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.
| DISEASES. | Admitted. | Died. | Proportion. NEARLY ONE IN |
|---|---|---|---|
| Fevers | 34 | 9 | 4 |
| Fluxes | 229 | 27 | 9 |
| Scurvy | 433 | 40 | 11 |
| Ulcers | 47 | 8 | 6 |
| Other Complaints | 82 | 10 | 8 |
| Total | 825 | 94 | 9 |
Account of the Sick landed at New York from the West-India Fleet, consisting of twenty-six Ships of the Line, in Autumn, 1782.
| DISEASES. | Admitted. | Died. | Proportion. NEARLY ONE IN |
|---|---|---|---|
| Fevers | 104 | 14 | 7 |
| Fluxes | 131 | 14 | 9 |
| Scurvy | 617 | 30 | 20 |
| Ulcers | 74 | 10 | 7 |
| Other Complaints | 70 | 4 | 17 |
| Total | 996 | 72 | 14 |
The difference of mortality here, from what occurred in the West Indies, is partly imputable to climate, and partly to the smaller number of acute diseases. In the two accounts last stated, the difference in favour of the latter seemed chiefly to arise from the superior attention to the sick, and the better treatment of them. It was mentioned before, that in autumn, 1782, at New York, they were better supplied, both at hospitals and on board of their ships, with every thing that could be wished, and that on this occasion almost every scheme I had proposed was realised. The extraordinary success in the scurvy was owing to the great quantities of vegetables that were supplied; for several fields of cabbages had been planted in the neighbourhood of the hospital for the use of the sick. This was owing to the humane attention of Admiral Digby, who had also caused cows to be purchased to supply the hospital with milk. Cleanliness, and the separation of diseases, were also strictly attended to; and I am persuaded that many of the scorbutic men were saved by keeping them separated from the fevers and fluxes; for it has been observed, that men ill of the scurvy, or recovering from it, are very apt to be infected, particularly with the flux.
It appears, that the disease in which climate makes the greatest difference is the flux. It was observable, that though the dysentery at this time was more fatal on board of the ships at New York than in the West Indies, yet it was less so at the hospital. The cause of this seems to be, that the acute state of this disease, of which men die on board before there is time to remove them to an hospital, is more fatal in a cold climate; but when it becomes more protracted, which is the case with most of the cases sent to hospitals, they then do much better in a cold than in a hot climate.
I shall here subjoin an account of the numbers that were admitted, and died, during the whole war, at the hospitals of the different parts at which the fleets I was connected with touched.
| DISEASES. | Admitted. | Died. | Proportion. NEARLY ONE IN |
|---|---|---|---|
| At Gibraltar | 2131 | 203 | 10 |
| Barbadoes | 4604 | 861 | 5 |
| Antigua | 6099 | 914 | 7 |
| St. Lucia | 3363 | 478 | 7 |
| St. Christopher’s | 853 | 142 | 6 |
| Jamaica | 10088 | 1672 | 6 |
| New York | 17880 | 2179 | 7½ |
| Total | 45018 | 6449 | 7 |