Gilbert Blane - Observations on the Diseases of Seamen

In the course of this passage the dysenteries came to prevail over the fevers, as we have found to be commonly the case at sea. It appears by the former table, compared with the next, that the mortality in fevers was much the same, and that in the dysentery it was greater than while the fleet was at Jamaica. This does not argue, however, that the diseases were equally malignant, but was owing to the want of an hospital, and of those comforts of diet which the sick enjoyed on board while in harbour. This last was particularly felt in the dysenteries, in the cure of which more depends upon diet than in most other diseases. In all the calculations of mortality on board of ships, if any have been sent to the hospital, they are to be deducted from the number; and these make a greater difference in the mortality on board than their numbers simply would indicate; for only the worst cases, and those therefore who were most likely to die, used to be sent to the hospital. But as the fleet was at sea during the whole of this month, no allowance of this kind is to be made.

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 mortality this month, in relation to the whole numbers on board, was one in one hundred and sixty-nine.

The scurvy began to appear very soon upon this passage; for by the end of August, at which time the fleet had only been six weeks at sea, and that in a warm climate, and in dry weather, it had made considerable progress. It first appeared and prevailed most in the Prince George and Royal Oak, though they had been ten weeks at Jamaica. This was the first sickness with which the latter had been affected since arriving in the West Indies; and there was no perceivable peculiarity in either of them to account for their being subject to it more early, or more violently, than the rest of the fleet. If the disease is contagious, as has been suspected, there might be a few men on board of them, who, being uncommonly prone to the disease, would be soon affected, and communicate it, or at least hasten the symptoms in those who might be less predisposed to it. But this is only conjecture. Before the end of the voyage, the whole fleet was more or less afflicted with it, though it had been only seven weeks and three days at sea; but the men had received so few refreshments while in port, that their constitutions were prepared to fall into this disease. The Barfleur, Alfred, and Princessa, were most affected with it next to the two ships mentioned above.

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 captain 21, 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.

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.