Page 31 - Who Was Sapper Brown

The Mystery Epidemic

The cause of Sapper Brown’s death is given as ‘Remittent Fever’, a descriptive rather than a diagnostic
term. This fever was rife that particularly hot summer and autumn amongst the soldiers and sailors

stationed in Britain’s Mediterranean possessions, and throughout the Levant.29-30 In Cyprus alone, in the
latter six months of 1878, there were 2,203 admissions to hospital with remittent fever, compared to 895

for ague [malaria], and only 14 for enteric fever [typhoid].31

‘The fever which made its appearance in the Mediterranean Fleet at Cyprus, in the month of July [1878],
was remittent.’
32

This descriptive term fell out of use a few years later during the dawning golden age of microbiology,
when advances in microscopic techniques in the next decade helped elucidate the cause of many of the

killers of the 19th century.

So what was this mystery illness that killed Sapper Brown? The answer is supplied by a much greater
man, practically contemporaneous with Sapper Brown, who became a giant of the medical profession

and of the Royal Army Medical Corps, and a Fellow of the Royal Society, Major General Sir David
Bruce. He was medical officer in charge of the Station Hospital in Malta from 1884 to 1888, in the rank

of Surgeon Captain:

‘Before long I was at work trying to find out the nature of Malta Fever. This at the time [1884] was thought
to be malarious in origin and was usually returned as Remittent Fever. At least the moderately severe cases

were called “Remittent”, the really severe and fatal cases were usually returned as “Enteric” and the very

mild cases as “Febricula”’.33

This feverish and debilitating illness was eventually named brucellosis in 1920 in honour of Sir David
Bruce, who discovered its causative organism in Malta in 1887, barely nine years after Sapper Brown’s

death.34 David Bruce would later chair the Mediterranean Fever Commission in 1904–1906 that
discovered that this widespread disease was caught by drinking milk from infected goats, a discovery

that was accompanied by serious controversy.35

29 ‘The summer of 1878 was an exceptionally unhealthy season in Malta, as it was in Cyprus, and generally throughout the
Levant. In the three battalions of British infantry, about 2,400 men, quartered here [Cyprus] during the hottest months of the
year, there were only [sic] 22 deaths, of which only 11 were owing to malarious fevers.’ Quoted from: Report, 1 March 1879, by

Surgeon General A D Home VC, KCB. Op cit. http://cypruslibrary.moec.gov.cy/ebooks/27395/files/search/searchtext.xml.
30 Veale, Surgeon-Major H (1881), ‘Report on the cases of fever from Cyprus, Malta and Gibraltar that were treated in
the medical division of the Royal Victoria Hospital, Netley, during the year 1879’ Army Medical Department, Appendix III to
Report for 1879. pp. 260–276.

31 Army Medical Department Annual Report (1878)
32 Statistical Report of the Health of the Navy for the year 1878
33 Sir David Bruce. Lecture to medical students at Aberdeen University, 2 June 1922.

34 In his original communication describing his discovery of the micro-organism responsible for Malta fever, Bruce gives
a sketch of the prominent features of this fever: ‘It is a disease of long duration, ninety-one cases treated in this hospital during
1886 having an average stay in hospital of 85.5 days. The fever, which often runs high, is continued, remittent, and intermittent in

type... Besides the rise in temperature, the spleen is usually found to be enlarged, and the patient suffers from profuse sweating and
sudamina... Relapses are almost invariable, accompanied or followed by pains of a rheumatic or neuralgic character, sometimes
swelling of joints, or orchitis. The mortality is as a rule exceedingly small... In some years, however, the disease appears to be more

virulent. In the present year, for example, up to the middle of July, as many as nine deaths from this fever have occurred among the
British soldiery in Malta.’ Bruce D (September 1887), ‘Note on the discovery of a micro-organism in Malta Fever.’ The Practi-
tioner; Vol. 39, No. 3, pp. 161–170
35 Vassallo D J (1996), ‘The saga of brucellosis: controversy over credit for linking Malta fever with goats’ milk.’ The Lancet,

Vol. 348, pp: 804–808. (For the record, stung by criticism, Bruce wrote to The Times to clarify to whom credit was due: ‘it may
be well to state that the actual observation which led up to this discovery was made by Dr T Zammit, the Maltese member of
the Commission; and this is clearly described in the introduction to Part III of the Commission’s Reports.’ Bruce D. The Times, 1

October 1907, p. 9.)

21