Observations on the Diseases of Seamen. Blane Gilbert
to what was before remarked, that fevers were more apt than fluxes to prevail in the bad air of a harbour16. It was also before remarked, that there were few or no fluxes in those ships in which the fever was most malignant; and now that the fever began to grow more mild in the French prizes, the flux began to appear. In the Barfleur, Duke, and Namur, both diseases seemed to prevail equally; but the fevers, though numerous, were more of the low nervous kind than bilious or malignant; and the fluxes chiefly attacked those who were recovering from fevers. We may farther remark, that these three men of war were three-decked ships, of 90 guns, the crews of which being more numerous, and composed of a more mixed set of men, were consequently subject to a greater chance of infection, and a greater variety of complaints. The Formidable still remained healthy to an extraordinary degree. Some fevers were indeed imported from the Ville de Paris by men that had been lent to that ship, and who were taken ill after their return. Of these, a few of the worst cases were sent to the hospital, and two died on board, who, with one that died the preceding month, make the whole mortality of this ship, since leaving England, amount only to the loss of three men.
There has been little or no increase of scurvy this month; for though the numbers put on the list appear to be greater, the mortality is much less. It may indeed appear a matter of surprise that there should have been any scurvy at all, considering that the greater part of the fleet was at anchor all this month. But as this was the greatest fleet that had ever visited Jamaica, it was impossible to find fresh provisions for the whole; and the small supply they had did not amount to one fresh meal in a week. Port Royal is also remote from the cultivated part of the island, so that fruit and vegetables were both scarce and high priced, particularly this year, on account of the usual rains in May and June having failed. There was, however, an allowance of fresh provisions and vegetables made to the sick by public bounty; for as the hospital could contain but a small proportion of the sick and wounded, an order was given for the supply of fresh meat, fruit, and vegetables, to the sick, and five hundred pounds of Peruvian bark were also distributed as a public gratuity, besides sugar, coffee, and wine.
With these aids, and the various good articles of victualling from England, the fleet was preserved uncommonly healthy for a West-India campaign: for though the mortality had increased considerably during our stay at Jamaica, yet the loss of men, upon the whole, was small, compared with that of other great fleets in this climate on former occasions. The greatest squadron, next to this, that had ever been on this station was that under Admiral Vernon in the year 1741, at the same season. From this fleet upwards of eleven thousand men were sent to the hospital in the course of that and the preceding year, of whom there died one in seven, besides what died on board of their own ships and in two hospital ships17. The disproportion of sickness in the two fleets will appear still greater, when it is considered that Admiral Vernon’s contained only fifteen thousand seamen and marines18; whereas that under Lord Rodney contained twenty-two thousand. What added to the sickness of the former was the unfortunate expedition to Carthagena in April, 1741; to which probably it was owing that a much greater proportion of yellow fevers were landed from the fleet at that time than from ours, as appears by the papers left by Mr. Hume, who was then surgeon of the hospital. The hospital was then at a place called Greenwich, on the side of the bay opposite to Port Royal, and was very large; but it was found to be in a situation so extremely unhealthy, that it was soon after abandoned and demolished, and the hospital has since been at Port Royal.
It appears by the tables, that a greater number was put on the list under the head of other complaints in this month than the last. This was owing to the great number of ulcers which I have remarked to keep pace with feverish as well as scorbutic complaints; for when the constitution of the air is favourable to disease, or the habit of body prone to it, wounds and sores are found then to be more difficult of cure. There were twelve deaths besides those occasioned by what have been called the three epidemics. Of these, five perished by drowning and other accidents, three died of ulcers, one of wounds received in action, one of cholera morbus, and one of an abscess.
It has appeared that very few ships of this numerous fleet preserved their health while lying at anchor; and it would seem that short and frequent cruises are very conducive to health. It was eleven weeks from the time that the first of our fleet came to anchor at Jamaica till the main body of it sailed for America on the 17th of July. Great fleets are in time of war under the necessity of being at one time longer at sea, and at another time longer in port, than is consistent with the health of the men, the ships being obliged to act in concert and to co-operate with each other. This is one reason, among others, for ships of the line being more sickly than frigates. As ships of war must be guided by the unavoidable exigencies of service, it would be absurd to consider health only; but if this were to be the sole object of attention, a certain salutary medium could be pointed out in dividing the time between cruising and being in harbour; and it is proper that this should be known, that regard may be had to it, as far as may be consistent with the service. I would say, then, that in a cold climate men ought not to be more than six weeks at sea at one time, and need not be less than five weeks, and that a fourth part of their time spent in port would be sufficient to replenish their bodies with wholesome juices. In a warm climate men may be at sea a considerable time longer, without contracting scurvy, provided they have been under a course of fresh and vegetable diet when in port.
Though contagion is not so apt either to arise or to spread in this climate as in colder ones, there were several circumstances about this time tending to prove that it may exist in a hot climate. Those ships which had their men returned to them from the French prizes, in all of which fevers prevailed, had an increase of sickness not only in the men that were returned, but in the rest of the crew. There was another presumption of contagion, from the proportion of mortality among the surgeons and their mates, who were by their duty more exposed to the breath, effluvia, and contact of the sick. There died, during our stay at Jamaica, three of the former, and four of the latter, which is a greater proportion than what died of any other class of officers or men.
It has been the opinion of some, that fevers do not arise from any putrid effluvia, except those of the living human body, or some specific infection generated by it while under the influence of disease. It has been alledged in proof of this, that the putrid air in some great cities is breathed without any bad effects; and a celebrated professor of anatomy19 used to observe, that those employed in dissecting dead bodies did not catch acute diseases more readily than other people. I believe this may be true, in a climate like Europe, where cold invigorates the body, and enables it to resist the effects of foul air; but I am persuaded it is otherwise in tropical climates. The external heat of the air induces great languor and relaxation, and we cannot breathe the same portion of air for the same length of time in a hot as in a cold climate, without great uneasiness. The want of coolness must, therefore, be compensated by a more frequent change of air, and by its greater purity: any foulness of the air is accordingly more felt in a hot climate; and, according to the modern theory, air, already loaded with putrid phlogistic vapour, will be less qualified to absorb the same sort of vapour from the blood in the lungs, in which, according to this theory, the use of respiration consists. Be this as it will, there is something in purity of air which invigorates the circulation, and refreshes the body; and the contrary state of it depresses and debilitates, particularly in a hot climate; and in this way foul air may induce disease, like any other debilitating cause, independent of infection, or any specific quality. There was no reason to suspect any such infection in the Ville de Paris; for there was no sickness on board of this ship when in possession of the enemy, and the sickness that prevailed after her being captured seemed to proceed from what may be called simple putrefaction. There was an instance of the same kind in one of our own ships of the line, in which a bad fever broke out in the beginning of July, which seemed to be owing to the foul air of a neglected hold; for there was a putrid stench proceeding from the pumps, which pervaded the whole ship. I perceived this very sensibly one day, when visiting some officers who were ill of fevers; and before I left the ship an alarm was given of two men being suffocated in what is called the well, which is the lowest accessible part of the hold. This fever was of a very malignant kind, and fell upon the officers more than the men; for six of them were seized with it, of whom three died on the third
I have seen an account of the diseases of the army at St. Lucia for a whole year, kept by Mr. Everard Home, an ingenious gentleman belonging to the army hospital, and it appears, that, during ten months out of the twelve, the dysentery was the predominant disease. This seems to contradict the opinion, that the land air is more apt to occasion fevers than fluxes; but it is to be remarked, that the sickness of the soldiers on this island was not so much owing to the malignant influence of the air, the situation of the garrison being high and airy, as to the bad accommodations and provisions, together with hard labour.
See Essay on the Yellow Fever, by Dr. Hume, in a Collection of Essays published by Dr. D. Monro.
Campbell’s Lives of the Admirals, Vol. IV.
The late Dr. William Hunter.