Health & Hygiene
in the 18th century
British Navy
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Health & Hygiene
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"Some three-quarters of a century ago, a ship of war was a scene of the most disgraceful negligence. The diet consisted of very salt beef, biscuits mouldy with long-keeping, and puddings made of salt suet and flour. The water was so putrid, often so thick and green from decomposition and vegetable growth, and emitting so strongly the fetor of rotten eggs, as to disgust sight, smell, and taste. The ship was damp, filthy, and ill-ventilated, and the air of the wells so polluted, that fatal asphyxia was by no means of rare occurrence. Personal cleanliness was neglected; the clothing was insufficient; little effort was made to amuse the mind, and none to instruct it; the sailors' only luxury, an exorbitant allowance of spirituous liquors, at sea, as on land, the fruitful source of disease, misery, insubordination, and crime in all its shapes; add to all these privations and discomforts, a discipline not merely strict but severe, and punishment too often inflicted at the instigation of momentary passion, and we have a faithful picture of the naval service at the period to which I have referred.
The consequences of such a state of things may be readily imagined. Disease alone was wanted to give the finishing touch to the picture, and convert this scene of hardship and deprivation into one of thrilling horror. Scurvy, putrid ulcer, malignant dysentery, and fever allied to that of gaols [gaol fever], (indeed, very frequently imported direct by discharged prisoners, as testified by Howard,) suddenly swept off the greater portions of many ships' crews and well nigh depopulated whole fleets. Scurvy alone, without any aid from the other diseases which I have just specified, has more than once sufficed to place a well-manned vessel at the mercy of the winds and waves. Witness Lord Anson's ship, the Centurion, in 1742; the crew so weakened by scurvy that only eight men were capable of doing duty, and these so reduced in health, that, had the ship been compelled to keep the sea a very few days longer, it would not have been possible to have brought her to an anchor at Juan Fernandez, and she must have gone adrift in the Pacific Ocean, the survivors perishing miserably, as once happened to a Spanish ship in the same Ocean, under the like circumstances. Or take the facts recorded in the table before you, which gives a summary of the deaths in Lord Anson's fleet in 1780:—
| Ship | Deaths in 10 Mths | No. of Men | Survivors |
|---|---|---|---|
| Centurion | 292 | 506 | 214 |
| Tryal | 42 | 81 | 39 |
| Gloucester | 292 | 374 | 82 |
In large fleets the mortality was not less frightful than in single ships; for Sir Richard Hawkins, the great navigator, who lived in the time of Queen Elizabeth and her successor, relates that, in the course of twenty years, he 'had known of 10,000 seamen' (a number short by only about 4,000 of all who served in the fleet which conquered the Spanish Armada) 'having perished by scurvy alone.' This fearful mortality is not a story merely of the olden time, for, even so late as the year 1780, Sir Gilbert Blane found that, in a fleet manned with between 7,000 and 8,000 seamen, the mortality, in one year, had been one in every seven. Nor was it from any peculiarity in our own mode of manning, working, or provisioning our ships, that this destruction of life took place. The same diseases and the same high mortality occurred on board the vessels and fleets of foreign nations. Take, as a single instance, the testimony of a Portuguese historian, in reference to one of the exploring expeditions of that enterprising people. He tells us, in a strain of warrantable hyperbole, that,
'if the dead who had been thrown overboard between the Coast of Guinea and the Cape of Good Hope, and between that Cape and Mozambique, could have had tomb-stones placed for them, each on the spot where he sank, the whole way would have appeared one continued cemetery.'
The disastrous effects of this high rate of sickness and mortality in time of war may be readily imagined but it may be well to give a few illustrations.
The expedition to the West Indies and North America in the year 1693, consisting of two ships of the line and six frigates, under Sir Francis Wheeler, miscarried in the attack on Martinique, through the force being weakened by diseases; and, in his voyage to England, the ships' crews were so weakened by deaths from scurvy and fever, that there were hardly hands enough to bring the ships to anchor on their arrival.
Again, Admiral Hosier, who was employed with seven ships of the line in the year 1726, to protect the trade of the West Indies, buried his ships' companies twice over, and, in place of quelling and coercing the Spaniards, was set at defiance and insulted by them, and died of a broken heart.
To this same cause, excessive sickness and mortality occurring on board our ships of war, Sir Gilbert Blane, with great apparent justice, attributes the failure of our arms to no less than six general engagements which took place during the seven years' war, and the American war, every one of which engagements was a drawn battle. Is it not presumable that some, if not all of these, might have proved victories, had it not been for the deficiency of hands in consequence of mortality and disease?
Contrast with these facts, which I might easily swell into a volume, the voyages of Cook in 1772 and 1773, and those of our intrepid explorers of a north-west passage, in which sickness and mortality were, if I may be allowed the expression, held in check and kept at bay, by a just admixture of articles of diet, and a scrupulous attention to cleanliness and ventilation. Anson, in ten months after leaving England, lost 626 men out of 961, or about 2 in, every 3. Captain Cook sailed round the world, and returned in three years with the loss of four men by accident, and one by disease. In Parry's three voyages of a year and a half and two years' duration, only seven men died out of 334. Or, if you prefer examples on a larger scale, take the Channel fleet in the year 1800, keeping the sea for four months without one vessel being in port, and bringing back, at the end of that time only sixteen subjects for the hospital; while only twenty years before the same fleet was so overrun with scurvy and fever as to be unable to keep the sea for ten weeks together. I will only add one more fact, or rather summary of facts, in illustration of this subject.
In the year 1779, out of nearly 30,000 men voted for the service of the Navy, nearly 1 in every 2 was sick in hospital, of whom 1 in 42 died; while (to pass over intermediate periods) in the year 1813, out of 140,000 men voted for the service of the Navy, little more than 1 in every 11 was admitted into hospital, of whom only 1 in 143 died.
In 1779 one sick in every two, and one death in every 42: in 1813 one sick in every 11, and one death in every 143! These figures merely compare the admissions and deaths in hospitals for the two periods. The comparison of the total annual mortality on board ship and in hospital taken together brings out results still more striking. Seventy years ago, the annual mortality in the navy was 123 per 1,000; it is now somewhat under 14 in the 1,000!
A more convincing proof of the efficacy of measures of prevention in preserving health and prolonging life can hardly be imagined or desired. The reality and importance of the science and art of hygiene could not receive a more conclusive demonstration. If it be true, as it undoubtedly is, that these improvements in the health of our seamen, due to a strict attention to diet, watersupply, clothing, cleanliness, and ventilation, aided in some degree by superior medical treatment, an improved discipline, a less capricious exercise of authority, and some praiseworthy efforts to amuse and instruct the mind of the sailor, — if it be true, I say, that these improvements in the health of our seamen have alone sufficed to double the effective force of our Navy, to make one ship, for all purposes of navigation and warfare, equivalent to two of equal force, to enable a vessel to keep the sea for twice or thrice the time which was possible some 60 or 70 vears ago; if it be true that at the old rate of mortality, all Europe could not have furnished the seamen necessary for our defence and safety during the great revolutionary war, then is it a mere waste of words to prove that public health is a great national blessing, the neglect of it a calamity and a curse, and the science and art of hygiene, which aims at its preservation and improvement, most worthy of the attention of all who enjoy opportunities of carrying its principles into practice.
At any rate, I trust that you will be ready to agree with me, that the wonderful improvements which have taken place, in the last three quarters of a century, in the health of our seamen, leading to the disappearance of the scurvy, and of the other loathsome diseases which I have mentioned having been associated with it, furnish a most convincing demonstration of the great truth for which I am contending, that some of the most severe diseases which have afflicted mankind have been in a great degree dependent on causes admitting of prevention or removal.
I am unwilling to quit the subject of scurvy without reminding you again of the great public services rendered by Captain Cook, in demonstrating the possibility of preventing scurvy and preserving the health of seamen by sedulous attention to the simple and obvious conditions of health. And I am equally unwilling to forego the opportunity which the mention of his name affords of adding another to the list of those philanthropists who have shown, by the whole tenor of their lives, that, if their immunity was not the direct offspring of religious principle, it was at least most closely associated with it. I shall have, in a future lecture, to speak of Howard as a martyr to the cause of the prisoner. It is an interesting coincidence, that Captain Cook lost his valuable life by practising in his own person the great lesson of humanity to the savage, which he had never failed to inculcate upon others.
In pursuance of the plan which I have proposed to myself, of proving, by means of leading facts and striking instances in the sanitary history of this country, the vital truth, on the ready acceptance and full appreciation of which by all classes of persons, the future well-being of our great and growing population must in no small degree depend, that some of the most fatal diseases which have afflicted us have been occasioned or promoted by causes admitting of removal, I had intended proceeding at once to the two subjects of small-pox and gaol fever.
But, before I enter upon these subjects, it may be well to detain you for a few minutes, while I follow up what I have been saying on scurvy and the diseases of seamen, by a brief reference to what has been done to improve the health of the other branch of the public service. I shall have occasion, in a future lecture, to prove to you that in time of war, the deaths from wounds received in battle bear but a small proportion to the deaths from disease. But, even in times of peace, there are many circumstances in the life of a soldier which expose him to a mortality exceeding that of the civil population of the same age. Among these circumstances. I may specify overcrowding in barracks, intemperance and dissipation, short or defective supplies of provisions, encampment upon undrained lands, exposure to the inclemency of the weather, and service in unhealthy climates. Hence a peculiar liability to agues and fevers, to diarrhoea, dysentery, cholera, and consumption. I shall not detain you at present by entering into any details respecting these complaints; but I will take this opportunity of enforcing what I have just stated respecting scurvy, by alluding to one or two instances in which that disease has committed sad ravages among our troops.
Lind tells us that, during the winter of 1756, the English garrison at Oswego was reduced by the scurvy to so great distress, that among 700 men they often could not muster 80 fit for duty — a number scarcely sufficient to protect them from the incursions of the Indians. Out of the 700 men, no less than 200 died of the disease.
Again, in the winter of 1759, the scurvy broke out among the garrison of Quebec. Speaking of this calamity, General Murray, the Commander-in-Chief, says:—
'The excessive coldness of the climate, and constant living on salt provisions, without any vegetables, introduced the scurvy among the troops, which, getting the better of every precaution of the officer, and every remedy of the surgeon, became as universal as it was inveterate; insomuch that, before the end of April, a thousand were dead, and above two thousand of what remained totally unfit for any service.'
So much regarding the scurvy among our troops.
If, from the mortality occasioned among our troops by this one disease, we turn to the mortality from all causes at different periods of time, we shall obtain conclusive evidence of the efficacy of preventive measures in preserving health and saving life. If we compare the average mortality of our troops in healthy climates, previous to the year 1836, with the average mortality which took place ten years later, we find that in the first period we lost nearly 22 per 1,000 of mean strength, in the latter period only 14 in the 1,000. If, again, we take the troops serving in tropical climates, we find the mortality reduced, in the same period of time, from 84 per 1,000 to 42 per 1,000, or exactly one half. A great part of this marked reduction was doubtless attributable to the very simple expedient of shifting the troops, where practicable, from the plains to the mountains. This course was recommended by Dr. Robert Jackson, in the case of the troops serving in Jamaica, and the consequence of acting on his wise suggestion was, that the annual mortality which, in the low grounds, was 120 per 1,000, fell, on the hills, to 20 per 1,000, being an annual saving of 100 lives in every 1,000!
Thus, then, from the records of both branches of the public service, do we derive undoubted evidence of the efficacy of the simplest measures of prevention, in preserving health and saving life.
This fact of the greater salubrity of high grounds in hot climates is one which may be acted upon with advantage by the soldiers in a holier warfare — I mean our missionaries. Missionary stations, like barracks, should be established on hills, and not in the plains.
The subject of my next lecture will be small-pox and vaccination.