Observations on the Diseases of Seamen

These observations naturally suggest several useful and practical remarks. It would appear that the utmost attention is necessary not only to guard against the actual presence of of disease, but to be jealous of all new draughts of men, especially if they should come from guardships, jails, or tenders, and have been turned over from ships where disease is known to have prevailed; nay, that it is best to avoid mixtures of any kind.

The infection of fevers seems different from most others in this, that it is very various in its degrees of virulence. There is reason to think that the poison of the small pox, and that of the venereal disease, are in their own nature invariable, and that the difference of these diseases, in point of malignancy, depends on the constitution and other circumstances of those affected; whereas that of fevers being of different degrees of activity, and being frequently obscure and latent, is, on that account, the more treacherous, and ought to be watched with the greater circumspection.

The mode of manning the navy by pressing, I take it for granted, is unavoidable; at any rate, it would not become me to arraign a practice which has had the public sanction for ages. It is, however, one of the principal means both of generating and spreading the seeds of disease, in consequence of the indiscriminate seizure of men for the public service, and the confinement that is necessary to secure them. And as the exigences of the service make it necessary to admit persons of every description, there is no other remedy for this evil but to annihilate, if possible, the contagion that may thus be conveyed into ships of war. This is done by stripping and washing the new recruits who may be suspected of importing infection; also by cutting off their hair, clothing them with new clothes, and destroying the old, before they are allowed to mix with the ship’s company in which they are to enter.

Those who have put these methods strictly in practice, have been sensible of their great utility; and the most exact attention is necessary, as a single infected man, or even any part of his clothing, may spread sickness through a whole ship’s company. When we reflect what havock an infectious fever sometimes makes in a ship, it will appear how very important this fort of attention is; 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.

After the first edition of this part of the work was printed, an excellent institution was established at Portsmouth for the prevention of infection. A ship was appointed for the reception of the recruits of the fleet to which they were carried, to be stripped, washed, and provided with new apparel, before they joined their respective ships. This had a visible good effect on the health of the fleet; and it was planned and executed by Sir Charles Middleton, Comptroller of the Navy, whole unwearied assiduity, as well as integrity and ability in that important post, claim the highest praise and gratitude from his country.

It follows farther, from the preceding observations, that there is a sort of risque in mixing two different sorts of men, even when there is no actual disease or suspicion of infection; for, whether it is from dormant infection, or merely from the circumstance of change of air, such mixtures are known from experience to be sometimes productive of sickness. The late Admiral Boscawen was so sensible of this, that he avoided it, unless when some evident utility or necessity of service made it proper; and upon this principle he used to resist the solicitation of captains when they requested to carry men from one ship to another upon changing their commands.

One probable reason, among others, for ships of the line being more sickly than frigates or smaller ships is, that in greater numbers there is a greater chance of men of various descriptions and modes of life being mixed together.

2. Means of preventing the Production of Infection

The infection of fever is not always imported from without, but may be originally and spontaneously generated on board. The causes of this, as mentioned before, are want of personal cleanliness, and also confinement and crowding in close apartments.

In order to promote cleanliness, care should be taken that every man, on his first entering into the service, be provided with a proper change of linen, and that a frequent muster and review be made, in order to inspect their persons, and to examine their stock of apparel. A true seaman is in general cleanly, but the greater part of men in a ship of war require a degree of compulsion to make them so; and such is the depravity of many, that it is common enough for them to dispose of their clothes for money to purchase spirituous liquors. A muster and review, therefore, wherein men should be obliged once in the week to present themselves clean before their officers, and to produce a certain necessary quantity of clean apparel, would conduce both to sobriety and cleanliness. The exertion of authority, and the infliction of punishment, is so far from being considered by the men as a hardship, that they expect it; and it is the duty of an officer, as it is of a parent to a child, to constrain those entrusted to his care to perform what is for their good. It is common also for men to lay up their clothes in a wet and unwashed state, which in time is productive of the most offensive and unwholesome vapours; and this can be prevented only by their chests and bags being frequently inspected by their superiors.

It must be evident to any one who reflects on this subject, that a regulation of this kind is as necessary as any other part of duty; and it deserves to be made an article in the public instructions, instead of being left to the discretion of officers. This sort of discipline is particularly necessary in ships of the line, in which one cause of the greater unhealthiness is the difficulty of taking cognizance of so great a number; for, unless some regular method, as by muster, is established, there will be men who will escape notice, and skulk below, indulging in laziness and filth.

The good sense and humanity of many captains in the late war, led them to adopt certain methodical regulations for the preservation of cleanliness and order. The only public sanction given to this sort of discipline, was that of Lord Howe, who gave it in orders to those under his command, that each ship’s company should be divided into as many divisions as there were lieutenants, and that these should be divided into squads, with a midshipman appointed to each; and that the officers should be respectively responsible for the good order and discipline of the men assigned to them.

It is an excellent custom, and pretty general in the navy, to allow the men one day in the week for washing, when the weather and other circumstances will admit of it. It would be a farther improvement in the rules of the service to supply sope in the same manner as tobacco and slops are supplied, that is, to let the men have what quantity they want from the purser, who is allowed to charge it against their wages47.

Next to want of cleanliness, the circumstances most apt to give rise to infection are, close air and crowding. A certain length of time is necessary, in order that these should have this effect, and the longer they take place, the more certainly will infection be produced, and it will be the more virulent48.

In order to admit air freely, the ports should be kept open whenever the weather will permit this to be done. The great objection to free ventilation is the danger of exposing men to the air in cold climates. But it fortunately happens, that fire, while it is the most effectual means of counteracting the cold air, is also the best means of promoting ventilation; for wherever there is fire, there is a constant change of air taking place by means of the draught to which it gives occasion. This cannot be done with safety and convenience in all parts of the ship; but frequent fires in the lower parts of a ship will prove extremely salutary by drying up the moisture, and producing a change of air, and also in a cold climate by the warmth it produces.

The hammocks and bedding should also be aired by exposing them upon deck, especially after the ports have been long shut in consequence of bad weather. They cannot be thoroughly aired unless they are unlashed; and as this could not be conveniently done daily in men of war, it might be done from time to time by the different divisions in rotation49. When the men come to sleep upon them after these operations, they experience the same agreeable sensations as from a change of linen; and this must conduce to health as well as pleasure, like all other natural and moderate gratifications. It may be farther remarked in favour of cleanliness, that it is not only directly conducive to health, but is naturally connected with habits of good order, sobriety, and other virtues. The most cleanly men are always the most decent and honest, and the most slovenly and dirty are the most vicious and irregular.

A ship of war must have a much greater number of men on board than what are necessary to navigate her; for, besides the marines, a great many hands are necessary to man the great guns in time of action. For this reason, there is a greater risque of the inconveniences of overcrowding than in ships intended for commerce, and therefore much greater attention is necessary with regard to ventilation and cleanliness. There is a piece of management which tends also in some measure to obviate the necessity of crowding. This is to berth the watches alternately, by which it is meant, that one half of each watch should lie on different sides, whereby they do not sleep so close, and are not so much exposed to each other’s breath and to the heat and effluvia of each other’s bodies. This has the farther advantage of preserving the trim of the ship.

What has been said of the ship and men in general, applies still more strongly to the sick, and the berth50 assigned to them; for there is nothing so apt to increase, and even generate, contagion, as a number of sick together, unless uncommon attention is paid to cleanliness and ventilation. This is so true, that, unless where the complaint is very catching, it is best not to separate the sick; for if they are a good set of men on board, those who are confined by sickness will be better nursed and tended by their messmates than in a sick berth. But if the state of infection renders separation necessary, the best part for the accommodation of the sick, in a ship of the line, is under the forecastle in a warm climate, and on the fore part of the main deck in a cold one. When they are under the forecastle, however, they ought to occupy only one side, as they would otherwise be disturbed by the men who must pass to and from the head, and the men in health would, in this case, be exposed also to contagion. As infection is most likely to arise among the sick, attention to cleanliness and air is doubly requisite where they lie; and it has a good effect to sprinkle hot vinegar and diffuse its steams among them once or twice a day.

Thus we see that cleanliness and discipline are the indispensable and fundamental means of health, without which every other advantage and precaution is thrown away. Government never bestowed more attention and expence upon the victualling of the navy than during the late war; but it would be to little purpose to provide the most nourishing and antiscorbutic diet, the most wholesome and cordial wines, the most efficacious remedies, and the most skilful physicians and surgeons, if the men are not constrained to keep their persons sweet, their clothing and bedding clean, and their berths airy and dry. It is, therefore, upon officers more than any others that the health of the fleet depends; and I should be excused in the frequent mention I make of this, were it known how often I have been the witness of the fatal effects of the neglect of these rules.

3. Means of eradicating Infection

When, from a neglect of the means above mentioned, an infectious fever comes actually to prevail, and the infection, perhaps, adheres obstinately to the ship in spite of cleanliness, good air, and diet, and all the other means, which, if employed in due time, would have prevented it, then some measures are to be taken for eradicating this subtile poison.

The first step towards this is, to prevent the disease from spreading, and this is done by separating the sick from the healthy, and cutting off all intercourse as much as possible. For this end, it is necessary to appropriate a particular berth to contagious complaints, and not only to prevent the idle visits of men in health, but to discover and separate the persons affected with such complaints as soon as possible, both to prevent them from being caught by others, and because recent complaints are most manageable and curable. Officers might be very useful in making an early discovery of complaints, by observing those who droop and look ill in the course of duty; for seamen think it unmanly to complain, and have an aversion to be put on the sick list. I have heard of a method practised in some ships, of keeping a book on the quarter deck for the officer to mark the names of such men as might look ill, or might be missed from duty upon calling the roll, in order to afford the surgeon a means of finding out those who should be the objects of his care.

Those whose profession it is to superintend the health of the ship, would find it for their ease and interest, and should consider it as their duty, to walk over the different decks once a day, or every other day, in order to make an early discovery of those who may be taken ill. Though I have laid great stress on the duty of the commander, as the proper guardian of health, yet his assiduity will not avail unless the surgeon also does his part, by such acts of attention as I have mentioned, joined to skill in his profession.

Surgeons are, perhaps, more regarded in our service than in that of other nations; but it would be for the public benefit if they were still more respected and encouraged. To men of liberal education and sentiments, as surgeons ought to be, and generally are, the most effectual inducements for them to do their duty are flattering attentions, and a certain degree of estimation in the eyes of their officers. Liberality of manners, on the part of superiors, is the most likely means of encouraging a conscientious performance of duty in this profession; for though strict and distant behaviour may operate upon the minds of those whose functions are merely mechanical, how can it infuse that tender attention to human sufferings, and that sense of duty, which may induce a man entrusted with the health and lives of his fellow creatures to act his part with propriety and effect?

In order to prevent sickness from spreading, it is not sufficient to cut off all personal intercourse. The clothes of men are as dangerous a vehicle of infection as their persons; and it should be a strict and invariable rule in case of death from fever, flux, or small pox, to throw overboard with the body every article of clothing and bedding belonging to it.

Upon the same principle, in case of recovery from any contagious disease, as it would be too great a waste to destroy the clothes and beds, they should be smoked, and then scrubbed or washed before the men join their messes and return to duty. This precaution is the more necessary, as infection in a ship is extremely apt to be communicated by bedding, from the custom of stowing the hammocks in the netting, by which they are brought in contact with each other. This, however, is an excellent custom, as it not only clears the ship below, and serves to form a barricade on the gunwale, but tends to air the bedding; and this salutary effect should not be prevented, except in case of rain, by the coverings, called hammock-cloths, by the use of which utility is evidently sacrificed to an excess of neatness.

It sometimes happens that the number of sick in a ship is so great, that it is not possible to take proper and effectual measures on board for stopping the progress of disease. But when she can be cleared of the sick by sending them to an hospital, no pains should be spared to extirpate the remaining seeds of infection.

For this purpose, let their clothing and bedding be sent along with them; let their hammocks, utensils, and whatever else they leave behind, be smoked, and either scrubbed or washed before they are used by other men, or mixed with the ship’s stores; let the decks, sides, and beams of their berths, be well washed, scraped, smoked, and dried by fire; then let them be sprinkled with hot vinegar, and, finally, white-washed all over with quick lime.

Should any officer object to the trouble and inconvenience of all this, let him reflect for a moment how much more troublesome and inconvenient, as well as noisome and disagreeable, sickness itself proves to be; let him reflect that the efficiency of the ship, considered as a bulwark of defence, or an engine of annoyance, depends on the number of healthy hands, and that his own character is to depend on the exertions to be made by them in the day of battle, not to mention the attention due from him as a man to the sufferings of the objects themselves.

But besides these recent infections, it sometimes happens that the seeds of disease adhere to the timbers of a ship for months and years together, and can be eradicated only by a thorough cleansing and fumigation. Sweeping, washing, scraping, and airing, are not sufficient entirely to remove the subtile infectious matter; but they will assist and will prepare it to be acted upon by heat and smoke, which are the only means to be depended upon. A complete fumigation can only be performed when the ship is in dock; and I shall here transcribe a method recommended by Dr. Lind.

“It will be proper to remove every thing out of the ship, so that the hold may be swept, and, when the men have withdrawn, to light a number of charcoal fires in different parts, and to throw a handful or two of brimstone on each. The steam of these should be closely confined by shutting the ports and hatchways from morning till evening, no person in the mean time being allowed to go below, nor for some time after opening the ports and hatchways, that the steam may be dispersed.

“In order to purify the men’s clothes, it would farther be proper to fumigate the hulk into which they are removed with tobacco once or twice a week while their ship is in dock, the men remaining below as long as they can bear it.

“The clothes and hammocks of the men should be exposed in the hulk to the smoke of the tobacco, and those which are more particularly suspected may be hung up the ship, and exposed to the steam of the charcoal and brimstone.

“The ship having been already fumigated with tobacco, it will be sufficient to use the fumigation of charcoal and brimstone above described for three days, and, after the last day’s fumigation, the inside of the ship should be well washed with boiling vinegar, and, before the men return on board, all the decks should be scraped and washed.”

When a ship is at sea, these precautions cannot be taken so completely; but if infection is present, or is suspected, then cleansing and fumigating may be practised in a less degree. I have known a ship at sea fumigated with gunpowder kneaded with vinegar, so as to prevent it from exploding, and to make it burn slowly with a spattering flame. Flowers of sulphur51, with about an eighth part of nitre, will answer still better. A quantity of these is placed in each interval of the guns between decks, every person being turned up, and the ports and hatches shut till they are consumed, and till the smoke has dispersed. It has also been recommended to burn resinous bodies, such as the woods of fir, spruce, and juniper, as the smoke of these is more salutary. Upon the same principle, the effluvium of tar is thought wholesome; and the cables that are coiled in the lower parts of a ship being soaked with tar, like most of the other ropes of a ship, probably conduce to the health of a place otherwise dank and unwholesome. Fumigation may also be performed by means of tar, either by throwing it on red-hot irons, or a wood fire, which may be carried about between decks in a pot or moveable grate, or over some cannon balls in a tub, or by immersing a red-hot loggerhead52 in a bucket of tar. If this is done in the place occupied by the sick, it will have a still better effect; and it will be of service to them to be removed for a short time under the half deck or forecastle till this or other means of purification are put in practice. In whatever manner fumigation is performed, it will be of service to spread out the clothes and bedding of the men, or to hang them upon lines, that they may be exposed to the heat and smoke.

It will also be of great service to make the men expose their frowsy clothes to the sun and wind. If a strong infection is suspected, and it cannot be afforded to destroy the clothes, the best means of eradicating the poison is to hang them for a length of time over pots of burning brimstone in a large cask standing endways, with small apertures to admit air enough for the brimstone to burn.

Fire in every shape is to be considered as the principal agent of purification, by its heat and the ventilation it occasions, perhaps, still more than its smoke. It has already been repeatedly inculcated, that the great enemies of infection are ventilation and heat. I have mentioned smoke and the effluvia of balsamic bodies, but these are not to be depended on; and it is the more necessary to mention this, as the attention bestowed on more trifling means may divert the mind from a proper regard to what is more essential. It is mentioned by the benevolent Mr Howard, that it is the custom in some parts abroad to scatter fresh branches of pine or spruce in the hospitals, in order to purify the air; but, trusting to this, they neglect the admission of fresh air, which is the only effectual method of sweetening the air.

There is reason to think that the open air very soon dissipates and renders inert all infections of the volatile kind, and of course the warmer the air is the more readily it will have this effect. It is accordingly observed, that infection is much less apt to be generated about the persons of men, and that it adheres to them for a much less space of time in a hot climate than in a cold or temperate one. This is a remark, which, so far as I know, has not been made by any author; and, till observation suggested it to me, I fancied the reverse to be the truth. I have seen so many instances of filth and crowding in ships and hospitals in the West Indies, without contagion being produced, and which in Europe could hardly have failed to produce it, or to render it more malignant, that I am convinced there is something in tropical climates unfavourable to the production and continuance of infectious fevers53. The ships which bring this fever from Europe in general get rid of it soon after arriving in a warm climate; and nothing but the highest degree of neglect can continue or revive it.

The facts above mentioned brought into my mind what is related of the plague at Smyrna and other places, that it disappears at the hottest part of the year. It is also curious and important to remark, that the true pestilence never has been heard of between the tropics. It is not easy to assign the cause of this effect of heat upon infection, as every thing relating to this subject is very obscure. We can conceive it to be owing to the greater degree of airiness which the heat of the climate makes necessary, or to the use of fewer woollen clothes. There may be something in the state of the body, particularly in the pores of the skin, which disposes them less to imbibe or produce the poisonous effluvia, or, when imbibed, it may more readily be thrown out by perspiration with the other acrimony of the blood; or more probably, as has been hinted above, the virulent matter is of such a degree of volatility as to be readily dissipated in a certain degree of heat54.

There is a fact, which, though seemingly of a contrary tendency, yet is in reality in proof of the same opinion. It is, that these same diseases disappear in circumstances of great cold. When England was last visited by the plague, it disappeared in winter; and the same is observed at Moscow and other places. In this case the infectious matter is rendered inert, but not extinct, and the return of heat sets it afloat in the atmosphere, so as to expose it to human respiration. Dr. Guthrie informs us, that infection is entangled and fixed by the cold of winter on the doors and walls of the houses of the Russian peasants, and that upon the return of the warm season it is set loose by the thaw, and then becoming active, produces diseases.