Kitabı oku: «Observations on the Diseases of Seamen», sayfa 3

PART I

BOOK II

Continuation of the Medical History of the Fleet, from August, 1781, till the Conclusion of the War in April, 1783.

CHAP. I

Some Account of the Interval between the Campaign of 1781 and the Junction of the Reinforcement from England in April, 1782. – The main Body of the Fleet goes to North America – Lord Rodney goes to England, and returns to the West Indies with twelve Ships of the Line – Health of the Fleet in England – Sickness most prevalent in the Beginning of a War – A natural Tendency to Recovery in Ships and Individuals – Advantages of this Squadron in point of Victualling.

When the main body of the fleet went to America in August, Lord Rodney went to England for the recovery of his health. – Wishing to lay before the public boards several reforms that suggested themselves to me in the course of the late service, I accompanied the Admiral, purposing to return when the season for hostile operations should have brought back the fleet from the coast of America.

Soon after arriving in England, I presented a memorial⁶ to the Board of Admiralty, proposing such means for the preservation of the health of the fleet as had occurred to me during my past service.

The Board of Admiralty considered this memorial with all the attention that could be expected in the general hurry of service, inseparable from a great and extensive war; and I am happy in being able to say, that, in consequence of my application, most of the particulars recommended have since been so far carried into effect as to produce a practical conviction of their utility.

Lord Rodney having recovered his health, hurried out to his station with all the force that could then be equipped, as the enemy were expected at the Caribbee Islands, with a superior force, after their successes against us in the autumn campaign in America.

I had again the honour to accompany the Admiral. He first sailed from Portsmouth, with four ships of the line, on the 14th of December, and was to have been joined by two more that lay ready at Plymouth; but by the time we arrived off this harbour the wind became contrary, whereby we were detained there till the 14th of January, 1782. During this time more ships were got ready, and six were added to the squadron; for the public anxiety at that time called forth every exertion to strengthen this reinforcement, upon which the fate of the whole West Indies was supposed to depend.

This fleet cleared the Channel in the midst of a storm, and with the wind at the same time so scanty, that we barely weathered Ushant; but Lord Rodney’s perseverance and resolution, stimulated by the exigency of the occasion, banished all hesitation and timidity. The rough weather, and contrary winds, continued through the variable latitudes; but having met with fresh blowing trade winds, common at that season, we had the good fortune to get safe to Barbadoes with the whole squadron on the 19th of February.

All the twelve ships⁷ of this reinforcement had been on service for a considerable length of time since they had been last commissioned, except the Anson, a new ship, which had never before been at sea, and the Fame and Yarmouth, which had lately undergone a thorough repair, since which time they had been only for a few weeks at sea in the Channel before they were ordered on this expedition.

The only ship that was sickly when we left England was the Fame, on board of which some pressed men, with the infection about them, had been received from the Conquestadore guardship; and the fever which broke out in Plymouth Sound, where I was first sent for to visit that ship, was probably owing to the infection which these men brought with them. The other ships were, upon the whole, healthy; for it appeared by the weekly accounts delivered to the Admiral, that the mortality, including even that of the Fame, for the four weeks before we sailed, had been only one in thirteen hundred, and that there had been about one in twenty-nine on the sick list.

An opportunity offered on this occasion of comparing the health of ships of war in England with that in the West Indies. The health of the fleet in general at home was at this time about the proportion above mentioned; but it is to be remarked, that it was healthier then than in the former part of the war.

Plymouth hospital, which is calculated for twelve hundred men, was not half full; and there were not at this time more than six hundred men at that of Haslar, which is calculated to contain two thousand; but the latter was generally full during the first two or three years of the war, from the great fleets that put into Portsmouth. At one time part of the sick were even obliged to be accommodated with tents in the neighbourhood of the hospital, for want of room. But towards the end of the year 1781 the infectious fever, which constitutes a great part of the sickness in the European seas, was almost extirpated, and in a cruise of five weeks in the north part of the Bay of Biscay, under Admiral Darby, in September and October of this year, only six men were buried in that time from twenty-eight ships of the line.

This was chiefly owing, as I apprehend, to the length of time which the war had continued, in consequence of which the men of the respective ship’s companies had been accustomed to each other, and habituated to the mode of life peculiar to a man of war, regulating themselves according to certain rules of good order and cleanliness. The causes of the fever above mentioned, as shall be more fully illustrated hereafter, are chiefly connected with the circumstances occurring in the beginning of a war, when men of all descriptions are mixed, without proper precautions being taken to guard against the infection imported from jails or guardships. The sickness in the French fleet was still greater in the beginning of the war than in the British; and this has been the case in all the wars of this century. In the fleet commanded by the Comte d’Orvilliers, in 1779, the sickness was so great as to disable many of the ships from service, and great numbers of men were landed at Brest, with a fever so malignant as to infect the inhabitants of the town and country adjacent. I believe, besides, that the general health prevailing at this time in the fleet in England, was, in part, owing to the sour crout and melasses, which were now supplied more amply than had ever been done before. The entire exemption from scurvy in particular is to be ascribed to these improvements in diet.

There is a tendency in acute diseases to wear themselves out, both in individuals that labour under them, and when the infection is introduced into a community. Unless there was such a vis medicatrix, there could be no end to the fatality of these distempers; for the infectious matter would go on multiplying itself without end, and would necessarily destroy every person who might be actually attacked, and would infect every person who might be exposed to it. But animal nature is so constituted, that this poison, after exciting a certain set of motions in the body, loses its effect, and recovery takes place; and those who happen not to be infected at first, become in some measure callous to its impression, by being habitually exposed to it. There is, therefore, a natural proneness to recovery, as well with regard to that indisposition which takes place among a set of men living together, as with regard to a single individual who actually labours under the disease. Thus the most prevailing period of sickness is when men are new to their situation and to each other, so that time of itself may prove the means of prevention as well as of cure.

This consideration, however, ought not to supersede any part of our attention with regard to the scurvy, which does not become spontaneously extinct like acute diseases.

During the three first weeks of this passage from England to the West Indies, there was wet and boisterous weather, but it had very little effect in augmenting sickness; and though it not only subjected the men to fatigue, cold, and damp, but prevented the ships from opening their lower-deck ports till the 2d of February, between the 31st and 32d degree of latitude, thereby producing close air and moisture where the men sleep, yet, in the whole squadron, from its leaving England till this time, there were only seven deaths, four of which were in the Fame.

The only sea epidemic that made its appearance was the infectious ship fever, which, in many cases, was attended with pleuritic, rheumatic, and other inflammatory symptoms, owing to the cold and wet, to which the men were exposed in the variable latitudes. The warm, dry, fresh breezes which we had during the remainder of the passage, were probably what prevented any bad consequences from the former hardships, for there died only four men from the above-mentioned date till we arrived at Barbadoes; and it appeared by the Admiral’s weekly account, that the proportion of the sick neither increased nor diminished from the time we got into a warm climate and fine weather till our arrival on the 19th of February.

This squadron left England with several advantages in point of victualling, which no ships had before enjoyed. They were amply supplied with sour crout and melasses; they had all more or less wine, of an excellent quality; and the Formidable had an entire supply of it, in place of spirits, of which none was put on board. This slip had hitherto, and did for some months afterwards, enjoy an extraordinary, perhaps an unparallelled, degree of health. What farther contributed to the health of this ship was, that she had been long in commission, and most of the recruits with which the crew had been completed were men turned over from other ships. There was also extraordinary medical attention paid, particularly in watching the first beginnings of complaints.

Upon the arrival of the squadron at Barbadoes, it was found, that, the two hostile fleets having returned from North America in the beginning of December, the campaign had opened with the siege of St. Christopher’s, which had been invested by twenty-eight ships of the line, and a considerable army. Our fleet, under Lord Hood, having attempted, with great enterprise and skill, but without success, to relieve it, Lord Rodney made haste to join them with the reinforcement he had brought from England. He remained at anchor at Barbadoes only one night, and in a few days came off Antigua, where he was informed of the surrender of St. Christopher’s; and here, on the 25th of February, he was joined by the rest of the fleet in their return to windward.

CHAP. II

Account of the Health of the Fleet from the Junction of the Squadron from England, till the general Rendezvous at St. Lucia in the Beginning of April. – The Fleet found on the Station very healthy – Health of the Ships from the American Station – Health of the Ships from England compared with that of the Ships found on the Station – Small-pox prevalent – Instance of the remarkable Efficacy of Lemon Juice in curing the Scurvy – Additional Reinforcement from England – Watering Duty dangerous and unhealthy – The most healthy Ships those that had been longest in the Climate – List of the Numbers taken ill of each Complaint in March – Inflammation of the Liver not common in the West Indies.

The fleet which was found in the West Indies consisted of all the sixteen that went from thence to America in August, 1781, (except the Terrible, which had been lost) together with six ships of the line⁸ from the American station, the St. Albans, which arrived from England in November, and the Russel, which had remained in the West Indies during the hurricane months. They were all extremely healthy, having only one man in twenty-eight on the sick list, and very few had been sent to hospitals.

This fleet, after arriving from America, had lain at anchor for three weeks at Barbadoes, where it had the advantage of the vegetable refreshments which that island affords; but during three weeks that it lay at anchor, in the face of the enemy, at St. Christopher’s, the men were excluded from all communication with the shore, and had no vegetable food, except some yams, with which they were supplied from Antigua, in place of biscuit, of which there was at this time a scarcity. These ships had therefore been in no port for six weeks, except for a few days that they lay in the road of Antigua refitting, and putting the sick and wounded on shore.

The men had also been deprived of their natural rest, and exposed to the air during all the time that the fleet was at anchor before St. Christopher’s; for they had been twice attacked by the enemy in that situation, and were therefore under the necessity of keeping the ships constantly clear for action; yet no increase of sickness followed. This might partly be owing to the eagerness and alacrity of spirits naturally excited in such a situation, and also to the fleet not lying under the lee of any land, and having springs upon their cables, so that they had all the perflation and all the purity of air which ships enjoy when at sea. The fumigation which ships undergo in battle, has also been thought to contribute to their health.

To whatever cause it was owing, the fleet we found in the West Indies was at this time healthier than that which had just come from England; and there was but little difference in the degree of health of the different ships that composed it. Of those which left the West Indies in August, and returned in December, the only one that could be said to have any epidemic disease was the Prince William, which had never got entirely free from the dysentery that was formerly mentioned as prevailing so much on board of this ship last year. The disease was kept up, by the ship never having been cleared of the men affected with it, and by the crew in general being ill provided with slops⁹, a circumstance that would render them more susceptible of whatever infection they might be exposed to.

There were also some remains of the same disease in the Intrepid, the seeds of it having been more or less continued from the summer of 1780, at which time it prevailed to a most violent degree. The Alfred had a few of all the sea epidemics, and had been for a long time before more or less in the same situation, from a neglect of cleanliness, particularly of the men’s persons.

The only ship in which there was any thing like an epidemic was the Canada, This ship, when at home, had for many months before she sailed been in unremitting service, and very little in port. On the passage from England to America, in August, 1781, there broke out a severe dysentery, to which the scorbutic habit of the men, from being so long at sea, probably predisposed them. Though it had abated much in February, 1782, it was then by no means extinct, and continued till April. The Prince George had been in commission all the war, and was a model of discipline and cleanliness, and consequently of health. This continued till the passage from America, when, upon the first cold weather after leaving New York, there broke out a violent dysentery, of which sixteen men died. This is agreeable to what Dr. Lind observes, that the flux may be brought on by a sudden transition, either from cold to heat, or from heat to cold. All the men that were ill of this disease having been sent to the hospital at Barbadoes, and the usual attention to cleanliness having been kept up, the disease entirely vanished.

All the other ships of the American station had been more or less visited with sickness after they left England, except the Bedford. This was probably owing to this ship having been longer in commission than any of the others, that is, for four years, and all that time under the same commander. This last circumstance falls to the lot of few ships; but a great advantage attends it; for the mutual knowledge and attachment of the captain and ship’s company is naturally productive of regularity and good discipline, and thereby of health.

The Royal Oak, Prudent, and America, which left England with the Bedford, though they had been afflicted with the scurvy and other complaints soon after arriving in America, had been quite healthy for some time before coming to the West Indies, and were so much so at this period, that, though there were a few sores and slight complaints on their sick lists, there was not a man confined with illness, so as properly to be called sick. The Royal Oak, having been the flag ship of Admiral Arbuthnot, was manned with choice seamen, which is a circumstance generally conducive to health; for these being accustomed to a sea life, are more provident, more handy and methodical in all that relates to diet, cloathing, and cleanliness. The scurvy, which infected her upon first arriving in America, was successfully treated on board by serving to those who were ill of it a mess, composed of soft bread, baked on purpose, and mixed with wine and essence of malt.

The Prudent, though now quite healthy, had been sickly soon after being put into commission in Europe, and upon first arriving in America. She had been uncommonly sickly, when a new ship, upon her first voyage, which was to the East Indies, during the peace. This remarkable degree of sickness was probably owing to a particular experiment that was made in preparing the wood of which she was built. This experiment consisted in soaking the timber for a length of time in a strong pickle, in order to make it less corruptible. The only other ship on which the trial of this was made was the Intrepid; and it has been already mentioned that this was an extremely sickly ship. The effect of it upon the wood was to cause a constant moisture and mouldiness in the orlops and holds. In the Intrepid, the sickness was never conquered till a practice was followed of pumping and bailing her with great care, and putting a fire into the well for six hours every day, by which means the dampness, and the mildew produced by it, were removed and prevented, and the ship thereby rendered healthy.

The two squadrons being united, and consisting of thirty-four ships of the line, proceeded to St. Lucia, where they arrived on the 1st of March.

I received monthly returns as formerly, and the form of them was improved by adding a column for the numbers taken ill of the several diseases in the course of the month. The returns of February are not complete, there being none for the 1st of that month, as we had not then arrived; but as the returns of the 1st of March have relation to the preceding month, a judgement may be formed of the sickness and mortality of February from the following table:

Extract from the Returns of the 1st of March, 1782.

This account is abstracted from the returns of twenty-nine ships of the line, and two frigates.

The diseases and deaths under the head of “Other Complaints,” is much more numerous in this month than usual, which is chiefly owing to the preceding actions with the enemy, and to the prevalence of the small pox. Of the deaths under this head, seventeen were in consequence of wounds, six from small pox, one from a mortification¹⁰ in the shoulder, and one from consumption.

None of the epidemics affected one part of the squadron more than another, except that the ships last from England had a less proportion of the flux than the rest; and the few cases of this disease that were in these ships arose after their arrival in the climate. The Conqueror and Fame, which were the two most sickly ships, had no complaints but fevers.

The fevers had now begun to take on some of the characteristic symptoms of the climate; the chief of which is a greater abundance of bile. In the Repulse, two men had the yellow colour of the skin, which is so peculiar to the fevers of this climate.

The crew of the Anson caught an infectious fever from a guardship in England; and when the Prothée sailed, there was a fever of the same kind on board; but from the change of climate, the symptoms became milder, and the disease disappeared in both these ships in the course of this month.

The small pox prevailed more at this time in the fleet than I have ever known it to do either before or since, and that both in the squadron from England and in that from North America. There were six cases in the Formidable, all of which did well, though two were of the confluent kind.

Though there needs hardly any additional proof of the extraordinary efficacy of lemon juice in curing the scurvy, yet it may be of service to impress so useful a truth on the mind by mentioning such striking proofs of it as occurred from time to time. The Arrogant spoke with a Portuguese vessel near Madeira, from which some of this fruit was procured, and the only scorbutic man on board happening to have some of the most desperate symptoms, such as putrid gums, contracted hams, the calves of the leg hard and livid, and frequent faintings, a fair opportunity offered for trying its virtues. The man was allowed two of them daily, and was perfectly well in sixteen days, during all which time the ship was at sea, so that it was impossible to ascribe the cure to any other cause.

The fleet remained at St. Lucia from the 1st till the 18th of March, completing the water, provisions and stores, landing the sick at the hospital, and also watching the motions of the enemy, who arrived about the same time at Martinico from the siege of St. Christopher’s. During this time we were reinforced with the Duke, of 90 guns, and the Warrior and Valiant, of 74 guns, from England. On the 18th the whole fleet, except the Invincible, which was detached with a convoy to Jamaica, sailed on a cruise to windward of Martinico, in quest of a French convoy expected from Europe; which having eluded us, and got into their own harbour, the whole fleet returned to St. Lucia on the 30th of March, excepting the Prudent, which was sent to Barbadoes.

We found at St. Lucia the Magnificent, of 74, and the Agamemnon, of 64 guns, which were the last reinforcement of this campaign, making the British fleet on this station amount to forty ships of the line, a much greater force than was ever before employed on foreign service. They were all copper bottomed.

The weather continued fine all this month, yet there was some increase of sickness, owing chiefly to the hardship the men underwent in wooding and watering. In Choc Bay, where the fleet watered, there was at this time a higher surf than was ever remembered, which made the operation of watering (at all times noxious in this climate) uncommonly toilsome and dangerous. It was, indeed, next to impracticable; for many longboats were staved on the beach, by which several men had their limbs broken, and some lost their lives, by being crushed or drowned; but the necessity of the service admitted of no relaxation or delay. There was no increase of wind to account for this surf, so that it was owing either to something in the currents, or to some subterraneous cause; and there had been felt at Barbadoes and St. Lucia, about this time, a slight shock of an earthquake¹¹, to which many imputed this extraordinary surf. In other respects, there were fewer causes of sickness than usually occur to a fleet in port in this part of the world; for the air of the road is remarkably pure, and there were fewer temptations and opportunities of intemperance than at the other islands.

The monthly returns of the surgeons were very full and complete; but as it would be tedious to insert at length those of every particular ship, and as the number of ships fluctuated in different months, I shall do no more hereafter than set down the general results from calculation, so as to shew the proportional prevalence of disease and mortality in each month.

Table, shewing the proportional Sickness and Mortality in March

Transcriber’s Keys:

A Proportion of those taken ill in the Course of this Month.

B Proportion of those who died, in relation to the Numbers of the Sick.

The first column is formed by dividing the whole number on board by the number taken ill. The second column is formed by first adding the number ill on board on the first of the month to the number taken ill during the month, subtracting from this sum the number sent to the hospital, and dividing the remainder by the number of deaths.

The number on the sick list of twenty-eight ships of the line, and two frigates, on the first of this month, was eight hundred and forty-five; the number put on the lists in the course of the month was one thousand eight hundred and eighty-four; and the number sent to the hospital in the same time was three hundred and seventy-three; and there died on board thirty-one.

The total mortality this month, in relation to the whole number of men on board, was one in six hundred and seven.

It almost always happens, that ships of war are more or less short of complement, and allowance is made for this in all the calculations; for having had an opportunity of inspecting the weekly accounts delivered to the Admiral, it was always in my power to be informed how many there were short of the legal complement of men in each ship.

It appears, from comparing the Tables of this month with those of the preceding, that there had been a great increase of fevers and fluxes, particularly of the latter. The fevers prevailed chiefly in the ships lately from England, especially the Fame and Conqueror. In the Duke there were a great number ill of fevers; but this ship not having arrived from England till after the first of the month, is not included in the calculation. The fluxes were most prevalent in the ships we found on the station, particularly the Canada, Resolution, and Nymph frigate. The scurvy had increased very little, but prevailed most in the ships we found here. The only ships of the new squadron that had this disease to a considerable degree, were the Conqueror and Nonsuch. The former had indeed a good many ill of it; but the return having been made in an imperfect manner, this ship is not included in the calculation.

But the ships that were by far the most healthy were those that had been the longest from England, the Ajax, Russel, Montague, Royal Oak, and Prudent. There had been formerly a great mortality in all these ships; and it would appear that this uncommon degree of health was owing, in some measure at least, to this circumstance, that the most weakly had been swept off by the different distempers to which they were exposed; so that only the more hardy and robust had survived.

Under the head of “Other Complaints,” a much smaller number were put on the list, and still fewer died, in this than the preceding month. This difference is owing to the number that died of wounds last month.

There died on board, in the course of this month, thirteen of fevers, seven of fluxes, and seven of other complaints, of whom five died of small pox, one of asthma, and one of wounds he received at St. Christopher’s.

In order to show more fully and minutely what are the complaints incident to fleets in this climate, I shall set down a list of the numbers taken ill of the different diseases and accidents during this month, extracted from the returns of twenty-eight ships of the line, and two frigates.

The number of ulcers bears here a smaller proportion to the whole than it does in general to the sum total of the sick list; for being the most tedious of all complaints, they consequently accumulate more than any other. Thus many of the cases now set down as slight accidents, will, in the ensuing month, be in the state of obstinate ulcers.

Most of the diseases of one hot climate resemble those of another, so far as I know; but there is one disease which we hear of as being extremely prevalent all over the East Indies, which is hardly ever met with in the tropical regions of the West. This is the inflammation of the liver, of which I remember to have seen only one well-marked case, and it was that of a gentleman who had been in the East Indies, and had been subject to it there: nor do I recollect more than one, or at most two, cases of this sort out of several thousand cases of various diseases that were reported to me. This is either owing to the greater heat and dryness of the air in the East Indies, or some other peculiarity with which we are not acquainted¹².

Every other inflammatory complaint exists more or less, though they are much rarer than in cold and temperate climates. The phthisis pulmonalis is not so common as in cold climates, but proves sooner fatal to most constitutions. There are certain pulmonic complaints, particularly those of the asthmatic kind, to which the climate of the West Indies is remarkably favourable; but those in which there are tubercles and ulceration seem to be hurried faster to a fatal termination. The climates, from the thirtieth to the fortieth degree of latitude, seem to be best suited to consumptive complaints. The rheumatisms that occur in hot climates are mostly of the chronic kind.