Tuesday, November 13, 2012
History: Rough Medicine
In the 17th century, medicine at sea was just getting its start. Surgeons sailed with many a vessel, both in navies and the merchant service. Perhaps surprisingly, even fishing fleets like those off the coast of Newfoundland had surgeons who were paid, at least in part, in dried fish. But as Kevin Brown points up in his meticulously researched book Poxed & Survied, "...the position of surgeon onboard ship was ill-defined and depended very much on the support and informed interest in hygiene of such captains as Francis Drake and Richard Hawkins."
This was true well into the 19th century. Patrick O'Brian, a master not only of storytelling but of accurate historical detail, knew this very well. His Stephen Maturin, a full-fledged physician who took a post with the Royal Navy only because of desperate poverty, would not have been able to accomplish half of what he did - as not only doctor but as naturalist and intelligencer - had it not been for the strong support of Captain Jack Aubrey. In "real life", captains like Nelson cared about all aspects of their crew's lives. Less capable commanders like Hugh Pigot or William Bligh were also less likely to support their surgeon.
Such circumstance would have been troubling for men with a sincere dedication to their vocation. And the problems were only multiplied by controls - or monopolies - imposed not only by the Admiralty but also by Parliament and even the King himself. At least in England.
As Brown points out, in July of 1626 the Privy Council started paying the Barber-Surgeons Company a yearly sum to allow them to provide medicine chests to both the navy and the army. This was followed up in 1629 by a mandatory examination for sea surgeons put in place by Charles I who chose John Woodall, first surgeon to the East India Company, to oversee both processes.
Woodall published The Surgions Mate in 1617 and the book became a must-have among sea going medical men. So much so in fact that Brown notes the book was widely distributed but few copies have survived to the present day. He tells us that this "... suggests that they were much used at sea" and that the book was a "... model for future manuals for the ship's doctor."
Given Woodall's expertise, it is not surprising that the king dumped so much in the doctor's lap. He was given "the whole ordering, making and appointing of His Highness' military provisions for surgery both for his land and sea service," according to the journals of Captain James Cook. As Brown rather snidely remarks: "Thus began a lucrative venture for Woodall, but also the long monopoly enjoyed by the Barber-Surgeons over the supply and inspection of ship's surgeons' chests."
Though the Barber-Surgeons grip on supplying ship's doctors could do more harm than good, there was a silver lining to the order. This process of inspection developed a certain uniformity of instruments and medicines available on both Royal Navy and merchant vessels. The upshot was a uniformity of treatment - at least on ships where caring for the crew in illness and injury was made a priority.
All the same, again as pointed up by Brown, the ship's surgeon was by and large a product of an apprentice rather than an educational system. True physicians - "lordly" to use Brown's term - had little interest in serving either navy or army until well into the 19th century. And only after the pay rates were adjusted to recognize their lordliness.
Meanwhile the ship's surgeon toiled on. He treated everything from bug bites to shattered limbs and for the most part dealt with day-to-day illness from STDs to the common cold. It was no glamor job, certainly. But at least some of the men who did it must have been as cherished by their captains and mates as Dr. Maturin himself.
Header: Paul Bettany as Stephen Maturin and Russell Crowe as Jack Aubrey; a still from the movie Master and Commander: The Far Side of the World