Observations on the Diseases of Seamen

45

See Martin’s History of the Western Islands, and Medical Communications, Vol. I. page 68.

46

There are some contagious diseases which cannot be propagated but by their own peculiar infections, as has been before observed, just as the seeds of vegetables are necessary to continue their several species; so that if the infectious poison were lost, so would the disease. Of this kind are the small pox, and the other diseases to which man is subject but once during life. There are other diseases which produce infection without having themselves proceeded from it. Of this kind are fevers and fluxes.

But there is no infection of any kind, however virulent, that affects indiscriminately all persons exposed to it. If a number of persons, who never have had the small pox, are equally exposed to it, some will be seized, while others will escape, who will be affected at another time, when they happen to be more susceptible. It is doubtful how far the habit of being exposed to such specific infections renders the body insensible to them, as was said with regard to fevers; but there is another principle of the animal œconomy laid down and illustrated by Mr. Hunter, which goes at least a certain length in explaining this variable state of the body with respect to its susceptibility of infectious diseases. This principle is, that the body cannot be affected by more than one morbid action at the same time. If a person is exposed to the small pox, for instance, while he labours under a fever, or while he is under the influence of the measles, he will not catch the first till the other has run its course. It may happen, therefore, that people escape the effect of contagion in consequence of being at the time under the influence of some other indisposition, either evident or latent: and supposing the body to be exposed to a number of noxious powers at the same time, one only could take effect. But it seems difficult to explain why some of those who are actually seized, and who have previously been to all appearance in equally good health, shall have it in a very mild degree, while in others it will be malignant and fatal. This is very remarkable with regard to the small pox, which are in some cases so slight, that they can hardly be called a disease, while in others they are so malignant, as hardly to admit of any alleviation from art. May not this, in some measure, be explained from some of the principles above mentioned, in the following manner: – The small pox, in their mildest form, are attended with little or no fever, which, therefore, is not essential to them; and when we see them attended with various forms of fever, and thereby prove fatal even in the most hale constitutions, we ought not to attribute this to any thing in the nature of the small pox, but rather to say, that they have served as an agent in exciting a fever, for which there happened to be some previous latent disposition, that would not otherwise have exerted itself, and that this disposition, or contamination, as it may be called, may have been induced by some past exposure to morbid effluvia, which either from habit, or some other circumstance, may not have been sufficiently powerful to excite the constitution to fever without some such stimulus. Any other occasional circumstance producing disturbance or irregularity in the functions of the body, may, in like manner, excite any particular kind of fever to which the body may at that time be disposed. Thus the amputation of a limb will have this effect; also exposure to cold or fatigue, and intemperance in eating or drinking.

It would appear from these considerations, that there are certain circumstances, or temporary situations of constitution, which invite infection, and render its effect more certain and violent in one case than another. There are artificial methods, however, of obtruding it, as it were, upon the constitution, though not particularly disposed, or even though averse to receive it; and may not this, in some measure, account for the greater safety of some diseases when communicated by inoculation, than when caught in the natural way?

But these, as well as many other facts in animal nature, do not admit of a satisfactory explanation upon any principle as yet known. Even the most common operations of the body, such as digestion and generation, when considered in their causes and modes of action, are so obscure and mysterious, as to be almost beyond the reach of rational conjecture. A little reflection will teach us the utmost modesty with regard to our knowledge of such things; for nature seems to have innumerable ways of working, particularly in the animal functions, to which neither our senses can extend, nor perhaps could our intellects comprehend them. Had we not, for instance, been endowed with the sense of sight, nothing could have led us even to suspect the existence of such a body as light; and there may be numberless other subtile and active principles pervading the universe, relative to which we have no senses, and from the knowledge of whose nature and exigence we must for ever be debarred. We have, indeed, become acquainted with electricity by an operation of reason; and animals have lately been discovered to which the electric fluid serves as a medium of sense through organs calculated to excite it, and to receive and convey its impressions.

But there are few subjects we can study that are more subtle and obscure than the influence of one living body on another. There is a familiar instance of the great subtilety of animal effluvia, and also of the fineness of sense in a dog’s being able to trace his master through crowds, and at a great distance; and we can conceive that infectious matter may adhere, and be communicated in a similar manner. We have endeavoured to illustrate the great obscurity of its operation by an allusion to generation, digestion, and other animal functions, with which it is equally obscure and inexplicable. It is similar to generation in this, that its influence does not pass from one species of animal to another; for the poison of the plague, that of the small pox, that of fever, and the venereal disease, do not affect brutes157, nor do the infectious diseases of brutes affect different species of them, nor the human species. The only exception to this, that we know of, is the bite of a mad dog.

From these facts, and also from what was formerly mentioned of contagion not affecting indiscrimately all that may be exposed to it, it would appear that some nice coincidence of circumstances is necessary to modify an animal body, so as to receive its action. There must be a sort of unison, as it were, or sympathy, betwixt different living bodies, so as to render them susceptible of each other’s influence.

It is none of the least curious facts with regard to infection, that there are some species of it by which the body is liable to be affected only once in life. When this is considered, it is indeed conformable to what happens in the course of the disease itself; for, unless there was in the body a power of resisting it, there could be no such thing as recovery. Where the disease actually exists, the continued presence of the poison, which is also infinitely multiplied, would infallibly prove fatal in all cases, unless the living powers were to become insensible to it158.

47

It is sincerely to be wished that this were adopted, and it is surprising that an article so salutary and necessary, and so difficult to be procured on foreign stations, should not have been the object of public attention, rather than a mere article of luxury, such as tobacco. But in order that it might not be a matter of choice with seamen, it would be worth while to supply them with it at prime cost, or even as a gratuity, and then they might be compelled to use it for the purpose of cleanliness. There are other articles of less importance, but being necessary to enable men upon foreign stations to keep themselves neat and clean, deserve to be made the object of public instruction. These are handkerchiefs for the neck, thread, worsted, needles, buckles, and knives.

48

At the time I am writing this, (March 8th, 1785) there has occurred a fact which proves the effect of time in generating infection. There now prevails a contagious fever in several of the hospitals in London, and, among others, in that to which I am physician. In another hospital it has been so violent, that there has been a vulgar report that the plague had broke out in it. The same fever also prevails among the poor at their own houses. The cause of it seems to be, that the cold weather has been uncommonly long and severe; for the frost began early in December, and the cold has hitherto been more like that of winter than spring. The thermometer all this month has varied from 30° to 35°. Cold is favourable to infection, by preventing ventilation; for people exclude the air in order to keep themselves warm, and the poor in particular do so on account of their bad clothing, and their not being able to afford fuel to make good fires. Heat is the great destroyer of infection, and seems to act by evaporating, and thereby dissipating it; and the effect of fires in apartments is to produce a constant change of air, thereby preventing its stagnation and corruption, and the accumulation of unwholesome effluvia. With this view, a chimney is of great use, even though no fire should be kept in it, as it serves for a ventilator. But if an aperture were to be made in an apartment merely with a view to ventilation, it should be placed in that part of the wall next the ceiling; for foul air naturally tends upwards, and the external air entering at the top of a room, would not be so apt to subject those within to the effect of cold, as it would not blow directly upon them. There would also be this advantage in jails, that apertures in this situation would not be so liable to be forced for the purpose of escape as if they were nearer the floor; and in hospitals they would be out of reach of those who, wishing to indulge in warmth, at the expence of pure air, might be induced to shut the windows. But an external communication with the air any where is of the utmost importance; and it is observable in Mr. Howard’s account of prisons, that the jail distemper was most frequently to be met with where there was no chimney.

49

It is of some consequence to attend to the materials of the seamen’s beds; for, instead of flock, they are frequently fluffed with chopped rags, which, consisting of old clothes, emit a disagreeable smell, and may even contain infection.

50

By a berth is understood the interval between two guns, or any space between decks, which is sometimes formed into a sort of apartment by means of a partition made of canvass.

51

It is remarkable that this method of purifying was practised in the most ancient times, as we learn from the following passage in Homer, where Ulysses is represented fumigating the apartments of his palace in which the suitors had been slain:

This practice was probably founded in superstition, rather than the knowledge of nature. That some divine influence should be ascribed to fire was very natural, as the principal deities of the ancients were only personifications of the elements; and it is worthy of remark, that their name for sulphur signifies something divine το θεῖον, which was probably owing to its being found in those chasms of the earth, in Sicily and Italy, which were supposed to communicate with the infernal regions; for the whole Greek mythology relating to these was taken from the phænomena attending the subterraneous fires in those parts. It is curious farther to remark, in other instances, how facts useful to mankind, the truth of which has been confirmed in later times by the more enlightened knowledge of nature, were first suggested by some superstitious circumstance. Thus the wound received by Sarpedon could not be cured, according to the Poet, till, by divine intimation, he was desired to apply to it the rust of the spear with which it had been inflicted, in consequence of which it healed. But the weapons in those days were made of brass, so that the rust of the spear must have been the ærugo æris, which has been found by the experience of modern surgery to be one of the best detergents in ill-conditioned sores. It is probably, from a false analogy, founded on some such incident, that an idea prevails among the vulgar, which has become proverbial, that some part taken from the offending body is good in all external injuries. Thus some part of a mad dog is said to have a virtue in curing his bite. Herein may be seen the difference of that knowledge which is suggested by superstition, and that which is acquired by the observation of nature.

52

A loggerhead is a large round mass of iron, with a long handle to it.

53

A fact, related in Anson’s Voyage, is also strongly in proof of the same opinion. When the rich Spanish prize was taken, it was necessary to crowd the prisoners into the hold, for fear of an insurrection, which was to be dreaded from their numbers; yet, when they arrived in China, none of them had died, nor had any disease broke out. They suffered only in their looks, being wan and emaciated to a great degree.

54

It may be brought as a farther proof of a warm climate being unfavourable to every sort of infection, that though the itch is very common in ships and hospitals in Europe, I do not remember ever to have met with it in the West Indies, except in ships newly arrived from England.

55

This circumstance, in the character of the English, is only of modern date; for we learn from Erasmus, who was in England about two hundred and fifty years ago, that they were then extremely slovenly. The following passage is extracted from a letter he wrote to a physician in York, after his return to Holland: – “Conclavia solâ fere strata sunt argillâ, tum scirpis palustribus, qui subinde sic renovantur ut fundamentum maneat aliquoties annos viginti sub se fovens sputa, vomitus, mictum canum et hominum, projectam cerevisiam et piscium reliquias, aliasque sordes non nominandas.” He adds, that the windows were very ill calculated for ventilation, and imputes to the closeness and filthiness of the houses the frequent and long continued plagues with which England was infested, and particularly the sweating sickness, which, he says, seemed peculiar to this country. He mentions that his own country had been freed from the pestilence by certain changes that the State had made in the houses, in consequence of the advice of some learned man. Erasm. Lib. xxii. Epistol. 13. – It is probable that the greater number of those epidemics, called plagues, were only bad infectious fevers. What would contribute still more to the production of infection was the want of linen, which was hardly in use in those days. The disappearance, or at least the great diminution of such complaints in modern times, particularly in London, has been ascribed to the great increase in the proportion of vegetable food; but it is certainly more owing to the improvement in personal cleanliness, and to the greater spaciousness and neatness of houses. As a farther proof of this, it may be mentioned that in the charity, called the Charterhouse, in London, founded by Henry the Eighth, for the maintenance and education of poor boys, their sustenance is all animal food, as it was at the original institution, yet they are extremely healthy. The same observation applies to Winchester school, which was founded some ages before that.

There are some passages in ancient history in confirmation of the same opinion. Herodotus relates, that the ancient Egyptians were the most healthy of all the nations, except the Libyans, and he imputes this to the invariableness of their weather, and the serenity of their sky. But he mentions in another part of his works, that they were also the most cleanly of all people, not only in their household utensils, but in their persons, and that their clothing was chiefly of linen, which it was one of the principal studies of their life to wash and keep clean – ἑιματα δε λινεα φορεουσι ἀιει νεοπλυτα ὲπιτηδευοντες τουτο μαλισα. Herodot. Euterp. 37. – It is remarkable that he makes no mention of the plague, though he gives a very minute account of the country from his own observation, from whence it may be naturally inferred, that it did not then exist there, though Egypt is now so subject to it, that the plague is supposed by many to be an endemial disease in it. It would appear also from another passage in this historian, that he uses the word λοιμος, which we translate plague in a loose sense to signify any violent acute distemper; for he relates that a great part of the army of Xerxes, in their retreat from Greece, perished by the plague λοιμου and dysentery, in consequence of famine. Herod. Lib. viii. cap. 115.

56

It is proper also to observe here, that those ships which are built of winter-felled timber are much drier than those built of what is summer felled; and this circumstance should have been mentioned with regard to the Montague, for the cause of her healthiness, notwithstanding her being a new ship, was probably from being built of winter-felled timber. It should, therefore, be strictly enjoined to fell the wood in winter; for those who are employed to do it have an interest in doing it in summer, on account of the value of the bark.

57

A windsail is a long cylinder of canvass, open at both ends, kept extended with hoops, and long enough to reach from the lowermost parts of the ship through all the hatchways into the open air.

58

It is not necessary that seamen should have chests, for bags or wallets answer their purpose equally well, and are much more convenient in respect of stowage.

59

Since the first edition of this work, I have met with a fact in confirmation of this principle, with regard to the cutaneous complaint called the ring-worm. This had prevailed in a private school in the neighbourhood of London, which I visited, but it had to all appearance become extinct; yet it nevertheless affected those boys who were newly sent to the school.

60

It is mentioned by Thucydides, that while the plague raged at Athens, the people were affected with no other disease; from which it would appear that those persons who would otherwise have been attacked with some particular indisposition, were seized with the plague in place of it. Vide note p. 247.

61

Part I. Book II. Chap. VI.

62

It is related by the travellers into Turkey, that the Christians save themselves from it, merely by shutting themselves up in their houses, and the inhabitants, who sleep on the open roofs of the houses, do not catch it even from those of the adjacent buildings, though the wall that separates them is of no great heighth.

63

Vide Opera Ambrosii Parei.

64

See Essay on Sea Diseases.

65

Limes, shaddocks, and perhaps all the other fruits of that class, possess the same virtues; but I have most frequently observed good effects from lemons.

66

In the course of the passage from England to the West Indies in February, 1782, the following directions for using the sour krout and melasses were given in public orders by the Admiral to the different ships of the squadron:

“The allowance of sour krout made by the public boards in England, is two pounds to each man every week; and the Admiral orders that from a pound and a half to two pounds (beginning with the lesser quantity, and increasing as the men may find it palatable) be boiled with every gallon of pease on a pease day. The cooks are desired not to wash it, nor to put it into the coppers till the pease are sufficiently broken. “Half a pound is directed to be issued raw to each man on beef days, and a quarter of a pound on pork days. It is recommended that the allowance of vinegar be saved, particularly on meat days. When sour krout runs short, the pease and beef days to have the preference; when shorter still, the pease days. Melasses having been allowed in lieu of part of the oatmeal, in the proportion of eleven pounds to two gallons, the Admiral directs, that a pound of melasses be boiled with every gallon of oatmeal on Mondays, Wednesdays, and Fridays, mixing it and stirring it round with the burgoo immediately after it is drawn off. He directs that half a pound of melasses be issued with every three pounds of flour over and above the common proportion of raisins; and to prevent any abuse, it is directed that the purser’s steward pour it into the platter with the flour of which the pudding is made. The Admiral forbids the use of pease in lieu of oatmeal, as has sometimes been the practice.”

These rules were suggested by Sir Charles Douglas, captain of the fleet, whose benevolence is equal to his known professional skill; and he had ascertained the utility of the preceding directions when captain of the Duke in the former part of the war.

67

In the French ships of war there is an oven large enough to supply not only all the officers and sick, but part of the crew, with soft bread every day. The advantages attending the use of flour in place of bread are so great and obvious, that the former will probably, in time, be substituted entirely for the latter. There is a proof of its being practicable to use it in place of bread in British ships of war, even with their present conveniences, communicated to me by Captain Caldwell. When he commanded the Agamemnon, of 64 guns, at New York, in the end of 1782, there happened to be no bread in store to supply that ship on her passage to the West Indies, and flour was given in place of it. The men, without any inconvenience, were able to bake it into bread for themselves, and it proved so salutary, that Captain Caldwell ascribed the uncommon degree of health which his men enjoyed to the use of the flour. The only objection that can be made to it is the greater consumption of wood occasioned by baking; but this may be obviated by adopting the grates invented by Mr. Brodie, in which the ovens are heated by the same fire with which the victuals are boiled.

68

Mr. Napeane, afterwards Under Secretary of State, was at that time purser of the Foudroyant, and acted a very benevolent and disinterested part, by being instrumental in introducing this reform in the navy victualling.

69

Half a pound of cocoa, and as much sugar, was allowed in place of a pound of butter.

70

Table, exhibiting the daily Allowance of Provisions for each Man in the Navy.

This has continued from the last century till the alterations above mentioned, all of which, except the introduction of vinegar, have been made in the three last years of this war. When the stock of small beer is exhausted, half a pint of spirits is allowed daily, diluted with four or five times its quantity of water. When wine is supplied, the daily allowance of it to a man is one pint.

71

Instead of leaving this to the management of the men themselves, it might be done with greater advantage to them by instituting short allowance in the following manner: – Let a certain proportion, suppose one third, of the salt provisions, bread, and pease, particularly the first, be stopped, and let the amount of this, for the whole crew be thrown into one estimate. Let the agent victualler pay into the purser’s hands the value of these provisions in money, at the contract price, with such a discount as will allow for the use of the money. Let the purser, in return, give him a receipt, as if for so much provisions checked. This money, being distributed in the name of short allowance, will enable the men to purchase vegetables, and the provisions will be saved for a time of want, or for a cruise.