The history of the yellow fever in 1864 is given in detail by Dr. Barrow.1

The total mortality was 14 officers, 173 men, 5 women, and 4 children. The deaths to strength were, among the officers, 189, and among the men, 149 per 1,000. The officers' mortality was owing to a large number of deaths among the medical officers.

The town of St. George's, in Bermuda, presents every local condition for the spread of yellow fever; the town is quite unsewered; badly supplied with water; badly built.

"Dandy fever," or break-bone (Dengue), has prevailed several times. "Continued fevers" (no doubt in part typhoid) have always prevailed more or less at Bermuda. In the ten years (1837-46) they gave 1,004 admissions out of 11,224 men, or 88 per 1,000 of strength, being much greater than at home. In ten years (1870-79) there were 884 admissions out of 18,974, or 47 per 1,000; in 1880 the ratio was 42.6.

In 1859 there were only 11 cases of "continued fever" out of 1,074 men; but in 1860 "continued fever" prevailed severely (209 cases in 1,052 men). It was of a mild type, and caused little mortality. It was probably not typhoid, but its nature has not been definitely determined. It prevailed in September, October, and November. It is said that the drainage was defective at Hamilton.

In

In 1866 there was decided typhoid fever, and a considerable mortality. In 1875 there were 5 admissions recorded and 1 death in 1,902 men. 1880, 27 admissions and 6 deaths.

Formerly tuberculous diseases caused a considerable mortality. In the years 1817-36, diseases of the lungs gave a mortality of no less than 8.7 per 1,000 of strength. In 1837-46, the lung diseases gave a yearly mor tality of 8.3 per 1,000 of strength. Of late years the amount has decreased. The admissions and deaths respectively were 10.5 and 2.6 in the seven years (1859-65). In 1870 the deaths from phthisis were 1.57, and in 1871 no less than 5.19 per 1,000 of strength; in 1875 they were 1.58.

Diarrhoea and dysentery were also formerly very common, but of late years there has been a great decrease. Diseases of the eyes are common.

There has always been much intemperance, and a large number of deaths from delirium tremens. This was the case even in 1866; there were no less than 5 deaths out of a total of 28.

Venereal diseases have averaged from 55 to 80 per 1,000 of strength. In considering the sanitary measures to be adopted at Bermuda, it would seem that drainage and ventilation are still most defective, and that means should be taken to check intemperance. If yellow fever occurs, the measures should be the same as in the West Indies.

SECTION IV.

NORTH AMERICAN STATIONS.

SUB-SECTION I.-CANADA.2

The usual garrison used to be from 3,000 in profound peace to 10,000 or 12,000 in disturbed times. In 1871 the troops were withdrawn from Canada and concentrated at Halifax.

1 Army Medical Report, vol. v., p. 290.

For an excellent account of the Canadian stations, see Sir W. Muir's Report in the Army Medical Report for 1862, p. 375.

LOWER CANADA.

Chief Stations-1. Quebec (62,446 inhabitants).

Temperature. Mean of year, 41°; hottest month (July), 71.3°; coldest (January), 11°. Annual fluctuation, 60.3°.

The undulations of temperature are enormous. In the winter, sometimes, there is a range of 30, 40, and even more degrees in twenty-four hours, from the alternation of northerly and southerly winds. In one case the thermometer fell 70° in twelve hours. The mercury is sometimes frozen.

The mean temperature of the three summer months is 69°; winter months, 12.8°. The climate is "extreme and variable.

Rain.-About 36 to 40 inches. The air is dry in the summer, and again in the depth of winter.

Barracks.-Built on lower Silurian rocks. No ague is known, though the lower town is damp.

Amount of cubic space small. Casemates in citadel very bad, damp, ill ventilated, ill lighted.

2. Montreal (140,862 inhabitants).

Temperature.-Mean of year, 44.6°; hottest month (July), 73.1°; coldest (January), 14.5°. Annual fluctuation, 58.6°. The undulations are very great, though not so great as at Quebec.

Mean of the three summer months, 70.8°; of the three winter months, 17.2°.

Rain.-36 to 44 inches.

Barracks.—Bad; very much overcrowded.

In Lower Canada are also many smaller stations.

UPPER CANADA.

Chief Stations-1. Toronto (86,455 inhabitants).

Temperature.-Mean of year, 44.3°; hottest month (July), 66.8°; coldest (February), 23.1°. Difference, 43.7°. Great undulations.

Rain.-31.5 inches.

The town stands on ground originally marshy. The new barracks are built on limestone rocks of Silurian age. Average cubic space only 350.

Drainage bad.

Intermittent fevers among the civil population; not very prevalent among the troops.

2. Kingston (14,093 inhabitants).

Temperature. Mean of year, 45.8°.

Malarious.

London, Hamilton, and several smaller stations-Fort George, Amherstberg, etc.—were also occupied at one time.

Diseases of the Civil Inhabitants.

Formerly ague was prevalent in Upper Canada, especially in Kingston; it is now much less. At Montreal ague used to be seen; now is much less frequent. It prevails from May to October, and is worst in August.

If the summer isothermal of 65° be the northern limit of malaria, both Quebec and Montreal are within the limit; yet the winter is too severe, and the period of hot weather too short, to cause much development of malaria.

The climate is in both provinces very healthy, and has been so from the earliest records, though, when the country was first settled, there was much scurvy.

Typhoid is sometimes seen. ships, but has not spread, or at vailed. Yellow fever dies out.

Typhus has been often carried in emigrant least has soon died out. Cholera has preConsumption is decidedly infrequent.

Acute pulmonary diseases used to be considered the prevalent complaints, but it is doubtful whether they are much more common than elsewhere.

Diseases of the Troops.

Years 1817-36 (20 years).-Admissions per 1,000 of strength = 1,097; deaths, 16.1 (without violent deaths).

Years 1837-46 (10 years).-Yearly admissions per 1,000 of strength, 982; average daily sick per 1,000 of strength, 39.1; mortality (violent deaths excluded), 13; mortality with violent deaths, 17.42.

The mortality was made up in part of-fever, 2.13; lung disease, 7.44; stomach and bowels disease, 1.11; brain disease, 1.28. Nearly two-thirds of the fevers are returned as 66 common continued," probably typhoid.

Venereal admissions, 117 per 1,000.

Erysipelas was epidemic at Quebec, Montreal, and Toronto in 1841; at Montreal in 1842, from bad sanitary conditions.

The following table shows the mean of the later years:—

These numbers show, what indeed is apparent in all the records, that Canada is a very healthy station.

The amount of phthisis was always smaller than on home service, and regiments of the Guards proceeding from London to Canada had on two occasions a marked diminution in phthisical disease.

In this respect, also, Canada contrasted formerly with the West Indies,

but of late years the decline of phthisis in the West Indies has lessened the superiority of Canada.

The comparatively small amount of phthisis was remarkable, as the troops were at times very much crowded in barracks. Latterly they had the home allowance of space (600 cubic feet).

In the later years phthisis declined considerably with improved barrack accommodation.

In the 20 years, 1817-36, the annual admissions were 6.5, and the deaths 4.22, per 1,000 of strength.

In the years 1859-65 the admissions from the whole tubercular class were 8.3, and the deaths were 1.67, per 1,000 of strength.' It is curious to observe that this diminution was coincident with a similar change at home. The acute lung affections, pneumonia, and acute bronchitis, appear formerly to have been rather more prevalent in Canada than they were in later years.

The following table gives the mean and extremes for 8 years (1859-66) :—

If this table is compared with the similarly constructed table (at page 283), showing the prevalence of these diseases at home, it appears that both pneumonia and acute bronchitis were rather more fatal in Canada. Both together gave a mortality of .868 per 1,000 at home, and 1.166 per 1,000 in Canada. The admissions from pneumonia were also higher, but those from acute bronchitis were one-third less than at home, showing that the common catarrhal affections were less frequent in Canada. On the whole, however, the influence of the severe climate and the exposure on guard in Canada produced less effect than might have been anticipated.

"Continued fevers" (probably enteric) almost yearly gave some mortality; the mean being about .6 per 1,000 of strength. This was actually more than on home service, and depended probably on the difficulties connected with drainage. A good dry system is the only plan which can be depended on in Canada.

The great healthiness of Canada in part probably depends on the fact, that the extreme cold in winter lessens or prevents decomposition of ani mal matter and the giving off of effluvia; hence, in spite of bad drainage

Still the lung complaints were higher than they ought to have been. Sir William Muir (Army Med. Report, vol. viii., p. 56), after detailing the measures taken by him to improve the barrack accommodation, says, "I cannot help thinking that the large number of men treated and invalided for chest disease, during the five years I have been on this command, bears a close relationship to this impure state of barrack air."

* In contrasting the consumptive invalidity at Gibraltar, Bermuda, and Canada, the Reporters of 1839 (Army Med. Report) remark, that the returns afford another interesting proof how little the tendency to consumption is increased either by intensity of cold or sudden atmospherical vicissitudes." See also the remarks on Phthisis in India at a subsequent page.

and deficient water, there is no very great amount of fever. In the hot summer, the life is an open-air one. Even in winter the dry cold permits a good deal of exercise to be taken.

The amount of drunkenness and delirium tremens in Canada used to be great. In 1863 no less than 9 out of 96 deaths, or nearly one-tenth, were caused by delirium tremens. Violent deaths also are usually large, drowning giving the largest proportion.

The sickness and mortality of Nova Scotia and Newfoundland are almost identical with Canada, and they are now included in the returns under the one head of "Dominion of Canada." Both stations have always been considered very healthy. There is some typhoid fever at Halifax, and at both places there was formerly much drinking, but that is now less. In British Columbia, where there is a small garrison of 100 to 150, the health is also extremely good.

SECTION V.

AFRICAN STATIONS.

SUB-SECTION I-ST. HELENA.

Garrison, 200. In 1880 only 194. Civil population (in 1881), 5,059. Until comparatively recently this small island was garrisoned by a local corps (St. Helena Regiment), which has now been disbanded.

The island has always been healthy; seated in the trade-winds, there is a tolerably constant breeze from southeast. The average mortality in the years 1859-66 was 9.75, or without violent deaths, 7.85. In 1867 the mortality from disease was only 5.24. In 1875 almost the same, viz., 5.41. There is very little malarious disease (about 50 to 60 admissions per 1,000 of strength), but there has frequently been a good many cases of "continued fever," and dysentery and diarrhoea are usual diseases. Formerly there appears to have been much phthisis, but this is now much less, giving another instance of the decline of this disease, as in so many other stations.

In the years 1837-46, the admissions from tubercular diseases averaged 21 per 1,000 per annum, and the deaths 5.45. In the years 1859-66 the admissions from tubercular diseases were 6.6; and the deaths 1.66 per 1,000. In 1867 there were no admissions. The health of the troops would have been even better if the causes of the continued fever and dysentery could have been discovered and removed, and if the amount of drunkenness had been less. The returns from St. Helena are now combined with those from the Cape of Good Hope.

SUB-SECTION II.-WEST COAST OF AFRICA.1

The principal stations are Sierra Leone and Cape-Coast Castle. The station of Gambia has now been given up, and troops are no longer stationed regularly at Lagos (500 miles from Cape-Coast Castle, and occupied in 1861). In 1875 Sierra Leone, Cape-Coast, and Accra were occupied, and Elmina for a short time, and since then the two first stations have been

1 For a very good account of the topography of the Gold Coast, see Dr. R. Clarke's paper in the Transactions Epid. Society, vol. i.

VOL. II.-21