Kitabı oku: «Observations on the Diseases of Seamen», sayfa 6

CHAP. VI

Account of the Health of the Fleet from its Departure from New York till the Conclusion of the War. – Passage to the West Indies – Account of the Ships there during our Absence – Arrival of a Squadron from England – Of these, two Ships only were healthy – Causes of this – Inflammatory Complaints in the Union – Probable Cause of these – Comparison of the two Squadrons – Increase of Sickness from Recruits brought from England – from French prisoners.

Thirteen ships of the line sailed from America for the West Indies on the 25th of October, under the command of Admiral Pigot, and the other half of the fleet was left under Lord Hood, to watch the motions of the French squadron, which was then at Boston.

The day on which we left the coast of America a storm came on, which lasted two days; but the rest of the passage being fair and moderate, we arrived at Barbadoes on the 20th of November, where the fleet continued for the remainder of the month.

All the above-mentioned squadron, except two ships, is comprehended in the calculation of the following table, and also the Magnificent, Prudent, and Nonsuch. The two last had continued in the West Indies, during our absence.

Table, shewing the Prevalence of Sickness and Mortality in November

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.

About a sixth part of the whole sick were sent to the hospital this month, and one half of these were sent to the hospital at Halifax from the Magnificent.

The proportion of deaths this month, in relation to the whole number on board, was one in eight hundred and eighty-seven.

Fewer were taken ill this month than the preceding, but more in proportion died; which might partly be owing to the fleet having been more at sea, and partly to the change of climate.

Fevers were now more numerous, and also more fatal than any other disease; and we see them follow the contrary proportion to fluxes in the progress to the southward, that they did in our progress to the northward. These fevers prevailed chiefly in the Formidable and Warrior. In the former it first appeared among some men that had been pressed at New York from a privateer, some of whom were seized a few days after our arrival at Barbadoes with the yellow fever, and they were the only instances of it at this time in the fleet.

The scurvy continued to diminish, but the ulcers increased as we came into the torrid zone.

Diseases in general were so slight and so few at this time, that the whole squadron from America sent only forty-eight men to the hospital at Barbadoes from its arrival to the end of the month.

It may be proper here to give an account of some of the ships that remained on this station, while the main body of the fleet was in America.

The Prudent, when she left us, was extremely healthy, and continued so till a flux broke out in July, which was communicated by some men from a cartel, who were ill of this disease. It spread among the ship’s company, and prevailed for three months. The only deaths during the seven months that this ship was separated from the fleet were, two from flux, and one from scurvy, and only twenty-five were sent to hospitals. This is a proof how much more healthy the windward station is than that of Jamaica. The scurvy arose at one time, in a cruise of five weeks, though there was no appearance of it at another time in a cruise of six weeks. The cause of this seems to be the difference of the weather at the two periods; for it was very wet in the former, and very dry in the latter. The time in which this ship was most exposed to sickness was while she was under repair at Antigua, a situation in which hardly any ship escapes a severe visitation of sickness; yet this ship was not at all affected by it, which seemed to be owing to the uncommon pains taken by the captain to prevent the men from labouring in the sun during the hot part of the day.

The Nonsuch was five months separated from the fleet, during which time ten men died. Nine of these died of fevers, and one of the dysentery. She sailed from Jamaica for Barbadoes about the same time that the fleet sailed for North America, and was nine weeks on the passage. A fever was the prevailing disease, and the men probably inhaled the seeds of it at Jamaica, in common with most of the other ships’ companies that were there. The scurvy, which had formerly prevailed so much, appeared at this time; but it was in a very moderate degree, considering the length of the passage. None died of it, and few were so ill as to require being sent to the hospital. Had this ship gone into a colder climate, like the others, it would probably have prevailed to a greater degree. The whole number sent to the hospitals for various complaints, during the five months, was only thirteen.

The Nymph frigate was the only other ship left in the West Indies which is included in the tables. There happened only two deaths in her from June to October, both months included. One of these was from scurvy, the other from asthma. She was in that time upon two cruises, each of which lasted eight weeks. During the first the weather was dry and fine, and during the other it was wet and sultry, with the same effect upon health as in the Prudent; for in the second cruise the scurvy prevailed to a considerable degree, but not at all during the first. This disease was prevented from becoming violent or fatal, on either occasion, by the great attention of Mr. Anderson, the surgeon. He found great benefit from the essence of malt, when given early in the complaint; and some limes having been taken in a prize, while this disease was at the worst, the scorbutic men were so much recovered by the use of them, that they were all able to return to duty before the ship arrived in port.

DECEMBER

The whole squadron remained at anchor at Barbadoes, and nothing worth notice occurred till the arrival of a reinforcement of eight ships of the line, under Sir Richard Hughes, on the 8th of December. This squadron had been detached by Lord Howe, after the relief of Gibraltar, and the action with the combined fleets on the 20th of October. It consisted of one ship of 90 guns, one of 80, three of 74, and three of 64. They sailed from England on the 9th of September, and from that time till their arrival at Barbadoes they had not been in port, except for ten days that they were at Madeira, where they were supplied with fresh meat, fruit, and vegetables, by which means the scurvy, which had begun to prevail to a considerable degree, was almost entirely eradicated, and the health of the men was surprisingly restored, for so short a time.

When they joined us, however, there was a good deal of sickness on board of them all, except the Union and Ruby. The former had been more than three years in commission, and in that time had never been sickly, and had now all the advantages of a long-established and well-regulated ship’s company. All the rest had been newly commissioned and manned when they left England. The superior health of the Ruby was owing to her having been manned with the crews of other ships, some of which had just arrived from the West Indies; whereas the others had been manned chiefly by draughts of pressed men from guardships, or by raw volunteers, of whom a great many were raised in Ireland about this time. The Bellona and Berwick having been somewhat longer in commission than the rest, were less sickly.

The following tables will shew the comparative state of health of the squadron formerly on the station with that which had newly arrived from England.

Table, shewing the Prevalence of Sickness and Mortality in the old Squadron, in December

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 the deaths this month to the whole number of men belonging to this part of the fleet, was one in eleven hundred and two. There were fifty-six sent to the hospital, which was one in eighteen of all the sick.

Table, shewing the Prevalence of Sickness and Mortality in the new Squadron, in December

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 the deaths this month to the whole number of men belonging to this part of the fleet, was one in four hundred and forty.

There were one hundred and eighty-nine sent to the hospital; but the proportion to the whole number of sick cannot be ascertained, as we do not know how many were on the list on the first of the month.

The increase of fevers in the old squadron was chiefly owing to their having spread in the Nonsuch; and they seemed to partake more of that kind which originates in jails and ships, than of that which is peculiar to the climate. The body of one of the men who died of this fever was inspected at the hospital, and there was found to be inflammation and even perforation of the intestines, without any previous symptom that could lead to expect such an appearance, a circumstance more likely to happen in the former sort of fever than the latter.

The increase of scurvy was owing to the numbers that were taken ill of it in the Magnificent on the passage from Halifax, from whence she sailed in the beginning of this month, and joined the fleet at Barbadoes in the end of it. There was a great deal of sickness in this ship at Halifax, and on the passage, owing to the want of such clothing as was suitable to that severe climate. One of the principal complaints was an inflammatory sore throat.

There was no change in the situation of the fleet, only that four ships of the line were sent on the 16th to cruise near Guadaloupe, and they continued at sea till the beginning of February.

The new squadron was much afflicted with the jail fever, brought from England; and it was much more prevalent, as well as malignant, on board of the Suffolk than any of the rest. During the passage it prevailed most in the Princess Amelia, not less than twenty having died of it. It subsided in this ship before she arrived in the West Indies; but on board of the Suffolk it continued to rage for some months after.

As the hospital at Barbadoes was too small to contain all the sick of this squadron, only the cases of greatest danger and the most infectious were sent on shore, and those that remained were provided with fresh vegetables and milk on board of their own ships, in the same manner as had been formerly practised with such success on similar occasions. This was continued for four weeks, during which time they all got into tolerable health, except the Suffolk.

There appeared, by the returns of the new squadron, to be a greater number under the head of “Other Complaints,” which was owing to the number of pulmonic complaints, the consequence of the influenza which prevailed in Europe, at sea, as well as on shore, in the spring and beginning of the summer of this year.

Though inflammatory complaints are rare in this climate, yet in a few of the ships there was some appearance of them; and I remarked that they occurred in those ships which were in other respects most healthy, and most free from infection. A good many of the men were seized with inflammatory sore throats in the Bellona a few days before she arrived at Barbadoes, and this was in other respects the most healthy ship next to the Union and Ruby. In the Union there was no violent acute complaint whatever, which was very singular among so great a body of men; but several rheumatisms, coughs, and catarrhs, arose in her this month, and there even occurred two pleurisies in the following month. The bowel complaints which occurred on board of this ship were also of an inflammatory nature. These distempers seemed to proceed from accidental exposure and irregularity; and is it not highly probable that these causes, instead of producing local inflammatory complaints, might have been the means of exciting bad fevers and fluxes, as in the other ships, had the men been equally predisposed to them, by living in foul air, or under the influence of infection?

The following tables will shew the comparative state of health of the two squadrons in the three first months of next year.

Table, shewing the Prevalence of Sickness and Mortality in the old Squadron in January, 1783

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 number on board, was one in twelve hundred and fifty-seven. About one fifteenth of all the sick were sent to the hospital.

Table, shewing the Prevalence of Sickness and Mortality in the new Squadron in January, 1783

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 to the whole number on board was one in five hundred and forty. About one in thirty of all the sick were sent to the hospital.

Table, shewing the Prevalence of Sickness and Mortality in the old Squadron in February

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 to the whole number on board was one in sixteen hundred and ninety-seven. One ninth of all the sick were sent to the hospital.

Table, shewing the Prevalence of Sickness and Mortality in the new Squadron in February

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 to the whole number was one in twelve hundred and seventy-six. The proportion sent to the hospital was the same this month as in the other part of the squadron.

Table, shewing the Prevalence of Sickness and Mortality in the old Squadron, in March

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 to the whole number was one in thirteen hundred and sixty-one. About one ninth of all the sick were sent to the hospital.

Table, shewing the Prevalence of Sickness and Mortality in the new Squadron, in March

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 to the whole number was one in four thousand and eighty-seven. About one in eleven of all the sick were sent to the hospital.

The main body of the fleet remained at Barbadoes till the 12th of January, when they went to cruise to windward of Martinico, in order to intercept a French squadron expected from North America. This cruise lasted four weeks; and intelligence being received of the enemy’s having taken a different route, the whole fleet bore away for St. Lucia, where it came to an anchor on the 8th of February.

In the course of the three months above mentioned, we see the two squadrons approaching to each other, in point of health, till they became pretty equal and similar; and the new squadron became even somewhat more healthy than the old.

The increase of fevers in the old squadron was owing to two causes. One was the importation of new-raised recruits brought from England by some ships that arrived in the beginning of January. These were distributed to such ships as stood most in need of men; and being very dirty and ill cloathed, were likely to harbour infection. They were evidently the cause of sickness in the Warrior and Royal Oak; for these ships were before that time healthy, and the fever began with these strangers, and spread amongst the former crew. It is remarkable that the ships that brought them from England were not affected by them.

It was caught in the Royal Oak from six men that came from England in the Anson, which men, though first put on board the Namur, communicated no fever there, having been kept separate from the rest of the men; but being sent to the Royal Oak, they were themselves first taken ill with a fever, which afterwards spread to about thirty of the other men. What was singular in this fever was, that the eyes and skin of all that were affected by it became yellow, though without any particular malignancy; for only two died on board, and one in the hospital. There was one whose skin was very yellow, yet his complaint was so slight as never to confine him to his bed.

The other cause of the increased proportion of fevers in the old squadron was, the great number of these complaints that arose in the Magnificent. This ship having been sent on a cruise about the middle of February, and the weather being rainy, squally, and uncommonly cold, for the climate, many fevers of the inflammatory kind appeared. During this cruise she made prize of a large French frigate, called the Concord, and the greater part of the prisoners being taken on board, the fever from that time assumed a different type, with new and uncommon symptoms; for, instead of being inflammatory and requiring bleeding, as before, it became more of a low, putrid kind, and was attended in most cases, if not in all, with a continual sweating; so that, instead of evacuations, the remedies that were found most effectual were the Peruvian bark, blisters, and opium. Thus we see fevers variously modified according to men’s constitutions, the state of the air, and the noxious effluvia of the strangers that intermix with them.

We find the proportion of fluxes increasing in the new squadron in January and February, as they had formerly done in most of the ships soon after their arrival from England. They were observed also to prevail principally in those ships that had formerly been most subject to fevers, and not to arise till the fever had subsided. They were found, for instance, to arise later in the Suffolk, where the fever was obstinate and malignant, than in the Princess Amelia, where the fever had been at one time general and fatal, but not so violent and lasting as in the other.

The four ships that were sent to cruise near Guadaloupe continued at sea for seven weeks; and it was owing to the prevalence of scurvy in these and in the Magnificent that the proportion of that disease was greater at this time in the old than in the new squadron.

The fleet remained at St. Lucia till the accounts of the peace arrived in the beginning of April. The service was then at an end, and I returned to England with the first division of the fleet, which sailed from St. Lucia on the 12th of April, under the command of Rear-admiral Sir Francis Drake, who was at this time in extremely bad health, and requested me to accompany him.

PART I

BOOK III

Of the Numbers and Mortality of different Diseases sent to Hospitals

CHAP. I

Hospital at Gibraltar, 1780 – at Barbadoes, 1780 – Causes of Mortality from various Diseases – Accidents – the Hurricane – Wounds – Amputations – Scorches – Fluxes very apt to arise at the Hospital – Proportion that were received and died at Antigua – St. Christopher’s – St. Lucia, and at Barbadoes, 1782 – at Jamaica, 1782 – at New York, Autumn, 1780 – 1782 – General View of the Admissions and Mortality at all the Hospitals during the War.

In order to judge of the loss sustained by disease, in the course of that service of which a relation has been attempted, the sick sent to the hospitals must be taken into account. I shall, therefore, give a short view of the different diseases admitted, and their mortality, at the several hospitals connected with the fleets in which I served. This will serve also to illustrate the different effects that different situations have upon the health and recovery of men²².

The fleet which effected the first relief of Gibraltar, under the command of Lord Rodney, consisting of twenty ships of the line, arrived there in the third week of January, 1780, after a passage of three weeks and a few days from England, in which they had an action with the Spanish fleet, and obtained a victory over them, on the 16th of that month. The whole fleet, except one ship, sailed from Gibraltar on the 13th of February, and while it lay there, the diseases sent to the hospital, and their respective mortality, were as follows²³:

²⁴This comprehends not only the deaths in the time the fleet remained there, but all that happened afterwards. The mortality, from wounds and ulcers, is greater than might be expected in so fine a climate, and at the coolest season of the year; but as the place was then besieged, the sick and wounded could not be supplied with those refreshments that were necessary to the recovery of the men, and wounds and ulcers are complaints very apt to be affected by the quality of the diet.

The following is an Account of the Men admitted at the Hospital at Barbadoes in the Campaign of 1780, that is, from the 16th of March till the end of June:

The fevers were chiefly from the five line-of-battle ships that came immediately from Europe in March. Upon their arrival they sent on shore one hundred and ninety-three men ill of fevers, only one with the flux, fifteen with the scurvy, and five with ulcers.

When these ships returned to Barbadoes in May, along with the rest of the fleet, the greater part of the sick were then also on board of them. By that time the flux and scurvy had broke out. The former prevailed chiefly in the Terrible; the latter in the Intrepid. That part of the fleet which we found on the station sent on shore a very small proportion of all the classes of complaints, except wounds.

Of the wounds, nineteen were amputations, of which there died nine, mostly of the locked jaw. There were forty-six scorched by gunpowder, of whom there died fourteen; so that, besides those who were killed outright, and those who died on board in consequence of accidents of this kind, before they could be sent to an hospital, about one fourth of all the wounds, and the same proportion of all the deaths from wounds, at the hospital, was owing to this cause. This circumstance ought to induce commanders to take every precaution to prevent such accidents. In the subsequent part of the war they were less frequent, in consequence of that greater caution, and more accurate method of working great guns, which were acquired by practice and experience²⁵.

In the account of the mortality, I have included only such as died before the 1st of January, 1781; for if any were carried off after that time, it was most probably by some incidental complaint. There were sixty-five of them at that time remaining, and they were chiefly men disabled by lameness waiting for a passage to England as invalids.

Out of the twenty-three that were killed by the fall of the house in the hurricane on the 10th of October, eight were of the number above accounted for; but these are not included in any of the classes of deaths.

The mortality among the men admitted at this time was greater than what occurred afterwards in any of the hospitals that I attended, except that at Jamaica. The principal cause of this was, that as the fleet was so much greater than had ever been known here before, there was not suitable accommodation for such numbers as it was necessary to send on shore, and we had not then fallen on the method of supplying refreshments to the men on board of their ships. The circumstance by which the men suffered most was, the great crowding which the want of room made necessary. There is here no public building appropriated for an hospital; so that this, as well as every thing else, being found by contract, and the number of sick being so much greater than it was usual to provide for, the whole was at this time conducted in a manner not very regular.

It appears that the greatest mortality in any class of disease was that of the fluxes, of which the greatest number sent to hospitals are such as have languished for some time under this disease, in which state it generally proves fatal in the West Indies, in consequence of incurable ulcers in the great intestines, to which the heat of the climate, as well as the scorbutic habit and sea diet, is particularly unfavourable. But the whole of the mischief arising from it does not appear in the table; for it was the most apt of any disease to supervene upon other complaints which were under cure at the hospital. It more particularly attacked those who were recovering from the scurvy, and was the cause of the greater number of deaths under this head in the table. It was found to be more contagious than fevers, either because the men’s constitutions were more predisposed to it, or, perhaps, because the infectious matter of it being more gross and less volatile, it is not so readily dissipated by the heat of the climate; for, either from this, or some other circumstance, infectious fevers are not so easily generated, nor so apt to spread, as in Europe. That these fluxes were owing to infection may be inferred from hence, that, when men ill of the scurvy were cured on board of the ships they belonged to, they were not liable to this disease, neither did they prevail at these hospitals afterwards, when great care was taken to separate infectious diseases from the others.

The only regular hospital on this station is that at Antigua. This island being the seat of the royal dock yard, there is an established hospital in time of peace as well as war. It so happened, that great fleets never came here to put their sick and wounded on shore, as at Barbadoes; so that the greater number of those received into it were from single ships that came to careen. As there was, therefore, less necessity for crowding, and as the slighter cases could be admitted, there was a less proportion of deaths here than at most of the other hospitals.

There were two other establishments for the reception of the sick and wounded on this station, but they were only temporary. These were at St. Lucia and St. Christopher’s, where the men being received in great numbers at a time from large fleets, and as there were accommodations only for the most urgent cases, the mortality approached more nearly to that of Barbadoes. There died at St. Christopher’s, in the years 1780 and 1781, in the proportion of one in six, and at St. Lucia, in the same time, one in five and a half, or two in eleven. The air of the hospital at St. Lucia was remarkably pure, and this degree of mortality was owing to the sick having been accommodated in tents and huts. In the two last years of the war, when an hospital was built, and regularly established, the mortality was not much above one half of this.

Some authors have endeavoured to form an estimate of the success of practice from the different rates of mortality; but this is extremely fallacious; for the fatality of diseases will depend on their violence, the proportion of deaths being very different in cases that are slight, from what it is in those that are dangerous. We shall take a view, however, of the hospital at Barbadoes at another period, in which there seemed little or no difference in the violence of the disease, and when the superior success seemed to be owing to the hospital’s not being so crowded, and to the better attendance and treatment of the sick. The following is a view of the diseases that were admitted in the last three months of the year 1782, the greater part of which were landed from the reinforcement of eight ships of the line that joined the fleet at Barbadoes in the beginning of December:

It happened on this, as on the former occasion, that none were sent on shore but such as were very ill, or had contagious complaints, the rest being provided with refreshments on board of their ships. There were no wounds at this time, but there was a greater proportion of fevers; so that the complaints, upon the whole, might be said to be about equally dangerous. The mortality now was, however, considerably less, and this is to be imputed to the more favourable situation of the hospital, which I did not allow to be overcrowded; and the men had all manner of justice done them in point of attendance and accommodation.

I shall give another example of the same kind in the hospital at Jamaica, when our fleet went there after the battle of the 12th of April. All the men accounted for here were landed from the fleet under Lord Rodney in May, June, and July, 1782²⁶.

This uncommon degree of mortality was not owing to the bad air of the place, for Port Royal is naturally as healthy as most parts in that climate; nor was it owing to bad accommodations, or to neglect of any kind; but is imputable entirely to this circumstance, that the hospital being extremely small, those only were sent to it who were very ill. There were at this time upwards of forty ships of the line at Jamaica, and an hospital, containing only three hundred beds, could afford but a very inadequate relief. Some officers are unwilling that any man should die on board of their ships, for fear of dispiriting the others; and many were sent to the hospital, in the most desperate stage of sickness, that they might there die.

There cannot be a stronger proof than this of the fallacy of judging of the success of practice by the proportion of the deaths; for the sick on this occasion were better accommodated, better provided for in every respect, and as regularly attended, as at any other period of my service in the West Indies, yet the mortality was greater than at any other time.

Having given instances of the common rate of mortality in hospitals in Europe and the West Indies, I shall next give examples of the success we had in North America, when the fleet was there in the autumns of 1780 and 1782.

Account of the Sick landed at New York from the West-India Fleet, consisting of eleven Ships of the Line, in Autumn, 1780.

Account of the Sick landed at New York from the West-India Fleet, consisting of twenty-six Ships of the Line, in Autumn, 1782.