Observations on the Diseases of Seamen

by Sir Gilbert Blane

CHAP. I.

Of Fevers.

Though it is impossible to refer every particular case of fever to a distinct class, on account of the mixed and anomalous symptoms that arise, yet there are certain distinguishing features which afford sufficient ground for dividing them into different kinds, and such a division will at least serve to facilitate description, and to afford room for laying down the outlines of practice.

The fevers which occurred most frequently on board of ships, and at naval hospitals belonging to the fleet in which I was employed, were the infectious ship fever, (which is the same with the jail and hospital fever) the bilious remitting fever, and the malignant yellow fever.

1. Of the infectious Ship Fever.

This does not occur so frequently in hot as in cold climates, both because it is the disease of ships newly fitted out, which they seldom are in the West Indies, and because there is something in the warmth of a climate which prevents the production of contagion, as has been formerly remarked. But as great fleets arrived from time to time in the West Indies from Europe, with numbers of men labouring under this fever, there were sufficient opportunities of making observations upon it.

It has been so well described by Sir John Pringle, Dr. Lind, and other writers, that it is unnecessary to enter into a minute detail of all its different appearances in its several stages; and I shall content myself with recounting some of the most distinguishing symptoms, and with marking the peculiarities that arose from the influence of the climate.

This fever is extremely various in its symptoms and in its degree of malignity and fatality. We are told in some of the histories of the jail distemper, that, upon its first attack, few escaped that were seized with it; but that afterwards it grew more mild; and it has been already observed, that the contagious poison of fever differs from that of small pox and other specific infections, by varying in its degrees of virulence.

There are, however, certain characteristic symptoms pretty constant in this fever in all its forms.

One of the most remarkable of these is a greater degree of muscular debility than what takes place in other fevers, and it deserves to be mentioned first, as being one of the most constant. It is also a tolerably true index of the degree of malignity, the danger being in proportion to this symptom. In the more advanced stages of the fever, a tremor of the hands, and of the tongue when put out, is a constant symptom, and seems to be connected with this weak state of the muscular fibres. I have seen, however, extreme debility without tremor in cases too of the greatest danger, and it was observable in these that there was little or no delirium.