Fewer were taken ill this month than the preceding, but more in proportion died; which might partly be owing to the fleet having been more at sea, and partly to the change of climate.

Fevers were now more numerous, and also more fatal than any other disease; and we see them follow the contrary proportion to fluxes in the progress to the southward, that they did in our progress to the northward. These fevers prevailed chiefly in the Formidable and Warrior. In the former it first appeared among some men that had been pressed at New York from a privateer, some of whom were seized a few days after our arrival at Barbadoes with the yellow fever, and they were the only instances of it at this time in the fleet.

The scurvy continued to diminish, but the ulcers increased as we came into the torrid zone.

Diseases in general were so slight and so few at this time, that the whole squadron from America sent only forty-eight men to the hospital at Barbadoes from its arrival to the end of the month.

It may be proper here to give an account of some of the ships that remained on this station, while the main body of the fleet was in America.

The Prudent, when she left us, was extremely healthy, and continued so till a flux broke out in July, which was communicated by some men from a cartel, who were ill of this disease. It spread among the ship’s company, and prevailed for three months. The only deaths during the seven months that this ship was separated from the fleet were, two from flux, and one from scurvy, and only twenty-five were sent to hospitals. This is a proof how much more healthy the windward station is than that of Jamaica. The scurvy arose at one time, in a cruise of five weeks, though there was no appearance of it at another time in a cruise of six weeks. The cause of this seems to be the difference of the weather at the two periods; for it was very wet in the former, and very dry in the latter. The time in which this ship was most exposed to sickness was while she was under repair at Antigua, a situation in which hardly any ship escapes a severe visitation of sickness; yet this ship was not at all affected by it, which seemed to be owing to the uncommon pains taken by the captain to prevent the men from labouring in the sun during the hot part of the day.

The Nonsuch was five months separated from the fleet, during which time ten men died. Nine of these died of fevers, and one of the dysentery. She sailed from Jamaica for Barbadoes about the same time that the fleet sailed for North America, and was nine weeks on the passage. A fever was the prevailing disease, and the men probably inhaled the seeds of it at Jamaica, in common with most of the other ships’ companies that were there. The scurvy, which had formerly prevailed so much, appeared at this time; but it was in a very moderate degree, considering the length of the passage. None died of it, and few were so ill as to require being sent to the hospital. Had this ship gone into a colder climate, like the others, it would probably have prevailed to a greater degree. The whole number sent to the hospitals for various complaints, during the five months, was only thirteen.

The Nymph frigate was the only other ship left in the West Indies which is included in the tables. There happened only two deaths in her from June to October, both months included. One of these was from scurvy, the other from asthma. She was in that time upon two cruises, each of which lasted eight weeks. During the first the weather was dry and fine, and during the other it was wet and sultry, with the same effect upon health as in the Prudent; for in the second cruise the scurvy prevailed to a considerable degree, but not at all during the first. This disease was prevented from becoming violent or fatal, on either occasion, by the great attention of Mr. Anderson, the surgeon. He found great benefit from the essence of malt, when given early in the complaint; and some limes having been taken in a prize, while this disease was at the worst, the scorbutic men were so much recovered by the use of them, that they were all able to return to duty before the ship arrived in port.

DECEMBER.

The whole squadron remained at anchor at Barbadoes, and nothing worth notice occurred till the arrival of a reinforcement of eight ships of the line, under Sir Richard Hughes, on the 8th of December. This squadron had been detached by Lord Howe, after the relief of Gibraltar, and the action with the combined fleets on the 20th of October. It consisted of one ship of 90 guns, one of 80, three of 74, and three of 64. They sailed from England on the 9th of September, and from that time till their arrival at Barbadoes they had not been in port, except for ten days that they were at Madeira, where they were supplied with fresh meat, fruit, and vegetables, by which means the scurvy, which had begun to prevail to a considerable degree, was almost entirely eradicated, and the health of the men was surprisingly restored, for so short a time.

When they joined us, however, there was a good deal of sickness on board of them all, except the Union and Ruby. The former had been more than three years in commission, and in that time had never been sickly, and had now all the advantages of a long-established and well-regulated ship’s company. All the rest had been newly commissioned and manned when they left England. The superior health of the Ruby was owing to her having been manned with the crews of other ships, some of which had just arrived from the West Indies; whereas the others had been manned chiefly by draughts of pressed men from guardships, or by raw volunteers, of whom a great many were raised in Ireland about this time. The Bellona and Berwick having been somewhat longer in commission than the rest, were less sickly.

The following tables will shew the comparative state of health of the squadron formerly on the station with that which had newly arrived from England.

Table, shewing the Prevalence of Sickness and Mortality in the old Squadron, in December.

Table, shewing the Prevalence of Sickness and Mortality in the new Squadron, in December.

There were one hundred and eighty-nine sent to the hospital; but the proportion to the whole number of sick cannot be ascertained, as we do not know how many were on the list on the first of the month.

The increase of fevers in the old squadron was chiefly owing to their having spread in the Nonsuch; and they seemed to partake more of that kind which originates in jails and ships, than of that which is peculiar to the climate. The body of one of the men who died of this fever was inspected at the hospital, and there was found to be inflammation and even perforation of the intestines, without any previous symptom that could lead to expect such an appearance, a circumstance more likely to happen in the former sort of fever than the latter.

The increase of scurvy was owing to the numbers that were taken ill of it in the Magnificent on the passage from Halifax, from whence she sailed in the beginning of this month, and joined the fleet at Barbadoes in the end of it. There was a great deal of sickness in this ship at Halifax, and on the passage, owing to the want of such clothing as was suitable to that severe climate. One of the principal complaints was an inflammatory sore throat.

There was no change in the situation of the fleet, only that four ships of the line were sent on the 16th to cruise near Guadaloupe, and they continued at sea till the beginning of February.

The new squadron was much afflicted with the jail fever, brought from England; and it was much more prevalent, as well as malignant, on board of the Suffolk than any of the rest. During the passage it prevailed most in the Princess Amelia, not less than twenty having died of it. It subsided in this ship before she arrived in the West Indies; but on board of the Suffolk it continued to rage for some months after.

As the hospital at Barbadoes was too small to contain all the sick of this squadron, only the cases of greatest danger and the most infectious were sent on shore, and those that remained were provided with fresh vegetables and milk on board of their own ships, in the same manner as had been formerly practised with such success on similar occasions. This was continued for four weeks, during which time they all got into tolerable health, except the Suffolk.

There appeared, by the returns of the new squadron, to be a greater number under the head of “Other Complaints,” which was owing to the number of pulmonic complaints, the consequence of the influenza which prevailed in Europe, at sea, as well as on shore, in the spring and beginning of the summer of this year.

Though inflammatory complaints are rare in this climate, yet in a few of the ships there was some appearance of them; and I remarked that they occurred in those ships which were in other respects most healthy, and most free from infection. A good many of the men were seized with inflammatory sore throats in the Bellona a few days before she arrived at Barbadoes, and this was in other respects the most healthy ship next to the Union and Ruby. In the Union there was no violent acute complaint whatever, which was very singular among so great a body of men; but several rheumatisms, coughs, and catarrhs, arose in her this month, and there even occurred two pleurisies in the following month. The bowel complaints which occurred on board of this ship were also of an inflammatory nature. These distempers seemed to proceed from accidental exposure and irregularity; and is it not highly probable that these causes, instead of producing local inflammatory complaints, might have been the means of exciting bad fevers and fluxes, as in the other ships, had the men been equally predisposed to them, by living in foul air, or under the influence of infection?

The following tables will shew the comparative state of health of the two squadrons in the three first months of next year.

Table, shewing the Prevalence of Sickness and Mortality in the old Squadron in January, 1783.

Table, shewing the Prevalence of Sickness and Mortality in the new Squadron in January, 1783.

Table, shewing the Prevalence of Sickness and Mortality in the old Squadron in February.

Table, shewing the Prevalence of Sickness and Mortality in the new Squadron in February.

Table, shewing the Prevalence of Sickness and Mortality in the old Squadron, in March.

Table, shewing the Prevalence of Sickness and Mortality in the new Squadron, in March.

The main body of the fleet remained at Barbadoes till the 12th of January, when they went to cruise to windward of Martinico, in order to intercept a French squadron expected from North America. This cruise lasted four weeks; and intelligence being received of the enemy’s having taken a different route, the whole fleet bore away for St. Lucia, where it came to an anchor on the 8th of February.

In the course of the three months above mentioned, we see the two squadrons approaching to each other, in point of health, till they became pretty equal and similar; and the new squadron became even somewhat more healthy than the old.

The increase of fevers in the old squadron was owing to two causes. One was the importation of new-raised recruits brought from England by some ships that arrived in the beginning of January. These were distributed to such ships as stood most in need of men; and being very dirty and ill cloathed, were likely to harbour infection. They were evidently the cause of sickness in the Warrior and Royal Oak; for these ships were before that time healthy, and the fever began with these strangers, and spread amongst the former crew. It is remarkable that the ships that brought them from England were not affected by them.

It was caught in the Royal Oak from six men that came from England in the Anson, which men, though first put on board the Namur, communicated no fever there, having been kept separate from the rest of the men; but being sent to the Royal Oak, they were themselves first taken ill with a fever, which afterwards spread to about thirty of the other men. What was singular in this fever was, that the eyes and skin of all that were affected by it became yellow, though without any particular malignancy; for only two died on board, and one in the hospital. There was one whose skin was very yellow, yet his complaint was so slight as never to confine him to his bed.

The other cause of the increased proportion of fevers in the old squadron was, the great number of these complaints that arose in the Magnificent. This ship having been sent on a cruise about the middle of February, and the weather being rainy, squally, and uncommonly cold, for the climate, many fevers of the inflammatory kind appeared. During this cruise she made prize of a large French frigate, called the Concord, and the greater part of the prisoners being taken on board, the fever from that time assumed a different type, with new and uncommon symptoms; for, instead of being inflammatory and requiring bleeding, as before, it became more of a low, putrid kind, and was attended in most cases, if not in all, with a continual sweating; so that, instead of evacuations, the remedies that were found most effectual were the Peruvian bark, blisters, and opium. Thus we see fevers variously modified according to men’s constitutions, the state of the air, and the noxious effluvia of the strangers that intermix with them.

We find the proportion of fluxes increasing in the new squadron in January and February, as they had formerly done in most of the ships soon after their arrival from England. They were observed also to prevail principally in those ships that had formerly been most subject to fevers, and not to arise till the fever had subsided. They were found, for instance, to arise later in the Suffolk, where the fever was obstinate and malignant, than in the Princess Amelia, where the fever had been at one time general and fatal, but not so violent and lasting as in the other.

The four ships that were sent to cruise near Guadaloupe continued at sea for seven weeks; and it was owing to the prevalence of scurvy in these and in the Magnificent that the proportion of that disease was greater at this time in the old than in the new squadron.

The fleet remained at St. Lucia till the accounts of the peace arrived in the beginning of April. The service was then at an end, and I returned to England with the first division of the fleet, which sailed from St. Lucia on the 12th of April, under the command of Rear-admiral Sir Francis Drake, who was at this time in extremely bad health, and requested me to accompany him.

PART I.
BOOK III.
Of the Numbers and Mortality of different Diseases sent to Hospitals.

CHAP. I.

Hospital at Gibraltar, 1780—at Barbadoes, 1780—Causes of Mortality from various Diseases—Accidents—the Hurricane—Wounds—Amputations—Scorches—Fluxes very apt to arise at the Hospital—Proportion that were received and died at Antigua—St. Christopher’s—St. Lucia, and at Barbadoes, 1782—at Jamaica, 1782—at New York, Autumn, 1780—1782—General View of the Admissions and Mortality at all the Hospitals during the War.

In order to judge of the loss sustained by disease, in the course of that service of which a relation has been attempted, the sick sent to the hospitals must be taken into account. I shall, therefore, give a short view of the different diseases admitted, and their mortality, at the several hospitals connected with the fleets in which I served. This will serve also to illustrate the different effects that different situations have upon the health and recovery of men22.

The fleet which effected the first relief of Gibraltar, under the command of Lord Rodney, consisting of twenty ships of the line, arrived there in the third week of January, 1780, after a passage of three weeks and a few days from England, in which they had an action with the Spanish fleet, and obtained a victory over them, on the 16th of that month. The whole fleet, except one ship, sailed from Gibraltar on the 13th of February, and while it lay there, the diseases sent to the hospital, and their respective mortality, were as follows23:

The following is an Account of the Men admitted at the Hospital at Barbadoes in the Campaign of 1780, that is, from the 16th of March till the end of June:

The fevers were chiefly from the five line-of-battle ships that came immediately from Europe in March. Upon their arrival they sent on shore one hundred and ninety-three men ill of fevers, only one with the flux, fifteen with the scurvy, and five with ulcers.

When these ships returned to Barbadoes in May, along with the rest of the fleet, the greater part of the sick were then also on board of them. By that time the flux and scurvy had broke out. The former prevailed chiefly in the Terrible; the latter in the Intrepid. That part of the fleet which we found on the station sent on shore a very small proportion of all the classes of complaints, except wounds.

Of the wounds, nineteen were amputations, of which there died nine, mostly of the locked jaw. There were forty-six scorched by gunpowder, of whom there died fourteen; so that, besides those who were killed outright, and those who died on board in consequence of accidents of this kind, before they could be sent to an hospital, about one fourth of all the wounds, and the same proportion of all the deaths from wounds, at the hospital, was owing to this cause. This circumstance ought to induce commanders to take every precaution to prevent such accidents. In the subsequent part of the war they were less frequent, in consequence of that greater caution, and more accurate method of working great guns, which were acquired by practice and experience25.

In the account of the mortality, I have included only such as died before the 1st of January, 1781; for if any were carried off after that time, it was most probably by some incidental complaint. There were sixty-five of them at that time remaining, and they were chiefly men disabled by lameness waiting for a passage to England as invalids.

Out of the twenty-three that were killed by the fall of the house in the hurricane on the 10th of October, eight were of the number above accounted for; but these are not included in any of the classes of deaths.

The mortality among the men admitted at this time was greater than what occurred afterwards in any of the hospitals that I attended, except that at Jamaica. The principal cause of this was, that as the fleet was so much greater than had ever been known here before, there was not suitable accommodation for such numbers as it was necessary to send on shore, and we had not then fallen on the method of supplying refreshments to the men on board of their ships. The circumstance by which the men suffered most was, the great crowding which the want of room made necessary. There is here no public building appropriated for an hospital; so that this, as well as every thing else, being found by contract, and the number of sick being so much greater than it was usual to provide for, the whole was at this time conducted in a manner not very regular.

It appears that the greatest mortality in any class of disease was that of the fluxes, of which the greatest number sent to hospitals are such as have languished for some time under this disease, in which state it generally proves fatal in the West Indies, in consequence of incurable ulcers in the great intestines, to which the heat of the climate, as well as the scorbutic habit and sea diet, is particularly unfavourable. But the whole of the mischief arising from it does not appear in the table; for it was the most apt of any disease to supervene upon other complaints which were under cure at the hospital. It more particularly attacked those who were recovering from the scurvy, and was the cause of the greater number of deaths under this head in the table. It was found to be more contagious than fevers, either because the men’s constitutions were more predisposed to it, or, perhaps, because the infectious matter of it being more gross and less volatile, it is not so readily dissipated by the heat of the climate; for, either from this, or some other circumstance, infectious fevers are not so easily generated, nor so apt to spread, as in Europe. That these fluxes were owing to infection may be inferred from hence, that, when men ill of the scurvy were cured on board of the ships they belonged to, they were not liable to this disease, neither did they prevail at these hospitals afterwards, when great care was taken to separate infectious diseases from the others.

The only regular hospital on this station is that at Antigua. This island being the seat of the royal dock yard, there is an established hospital in time of peace as well as war. It so happened, that great fleets never came here to put their sick and wounded on shore, as at Barbadoes; so that the greater number of those received into it were from single ships that came to careen. As there was, therefore, less necessity for crowding, and as the slighter cases could be admitted, there was a less proportion of deaths here than at most of the other hospitals.

There were two other establishments for the reception of the sick and wounded on this station, but they were only temporary. These were at St. Lucia and St. Christopher’s, where the men being received in great numbers at a time from large fleets, and as there were accommodations only for the most urgent cases, the mortality approached more nearly to that of Barbadoes. There died at St. Christopher’s, in the years 1780 and 1781, in the proportion of one in six, and at St. Lucia, in the same time, one in five and a half, or two in eleven. The air of the hospital at St. Lucia was remarkably pure, and this degree of mortality was owing to the sick having been accommodated in tents and huts. In the two last years of the war, when an hospital was built, and regularly established, the mortality was not much above one half of this.

Some authors have endeavoured to form an estimate of the success of practice from the different rates of mortality; but this is extremely fallacious; for the fatality of diseases will depend on their violence, the proportion of deaths being very different in cases that are slight, from what it is in those that are dangerous. We shall take a view, however, of the hospital at Barbadoes at another period, in which there seemed little or no difference in the violence of the disease, and when the superior success seemed to be owing to the hospital’s not being so crowded, and to the better attendance and treatment of the sick. The following is a view of the diseases that were admitted in the last three months of the year 1782, the greater part of which were landed from the reinforcement of eight ships of the line that joined the fleet at Barbadoes in the beginning of December:

It happened on this, as on the former occasion, that none were sent on shore but such as were very ill, or had contagious complaints, the rest being provided with refreshments on board of their ships. There were no wounds at this time, but there was a greater proportion of fevers; so that the complaints, upon the whole, might be said to be about equally dangerous. The mortality now was, however, considerably less, and this is to be imputed to the more favourable situation of the hospital, which I did not allow to be overcrowded; and the men had all manner of justice done them in point of attendance and accommodation.

I shall give another example of the same kind in the hospital at Jamaica, when our fleet went there after the battle of the 12th of April. All the men accounted for here were landed from the fleet under Lord Rodney in May, June, and July, 178226.

This uncommon degree of mortality was not owing to the bad air of the place, for Port Royal is naturally as healthy as most parts in that climate; nor was it owing to bad accommodations, or to neglect of any kind; but is imputable entirely to this circumstance, that the hospital being extremely small, those only were sent to it who were very ill. There were at this time upwards of forty ships of the line at Jamaica, and an hospital, containing only three hundred beds, could afford but a very inadequate relief. Some officers are unwilling that any man should die on board of their ships, for fear of dispiriting the others; and many were sent to the hospital, in the most desperate stage of sickness, that they might there die.

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.

Account of the Sick landed at New York from the West-India Fleet, consisting of twenty-six Ships of the Line, in Autumn, 1782.

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.

I have been able to calculate the numbers of deaths from disease in this great fleet, both on board and at hospitals, during the period of my own service, which was three years and three months, and they amounted to three thousand two hundred27 independent of those that were killed and died of wounds.

There died of disease in the fleet I belonged to, from July, 1780, to July, 1781, about one man in eight, including both those who died on board and at hospitals28. But the annual mortality in the West-India fleet, during the last year of the war, that is, from March, 1782, to March, 1783, was not quite one in twenty29. This difference was partly owing to the general increase of health in fleets as a war advances, partly to some improvements in victualling, and partly to better accommodations as well as regulations in what related to the care of the sick.

Though the mortality in fleets in the West Indies is, upon the whole, greater than in Europe, yet it has so happened, that, in the late war, the fleet at home has, at particular periods, been considerably more sickly than that in the West Indies was at any one time. I was informed by Dr. Lind, that, when the grand fleet arrived at Portsmouth in November, 1779, a tenth part of all the men were sent to the hospital. It appears30, that in the years 1780 and 1781, a period at which the fleet in the West Indies was most sickly, the medium of the numbers on the sick list was one in fifteen, and many of these were very slight complaints; whereas, in the fleet alluded to in England, the diseases were mostly fevers, and so ill as actually to be sent to the hospital. It appears likewise, that there was the greatest proportion of sick in our fleet when it was on the coast of America in September, 178031. This difference is owing to the greater prevalence of the ship fever, and of the scurvy, in a cold than in a hot climate.

With regard to the mortality at hospitals, the comparison is greatly in favour of those in England. This is owing to the greater regularity, and the better accommodation and diet, which an hospital at home admits of, as well as to the difference of climate. It has also been mentioned, that, on most occasions, the hospitals I attended abroad were so limited as to contain only the worst cases, in consequence of which there would of course be a greater proportional mortality than in the great hospitals of England.

The following is an account of the whole loss of lives from disease, and by the enemy32, in three years and three months, in the fleets and hospitals with which I was connected:

PART II.
of the
CAUSES of SICKNESS in FLEETS,
and the
MEANS of PREVENTION.

INTRODUCTION.

In the year 1780 I printed a small treatise for the use of the fleet, containing general rules for the prevention of sickness; and this part of the work is chiefly taken from it.

My own opportunities of experience, as exhibited in the preceding Part, have been sufficiently extensive to suggest many observations on this subject; but as my object is utility, rather than the praise of originality, I shall not confine myself to these. Great part of what is to be advanced is taken from books35 and conversation, as well as my own experience, my design being to exhibit a concise view of all the discoveries on this subject that have come to my knowledge. I have assumed nothing, however, from mere report or testimony, having had opportunities, from my own observations, of verifying or disproving the assertions of others.

More may be done towards the preservation of the health and lives of seamen than is commonly imagined; and it is a matter not only of humanity and duty, but of interest and policy.

Towards the forming of a seaman a sort of education is necessary, consisting in an habitual practice in the exercise of his profession from an early period of life; so that if our stock of mariners should come to be exhausted or diminished, this would be a loss that could not be repaired by the most flourishing state of the public finances; for money would avail nothing to the public defence without a sufficient number of able and healthy men, which are the real resources of a state, and the true sinews of war.

In this view, as well as from the peculiar dependence of Britain on her navy, this order of men is truly inestimable; and even considering men merely as a commodity, it could be made evident, in an œconomical and political view, independent of moral considerations, that the lives and health of men might be preserved at much less expence and trouble than what are necessary to repair the ravages of disease.

It would be endless to enumerate the accounts furnished by history of the losses and disappointments to the public service from the prevalence of disease in fleets. Sir Richard Hawkins, who lived in the beginning of the last century, mentions, that in twenty years he had known of ten thousand men who had perished by the scurvy. Commodore Anson, in the course of his voyage of circumnavigation, lost more than four fifths of his men chiefly by that disease. History supplies us with many instances of naval expeditions that have been entirely frustrated by the force of disease alone: that under Count Mansfeldt in 1624; that under the Duke of Buckingham the year after; that under Sir Francis Wheeler in 1693; that to Carthagena in 1741; that of the French under D’Anville in 1746; and that of the same nation to Louisbourg in 175736.

That the health of a ship’s company depends in a great measure upon means within our power, is strongly evinced by this, that different ships in the same situation of service enjoy very different degrees of health. Every one who has served in a great fleet must have remarked, that out of ships with the same complement of men, who have been the same length of time at sea, and have been victualled and watered in the same manner, some are extremely sickly, while others are free from disease. Is it not naturally to be inferred from hence, that the health of men at sea depends in a great measure upon circumstances within the power of officers, and, indeed, upon their exertions, much more than medical care37?

It has appeared in the preceding part of this work, that the diseases most prevalent among seamen are fevers, fluxes, and the scurvy. These are indeed some of the most fatal that can attack the human body; but there is a numerous tribe of complaints, which are also some of the most severe scourges of human nature, from which they are in a manner entirely exempt.—These are the diseases to which the indolent and luxurious are subject, and which so far embitter their life as to render their portion of worldly enjoyment nearly on a level with that of the poor and laborious. The diseases alluded to are chiefly the gout, stomach complaints, hypochondriac and other nervous disorders. In all countries it is the better sort of people that are most subject to these; for they are owing to the want of bodily exercise, to the great indulgence of the senses, and a greater keenness and delicacy in the passions and sentiments of the mind. Man being formed by nature for active life, it is necessary to his enjoying health that his muscular powers should be exercised, and that his senses should be habituated to a certain strength of impression. Animal and vegetable nature may be aptly enough compared to each other in this respect; for a tree or plant brought up in a greater degree of shelter and shade than what is suitable to its nature, will be puny and sickly; it will neither attain its natural growth nor strength of fibre, nor will it be able to bear the influence of the weather, nor the natural vicissitudes of heat and cold to which it may be exposed.

It is to be remarked, however, that exercise and temperance may be carried to excess, and that in these there is a certain salutary medium; for when labour and abstinence amount to hardship, they are equally pernicious as indulgence and indolence. This is strongly exemplified in seamen; for, in consequence of what they undergo, they are in general short lived, and have their constitutions worn out ten years before the rest of the laborious part of mankind. A seaman, at the age of forty-five, if shewn to a person not accustomed to be among them, would be taken by his looks to be fifty-five, or even on the borders of sixty38.

The most common chronic complaints which a long course of fatigue, exposure to the weather, and other hardships, tend to bring on, are pulmonary consumptions, rheumatisms, and dropsies. It is also to be considered, that these complaints, particularly the last, are farther fomented by hard drinking, which is a common vice among this class of men, and they are led to indulge in it by the rigorous and irregular course of duty incident to their mode of life.

With regard to gout, indigestion, hypochondriac complaints, and low spirits, there is something in hard labour of every kind that tends to avert them, and particularly in that rough mode of it peculiar to a sea life. There is also something in the harsh sensations from the objects which seamen are in use to see, hear, and handle, which so modifies their constitutions and hardens their nerves as to make them little liable to what may be called the diseases of excessive refinement, such as those above mentioned. I have, indeed, met with such diseases at naval hospitals; but I always remarked that they were in landsmen who had been pressed, and who had been bred to sedentary and indolent occupations.

The diseases above enumerated, as well as most other chronic complaints, being the offspring of indolence and luxury, while fevers and feverish complaints fall equally on all ranks and descriptions of men, it was a saying of some of the ancients, that acute diseases were sent from heaven39; whereas chronic diseases were of man’s own creation. But I shall endeavour in the course of this work to evince, that, with regard to seamen at least, acute diseases are as much artificial as any others, being the offspring of mismanagement and neglect; with this difference, that they are imputable not so much to the misconduct of the sufferers themselves, as of those under whose protection they are placed.

If I were to add any other complaint to the three already mentioned, as most prevalent, and peculiar to a sea life, it would be those foul and incurable ulcers which are so apt to arise at sea, particularly in a hot climate. The slightest scratch, or the smallest pimple, more especially on the lower extremities, is apt to spread, and to become an incurable ulcer, so as to end in the loss of a limb. The nature of the diet, and the malignant influence of the climate, both conspire in producing them.

The diseases most frequent and prevalent at sea have this advantage, that they are more the subjects of prevention than most others, because they depend upon remote causes that are assignable, and which increase and diminish according to certain circumstances, which are in a great measure within our power.

The prevention of diseases is an object as much deserving our attention as their cure; for the art of physic is at best but fallible, and sickness, under the best medical management, is productive of great inconvenience, and is attended with more or less mortality. The means of prevention are also more within our power than those of cure; for it is more in human art to remove contagion, to alter a man’s food and cloathing, to command what exercise he is to use and what air he is to breathe, than it is to produce any given change in the internal operations of the body. What we know concerning prevention is also more certain and satisfactory, in as much as it is easier to investigate the external causes that affect health than to develope the secret springs of the animal œconomy.

This part of the work, therefore, is chiefly addressed to those who direct the navy either in a civil or military capacity; for the general health of ships depends so much upon the victualling and manning in the first instance, and, afterwards, on the degree of discipline and order which are kept up, that I am persuaded that a certain degree of attention on their part would almost entirely eradicate disease from our fleets.

Several remarks in this part of the work will be found so obvious, that it might seem superfluous to mention them. But it has been my intention to omit nothing that I have heard of or observed as a matter of ascertained utility, and, I believe, the most experienced will find either something new, or what they had not before sufficiently attended to. Though the design of it is that of being extensively useful, yet my trouble would be compensated, should it prove the means of health and comfort to a single ship’s company; nay, I should not repent my labour, could I enjoy the conscious certainty of its being the means of saving the life of one brave and good man.

The prevention of disease has relation only to the external causes that affect health, and I shall consider these under the four heads of

I. AIR,
II. ALIMENT,
III. EXERCISE,
IV. CLOATHING.

CHAP. I.
AIR.

Under this head I shall not only consider the natural state of the air of the atmosphere in point of heat and cold, moisture and dryness, purity and corruption, but also the different artificial impregnations of it from the holds or other parts of a ship, or from the persons of men who have been neglected in point of cleanliness.

The common air of the atmosphere at sea is purer than on shore, which gives to a sea life a very great advantage over a life at land. This advantage is still greater in the tropical regions, where the land air, especially such as proceeds from woods and marshes, is so fatal, and where the heat is also considerably less at sea than on shore. But this superior purity of the air at sea is more than counterbalanced by the artificial means of propagating diseases on board of a ship. Since a sea life, however, has this great natural advantage to health, the causes of disease peculiar to it are chargeable rather to the mismanagement of men than to any thing unavoidable in nature; and we are from this encouraged to exert our endeavours in removing them.

The effects of land air, however, are not to be neglected by those who are studious of preserving the health of a ship’s company, for seamen are exposed to it in various ways while they are in harbour; and this is what we shall first treat of.

SECT. I.
Of the noxious Effects of Land Air in particular Situations.

All the diseases incident to a fleet, except the scurvy, are more apt to arise in a harbour than at sea, and particularly the violent fevers peculiar to hot climates. There are generally woods and marshes adjacent to the anchoring places in the West Indies, and the men are exposed to the bad air proceeding from thence, either in consequence of the ship’s riding to leeward of them, or of people’s going on shore on the duties of wooding and watering. Instances of this, without number, might be adduced from the accounts of voyages to all the tropical countries. Our fatal expeditions to the Bastimentos, and to Carthagena, in former wars, are striking proofs of it; and we have seen the same effects, though in a much less degree, while the fleet was at Jamaica in 1782.

I have known a hundred yards in a road make a difference in the health of a ship at anchor, by her being under the lee of marshes in one situation, and not in the other40. Where people at land are so situated, as not to be exposed to the air of woods and marshes, but only to the sea air, they are equally healthy as at sea. There was a remarkable instance of this on a small island, called Pidgeon Island, formerly described, where forty men were employed in making a battery, and they were there from June to December, which includes the most unhealthy time of the year, without a man dying, and with very little sickness among them, though they worked hard, lived on salt provisions, and had their habitations entirely destroyed by the hurricane. During this time near one half of the garrison of St. Lucia died, though in circumstances similar in every respect, except the air of the place, which blew from woods and marshes.

The duties of wooding and watering are so unwholesome, that negroes, if possible, should be hired to perform them. In general, however, the employing of seamen in filling water and cutting wood is unavoidable, but it should be so managed as not to allow them, on any account, to stay on shore all night; for, besides that the air is then more unwholesome, men, when asleep, are more susceptible of any harm, either from the cold or the impurity of air, than when awake and employed.

As the service necessarily requires that men should be on shore more or less, however unwholesome the air may be, means are to be used to prevent its pernicious impressions on the body. Certain internal medicines, such as bitters, aromatics, and small quantities of spirituous liquors, tend to preserve the body from its bad effects. Of the bitters, Peruvian bark is, perhaps, the best; and there is a well-affected instance of its efficacy in the account given by Mr. Robertson of a voyage in the Rainbow to the coast of Africa; and by the same means Count Bonneval and his suite escaped sickness in the camps in Hungary, while half of the army were cut off by fevers. In consequence of Mr. Robertson’s representation of the effects of bark in curing and preventing the fevers of that climate, the ships of war fitted out for the coast of Guinea have been supplied with it gratuitously, and Government would find its account in extending this bounty to all the tropical stations.

We have seen, in the former part of this work, that the fever produced by the impure air of marshes may not appear for many days after the noxious principle, whatever it is, has been imbibed; men having been sometimes seized with it more than a week after they had been at sea. It naturally occurs, therefore, that something may be done in the intermediate time to prevent the effects of this bad air; and nothing is more adviseable than to take some doses of Peruvian bark, after clearing the bowels by a purgative. Some facts, related in the first part of this work, show that an interval of ten days or a fortnight may elapse between the imbibing of the poison and its taking effect. And, in order to guard against the diseases of this climate in general, it would be more proper to take some large doses of bark once in either of these periods, than to make a constant practice of taking a little, as I have known some people do, by which they may also render their body in some measure insensible to its good effects. I knew a physician of some eminence in the West Indies, who always enjoyed uninterrupted health, and he imputed it to his taking from half an ounce to an ounce of bark every change and full of the moon, as he thought that fevers of the intermitting and remitting kind, were more apt to occur at these periods. Whether this idea be well founded or not, the practice is proper, upon the other principle that has been mentioned, and the phases of the moon will at least serve as an aid to the memory.

The spices of the country, such as capsicum and ginger, for which nature has given the inhabitants of the torrid zone an appetite, have also been found powerful in fortifying the body against the influence of noxious air. Either these, or the bark, or similar substances, of a bitter and aromatic nature, given in a glass of spirits to men going upon unwholesome duty, have been found to have a powerful effect in preventing them from catching the fevers of the climate. The practice may be thought too troublesome in the hurry of service in a great fleet; and I in general avoid mentioning any thing but what is easily practicable, and highly important to the body of seamen at large; but such a precaution may be of service at least to officers, or to a ship’s company, when service is easy, or on a small scale.

But besides the poisonous effluvia of woods and marshes, the sensible qualities of the air are also to be attended to. If I were required to fix on the circumstances most pernicious to Europeans, particularly those newly arrived in the West Indies, I would say, that they are too much bodily exercise in the sun, and sleeping in the open air; and the practices most hurtful next to these are, intemperance in drinking, and bad hours. The sickness and mortality among new comers may, in general, be imputed to some one of these causes. It is in favour of this opinion that women are not subject to the same violent fevers as the other sex, which is probably owing to their not giving into the above-mentioned irregularities.

The last direction I shall mention with regard to the preservation of health in a harbour is, that the ship should be made to ride with a spring on the cable, that the side may be turned to the wind, whereby a free ventilation will be produced, and the foul air from the head, which is the most offensive part, will not be carried all over the decks, as it must be when the ship rides head to wind.

Having little experience of my own with regard to diseases at sea in cold climates, I cannot recommend any particular precautions; but Dr. Lind thinks that garlick infused in spirits is one of the best preservatives against the bad effects of cold and wet. The French ships of war are furnished with great quantities of garlick as an article of victualling, and its effects seem to be very salutary. It would appear, that substances of this kind are very conducive to health in hot climates also. I was informed by Capt. Caldwell, that, when he commanded a sloop of war on the coast of Guinea, he was supplied with a large quantity of shalots by a Portuguese about the time he left the coast, and his men were remarkably healthy on the passage to the West Indies, while the other ships in company, who wanted this supply, were very sickly.

But besides the obvious and sensible qualities of the air above mentioned, there are certain obscure properties which we do not understand, and which we find difficult to investigate; for there are diseases prevailing in certain places which seem to depend on some latent state of the air. Of this kind is the complaint of the liver, so common in the East Indies, yet almost entirely unknown in the West Indies; and in the West Indies there are certain diseases which prevail in one island and not in another; such as the elephantiasis41 of Barbadoes, which is an affection of the lymphatics peculiar to that island. In the climates of Europe there are also certain obscure conditions of the air that favour one epidemic more than another, and in some years more than others42. All this is very mysterious to us; and although we could detect these properties of the air, we probably could not prevent their bad effects, since man must every where breathe the air, whatever its qualities may be.