Observations on the Diseases of Seamen

by Sir Gilbert Blane

I have no other internal remedy to recommend; for whatever power of retention the stomach may have should be employed in taking bark. If it should become tolerably retentive, camphor will be found of service; and if given in the evening with an opiate, perspiration and sleep will probably be procured, by which the patient will be greatly relieved.

Blisters to the thighs and legs seemed to coincide with the general intention of cure, and they appeared to be of advantage in the cases in which they were tried.

4. Of the Effects of Flowers of Zinc and White Vitriol in the Cure of obstinate Intermittent Fevers.

It frequently happens in the West Indies that intermittent fevers are so obstinate as to resist the common means of cure by the Peruvian bark; so that these complaints become extremely distressing to the medical practitioner as well as to the patient. Indeed this was a difficulty that occurred so often, that I was sometimes tempted to think, either that the great reputation of this medicine is not so well founded as is commonly believed, or that the bark generally in use in these times is not of so good a quality as that employed by the physicians who first established its character.

But, in the first place, the experience upon which its reputation was first built was in a temperate climate, where very few agues are found to resist it when properly administered. In the next place, there is reason to believe that, in fact, the medicine itself now commonly in use is not equally powerful with what was first employed; and a species of it, called the Red Peruvian Bark, has lately been discovered, or rather, perhaps, revived, which is certainly of a superior quality, and has been found to cure intermittents in which the common sort had failed[110].

However this may be, it is an undoubted fact that obstinate agues are much more frequent in the West Indies than in Europe; and something to supply the insufficiency of the bark seemed to be a desideratum.

I was informed by Dr. Hendy, of Barbadoes, that he had found the flowers of zinc to answer in cases of intermittent fever, in which even the bark and every other remedy and mode of treatment had failed. It was found very successful in the like cases, both in my own trials at the hospitals, and by the surgeons of the men of war to whom I recommended the use of it. In order to judge what may be expected from it, I shall give a specimen of its success in some cases, at the hospital at St. Lucia, of which I kept an accurate account, in the months of February and March, 1783.

About the time the fleet arrived there, six cases of intermittent fevers were sent to the hospital from different ships. One was of six weeks continuance, and had been some times of the tertian, sometimes of the quartan type. Two were quartans; one of which was of two months, the other of eight months duration. Two were regular tertians; of which one had only had two fits, but was a relapse after a week’s exemption from an attack of several weeks. The other was of three months continuance, attended with an eruption on the hands and arms. The sixth case was a quotidian of three weeks, attended with a cough of the same standing, and joined with sea scurvy.

In all of them the bark had been given at some period or other; and the flowers of zinc were now tried in all, except the last. In three out of the five this medicine had the most visible good effects. In one the disease was so speedily removed, that there was only one fit after the first day of taking this medicine, and the other two had recovered perfectly after it had been used for seven days.

In these cases there can be little or no ambiguity with regard to the real efficacy of the medicine, as the disease had lasted from two to six months, and there was no other circumstance of change in the situation or treatment of the patients that could account for their recovery.