Chapter XX: Part III (2)

[32] None are comprehended but those who were killed or wounded in battles in which the whole fleet was present, this account not including those who fell in single actions in frigates or other ships.

[33] It would appear, that, anciently, though the slaughter in battle was greater than in modern times, yet that disease was still more destructive than the sword. One of the oldest testimonies to this purpose is in the History of Alexander’s Expedition, by Arrian--τους μεν ἐν ταῖς μαχαις ἀπολωλεκασιν, ὁι δε ἐκ των τραυματων ἀπομαχοι γεγενημενοι, ὁι πλειοῦς δε νοσω ἀπολωλεσαν.--Arrian. Hist. Alex. Exped.

Lib. v. cap. 26.

[34] Upwards of three thousand were also lost at sea in ships of war belonging to the same fleets in the hurricane of October, 1780, and in the storm in September, 1782, in which the Ville de Paris and the other French prizes were lost on their passage to England.

[35] The authors from whom I have borrowed have been chiefly Dr. Lind and Capt. Cook. To the former we are indebted for the most accurate observations on the health of seamen in hot climates; of the improvements made by the latter, an excellent compendium may be seen in Sir John Pringle’s Discourse before the Royal Society, on the occasion of adjudging a prize medal to Capt. Cook for his paper upon this subject.

[36] In the late war sickness alone was not the cause of want of success in any instance, except in the last action in the East Indies, in which so many men were ill of the scurvy, that there were not hands enow to manage the guns.

There is another fact in history, which, though not so applicable to this subject as those above recited, forcibly evinces how important a study the health of men ought to be in military affairs. When Henry V. was about to invade France, he had an army of fifty thousand men; but owing to a sickness which arose in the army, in consequence of some delays in the embarkation, their number was reduced to ten thousand at the battle of Agincourt. The disease of which they chiefly died was the dysentery.

RAPIN.

[37] It is not meant by this to insinuate that every commander is absolutely accountable for the health of his ship’s company, and censurable when they are sickly; for this may depend on his predecessor in command, or a stubborn infection may have prevailed from the original fitting out or manning of the ship which he may not have superintended.

[38]

Οὐ γαρ ἐγωγέ τι οῗδα κακώτερον ἄλλο θαλάσσης,
Ανδεά τε συγχεῦαι, εἰ καὶ μάλα καρτερὸς εἴη.

ΟΜΗΡ. ΟΔΥΣ. Θ.

Dire is the ocean, dread in all its forms!
Man must decay, when man contends with storms.

POPE.

[39] Wherever causes are obscure, superstition naturally ascribes them to some preternatural influence; and what seemed farther to have encouraged this, anciently, was, that violent epidemics occurred most frequently in camps and at sieges where great political conjunctures were likely to arise, in which superior powers were supposed to interest themselves. Thus we read in Homer of fatal diseases being sent as punishments by the gods. But the pestilential diseases so often mentioned by poets and historians as prevailing in cities and armies, were probably nothing else but fevers, produced partly perhaps by the scarcity and bad quality of provisions, but probably still more by corrupted human effluvia, which was very apt to he produced by the want of personal cleanliness, to which the mode of cloathing among the ancients would more particularly subject them, especially in camps and besieged towns.

[40] If the experiments of modern philosophy are to be depended on, they go a certain way to account for the unwholesomeness of air from woods in hot climates, and in wet weather; for Dr. Ingenhousz found that the effluvia of plants in the night time, and in the shade, are more poisonous in hot than in cold weather; but though there is a salubrity in the effluvia in sunshine, the heat of the weather makes no difference with regard to this. He found also that vegetables, when wet, yield an unwholesome air.

It is difficult to ascertain how far the influence of vapours from woods and marshes extend; but there is reason to think that it is to a very small distance. When the ships watered at Rock Fort, they found that if they anchored close to the shore, so as to smell the land air, the health of the men was affected; but upon removing two cables length, no inconvenience was perceived. I was informed of the following fact, in proof of the same, by the medical gentlemen who attended the army in Jamaica:--The garrison of Fort Augusta, which stands very near some marshes, to which it is to leeward when the land wind blows, was yet remarkably healthy; but it became at one time extremely sickly upon the breaking in of the sea in consequence of a high tide, whereby the water which was retained in the hollows of the fort produced a putrid moisture in the soil, exhaling a vapour offensive to the smell, and with all the noxious effects upon health commonly arising from the effluvia of marshes.

[41] Dr. Hendy has lately published an ingenious treatise upon this disease.

[42] See Sydenham’s Works.

[43] See Part I. Book II. Chap. VI.

[44] We have a proof of this fact in particular, in the account of the jail distemper, which broke out at the Old Bailey in the year 1750.

[45] See Martin’s History of the Western Islands, and Medical Communications, Vol. I. page 68.

[46] There are some contagious diseases which cannot be propagated but by their own peculiar infections, as has been before observed, just as the seeds of vegetables are necessary to continue their several species; so that if the infectious poison were lost, so would the disease. Of this kind are the small pox, and the other diseases to which man is subject but once during life. There are other diseases which produce infection without having themselves proceeded from it. Of this kind are fevers and fluxes.

But there is no infection of any kind, however virulent, that affects indiscriminately all persons exposed to it. If a number of persons, who never have had the small pox, are equally exposed to it, some will be seized, while others will escape, who will be affected at another time, when they happen to be more susceptible. It is doubtful how far the habit of being exposed to such specific infections renders the body insensible to them, as was said with regard to fevers; but there is another principle of the animal œconomy laid down and illustrated by Mr. Hunter, which goes at least a certain length in explaining this variable state of the body with respect to its susceptibility of infectious diseases. This principle is, that the body cannot be affected by more than one morbid action at the same time. If a person is exposed to the small pox, for instance, while he labours under a fever, or while he is under the influence of the measles, he will not catch the first till the other has run its course. It may happen, therefore, that people escape the effect of contagion in consequence of being at the time under the influence of some other indisposition, either evident or latent: and supposing the body to be exposed to a number of noxious powers at the same time, one only could take effect. But it seems difficult to explain why some of those who are actually seized, and who have previously been to all appearance in equally good health, shall have it in a very mild degree, while in others it will be malignant and fatal. This is very remarkable with regard to the small pox, which are in some cases so slight, that they can hardly be called a disease, while in others they are so malignant, as hardly to admit of any alleviation from art. May not this, in some measure, be explained from some of the principles above mentioned, in the following manner:--The small pox, in their mildest form, are attended with little or no fever, which, therefore, is not essential to them; and when we see them attended with various forms of fever, and thereby prove fatal even in the most hale constitutions, we ought not to attribute this to any thing in the nature of the small pox, but rather to say, that they have served as an agent in exciting a fever, for which there happened to be some previous latent disposition, that would not otherwise have exerted itself, and that this disposition, or contamination, as it may be called, may have been induced by some past exposure to morbid effluvia, which either from habit, or some other circumstance, may not have been sufficiently powerful to excite the constitution to fever without some such stimulus. Any other occasional circumstance producing disturbance or irregularity in the functions of the body, may, in like manner, excite any particular kind of fever to which the body may at that time be disposed. Thus the amputation of a limb will have this effect; also exposure to cold or fatigue, and intemperance in eating or drinking.

It would appear from these considerations, that there are certain circumstances, or temporary situations of constitution, which invite infection, and render its effect more certain and violent in one case than another. There are artificial methods, however, of obtruding it, as it were, upon the constitution, though not particularly disposed, or even though averse to receive it; and may not this, in some measure, account for the greater safety of some diseases when communicated by inoculation, than when caught in the natural way?

But these, as well as many other facts in animal nature, do not admit of a satisfactory explanation upon any principle as yet known. Even the most common operations of the body, such as digestion and generation, when considered in their causes and modes of action, are so obscure and mysterious, as to be almost beyond the reach of rational conjecture. A little reflection will teach us the utmost modesty with regard to our knowledge of such things; for nature seems to have innumerable ways of working, particularly in the animal functions, to which neither our senses can extend, nor perhaps could our intellects comprehend them. Had we not, for instance, been endowed with the sense of sight, nothing could have led us even to suspect the existence of such a body as light; and there may be numberless other subtile and active principles pervading the universe, relative to which we have no senses, and from the knowledge of whose nature and exigence we must for ever be debarred. We have, indeed, become acquainted with electricity by an operation of reason; and animals have lately been discovered to which the electric fluid serves as a medium of sense through organs calculated to excite it, and to receive and convey its impressions.

But there are few subjects we can study that are more subtle and obscure than the influence of one living body on another. There is a familiar instance of the great subtilety of animal effluvia, and also of the fineness of sense in a dog’s being able to trace his master through crowds, and at a great distance; and we can conceive that infectious matter may adhere, and be communicated in a similar manner. We have endeavoured to illustrate the great obscurity of its operation by an allusion to generation, digestion, and other animal functions, with which it is equally obscure and inexplicable. It is similar to generation in this, that its influence does not pass from one species of animal to another; for the poison of the plague, that of the small pox, that of fever, and the venereal disease, do not affect brutes[47], nor do the infectious diseases of brutes affect different species of them, nor the human species. The only exception to this, that we know of, is the bite of a mad dog.

From these facts, and also from what was formerly mentioned of contagion not affecting indiscrimately all that may be exposed to it, it would appear that some nice coincidence of circumstances is necessary to modify an animal body, so as to receive its action. There must be a sort of unison, as it were, or sympathy, betwixt different living bodies, so as to render them susceptible of each other’s influence.

It is none of the least curious facts with regard to infection, that there are some species of it by which the body is liable to be affected only once in life. When this is considered, it is indeed conformable to what happens in the course of the disease itself; for, unless there was in the body a power of resisting it, there could be no such thing as recovery. Where the disease actually exists, the continued presence of the poison, which is also infinitely multiplied, would infallibly prove fatal in all cases, unless the living powers were to become insensible to it[48].

[47] Hunter’s Experiments.

[48] Mr. Hunter’s Lectures.

[49] It is sincerely to be wished that this were adopted, and it is surprising that an article so salutary and necessary, and so difficult to be procured on foreign stations, should not have been the object of public attention, rather than a mere article of luxury, such as tobacco. But in order that it might not be a matter of choice with seamen, it would be worth while to supply them with it at prime cost, or even as a gratuity, and then they might be compelled to use it for the purpose of cleanliness. There are other articles of less importance, but being necessary to enable men upon foreign stations to keep themselves neat and clean, deserve to be made the object of public instruction. These are handkerchiefs for the neck, thread, worsted, needles, buckles, and knives.

[50] At the time I am writing this, (March 8th, 1785) there has occurred a fact which proves the effect of time in generating infection. There now prevails a contagious fever in several of the hospitals in London, and, among others, in that to which I am physician. In another hospital it has been so violent, that there has been a vulgar report that the plague had broke out in it. The same fever also prevails among the poor at their own houses. The cause of it seems to be, that the cold weather has been uncommonly long and severe; for the frost began early in December, and the cold has hitherto been more like that of winter than spring. The thermometer all this month has varied from 30° to 35°. Cold is favourable to infection, by preventing ventilation; for people exclude the air in order to keep themselves warm, and the poor in particular do so on account of their bad clothing, and their not being able to afford fuel to make good fires. Heat is the great destroyer of infection, and seems to act by evaporating, and thereby dissipating it; and the effect of fires in apartments is to produce a constant change of air, thereby preventing its stagnation and corruption, and the accumulation of unwholesome effluvia. With this view, a chimney is of great use, even though no fire should be kept in it, as it serves for a ventilator. But if an aperture were to be made in an apartment merely with a view to ventilation, it should be placed in that part of the wall next the ceiling; for foul air naturally tends upwards, and the external air entering at the top of a room, would not be so apt to subject those within to the effect of cold, as it would not blow directly upon them. There would also be this advantage in jails, that apertures in this situation would not be so liable to be forced for the purpose of escape as if they were nearer the floor; and in hospitals they would be out of reach of those who, wishing to indulge in warmth, at the expence of pure air, might be induced to shut the windows. But an external communication with the air any where is of the utmost importance; and it is observable in Mr. Howard’s account of prisons, that the jail distemper was most frequently to be met with where there was no chimney.

[51] It is of some consequence to attend to the materials of the seamen’s beds; for, instead of flock, they are frequently fluffed with chopped rags, which, consisting of old clothes, emit a disagreeable smell, and may even contain infection.

[52] By a _berth_ is understood the interval between two guns, or any space between decks, which is sometimes formed into a sort of apartment by means of a partition made of canvass.

[53] It is remarkable that this method of purifying was practised in the most ancient times, as we learn from the following passage in Homer, where Ulysses is represented fumigating the apartments of his palace in which the suitors had been slain:

Τὴν δ᾿ἀπαμειζόμενος προσεφη Πολυμητις Ὀδυσσευς
Πυρ νυ̃ν μοι πρώτιστον ἐνὶ μεγάροισι γενέσθω.
Ως ἔφαθ’. ουδ’ἀπιθησε φιλη τροφος Ἐυρυκλειος
Ἠνεγκεν δ᾿ ἄρα πυρ και θηιον. αυταρ Ὀδυσσευς
Ἒυ διεθέιωσεν μέγαρον και δῶμα και ἀυλήν.

ΟΜΗΡ. ΟΔΥΣ. Χ.

Bring sulphur straight, and fire, the Monarch cries;
She heard, and at the word obedient flies.
With fire and sulphur, cure of noxious fumes,
He purg’d the walls and blood-polluted rooms.

POPE.

This practice was probably founded in superstition, rather than the knowledge of nature. That some divine influence should be ascribed to fire was very natural, as the principal deities of the ancients were only personifications of the elements; and it is worthy of remark, that their name for sulphur signifies _something divine_ το θεῖον, which was probably owing to its being found in those chasms of the earth, in Sicily and Italy, which were supposed to communicate with the infernal regions; for the whole Greek mythology relating to these was taken from the phænomena attending the subterraneous fires in those parts. It is curious farther to remark, in other instances, how facts useful to mankind, the truth of which has been confirmed in later times by the more enlightened knowledge of nature, were first suggested by some superstitious circumstance. Thus the wound received by Sarpedon could not be cured, according to the Poet, till, by divine intimation, he was desired to apply to it the rust of the spear with which it had been inflicted, in consequence of which it healed. But the weapons in those days were made of brass, so that the rust of the spear must have been the _ærugo æris_, which has been found by the experience of modern surgery to be one of the best detergents in ill-conditioned sores. It is probably, from a false analogy, founded on some such incident, that an idea prevails among the vulgar, which has become proverbial, that some part taken from the offending body is good in all external injuries. Thus some part of a mad dog is said to have a virtue in curing his bite. Herein may be seen the difference of that knowledge which is suggested by superstition, and that which is acquired by the observation of nature.

[54] A loggerhead is a large round mass of iron, with a long handle to it.

[55] A fact, related in Anson’s Voyage, is also strongly in proof of the same opinion. When the rich Spanish prize was taken, it was necessary to crowd the prisoners into the hold, for fear of an insurrection, which was to be dreaded from their numbers; yet, when they arrived in China, none of them had died, nor had any disease broke out. They suffered only in their looks, being wan and emaciated to a great degree.

[56] It may be brought as a farther proof of a warm climate being unfavourable to every sort of infection, that though the itch is very common in ships and hospitals in Europe, I do not remember ever to have met with it in the West Indies, except in ships newly arrived from England.

[57] This circumstance, in the character of the English, is only of modern date; for we learn from Erasmus, who was in England about two hundred and fifty years ago, that they were then extremely slovenly. The following passage is extracted from a letter he wrote to a physician in York, after his return to Holland:--“Conclavia solâ fere strata sunt argillâ, tum scirpis palustribus, qui subinde sic renovantur ut fundamentum maneat aliquoties annos viginti sub se fovens sputa, vomitus, mictum canum et hominum, projectam cerevisiam et piscium reliquias, aliasque sordes non nominandas.” He adds, that the windows were very ill calculated for ventilation, and imputes to the closeness and filthiness of the houses the frequent and long continued plagues with which England was infested, and particularly the sweating sickness, which, he says, seemed peculiar to this country. He mentions that his own country had been freed from the pestilence by certain changes that the State had made in the houses, in consequence of the advice of some learned man. Erasm. Lib. xxii. Epistol. 13.--It is probable that the greater number of those epidemics, called plagues, were only bad infectious fevers. What would contribute still more to the production of infection was the want of linen, which was hardly in use in those days. The disappearance, or at least the great diminution of such complaints in modern times, particularly in London, has been ascribed to the great increase in the proportion of vegetable food; but it is certainly more owing to the improvement in personal cleanliness, and to the greater spaciousness and neatness of houses. As a farther proof of this, it may be mentioned that in the charity, called the Charterhouse, in London, founded by Henry the Eighth, for the maintenance and education of poor boys, their sustenance is all animal food, as it was at the original institution, yet they are extremely healthy. The same observation applies to Winchester school, which was founded some ages before that.

There are some passages in ancient history in confirmation of the same opinion. Herodotus relates, that the ancient Egyptians were the most healthy of all the nations, except the Libyans, and he imputes this to the invariableness of their weather, and the serenity of their sky. But he mentions in another part of his works, that they were also the most cleanly of all people, not only in their household utensils, but in their persons, and that their clothing was chiefly of linen, which it was one of the principal studies of their life to wash and keep clean--ἑιματα δε λινεα φορεουσι ἀιει νεοπλυτα ὲπιτηδευοντες τουτο μαλισα. Herodot. Euterp. 37.--It is remarkable that he makes no mention of the plague, though he gives a very minute account of the country from his own observation, from whence it may be naturally inferred, that it did not then exist there, though Egypt is now so subject to it, that the plague is supposed by many to be an endemial disease in it. It would appear also from another passage in this historian, that he uses the word λοιμος, which we translate _plague_ in a loose sense to signify any violent acute distemper; for he relates that a great part of the army of Xerxes, in their retreat from Greece, perished by the _plague_ λοιμου and dysentery, in consequence of famine. Herod. Lib. viii. cap. 115.

[58] It is proper also to observe here, that those ships which are built of winter-felled timber are much drier than those built of what is summer felled; and this circumstance should have been mentioned with regard to the Montague, for the cause of her healthiness, notwithstanding her being a new ship, was probably from being built of winter-felled timber. It should, therefore, be strictly enjoined to fell the wood in winter; for those who are employed to do it have an interest in doing it in summer, on account of the value of the bark.

[59] A windsail is a long cylinder of canvass, open at both ends, kept extended with hoops, and long enough to reach from the lowermost parts of the ship through all the hatchways into the open air.

[60] It is not necessary that seamen should have chests, for bags or wallets answer their purpose equally well, and are much more convenient in respect of stowage.

[61] Since the first edition of this work, I have met with a fact in confirmation of this principle, with regard to the cutaneous complaint called the _ring-worm_. This had prevailed in a private school in the neighbourhood of London, which I visited, but it had to all appearance become extinct; yet it nevertheless affected those boys who were newly sent to the school.

[62] It is mentioned by Thucydides, that while the plague raged at Athens, the people were affected with no other disease; from which it would appear that those persons who would otherwise have been attacked with some particular indisposition, were seized with the plague in place of it. Vide note p. 247.

[63] Part I. Book II. Chap. VI.

[64] It is related by the travellers into Turkey, that the Christians save themselves from it, merely by shutting themselves up in their houses, and the inhabitants, who sleep on the open roofs of the houses, do not catch it even from those of the adjacent buildings, though the wall that separates them is of no great heighth.

[65] Vide Opera Ambrosii Parei.

[66] See Essay on Sea Diseases.

[67] Limes, shaddocks, and perhaps all the other fruits of that class, possess the same virtues; but I have most frequently observed good effects from lemons.

[68] In the course of the passage from England to the West Indies in February, 1782, the following directions for using the sour krout and melasses were given in public orders by the Admiral to the different ships of the squadron:

“The allowance of sour krout made by the public boards in England, is two pounds to each man every week; and the Admiral orders that from a pound and a half to two pounds (beginning with the lesser quantity, and increasing as the men may find it palatable) be boiled with every gallon of pease on a pease day. The cooks are desired not to wash it, nor to put it into the coppers till the pease are sufficiently broken. “Half a pound is directed to be issued raw to each man on beef days, and a quarter of a pound on pork days. It is recommended that the allowance of vinegar be saved, particularly on meat days. When sour krout runs short, the pease and beef days to have the preference; when shorter still, the pease days. Melasses having been allowed in lieu of part of the oatmeal, in the proportion of eleven pounds to two gallons, the Admiral directs, that a pound of melasses be boiled with every gallon of oatmeal on Mondays, Wednesdays, and Fridays, mixing it and stirring it round with the burgoo immediately after it is drawn off. He directs that half a pound of melasses be issued with every three pounds of flour over and above the common proportion of raisins; and to prevent any abuse, it is directed that the purser’s steward pour it into the platter with the flour of which the pudding is made. The Admiral forbids the use of pease in lieu of oatmeal, as has sometimes been the practice.”

These rules were suggested by Sir Charles Douglas, captain of the fleet, whose benevolence is equal to his known professional skill; and he had ascertained the utility of the preceding directions when captain of the Duke in the former part of the war.

[69] In the French ships of war there is an oven large enough to supply not only all the officers and sick, but part of the crew, with soft bread every day. The advantages attending the use of flour in place of bread are so great and obvious, that the former will probably, in time, be substituted entirely for the latter. There is a proof of its being practicable to use it in place of bread in British ships of war, even with their present conveniences, communicated to me by Captain Caldwell. When he commanded the Agamemnon, of 64 guns, at New York, in the end of 1782, there happened to be no bread in store to supply that ship on her passage to the West Indies, and flour was given in place of it. The men, without any inconvenience, were able to bake it into bread for themselves, and it proved so salutary, that Captain Caldwell ascribed the uncommon degree of health which his men enjoyed to the use of the flour. The only objection that can be made to it is the greater consumption of wood occasioned by baking; but this may be obviated by adopting the grates invented by Mr. Brodie, in which the ovens are heated by the same fire with which the victuals are boiled.

[70] Mr. Napeane, afterwards Under Secretary of State, was at that time purser of the Foudroyant, and acted a very benevolent and disinterested part, by being instrumental in introducing this reform in the navy victualling.

[71] Half a pound of cocoa, and as much sugar, was allowed in place of a pound of butter.

[72] TABLE, exhibiting the daily Allowance of Provisions for each Man in the Navy.

---------+---------+------+----------------------------------------+---------
| Biscuit.| Beer.| Beef.| Pork.| Pease.| Oatmeal.| Butter.| Cheese.
| lbs. |galls.| lbs. | lbs. | Pint. | Pint. | ozs. | ozs.
---------+---------+------+------+------+-------+---------+--------+---------
Sunday | 1 | 1 | | 1 | half | | |
Monday | 1 | 1 | | | | 1 | 2 | 4
Tuesday | 1 | 1 | 2 | | | | |
Wednesday| 1 | 1 | | | half | 1 | 2 | 4
Thursday | 1 | 1 | | 1 | half | | |
Friday | 1 | 1 | | | half | 1 | 2 | 4
Saturday | 1 | 1 | 2 | | | | |
---------+---------+------+------+------+-------+---------+--------+---------

This has continued from the last century till the alterations above mentioned, all of which, except the introduction of vinegar, have been made in the three last years of this war. When the stock of small beer is exhausted, half a pint of spirits is allowed daily, diluted with four or five times its quantity of water. When wine is supplied, the daily allowance of it to a man is one pint.

[73] Instead of leaving this to the management of the men themselves, it might be done with greater advantage to them by instituting short allowance in the following manner:--Let a certain proportion, suppose one third, of the salt provisions, bread, and pease, particularly the first, be stopped, and let the amount of this, for the whole crew be thrown into one estimate. Let the agent victualler pay into the purser’s hands the value of these provisions in money, at the contract price, with such a discount as will allow for the use of the money. Let the purser, in return, give him a receipt, as if for so much provisions checked. This money, being distributed in the name of short allowance, will enable the men to purchase vegetables, and the provisions will be saved for a time of want, or for a cruise.

[74] The sailors in the squadron of Commodore Anson never murmured more under any of their hardships than when they were fed with fresh turtle for a length of time in the South Sea.

[75] Since the first edition of this work was printed, I have met with a book published by Mr. Fletcher, a navy surgeon, in which he mentions that spices, being antiseptic bodies, might be substituted for part of the salt in curing provisions, and this would, no doubt, be an improvement in the sea victualling. The quantity of spice he proposes for every barrel of beef or pork is four ounces of black pepper, and as much allspice, and also eight ounces of nitre in powder. It may be farther alledged as an advantage of spice over salt, that it would be less apt to run into brine, which robs the meat of the greater part of its nourishment.

[76] This accident happened in the Cyclops frigate in September, 1780. Mr. Gordon, the surgeon, favoured me with the following account of it:

“Mr. Smith, an officer, John Barber and Anthony Wright, seamen, having eat some victuals prepared in a foul copper, complained soon after of violent gripes, giddiness, and vomiting, and they had a few loose stools. There was intense heat; the pulse was quick, full, and hard; a tremor of the hands and tongue, and wildness of the eyes. The looseness was soon succeeded by obstinate costiveness, tension of the abdomen, difficult breathing, and loss of deglutition. In the night, towards the morning, there came on insensibility, with an increase of all the symptoms, except the heat. The body was violently convulsed, with cold clammy sweats and coldness of the extremities. The abdomen subsided a short time before they died, and, before they expired, a small quantity of greenish matter, mixed with phlegm, issued from the mouths of two of them.

Thirty three other men were put upon the sick list with similar symptoms in a less degree, and some of them continued on the list for five or six weeks before they perfectly recovered.”

It is not said what means were attempted for the recovery of these men; but, besides emetics and milk, or oil, a dilute solution of the fixed alkali in water has been recommended against this poison.

[77] I was furnished by Dr. Clephane, physician to the fleet at New York, with the following fact, as a strong proof of the excellence of this liquor:

In the beginning of the war two store ships, called the Tortoise and Grampus, sailed for America under the convoy of the Dædalus frigate. The Grampus happened to be supplied with a sufficient quantity of porter to serve the whole passage, which proved very long. The other two ships were furnished with the common allowance of spirits. The weather being unfavourable, the passage drew out to fourteen weeks, and, upon their arrival at New York, the Dædalus sent to the hospital a hundred and twelve men; the Tortoise sixty-two; the greater part of whom were in the last stage of the scurvy. The Grampus sent only thirteen, none of whom had the scurvy.

[78] We have a remarkable proof of this in comparing the fleet under the command of Admiral Byron with that under the Count d’Estaing, when they both arrived from Europe on the coast of America in the year 1778, some of the British ships having been unserviceable from the uncommon prevalence of scurvy, while the French were not affected with it.

[79] See an article in Rozier’s Journal de Medicine for July, 1784, by Dr. Ingenhousz.

[80] Since I came to England I have met with a pamphlet published by Mr. Henry, of Manchester, in which an ingenious method, founded on chemical principles, is proposed for separating the quick lime from water; but I fear it is too nice and complex to be brought into common practice. It would certainly be worth the trouble; but there are so many duties in a ship of war to call off the attention of the men, and they are so little accustomed to nice operations, that it would be difficult to persuade officers to attend to it and enforce it. If a sufficient quantity should not be precipitated by the air in the water, and by the accidental exposure to the atmosphere, it might be more effectually exposed to the air by Osbridge’s machine, to be described hereafter, or by a long-nozzled bellows, and if a small impregnation should be left, this is rather to be desired than avoided.

[81] See Dr. Lind on the Health of Seamen.

[82] The want of this apparatus may be supplied, in case of exigency, by a contrivance mentioned by Dr. Lind, consisting of a tea-kettle with the handle taken off, and inverted upon the boiler, with a gun barrel adapted to the spout, passing through a barrel of water by way of refrigeratory, or kept constantly moist with a mop.

In this place I cannot help mentioning also, that in case of great extremity it has been found that the blood may be diluted, and thirst removed, by wetting the surface of the body even with sea water, the vapour of which is always fresh, and is inhaled by those pores of the skin whose natural function it is to imbibe moisture, of which there is always more or less in the common air of the atmosphere.

[83] When we consider that linen was not in use among the ancient Romans, we might be apt to wonder that they were not more unhealthy; but their substitute for this was frequent bathing, which not only served to remove the _sordes_ adhering to the surface of the body, but to air that part of the clothing which was usually in contact with the skin. The washing of the bodies of men suspected of infection upon their first entrance into a ship, has already been mentioned, and I have known some commanders who made their men frequently bathe themselves with great seeming advantage.

[84] A coarse woollen stuff so called.

[85] He makes the following computation of the additional expence for each man in some of the articles that have been mentioned:

£. _s._ _d._
For 3 handkerchiefs, at 1s. 6d. 0 4 6
12 pounds of sope, at 6d. 0 6 0
1 knife, at 1s. 0 1 0
1 pair of buckles, at 9d. 0 0 9
-------------
0 12 3

Suppose 3 shirts a year, the difference 0 2 3
3 pair of trowsers, ditto 0 2 3
1 milled cap 0 2 0
----------
Total £. 0 18 9

[86] See Part I.

[87] Had I then known the salutary effects of porter and spruce beer, of which I have since been convinced, I should have proposed them as substitutes for rum.

[88] The authenticity of this fact, as well as every other assertion in this work relating to the mortality in the fleet, may be proved from the ship’s books, deposited at the Navy Office.

[89] I fancied that my reasoning on this subject was in a great measure new; but I lately met with the following passages in Celsus and Hippocrates, which seem to be illustrative of the same idea:--Quibus causa doloris, neque sensus ejus est, his mens laborat. Celsus, Lib. ii. cap. vii. which is nearly a translation of the following aphorism of Hippocrates:--[Greek hOkosoi poneontes ti tou sômatos, ta polla tôn ponôn ouk a sthanontai, touteoisin hê gnômê noseei]. Hippoc. Aphor. Lib. ii. Aphor. 6.

The same principle is ingeniously explained by Mr. Hunter in his Lectures.

[90] See page 181.

[91] See pages 125 and 126.

[92] The form of administering this medicine was to add twenty drops of thebaic tincture, from half a grain to a grain of emetic tartar, and from five to ten grains of nitre, to two ounces of water or camphorated julep, of which one half was given about two hours before the common hour of rest, and the remainder at that hour. If spiritus Mindereri is preferred to the nitre, it may be given from two drachms to half an ounce for a dose, and it is better to administer it separately; for if it should not be exactly neutralized, it may decompose the antimonial, and render it inactive.

[93] Since the publication of the first edition of this work, there has appeared a small tract on the treatment of low fevers, by Dr. Wall, of Oxford, and as his ingenuity and learning give him a just claim to the high rank he holds in his profession, attention is due to what he advances. The principal scope of the work is to recommend, from his own observation, the early use of opiates in those fevers, and the Doctor’s authority, as well as my own experience, convince me of the propriety of this practice in many cases occurring in this country, particularly among the lower sort of people, for whom spare diet and hard labour render evacuations less necessary than among the better sort. The inferior class of people are also more subject to this sort of fever from their houses and persons being less clean, and their apartments being worse ventilated; so that practice in these, as well as other cases, is to be varied according to the constitution and previous habits of life.

[94] I first learned this, as well as many other useful and practical facts, from Mr. Farquhar, Surgeon in London, who has laid me under the greatest obligations by communicating many of his observations, derived from the most extensive experience and a truly penetrating sagacity.

[95] I owe this piece of instruction, as well as many others, to Dr. Cullen’s Lectures.

[96] In a review of Haslar hospital made in person by that excellent officer, Vice-admiral Barrington, in 1780, it was very judiciously proposed, among other salutary improvements, that there should be two apartments for the reception of the sick upon their first landing; one wherein they should be stripped of their dirty clothes, and another in which they should go into the warm bath, and put on the hospital dress, that they might not carry infection into the wards.

[97] The following is the form of it, and it was first introduced by Mr. Whitfield, apothecary to the hospital, under the name of Bolus Sedativus:--℞. Confection. Damorat. [dram]ss. Castor. Russic. pulv. [scruple]ss. Tinct. Thebaic. g^{tt.} iv. Syr. sim. q.s. Fiat bolus sexta quaque hora sumendus.

[98] Great nicety is required in all cases with regard to the times and doses of cordials; for it by no means follows that these should be in proportion to the lowness and loss of strength. This is well illustrated by Mr. Hunter in his Lectures, where he explains the distinction between the powers of the body and its _actions_. There must be a certain degree of strength to bear the excitement occasioned by stimulating and strengthening medicines or diet; for nothing is more pernicious, or even fatal, than that any part or function should make exertions beyond its strength; and there is the more danger in ill-timed remedies of this kind, as a state of weakness is generally a state of irritability.

[99] See a method proposed for obviating this, page 358.

[100] Page 381 et seq.

[101] Sailor’s fever.

[102] See pages 161, 181, and 380-1.

[103] I have in the whole of this work been extremely cautious in reasoning concerning causes, from an opinion that they are very obscure, and that the theoretical part of physic is very imperfect and fallacious. This is perhaps in no instance more remarkable than in those opinions that prevail concerning the nature and influence of bile in producing diseases. An increased secretion of bile commonly attends the feverish complaints of hot climates, and those of the hot seasons of temperate and cold climates. It is not unnatural, therefore, to impute the disease then prevailing to this redundancy of bile: but, upon considering the matter more closely, it will appear to be rather a concomitant symptom, or effect, than a cause of those fevers; for, in the first place, in those cases in which there is the greatest secretion of bile, as in the _cholera morbus_, there is no fever. The only danger in this disease arises from the violent irritation produced in the bowels by such an extraordinary quantity of this secretion which commonly passes downwards; though I have seen it prove fatal when it flowed into the stomach, and produced perpetual retching and excoriation of the fauces; but in this case also without any fever. Secondly, in the most fatal of all fevers, in the West Indies, there are no marks of an increased secretion of bile, but, on the contrary, a preternatural defect of it, as appears by its not being evacuated either by stool or vomiting, by the white stools which sometimes attend the yellow fever, and by its not appearing in the first passages, nor in its own receptacles after death. Perhaps also that state of the bowels which renders it so difficult to procure stools may be in part owing to the want of this natural stimulus. It is nevertheless true, that in the intermitting and remitting fevers of hot climates and seasons there is perhaps always an accumulation of bile at the beginning, and an increased secretion of it during their course. It is farther true, that this adds to the patient’s uneasiness, and aggravates the symptoms, and that the cure consists partly in the evacuation of the bile. But it is also true, that in the very worst sort of fevers in hot climates it is a favourable symptom where the secretion of the liver is restored and increased, a bilious diarrhœa being one of the most auspicious symptoms that can occur in a yellow fever; and in those that are protracted and afford hopes of recovery, there is generally a gush of bile from time to time.--We may therefore lay down the following positions: 1. That in cases in which bile is most freely and copiously secreted no fever exists, as in _cholera morbus_. 2. That in the worst sort of fevers there is no preternatural secretion of bile, but, on the contrary, a defect of it. 3. That nevertheless there is an uncommon quantity of bile secreted in most of the fevers of hot climates, and that part of the cure consists in evacuating it.

I am extremely diffident, as I have said, in all matters depending on our supposed knowledge of the animal œconomy; but the preceding circumstances seem to countenance the following reasoning:--The bile, according to Dr. Maclurg, who has given one of the best dissertations on its nature and properties, is composed of two parts; the gross part, which is coagulable by acids, and that part in which the bitter principle resides. The first constitutes the principal part in point of quantity, and seems to be that portion of the mass of fluids which loses the property of sound healthy blood, by a tendency to putrefaction, and is thrown out by this secretion. I will not undertake to vouch for the truth of this, but shall assume it as true in the following reasoning:--According to this theory, therefore, the greater part of the bile is what may be called the effete part of the circulating mass, or perhaps only of the red globules or gluten, the watery and saline part, which passes off by urine being the corrupted part of the serum. This part of the bile being very liable to putrefaction, the bitter part is considered by Dr. Maclurg as intended to correct this, and also to answer some good purpose in digestion. One of the effects of the bile in this operation is to extinguish acidity, whether proceeding from substances taken in, or generated in the stomach. The blood in all climates, and in all situations of life, is subject to have part of it thus corrupted, which, being separated from the common mass by the liver, is mingled and discharged with the common _feces_; but external heat continued for any length of time tends to augment this corruption of the fluids, and therefore to increase the secretion of bile; and it has been observed both by myself and others, that the bile found in those bodies that have been inspected after death, in consequence of fevers in hot climates, is less bitter, and not so penetrating to the fingers, being therefore deficient in the antiseptic principle. But since external heat makes no alteration in the degree of temperature of the fluids themselves, this effect must take place through the medium of the solids, in consequence of that general languor and want of energy which too much external heat induces in the functions, particularly in that power by which the living body preserves itself from putrefaction. Now if this portion of the blood, thus altered and depraved, is readily secreted and speedily thrown out, as in _cholera morbus_, no harm befals the constitution, nor any inconvenience but what arises from the irritation of the _primæ viæ_. But this may not take place if the body should be otherwise deranged; for the removal of this noxious matter from the mass of blood depends upon a due irritability of the blood vessels, the liver, and the bowels, whereby they are stimulated to contract, and thereby expel it. According to the principle of Mr. John Hunter, (whose deep and industrious researches into the animal œconomy place him high in the list of those few on whom nature has bestowed real genius, and who are capable of adding something new to the stock of human knowledge,) there is in a state of health a relative habitude or mutual harmony existing between the solids and fluids, whereby they stimulate and produce actions in each other, in which the healthy state of the functions consists, whether employed in the formation of what is found, or the expulsion of what is noxious: so that where it happens that the solids have a morbid insensibility to the impressions of corrupted and acrimonious fluids, the retention of these adds still more to the general derangement. To illustrate this, it may be observed, that the stomach and bowels, when they are endowed, as it were, with their natural perception, immediately expel any preternatural accumulations of bile that may take place; but when they are insensible to this stimulus through disease, no effort is made to relieve nature till it is excited by medicine. The same reasoning may be applied to the various vessels and ducts. Thus when we see the liver gorged with bile, without any free excretion of it into the gall bladder, as I have sometimes found to be the case upon inspecting the body in some of the worst cases of fever, would it not appear that the gall ducts have lost that natural irritability whereby the bile is expelled? Or, in consequence of a depraved state of action, connected with febrile affection, may it not happen that the absorbents, which, in their natural state, only absorb particular substances, and in a given quantity, will suffer a change in this natural action, and absorb whatever happens to be applied to their orifices? In case of jaundice, the bile, which is perhaps not at all absorbed in a state of health, is taken up in large quantities, and mingled with the mass of blood, which proves a seasonable relief in the state of accumulation and distension occasioned by the obstruction. This may happen in cases of fever, not indeed as a relief to nature, but from a depraved state of irritability in the lymphatics, induced by disease. Though no increased quantity of bile, therefore, is found in the gall bladder, there may have been an increased excretion of it, a preternatural absorption having been excited. So that it may admit of a question whether the colour of the skin, in the yellow fever, is owing to this, or if the idea of it given in the text[104] is more just; but in either case it seems probable that the extreme tendency to putrefaction in the whole body is owing either to the presence of bile, in consequence of absorption, or the retention of something in the blood from a defect of its secretion.

This reasoning concerning the bile in hot climates may, in some sort, be illustrated by what happens to the urine in cold climates. The urine is the vehicle of an excrementitious part of the blood, of which an increased proportion is generated in certain fevers, and if it is thrown out in the form of high-coloured, turbid urine, the fever will most probably be slight and short; but if it becomes pellucid, or _crude_, as it is called, the general derangement will be increased, the fever will be more violent and dangerous, and the first sign of returning health will be a turbid appearance and sediment.

If the reasoning in the above discussion should appear to some readers unsatisfactory, or ill connected, I can only say that if it is deserving of this character, I am willing to have it considered not only as an illustration, but an example of the nicety and fallacy of theoretical disquisitions.

[104] See page 437-8.

[105] I have been very cautious of admitting any theory into this work; but I cannot help adopting the doctrine of my much-valued master, Dr. Cullen, on this point, viz. that a great part of the symptoms of fever arise from reaction, or that effort which nature makes to overcome the morbid cause. I am happy in any opportunity of acknowledging my obligations to this learned professor, to whom the medical world in general is so much indebted, as well for the rational views of the animal œconomy, which he teaches, as for that spirit of study and inquiry which he infuses into the minds of his pupils.

[106] M. Desportes, who wrote a treatise on the diseases of St. Domingo.