Kitabı oku: «Observations on the Diseases of Seamen», sayfa 2

CHAP. II

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.

TABLE III

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.

The great benefit derived to the health of the fleet, from the change of climate, as well as other reasons, justified the Admiral in going to North America; and there was the more merit in this measure, as it was undertaken without precedent, and without instruction. Upon our return we found there was great good fortune in it, as well as wisdom; for there had happened on the 10th of October a more violent hurricane than any in the memory of man, and the ravage it made both by sea and land is, perhaps, unparallelled in history. Several of the ships of the line were exposed to it; but though they suffered extremely, and were in the utmost danger, none were lost. Two of them happened to be at Antigua, which was out of the track of this hurricane, as it extended only from the 12th to the 15th degree of N. latitude; so that the only islands that suffered by it were Barbadoes, St. Lucia, St. Vincent, and Martinico. – Four frigates, and as many sloops of war, either foundered or were wrecked, and about one thousand seamen perished in them. One of the buildings of the hospital at Barbadoes was entirely demolished by the impetuosity of the sea, which, having risen to a great height, dashed a ship against it, and twenty-three seamen were buried in the ruins³.

The Montague suffered most on this occasion, and was also most subject to sickness and mortality, brought on in consequence of the great fatigue and hardships of the men in bringing her into port and refitting her; for the ship was almost torn to pieces both in the rigging and hull, and the bedding and other necessaries and conveniencies were entirely destroyed. The fever that prevailed on board at this time was of the most malignant kind known in this climate; and the worst cases arose in watering, and the other necessary duties on shore, from which the men would sometimes return frantic, and die in a few hours. There was a party of soldiers on board; and as they were not called upon to perform any duties on shore, they had but little sickness in companion of the sailors.

The other ships having suffered less from the storm, were also less sickly, as it was not necessary for them to remain so long in the unhealthy Carenage to repair.

The only disease that prevailed at this time, in these two ships, was fevers, there being few or no fluxes, though they had been so frequent in the former part of the year. Though fevers and fluxes depend on the same general causes, yet when these causes exist in a higher degree, it would appear that they are more apt to produce fevers. Thus the exhalations of the earth from marshes are more apt to produce fevers; and mere excesses of heat and cold, or moisture, are more apt to produce fluxes; just as in Europe a catarrh, which may be considered as a local febrile affection, as well as a dysentery, will be excited by exposure to cold or damp, without any specific bad quality in the air.

The Ajax and Montague are the only two ships of those left in the West Indies, which are included in the estimate of sickness and mortality in November and December, and they bear a very great proportion to the whole; for out of forty-four that died in fourteen ships of the line in November, twenty died in the Montague, and five in the Ajax; and out of forty-three, the whole number of deaths in December in twenty-one ships of the line, ten were of the Montague, and eleven of the Ajax.

CHAP. III

Account of the Health of the Fleet from January, 1781, till July, 1781, both Months included. – Arrival of seven Ships of the Line from England – Increase of Sickness in consequence of a Descent on St. Vincent’s – Long Cruise to windward of Martinico – Great Prevalence of Scurvy – Difference of Health in different Ships – New Ships not more unhealthy than others – Why Frigates are more healthy than Ships of the Line – Remarkable Cure of Scurvy in two Ships – Essence of Malt – Vegetables most antiscorbutic in their natural State – Advantage of supplying Refreshments on board of Ships in preference to Hospitals.

We are now come to that period in which our fleet was reinforced with seven ships of the line, which arrived at Barbadoes from England on the 5th of January, 1781, under the command of Lord Hood. This addition, with two which had arrived in November, made the force upon this station again amount to twenty-one ships of the line.

TABLE IV

Shewing the Number of each Disease on board on the First of each Month, the Numbers sent to the Hospital, and Dead, in the Course of the Month

KEY:

B On board.

H Sent to the Hospital.

D Dead.

N. B. Where the Spaces are marked thus, §, no Return was made.

The whole fleet was tolerably healthy during this month, the season being dry and cool; there was, however, a small increase of sickness at this time, and it was owing to a descent made on St. Vincent’s in December. The soldiers, (of whom there was still a regiment on board of the fleet) the marines, and some of the seamen, had been on shore for one night only; but many of them having lain on the ground, some having been intoxicated, or having eaten to excess of sugar-cane and fruit, caught fevers and fluxes, which increased the proportion of diseases and deaths the following months, as appears by the Table.

I have exhibited, in another Table, a view of the sickness and mortality of this fleet for the five succeeding months. (Table IV.) This account, as well as most of those that are to follow, is confined to three diseases, that may be called the sea epidemics. These are, fever, flux, and scurvy.

The whole fleet met at Barbadoes on the 13th of January, and no service was undertaken till the accounts of the Dutch war arrived on the 30th of that month. In consequence of this intelligence, the greater part of the ships of war went against St. Eustatius, which was taken on the 3d of February.

Ten days after this a squadron of seventeen ships of the line was sent to cruise to windward of Martinico, with a view to intercept a French squadron which was then said to be on its passage from Europe. The cruise was there continued for six weeks; after which small divisions of the ships were sent to water and refit, by turns, at St. Lucia, and were relieved by the ships left for the protection of that island.

Soon after this, the whole squadron came to leeward of Martinico; and though the former intelligence had proved false, the greater part of our fleet still kept the sea, in order to block up the enemy in Fort-Royal Bay. This they continued to do till the 29th of April, when a French fleet of twenty-two ships of the line, from Europe, joined by four from Martinico, forced their way into their own port, pushing to leeward our fleet, consisting only of eighteen ships of the line; so that the greater part of them did not get into port till they came to an anchor at Barbadoes on the 23d of May.

It was in this season of cruising, and keeping the sea, that the fleet contracted such a degree of scurvy as had never before been known in the West Indies. This disease is not so apt to arise in a hot climate as in a cold one; and the prevalence of it on this occasion was owing to the men having been for a great length of time upon sea victualling; for one part of the fleet had not had a fresh meal from the time of leaving America, that is, for six months; and that part of it which came last from England had been in the same circumstances for seven months; nor had any of them been in a place capable of supplying vegetable refreshments from the time they left Barbadoes in the end of January. But though no fresh meat or vegetables could be procured at St. Lucia or St. Eustatius, yet the scurvy did not make such progress in the ships that lay at anchor there, as in those that were at sea; and it appears that the time in which it prevailed most was, while the greatest number of ships was at sea, that is, in the month of March. It appears, indeed, by the Table, that there was a greater number ill of this complaint on the 1st of May than on the 1st of April; but it appears also, that more were sent to the hospital in March than in April, and very near half of the May list must have been taken ill in March⁴. The difference of being in port and at sea consists chiefly, 1st, In there being plenty of water while in port, so that it can be used freely, not only to drink, but to wash the clothes; and we know that cleanliness tends greatly to ward off the scurvy. 2dly, Though no fresh meat nor vegetables could be procured at those ports, sugar, which may be considered as a very antiscorbutic article of diet, could always be procured at a very cheap rate, and the seamen, when in port, used to exchange their salt provisions for it. 3dly, There is at sea a dismal uniformity of life, favourable to indolence and sadness, and therefore tending to hasten the progress and aggravate the symptoms of the scurvy; whereas the change of scene and variety of objects, when in port, tend to cheer and recreate the mind, and thereby to avert this disease.

The squadron that came from England under Lord Hood, suffered, upon the whole, much less from acute diseases, during the first months of their service in this climate, than the ships that arrived with Lord Rodney, which was probably owing, in part at least, to the former having arrived at the driest and coolest season of the year. The Barfleur, however, had a large proportion of all the three prevailing diseases; and large ships are in general more subject to them than those of a smaller rate. But of all the ships in the fleet, the Alfred had the greatest proportion of the three sea epidemics. The Prince William suffered more than any other ship in the fleet from the flux, and the Princessa from the scurvy. In some instances, reasons can be assigned for the prevalence of particular diseases in particular ships, such as accidental infection, or the manner in which they have been victualled, manned, or disciplined; but in many cases the cause is so subtile or obscure as to elude our inquiry.

The most healthy of the new squadron, during this campaign, were the Belliqueux and Panther; the former was a new ship, and came from England with a very irregular and ill-disciplined crew. Soon after arriving in the climate, she was threatened with a dysentery, which, though it spread a good deal, did not prove severe nor mortal; but being left at St. Eustatius on this account, while the rest of the fleet was cruising, she soon became very healthy, and remained so. This is the second instance we have had occasion to remark of a new ship being healthy.

The Panther preserved her health by being on small separate cruises, and frequently in port, not being attached to the main squadron. The Sandwich was the only other ship not engaged in the long cruise.

Of the ships lately from England, that were employed in this cruise, the Gibraltar seems to have been the least sickly. This ship left England healthy; but having received a draft of dirty men when upon the eve of sailing, a fever of the infectious kind broke out on the passage, so that she arrived in the West Indies in a sickly state. This fever disappeared very soon after; and it is proved by this, as well as other facts, that a warm climate, so far from tending to generate, or even to foster the infection of fever, tends rather to extinguish it. The Gibraltar had been put under excellent discipline by her former commander, while in the Channel service; and this being afterwards kept up, the men were always clean and regular. This was the Spanish Admiral’s ship, taken by the fleet under the command of Lord Rodney off Cape St. Vincent’s, in January 1780. She was then called the Phœnix, and was of a singular excellence both with respect to materials and construction. Whether the cedar, of which a great part of her timbers consisted, contributed to the healthiness, by its balsamic effluvia, I will not pretend to determine.

The Invincible was also uncommonly healthy during this cruise, which may likewise be ascribed to good discipline, and to her having been more than three years in commission before sailing from England, whereby the men were brought into order, and accustomed to each other and to a sea life. This ship was almost singular in having no acute diseases for several months after arriving from Europe; but at length paid the tribute to the climate in May and June, as may be seen in the Table.

From the account of the three frigates at the bottom of the list in the Table, it appears how much more healthy they are than ships of the line. The total complements of the three is exactly equal to that of one seventy-four-gun ship; but their whole sickness and mortality is less than that of any one ship of the line of that class, although the Triton was uncommonly sickly for a frigate.

There seem to be several causes for the superior degree of health usually enjoyed by this smaller class of ships. There is less chance of mixtures of men in frigates, as their complement is smaller, and it is more easy for the captain and officers to keep an eye over a few men than a great number; for, in a great ship, there are generally men, who, concealing themselves in the most retired parts, no one takes cognizance of them, and they destroy themselves, and infect others, by their laziness and filth. In the next place, there is a greater proportion of volunteers and real seamen in frigates, and more landmen and pressed men in ships of the line, the former being more in request, on account of the greater chance of prize money. Lastly, a small ship is more easily ventilated, and the mass of foul air issuing from the hold, from the victuals, water, and other stores, as well as the effluvia exhaling from the men’s bodies, is less than in a large ship.

Many other and more minute remarks might be made on different ships in this season of hard service; but to do this would be tedious, and the inspection of the Tables may suggest observations to the reader. There is a striking and instructive fact, however, with regard to two ships, which I cannot help relating. The Alcide and Invincible, both of seventy-four guns, in working to windward, after the action with the French fleet, on the 29th of April, anchored at Montserrat on the 11th of May, in order to water. They remained there only part of two days, and they procured no refreshment, except a few bushels of limes. The scurvy then prevailed to a great degree in both ships; but between this time and the 23d of May, when they came to an anchor at Barbadoes, sixty men, who had been confined with this disease, were discharged, as fit for duty, from the sick list of the Invincible, and a hundred and fourteen from that of the Alcide. These were the only two ships that had the advantage of the limes; and during these twelve remaining days of the voyage the scurvy continued to increase in all the other ships. Dr. Lind is the first author who gives a decided preference to lemons, limes, and oranges, over every other antiscorbutic; and the above-mentioned fact proves as demonstrably as possible the infinite advantage of this species of acid in scurvy.

The fleet was supplied with essence of malt during all this campaign; and though it was, no doubt, of service, it was far from having that powerful and manifest effect that the acid fruits had, and certainly did by no means prevent the scurvy in all cases. I have strong testimonies, however, of its beneficial effects from the surgeons of several of the ships, particularly of the Gibraltar, Centaur, Torbay, and Alcide, in all of which it was found either to cure the scurvy in its first beginning, to retard its progress, or to mend the appearance of scorbutic ulcers, and dispose them to heal.

I had conceived that melasses, being a vegetable sweet, must have been a very powerful antiscorbutic; but the greatest part of the last reinforcement of seven ships came from England furnished with this as an article of victualling, as a substitute for a certain proportion of oatmeal, which was withheld agreeably to a late very judicious order of the Admiralty. But though I am persuaded that this article of diet mitigated the disease, it was very far from preventing it; and the Princessa in particular, which suffered most from the scurvy, was well supplied with it.

There is reason to think that it is not in the vegetable sweet alone that the antiscorbutic principle resides, but in this in conjunction with the natural mucilage, such as exists in the malt. I suspect likewise that the change which the essence undergoes in its preparation tends also to rob it of some of its original virtue. But the melasses are still farther altered by being deprived of the natural mucilage by means of quick lime, with which all sugar is clarified in the boilers. Dr. Hendy, of Barbadoes, to whom I have been obliged for several remarks, informed me, that the liquor, before it undergoes this operation, has been found by him to produce the most salutary effects in the scurvy; but as this cannot be had at sea, we had no opportunity of comparing it with other antiscorbutics. It is certain also that the medical effects of the native sweet juices are, in other respects, very different from what they are in their refined state; for manna, wort, and the native juice of the sugar cane, are purgative; whereas sugar itself is not at all so⁵. This affords a presumption, that they may be also different in their antiscorbutic quality; and there is reason to think, from experience, that the more natural the state in which any vegetable is, the greater is its antiscorbutic quality. Vegetables, in the form of sallads, are more powerful than when prepared by fire; and I know, for certain, that the rob of lemons and oranges is not to be compared to the fresh fruit. Raw potatoes have been used with advantage in the fleet, particularly by Mr. Smith, of the Triton, who made the scorbutic men eat them, sliced with vinegar, with great benefit. This accords also with what Dr. Mertans, of Vienna, has lately communicated to the Royal Society of London.

When the fleet arrived at Barbadoes on the 23d of May, it was found that the number of sick on board amounted to sixteen hundred, and that there was not accommodation for more than two hundred at the hospital. As there was hardly any complaint but scurvy, the Admiral, at my representation, issued an order for serving the sick on board of their own ships with fruit and other vegetables and refreshments, such as milk and soft bread. This course of diet commenced in the beginning of June; and as the greater part of the fleet was near four weeks thereafter in port, they enjoyed the advantages of it during that time; and the very great diminution of sickness and mortality, which appears by the Tables in that month, sufficiently evinces the benefit derived from it. In less than four weeks the fleet, from being very sickly, became extremely healthy.

It was remarked, that the men recovered faster on board than on shore; and it would appear that land air, merely as such, has no share in the cure of the scurvy, and that the benefit arises from the concomitant diet, cleanliness, and recreation. The expedient of curing men on board of their ships was here suggested by necessity; but it succeeded so well, that it was adopted afterwards in preference to an hospital, which is indeed a useful relief to a fleet where there are contagious, acute disorders; but with regard to scurvy, I am convinced, that on foreign stations, at least, where the accommodations of the sick are more indifferent than in England, many advantages would arise from supplying men with refreshments on board of their ships. It appears that only four men died of this disease in the whole fleet in the month of June, though there were so many ill of it; whereas it appears by the books of hospitals, that scorbutic men die there in a much greater proportion, and chiefly in consequence of other diseases, particularly the flux, which they catch by infection, or bring on by intemperance. It is farther in favour of this scheme, that great numbers of those sent on shore are lost by desertion. It is also a great saving to Government, the expence not being a fourth part of what it would cost at an hospital.

The fleet left Barbadoes on the 10th and 12th of July, and continued healthy till the greater part of it sailed for North America in the beginning of August.