by Roy Adkins
When rescue was not possible, they set sail again, as Sinclair sadly noted: ‘For a very short time the memory of the lost one is spoken of with regret, but soon fades away, and his only epitaph will be the two letters opposite to his name in the ship’s books, – D.D. – discharged dead.’45
Other accidents occurred because of the physical strain involved in many aspects of work on board, in particular when filling and lifting water casks. Seamen were frequently afflicted by hernias, also referred to as ruptures, in which an organ protrudes into another part of the body – usually part of the intestine protruding through the abdominal wall of tissue. Trusses were frequently supplied to the seamen to keep organs in place, but they were not always effective. In March 1804, William Shoveller, surgeon of the Leviathan, described the suffering of George Barnes, a twenty-seven-year-old seaman: ‘The hernia was reducible and supported by a truss; but from his inattention to its application, has allowed the rupture to slip into the scrotum, and his bowels to remain for some days in a state of constipation. Bleeding, enemas, drastic purges and fomentations have been used, without effect. [Sent to] Haslar Hospital.’46
Hernias were so commonplace that men were not admitted into the navy with a pre-existing condition. Because seamen could obtain a pension from the Chatham Chest for injuries sustained, it was specifically decreed that ‘The Directors of the Chest having reason to believe that many persons having obtained Pensions for Ruptures which they had upon them before entering into His Majesty’s Service, the Surgeons are desired in all cases for the above complaint to be careful in examining whether such injury has recently happened.’47 George Wheeler, also twenty-seven years old and an able seaman from the Phaeton, was deemed worthy of a pension, ‘by a considerable portion of intestine and omentum being forced down into the left side of the scrotum, which was with difficulty returned; and has been down several times since; from making too great an exertion on the twenty seventh of June eighteen hundred and eleven … training one of the main deck guns when at his quarters off the coast of Borneo in the East Indies’.48
It is not surprising that the men also suffered from a whole host of other conditions, such as rheumatism, respiratory problems and bowel complaints, but the difficulty for the surgeon was that most illnesses were not understood. Disease was the invisible terror, because virtually nothing was known about the real causes or identifications of sickness, which was believed to fall into three main categories – ‘fevers, fluxes, and the scurvy’.49 Most physicians thought that disease was due to noxious smells or ‘miasmas’, while the more pious believed it was caused by sin. Some also believed that disease was linked to the phases of the moon and weather conditions. The surgeon Lionel Gillespie repeatedly linked the weather and the moon to the condition of his patients, as at the Nore on 8 December 1787: ‘The wind came to the S.W. last night and blew fresh with rain. It continued in that quarter. Heavy dark clouds and a moist air. The restlessness and watchfulness of several, patients as well as others, on the nights of the 6th and 7th seemed to predict variation in our atmosphere coinciding with the approaching phase of the moon – one or two were attacked with arthritis.’50 Over a decade later George Magrath admitted: ‘Notwithstanding the great advances which of late years have been made in the science of medicine, we are not yet sufficiently acquainted with the laws which govern the system in a state of health.’51 Nelson, writing to another physician, commented: ‘The great thing in all military service is health; and you will agree with me, that it is easier for an officer to keep men healthy, than for a physician to cure them.’52
Sometimes the seamen recovered in spite of, rather than because of, the surgeon’s intervention. If a disease was identified imprecisely, the treatment could be unhelpful if not dangerous, with much blood-letting, deliberate blistering of skin, purgatives and emetics. On 20 December 1805 at Plymouth, the surgeon William Shoveller recorded that Robert Leister, a twenty-four-year-old seaman, ‘complains of cough, pain in his breast affecting his respiration and headache and general pains’.53 For what may have been a severe cold or influenza, Shoveller carried out drastic initial treatment: ‘Bled, purged, blistered.’54 By the 30th Leister was discharged to duty, though no thanks to his medical care.
George Magrath was mystified by one illness that spread rapidly through the Russell. Soon after leaving Yarmouth in March 1801, under Captain William Cuming, to join in Nelson’s bombardment of Copenhagen, many were laid low, and the illness only abated when they went to the Mediterranean three months later, but it returned on their way back to England in September. Magrath likened it to typhus and scurvy, and wrote in frustration that ‘I am not really in possession of language sufficiently emphatical or expressive to describe the distressed situation of the Russell ’s crew, during the prevalence of this scourge, without feeling and lamenting for the poor sufferers who underwent more human misery than even the imagination can conceive.’55
On arriving in port, ships’ crews were frequently forced to remain on board for a while in a period of quarantine, in order to minimise the risk of diseases like yellow fever and plague being brought ashore. Generally, the seamen and officers hated this period of quarantine and felt that it served no purpose.
As soon as ships put to sea, many new recruits suffered from seasickness, though this could afflict old hands as well. James Scott, who in 1803 at the age of thirteen had just joined the Phaeton frigate as a volunteer recruit, suffered badly from seasickness at first and reckoned that ‘Sea-sickness I found worse than the doctor’s emetics at home’.56 The surgeon Lionel Gillespie wrote in nauseating detail in his journal about seasickness, which he experienced when his ship, the Vanguard, sailed from Woolwich to Portsmouth in May 1787:
The ship pitched most intolerably. Most of our people were more or less affected with seasickness. 25 [May] – blowed hard. About noon I became sick, could not eat any all day, vomited at first an acid, then an insipid phlegm. Slept badly, but about 6 o’clock of the 26th A.M. the ship pitching much, I became affected with insufferable nausea, spitting, dizziness … and at length vomited two or three times yellow bile. At noon got better … for 24 hours my sickness continued. I eat or drink nothing. About the time the bilious vomiting occurred I had a stool after being costive for some days. My sickness as well as that of several others on board regularly observed the period of a day occurring at noon and going off about the same time. Found some benefit from chewing of ginger.57
Eight months later, during another bout of seasickness, this time on board the Racehorse, Gillespie was more analytical about the condition:
The consent between the brain, stomach and vessels of the skin in seasickness is remarkable. A vertiginous sensation is first perceived, followed by anxiety and nausea. The face becomes pale, the extremities chilly, and the whole surface shrivelled. A few quick motions of the ship produces a straining and vomiting. The contents of the stomach are thrown up and the subsequent straining … of the respiratory organs proves a stimulus to the organs of the circulation. The blood being also forced up to the head perhaps stimulates the brain. The vessels of [the] surface become relaxed and filled with blood. The depressing nausea is relieved and spirits return for a time. I have to remark with regard to seasickness that it is proper to prepare for it by opening the belly previously, by avoiding all cause of indigestion, avoiding the use of fluids, to be abstemious, when at sea to keep in the air and if possible to work, to pull and haul; or when the stomach has been emptied, to avoid drinking and support a warmth of surface lying abed with much clothing. I’ve sometimes met with persons who are never affected with seasickness, an instance of this sort I have now before me in a boy. I think that most of those I have seen thus happy have been of a thin rather delicate habit with a long neck and consumptive make.58
New recruits were also responsible for the deaths of hundreds of seamen, because after being seized by the press-gang, the men came on board in their filthy clothes, bringing with them lice that rapidly spread what is nowadays c
alled epidemic typhus. The crowded conditions on board led to the rapid spread of such diseases, and the surgeon Thomas Trotter reckoned that ‘There is no situation where so large a number of human beings are confined in so small a space as in a man of war.’59 Typhus in particular was so common in overcrowded places with inadequate or dire standards of hygiene that it was often called jail, hospital, camp, ship or war fever. When lice suck the blood of an infected person, the bacteria multiply inside them and are excreted in their faeces. Seamen scratching lice bites became infected by rubbing infected lice faeces into their wounds, and the disease was also spread by coming into contact with lice faeces on the clothing and bedding of sufferers.
The main symptoms of this potentially fatal disease are a prolonged high fever, severe headache and a rash. Although the causes of the disease would not be discovered for decades, it was realised that impressed seamen were a prime cause, and Gilbert Blane commented that ‘a single infected man, or even any part of his cloathing, may spread sickness through a whole ship’s company … and when the cause of the sickliness of particular ships is traced to its source, it will generally be found to have originated from taking on board infected men at Spithead, or wherever else the ship’s company may have been completed’.60 The response was to attempt to have impressed men stripped, washed and provided with new clothes, and Blane also advocated strict hygiene and ventilation on board ships, because of the belief that typhus and other diseases were caused by foul smells and poor-quality air. This reduced the cases of typhus, but the disease was never eradicated.
The ‘flux’ was a common complaint that included dysentery, gastroenteritis and food poisoning. Dysentery (an intestinal infection caused by eating or drinking contaminated food or water) was also described as ‘the bloody flux’, and patients suffered from diarrhoea, often with blood, abdominal cramps and dehydration. On board the Rainbow in the West Indies in 1773, the surgeon Robert Robertson commented that dysentery had hit them hard: ‘The dysentery still continued to rage amongst the people, attacking young and old; but none of the officers were seized with it. However, this is not much to be wondered at, if it be considered that they lived better in every respect, and were not exposed to so many hardships as the people were … All the attendants of the sick were affected with the flux.’61 He added:
Of all the diseases which attack a ship’s company, the dysentery, if not the most fatal, is in my opinion equally so with any other; and by far the most loathsome. The constant doleful complaints from the various violent pains of the bowels; from gripes, and tenesmus; from the continual noxious fetor about the sick, as well as from that of the necessary [toilet] buckets … What renders the dysentery on board of ships most distressing, is, that no certain method of curing it has yet been discovered.62
The disease sailors feared most was yellow fever, which had a very high mortality rate, and they dreaded hearing that their destination was the West Indies, where it was so prevalent. In 1794 at Port Royal in Jamaica, Midshipman Frederick Hoffman described its spread on board his own ship: ‘The yellow fever was now making lamentable havoc among the crew. Six were either carried to the hospital or buried daily. After losing fifty-two men, one of the lieutenants, the captain’s clerk, and four mids, the captain requested the admiral’s permission to go to sea, for, although we had more than thirty cases of the fever on board, the surgeon thought the pure sea-breeze might be the means of preserving their lives.’63
The surgeon’s assumption that they were safer at sea was correct, though he had no idea that by leaving land, they also left behind mosquitoes which carried and spread the yellow fever virus. It was often called ‘yellow jack’ because of the yellow quarantine flag flown on ships where men had contracted the disease, but it was also known as ‘the vomits’ or ‘black vomits’ because sufferers became feverish and vomited dark bloody liquid. Their skin and eyes also turned yellow through jaundice caused by the breakdown of the liver. The progress of the disease was rapid. A few days after being bitten by a mosquito, the fever rapidly took hold, with either death less than a week later or else a prolonged period of convalescence. The real cause of yellow fever was unknown, and some surgeons used bark,* while others distrusted its use and favoured a mercury purgative (in the form of calomel pills) and bleeding. This terrifying disease frequently overwhelmed ships’ crews, leaving only a handful of survivors out of several hundred previously healthy men. Those who recovered had a lifelong immunity.
Once Hoffman’s ship was finally rid of yellow fever, the crew next suffered from scurvy, and ‘one hundred and forty of the seamen were obliged to keep their beds. Their legs, hands, feet and gums became almost black, and swollen to twice their natural size.’64 Scurvy was a slow and insidious disease caused by vitamin C deficiency and had truly appalling effects. It was probably the worst disease caused by poor diet, and yet by far the easiest to prevent and cure. It was very much a plague of sailors confined on board ship, with no easy access to fresh fruit and vegetables – more seamen died from scurvy than all other causes of mortality combined. Those falling prey to scurvy would gradually experience listlessness and depression, aching and stiff joints, old wounds opened and previously healed bone fractures separated. In addition, new injuries such as bruises, cuts and fractured bones failed to heal, gums became sore and swollen, teeth loosened and fell out, while the breath stank. On the skin, haemorrhages caused purple blotches and spots, which eventually turned black. Without effective treatment, sufferers became totally lethargic and eventually died.
When Hoffman’s ship reached the island of St Domingo, some scurvy sufferers were taken on land, because burying them in the ground was (bizarrely) considered a cure:
Immediately, on anchoring, by the advice of the surgeon, we sent a party on shore with spades to dig holes in the softest soil they could find for the purpose of putting the worst scurvy subjects into them … Twenty men, who looked like bloated monsters, were removed on shore, and buried in them up to their chins. Some of the boys were sent with the sufferers to keep flies and insects from their faces. It was ridiculous enough to see twenty men’s heads stuck out of the ground. The patients were kept in fresh earth for two hours, and then put into their hammocks under a large tent. On the fourth day they were so much benefited by that treatment and living on oranges, shaddocks, and other antiscorbutic* fruits, that they were able to go on board again.65
Scurvy was such a serious hazard of long sea voyages that many doctors searched for a cure, and by the mid-eighteenth century it was established – but not universally accepted – that citrus fruits and fresh green vegetables dramatically reversed its course in a matter of days. The crew on board Hoffman’s ship could have been simply treated with the fresh fruit, without undergoing burial in soil, but ignorance prevailed. Scurvy was much more a disease of the ordinary seaman, as their diet was more basic than that of most officers.
In 1795 the physician Sir Gilbert Blane resigned from St Thomas’s Hospital in London and became a commissioner for the Board of the Care of Sick and Wounded Seamen (Sick and Hurt Board). He straightaway ordered that lemon juice should be issued daily, mixed with rum, sugar and water. When in the West Indies, limes were often substituted, so that the seamen came to be called ‘limeys’, yet lemons contained twice as much vitamin C and were far more effective at combating scurvy. Citrus fruits had been shown to be effective decades earlier, when James Lind advocated lemon juice, but he had recommended rob, a boiled lemon syrup that loses its vitamin C. With Blane’s intervention, this once appalling disease was virtually eradicated. In the years afterwards it occurred only sporadically, as in 1801 on board the Russell, when the surgeon George Magrath was greatly affected by the torment of the seamen:
Several of the scorbutic cases were truly the most deplorable I ever beheld, exhibiting the most aggravated symptoms of malignancy and distress. It first invaded with much languor and torpor the body; the countenance became pale and bloated … respiration was much disturbed, nay, in many, quite s
uspended on the slightest exertion or motion of the body. Soon after the appearance of these unfriendly precursors, the gums acquired a softness and considerable tumour, from which arose hemorrhage … the teeth in many instances became loose and the breath evicted a most offensive and foetid smell.66
Magrath did say they had no deaths, ‘as the citric acid performed a cure in every instance’.67 Nevertheless, throughout the Napoleonic Wars scurvy was a minor complaint for British sailors, in contrast to earlier times, and at long last Royal Navy ships could remain at sea effectively for long periods of time.
Blane observed that crews were more prone to illness when anchored close in to shore, but thought this was because of the bad air (‘mal aria’) from nearby marshes. The surgeon James Prior on board the Nisus in 1811 agreed that it was far healthier at sea than on land: ‘The sea is without doubt the healthiest place in a tropical climate. The breeze, pure, fresh and invigorating, untainted by pestiferous effluvia, and uninterrupted by obstructions, revives the drooping frame from the effects of heat or laborious avocations.’68 He added: ‘In all the detested spots that conspire against human life – and America has her West-Indies and Guiana, Africa her Gambia and Senegal, Asia her Java and Banda, and parts of Europe are yet scourged by plague, the best preservative is to keep embarked. Here we may often bid defiance to the grim fiend – Death, and his ruthless agents, marsh and animal effluvia.’69
Mosquitoes were a nuisance for their bites, but nobody realised that they were carriers of disease and of malarial parasites, which are transferred to humans when bitten. Men frequently went on shore to search for firewood and to fill up water casks, where they encountered mosquitoes, and Blane’s advice was that ‘The duties of wooding and watering are so unwholesome, that negroes, if possible, should be hired to perform them.’70 This was not because he thought black Africans were expendable, but because it was thought they were more resistant to such diseases. Blane knew that in most cases seamen would have to be employed in wooding and watering, and so his advice was that they should not stay on shore overnight and to swallow some Peruvian bark, commenting that
