Even as it is the number of admissions into Hospital, as well as the mortality among invalids is very great.
Returns send to us for twenty-two months proceeding October 31st, 1857, show that out of an average monthly strength of 749 there were 6,393 admissions into Hospital, and 142 deaths.
It would thus appear that the admissions per annum are four and a-half times the average strength, while the deaths to strength have been 103 per 1,000 per annum. Of these deaths nearly 40 per cent. arose from phthisis. This mortality, it must be remembered, takes place among invalids who have already passed through Hospital and been weeded there of the worst cases of death. There is sufficient reason for believing that the sanitary condition of these casemates acts injuriously on the health of the invalids in them.
St. Mary’s casemates are certainly te last places to which consumptive invalids ought to be sent, whether we regard their exposed position, the neighbouring wet marshy ground, or their very defective sanitary condition.
The real difficulty is to know what to do with them. Were there accommodation for the invalids elsewhere, they ought to be at once removed and the casemates vacated. While on the other hand it would require a large outlay to make them habitable as barracks for troops.
There appears to be no course open except to deal with them as we would do with a barrack, and to allot 600 cubic feet for each man in them.
We are of the opinion therefore:-
1. That 600 cubic feet of space be allowed to every inmate of the casemates.
2. That all the casemates be provided with additional means of ventilation by air shafts at the end opposite the door, and that perforated zinc panes be introduced into the fanlights to admit fresh air at all times, and that all the gas burners be ventilated.
3. That the lower casemates be floored with wood.
4. That the kitchens be fitted up with a suitable roasting and baking apparatus.
5. That the wash-house be fitted up with wooden gratings and stands for tubs, or with washing troughs, and that a suitable laundry stove be provided.
6. That the privies be converted into water latrines, with suitable flushing apparatus, and flushed out once a-day.
There are three guard rooms and two lock-up rooms connected with the casemates. They are all overcrowded and imperfectly ventilated.
1. The barrier guard room ought to accommodate, according to regulation, 12 men in 1,710 cubic feet of space, giving 142 feet per man. It happens to be occupied by one man.
The regulation number of men ought to be reduced from 12 to 3.
2. St. Mary’s guard room has regulation accommodation for 14 men, giving only 207 cubic feet for each. It ought to contain no more than 6 men.
3. The Magazine guard room has been 14 men where only 6 ought to be.
4. In St. Mary’s guard lock-up each inmate has only 262 cubic feet when it is occupied by the regulation number of 10 men. At 600 cubic feet per man it would hardly accommodate half the number.
5. The Regimental lock-up would accommodate 12 men in a space in which 20 men may be placed according to regulation.
All these guard rooms and lock-up places require ventilation through the ceilings and roofs, besides reduction of numbers so as to give 600 cubic feet per man.
We have made these recommendation in order that the more urgent defects n this establishment may be removed at the least expense; but were it practicable there can be no doubt as to the propriety of removing the troops and invalids from them entirely.
They are best adapted for use in cases of necessity, as, for instance, during a siege, when they may be the means of saving life – at present their effect is probably the reverse.
We have the honour to be, &c.
Sidney Herbert.
John Sutherland.
W.H. Burrell.
Douglass Galton.
