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Long voyages like de Bougainville's, Cook's, Anson's, or Porter's were particularly good breeding grounds for scurvy. As early as the Seven Years War the disease had been largely eliminated for ships stationed close to home or nearby to other sources of fresh victuals. 26 Crews of ships that spent months away from friendly ports or regular sources of supply were not so lucky. They had to rely on preserved foods and available medicines, and even if their captains had seen fit to stock up on antiscorbutics, contemporary methods of preservation often robbed the vital fruits and vegetables of their usefulness. 27
One other concern that affected not only attempts to combat scurvy but also nearly every other effort to improve the lot of sailors in the eighteenth and early nineteenth centuries, was the inevitable parsimony of the various naval establishments. William Barton was well aware that any reforms he proposed had to be acceptable on both medical and financial grounds. For example, in his plan for a naval hospital, wherein he details the facility's construction, diets and even its linens, Barton evinced a concern for economy almost equal to his interest in medicine 28 David Porter, in a letter to Dr. Barton, expressed a preference for lemon crystals as an antiscorbutic but also complained of the prohibitive cost of such supplies. 29
Similar problems bedeviled the thinly stretched Royal Navy as well. 30 And if the navies of the day, upon which the fates of nations rested, had difficulty protecting their seamen from disease, the merchant services could not hope to do better. Noting that avaricious shippers often skimped on rations, Lind recommended that captains of merchant ships be dissuaded from buying insufficient provisions for a voyage by having the difference docked from their pay and given to the crew. 31 Despite such recommendations, it was usually the crews of both merchantmen and warships that suffered the most from a neglected diet. Officers, who could and often did supplement their diets with fresh food, suffered less than seamen who often had to rely solely on their daily ration. 32 The difficulty the average seaman had in obtaining fresh foods on his own is highlighted by the fact that de Bougainville troubled to note the unusually low prices of poultry, eggs, and fruit in the Celebes. 33 As always, rank had its privileges, though on an eighteenth-century warship some privileges were more important than others. Thus, the officers of a ship usually had the opportunity and the means to provide themselves with more and better provisions, and rarely suffered from scurvy to the same extent as the men.
With the exception of scurvy, the biggest threat facing the mariner on a distant station was fever. The generic term fever encompassed a host of afflictions, including those later identified as malaria, yellow fever, typhus, typhoid fever, jaundice, and dengue. 34 The treatment of these largely tropical diseases occupied much of the naval surgeon's attention. Most physicians followed the same general scheme of classifying fevers by their pathological behavior. For example, Lind identified three types of fevers: intermitting, with regular intermissions; remitting, with irregular intermissions; and continual, with no intermissions. Intermitting fevers Lind classified as either quotidian, with fits of fever every day, or tertian, with fits every other day. 35 Contemporaries of Lind generally agreed. George Cleghorn, a British surgeon at Minorca from 1733 to 1749, further divided tertian fevers into simple and double tertians, each either true or spurious. 36
 Beyond a general scheme of classification, though, the learned doctors rarely agreed. Causation and contagion were particularly disputatious topics. Cleghorn posited "distempered bile" as a cause of tertian fevers, or perhaps, he observed, it was the body's attempt to rid its self of "noxious humours." He also believed that fevers could be contagious. 37 Stubborn Benjamin Rush, however, disagreed, at least as regarded yellow fever. "It is always the offspring of putrid exhalations from dead animal and vegetable matters," he wrote. "Beyond and out of the reach of such exhalations, a yellow fever never did exist, as an epidemic, in any age or country." 38 Furthermore, Rush maintained yellow fever was not contagious, and that little benefit arose from separating the healthy from those afflicted with the disease. 39 On the other hand, James Lind attributed the outbreak of fever in Portsmouth in 1765 to excessive heat and standing water, which conspired to release the "putrid moisture in the soil." 40
Naturalistic explanations for fever and most other afflictions abounded. Cleghorn, for example, not only attributed the fevers at Minorca to extreme temperature changes and hot winds but also assumed that spiders, vipers, and scorpions owed their venom to the island's hot climate. 41 Rush, on the other hand, was sure that typhus resulted from "exhalations from sickly or filthy or half-famished human bodies." 42 Similarly, Dr. Lind declared that the "noisome vapor" arising from the hot sands of Egypt was the cause of fever in the land of the Pharaohs, and he maintained that, in the tropics, the falling rain itself could cause disease. 43
Never one to mince words, the American physician William Barton blamed the practice of frequently and copiously washing down the decks of warships for causing typhus. "I am acquainted with no practice more pernicious to the comfort of the men, or more fraught with disease and destruction of life, than that of perpetually drenching the main, gun, and berth-decks, with water. 44Barton echoed the views of another American naval surgeon, Edward Cutbush, who also advised against the indiscriminate wetting of the decks. 45
 The
Ladies Medicine Chest
Naval Medicine in 1812 pages 1 | 2 | 3 | 4 | 5 | 6 | 7
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