Observations on the Diseases of Seamen

by Sir Gilbert Blane

3. Means of eradicating Infection.

When, from a neglect of the means above mentioned, an infectious fever comes actually to prevail, and the infection, perhaps, adheres obstinately to the ship in spite of cleanliness, good air, and diet, and all the other means, which, if employed in due time, would have prevented it, then some measures are to be taken for eradicating this subtile poison.

The first step towards this is, to prevent the disease from spreading, and this is done by separating the sick from the healthy, and cutting off all intercourse as much as possible. For this end, it is necessary to appropriate a particular berth to contagious complaints, and not only to prevent the idle visits of men in health, but to discover and separate the persons affected with such complaints as soon as possible, both to prevent them from being caught by others, and because recent complaints are most manageable and curable. Officers might be very useful in making an early discovery of complaints, by observing those who droop and look ill in the course of duty; for seamen think it unmanly to complain, and have an aversion to be put on the sick list. I have heard of a method practised in some ships, of keeping a book on the quarter deck for the officer to mark the names of such men as might look ill, or might be missed from duty upon calling the roll, in order to afford the surgeon a means of finding out those who should be the objects of his care.

Those whose profession it is to superintend the health of the ship, would find it for their ease and interest, and should consider it as their duty, to walk over the different decks once a day, or every other day, in order to make an early discovery of those who may be taken ill. Though I have laid great stress on the duty of the commander, as the proper guardian of health, yet his assiduity will not avail unless the surgeon also does his part, by such acts of attention as I have mentioned, joined to skill in his profession.

Surgeons are, perhaps, more regarded in our service than in that of other nations; but it would be for the public benefit if they were still more respected and encouraged. To men of liberal education and sentiments, as surgeons ought to be, and generally are, the most effectual inducements for them to do their duty are flattering attentions, and a certain degree of estimation in the eyes of their officers. Liberality of manners, on the part of superiors, is the most likely means of encouraging a conscientious performance of duty in this profession; for though strict and distant behaviour may operate upon the minds of those whose functions are merely mechanical, how can it infuse that tender attention to human sufferings, and that sense of duty, which may induce a man entrusted with the health and lives of his fellow creatures to act his part with propriety and effect?

In order to prevent sickness from spreading, it is not sufficient to cut off all personal intercourse. The clothes of men are as dangerous a vehicle of infection as their persons; and it should be a strict and invariable rule in case of death from fever, flux, or small pox, to throw overboard with the body every article of clothing and bedding belonging to it.

Upon the same principle, in case of recovery from any contagious disease, as it would be too great a waste to destroy the clothes and beds, they should be smoked, and then scrubbed or washed before the men join their messes and return to duty. This precaution is the more necessary, as infection in a ship is extremely apt to be communicated by bedding, from the custom of stowing the hammocks in the netting, by which they are brought in contact with each other. This, however, is an excellent custom, as it not only clears the ship below, and serves to form a barricade on the gunwale, but tends to air the bedding; and this salutary effect should not be prevented, except in case of rain, by the coverings, called hammock-cloths, by the use of which utility is evidently sacrificed to an excess of neatness.

It sometimes happens that the number of sick in a ship is so great, that it is not possible to take proper and effectual measures on board for stopping the progress of disease. But when she can be cleared of the sick by sending them to an hospital, no pains should be spared to extirpate the remaining seeds of infection.

For this purpose, let their clothing and bedding be sent along with them; let their hammocks, utensils, and whatever else they leave behind, be smoked, and either scrubbed or washed before they are used by other men, or mixed with the ship’s stores; let the decks, sides, and beams of their berths, be well washed, scraped, smoked, and dried by fire; then let them be sprinkled with hot vinegar, and, finally, white-washed all over with quick lime.

Should any officer object to the trouble and inconvenience of all this, let him reflect for a moment how much more troublesome and inconvenient, as well as noisome and disagreeable, sickness itself proves to be; let him reflect that the efficiency of the ship, considered as a bulwark of defence, or an engine of annoyance, depends on the number of healthy hands, and that his own character is to depend on the exertions to be made by them in the day of battle, not to mention the attention due from him as a man to the sufferings of the objects themselves.

But besides these recent infections, it sometimes happens that the seeds of disease adhere to the timbers of a ship for months and years together, and can be eradicated only by a thorough cleansing and fumigation. Sweeping, washing, scraping, and airing, are not sufficient entirely to remove the subtile infectious matter; but they will assist and will prepare it to be acted upon by heat and smoke, which are the only means to be depended upon. A complete fumigation can only be performed when the ship is in dock; and I shall here transcribe a method recommended by Dr. Lind.

“It will be proper to remove every thing out of the ship, so that the hold may be swept, and, when the men have withdrawn, to light a number of charcoal fires in different parts, and to throw a handful or two of brimstone on each. The steam of these should be closely confined by shutting the ports and hatchways from morning till evening, no person in the mean time being allowed to go below, nor for some time after opening the ports and hatchways, that the steam may be dispersed.

“In order to purify the men’s clothes, it would farther be proper to fumigate the hulk into which they are removed with tobacco once or twice a week while their ship is in dock, the men remaining below as long as they can bear it.

“The clothes and hammocks of the men should be exposed in the hulk to the smoke of the tobacco, and those which are more particularly suspected may be hung up the ship, and exposed to the steam of the charcoal and brimstone.

“The ship having been already fumigated with tobacco, it will be sufficient to use the fumigation of charcoal and brimstone above described for three days, and, after the last day’s fumigation, the inside of the ship should be well washed with boiling vinegar, and, before the men return on board, all the decks should be scraped and washed.”

When a ship is at sea, these precautions cannot be taken so completely; but if infection is present, or is suspected, then cleansing and fumigating may be practised in a less degree. I have known a ship at sea fumigated with gunpowder kneaded with vinegar, so as to prevent it from exploding, and to make it burn slowly with a spattering flame. Flowers of sulphur[53], with about an eighth part of nitre, will answer still better. A quantity of these is placed in each interval of the guns between decks, every person being turned up, and the ports and hatches shut till they are consumed, and till the smoke has dispersed. It has also been recommended to burn resinous bodies, such as the woods of fir, spruce, and juniper, as the smoke of these is more salutary. Upon the same principle, the effluvium of tar is thought wholesome; and the cables that are coiled in the lower parts of a ship being soaked with tar, like most of the other ropes of a ship, probably conduce to the health of a place otherwise dank and unwholesome. Fumigation may also be performed by means of tar, either by throwing it on red-hot irons, or a wood fire, which may be carried about between decks in a pot or moveable grate, or over some cannon balls in a tub, or by immersing a red-hot loggerhead[54] in a bucket of tar. If this is done in the place occupied by the sick, it will have a still better effect; and it will be of service to them to be removed for a short time under the half deck or forecastle till this or other means of purification are put in practice. In whatever manner fumigation is performed, it will be of service to spread out the clothes and bedding of the men, or to hang them upon lines, that they may be exposed to the heat and smoke.

It will also be of great service to make the men expose their frowsy clothes to the sun and wind. If a strong infection is suspected, and it cannot be afforded to destroy the clothes, the best means of eradicating the poison is to hang them for a length of time over pots of burning brimstone in a large cask standing endways, with small apertures to admit air enough for the brimstone to burn.

Fire in every shape is to be considered as the principal agent of purification, by its heat and the ventilation it occasions, perhaps, still more than its smoke. It has already been repeatedly inculcated, that the great enemies of infection are ventilation and heat. I have mentioned smoke and the effluvia of balsamic bodies, but these are not to be depended on; and it is the more necessary to mention this, as the attention bestowed on more trifling means may divert the mind from a proper regard to what is more essential. It is mentioned by the benevolent Mr Howard, that it is the custom in some parts abroad to scatter fresh branches of pine or spruce in the hospitals, in order to purify the air; but, trusting to this, they neglect the admission of fresh air, which is the only effectual method of sweetening the air.

There is reason to think that the open air very soon dissipates and renders inert all infections of the volatile kind, and of course the warmer the air is the more readily it will have this effect. It is accordingly observed, that infection is much less apt to be generated about the persons of men, and that it adheres to them for a much less space of time in a hot climate than in a cold or temperate one. This is a remark, which, so far as I know, has not been made by any author; and, till observation suggested it to me, I fancied the reverse to be the truth. I have seen so many instances of filth and crowding in ships and hospitals in the West Indies, without contagion being produced, and which in Europe could hardly have failed to produce it, or to render it more malignant, that I am convinced there is something in tropical climates unfavourable to the production and continuance of infectious fevers[55]. The ships which bring this fever from Europe in general get rid of it soon after arriving in a warm climate; and nothing but the highest degree of neglect can continue or revive it.

The facts above mentioned brought into my mind what is related of the plague at Smyrna and other places, that it disappears at the hottest part of the year. It is also curious and important to remark, that the true pestilence never has been heard of between the tropics. It is not easy to assign the cause of this effect of heat upon infection, as every thing relating to this subject is very obscure. We can conceive it to be owing to the greater degree of airiness which the heat of the climate makes necessary, or to the use of fewer woollen clothes. There may be something in the state of the body, particularly in the pores of the skin, which disposes them less to imbibe or produce the poisonous effluvia, or, when imbibed, it may more readily be thrown out by perspiration with the other acrimony of the blood; or more probably, as has been hinted above, the virulent matter is of such a degree of volatility as to be readily dissipated in a certain degree of heat[56].

There is a fact, which, though seemingly of a contrary tendency, yet is in reality in proof of the same opinion. It is, that these same diseases disappear in circumstances of great cold. When England was last visited by the plague, it disappeared in winter; and the same is observed at Moscow and other places. In this case the infectious matter is rendered inert, but not extinct, and the return of heat sets it afloat in the atmosphere, so as to expose it to human respiration. Dr. Guthrie informs us, that infection is entangled and fixed by the cold of winter on the doors and walls of the houses of the Russian peasants, and that upon the return of the warm season it is set loose by the thaw, and then becoming active, produces diseases.

With regard to the West Indies, the precautions that have been laid down are chiefly necessary when a ship newly arrives in the climate; for it is during the first three or four months that sickness is apt to prevail.

This does not depend upon any thing peculiar to the climate; for I have known ships arrive without being visited with any sickness. It seems to be owing, for the most part, to that flock of infection and disease imported from Europe exerting its effects, and when this has spent itself, the men remain in good health, unless exposed to the land air or other accidents; for the air at sea in those climates, as well as every where else, is extremely pure and wholesome, and there is no where that seamen are more healthy or comfortable.

SECT. III.
Of the Foul Air generated in a Ship.

I mean here to distinguish the unwholesome vapour produced by the contents of the ship from the infection produced by the effluvia of men’s persons, which was treated of in the last section.

The means of preventing this foul air from being generated are, cleanliness, dryness, and ventilation.

All parts of a ship may, if neglected, become dirty, and emit an offensive vapour; but the parts under water consisting of the orlop and hold, are more particularly so from the materials they contain, and from the want of free access to the fresh air; accordingly, there is always more or less stench in those parts, even in the best-regulated ships.

It was mentioned in the first part of this work, that an opinion was entertained by some that no foul air was productive of fevers but such as proceeds from the living human body. I alledged that this was otherwise, at least in hot climates; and some proofs of this opinion were adduced, particularly from the French prizes. Though the neglect of personal cleanliness is the principal source of disease, yet cleanliness of every kind, and purity of the air in every respect, is to be anxiously studied.

With regard to general cleanliness, it is hardly necessary to mention sweeping, washing, and scrubbing of the decks; for the natural propensity of the English[57] nation to neatness seldom allows any neglect of these. Lord Howe, to whose virtues as a man, and abilities as an officer, his country is so much indebted, gave it in general orders to wash the upper decks every day, the lower decks twice a week, and the orlop once a week at least. He also ordered that, every washing, smoking, mustering, and review of clothes, or any other means taken for the health of the ship, should be marked in the logbook, and the reason to be assigned there if omitted at the stated times. These rules are a good specimen of the order that ought to prevail in every branch of public duty; for it is well known to every experienced officer that it is a methodical proceeding of this kind which can alone render service either easy or effective.

The loss of men’s lives from the foul air of the well is a common accident in ships, and I have been myself witness to several instances of it. Where there is the least suspicion of this, a candle should previously be let down, and if it should be extinguished, it may be concluded that the air is deadly. It becomes safe for men to breathe in it by leaving it open for some time, or, more expeditiously, by letting down fire in a pot or grate, which soon changes the air, by producing a draught of it upwards.

It is a very salutary practice to let down fires frequently into the well, both in order to purify the air and to dry the surrounding parts. It was formerly mentioned that this was daily done in the Intrepid, and the effect of it was to remove the wetness of the ballast and the mouldiness which had overspread the sides and beams; and having had the effect of sweetening and purifying the air, it seemed to be the principal circumstance that tended to make this ship extremely healthy from being the most sickly of all the fleet. This precaution, as well as every other point of cleanliness, is more necessary in large ships, because the mass of foul air, as well as the quantity of corrupting materials, is greater[58].

The following fact strongly evinces the good effect of fire and smoke:—When it was the custom for frigates to have their kitchens between decks, they were much more healthy than in the present construction, in which they have them under the forecastle, where the heat and smoke are dissipated without being diffused through the ship, and causing a draught of air upwards, as formerly. The men derived then also great benefit and comfort from having a large fire, round which they might assemble to warm and dry themselves in a sheltered place. I leave it to those who preside in the construction of the navy to determine how far it would be advisable to return to the old manner of construction. The French ships of the line have their kitchens and ovens between decks, and this must tend to counteract the effects of their want of cleanliness. The Dutch ships of the line have their kitchens on the orlop deck, which must be still more conducive to the general purity of the air.

Moisture is pernicious both in itself and as the instrument of putrefaction. All the complaints, called colds, are more owing to wet than cold; and moisture may be the means of producing, or at least of exciting dangerous fevers, when they would not otherwise appear. It besides contributes greatly to the production of scurvy. Ships built of ill-seasoned wood are found to be very unhealthy on account of the moisture contained in it. The moisture of timber arises not only from being used too soon after being felled, but also, as I am informed, from being stripped of its bark and outer surface when piled and exposed to the weather in dock yards. This method of smoothing and piling the wood is only a late practice; and the advantage in point of convenience and neatness seems to be more than overbalanced by the detriment it thereby receives.

A wet hold diffuses moist vapour all over the ship; and it was a rule with some of those commanders whom I observed to be most successful in preserving the health of their men, not only to have daily fires in the well, but to bail out the water when the pumps could not exhaust it all, and never to allow it to collect to more than the depth of a few inches. It is, therefore, very doubtful whether it is a good practice to let in water, as is very commonly done in order to sweeten the hold, for the same sweetness will be preserved if it is kept strictly dry. If it should happen, indeed, that there should be a great deal of putrid matter in the lower parts of the ship, from previous neglect or unavoidable leakage, it may be adviseable to let in a quantity of water in order to loosen and wash off what is offensive, and then to pump it out.

There is a circumstance in the first fitting out of a ship well worth attention, as highly conducive to the dryness and cleanness of the hold. I mean the choice of the ballast; for that which is called shingle, consisting all of pebbles, is far preferable to that which is sandy and earthy, as it does not so readily soak and retain the moisture and filth. Water or fluid of any kind readily subsides in it, and should any putrid matter be entangled in it, there will be less difficulty in washing it out.

The decks should not be washed so often when the weather is moist as when it is fine, as it will be more difficult to dry them, and more harm may arise from the moisture than benefit from the cleanness. Washing should also be performed very early in the morning, even in the best weather, in order that there may be time for the decks to become dry in the course of the day. It is after a general washing that the moveable fires, formerly described, are most proper and useful.

Every contrivance should be fallen upon to change the air in the orlop and hold. Ventilators and windsails[59] are well adapted for this purpose, and should be used as frequently and for as long a time as possible. It has also a good effect in cooling the air in the lower parts of a ship in the West Indies, to lift the gratings of the hatches, raising them on their edges, and lashing them to the staunchions. It contributes likewise to cleanliness and coolness to keep the decks as clear as possible from[60] chests and other lumber, which are in the way of sweeping and washing, and prevent also the free course of the air.

Particular attention to ventilation is necessary in frigates, for almost all that part in which the men sleep is excluded from the air, and they are therefore very uncomfortable in the West Indies unless small scuttles are cut in the sides. But if this should be objected to as weakening or endangering the ship, there is a good contrivance for the same purpose, which I met with on board of the Nymphe frigate. It consists of a square wooden pipe, of about nine inches in the side coming from between decks, running along the side of the ship, and opening over the gunwale of the forecastle. There was one on each side.

SECT. IV.
Means of guarding against Infection and Bad Air.

Infection never prevails to such a degree, as to affect every person indiscriminately who is exposed to it. Even where the plague and small-pox prevail to the greatest degree, there are some persons who, though susceptible of these diseases, yet escape them. There are certain other infections of a weaker nature, as was before observed, and these will remain entirely inactive, till they find constitutions so disposed as to be fit subjects of their action. The seeds of disease may be compared to those of vegetables, which lye dormant, unless they happen to fall into a situation peculiarly adapted for exciting their activity. It is very difficult to account for this uncertainty in the operation of infection, but it is extremely providential, that under the most calamitous state of sickness, there are always some who are in health and who survive, for the necessary purposes of life. If this were not the case, it might happen that every person on board of a ship might perish from sickness in the course of a voyage, a circumstance which I believe has never been known to happen.

There is an endless variety in the constitution of the human frame, both in mind and body, as well as in the features of the face. There are, perhaps, no two individuals in the world in whom the same effect precisely is produced by the same food, air, medicine, poison, or passions of the mind. The different effects of infection, therefore, upon different people, seem to depend, in many cases, on peculiarities of constitution too obscure to be explained; but there are also known circumstances which resist or encourage its effects.

The great power of habit[61] in taking off the effect of infection, has already been mentioned, and it would appear that novelty gives an increased energy and activity to all impressions, as well as those on the senses. If a person, therefore, escapes the first attack of infection, he will be more likely to continue exposed to it with safety in future.

There are certain precautions necessary to be attended to by those who are unavoidably exposed to contagion, particularly in the first instance. Those who can afford a full diet, and a liberal use of wine, have been observed to resist infection better than those who use food and drink that is meagre and watery. It is also a good rule not to go among the sick, nor otherwise to expose one’s self to infectious air, with an empty stomach; for whether it is that the body is then more susceptible, or that the pores of the skin and lungs are in a more highly absorbing state, so as with greater readiness to inhale the poison of disease, it is certain that a person in that situation is more apt to catch harm from foul air of any kind. Whatever else weakens and exhausts the body, renders it also more susceptible of noxious impressions. Under the head of weakening powers, I comprehend not only what empties the body of its fluids, such as loss of blood, or a diarrhœa, but intoxication, fatigue, fasting, watching, and certain affections of the mind, such as care and grief.

Cold and moisture may also be enumerated among the causes that invite the attack of infectious diseases. They are of themselves simply productive of catarrhs, rheumatisms, and the like disorders; but if an infection should be accidentally present when the body is exposed to them, then instead of these complaints, the disease peculiar to that infection will be produced[62]. This was illustrated in the last reinforcement we had from England; for while bad fevers were breaking out in most of the other ships, the [63]Union was affected with those complaints only which are simply the effects of cold and moisture. It would be more proper, perhaps, to say, exposure to the air, than to call it cold; for exposing the naked body to the open air, even in the warmest climate, is prejudicial to health. This holds at least with regard to Europeans who are accustomed to clothing, however the natives of hot climates who are naked, may expose themselves with impunity.

It is of the greatest consequence to ascertain the extent of the influence of infection, for the means of avoiding and preventing it will very much depend upon this. It is now known, that infection extends itself to a very small distance. There are, indeed, some morbid poisons, such as that of the bite of a mad dog, and that of the venereal disease, which require actual contact to make them take effect. Others are more volatile, and seem to he inhaled by the breath, or absorbed by the skin, but these do not extend far. That of the plague[64] does not reach above a few yards, and that of the small-pox and of fevers is probably equally limited. This discovery is very valuable, by ascertaining the limits of danger; for when a person imagines he runs the same risk when at a considerable distance from the seat of disease, as if he were in contact with the person affected, he will be apt to expose himself wantonly and unnecessarily to the infection.

It seems to be owing to the ignorance of the extent of its influence, that the plague has in general been so fatal; for in consequence of the opinion that the whole surrounding atmosphere was affected, it was vainly attempted to purify it by large fires in the open air, or by [65]firing off artillery, instead of trusting to the separation of the sick so as to avoid their near approach, and to the confinement of those in health to their own houses, which are all the precautions necessary to prevent its progress.