Observations on the Diseases of Seamen

It has been observed before, that one use of frequent reviews and musters in a numerous crew is, to call forth men that would otherwise be overlooked, to oblige them to come into the open air, to keep themselves clean, and to prevent them from indulging in filth and laziness. It is observed, that seamen are in general less subject to scurvy than marines and landsmen, which seems to be owing to the greater activity of their life and alacrity of their minds.

There is an essay on the causes of the pestilence, by an anonymous author, published at Edinburgh in 1759, in which this disease is said to be entirely the offspring of idleness, and he illustrates this by its being more apt to arise in besieged towns than any other situation; and he alledges that a false alarm of the plague will actually produce it by throwing people idle, as was the case, he affirms, when the plague was last at Messina.

There are always numbers who have been pressed into the service, to whom a sea life is new, and who are therefore prone to indolence, low spirits, and self-neglect. Men of this description are by far the most apt to fall into the scurvy; and next to the quality of the food, there is nothing contributes more to promote the scurvy than such a disposition. It is indeed both a cause and a symptom of this disease, and therefore idleness and skulking should be rigidly discouraged, unless the complaint is so far advanced as to render it cruel and even impossible to force men to take exercise.

The Conqueror, of 74 guns, one of our squadron in the last year of the war, was an instance of a ship in which only the prime seamen were attacked with the scurvy, and this is to be accounted for upon the same principle, for it proceeded from their having been exempted from the duty of pumping, in which the inferior classes of men were constantly employed, owing to the leaky state of the ship.

As low spirits and indolence have such an unfavourable effect upon health, it would be wise, as well as benevolent, to promote whatever produces jollity, contentment, and good humour, so far as is consistent with sobriety and regularity. There are certain rough sports which are now almost in disuse; and whoever would revive and encourage them, would perform a useful office to the service.

A sea life frequently demands violent temporary exertions, from the uncertainty of the weather, and other incidents; so that men are more exposed to extreme fatigue and sudden calls of duty in this than in any other situation of life. Nothing tends more to shorten life than excessive bodily labour and watching; and it is for this reason that seamen in general are short lived, and that their countenance and general appearance make them appear older than they really are by several years. This is remarkably the case when a seaman comes to be upwards of forty and it has been mentioned before, that a person not acquainted with this circumstance will make a mistake of ten years in guessing at the age of a seaman from his looks.

Fatigue being therefore frequently the means of bringing on disease and breaking the constitution, as much tenderness is due to men as is consistent with the necessary duties of service. This is a circumstance in which young officers are apt to forget themselves; and they should take care how they call all hands wantonly, and oblige men to make exertions beyond their strength, especially as this will be submitted to more readily by sailors than any other set of men, from the generous alacrity of their nature.

It would be well if it could be rendered convenient at all times, except in cases of danger or emergency, to put the men at three watches instead of watch and watch. By the former arrangement they have eight hours sleep and rest; by the latter only four hours are allowed, which is not sufficient for refreshment, nor is there time for them to get dry, in case they have been exposed to wet.

It would be a good rule to have as few men as possible out of bed in the night-time, unless where active service renders it necessary; for, if unoccupied, they lie about the decks, fall asleep, and catch cold. In such situations, might not all the topmen but one remain on the forecastle, where they might take exercise, which they could not do aloft? I am indebted for this remark to the Rev. Mr. Ramsay, who joins to a great knowledge of the sea service a warm and disinterested zeal for its prosperity, and has been so good in several other instances as to communicate to me the results of his experience and observation.

The good effects resulting from the indulgent treatment of men are, that it encourages them to enter into the service, and to do their duty with cheerfulness and resolution. There is something more daunting to the mind of man to see his companions suffering under oppression and languishing in disease, or perishing miserably from sores or sickness, than in the terrors of fire and sword, which, as we have seen, make the least part of the calamities of war. The good treatment of seamen, in so far as it regards their health, is by no means incompatible with strict discipline. Indeed strictness and even severity is necessary with seamen; for it is observed with regard to men who are used to arbitrary government, that they cannot bear indulgence and relaxation. But the steady enforcement of discipline and regularity is so far from being akin to cruelty, that it tends to prevent both sickness and the commission of crimes, consequently rendering the infliction of punishment less frequent and necessary. The chief excellence in the character of an officer seems to consist in uniting strict discipline with indulgence and humanity.

CONCLUSION

The subject of the preceding remarks has been the prevention of diseases and it has appeared that the means of this are not so much in the province of the medical profession as of those who are entrusted with the direction of the navy in a civil or military capacity; and that with regard to cure and recovery also, a great deal depends upon them, by their having it in their power to make a suitable provision of proper diet and cordials. The great importance of the subject will plead my excuse for again calling to mind, that such attentions are not only dictated by humanity, but would be the greatest wisdom in an œconomical and national light, considering how expensive it is to replace men and to support invalids, not to mention that it is upon the health and lives of men that every public exertion essentially depends, and upon which may depend not only the character of officers, but the national character in the day of battle.

It must be confessed, that though there is still room for improvement, the navy is now on a better footing with regard to the health and comfort of seamen than it appears to have been in former times. The victuals were in general in the late war of excellent quality; the civil branch has shewn in many instances a readiness to adopt the means and to furnish the articles that were recommended for the health of the men[84 - See Part I.]; and most of the commanders whom I have the honour to know are humane, attentive, and intelligent.

To conclude; there is no situation of life in which there is room for more virtues, more conduct and address, than that of a sea officer. The men are thrown upon his humanity and attention in more views than one: they are subject to a more arbitrary exertion of power than the constitution of the date authorities in civil life, Englishmen giving up into his hands, from considerations of public expediency, that which they hold most dear, and of which they are most jealous, their LIBERTY. It is the character of seamen to be thoughtless and neglectful of their own interest and welfare, requiring to be tended like children; but from their bravery, utility, and other good qualities, they seem entitled to a degree of parental tenderness and attention from the state they protect and the officers they obey.

APPENDIX TO PART II

In order to exhibit a concise view of the most material observations contained in this part of the Work, a Memorial, delivered to the Board of Admiralty in October, 1781, is here subjoined.

MEMORIAL,

Proposing Means for preventing the Sickness and Mortality prevailing among His Majesty’s Seamen in the West Indies.

I have for the two last years attended a squadron, consisting seldom of less than twenty ships of the line, in quality of physician to the fleet at Barbadoes and the Leeward Islands. I received, by the order of the Commander in Chief, a monthly return from the surgeon of each ship, setting forth the diseases, deaths, and other circumstances of the respective ships companies. I also superintended the hospital of the place where the fleet happened to lie when in port. These advantages have afforded me an intimate knowledge of the nature and causes of the sickness and mortality among the seamen, both on board of their ships and in hospitals.

It appears by my returns, that there died in the course of the twelve months preceding July last, on board of ships, seven hundred and fifteen seamen and marines, of whom only fifty-nine died in battle and of wounds. There died in the same time in hospitals eight hundred and sixty-two: so that out of twelve thousand one hundred and nine men, which is the sum total of the complement of twenty ships of the line, there have perished in one year one thousand five hundred and seventy-seven, that is nearly every seventh man.

There were also sent to England in the same year, three hundred and fifty men, disabled by lameness and chronic complaints, the greater part of whom will be for ever lost to the service.

The degree of sickness is very different at different times; but it appears by the returns, that, at a medium, there has been one man in fifteen on the sick list.

Having employed all the attention of which I was capable to find out the causes of this sickness and mortality, in order, if possible, to point out the means of prevention, I flatter myself with being able to assign the most general causes, and to propose some effectual remedies.

When it is considered that sickness is almost entirely confined to ships of two and three decks, and that some of these are as healthy as frigates and merchant ships, though in the same circumstances of service with others that are extremely sickly, we are led from hence to infer, that sickness is not in its own nature unavoidable, and we are encouraged to hope, that the attainment of general health is within the compass of human management.

I humbly and earnestly solicit attention to some of the most material observations and conclusions which have occurred in the course of a service, which, though short, has been extensive; and whatever is here proposed has this recommendation, that it is easily practicable, and is no addition to the public charges.

First, I hardly ever knew a ship’s company become sickly which was well regulated in point of cleanliness and dryness. It is the custom in some ships to divide the crew into squads or divisions under the inspection of respective officers, who make a weekly review of their persons and clothing, and are answerable for the cleanliness and regularity of their several allotments. This ought to be an indispensable duty in ships of two or three decks; and when it has been practised, and at the same time ventilation, cleanliness, and dryness below and between decks, have been attended to, I have never known seamen more unhealthy than other men. The neglect of such attentions is a never-failing cause of sickness.

I would, therefore, with all becoming deference, suggest, that such a regulation, instead of being left to the discretion of officers, should be made a part of the public instructions. From some commanders, who already practise these rules, the advantage of them comes to be known; and would not a public sanction not only render them general and permanent, but facilitate the duty of the officer, by making such a regulation appear a matter of legal necessity, instead of his own arbitrary act?

Secondly, Scurvy is one of the principal diseases with which seamen are afflicted, and this may be infallibly prevented, or cured, by vegetables and fruit, particularly oranges, lemons, or limes. These might be supplied by employing one or more small vessels to collect them at different islands, and such an expedient would prevent much sickness, and save many lives. I am well convinced that more men would be saved by such a purveyance of fruit and vegetables, than could be raised by double the expence and trouble employed on the imprest service; so that policy, as well as humanity, concur in recommending it. Every fifty oranges or lemons might be considered as a hand to the fleet, inasmuch as the health, and perhaps the life, of a man would thereby be saved.

Thirdly, The use of wine, in place of rum, has been found extremely conducive to health. In the course of my observation I have met with the most unquestionable proofs of the benefit that would arise from this substitution. It is a farther reason for such a change, that good rum is seldom or never supplied in the West Indies.

Fourthly, The necessaries provided for the sick by the present establishment are not at all adequate, especially on a distant station, where the supply is not regular, and the quantity at best is such as can contribute but little to their comfort and recovery. An ample provision might be made for the sick, without any additional expence, in the following manner:

It is a rule in the service, that though men are sick, their ordinary allowance of salt meat and other victuals is nevertheless served out, and is either used by the other seamen, who stand in no need of it, or is wasted. Now, if the pursers were instructed to provide themselves with certain species of necessaries, such as Madeira wine, sugar, rice, and dried fruits, to serve to the sick, in place of rum, and the common provisions of the ship, such a regulation would be productive of the very best effects, in recovering the health, and preserving the lives of those men who have the misfortune to be taken ill in a situation necessarily destitute of most of the comforts that can alleviate their sufferings. I cannot help here applauding a late regulation, by which melasses are substituted for part of the oatmeal; for the quantity of the latter heretofore legally allowed was so much greater than what was necessary, that one half of it has commonly been wasted.

It is to be observed, in general, with regard to the West Indies, that ships on service are to be considered, in a great measure, in the light of ships constantly at sea; for, excepting the island of Barbadoes, there is no other port in which fresh meat and vegetables can be procured in any quantity, and therefore sour krout, melasses, and such other articles of antiscorbutic diet as can be supplied on board, are absolutely necessary. Fleets could hardly exist here, were it not that a warm climate is naturally more unfavourable to the scurvy than a cold one.

Fifthly, Though the health of a ship’s company depends chiefly on diet, and that discipline and order which is the business of officers, yet much depends also on the medical art, particularly in the West Indies; and as surgeons frequently cannot do justice to the men without wronging themselves, in a country where the price of every thing is exorbitant, and medicines often unsound, Government would find its account in supplying gratuitously some of the most costly articles, particularly Peruvian bark in a fresh state, from time to time, from England.

Sixthly, It is now the general custom to send every sick person on shore to an hospital, where there is frequently worse air and worse accommodation than on board, from overcrowding the apartments. Contagious diseases, though not so common as in Europe, are here often mixed with those that are not so, whereby numbers are infected and carried off; and, besides this, the land air is infinitely more unwholesome in the West Indies than the air at sea or in a road. The scurvy is perhaps not at all contagious, nor is it very difficult of cure; but a number of cases of it terminate fatally from the flux or fever, caught either by contagion in hospitals, by the noxious influence of land vapours, or by intemperance. I beg leave, therefore, humbly to suggest, that as few sick as possible of any disease, but what is contagious, be sent to hospitals, and that some method be established for the supply of vegetables and other refreshments to the sick on board of their ships.

Seventhly, Crowding, filth, and the mixture of diseases, are the great causes of mortality in hospitals. There should be a space of five hundred cubic feet allowed for each man; and in general the sick had better remain on board than be crowded beyond that degree; or relief should be provided to the hospital by an hospital ship, which, for reasons already given, is preferable to any accommodation on shore; and such an institution would be more particularly proper for the reception of convalescent men.

I would beg leave, therefore, earnestly to recommend that cleanliness, the separation of diseases, and a competent space, be regularly enjoined and strictly enforced in hospitals; and in order to make this more practicable in the great scale of service now going on, I would farther propose that hospital ships be established for the reception of the sick or recovering. I know from extensive experience and close observation, that these circumstances are more essential than even medicine and diet.

These are a few remarks extracted from a series of observations, and derived from great opportunities of experience. Many other remarks would suggest themselves; but I purposely confine myself to what is highly important, and easily practicable, with little or no addition to the public expence. Some of the improvements recommended are indeed an immediate, and all of them will be an eventual, saving to the public.

The alterations that have been proposed are,

1st, The establishment of a certain method and discipline, in order to secure regularity and cleanliness among the men, and to render the ships clean and dry.

2dly, The supply of fruit and other vegetables for the cure of the scurvy.

3dly, The substitution of wine[85 - Had I then known the salutary effects of porter and spruce beer, of which I have since been convinced, I should have proposed them as substitutes for rum.] for rum.

4thly, The provision of an adequate quantity of necessaries for the sick.

5thly, The gratuitous supply of certain medicines.

6thly, The curing of certain diseases on board instead of sending them to hospitals; and,

Lastly, The preventing of filth, crowding, and the mixture of diseases in hospitals, by proper regulations, and by establishing hospital ships.

I beg leave again to call to mind, that 1518 deaths from disease, besides 350 invalids, in 12,109 men, in the course of one year, is an alarming waste of British seamen, being a number that would man three of His Majesty’s ships of the line; and what I advance is from a real conviction that a due attention to the above-mentioned propositions would save more than two thirds of the seamen that would otherwise die in that climate. It was to set this in a proper light that I requested leave to quit my duty during the absence of the greater part of the squadron in the hurricane months; and should any thing I propose meet with public approbation, and be carried into effect, I should esteem it a recompence far above any other gratification I can derive from the service.

London,

October 13, 1781.

To the Right Hon. the Lords Commissioners of the Admiralty.

Next year the following Supplement to the preceding Memorial was sent to the Board of Admiralty: