Observations on the Diseases of Seamen

N. B. The Ships marked thus, *, came from England in February and March, 1782.

All the Ships named in the Table were in the Engagements in April, except the Ramillies and the two Frigates.

In the Spaces marked thus, §, no Return was made.

Might not this extraordinary degree of health have also been owing, in part, to the effects of success upon the spirits of the men? It is related[13 - Dr. Lind, on the authority of Mr. Ives, surgeon to Admiral Matthews.], that, when the fleet under Admiral Matthews was off Toulon, in daily expectation for some time of engaging the combined fleet of France and Spain, there was a general stop put to the progress of disease, particularly of the scurvy, from the influence of that generous flow of spirits, with which the prospect of battle inspires British seamen. But if the mere expectation and ardour of a battle, without any happy event, could have such a sensible effect, what must have been the effect of the exultation of VICTORY, a victory in which the naval glory of our country was revived and retrieved, after a series of misfortunes and disgraces, which had well nigh extinguished the national pride in every department of service! The plain and honest, though unthinking seaman, is not less affected by this than the more enlightened lover of his country. Even the invalids at the hospital demonstrated their joy, upon hearing of this victory, by hoisting shreds of coloured cloth on their crutches.

It would appear, that there is something in situations of exertion and danger, which infuses a sort of preternatural vigour. When the mind is interested and agitated by active and generous affections, the body forgets its wants and feelings, and is capable of a degree of labour and exertion, which it could not undergo in cold blood. The quantity of muscular action employed in fighting at a great gun for a few hours, is perhaps more that what is commonly employed in a week in the ordinary course of life, and though performed in the midst of heat and smoke, and generally with the want of food and drink, yet the powers of nature are not exhausted nor overstrained; even the smart of wounds is not felt; and the future health of those who survive unhurt by external violence is so far from being injured, that it is sometimes mended by this violent, but salutary agitation.

The loss in action, and the number of mortal wounds, were not so great as might have been expected in a battle continued for a whole day. This advantage was owing to the superiority of our fire, as well as to the closeness of the fight, of which the Commander in Chief set the illustrious example, by penetrating the enemy’s line with his own ship; a bold and singular effort which first decided the event of the day. When ships in action are opposed to each other at a small distance, the velocity of cannon balls is so great, that in penetrating a ship’s side, few or no splinters are torn off; and by these more men are commonly killed and wounded, than by the ball itself. For the same reason, a close shot does less damage also to the ship itself, than a distant one; for a quick-flying ball makes an aperture less than its own diameter, whereas a spent one produces innumerable deadly splinters, at the same time shivering the object it strikes, and making wide and extensive rents in it. The proportion of the wounded to the killed, is also greater in distant, than in close fight, on account of the great number of small splinters; and we have an experimental proof of this, in comparing the action in Fort Royal Bay in April 1781, with this near Dominica in April 1782. In the former, the enemy having kept far to windward, and engaged at a great distance, the proportion of the wounded to the killed was considerably more than four to one[14 - London Gazette, June, 1781.]; whereas in the latter, where the greater part of the battle was close, the proportion of the wounded to the killed, was little more than three to one[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.].

Though it is a remark not belonging to a medical work, yet it may be observed, that the greatest advantage that arose to us from close action was, that the fire of the enemy was thereby silenced; for the advantages would be mutual and equal, on the supposition, that the French, in such a situation, were to keep the deck, and stand to their guns equally well with the British seamen.

It appears, by examining the table, that the ships in which the fevers chiefly prevailed this month, were those that came last from England, and that those in which the fluxes prevailed most were chiefly of the squadron we found on the station, namely, the Canada, Resolution, and Prince William. The latter however recovered greatly in the course of this month. Some of the Ships that arrived last from England, namely, the Arrogant, Prothée, and Anson, were also considerably afflicted with fluxes, but they were of an extremely mild kind; and the small number of deaths from this disease in comparison with those from fevers, is a proof of a former observation, that this is the safest form in which an acute disease can shew itself. This small degree of mortality was also owing to the judicious method of treating it which was in general practised throughout the fleet; and it is but justice to the medical gentlemen to say, that they shewed on this, as well as every other occasion, great skill and attention in the treatment of the sick and wounded.

The sum total of fevers and fluxes that have been put on the list this month, is much the same as that of the preceding month; but the proportion of fluxes in April is much greater.

The proportion of scurvy is somewhat increased; which is not to be wondered at, when it is considered, that though the fleet had not been so long at sea as is necessary to produce it, especially in this climate, yet the men having had no refreshments when last in port, may be considered as having been all that time at sea.

The superior degree of health in this month will appear in a still stronger light, if we cast our eye on the column expressing the number sent to the hospital, the proportion of which is, comparatively, very small.

The ships that had been the longest from England, were still among the most healthy. But of all the fleet, none was so free from sickness and mortality as the Formidable. No man belonging to this ship died of disease for the first four months after sailing from Plymouth, though there were at times 900 men on board, and never less than the established complement, which is 750; and so few were taken sick in that time, that only thirteen were sent to hospitals, and their complaints were small-pox and ulcers.

This ship left England provided with every thing that could be supposed to conduce to the health of men, and may be considered as an experiment to prove what degree of health may be attained by proper management and attention. She was furnished not only with abundance of sour krout, melasses, and essence of malt, in common with the other ships; but what was peculiar to her, was an entire supply of excellent wine, in place of spirits, of which none was used during the period mentioned.

CHAP. IV

Account of the Health of the Fleet while it lay at Jamaica during May, June, and Part of July, 1782. – French Prizes Causes of Sickness – Their Difference from the English in point of Cleanliness and Discipline – Bad Effects of Land Wind and Watering Duty – Situation of Port Royal – Season uncommonly dry and windy – Fluxes more prevalent at Sea than in Harbour – Comparison of the Sickness at this Time with that of the Army and with that of the Squadron under Admiral Vernon forty-one Years before – Effects of Contagion and foul Air – Officers more affected than the common Men.

All the squadron that was left to windward of Jamaica, consisting of twenty-four ships of the line, kept the sea during great part of May, the last division of it not having come to Port Royal till the 25th of that month.

The whole fleet remained in harbour during the remainder of the month, and the whole of the next, except the Warrior, Prothée, and Russell; the two former were sent on a cruise, in which the Warrior continued quite healthy, as she had been ever since her arrival from England; and in the Prothée a great check was given to the fevers and fluxes which had begun to prevail at Port Royal. The Russell was sent to England with a convoy.

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

Transcriber’s Keys:

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

B Proportion of those that died in relation to the Numbers of Sick or wounded.

The whole number of sick on board on the first of this month, in thirty-six ships of the line and two frigates, upon which the preceding calculation is formed, was one thousand four hundred and eighteen. The whole number taken ill in the course of the month was two thousand eight hundred and twenty-eight; the number sent to the hospital was one hundred and seventy-three; and there died on board ninety-four.

The proportion of those who died this month, in relation to the whole number on board, was one in two hundred and eighty-seven.

There was a considerable increase of sickness and mortality this month in all the common diseases, and chiefly in that part of the squadron which was in port. There was less increase in the number of fevers than either of the other two epidemics; but such was their increased malignancy, that more died of them than of both the others. The number of fluxes was more than double of what it was the preceding month, and the mortality from them was also in a much greater proportion, as may be seen from the Tables.

The fevers prevailed chiefly in port, and the fluxes at sea. A good many of the latter, indeed, arose in the Alcide, though constantly in port; but this seemed to be owing to contagion conveyed by some British soldiers, who were sent on board of this ship after being retaken in one of the French men of war, several of whom were ill of this disease. But there were few fluxes in those ships at Jamaica in which the most malignant fevers appeared. There were a few in those in which the fevers arose from the air of the marshes on the watering duty; but there were none on board of the French prizes, nor in those ships in which that sort of fever was which proceeded from a similar cause, that is, filth and animal effluvia. Upon the whole, in those ships in which the fever was most malignant, there the fewest fluxes were found.

Several circumstances contributed to the increase of sickness and mortality this month.

1st. The infection, or rather the foul air, of the French prizes, in most of which a very bad fever broke out among the officers and men that were sent from the ships of our fleet to take charge of them.

The discipline and internal œconomy of the French ships of war are greatly inferior to those of the British. Their decks are never washed, and there is a great defect in every point of cleanliness and order. The free course of the air is obstructed by lumber of every kind, and by bulkheads, which are not taken down even in the time of battle; and the gratings are covered night and day with tarpaulins, even in a hot climate. There are not even scuppers opened on the lower deck as outlets to the water and filth, which necessarily accumulate there, and for which the only vent is a pipe contrived on purpose, passing from that deck along the ship’s side into the hold, which becomes thereby a common sink, inconceivably putrid and offensive. And in addition to the ordinary causes of corruption, there was one peculiar to the occasion; for the blood, the mangled limbs, and even whole bodies of men, were cast into the orlop, or hold, and lay there putrifying for some time. The common sailors among the French have a superstitious aversion to the throwing of bodies overboard immediately after they are killed, the friends of the deceased wishing to reserve their remains, in order to perform a religious ceremony over them when the hurry and danger of the day shall be over. When, therefore, the ballast, or other contents of the holds of these ships, came to be stirred, and the putrid effluvia thereby let loose, there was then a visible increase of sickness. For the first three weeks after the capture, the stench proceeding from the numbers of wounded men contributed also to taint the air.

The Ville de Paris was much more sickly than the other prizes, not only from her being larger, and thereby containing a greater mass of foul air, but by receiving the surviving part of the crew of the Santa Monica, one of our frigates, which had been cast away on the Virgin Islands, and whose men were so reduced by hardship and intemperance, that most of them were taken ill as soon as they came to breathe the unwholesome air of the French prize. To whatever cause it was owing, the fever was much more violent here than in the other prizes, and it generally carried men off on the third or fourth day; and what is remarkable, the officers were affected by it in a greater proportion than the common men. One lieutenant, and every warrant officer, except the boatswain, died of it. This was a proof that the sickliness was owing to the bad air, and not to the intemperance and irregularity so usual on board of prizes, which only the common men give into; and the probable cause of the officers being most affected is, that they were accustomed in common to a purer air, by living in the most clean and airy parts of the ship.

It is also remarkable, that the Ville de Paris was healthy when taken, and had been so ever since leaving France in March, 1781; nor had any other of the captured ships of the line been sickly for some time before, except the Ardent, when she arrived at Martinico four months before, at which time the greater part of the crew were sent to the hospital with fevers. This, as well as other facts of the same kind, tends to prove, that when men come to be much habituated to bad air, their health is not affected by it.

The French ships were purified by washing and scraping, by fumigating daily with gunpowder and vinegar, and by the use of wind sails; but nothing seemed to contribute so much to sweeten the air in them as burning fires in the hold; for this tended both to make the putrid matter exhale, and to carry it off, by producing a perpetual change of air. Captain Curgenven, who at this time commanded the Ville de Paris, had great merit from his very assiduous and successful endeavours in so difficult a duty as the management and equipment of this great ship. In consequence of the judicious measures taken, and the men becoming more used to the bad air, the sickness ceased in the course of a few weeks.

In the accounts given in the tables, the French prizes are not included, for the disorderly state in which they were at this time prevented my receiving regular returns: but having made inquiry concerning the mortality in the Ville de Paris, I found, that of a crew of three hundred and twelve men, there died ten in the month of May, and there were thirty sent to the hospital, whose cases were so unfavourable, that about one half died. The only diseases were fevers. The surgeon of the Ardent told me about the same time, that one third of the crew of that ship was ill of fevers.

The second cause of the prevalence of sickness, while the fleet was at Jamaica, was, the watering duty, which was carried on at Rock-fort, about three leagues from Port Royal. It was the practice of many of the ships to leave the water casks on shore all night, with men to watch them; and as there is a land wind in the night, which blows over some ponds and marshes, there were hardly any of the men employed on that duty who were not seized with a fever of a very bad sort, of which a great many died. The ships that followed a different practice were somewhat longer in watering; but this was much more than compensated by their preserving the health and saving the lives of their men.

The land wind which blows on the shore in the night time, is a circumstance in which Jamaica differs from the small islands to windward, over which the trade wind blows without any interruption: but though this land wind blows upon Port Royal from some marshes at a few miles distance, it does not seem to produce sickness, for it is a very healthy place, and several of the ships enjoyed as good health as in the best situations on the windward station. The bay which forms this harbour is bounded towards the sea by a peninsula of a singular form, being more than ten miles in length, and not a quarter of a mile broad at any part. Great part of it is swampy and overgrown with mangroves, and though of such small extent, we fancied that some of the ships that lay immediately to leeward of this part were more sickly than those that were close to the town of Port Royal, which stands at the very extremity of this long peninsula upon a dry, gravelly soil.

The weather this month was uniformly dry in port; but at sea the air was moist and hazy. Between Jamaica and Hispaniola, where part of the squadron was left to cruise, dead calms prevailed; and this, joined to the moisture of the air, was probably what caused the flux to prevail chiefly in this part of the fleet. At Port Royal, on the contrary, there was a strong dry breeze, which set in every day about nine o’clock in the morning, and blew all day so fresh, that there was frequently danger in passing from one ship to another in boats. This is called, in the language of the country, the fiery sea breeze, an epithet which it seems to have got not from its absolute heat, but from the feverish feeling which it occasions by drying up the perspiration. It was remarked, that this breeze was stronger this season than had ever been remembered; and it sometimes even blew all night, preventing the land breeze from taking its usual course. This year was farther remarkable for the want of the rains that were wont to fall in the months of May and June. We shall have occasion to remark hereafter, that this was a very uncommon season also in Europe and America. The heat, by the thermometer, this month, on board of a ship at Port Royal, was, in general, when lowest in the night, at 77°, and when highest in the day, in the shade, at 83°.

There was a considerable increase of scurvy in this month, compared with the former months of this campaign; but very inconsiderable, compared with what had occurred in cruises of the same length in former years. The last division of the fleet had been at sea seven weeks, all but one day, when it arrived at Port Royal; and though the scurvy had appeared in several of the ships, it did not prevail in any of them to a great degree, except in the Nonsuch. Out of fourteen deaths which happened in the whole fleet from this disease, in May, seven of them were in this ship, and several were sent from her to the hospital in the last and most desperate stage of it. But, upon the whole, the cases of the true sea scurvy in the fleet, in general, were few and slight, and a great many of those given in the reports under the head of scurvy, were cutaneous eruptions or ulcers, not properly to be classed with it.

The cruise in the preceding year to windward of Martinico, may be compared with that in May of this year; for the fleet in both cases had been at sea about the same length of time. But the comparison is very greatly in favour of the latter, which is most probably to be imputed to the plentiful supply of melasses, wine, sour krout, and essence of malt. But no adequate reason that I could discover can be assigned for the prevalence of it in the Nonsuch to a degree so much more violent than in the other ships; and it was here farther remarkable, that it attacked every description of men indiscriminately; for I was assured by the officers and by the surgeon, that not only the helpless and dispirited landsman was affected, but old seamen, who had never before suffered from it on the longest cruises. I have been led by this, and some other facts, to suspect that there may be something contagious in this disease.

JUNE

The greater part of the fleet remained at Jamaica during this month, refitting and watering. Twelve ships of the line were sent to sea on the 17th, under the command of Rear-admiral Drake, but not being able to get to windward on account of the fresh breezes that prevailed, they returned to Port Royal on the 28th. Such of these ships as were sickly, became more healthy while at sea; but some bad fevers arose, particularly in the Princessa; and it is a curious circumstance, that these fevers attacked only those men who had been on shore on the watering duty; from which it would appear, that something caught or imbibed, which is the cause of the fever, lies inactive for some time in the constitution, some of the men not having been affected for more than a week after they had been at sea.

The weather continued dry and windy, as in the former month; but the heat was in general about two degrees higher, the thermometer varying from 79° to 84½°.

Table, shewing the proportional Sickness and Mortality in June

Transcriber’s Keys:

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

B Proportion of those who died, in relation to the Numbers of the Sick.

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

There was only one in thirty of the sick sent to the hospital in the course of this month.

There was an increase both in the numbers and fatality of fevers. This increase was chiefly in that sort of fever which depends on the air and climate, the greater part of which was caught on the watering duty. There was a diminution of those fevers depending on infection, and the foul air of ships, which arose in the French prizes. The care that was taken in purifying these ships was very effectual; for only four died this month in the Ville de Paris, and fewer also were sent to the hospital than in May. The increase of the other kind of fever was chiefly owing to there being a greater number of ships in port, the crews of which were employed in watering, and partly, no doubt, to the increase of heat in the weather. The ships in which the fevers were most fatal were the Monarch, the Duke, the Torbay, and the Resolution. The sickness in the Duke was still in a great measure owing to the same infection that had hitherto prevailed; for this ship had never been cleared of the infectious fever, for want of room at the hospital. That which broke out in the Torbay was also of the low infectious kind, few of them having the symptoms of that which is peculiar to the climate, which prevailed in the other ships. This ship, though formerly very subject to infectious complaints, had been remarkably healthy for some time past; but it would appear that there was a large stock of latent infection, which shewed itself from time to time.

Some ships, particularly the Montague and Royal Oak, had no increase of fevers or other complaints, though the one lay in port for seven, and the other for eleven weeks, and were more or less exposed to the causes of sickness which affected the rest of the fleet. This is a proof, among many others, that a particular combination of causes is necessary to produce a disease: no single one, however powerful, being sufficient, without the concurrence of others. What seemed to be wanting here was the predisposition requisite for the admission of disease into the constitution; for the ships that enjoyed this happy exemption were such as had long-established and well-regulated crews, accustomed to the service and climate.

There had been this month a diminution both of the numbers and mortality of fluxes, which is agreeable to what was before remarked, that fevers were more apt than fluxes to prevail in the bad air of a harbour[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.]. It was also before remarked, that there were few or no fluxes in those ships in which the fever was most malignant; and now that the fever began to grow more mild in the French prizes, the flux began to appear. In the Barfleur, Duke, and Namur, both diseases seemed to prevail equally; but the fevers, though numerous, were more of the low nervous kind than bilious or malignant; and the fluxes chiefly attacked those who were recovering from fevers. We may farther remark, that these three men of war were three-decked ships, of 90 guns, the crews of which being more numerous, and composed of a more mixed set of men, were consequently subject to a greater chance of infection, and a greater variety of complaints. The Formidable still remained healthy to an extraordinary degree. Some fevers were indeed imported from the Ville de Paris by men that had been lent to that ship, and who were taken ill after their return. Of these, a few of the worst cases were sent to the hospital, and two died on board, who, with one that died the preceding month, make the whole mortality of this ship, since leaving England, amount only to the loss of three men.

There has been little or no increase of scurvy this month; for though the numbers put on the list appear to be greater, the mortality is much less. It may indeed appear a matter of surprise that there should have been any scurvy at all, considering that the greater part of the fleet was at anchor all this month. But as this was the greatest fleet that had ever visited Jamaica, it was impossible to find fresh provisions for the whole; and the small supply they had did not amount to one fresh meal in a week. Port Royal is also remote from the cultivated part of the island, so that fruit and vegetables were both scarce and high priced, particularly this year, on account of the usual rains in May and June having failed. There was, however, an allowance of fresh provisions and vegetables made to the sick by public bounty; for as the hospital could contain but a small proportion of the sick and wounded, an order was given for the supply of fresh meat, fruit, and vegetables, to the sick, and five hundred pounds of Peruvian bark were also distributed as a public gratuity, besides sugar, coffee, and wine.