Читать книгу Observations on the Diseases of Seamen - Blane Gilbert - Страница 11

Account of the Health of the Fleet while it lay at Jamaica during May, June, and Part of July, 1782. – French Prizes Causes of Sickness – Their Difference from the English in point of Cleanliness and Discipline – Bad Effects of Land Wind and Watering Duty – Situation of Port Royal – Season uncommonly dry and windy – Fluxes more prevalent at Sea than in Harbour – Comparison of the Sickness at this Time with that of the Army and with that of the Squadron under Admiral Vernon forty-one Years before – Effects of Contagion and foul Air – Officers more affected than the common Men.

All the squadron that was left to windward of Jamaica, consisting of twenty-four ships of the line, kept the sea during great part of May, the last division of it not having come to Port Royal till the 25th of that month.

The whole fleet remained in harbour during the remainder of the month, and the whole of the next, except the Warrior, Prothée, and Russell; the two former were sent on a cruise, in which the Warrior continued quite healthy, as she had been ever since her arrival from England; and in the Prothée a great check was given to the fevers and fluxes which had begun to prevail at Port Royal. The Russell was sent to England with a convoy.

Table, shewing the proportional Prevalence of Sickness and Mortality in May

Transcriber’s Keys:

A Proportion of those taken ill or wounded in the Course of the Month.

B Proportion of those that died in relation to the Numbers of Sick or wounded.

The whole number of sick on board on the first of this month, in thirty-six ships of the line and two frigates, upon which the preceding calculation is formed, was one thousand four hundred and eighteen. The whole number taken ill in the course of the month was two thousand eight hundred and twenty-eight; the number sent to the hospital was one hundred and seventy-three; and there died on board ninety-four.

The proportion of those who died this month, in relation to the whole number on board, was one in two hundred and eighty-seven.

There was a considerable increase of sickness and mortality this month in all the common diseases, and chiefly in that part of the squadron which was in port. There was less increase in the number of fevers than either of the other two epidemics; but such was their increased malignancy, that more died of them than of both the others. The number of fluxes was more than double of what it was the preceding month, and the mortality from them was also in a much greater proportion, as may be seen from the Tables.

The fevers prevailed chiefly in port, and the fluxes at sea. A good many of the latter, indeed, arose in the Alcide, though constantly in port; but this seemed to be owing to contagion conveyed by some British soldiers, who were sent on board of this ship after being retaken in one of the French men of war, several of whom were ill of this disease. But there were few fluxes in those ships at Jamaica in which the most malignant fevers appeared. There were a few in those in which the fevers arose from the air of the marshes on the watering duty; but there were none on board of the French prizes, nor in those ships in which that sort of fever was which proceeded from a similar cause, that is, filth and animal effluvia. Upon the whole, in those ships in which the fever was most malignant, there the fewest fluxes were found.

Several circumstances contributed to the increase of sickness and mortality this month.

1st. The infection, or rather the foul air, of the French prizes, in most of which a very bad fever broke out among the officers and men that were sent from the ships of our fleet to take charge of them.

The discipline and internal œconomy of the French ships of war are greatly inferior to those of the British. Their decks are never washed, and there is a great defect in every point of cleanliness and order. The free course of the air is obstructed by lumber of every kind, and by bulkheads, which are not taken down even in the time of battle; and the gratings are covered night and day with tarpaulins, even in a hot climate. There are not even scuppers opened on the lower deck as outlets to the water and filth, which necessarily accumulate there, and for which the only vent is a pipe contrived on purpose, passing from that deck along the ship’s side into the hold, which becomes thereby a common sink, inconceivably putrid and offensive. And in addition to the ordinary causes of corruption, there was one peculiar to the occasion; for the blood, the mangled limbs, and even whole bodies of men, were cast into the orlop, or hold, and lay there putrifying for some time. The common sailors among the French have a superstitious aversion to the throwing of bodies overboard immediately after they are killed, the friends of the deceased wishing to reserve their remains, in order to perform a religious ceremony over them when the hurry and danger of the day shall be over. When, therefore, the ballast, or other contents of the holds of these ships, came to be stirred, and the putrid effluvia thereby let loose, there was then a visible increase of sickness. For the first three weeks after the capture, the stench proceeding from the numbers of wounded men contributed also to taint the air.

The Ville de Paris was much more sickly than the other prizes, not only from her being larger, and thereby containing a greater mass of foul air, but by receiving the surviving part of the crew of the Santa Monica, one of our frigates, which had been cast away on the Virgin Islands, and whose men were so reduced by hardship and intemperance, that most of them were taken ill as soon as they came to breathe the unwholesome air of the French prize. To whatever cause it was owing, the fever was much more violent here than in the other prizes, and it generally carried men off on the third or fourth day; and what is remarkable, the officers were affected by it in a greater proportion than the common men. One lieutenant, and every warrant officer, except the boatswain, died of it. This was a proof that the sickliness was owing to the bad air, and not to the intemperance and irregularity so usual on board of prizes, which only the common men give into; and the probable cause of the officers being most affected is, that they were accustomed in common to a purer air, by living in the most clean and airy parts of the ship.

It is also remarkable, that the Ville de Paris was healthy when taken, and had been so ever since leaving France in March, 1781; nor had any other of the captured ships of the line been sickly for some time before, except the Ardent, when she arrived at Martinico four months before, at which time the greater part of the crew were sent to the hospital with fevers. This, as well as other facts of the same kind, tends to prove, that when men come to be much habituated to bad air, their health is not affected by it.

The French ships were purified by washing and scraping, by fumigating daily with gunpowder and vinegar, and by the use of wind sails; but nothing seemed to contribute so much to sweeten the air in them as burning fires in the hold; for this tended both to make the putrid matter exhale, and to carry it off, by producing a perpetual change of air. Captain Curgenven, who at this time commanded the Ville de Paris, had great merit from his very assiduous and successful endeavours in so difficult a duty as the management and equipment of this great ship. In consequence of the judicious measures taken, and the men becoming more used to the bad air, the sickness ceased in the course of a few weeks.

In the accounts given in the tables, the French prizes are not included, for the disorderly state in which they were at this time prevented my receiving regular returns: but having made inquiry concerning the mortality in the Ville de Paris, I found, that of a crew of three hundred and twelve men, there died ten in the month of May, and there were thirty sent to the hospital, whose cases were so unfavourable, that about one half died. The only diseases were fevers. The surgeon of the Ardent told me about the same time, that one third of the crew of that ship was ill of fevers.

The second cause of the prevalence of sickness, while the fleet was at Jamaica, was, the watering duty, which was carried on at Rock-fort, about three leagues from Port Royal. It was the practice of many of the ships to leave the water casks on shore all night, with men to watch them; and as there is a land wind in the night, which blows over some ponds and marshes, there were hardly any of the men employed on that duty who were not seized with a fever of a very bad sort, of which a great many died. The ships that followed a different practice were somewhat longer in watering; but this was much more than compensated by their preserving the health and saving the lives of their men.

The land wind which blows on the shore in the night time, is a circumstance in which Jamaica differs from the small islands to windward, over which the trade wind blows without any interruption: but though this land wind blows upon Port Royal from some marshes at a few miles distance, it does not seem to produce sickness, for it is a very healthy place, and several of the ships enjoyed as good health as in the best situations on the windward station. The bay which forms this harbour is bounded towards the sea by a peninsula of a singular form, being more than ten miles in length, and not a quarter of a mile broad at any part. Great part of it is swampy and overgrown with mangroves, and though of such small extent, we fancied that some of the ships that lay immediately to leeward of this part were more sickly than those that were close to the town of Port Royal, which stands at the very extremity of this long peninsula upon a dry, gravelly soil.

The weather this month was uniformly dry in port; but at sea the air was moist and hazy. Between Jamaica and Hispaniola, where part of the squadron was left to cruise, dead calms prevailed; and this, joined to the moisture of the air, was probably what caused the flux to prevail chiefly in this part of the fleet. At Port Royal, on the contrary, there was a strong dry breeze, which set in every day about nine o’clock in the morning, and blew all day so fresh, that there was frequently danger in passing from one ship to another in boats. This is called, in the language of the country, the fiery sea breeze, an epithet which it seems to have got not from its absolute heat, but from the feverish feeling which it occasions by drying up the perspiration. It was remarked, that this breeze was stronger this season than had ever been remembered; and it sometimes even blew all night, preventing the land breeze from taking its usual course. This year was farther remarkable for the want of the rains that were wont to fall in the months of May and June. We shall have occasion to remark hereafter, that this was a very uncommon season also in Europe and America. The heat, by the thermometer, this month, on board of a ship at Port Royal, was, in general, when lowest in the night, at 77°, and when highest in the day, in the shade, at 83°.

There was a considerable increase of scurvy in this month, compared with the former months of this campaign; but very inconsiderable, compared with what had occurred in cruises of the same length in former years. The last division of the fleet had been at sea seven weeks, all but one day, when it arrived at Port Royal; and though the scurvy had appeared in several of the ships, it did not prevail in any of them to a great degree, except in the Nonsuch. Out of fourteen deaths which happened in the whole fleet from this disease, in May, seven of them were in this ship, and several were sent from her to the hospital in the last and most desperate stage of it. But, upon the whole, the cases of the true sea scurvy in the fleet, in general, were few and slight, and a great many of those given in the reports under the head of scurvy, were cutaneous eruptions or ulcers, not properly to be classed with it.

The cruise in the preceding year to windward of Martinico, may be compared with that in May of this year; for the fleet in both cases had been at sea about the same length of time. But the comparison is very greatly in favour of the latter, which is most probably to be imputed to the plentiful supply of melasses, wine, sour krout, and essence of malt. But no adequate reason that I could discover can be assigned for the prevalence of it in the Nonsuch to a degree so much more violent than in the other ships; and it was here farther remarkable, that it attacked every description of men indiscriminately; for I was assured by the officers and by the surgeon, that not only the helpless and dispirited landsman was affected, but old seamen, who had never before suffered from it on the longest cruises. I have been led by this, and some other facts, to suspect that there may be something contagious in this disease.

JUNE

The greater part of the fleet remained at Jamaica during this month, refitting and watering. Twelve ships of the line were sent to sea on the 17th, under the command of Rear-admiral Drake, but not being able to get to windward on account of the fresh breezes that prevailed, they returned to Port Royal on the 28th. Such of these ships as were sickly, became more healthy while at sea; but some bad fevers arose, particularly in the Princessa; and it is a curious circumstance, that these fevers attacked only those men who had been on shore on the watering duty; from which it would appear, that something caught or imbibed, which is the cause of the fever, lies inactive for some time in the constitution, some of the men not having been affected for more than a week after they had been at sea.

The weather continued dry and windy, as in the former month; but the heat was in general about two degrees higher, the thermometer varying from 79° to 84½°.

Table, shewing the proportional Sickness and Mortality in June

Transcriber’s Keys:

A Proportion of those taken ill in the Course of this Month.

B Proportion of those who died, in relation to the Numbers of the Sick.

The proportion of deaths in relation to the whole numbers on board, was one in one hundred and thirty-eight.

There was only one in thirty of the sick sent to the hospital in the course of this month.

There was an increase both in the numbers and fatality of fevers. This increase was chiefly in that sort of fever which depends on the air and climate, the greater part of which was caught on the watering duty. There was a diminution of those fevers depending on infection, and the foul air of ships, which arose in the French prizes. The care that was taken in purifying these ships was very effectual; for only four died this month in the Ville de Paris, and fewer also were sent to the hospital than in May. The increase of the other kind of fever was chiefly owing to there being a greater number of ships in port, the crews of which were employed in watering, and partly, no doubt, to the increase of heat in the weather. The ships in which the fevers were most fatal were the Monarch, the Duke, the Torbay, and the Resolution. The sickness in the Duke was still in a great measure owing to the same infection that had hitherto prevailed; for this ship had never been cleared of the infectious fever, for want of room at the hospital. That which broke out in the Torbay was also of the low infectious kind, few of them having the symptoms of that which is peculiar to the climate, which prevailed in the other ships. This ship, though formerly very subject to infectious complaints, had been remarkably healthy for some time past; but it would appear that there was a large stock of latent infection, which shewed itself from time to time.

Some ships, particularly the Montague and Royal Oak, had no increase of fevers or other complaints, though the one lay in port for seven, and the other for eleven weeks, and were more or less exposed to the causes of sickness which affected the rest of the fleet. This is a proof, among many others, that a particular combination of causes is necessary to produce a disease: no single one, however powerful, being sufficient, without the concurrence of others. What seemed to be wanting here was the predisposition requisite for the admission of disease into the constitution; for the ships that enjoyed this happy exemption were such as had long-established and well-regulated crews, accustomed to the service and climate.

There had been this month a diminution both of the numbers and mortality of fluxes, which is agreeable to what was before remarked, that fevers were more apt than fluxes to prevail in the bad air of a harbour16. It was also before remarked, that there were few or no fluxes in those ships in which the fever was most malignant; and now that the fever began to grow more mild in the French prizes, the flux began to appear. In the Barfleur, Duke, and Namur, both diseases seemed to prevail equally; but the fevers, though numerous, were more of the low nervous kind than bilious or malignant; and the fluxes chiefly attacked those who were recovering from fevers. We may farther remark, that these three men of war were three-decked ships, of 90 guns, the crews of which being more numerous, and composed of a more mixed set of men, were consequently subject to a greater chance of infection, and a greater variety of complaints. The Formidable still remained healthy to an extraordinary degree. Some fevers were indeed imported from the Ville de Paris by men that had been lent to that ship, and who were taken ill after their return. Of these, a few of the worst cases were sent to the hospital, and two died on board, who, with one that died the preceding month, make the whole mortality of this ship, since leaving England, amount only to the loss of three men.

There has been little or no increase of scurvy this month; for though the numbers put on the list appear to be greater, the mortality is much less. It may indeed appear a matter of surprise that there should have been any scurvy at all, considering that the greater part of the fleet was at anchor all this month. But as this was the greatest fleet that had ever visited Jamaica, it was impossible to find fresh provisions for the whole; and the small supply they had did not amount to one fresh meal in a week. Port Royal is also remote from the cultivated part of the island, so that fruit and vegetables were both scarce and high priced, particularly this year, on account of the usual rains in May and June having failed. There was, however, an allowance of fresh provisions and vegetables made to the sick by public bounty; for as the hospital could contain but a small proportion of the sick and wounded, an order was given for the supply of fresh meat, fruit, and vegetables, to the sick, and five hundred pounds of Peruvian bark were also distributed as a public gratuity, besides sugar, coffee, and wine.

With these aids, and the various good articles of victualling from England, the fleet was preserved uncommonly healthy for a West-India campaign: for though the mortality had increased considerably during our stay at Jamaica, yet the loss of men, upon the whole, was small, compared with that of other great fleets in this climate on former occasions. The greatest squadron, next to this, that had ever been on this station was that under Admiral Vernon in the year 1741, at the same season. From this fleet upwards of eleven thousand men were sent to the hospital in the course of that and the preceding year, of whom there died one in seven, besides what died on board of their own ships and in two hospital ships17. The disproportion of sickness in the two fleets will appear still greater, when it is considered that Admiral Vernon’s contained only fifteen thousand seamen and marines18; whereas that under Lord Rodney contained twenty-two thousand. What added to the sickness of the former was the unfortunate expedition to Carthagena in April, 1741; to which probably it was owing that a much greater proportion of yellow fevers were landed from the fleet at that time than from ours, as appears by the papers left by Mr. Hume, who was then surgeon of the hospital. The hospital was then at a place called Greenwich, on the side of the bay opposite to Port Royal, and was very large; but it was found to be in a situation so extremely unhealthy, that it was soon after abandoned and demolished, and the hospital has since been at Port Royal.

It appears by the tables, that a greater number was put on the list under the head of other complaints in this month than the last. This was owing to the great number of ulcers which I have remarked to keep pace with feverish as well as scorbutic complaints; for when the constitution of the air is favourable to disease, or the habit of body prone to it, wounds and sores are found then to be more difficult of cure. There were twelve deaths besides those occasioned by what have been called the three epidemics. Of these, five perished by drowning and other accidents, three died of ulcers, one of wounds received in action, one of cholera morbus, and one of an abscess.

It has appeared that very few ships of this numerous fleet preserved their health while lying at anchor; and it would seem that short and frequent cruises are very conducive to health. It was eleven weeks from the time that the first of our fleet came to anchor at Jamaica till the main body of it sailed for America on the 17th of July. Great fleets are in time of war under the necessity of being at one time longer at sea, and at another time longer in port, than is consistent with the health of the men, the ships being obliged to act in concert and to co-operate with each other. This is one reason, among others, for ships of the line being more sickly than frigates. As ships of war must be guided by the unavoidable exigencies of service, it would be absurd to consider health only; but if this were to be the sole object of attention, a certain salutary medium could be pointed out in dividing the time between cruising and being in harbour; and it is proper that this should be known, that regard may be had to it, as far as may be consistent with the service. I would say, then, that in a cold climate men ought not to be more than six weeks at sea at one time, and need not be less than five weeks, and that a fourth part of their time spent in port would be sufficient to replenish their bodies with wholesome juices. In a warm climate men may be at sea a considerable time longer, without contracting scurvy, provided they have been under a course of fresh and vegetable diet when in port.

Though contagion is not so apt either to arise or to spread in this climate as in colder ones, there were several circumstances about this time tending to prove that it may exist in a hot climate. Those ships which had their men returned to them from the French prizes, in all of which fevers prevailed, had an increase of sickness not only in the men that were returned, but in the rest of the crew. There was another presumption of contagion, from the proportion of mortality among the surgeons and their mates, who were by their duty more exposed to the breath, effluvia, and contact of the sick. There died, during our stay at Jamaica, three of the former, and four of the latter, which is a greater proportion than what died of any other class of officers or men.

It has been the opinion of some, that fevers do not arise from any putrid effluvia, except those of the living human body, or some specific infection generated by it while under the influence of disease. It has been alledged in proof of this, that the putrid air in some great cities is breathed without any bad effects; and a celebrated professor of anatomy19 used to observe, that those employed in dissecting dead bodies did not catch acute diseases more readily than other people. I believe this may be true, in a climate like Europe, where cold invigorates the body, and enables it to resist the effects of foul air; but I am persuaded it is otherwise in tropical climates. The external heat of the air induces great languor and relaxation, and we cannot breathe the same portion of air for the same length of time in a hot as in a cold climate, without great uneasiness. The want of coolness must, therefore, be compensated by a more frequent change of air, and by its greater purity: any foulness of the air is accordingly more felt in a hot climate; and, according to the modern theory, air, already loaded with putrid phlogistic vapour, will be less qualified to absorb the same sort of vapour from the blood in the lungs, in which, according to this theory, the use of respiration consists. Be this as it will, there is something in purity of air which invigorates the circulation, and refreshes the body; and the contrary state of it depresses and debilitates, particularly in a hot climate; and in this way foul air may induce disease, like any other debilitating cause, independent of infection, or any specific quality. There was no reason to suspect any such infection in the Ville de Paris; for there was no sickness on board of this ship when in possession of the enemy, and the sickness that prevailed after her being captured seemed to proceed from what may be called simple putrefaction. There was an instance of the same kind in one of our own ships of the line, in which a bad fever broke out in the beginning of July, which seemed to be owing to the foul air of a neglected hold; for there was a putrid stench proceeding from the pumps, which pervaded the whole ship. I perceived this very sensibly one day, when visiting some officers who were ill of fevers; and before I left the ship an alarm was given of two men being suffocated in what is called the well, which is the lowest accessible part of the hold. This fever was of a very malignant kind, and fell upon the officers more than the men; for six of them were seized with it, of whom three died on the third day after being taken ill.

The fevers, which were of the greatest malignity at this time, affected the officers more than the common men. Only one captain died at Jamaica while the fleet was there, and it was of this fever. We lost five lieutenants, of whom four died of it; and this was the disease which carried off the three surgeons. But foul air was not the only cause that produced this fever among the officers, several of whom brought it on by hard drinking, or fatiguing themselves by riding or walking in the heat of the sun. It cannot be too much inculcated to those who visit tropical countries, that exercise in the sun, and intemperance, are most pernicious and fatal practices, and that it is in general by the one or the other that the better sort of people, particularly those newly arrived from Europe, shorten their lives.

Before leaving Jamaica, I sent to England a Supplement to the Memorial given in, last year20.