Observations on the Diseases of Seamen

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 (#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 (#APPENDIX_TO_PART_II).

21

Captain Samuel Thompson.

22

As my own stay at different ports was short, and as my own knowledge could not extend beyond that period, Dr. Farquarson, First Commissioner of Sick and Wounded Seamen, very politely gave me leave to inspect the books of the different hospitals at his office, and I collected from them the fate of all the men that were landed.

23

It is proper to mention, that the name of the disease in the hospital books being taken from the ticket sent on shore with each sick person, great accuracy is not to be expected, as this is frequently done in a careless manner. My returns were made with great exactness; and, in the latter part of the war, the hospital books may also be depended upon in this respect, the tickets, at my request, having been made out with accuracy.