Kitabı oku: «Observations on the Diseases of Seamen», sayfa 5
It appears by the tables, that a greater number was put on the list under the head of other complaints in this month than the last. This was owing to the great number of ulcers which I have remarked to keep pace with feverish as well as scorbutic complaints; for when the constitution of the air is favourable to disease, or the habit of body prone to it, wounds and sores are found then to be more difficult of cure. There were twelve deaths besides those occasioned by what have been called the three epidemics. Of these, five perished by drowning and other accidents, three died of ulcers, one of wounds received in action, one of cholera morbus, and one of an abscess.
It has appeared that very few ships of this numerous fleet preserved their health while lying at anchor; and it would seem that short and frequent cruises are very conducive to health. It was eleven weeks from the time that the first of our fleet came to anchor at Jamaica till the main body of it sailed for America on the 17th of July. Great fleets are in time of war under the necessity of being at one time longer at sea, and at another time longer in port, than is consistent with the health of the men, the ships being obliged to act in concert and to co-operate with each other. This is one reason, among others, for ships of the line being more sickly than frigates. As ships of war must be guided by the unavoidable exigencies of service, it would be absurd to consider health only; but if this were to be the sole object of attention, a certain salutary medium could be pointed out in dividing the time between cruising and being in harbour; and it is proper that this should be known, that regard may be had to it, as far as may be consistent with the service. I would say, then, that in a cold climate men ought not to be more than six weeks at sea at one time, and need not be less than five weeks, and that a fourth part of their time spent in port would be sufficient to replenish their bodies with wholesome juices. In a warm climate men may be at sea a considerable time longer, without contracting scurvy, provided they have been under a course of fresh and vegetable diet when in port.
Though contagion is not so apt either to arise or to spread in this climate as in colder ones, there were several circumstances about this time tending to prove that it may exist in a hot climate. Those ships which had their men returned to them from the French prizes, in all of which fevers prevailed, had an increase of sickness not only in the men that were returned, but in the rest of the crew. There was another presumption of contagion, from the proportion of mortality among the surgeons and their mates, who were by their duty more exposed to the breath, effluvia, and contact of the sick. There died, during our stay at Jamaica, three of the former, and four of the latter, which is a greater proportion than what died of any other class of officers or men.
It has been the opinion of some, that fevers do not arise from any putrid effluvia, except those of the living human body, or some specific infection generated by it while under the influence of disease. It has been alledged in proof of this, that the putrid air in some great cities is breathed without any bad effects; and a celebrated professor of anatomy19 used to observe, that those employed in dissecting dead bodies did not catch acute diseases more readily than other people. I believe this may be true, in a climate like Europe, where cold invigorates the body, and enables it to resist the effects of foul air; but I am persuaded it is otherwise in tropical climates. The external heat of the air induces great languor and relaxation, and we cannot breathe the same portion of air for the same length of time in a hot as in a cold climate, without great uneasiness. The want of coolness must, therefore, be compensated by a more frequent change of air, and by its greater purity: any foulness of the air is accordingly more felt in a hot climate; and, according to the modern theory, air, already loaded with putrid phlogistic vapour, will be less qualified to absorb the same sort of vapour from the blood in the lungs, in which, according to this theory, the use of respiration consists. Be this as it will, there is something in purity of air which invigorates the circulation, and refreshes the body; and the contrary state of it depresses and debilitates, particularly in a hot climate; and in this way foul air may induce disease, like any other debilitating cause, independent of infection, or any specific quality. There was no reason to suspect any such infection in the Ville de Paris; for there was no sickness on board of this ship when in possession of the enemy, and the sickness that prevailed after her being captured seemed to proceed from what may be called simple putrefaction. There was an instance of the same kind in one of our own ships of the line, in which a bad fever broke out in the beginning of July, which seemed to be owing to the foul air of a neglected hold; for there was a putrid stench proceeding from the pumps, which pervaded the whole ship. I perceived this very sensibly one day, when visiting some officers who were ill of fevers; and before I left the ship an alarm was given of two men being suffocated in what is called the well, which is the lowest accessible part of the hold. This fever was of a very malignant kind, and fell upon the officers more than the men; for six of them were seized with it, of whom three died on the third day after being taken ill.
The fevers, which were of the greatest malignity at this time, affected the officers more than the common men. Only one captain died at Jamaica while the fleet was there, and it was of this fever. We lost five lieutenants, of whom four died of it; and this was the disease which carried off the three surgeons. But foul air was not the only cause that produced this fever among the officers, several of whom brought it on by hard drinking, or fatiguing themselves by riding or walking in the heat of the sun. It cannot be too much inculcated to those who visit tropical countries, that exercise in the sun, and intemperance, are most pernicious and fatal practices, and that it is in general by the one or the other that the better sort of people, particularly those newly arrived from Europe, shorten their lives.
Before leaving Jamaica, I sent to England a Supplement to the Memorial given in, last year20.
CHAP. V
Account of the Health of the Fleet, from its leaving Jamaica on the 17th of July, till its Departure from New York on the 25th of October. – What Diseases most prevalent on the Passage to America – Rapid Increase of the Scurvy during the last Week of the Passage – Method of supplying the Sick at New York – The Fleet uncommonly healthy in October – State of the Weather and of Health in America in Summer and Autumn, 1782.
The season of the hurricanes approaching, and all the convoys destined for England this year being dispatched, the main body of the fleet, consisting of twenty-four ships of the line, left Port Royal on the 17th of July, under the command of Admiral Pigot, in order to proceed to the coast of America. A great convoy for England had been sent off a few days before, protected by the Ville de Paris and six other ships of the line, which we overtook and passed at the west end of the island. When we arrived off the Havannah, a large squadron of the enemy was seen there in readiness to sail, which induced the Admiral to wait in sight of it for the convoy, which did not come up till ten days after. Owing to this delay, and our meeting with baffling winds on the rest of the passage, we did not arrive at New York till the 7th of September. We found there the Invincible and Warrior, which sailed after us, but arrived before us, by having taken the windward passage.
Table, shewing the proportional Prevalence of different Diseases, and their Mortality, in July, 1782
Transcriber’s Keys:
A Proportion of those taken ill in the Course of the Month.
B Proportion of Deaths, in relation to the Numbers of the Sick.
The mortality this month, in relation to the whole numbers on board, was one in a hundred and thirty.
There were only one in thirty-eight of the sick sent to the hospitals.
The fevers arose chiefly during the first two weeks after leaving Jamaica, which renders it probable that the seeds of them were brought from thence. Had they been owing to the heat simply, they would have been as apt to arise in some subsequent part of the passage; for the tropical heats at this season of the year extend to the 30th degree of latitude, which we did not cross till the 22d of August, that is, near five weeks after leaving Jamaica. The only ships in which the fever could be imputed to infection or foul air were the Barfleur, Alcide, and the Aimable frigate. The first had received, as recruits, at Jamaica, men who had been confined for some time before in a French jail, and a fever of a bad kind spread on board of her soon after. The Aimable was a prize from the French; and the sickness was here so evidently owing to foul air, that, whenever the contents of the hold were stirred, so as to let loose the putrid effluvia, there was then an evident increase of sickness. The fever in the Alcide was of a peculiar slow kind, to be described hereafter, and seemed to be a continuation of the same infection which had so long existed in that ship.
The Duke, which had hitherto been by far the most subject to fevers of any ship in the fleet, became more and more free from them even in the most early part of this passage, and might be said to be entirely so at the time she arrived in America. The fever had been so very prevalent in this ship since leaving England, that there was hardly a man who had escaped it. Could this have any effect in making them less liable to catch it a second time?
In the course of this passage the dysenteries came to prevail over the fevers, as we have found to be commonly the case at sea. It appears by the former table, compared with the next, that the mortality in fevers was much the same, and that in the dysentery it was greater than while the fleet was at Jamaica. This does not argue, however, that the diseases were equally malignant, but was owing to the want of an hospital, and of those comforts of diet which the sick enjoyed on board while in harbour. This last was particularly felt in the dysenteries, in the cure of which more depends upon diet than in most other diseases. In all the calculations of mortality on board of ships, if any have been sent to the hospital, they are to be deducted from the number; and these make a greater difference in the mortality on board than their numbers simply would indicate; for only the worst cases, and those therefore who were most likely to die, used to be sent to the hospital. But as the fleet was at sea during the whole of this month, no allowance of this kind is to be made.
Table, shewing the proportional Sickness and Mortality in August
Transcriber’s Keys:
A Proportion of those taken ill in the Course of the Month.
B Proportion of Deaths, in relation to the Numbers of the Sick.
The mortality this month, in relation to the whole numbers on board, was one in one hundred and sixty-nine.
The scurvy began to appear very soon upon this passage; for by the end of August, at which time the fleet had only been six weeks at sea, and that in a warm climate, and in dry weather, it had made considerable progress. It first appeared and prevailed most in the Prince George and Royal Oak, though they had been ten weeks at Jamaica. This was the first sickness with which the latter had been affected since arriving in the West Indies; and there was no perceivable peculiarity in either of them to account for their being subject to it more early, or more violently, than the rest of the fleet. If the disease is contagious, as has been suspected, there might be a few men on board of them, who, being uncommonly prone to the disease, would be soon affected, and communicate it, or at least hasten the symptoms in those who might be less predisposed to it. But this is only conjecture. Before the end of the voyage, the whole fleet was more or less afflicted with it, though it had been only seven weeks and three days at sea; but the men had received so few refreshments while in port, that their constitutions were prepared to fall into this disease. The Barfleur, Alfred, and Princessa, were most affected with it next to the two ships mentioned above.
The seventeen ships which arrived from England in February and March were much less affected with it than the rest of the fleet, which was, no doubt, owing to the wine, melasses, and sour krout, with which they were so amply supplied. Though these articles were all expended before leaving Jamaica, yet the good effects of them on the constitutions of the men were visible in the course of this passage.
The America was the most free from it of all the ships of the old squadron; and this was owing to the great humanity and attention of the captain21, who, as soon as any of the men were taken ill, allowed them wine and other refreshments from his private store. There was another proof in the Conqueror of the great importance of attending to this disease in its earliest stage. Mr. Lucas, the surgeon of this ship, by watching the first beginnings of it, by a proper regulation of diet, and the administration of the essence of malt and juice of limes, not only prevented the progress of the disease, but proved, that, with great attention, it may even be cured at sea. It is of the utmost consequence in this disease to put the men on the sick list on the very first appearance of the symptoms, so that they may early have the advantage of proper treatment and regimen. It is only at this period of it that the effects of essence of malt are sensible; but we have seen that the juice of certain fruits will cure it in more advanced stages.
There is a very important remark suggested by comparing the two preceding tables with that which follows. It appears that in the month of September a much greater number was taken ill of scurvy, and also that there died of this disease a greater proportion than in the two preceding months. All the mischief from it in that month happened in the first week of it, during which as many died as in the whole month of August; for the fleet came to an anchor on the 7th of September at New York, where the worst cases were immediately sent to the hospital, and those that remained on board were supplied with every necessary refreshment. Had the fleet remained longer at sea, the mortality would probably have increased in the same progression; and this circumstance ought to be well considered in undertaking cruises.
Table, shewing the proportional Prevalence of Sickness and Mortality in September
Transcriber’s Keys:
A Proportion of those taken ill in the Course of the Month.
B Proportion of Deaths, in relation to the Numbers of the Sick.
The proportion of deaths, in relation to the whole numbers on board, was one in three hundred and ninety-eight.
About one third of all the sick were sent to the hospital.
As the proportion of ulcers was uncommonly great, I thought it worth while to make a calculation of it. The Barfleur had the greatest number; and this ship, for causes I cannot assign, was more afflicted with bad ulcers than any other in the fleet, for several months together.
The fleet having arrived at New York in this unhealthy state, the first care was to make provision for the sick. There were somewhat more than fifteen hundred on the sick lists of all the ships, and the hospital could accommodate little more than six hundred. In order that it might not be overcrowded, and that each ship might have a just share of relief, I went round the fleet to ascertain the due proportion of those cases that were the most proper objects for being sent on shore. All the infectious and acute Complaints, and some of the worst scorbutics, were accordingly sent to the hospital. Those who were kept on board being chiefly such as were affected with the scurvy, were supplied with various refreshments in their respective ships, and seemed to recover as soon as if they had been sent on shore. They had indeed almost every advantage enjoyed by those at the hospital; for, besides fresh meat thrice a week, and spruce beer daily in common with the other seamen, each man on the sick list was supplied every week at the public expence with four pounds of apples and half a pound of sope. There were also thirty casks of limes taken in a prize, which were distributed among the scorbutic men, and proved of infinite use. Admiral Pigot’s great zeal for the good of the service, as well as his natural humanity, induced him to listen to whatever was proposed for the benefit of the men.
The supply of sope was a thing entirely new in the service; but the good effect of all the other articles would most probably have been defeated, unless the men had been furnished with the means of cleanliness, which is the most essential requisite of health. The advantage of this method will appear by the returns of next month to have been very conspicuous; and it was on this occasion more than any other that I saw realised in every particular the plan proposed in the memorial to the Admiralty. It may be added, that the sick that were left on board were not even without the recreation of the shore enjoyed by those at the hospital; for most of the captains had the attention to send daily on shore, for amusement and exercise, such as were able to walk. Thus there were all the advantages of an hospital obtained at much less expence to Government, and without the risque of intemperance, desertion, or infection, which are the inconveniencies connected with an hospital. What farther contributed to health at this time was, a large quantity of excellent wine with which the fleet was supplied.
Table, shewing the proportional Sickness and Mortality in October
Transcriber’s Keys:
A Proportion of those taken ill in the Course of the Month.
B Proportion of Deaths, in relation to the Numbers of the Sick.
The proportion of deaths in this month, in relation to the whole number on board, was only one in fourteen hundred and seventy-eight.
About one in twenty-nine of the sick was sent to the hospital.
There was, upon the whole, less sickness and mortality in this month than in any other during which I kept records of the fleet. This was, no doubt, owing in part to the climate, but was chiefly the effect of the extraordinary attention paid to the refreshments of the men. The fleet was here exactly in the same situation, and at the same season, two years before, but was not near so healthy.
Nor were the advantages derived from the great plenty of refreshments, procured at this time at New York, merely temporary; for the men’s constitutions were so much improved by them, that the part of the fleet which remained under the command of Lord Hood was at sea for twelve weeks without being affected by the scurvy. This was chiefly to be ascribed to the previous refreshments; for we have seen, that, in a passage of seven weeks from Jamaica to New York, the fleet was greatly affected with the scurvy, in consequence of not having had the advantages of fresh meat and vegetables when last in port. The climate had, no doubt, also a share in keeping off the scurvy; for the greater part of the twelve weeks was taken up in a cruise off St. Domingo; and, I believe, it never was known that a fleet was so long at sea, in a cold climate, without being greatly affected with this disease.
It appears, that though the proportion of fevers had increased somewhat this month over that of fluxes, yet the former were less fatal; and, I think, the true dysentery is more frequent in this climate, and more apt to prove fatal in its acute state, than in the West Indies. I have indeed preferred the term flux to that of dysentery, for this reason, that the symptoms in many cases did not rise so high as properly to constitute dysentery; and the disease proves fatal in the West Indies more frequently in the chronic than in the acute state. The fluxes were daily gaining ground when we left New York, and continued to prevail to a great degree in the Magnificent, which remained in that climate several weeks after us.
The climate and situation of the fleet had a greater effect in diminishing ulcers than any other complaints; for the proportion of them in this month is little more than one third of what it was in the last.
The calculation for October was made upon thirteen ships of the line, which sailed from New York on the 25th of that month.
The weather had then begun to grow cold; but few or none of the diseases peculiar to a cold climate had appeared. There occurred, while we were at New York, several cases of inflammation of the liver among the officers and men who came from the West Indies. It was remarked formerly, that this complaint hardly ever occurred in the West Indies; but it would appear that the residing there disposes to an inflammation of this organ upon changing to a colder climate.
The preceding summer had been uncommonly cold, not only in North America, but in the whole temperate part of the northern hemisphere, so far as I could learn by inquiry. In consequence of this, the crops failed in Europe, America, and the northern parts of Asia. The same circumstance had a remarkable effect on the reigning diseases of the season at New York; for, instead of the bilious complaints common in the end of summer and in autumn, a slight fever of the inflammatory kind had prevailed. An epidemic catarrh had spread all over Europe, and some part of Asia, in the earlier part of the year; and perhaps this was connected with the peculiar state of the atmosphere about this time. It was before observed, that there was something unusual in the state of the weather at Jamaica while the fleet lay there; and it is possible that this might be owing to the same general cause.
