Observations on the Diseases of Seamen

by Sir Gilbert Blane

• A.
• Absorbents useful in fluxes, [491], & seq.
• Action, close, the advantages of it, [103], & seq.
• Air, superiority of that at sea, [225].
• —Noxious effects of it at land in a hot climate, [227].
• —Extent of its influence, [228].
• Alcide, sickly on the passage to America, [36].
• —Subject to various forms of fevers, [39].
• Aliment, want of proper, chief cause of scurvy, [300].
• —Increases the vigour of the body in two ways, [510].
• America, North, hotter in summer than the West Indies, [30].
• —Fleet goes there to avoid the hurricanes, [35], [146].
• —Uncommon season there, [156], & seq.
• Amputation, the number that died of it at Barbadoes, [190].
• Amputation, Mr. Alanson’s method of performing it, [543].
• Antimonials, best adapted to bilious fevers, [420].
• —A caution with regard to them, [422].
• Army at St. Lucia, diseases in it, [127].
• —Mortality in it, [27], [228], & seq.
• Asthma, climate in the West Indies favourable to it, [97].
• B.
• Barbadoes, more refreshments at it than any other island, [27].
• —Ravaged by a hurricane, [41].
• —Composed of coral rock, [89].
• —Conjecture concerning its origin, ibid.
• Barfleur, fevers on board in consequence of recruits from a French jail, [142].
• Bark, Peruvian, its effects in preventing fevers, [230], & seq.
• —When useful in continued fevers, [390], & seq., [402], [422], & seq.
• Bark, Peruvian, red, some account of it, [457].
• Barricading a ship, what meant by it, [21].
• Bath, warm, of use in the dysentery, [480].
• —In the locked jaw, [522].
• —Its proper temperature, [535].
• Battle, the ardour of, favourable to health, [22], [77], [101].
• —Number killed in, [209].
• —Loss in those of April, 1782, [520].
• Bedding, utility of airing it, [260].
• Bile, a defect of it in the worst cases of yellow fever, [429],& seq.
• —Theoretical disquisition on its influence in fevers, ibid.
• Bile, the marks of a redundance of it in dysenteries, [477].
• —Its tendency to prolong fluxes, [483], & seq.
• Blindness from the scurvy, [24], [501].
• Blisters of use in the ship fever, [399].
• —For removing irritability of stomach in the yellow fever, [453], & seq.
• —Of service in dysentery, [480], & seq.
• Blood, a remark concerning the buff upon it, [450].
• Bloodletting, cautions with regard to it in ship fevers, [388].
• —In bilious fevers, [418].
• —In the yellow fever, [450].
• Butter, objections to its use, [310].
• C.
• Calomel, in certain cases, the best purgative, [421].
• Camphor, estimate of its virtues, [407].
• Catarrh, epidemic, one in Europe affected men at sea, [157].
• —Communicated by strangers not affected with it themselves, in one of the Western Islands, [244].
• Causes, a combination of them necessary to produce diseases, [126], & seq.
• Chronic complaints brought on by hardship, [218].
• Cleanliness the principal means of health, [254], [337].
• Clothing, its great influence upon health, [238].
• —Advantages and disadvantages of it, [334], & seq.
• Cocoa substituted, with advantage, for butter, [311].
• Cold favourable to infection, [258].
• Cold hurtful in all climates, [297].
• Colica pictonum, forms of medicines adapted to it, [555].
• Coma, a symptom in the ship fever, [373].
• Commission, Ships long in, most healthy, [54], [79], [93], [167].
• Constitution, the great variety of it, [294].
• —Regard to be had to it in practice, [406].
• Coppers, cautions with regard to them, and instance of poison from neglect of them, [317], & seq.
• Cordials, a caution with regard to them, [410].
• Crowding, bad effects of it, [192].
• Cruises to windward of Martinico, [48], [180].
• —Near Jamaica, [120].
• —How long they ought to be continued consistent with health, [148], & seq.
• —A long one off St. Domingo, without the scurvy appearing, [154], & seq.
• Cullen, Dr., his opinion of the origin of nervous fevers, [237].
• —His great merit, [445].
• D.
• Delirium, a remarkable symptom in the ship fever, [373].
• —Explanation of it, ibid., & seq.
• —Means of removing it, [398], & seq.
• —Sudden and violent in bilious fevers, [416].
• Diaphoretic, what safest and best, [395].
• Diet, a table of the daily allowance of it in the navy, [311].
• —A method of providing what is suitable to the sick, [335].
• Diet, a caution with regard to it in convalescent fevers, [358].
• Diet, what best in fluxes, [494], & seq.
• Dilution, the great advantage of it, [391], & seq.
• Discipline, advantage of, to health, [348], [355].
• Diseases, list of all those on board of the fleet, [94].
• —What sorts seamen are most subject to, and most exempt from, [216].
• Diseases, acute, tend naturally to wear themselves out, [70].
• —Imputed anciently to supernatural influence, [220].
• —Owing to neglect, ibid.
• Dropsy, medicines adapted to it, [558].
• Dysentery depends on the same cause as fevers, [36].
• —Arises in the Prince George from cold weather, [79].
• —More fatal in its acute state in a cold than a hot climate, [155].
• Dysentery, appearances upon dissection, [471], & seq.
• Dysentery, forms of medicines adapted to it, [553].
• E.
• Earthquakes frequent in the West Indies, [88].
• Effluvia, what kind of them produce diseases, [134], & seq.
• Elephantiasis, peculiar to Barbadoes, [235], & seq.
• England, health of the fleet there compared to that in the West Indies, [67], & seq.
• —Fleet there more sickly at particular periods than in the West Indies, [208].
• English, their cleanliness only of modern date, [282].
• Erasmus, his account of the causes of pestilential diseases in England, [282].
• Erysipelas, Peruvian bark the best medicine in it, [558].
• Exercise, the advantage of it, [343].
• Exercise in the sun very pernicious, [233].
• Expeditions, list of, frustrated by disease alone, [214].
• Explosions of gunpowder, frequent and destructive, [539].
• —Means of preventing them, [540].
• F.
• Fatigue tends to shorten life, [346].
• Fevers depend on the same cause as fluxes, [36], & seq.
• —More prevalent in port than fluxes, [113], [127].
• —Assume a different type upon the importation of infection, [182].
• —Difference of its infection from that of some other diseases, [244], [249].
• Fever, ship, description of it, [371].
• —Treatment of it, [386].
• Fever, inflammatory, principal symptoms of it, [384].
• Fevers, intermittent, some unusual remedies for them, [456], & seq.
• —Forms of medicines adapted to them, [552].
• Fires, the most effectual means of sweetening the air of a ship, [117].
• —The most powerful means of destroying infection, [276], & seq.
• Flour preferable to bread for exportation, [307].
• Fluxes depend on the same cause as fevers, [36], & seq.
• —Prevail least when fevers most violent, [44], [113].
• —Apt to arise in ships soon after their arrival in the West Indies, [19], [84], [183].
• —More frequent at sea than in port, [113].
• —More frequent in ships that have been subject to fevers, [183].
• —Why so frequent and fatal at West India hospitals, [192], & seq.
• —Observations on them, [466].
• —Treatment of them, [473].
• Formidable, extraordinary degree of health on board of her, [107], [128], [365].
• —Causes of it, [72], [108].
• —Fever arises in her from men lent to another ship, [128].
• —From pressed men, [161].
• French ships, their discipline and œconomy inferior to British, [114].
• Frigates more healthy than ships of the line, causes of this, [54], & seq.
• —More healthy when their fire place was between decks, [287].
• —A contrivance for ventilating them, [292].
• Fumigation, method of performing it, [270], & seq.
• G.
• Gibraltar relieved by Lord Rodney, [19].
• —Admissions and deaths at the hospital there, [187], [205].
• Gibraltar man of war, account of her, [53].
• Grosislet Bay, description of it, [28].
• Gunpowder, accidents from it, [190], [539], & seq.
• Guthrie, Dr., his observations on infection in Russia, [279].
• H.
• Habit, effect of it in resisting infection, [294].
• Hæmorrhages, internal, oil and tincture of rhubarb of eminent service in them, [486], & seq.
• Hæmorrhage, a limb sometimes carried off without any ensuing, [542].
• Hæmorrhoids, medicines adapted to them, [555].
• Hardship impairs health and shortens life, [218].
• Heat communicated to the hand, a symptom of the ship fever, [378], & seq.
• Hemisphere, Northern, a cold summer general all over it, [157].
• Herodotus, his account of the clothing and health of the ancient Ægyptians, [284].
• Hospitals not so proper for the sick as their own ships, [60].
• —Account of diseases sent to them, [185].
• —At Gibraltar, [187].
• —At Barbadoes, [189], [197].
• —At St. Christopher’s, [195].
• —At St Lucia, ibid.
• —At Jamaica, [198].
• —At New York, [201], & seq.
• —General view of them all, [205].
• —Proportion of deaths in them no criterion of the success of practice, [195], [200].
• Hurricane months, [28].
• Hurricane, a violent one in the West Indies—its good effect on the health of the inhabitants, [40], & seq.
• Hypochondriac complaints do not affect the laborious part of mankind, [219].
• I.
• Jaw, locked, account of those affected by it in the battles of April, 1782, [520], & seq.
• —Its symptoms different from those of the tetanus, [526].
• —Wherefore most frequent in hot climates, [529], & seq.
• Indolence a cause of scurvy, [345].
• Infection, the obscurity of and difficulty of investigating it, [238].
• —Various ways in which it is introduced into a ship, [241].
• —It may arise without the presence of fever, [242].
• —Habit renders people insensible to it, ibid. & seq.
• —It never affects all indiscriminately who are exposed to it, [245].
• —It does not pass from one species of animal to another, [249].
• —How to prevent the production of it, [254].
• —Means of eradicating it, [264].
• —Method of guarding against it, [293].
• —Less frequent in hot climates than cold, [276].
• Inflammatory complaints most frequent in ships where no infection, [172].
• Inoculation, conjecture concerning the cause of its safety, [247].
• Intermittent fevers sometimes arise on board of a ship, [32].
• —Some unusual remedies for them, [456], & seq.q.
• Intestines, great, the principal seat of the dysentery, [470].
• L.
• Labour necessary to health, [217].
• —Pernicious if in excess, ibid.
• —What diseases it tends to avert, [219].
• —Scurvy prevented by it, [344].
• Land wind at Jamaica, [119].
• —Not at the small islands, ibid.
• Lemon juice, extraordinary instance of its efficacy in scurvy, [86].
• —The most effectual remedy in scurvy, [303].
• Lemons and limes, their juice the best detergent in scorbutic ulcers, [502], & seq.
• Lientery, a symptom in obstinate fluxes, [489].
• Limes, instance of their great antiscorbutic effect, [56].
• Liver, inflammation of it seldom known in the West Indies, [95].
• —But appeared at New York in men belonging to the West-India fleet, [156].
• M.
• Magnesia, given with acids, removes sickness of the stomach, [452].
• Malt liquor, the utility of it, [320].
• Malt, essence of, a weak antiscorbutic, [57], [504].
• —Of service in the beginning of scurvy, [146], [164].
• Manners, Lord Robert, his death lamented, [520].
• Marshes, their exhalations cause fevers, [43].
• Melasses, method of using it, [305].
• —Great utility of it, [308].
• Mixing of men, bad consequences of, [252], & seq.
• Moisture, the bad effects of it, [288].
• Mortality, method of calculating the proportion of it, [88].
• —Greater at sea from the want of an hospital and of proper diet, [143].
• —In the fleets and hospital at different periods, [205].
• —In the army in the West Indies, [206].
• —In England, [207].
• —Total in the fleet for three years and three months, [209].
• Mortification, an uncommon instance of it in the shoulder, [83].
• N.
• Necessaries, Surgeons, their quantity very inadequate, [302].
• New York, the fleet therein 1780, [38].
• —in 1782, [150].
• Nyctalopia, a symptom of the scurvy, [24], [501].
• Nymph frigate, account of her health, [164].
• O.
• Oatmeal, the abuse of it, [308].
• Observations, the difficulty of making them, [9].
• Officers, more affected by foul air than common men, [116], [137].
• Opium, advantage of combining with antimonials, [392].
• —With neutral salts, [395].
• —Its use in continued fevers, [404], [408].
• —Cautions and directions with regard to it in fluxes, [476], [479].
• —Its use in ulcers, [504].
• —The best method of giving it in the locked jaw, [532], & seq.
• Osbridge, Lieut, his ingenious contrivance for sweetening water, [331].
• P.
• Pediluvia hurtful in inflammatory fevers, [397].
• Petechiæ, a symptom in the ship fever, [377].
• Phthisis pulmonalis, not so common in the West Indies as Europe, [97].
• —but more rapid, ibid.
• Phœnix, Spanish Admiral’s ship, her excellent materials and construction, [53].
• Pigeon Island, remarkable proof of its healthiness, [228], & seq.
• Plague, its infection does not spread far, [298].
• —Means of preventing it from spreading, ibid. and [299].
• —Never known in tropical climates, [277], & seq.
• Porter, its effect in preventing scurvy, [320].
• Potatoes, raw, a remedy for scurvy, [60].
• —Proposed as an article of victualling, [309], & seq.
• Prudent, effects of soaking her timbers in pickle, [81].
• Pulmonic complaints, medicines adapted to them, [556].
• Putrefaction, simple, effluvia of it may produce fevers, [134], & seq.
• Q.
• Quick lime, the best preservative of water, [326], & seq.
• R.
• Recruits, new raised, the cause of sickness, [180].
• Returns, intention of them, [6], [7].
• —Specimens of them, [23].
• —Method of forming them into tables, [24].
• Rheumatism, forms of medicines adapted to it, [557].
• Royal Oak, cause of her health, [80].
• —Method of curing the scurvy on board, [81].
• Ruby, remarkably healthy, [167].
• S.
• St. Lucia, woody, mountainous, and rainy, [27].
• —Proportion of deaths at the hospital there, [195].
• Salt, the good effects of it in diet, [314].
• Sandwich, health of, on her first arrival, [19].
• Scorches, great numbers killed and wounded in this manner, [190].
• Scurvy, in a cruise to windward of Martinico, [49].
• —In a cruise near Jamaica, [121].
• —High degree of it in the Nonsuch, ibid.
• —On the passage to New York, [148].
• —Why less of it in the ships last from England, [147].
• —Its rapid progress in the latter part of a cruise, [148], & seq.
• —Method of curing it on board of the fleet at New York, [151].
• —Numbers that died of it according to Sir Richard Hawkins, [214].
• —In Commodore Anson’s Squadron, ibid.
• Scurvy, observations on it, [499].
• —What meant by the latent state of it, [505].
• —The best remedies for it, [506], & seq.
• —In what manner the nature of the diet induces it, [509].
• —Whether it is infectious, [516].
• Seasons in the West Indies, account of them, [28], & seq.
• Ships, new, not more unhealthy than others, [19], [52].
• —Disadvantage in changing their commanders, [80].
• —Why large ones most sickly, [128], [133], [253].
• Shingle ballast, the advantage of it, [289].
• Shoes of great use to seamen, [339].
• Sick, what the best place for them in a ship, [262].
• Sickness, method of calculating the proportion of it, [90].
• Situation, effects of the difference of it upon health, [28].
• Small-pox very prevalent in the fleet, [85].
• Sope supplied on board of the fleet, [145].
• —Its great utility, [151], [257].
• Sour krout, manner of using it, [305].
• Splinters more destructive than balls, [103].
• Spices good against noxious air, [230].
• Spruce beer, the great advantage of it, [320].
• Strangers communicate disease to each other without any apparent previous disease, [243].
• Surf, danger from it in watering at St. Lucia, [88].
• Surgeons, a greater proportion of mortality among them and their mates, [134].
• —Advantage of encouraging them, [266].
• Sweating of use in curing the ship fever, [388], & seq.
• —In the dysentery, [475].
• Sweet vegetables more antiscorbutic and medicinal in their natural state, [58].
• T.
• Tables, method of forming them, [90].
• Tenaculam recommended in amputation, [543].
• Thermometer, general range of it in the West Indies, [29].
• —Observations on it at Port Royal, [124].
• Thucydides, his observations on the plague at Athens, [296].
• U.
• Ulcers keep pace with scorbutic and feverish complaints, [132].
• —Proportion of them, [150].
• —Very frequent in the Barfleur, ibid.
• —Great effect of a cold climate in diminishing them, [156].
• —Form a considerable part of sea complaints, [221].
• —Apt to arise in scorbutic habits, [339], [500], [505].
• Uniform for common seamen recommended, [336].
• Union remarkably healthy, [167].
• —Subject only to inflammatory complaints, [173], [297].
• Urine, appearance of it in the yellow fever, [437], [440], & seq.
• V.
• Venereal disease, the medicines best adapted to the various forms of it, [559].
• Vernon, Admiral, health of his fleet compared with Lord Rodney’s, [131], [198].
• —The first who caused the spirits allowed the seamen to be diluted, [324], & seq.
• Victory, 12th of April, 1782, [99].
• —Its effects on the health of the men, [101], & seq.
• Ville de Paris, sickness and mortality on board after being captured, [115].
• —Foundered, [210].
• Vinegar, use of it in the navy, [302].
• —In the Roman armies, ibid.
• Vitriol, white, used as a remedy in intermittent fevers, [462].
• Vomit, black, the most dangerous symptom in the yellow fever, [436].
• W.
• Wall, Dr. recommends opium in low fevers, [393].
• War, why fleets most sickly in the beginning of it, [69].
• Warren, Dr., his successful treatment of a case of the locked jaw, [532].
• Water of springs preferable to running water, [324].
• —Quick lime the best preservative of it, [326].
• —Various other means of correcting it, [329].
• —Distillation from sea water recommended, [332].
• Watering duty dangerous and unwholesome, [88], [118].
• Well of a ship, great danger of foul air in it, [285].
• —Method of preventing it, ibid.
• Wind of a ball, the effects of it, [537].
• Wine, the great advantage of it in the French fleet, [322].
• —Superior to spirits, [324].
• —Its utility in continued fevers, [410].
• Women, why not so subject to acute diseases in the West Indies as men, [234].
• Wounds, number that died of, [209].
• —Account of those received in April, 1782, [520].
• Y.
• Yams used in place of bread, [76].
• Yellow fever, [425].
• Yellowness of the skin not always a symptom of malignity, [181].
• Z.
• Zinc, effects of it in obstinate intermittent fevers, [456].
• —Cases in which it is proper, [461].

FOOTNOTES:

[1] These were the Conqueror, the Cornwall, and the Boyne, which were so damaged in the battles, that they were obliged to bear away for St. Lucia.

[2] The following may serve as a specimen of these returns:

State of Health of His Majesty’s Ship Alcide. Carlisle Bay, Barbadoes, 1st June, 1781.

Sick now on Board.		Died in the course of last Month.		Sent to the Hospital in the course of last Month.
Fevers	4	Of Fever	1	Ill of Scurvy	35
Flux	5
Scurvy	26
Catarrh and Rheumatism	7
Total	42

REMARKS.

During the course of last month we had one hundred and fourteen of the men, who contracted the scurvy in the late long cruise, recovered by the use of limes, which were procured at Montserrat. A pint of wine, with an equal quantity of water, made agreeable with sugar and tamarinds, is served to each patient daily. The regimen is exactly the same as mentioned last month.

Since we came into port, very few have been seized with scurvy, but several complain daily of fluxes and feverish complaints, none of which seem at present to be of any consequence.

Four patients have last month complained of an almost total blindness towards evening, accompanied with head-ach, vertigo, nausea, and a sense of weight about the precordia. The pupil is then extremely dilated, but contracts readily when a strong light is presented to it. Two of them had the scurvy in a high degree, one of them slightly, and the other seemed entirely free from it. I am not well acquainted with the nature or cure of this disease, which I believe is called Nyctalopia by some systematic writers.