which lies rotting the decayed vegetation of many centuries. From the noxious agencies likely to be generated in such a tract, the peninsula of Sierra Leone, however, is sheltered by the mountain ranges which form the boundary in that direction, while on the south it is washed by the Atlantic, and on the north by an estuary terminating in the Sierra Leone river, so that it seems protected by nature from all extraneous sources of disease, except such as may originate on the opposite side of the river, called the Bulam shore; and, so far as can be ascertained, there is nothing within the limit of the colony itself, likely to induce that sickness which has proved so fatal to every class of the population. From the census of 1838, it appears that the population of Sierra Leone then consisted of about 42,000 persons-of whom there were-whites, 83 males, 19 females; black, 21,559 males, 18,381 females; aliens, 1,681 males and females. Free Town, the capital, stands on the south bank of the Sierra Leone river, about five miles from the sea. At the distance of about a mile it is surrounded on the west, south, and east, by a semi-circular range of lofty hills, clothed to the summit with high trees and thick underwood, and to which there is a gradual ascent from the river. This position gives it a very pleasing aspect, by no means calculated to impress an idea of insalubrity, and as the soil is gravelly, and has a gentle slope, the rain is speedily absorbed or drained off even during the most inclement periods of the wet season. The houses are mostly built of wood and disposed in broad and regular streets, in many places yet uncleared of the brush and underwood with which the site was originally covered. There is little cultivation in the immediate vicinity of the town, the soil not possessing great capabilities for agriculture; but considerable progress has been made at some of the villages in the interior, where it is better adapted for that purpose. The town is elevated about fifty feet above the river, the banks of which were formerly covered with a dense barrier of mangrove bushes. This, having been supposed a fertile source of disease, was cleared to a considerable extent, without however effecting any obvious improvement in salubrity. The distance from the Bulam shore opposite is about seven miles; the soil on that shore is a ferruginous clayey loam, which is apt to form marshes. during the rainy season, owing to the surface being almost level. In the earlier years to which this Report refers it was covered with thick brush and underwood, and supposed in some instances to have given rise to the unhealthiness of the colony; but though cultivation has since made consider able progress in that quarter, and the face of the country is rapidly improving, no corresponding amelioration has been permanently manifested in salubrity. The Isles de Loss lie about 60 miles north-west of Sierra Leone. Only three are habitable. The nearest is three, and the most distant eight, miles from the main land. A few disbanded black soldiers and two or three Europeans, who have established a factory there, form with the detachment, the only inhabitants. Crawford's Island, on which the troops are stationed, is the centre of the group, and is described as entirely composed of granite, elevated 250 feet above the level of the sea, and about a mile and a half in length, though scarcely 100 yards in breadth. It is entirely exempt from that exhuberance of vegetation which prevails on the main land, and in no part of it, nor in any of the other islands, are either pools or marshes to be found. The Island of St. Mary's, the principal settlement on the Gambia, is about five miles in length and one in breadth, and consists merely of a sand-bank, formed by the confluence of the tides at the mouth of the river. It is consequently in many places under high-water mark, which renders it during the rainy season, one complete marsh. The soil is too light to be well fitted for agriculture, but, where intersected by creeks and aided by the alluvial deposits brought down by the river, gives birth to dense masses of mangroves, underwood, and every species of rank vegetation, which, particularly during the hot season, create most offensive effluvia throughout the whole island. The Town of Bathurst is built on the east side of the island, along the beach, upon a ridge of sand somewhat elevated above the level of the sea. Efforts have of late been made, by the construction of dykes and drains, to render the town less swampy during the rainy season, and thus improve its salubrity, but without much success. In 1826 the inhabitants, exclusive of the military, amounted to 1867, of whom only 20 were Europeans. Such is the locale of the Sierra Leone Command. The main characteristic of the climate is extreme humidity, a circumstance which is sufficiently attested by the fact of more rain having fallen in two successive days, the 22nd and 23rd of August, 1828, than in Britain throughout the whole year. The quantity of rain at the Gambia is not so great as at Sierra Leone. The Temperature, compared with that of similar latitudes exhibits no very marked peculiarity. With the exception of Sierra Leone, where the diurnal range of the thermometer rarely exceeds 10°, sudden transitions from heat to cold, with dense and chilling fogs for many months of the year, form the general characteristic of the whole west coast of Africa, particularly at the Gambia, where the thermometer has sometimes fallen as low as 62° in the morning, during October, November, and December, and then risen to 80° in the course of a few hours. These sudden changes of temperature, observes Major Tulloch, are by no means uncommon in tropical climates. The thermometer, for example, at Seringapatam, has been observed at 54° in the morning, accompanied by cold dense fogs, and as high as 92° by mid-day, being a much wider range than on this coast, without any great degree of mortality being thereby induced. The Peninsula of Sierra Leone, though beyond the trade winds, enjoys a regular succession of sea and land breezes, the former commencing about nine o'clock, A.M. from the West-North-West, always cool and pleasant, the latter setting in about the same hour in the evening, from the East and South-East, but generally heated, and laden with humid exhalations from the low and swampy ground over which it passes. The interval between the dying away of one breeze and the springing up of another is always hot and oppressive. At the Isles de Loss and Gambia the land and sea breezes are generally from the north-west and south-west. All along the coast there prevails, during the months of December, January, and February, a dry, parching, easterly wind, termed the Harmattan; but, except on catarrhal and pulmonary affections, its influence seems rather favourable than prejudicial to health. The wet season extends, at Sierra Leone and the Isles de Loss, from May to November, and at the Gambia from June to September or October, and is always ushered in and carried off by tornados. Nothing can exceed the gloominess of the weather during this period: the hills are wrapped in impenetrable fogs, and the rain falls in such torrents as to preclude that exercise and amusement which are so necessary to invigorate the body and give energy to the mind. At this period, the diseases which prove so fatal on the coast have generally made their appearance, though there have been so many exceptions, that they can scarcely be said to belong peculiarly to any season. During most of the period under review, the force consisted of a colonial corps of white and black troops, the former unfortunately of a class the least fitted to contend with such a climate, being principally soldiers allowed to volunteer their services as a commutation of punishment, and whose vices and intemperance, no doubt, in many instances facilitated the inroads of disease. Till 1817 the number of white and black soldiers was nearly equal, but in that year most of the former were removed to the frontier settlements of the Cape of Good Hope; and in 1819 the whole corps was disbanded and replaced by the 2nd West India Regiment, composed, with the exception of a few serjeants, entirely of negroes. In 1823, however, a war having broke out with the Ashantees, the white soldiers formerly disbanded at the Cape of Good Hope were hastily re-embodied and sent to the defence of Cape Coast Castle; the survivors of these were subsequently transferred to the Sierra Leone Command, and, with several drafts of commuted punishment men from England, formed into the Royal African Colonial Corps, which thus again consisted of Europeans of the most degraded class. Death, however, thinned the ranks with such rapidity that an attempt had to be made, in 1825, to keep up the force by voluntary enlistment; above 100 recruits were in this manner raised and sent from Britain, but though their character and conduct appear to have been unexceptionable, they soon shared the same fate as their depraved comrades. The impossibility of maintaining white troops in such a climate being thus demonstrated, the garrison has, since the end of 1829, consisted entirely of blacks, with the exception of a few European serjeants. 1* |