Later voyages during the century took anywhere from two to three months. Despite the precautions taken by some, of a rest, in the West Indies to bring about "restitution of our sick people into health by the helpes of fresh ayre, diet and the baths," the trip aboard the pestered ships continued to exact a heavy death toll and to discharge disease and diseased persons. Benefits resulting from the stopover in the Indies were countered by the considerable exposure to tropical infections. One convoy carrying colonists to Virginia in 1609 and running a southerly course through "fervent heat and loomes breezes" had many of the crew and passengers fall ill from calenture (tropical or yellow fever). Out of two ships so afflicted, thirty-two persons died and were thrown overboard. Another of these ships reported the plague raging in her.
Irritated by frequent references to the unhealthy climate of Virginia and fearful that the bad publicity would increase the difficulties in obtaining colonists, officials of the London Company took pains to expose the part that the ocean voyage played in bringing about the deaths of newcomers. Musty bread and stinking beer aboard the pestered ships, according to a contemporary, worked as a chief cause of the mortality attributed falsely to the Virginia climate and conditions at Jamestown. In 1624 Governor Wyatt and his associates recommended to commissioners from England that "care must be had that the ships come not over pestered and that they may be well used at sea with that plenty and goodness of dyet as is promised in England but seldom performed." Others complained of the crowding of men in their own "aires," uncleanliness of the ships, and the presence of fatal "infexion."
Insomuch as seventeenth-century medical theory paid scant attention to sanitation and hygiene in the study of the causes of disease, it is surprising to find the early Virginian rightly recognizing the ships as sources of sickness. On the other hand, observation could not help but lead passengers to conclude that sickness, such as flux or dysentery, with which they had to suffer aboard ship, might have a causal relationship to the ship. To have related the transmission of the plague from epidemic centers in England via infected shipboard rats, and transmission of tropical fevers, as well, by the medium of shipboard water buckets infected with mosquito larvae from the tropics, was beyond the capacity of both medical theory and of first-hand observation.
Physicians or surgeons did ship aboard the seventeenth-century ocean-going vessels, but Doctor Wyndham B. Blanton, the chief authority on seventeenth-century Virginia medicine, concludes that most of them probably had poor educations and little more to recommend them than "a smattering of drugs, a little practice in opening abscesses and a liking for the sea." A seventeenth-century contemporary recommended that a ship's surgeon—surgeons went to sea far more often than physicians—be the possessor of a certificate from a barber-surgeon guild and be freed from all ship's duties except the attending of the sick and the cure of the wounded. The ship's surgeon, then, crossed the professional line between surgeon and physician, a line that necessity would soon force so many medical men to cross in America.
Throughout the century ship's surgeons abandoned their shipboard duties to settle in the Virginia colony, and there seems little reason to doubt that those remaining aboard ship took advantage of the opportunity when in port to help meet the medical needs of the colonists, thus supplementing the medical talent which had taken up residence in Virginia.
The labors of the ship's surgeon at sea, no matter how valiant, could not offset the miseries of the long sea voyage, and the sight of Virginia's coast greatly cheered all hands. After the foul air, crowded quarters, and inadequate provisions of the ship, many settlers must have reacted to the Virginia land as Captain John Smith did: "heaven and earth never agree better to frame a place for man's habitation." It is not surprising then that the first permanent settlers were somewhat less than careful when evaluating, against standards of health, the possible sites for settlement.
The Selection of Sites for Settlement
In a fairly extensive set of instructions "by way of advice, for the intended voyage to Virginia," the London Company, in 1606, took into account the part that disease and famine could play in the life—or death—of the colony. Probably knowing that the chances for survival of the Spanish conquistadors had been enhanced by their superhuman qualities in the eyes of the Indians, the Company urged that no information on deaths or sicknesses among the whites be allowed to the natives. More important, as the course of events was to demonstrate, was the advice not to:
plant in a low or moist place, because it will prove unhealthfull. You shall judge of the good air by the people; for some part of that coast where the lands are low, have their people blear eyed, and with swollen bellies and legs: but if the naturals be strong and clean made, it is a true sign of wholesome soil.
The idea that climate had an influence upon human physiognomy did not originate with the London Company. In an essay dating back to the fifth century B.C. and preserved among the works of the Hippocratic school the ancient—but in the seventeenth century still influential—authorities argued that human physiognomies could be classified into the well-wooded and well-watered mountain type; the thin-soiled waterless type; the well-cleared and well-drained lowland type; and the meadowy, marshy type.