Observations on the Diseases of Seamen

I have exhibited, in another Table, a view of the sickness and mortality of this fleet for the five succeeding months. (Table IV (#TABLE_IV).) This account, as well as most of those that are to follow, is confined to three diseases, that may be called the sea epidemics. These are, fever, flux, and scurvy.

The whole fleet met at Barbadoes on the 13th of January, and no service was undertaken till the accounts of the Dutch war arrived on the 30th of that month. In consequence of this intelligence, the greater part of the ships of war went against St. Eustatius, which was taken on the 3d of February.

Ten days after this a squadron of seventeen ships of the line was sent to cruise to windward of Martinico, with a view to intercept a French squadron which was then said to be on its passage from Europe. The cruise was there continued for six weeks; after which small divisions of the ships were sent to water and refit, by turns, at St. Lucia, and were relieved by the ships left for the protection of that island.

Soon after this, the whole squadron came to leeward of Martinico; and though the former intelligence had proved false, the greater part of our fleet still kept the sea, in order to block up the enemy in Fort-Royal Bay. This they continued to do till the 29th of April, when a French fleet of twenty-two ships of the line, from Europe, joined by four from Martinico, forced their way into their own port, pushing to leeward our fleet, consisting only of eighteen ships of the line; so that the greater part of them did not get into port till they came to an anchor at Barbadoes on the 23d of May.

It was in this season of cruising, and keeping the sea, that the fleet contracted such a degree of scurvy as had never before been known in the West Indies. This disease is not so apt to arise in a hot climate as in a cold one; and the prevalence of it on this occasion was owing to the men having been for a great length of time upon sea victualling; for one part of the fleet had not had a fresh meal from the time of leaving America, that is, for six months; and that part of it which came last from England had been in the same circumstances for seven months; nor had any of them been in a place capable of supplying vegetable refreshments from the time they left Barbadoes in the end of January. But though no fresh meat or vegetables could be procured at St. Lucia or St. Eustatius, yet the scurvy did not make such progress in the ships that lay at anchor there, as in those that were at sea; and it appears that the time in which it prevailed most was, while the greatest number of ships was at sea, that is, in the month of March. It appears, indeed, by the Table, that there was a greater number ill of this complaint on the 1st of May than on the 1st of April; but it appears also, that more were sent to the hospital in March than in April, and very near half of the May list must have been taken ill in March[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.]. The difference of being in port and at sea consists chiefly, 1st, In there being plenty of water while in port, so that it can be used freely, not only to drink, but to wash the clothes; and we know that cleanliness tends greatly to ward off the scurvy. 2dly, Though no fresh meat nor vegetables could be procured at those ports, sugar, which may be considered as a very antiscorbutic article of diet, could always be procured at a very cheap rate, and the seamen, when in port, used to exchange their salt provisions for it. 3dly, There is at sea a dismal uniformity of life, favourable to indolence and sadness, and therefore tending to hasten the progress and aggravate the symptoms of the scurvy; whereas the change of scene and variety of objects, when in port, tend to cheer and recreate the mind, and thereby to avert this disease.

The squadron that came from England under Lord Hood, suffered, upon the whole, much less from acute diseases, during the first months of their service in this climate, than the ships that arrived with Lord Rodney, which was probably owing, in part at least, to the former having arrived at the driest and coolest season of the year. The Barfleur, however, had a large proportion of all the three prevailing diseases; and large ships are in general more subject to them than those of a smaller rate. But of all the ships in the fleet, the Alfred had the greatest proportion of the three sea epidemics. The Prince William suffered more than any other ship in the fleet from the flux, and the Princessa from the scurvy. In some instances, reasons can be assigned for the prevalence of particular diseases in particular ships, such as accidental infection, or the manner in which they have been victualled, manned, or disciplined; but in many cases the cause is so subtile or obscure as to elude our inquiry.

The most healthy of the new squadron, during this campaign, were the Belliqueux and Panther; the former was a new ship, and came from England with a very irregular and ill-disciplined crew. Soon after arriving in the climate, she was threatened with a dysentery, which, though it spread a good deal, did not prove severe nor mortal; but being left at St. Eustatius on this account, while the rest of the fleet was cruising, she soon became very healthy, and remained so. This is the second instance we have had occasion to remark of a new ship being healthy.

The Panther preserved her health by being on small separate cruises, and frequently in port, not being attached to the main squadron. The Sandwich was the only other ship not engaged in the long cruise.

Of the ships lately from England, that were employed in this cruise, the Gibraltar seems to have been the least sickly. This ship left England healthy; but having received a draft of dirty men when upon the eve of sailing, a fever of the infectious kind broke out on the passage, so that she arrived in the West Indies in a sickly state. This fever disappeared very soon after; and it is proved by this, as well as other facts, that a warm climate, so far from tending to generate, or even to foster the infection of fever, tends rather to extinguish it. The Gibraltar had been put under excellent discipline by her former commander, while in the Channel service; and this being afterwards kept up, the men were always clean and regular. This was the Spanish Admiral’s ship, taken by the fleet under the command of Lord Rodney off Cape St. Vincent’s, in January 1780. She was then called the Phœnix, and was of a singular excellence both with respect to materials and construction. Whether the cedar, of which a great part of her timbers consisted, contributed to the healthiness, by its balsamic effluvia, I will not pretend to determine.

The Invincible was also uncommonly healthy during this cruise, which may likewise be ascribed to good discipline, and to her having been more than three years in commission before sailing from England, whereby the men were brought into order, and accustomed to each other and to a sea life. This ship was almost singular in having no acute diseases for several months after arriving from Europe; but at length paid the tribute to the climate in May and June, as may be seen in the Table.

From the account of the three frigates at the bottom of the list in the Table, it appears how much more healthy they are than ships of the line. The total complements of the three is exactly equal to that of one seventy-four-gun ship; but their whole sickness and mortality is less than that of any one ship of the line of that class, although the Triton was uncommonly sickly for a frigate.

There seem to be several causes for the superior degree of health usually enjoyed by this smaller class of ships. There is less chance of mixtures of men in frigates, as their complement is smaller, and it is more easy for the captain and officers to keep an eye over a few men than a great number; for, in a great ship, there are generally men, who, concealing themselves in the most retired parts, no one takes cognizance of them, and they destroy themselves, and infect others, by their laziness and filth. In the next place, there is a greater proportion of volunteers and real seamen in frigates, and more landmen and pressed men in ships of the line, the former being more in request, on account of the greater chance of prize money. Lastly, a small ship is more easily ventilated, and the mass of foul air issuing from the hold, from the victuals, water, and other stores, as well as the effluvia exhaling from the men’s bodies, is less than in a large ship.

Many other and more minute remarks might be made on different ships in this season of hard service; but to do this would be tedious, and the inspection of the Tables may suggest observations to the reader. There is a striking and instructive fact, however, with regard to two ships, which I cannot help relating. The Alcide and Invincible, both of seventy-four guns, in working to windward, after the action with the French fleet, on the 29th of April, anchored at Montserrat on the 11th of May, in order to water. They remained there only part of two days, and they procured no refreshment, except a few bushels of limes. The scurvy then prevailed to a great degree in both ships; but between this time and the 23d of May, when they came to an anchor at Barbadoes, sixty men, who had been confined with this disease, were discharged, as fit for duty, from the sick list of the Invincible, and a hundred and fourteen from that of the Alcide. These were the only two ships that had the advantage of the limes; and during these twelve remaining days of the voyage the scurvy continued to increase in all the other ships. Dr. Lind is the first author who gives a decided preference to lemons, limes, and oranges, over every other antiscorbutic; and the above-mentioned fact proves as demonstrably as possible the infinite advantage of this species of acid in scurvy.

The fleet was supplied with essence of malt during all this campaign; and though it was, no doubt, of service, it was far from having that powerful and manifest effect that the acid fruits had, and certainly did by no means prevent the scurvy in all cases. I have strong testimonies, however, of its beneficial effects from the surgeons of several of the ships, particularly of the Gibraltar, Centaur, Torbay, and Alcide, in all of which it was found either to cure the scurvy in its first beginning, to retard its progress, or to mend the appearance of scorbutic ulcers, and dispose them to heal.

I had conceived that melasses, being a vegetable sweet, must have been a very powerful antiscorbutic; but the greatest part of the last reinforcement of seven ships came from England furnished with this as an article of victualling, as a substitute for a certain proportion of oatmeal, which was withheld agreeably to a late very judicious order of the Admiralty. But though I am persuaded that this article of diet mitigated the disease, it was very far from preventing it; and the Princessa in particular, which suffered most from the scurvy, was well supplied with it.

There is reason to think that it is not in the vegetable sweet alone that the antiscorbutic principle resides, but in this in conjunction with the natural mucilage, such as exists in the malt. I suspect likewise that the change which the essence undergoes in its preparation tends also to rob it of some of its original virtue. But the melasses are still farther altered by being deprived of the natural mucilage by means of quick lime, with which all sugar is clarified in the boilers. Dr. Hendy, of Barbadoes, to whom I have been obliged for several remarks, informed me, that the liquor, before it undergoes this operation, has been found by him to produce the most salutary effects in the scurvy; but as this cannot be had at sea, we had no opportunity of comparing it with other antiscorbutics. It is certain also that the medical effects of the native sweet juices are, in other respects, very different from what they are in their refined state; for manna, wort, and the native juice of the sugar cane, are purgative; whereas sugar itself is not at all so[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.]. This affords a presumption, that they may be also different in their antiscorbutic quality; and there is reason to think, from experience, that the more natural the state in which any vegetable is, the greater is its antiscorbutic quality. Vegetables, in the form of sallads, are more powerful than when prepared by fire; and I know, for certain, that the rob of lemons and oranges is not to be compared to the fresh fruit. Raw potatoes have been used with advantage in the fleet, particularly by Mr. Smith, of the Triton, who made the scorbutic men eat them, sliced with vinegar, with great benefit. This accords also with what Dr. Mertans, of Vienna, has lately communicated to the Royal Society of London.

When the fleet arrived at Barbadoes on the 23d of May, it was found that the number of sick on board amounted to sixteen hundred, and that there was not accommodation for more than two hundred at the hospital. As there was hardly any complaint but scurvy, the Admiral, at my representation, issued an order for serving the sick on board of their own ships with fruit and other vegetables and refreshments, such as milk and soft bread. This course of diet commenced in the beginning of June; and as the greater part of the fleet was near four weeks thereafter in port, they enjoyed the advantages of it during that time; and the very great diminution of sickness and mortality, which appears by the Tables in that month, sufficiently evinces the benefit derived from it. In less than four weeks the fleet, from being very sickly, became extremely healthy.

It was remarked, that the men recovered faster on board than on shore; and it would appear that land air, merely as such, has no share in the cure of the scurvy, and that the benefit arises from the concomitant diet, cleanliness, and recreation. The expedient of curing men on board of their ships was here suggested by necessity; but it succeeded so well, that it was adopted afterwards in preference to an hospital, which is indeed a useful relief to a fleet where there are contagious, acute disorders; but with regard to scurvy, I am convinced, that on foreign stations, at least, where the accommodations of the sick are more indifferent than in England, many advantages would arise from supplying men with refreshments on board of their ships. It appears that only four men died of this disease in the whole fleet in the month of June, though there were so many ill of it; whereas it appears by the books of hospitals, that scorbutic men die there in a much greater proportion, and chiefly in consequence of other diseases, particularly the flux, which they catch by infection, or bring on by intemperance. It is farther in favour of this scheme, that great numbers of those sent on shore are lost by desertion. It is also a great saving to Government, the expence not being a fourth part of what it would cost at an hospital.

The fleet left Barbadoes on the 10th and 12th of July, and continued healthy till the greater part of it sailed for North America in the beginning of August.

PART I

BOOK II

Continuation of the Medical History of the Fleet, from August, 1781, till the Conclusion of the War in April, 1783.

CHAP. I

Some Account of the Interval between the Campaign of 1781 and the Junction of the Reinforcement from England in April, 1782. – The main Body of the Fleet goes to North America – Lord Rodney goes to England, and returns to the West Indies with twelve Ships of the Line – Health of the Fleet in England – Sickness most prevalent in the Beginning of a War – A natural Tendency to Recovery in Ships and Individuals – Advantages of this Squadron in point of Victualling.

When the main body of the fleet went to America in August, Lord Rodney went to England for the recovery of his health. – Wishing to lay before the public boards several reforms that suggested themselves to me in the course of the late service, I accompanied the Admiral, purposing to return when the season for hostile operations should have brought back the fleet from the coast of America.

Soon after arriving in England, I presented a memorial[6 - See Appendix to Part II (#APPENDIX_TO_PART_II).] to the Board of Admiralty, proposing such means for the preservation of the health of the fleet as had occurred to me during my past service.

The Board of Admiralty considered this memorial with all the attention that could be expected in the general hurry of service, inseparable from a great and extensive war; and I am happy in being able to say, that, in consequence of my application, most of the particulars recommended have since been so far carried into effect as to produce a practical conviction of their utility.

Lord Rodney having recovered his health, hurried out to his station with all the force that could then be equipped, as the enemy were expected at the Caribbee Islands, with a superior force, after their successes against us in the autumn campaign in America.

I had again the honour to accompany the Admiral. He first sailed from Portsmouth, with four ships of the line, on the 14th of December, and was to have been joined by two more that lay ready at Plymouth; but by the time we arrived off this harbour the wind became contrary, whereby we were detained there till the 14th of January, 1782. During this time more ships were got ready, and six were added to the squadron; for the public anxiety at that time called forth every exertion to strengthen this reinforcement, upon which the fate of the whole West Indies was supposed to depend.

This fleet cleared the Channel in the midst of a storm, and with the wind at the same time so scanty, that we barely weathered Ushant; but Lord Rodney’s perseverance and resolution, stimulated by the exigency of the occasion, banished all hesitation and timidity. The rough weather, and contrary winds, continued through the variable latitudes; but having met with fresh blowing trade winds, common at that season, we had the good fortune to get safe to Barbadoes with the whole squadron on the 19th of February.

All the twelve ships[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.] of this reinforcement had been on service for a considerable length of time since they had been last commissioned, except the Anson, a new ship, which had never before been at sea, and the Fame and Yarmouth, which had lately undergone a thorough repair, since which time they had been only for a few weeks at sea in the Channel before they were ordered on this expedition.

The only ship that was sickly when we left England was the Fame, on board of which some pressed men, with the infection about them, had been received from the Conquestadore guardship; and the fever which broke out in Plymouth Sound, where I was first sent for to visit that ship, was probably owing to the infection which these men brought with them. The other ships were, upon the whole, healthy; for it appeared by the weekly accounts delivered to the Admiral, that the mortality, including even that of the Fame, for the four weeks before we sailed, had been only one in thirteen hundred, and that there had been about one in twenty-nine on the sick list.

An opportunity offered on this occasion of comparing the health of ships of war in England with that in the West Indies. The health of the fleet in general at home was at this time about the proportion above mentioned; but it is to be remarked, that it was healthier then than in the former part of the war.

Plymouth hospital, which is calculated for twelve hundred men, was not half full; and there were not at this time more than six hundred men at that of Haslar, which is calculated to contain two thousand; but the latter was generally full during the first two or three years of the war, from the great fleets that put into Portsmouth. At one time part of the sick were even obliged to be accommodated with tents in the neighbourhood of the hospital, for want of room. But towards the end of the year 1781 the infectious fever, which constitutes a great part of the sickness in the European seas, was almost extirpated, and in a cruise of five weeks in the north part of the Bay of Biscay, under Admiral Darby, in September and October of this year, only six men were buried in that time from twenty-eight ships of the line.

This was chiefly owing, as I apprehend, to the length of time which the war had continued, in consequence of which the men of the respective ship’s companies had been accustomed to each other, and habituated to the mode of life peculiar to a man of war, regulating themselves according to certain rules of good order and cleanliness. The causes of the fever above mentioned, as shall be more fully illustrated hereafter, are chiefly connected with the circumstances occurring in the beginning of a war, when men of all descriptions are mixed, without proper precautions being taken to guard against the infection imported from jails or guardships. The sickness in the French fleet was still greater in the beginning of the war than in the British; and this has been the case in all the wars of this century. In the fleet commanded by the Comte d’Orvilliers, in 1779, the sickness was so great as to disable many of the ships from service, and great numbers of men were landed at Brest, with a fever so malignant as to infect the inhabitants of the town and country adjacent. I believe, besides, that the general health prevailing at this time in the fleet in England, was, in part, owing to the sour crout and melasses, which were now supplied more amply than had ever been done before. The entire exemption from scurvy in particular is to be ascribed to these improvements in diet.

There is a tendency in acute diseases to wear themselves out, both in individuals that labour under them, and when the infection is introduced into a community. Unless there was such a vis medicatrix, there could be no end to the fatality of these distempers; for the infectious matter would go on multiplying itself without end, and would necessarily destroy every person who might be actually attacked, and would infect every person who might be exposed to it. But animal nature is so constituted, that this poison, after exciting a certain set of motions in the body, loses its effect, and recovery takes place; and those who happen not to be infected at first, become in some measure callous to its impression, by being habitually exposed to it. There is, therefore, a natural proneness to recovery, as well with regard to that indisposition which takes place among a set of men living together, as with regard to a single individual who actually labours under the disease. Thus the most prevailing period of sickness is when men are new to their situation and to each other, so that time of itself may prove the means of prevention as well as of cure.

This consideration, however, ought not to supersede any part of our attention with regard to the scurvy, which does not become spontaneously extinct like acute diseases.

During the three first weeks of this passage from England to the West Indies, there was wet and boisterous weather, but it had very little effect in augmenting sickness; and though it not only subjected the men to fatigue, cold, and damp, but prevented the ships from opening their lower-deck ports till the 2d of February, between the 31st and 32d degree of latitude, thereby producing close air and moisture where the men sleep, yet, in the whole squadron, from its leaving England till this time, there were only seven deaths, four of which were in the Fame.

The only sea epidemic that made its appearance was the infectious ship fever, which, in many cases, was attended with pleuritic, rheumatic, and other inflammatory symptoms, owing to the cold and wet, to which the men were exposed in the variable latitudes. The warm, dry, fresh breezes which we had during the remainder of the passage, were probably what prevented any bad consequences from the former hardships, for there died only four men from the above-mentioned date till we arrived at Barbadoes; and it appeared by the Admiral’s weekly account, that the proportion of the sick neither increased nor diminished from the time we got into a warm climate and fine weather till our arrival on the 19th of February.

This squadron left England with several advantages in point of victualling, which no ships had before enjoyed. They were amply supplied with sour crout and melasses; they had all more or less wine, of an excellent quality; and the Formidable had an entire supply of it, in place of spirits, of which none was put on board. This slip had hitherto, and did for some months afterwards, enjoy an extraordinary, perhaps an unparallelled, degree of health. What farther contributed to the health of this ship was, that she had been long in commission, and most of the recruits with which the crew had been completed were men turned over from other ships. There was also extraordinary medical attention paid, particularly in watching the first beginnings of complaints.

Upon the arrival of the squadron at Barbadoes, it was found, that, the two hostile fleets having returned from North America in the beginning of December, the campaign had opened with the siege of St. Christopher’s, which had been invested by twenty-eight ships of the line, and a considerable army. Our fleet, under Lord Hood, having attempted, with great enterprise and skill, but without success, to relieve it, Lord Rodney made haste to join them with the reinforcement he had brought from England. He remained at anchor at Barbadoes only one night, and in a few days came off Antigua, where he was informed of the surrender of St. Christopher’s; and here, on the 25th of February, he was joined by the rest of the fleet in their return to windward.

CHAP. II

Account of the Health of the Fleet from the Junction of the Squadron from England, till the general Rendezvous at St. Lucia in the Beginning of April. – The Fleet found on the Station very healthy – Health of the Ships from the American Station – Health of the Ships from England compared with that of the Ships found on the Station – Small-pox prevalent – Instance of the remarkable Efficacy of Lemon Juice in curing the Scurvy – Additional Reinforcement from England – Watering Duty dangerous and unhealthy – The most healthy Ships those that had been longest in the Climate – List of the Numbers taken ill of each Complaint in March – Inflammation of the Liver not common in the West Indies.

The fleet which was found in the West Indies consisted of all the sixteen that went from thence to America in August, 1781, (except the Terrible, which had been lost) together with six ships of the line[8 - These were the Prince George, of 90; the Bedford, Canada, and Royal Oak, of 74; the America and Prudent, of 64 guns.] from the American station, the St. Albans, which arrived from England in November, and the Russel, which had remained in the West Indies during the hurricane months. They were all extremely healthy, having only one man in twenty-eight on the sick list, and very few had been sent to hospitals.

This fleet, after arriving from America, had lain at anchor for three weeks at Barbadoes, where it had the advantage of the vegetable refreshments which that island affords; but during three weeks that it lay at anchor, in the face of the enemy, at St. Christopher’s, the men were excluded from all communication with the shore, and had no vegetable food, except some yams, with which they were supplied from Antigua, in place of biscuit, of which there was at this time a scarcity. These ships had therefore been in no port for six weeks, except for a few days that they lay in the road of Antigua refitting, and putting the sick and wounded on shore.

The men had also been deprived of their natural rest, and exposed to the air during all the time that the fleet was at anchor before St. Christopher’s; for they had been twice attacked by the enemy in that situation, and were therefore under the necessity of keeping the ships constantly clear for action; yet no increase of sickness followed. This might partly be owing to the eagerness and alacrity of spirits naturally excited in such a situation, and also to the fleet not lying under the lee of any land, and having springs upon their cables, so that they had all the perflation and all the purity of air which ships enjoy when at sea. The fumigation which ships undergo in battle, has also been thought to contribute to their health.

To whatever cause it was owing, the fleet we found in the West Indies was at this time healthier than that which had just come from England; and there was but little difference in the degree of health of the different ships that composed it. Of those which left the West Indies in August, and returned in December, the only one that could be said to have any epidemic disease was the Prince William, which had never got entirely free from the dysentery that was formerly mentioned as prevailing so much on board of this ship last year. The disease was kept up, by the ship never having been cleared of the men affected with it, and by the crew in general being ill provided with slops[9 - This is a term in use for the different articles of seamen’s cloathing, particularly shirts and trowsers.], a circumstance that would render them more susceptible of whatever infection they might be exposed to.

There were also some remains of the same disease in the Intrepid, the seeds of it having been more or less continued from the summer of 1780, at which time it prevailed to a most violent degree. The Alfred had a few of all the sea epidemics, and had been for a long time before more or less in the same situation, from a neglect of cleanliness, particularly of the men’s persons.

The only ship in which there was any thing like an epidemic was the Canada, This ship, when at home, had for many months before she sailed been in unremitting service, and very little in port. On the passage from England to America, in August, 1781, there broke out a severe dysentery, to which the scorbutic habit of the men, from being so long at sea, probably predisposed them. Though it had abated much in February, 1782, it was then by no means extinct, and continued till April. The Prince George had been in commission all the war, and was a model of discipline and cleanliness, and consequently of health. This continued till the passage from America, when, upon the first cold weather after leaving New York, there broke out a violent dysentery, of which sixteen men died. This is agreeable to what Dr. Lind observes, that the flux may be brought on by a sudden transition, either from cold to heat, or from heat to cold. All the men that were ill of this disease having been sent to the hospital at Barbadoes, and the usual attention to cleanliness having been kept up, the disease entirely vanished.

All the other ships of the American station had been more or less visited with sickness after they left England, except the Bedford. This was probably owing to this ship having been longer in commission than any of the others, that is, for four years, and all that time under the same commander. This last circumstance falls to the lot of few ships; but a great advantage attends it; for the mutual knowledge and attachment of the captain and ship’s company is naturally productive of regularity and good discipline, and thereby of health.