Observations on the Diseases of Seamen. Blane Gilbert
to ascertain more precisely the means of preventing and removing such diseases.
The favourable reception which the first edition of this work has met with, renders it necessary to offer another to the Public; and though no new opportunities have occurred of making additional observations in the naval service I have endeavoured, during the last two years, from a pretty extensive experience in a large hospital, and from private practice, to add some new information on some practical points; and I hope this edition will be found throughout more full and correct than the former.
The method I propose to follow in this work, is, First, to deliver the history of the different voyages and expeditions, so far as relates to health, giving an account of the prevalence and nature of the diseases and mortality on board of ships and in hospitals.
Secondly, To deduce, from observations founded on these facts, and also from the former experience of others, the causes of sickness in fleets, and the means of prevention.
Thirdly, To deliver some practical observations on the cure of the most common diseases incident to fleets, particularly in hot climates.
PART I
BOOK I
Comprehending the Medical History of the Fleet, from March, 1780, till August, 1781.
CHAP. I
Containing an Account of the Health of the Fleet from March, 1780, till July following. – Five Ships of the Line arrive at Barbadoes from Europe in March – Join a large Squadron then on that Station – Their Health compared – Engagements with the Enemy in April and May producing Hardship and Exposure, but little Increase of Sickness – Method of collecting the Returns of the Surgeons – Influence of Situation upon Health in Harbours – Course of the Seasons, and Temperature of the West Indies – The Fleet reinforced in June and July with Ships from England and North America – Their Health.
During the war, which broke out with France in 1778, and with Spain in 1779, the West Indies was the principal seat of naval operations, and much greater fleets were then employed in that quarter of the world than in any former period.
Though there had been a great squadron on the Caribbee station during the greater part of 1779, no physician was appointed to it till the beginning of the next year, when I arrived there in that character with my friend and protector, Lord Rodney.
There were then sixteen ships of the line on that station, most of which had been upwards of twelve months in the climate; and they were reinforced at this time by five more from England.
The squadron which we found on the station was then extremely healthy, and in several of the ships there was not a man unfit for duty. We were told, however, that they had all been subject to sickness, particularly to the dysentery, soon after their arrival in that climate. Of the five with which the fleet was at this time reinforced, all but the Intrepid left England at Christmas, making part of the squadron which effected the first relief of Gibraltar, under the command of Lord Rodney, who continued his route to the West Indies, in order to take the command on the Windward station, where he arrived on the 16th of March. The Intrepid had arrived with a convoy the day before. These five ships were all pretty healthy on their passage, except the Sandwich and Terrible, in which a fever prevailed; but they had almost recovered from it before they arrived in the West Indies. A dysentery broke out in April in all the ships newly arrived, and it prevailed to the greatest degree in those which had been most affected with fevers in Europe, namely, in the Terrible and Intrepid. The Sandwich and Ajax were also affected, though in a less degree; but the Montagu, though this was her first voyage, and though she was just off the stocks, had been the most healthy of any of them from the time of leaving England, and continued so during all this campaign. I have not observed that new ships are more unhealthy than others, unless they are built of ill-seasoned timber; and they have this advantage, that there is no previous infection adhering to them. What may have contributed also to the superior health of the Montagu, was the precaution that was taken when this ship was first manned and fitted out, of stripping and washing the men that were brought from the guardship to complete the crew.
The Intrepid, while in England, had been afflicted with fevers to a most uncommon degree; for, being one of the fleet in the Channel cruise the year before, almost the whole crew either died at sea, or were sent to the hospital upon arriving at Portsmouth. This ship, after refitting, was pretty healthy for a little time; but, probably from the operation of the old adhering infection, she became extremely sickly immediately after joining our fleet, and sent two hundred men to the hospital the first two months after arriving in the West Indies. Most of these were ill of the dysentery.
The Pegasus frigate arrived with the ships from Gibraltar, and we have here an instance of the superior health commonly enjoyed by this class of ships over ships of the line; for when she was dispatched to England in the end of April, there had not been a man taken ill from the time of her arrival on the station.
This season was a very active one in the operations of war; for, besides the general battle of the 17th of April, there were two partial actions in May; and, from the 15th of the former month till the 20th of the latter, our fleet was constantly in the face of the enemy’s, except for a few days that it was refitting at St. Lucia after the first battle. This was extremely harrassing to the men, not only from the incessant labour necessary in the evolutions of the fleet, but by their being constantly at quarters with the ships clear for action; for, in that situation, they had nothing to sleep upon but the bare decks, the hammocks and bedding being removed from between decks, where they might embarrass the men in fighting, and they become useful on the quarter deck, by serving to barricade the ship, which is done by placing them in ranges on the gunwale, to cover the men from the enemy’s grape and small shot. These hardships were productive of some sickness, though much less than might have been expected; for the weather is at all times warm, and it was at this time extremely moderate and dry. Besides we shall see in other instances as well as this, that, in the ardour inspired by the presence of an enemy, men are less exhausted by their exertions than on ordinary and less interesting occasions.
Almost the whole of the sick and wounded, to the number of 750, were put on shore at Barbadoes, where all the fleet, except three ships1, arrived on the 22d of May.
I now began to keep regular and methodical accounts of the sickness and mortality in the fleet, though in a manner more imperfect and less accurate than was afterwards adopted. I was embarked on board of the Sandwich, where the Commander in Chief had his flag, so that I was always present with the main body of the fleet, whether at sea or in port.
A form of monthly returns2 was adopted, which, as well as other points of method, was afterwards improved.
After collecting the returns for each month, I made abstracts of them in tables; in one column of which the complement of each ship is set down, in order to form calculations of the comparative prevalence and mortality of different diseases at different times. One of the abstracts is here inserted, (Table I.) by way of specimen, and the proportional result of them for fourteen months is set down in another table, (Table II.)
Though this last exhibits a tolerably just view, yet it may be remarked, as one imperfection, that there was no distinction made at this time in my returns between the killed and those who died of disease; so that in the month of May, which stands first, the proportion is too high; for there were sixty-four killed, and two hundred wounded, in the two actions of that month.
Transcriber’s keys:
A Complement.
B Sick and Wounded on Board.
C Sent to the Hospital in the course of last Month.
D Dead on Board in the course of last Month.
The main body of the fleet lay at Barbadoes till the 6th of June, and the men had recruited extremely by
These were the Conqueror, the Cornwall, and the Boyne, which were so damaged in the battles, that they were obliged to bear away for St. Lucia.
The following may serve as a specimen of these returns:
State of Health of His Majesty’s Ship Alcide. Carlisle Bay, Barbadoes, 1st June, 1781.
During the course of last month we had one hundred and fourteen of the men, who contracted the scurvy in the late long cruise, recovered by the use of limes, which were procured at Montserrat. A pint of wine, with an equal quantity of water, made agreeable with sugar and tamarinds, is served to each patient daily. The regimen is exactly the same as mentioned last month.
Since we came into port, very few have been seized with scurvy, but several complain daily of fluxes and feverish complaints, none of which seem at present to be of any consequence.
Four patients have last month complained of an almost total blindness towards evening, accompanied with head-ach, vertigo, nausea, and a sense of weight about the precordia. The pupil is then extremely dilated, but contracts readily when a strong light is presented to it. Two of them had the scurvy in a high degree, one of them slightly, and the other seemed entirely free from it. I am not well acquainted with the nature or cure of this disease, which I believe is called Nyctalopia by some systematic writers.
I gave those who were affected with it an emetic, which brought up a great deal of bile, and relieved the symptoms both of the head and stomach. This encouraged me to a repetition of it, which seemed also to be attended with benefit. I likewise applied blisters behind the ears, and gave bark and elixir of vitriol, with the antiscorbutic course, to those that required it.
I can form no probable conjecture concerning the cause of this disease. I have observed a dilation of the pupil in scorbutic patients, and they complained of a cloud before their eyes, with imperfect vision, which disappeared as the scurvy went off.
To Dr. Blane,
Physician to the Fleet.