Observations on the Diseases of Seamen

The seventeen ships which arrived from England in February and March were much less affected with it than the rest of the fleet, which was, no doubt, owing to the wine, melasses, and sour krout, with which they were so amply supplied. Though these articles were all expended before leaving Jamaica, yet the good effects of them on the constitutions of the men were visible in the course of this passage.

The America was the most free from it of all the ships of the old squadron; and this was owing to the great humanity and attention of the captain21, who, as soon as any of the men were taken ill, allowed them wine and other refreshments from his private store. There was another proof in the Conqueror of the great importance of attending to this disease in its earliest stage. Mr. Lucas, the surgeon of this ship, by watching the first beginnings of it, by a proper regulation of diet, and the administration of the essence of malt and juice of limes, not only prevented the progress of the disease, but proved, that, with great attention, it may even be cured at sea. It is of the utmost consequence in this disease to put the men on the sick list on the very first appearance of the symptoms, so that they may early have the advantage of proper treatment and regimen. It is only at this period of it that the effects of essence of malt are sensible; but we have seen that the juice of certain fruits will cure it in more advanced stages.

There is a very important remark suggested by comparing the two preceding tables with that which follows. It appears that in the month of September a much greater number was taken ill of scurvy, and also that there died of this disease a greater proportion than in the two preceding months. All the mischief from it in that month happened in the first week of it, during which as many died as in the whole month of August; for the fleet came to an anchor on the 7th of September at New York, where the worst cases were immediately sent to the hospital, and those that remained on board were supplied with every necessary refreshment. Had the fleet remained longer at sea, the mortality would probably have increased in the same progression; and this circumstance ought to be well considered in undertaking cruises.

Table, shewing the proportional Prevalence of Sickness and Mortality in September

Transcriber’s Keys:

A Proportion of those taken ill in the Course of the Month.

B Proportion of Deaths, in relation to the Numbers of the Sick.

The proportion of deaths, in relation to the whole numbers on board, was one in three hundred and ninety-eight.

About one third of all the sick were sent to the hospital.

As the proportion of ulcers was uncommonly great, I thought it worth while to make a calculation of it. The Barfleur had the greatest number; and this ship, for causes I cannot assign, was more afflicted with bad ulcers than any other in the fleet, for several months together.

The fleet having arrived at New York in this unhealthy state, the first care was to make provision for the sick. There were somewhat more than fifteen hundred on the sick lists of all the ships, and the hospital could accommodate little more than six hundred. In order that it might not be overcrowded, and that each ship might have a just share of relief, I went round the fleet to ascertain the due proportion of those cases that were the most proper objects for being sent on shore. All the infectious and acute Complaints, and some of the worst scorbutics, were accordingly sent to the hospital. Those who were kept on board being chiefly such as were affected with the scurvy, were supplied with various refreshments in their respective ships, and seemed to recover as soon as if they had been sent on shore. They had indeed almost every advantage enjoyed by those at the hospital; for, besides fresh meat thrice a week, and spruce beer daily in common with the other seamen, each man on the sick list was supplied every week at the public expence with four pounds of apples and half a pound of sope. There were also thirty casks of limes taken in a prize, which were distributed among the scorbutic men, and proved of infinite use. Admiral Pigot’s great zeal for the good of the service, as well as his natural humanity, induced him to listen to whatever was proposed for the benefit of the men.

The supply of sope was a thing entirely new in the service; but the good effect of all the other articles would most probably have been defeated, unless the men had been furnished with the means of cleanliness, which is the most essential requisite of health. The advantage of this method will appear by the returns of next month to have been very conspicuous; and it was on this occasion more than any other that I saw realised in every particular the plan proposed in the memorial to the Admiralty. It may be added, that the sick that were left on board were not even without the recreation of the shore enjoyed by those at the hospital; for most of the captains had the attention to send daily on shore, for amusement and exercise, such as were able to walk. Thus there were all the advantages of an hospital obtained at much less expence to Government, and without the risque of intemperance, desertion, or infection, which are the inconveniencies connected with an hospital. What farther contributed to health at this time was, a large quantity of excellent wine with which the fleet was supplied.

Table, shewing the proportional Sickness and Mortality in October

Transcriber’s Keys:

A Proportion of those taken ill in the Course of the Month.

B Proportion of Deaths, in relation to the Numbers of the Sick.

The proportion of deaths in this month, in relation to the whole number on board, was only one in fourteen hundred and seventy-eight.

About one in twenty-nine of the sick was sent to the hospital.

There was, upon the whole, less sickness and mortality in this month than in any other during which I kept records of the fleet. This was, no doubt, owing in part to the climate, but was chiefly the effect of the extraordinary attention paid to the refreshments of the men. The fleet was here exactly in the same situation, and at the same season, two years before, but was not near so healthy.

Nor were the advantages derived from the great plenty of refreshments, procured at this time at New York, merely temporary; for the men’s constitutions were so much improved by them, that the part of the fleet which remained under the command of Lord Hood was at sea for twelve weeks without being affected by the scurvy. This was chiefly to be ascribed to the previous refreshments; for we have seen, that, in a passage of seven weeks from Jamaica to New York, the fleet was greatly affected with the scurvy, in consequence of not having had the advantages of fresh meat and vegetables when last in port. The climate had, no doubt, also a share in keeping off the scurvy; for the greater part of the twelve weeks was taken up in a cruise off St. Domingo; and, I believe, it never was known that a fleet was so long at sea, in a cold climate, without being greatly affected with this disease.

It appears, that though the proportion of fevers had increased somewhat this month over that of fluxes, yet the former were less fatal; and, I think, the true dysentery is more frequent in this climate, and more apt to prove fatal in its acute state, than in the West Indies. I have indeed preferred the term flux to that of dysentery, for this reason, that the symptoms in many cases did not rise so high as properly to constitute dysentery; and the disease proves fatal in the West Indies more frequently in the chronic than in the acute state. The fluxes were daily gaining ground when we left New York, and continued to prevail to a great degree in the Magnificent, which remained in that climate several weeks after us.

The climate and situation of the fleet had a greater effect in diminishing ulcers than any other complaints; for the proportion of them in this month is little more than one third of what it was in the last.

The calculation for October was made upon thirteen ships of the line, which sailed from New York on the 25th of that month.

The weather had then begun to grow cold; but few or none of the diseases peculiar to a cold climate had appeared. There occurred, while we were at New York, several cases of inflammation of the liver among the officers and men who came from the West Indies. It was remarked formerly, that this complaint hardly ever occurred in the West Indies; but it would appear that the residing there disposes to an inflammation of this organ upon changing to a colder climate.

The preceding summer had been uncommonly cold, not only in North America, but in the whole temperate part of the northern hemisphere, so far as I could learn by inquiry. In consequence of this, the crops failed in Europe, America, and the northern parts of Asia. The same circumstance had a remarkable effect on the reigning diseases of the season at New York; for, instead of the bilious complaints common in the end of summer and in autumn, a slight fever of the inflammatory kind had prevailed. An epidemic catarrh had spread all over Europe, and some part of Asia, in the earlier part of the year; and perhaps this was connected with the peculiar state of the atmosphere about this time. It was before observed, that there was something unusual in the state of the weather at Jamaica while the fleet lay there; and it is possible that this might be owing to the same general cause.

CHAP. VI

Account of the Health of the Fleet from its Departure from New York till the Conclusion of the War. – Passage to the West Indies – Account of the Ships there during our Absence – Arrival of a Squadron from England – Of these, two Ships only were healthy – Causes of this – Inflammatory Complaints in the Union – Probable Cause of these – Comparison of the two Squadrons – Increase of Sickness from Recruits brought from England – from French prisoners.

Thirteen ships of the line sailed from America for the West Indies on the 25th of October, under the command of Admiral Pigot, and the other half of the fleet was left under Lord Hood, to watch the motions of the French squadron, which was then at Boston.

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1

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.

2

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.

REMARKS

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.

WILLIAM TELFORD.

To Dr. Blane,

Physician to the Fleet.

3

Although this hurricane, in itself and its consequences, was so destructive to the lives and health of men, yet, with regard to the inhabitants on shore, it had a surprising and unexpected effect in mending their health. I wrote an account of this hurricane to the late Dr. Hunter, who communicated it to the Royal Society, and the following passage is extracted from it:

“The consequences of this general tumult of nature, on the health of man, was none of the least curious of its effects. I made much inquiry on this head, not only of the medical gentlemen who had the charge of hospitals, and of the physicians of the country, but of the inhabitants, and every one had some cure to relate either of themselves or their neighbours, in a variety of diseases. Nor could I find that either those who were in health, or those who were ill of any disease whatever suffered from it, otherwise than by its mechanical violence; but, on the contrary, that there was a general amendment of health. This is a fact, which I could neither credit, nor would venture to relate, were it not supported by so many concurring testimonies. It had a visible good effect on the acute diseases of the climate. The chronic fluxes, of which there were then some at the naval hospital, were cured or much relieved by it. But the diseases upon which it had most evident and sensible effects, were pulmonic consumptions. Some recent cases of phthisis, and even the acute state of pleurisy, was cured by it; and in the advanced and incurable state of it, the hectic fever was removed, and remarkable temporary relief afforded. A delicate lady of my acquaintance, who was ill of a pleurisy at the time, and passed more than ten hours in the open air, sitting generally several inches deep in water, found herself free of complaint next day; had no return of it; and when I saw her a few weeks after, was in much better health and looks then usual. The people observed that they had remarkably keen appetites for some time after, and the surviving part of them became uncommonly healthy; some of both sexes, whom I had left fallow and thin a few months before, looking now fresh and plump.

It is very difficult to account for this, as well as every thing else in the animal œconomy; but it was probably owing in part, at least, to the very great coldness and purity of the air from the upper regions of the atmosphere. Great agitation of mind sometimes also produces a revolution in health; and we know that the effect of external impressions in general is very different when the mind is vacant, from what it is when occupied and interested by objects, whether of pleasure and satisfaction, or of danger and suffering.”

4

In order to ascertain more exactly the degree of sickness in each month, a column was afterwards added to the form of the returns, expressing the number taken ill of the several diseases in the course of the month.

5

I was informed by Captain Caldwell, that when he commanded the Hannibal, of 50 guns, his crew was so much afflicted with the scurvy, in a passage of nine weeks from St. Helena to Crookhaven, in Ireland, that ninety-two men were confined to their hammocks in the last stage of that disease, though they had been supplied with sugar at St. Helena, and served with it on the passage. They remained three weeks at Crookhaven; at the end of which time every man was fit for duty: and though they had fresh provision, they had no fresh vegetables, so that their cure is to be ascribed to the use of lemons and oranges, which the Captain very humanely ordered to be purchased for them from on board of a foreign ship that happened to put into the same harbour.

6

See Appendix to Part II.

7

They were the Formidable and Namur, of 90 guns; the Arrogant, Conqueror, Marlborough, Hercules, and Fame, of 74 guns; the Yarmouth, Repulse, Prothée, Anson, and Nonsuch, of 64 guns.

8

These were the Prince George, of 90; the Bedford, Canada, and Royal Oak, of 74; the America and Prudent, of 64 guns.

9

This is a term in use for the different articles of seamen’s cloathing, particularly shirts and trowsers.

10

The mortification in the shoulder, mentioned above, was somewhat singular. It happened to a man in the Yarmouth, who, after being for a week ill of a fever and flux, was one day, early in the morning, seized with a pain in the upper part of the right arm, which immediately began to mortify. He soon after became convulsed, and died the same day about two o’clock.

11

Earthquakes are frequent in the West Indies, and perhaps proceed from a weaker operation of the same cause that originally produced the islands themselves, which seem all to have been raised from the sea by subterraneous fire. There are evident vestiges of volcanoes in them all, except Barbadoes; but there are other unequivocal marks of this island having been raised from the bottom of the sea; for it is entirely formed of coral, and other sub-marine productions, of which the strata are broken, and the parts set at angles to each other, as might be expected from such a cause. There is, perhaps, at all times in the caverns of the earth, elastic vapour struggling to vent itself, and when near the surface, it may sometimes overcome the incumbent masses of matter, and produce certain convulsions of nature. In the account of the hurricane which I wrote to Dr. Hunter, I gave reasons for believing, from the testimony of the inhabitants, that hurricanes are attended with earthquakes; and if a conjecture might be advanced concerning the cause of this, it might be said, that as the atmosphere is lighter at that time, by several inches of the barometer, the elastic vapour, confined by the weight of the incumbent earth and atmosphere, being less compressed, may exert some sensible effects, producing a sort of explosion.

12

Since the publication of the first edition of this work I have been informed that this complaint is not so rare on shore as in the fleet, which may be partly owing to the greater coolness of the air at sea, and partly from the seamen not having been a sufficient length of time in the climate to be affected with this disease, as few of them had been more than two years from England. But as this affection of the liver was very common in the fleets and naval hospitals in the East Indies, it is evident that there is a great difference of the climates in this respect. It is worth remarking, that it sometimes breaks out in the West-India Islands like an epidemic. The complaint, for instance, was very little known in the island of Grenada, till about the year 1785, when it became very frequent in a particular quarter of the island; and the gentleman who sent the description of it to England alledged, that there were the most unequivocal proofs of its being contagious. It was most successfully treated by very copious bloodletting, and in exciting a salivation by mercury. See Dr. Duncan’s Medical Commentaries, Decad. 2, vol. I.

13

Dr. Lind, on the authority of Mr. Ives, surgeon to Admiral Matthews.

14

London Gazette, June, 1781.

15

This is well illustrated by the manner in which Captain Nott, of the Centaur, was killed in Fort-Royal Bay. This brave man, having carried his Ship nearer the enemy than the rest of the line, but nevertheless at a great distance, had his signal made to keep the line, and having gone into his cabin, as it is said, to examine the import of the signal, a cannon ball struck him in the groin, and it was so far spent, that it stuck in his body. It tore away a whole plank of the ship’s side, the splinters of which killed a young gentleman, the only person near him.

16

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.

17

See Essay on the Yellow Fever, by Dr. Hume, in a Collection of Essays published by Dr. D. Monro.

18

Campbell’s Lives of the Admirals, Vol. IV.

19

The late Dr. William Hunter.

20

See Appendix to Part II.

21

Captain Samuel Thompson.