Gilbert Blane - Observations on the Diseases of Seamen

In June, the Russel, of 74 guns, arrived from North America, and the Shrewsbury, a ship of the same rate, from England. The former left England in 1778, but was obliged to put back by stress of weather and sickness, and upon arriving afterwards on the coast of America, was extremely afflicted both with fevers and the scurvy. These were removed to the hospital, and this ship had become free of all sickness before sailing for the West Indies, except that a few of the men were seized with fevers, and she remained healthy after arriving there, not suffering from any regular attack of sickness, such as affected the ships in general from Europe. The Shrewsbury left England healthy, but was soon attacked with a fever and flux, which continued to prevail till the end of the year.

The fever in these two ships resembled rather the low ship fever of Europe than the bilious one peculiar to the climate. This last, indeed, seldom or never prevails to a great degree on board of a ship, unless it has been caught on the watering duty, or from some other exposure to the air of the land. I have, however, known a few instances of bilious fevers in men who never had been on shore from the time they left England; I have even known men of the same description attacked with intermittent fevers, which are supposed to depend still more on land air. This is perhaps owing either to the quantity of water in a great ship, part of which is always more or less putrid, or to the fresh-cut wood of the country taken on board for fuel, the steam of all which must resemble a good deal the effluvia of woods and marshes, which are supposed to give rise to intermittents.

In the beginning of July our fleet was reinforced with the Culloden, Egmont, and Centaur, all of 74 guns. In the end of the same month we were joined by the Alcide and Torbay, of the same rate, and also directly from England. The fleet was at this time at St. Christopher’s, having arrived there on the 22d of the month, with a large convoy from England, which had joined it at St. Lucia, under protection of the Thunderer and Berwick, two ships of the line, which being bound to Jamaica, I do not reckon as belonging to our fleet.

Shewing the proportional Sickness and Mortality, in relation to the whole Numbers on board, for fourteen Months.

Transcriber’s keys: A Proportion of Sick and Wounded on board on the First of the Month. B Proportion of Sick and Wounded sent to the Hospital in the Course of the Month. C Proportion of Deaths on board in the Course of the Month.

Account of the Health of the Fleet from August, 1780, till December following. – The Fleet divided – The principal Squadron goes to North America – Fluctuation between Fevers and Fluxes – The Alcide and Torbay the most sickly Ships – Health mended by the Climate and Diet in North America – Hurricane in the West Indies – Sufferings in consequence of it – Fevers the chief Disease.

The hurricane months approaching, the season for active operations in the West Indies was now over. The whole force of the enemy, consisting of thirty-fix French and Spanish ships of the line, having gone to St. Domingo in the end of July, ten sail of the line were detached after them from our station, for the protection of Jamaica. The Admiral sailed for North America in August, with eleven ships of the line, leaving six for the protection of the islands.

There was little alteration in the general state of the sick during the voyage to America, and indeed we found no diminution of the West-India heat, which at this season is at the greatest height, until we came to the 33° of N. latitude.

The only material alteration in point of health was in the Alcide and Torbay, which had arrived from England with a few men ill of fevers; but in the course of this voyage these two ships became as unhealthy as any that ever came under my observation. There was a greater number of sick on board of them than all the fleet besides, and it increased to such a degree, that upon their arrival at New York, which was in the middle of September, after a passage of three weeks, near one half of their men were unfit for duty. In the Alcide it was a fever that raged; in the Torbay it was a dysentery; and the unusual degree of sickness and mortality which appears in the Table for the month of September, was owing to the very sickly state of these two ships.

Shewing the Number of Fevers and Fluxes on board on the First of each Month, and the Number sent to the Hospital in the Course of the Month.

Key: B On board. H Sent to the Hospital.

We shall hereafter see reason for supposing that fever and dysentery proceed from the same cause; and as both these ships arrived from England in a similar state with regard to health, fevers would probably have been the prevailing disease in both; but a part of the 87th regiment, then serving as marines in the fleet, was put on board of the Torbay at St. Christopher’s, and some of them being ill of the dysentery, gave this turn to the disease which afterwards prevailed on board. I have formed a Table to shew the fluctuating state of these two diseases, and this was one of my first and most imperfect attempts towards a medical history of the fleet in a methodical way. ( Table III.)

There was but little sickness in the rest of this squadron, except in the Terrible, where the dysentery prevailed a good deal. None of the ships of the line which we found in the West Indies, upon our arrival there, were now in company, except the Yarmouth, and this was the most healthy of all the ships that went to North America.

The health of the fleet was very much recruited by its short stay in America; for the men were supplied with fresh meat and spruce beer, and they enjoyed the two finest months of the year in that temperate climate. The squadron left New York in the middle of November, and though dispersed by a violent storm, all the ships arrived safe in the West Indies before the middle of December.

In October the fleet had attained such a degree of health, that though the calculation in the Table is made from five of the most sickly ships, no death happened in this month on board of any of them. In November the mortality was also inconsiderable, though the ships left in the West Indies are included in the calculation; which, had it been made upon those only that went to North America, the deaths would have been no more than one in seven hundred and eleven in this month, which is rather less than that of any other month in the Table.

The amendment in health, in consequence of the change of climate, was most remarkable in the Terrible, which, by the time she left America, had entirely got rid of the violent dysentery that had prevailed for some time on board. This sudden change in the health of this ship was evidently owing to the great attention of the Captain to cleanliness and discipline, and no less to the assiduity and abilities of the Surgeon. The Alcide still continued sickly, though not so much so as the Torbay. The former had sailed on a cruise in October, and having met with very rough weather, the sick list was thereby increased. The dysentery now prevailed in that ship, as well as fevers, and those men chiefly were attacked with fevers who were ill of the scurvy, or recovering from it. This was not very common; and there were several other remarkable particulars with regard to the fevers in this ship; for her men were not only uncommonly subject to this disease, both in America and the West Indies, but to all the various forms of it; the low, infectious, ship fever of Europe, the bilious remitting, and the malignant yellow fever of hot climates. It would appear from this, as well as other instances, that a ship may assume, as it were, a particular constitution, or a tendency to some particular disease, for a length of time, and this depending on some lurking and adhering infection, or the manner in which she may have been victualled, watered, disciplined, or manned.