Gilbert Blane - Observations on the Diseases of Seamen

I now began to keep regular and methodical accounts of the sickness and mortality in the fleet, though in a manner more imperfect and less accurate than was afterwards adopted. I was embarked on board of the Sandwich, where the Commander in Chief had his flag, so that I was always present with the main body of the fleet, whether at sea or in port.

A form of monthly returns 2 2 The following may serve as a specimen of these returns: State of Health of His Majesty’s Ship Alcide. Carlisle Bay, Barbadoes, 1st June, 1781. REMARKS During the course of last month we had one hundred and fourteen of the men, who contracted the scurvy in the late long cruise, recovered by the use of limes, which were procured at Montserrat. A pint of wine, with an equal quantity of water, made agreeable with sugar and tamarinds, is served to each patient daily. The regimen is exactly the same as mentioned last month. Since we came into port, very few have been seized with scurvy, but several complain daily of fluxes and feverish complaints, none of which seem at present to be of any consequence. 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. was adopted, which, as well as other points of method, was afterwards improved.

After collecting the returns for each month, I made abstracts of them in tables; in one column of which the complement of each ship is set down, in order to form calculations of the comparative prevalence and mortality of different diseases at different times. One of the abstracts is here inserted, ( Table I.) by way of specimen, and the proportional result of them for fourteen months is set down in another table, ( Table II.)

Though this last exhibits a tolerably just view, yet it may be remarked, as one imperfection, that there was no distinction made at this time in my returns between the killed and those who died of disease; so that in the month of May, which stands first, the proportion is too high; for there were sixty-four killed, and two hundred wounded, in the two actions of that month.

Transcriber’s keys:

A Complement.

B Sick and Wounded on Board.

C Sent to the Hospital in the course of last Month.

D Dead on Board in the course of last Month.

The main body of the fleet lay at Barbadoes till the 6th of June, and the men had recruited extremely by their stay there; for vegetables, fruit, and other refreshments, can be procured at an easier rate, and in much greater plenty, at this island, than any other on the station.

The fleet arrived at St. Lucia the next day after it sailed from Barbadoes, and remained there till the 18th of June. The whole of this month was showery at this island, though it is not accounted the common rainy season; for more rain falls here than at any of the other islands at that time in our possession, being the most mountainous, as well as the most woody and uncultivated, of them all. These rains produced some increase of sickness, but very little, when compared to what took place at the same time in the army on shore, and in the ships refitting at the Carenage. There died about this time from fifty to fifty-five men every week in an army of not quite two thousand men.

The difference in point of health between the Carenage (which, as the word implies, is the place where ships go to be hove down, or otherwise repaired) and Gros-Islet Bay, where the main body of the fleet lay, affords a striking proof of the effects of situation. The Carenage is a land-locked creek, with a marsh adjacent to it, whereas the other is a road open to the fine air of the sea, the only land sheltering it to windward being a small, dry island, consisting of one hill, of half a league in circumference, and some of the cliffs of the main island of St. Lucia.

The increase of sickness here was farther prevented by the men having little labour to perform on shore, nor any haunts to encourage intemperance, a vice which the Admiral endeavoured still more effectually to prevent, by ordering all the rum stills in the neighbourhood to be destroyed.

It may be proper here to introduce a general account of the seasons and temperature of the West Indies, as there will be frequent occasion hereafter to make allusions to them. With regard to the heat, though the range of the temperature is very small, in comparison of what it is in Europe, the variations follow the same seasons; for July and August are the hottest months, and December and January the coolest. This we would naturally expect, as our plantations lie all in the northern hemisphere, between the 10th and 20th degree of N. latitude, and therefore bear the same relation as Europe does to the sun’s annual course. The hurricanes happen in the same season in which the periodical rains chiefly fall, that is, in the months of August, September, and October, which are called the hurricane months, and this is also the most unhealthy season. The time of the year which is most apt to be rainy, next to this, is from the middle of May to the middle or end of June, but this is not invariable. The lowest I ever observed the thermometer was at 69°; it stands very commonly at 72° at sunrise, in the cool season, rising to 78° or 79° in the middle of the day. In the hot season, the common range is from 76° to 83°. It seldom exceeds this in the shade at sea; and the greatest height at which I ever observed it in the shade at land was 87°. This is far short of the extremes of heat which they experience at certain seasons on the continent of North America, even very far north. In Pennsylvania and New York, the thermometer, I have been assured, rises frequently above 90°. It does so commonly enough in the East Indies; but I believe it never was known to rise so high in the West Indies, so that the heat, comparatively speaking, may be called moderate and steady.

The comparative mortality in June is small, owing to the fleet’s having been cleared of all the bad cases at Barbadoes before it sailed from thence. Though the proportion of sick in July is less, that of the mortality is greater, (see Table II.) which seems to be owing to this circumstance, that the cases taken ill during the rainy weather of June did not terminate fatally till the succeeding month.

In the course of this summer the fleet was reinforced by several ships of the line from England. The Triumph arrived in May, without any sick on board; but a flux prevailed a few weeks afterwards, without any evident cause, except the influence of the climate, and the exposure and fatigues during the operations of May. The disease, however, soon subsided, and the ship being kept in excellent order and discipline, continued healthy during all the remaining time in which she served with us.