History: The Home Remedy

While sawing off bones and applying blisters may have been more dramatic, the surgeon at sea was usually more occupied with the dispensing of pills and syrups to keep his mates going. Often, perhaps more often than we might suppose, these little remedies came from home rather than the wards of a training hospital. The truth is, most naval surgeons had no formal training and most pirate surgeons were simply kidnapped away from various navies.

The cures were generally for such recognizable maladies as colds, sore throats, indigestion, nausea and "the itch" (more on that in a minute.) Some of these are documented, to one degree or another, in the large seafaring memoirs of doctors like Alexander Exquemelin but most are more readily found in writings more close to shore. Mrs. Child in her The Family Nurse of 1837, for instance, gives us some insight into the time-tested cures that were certainly in use for centuries when she wrote them down.

Just as a few examples, colds could be treated by soaking the feet in warm water, binding them up with a warm onion each and then putting the patient to bed with a half pint of strong penny royal or calamint tea. Mrs. Child assures the reader that this is "almost sure to cure a cold."

Likewise, a small lump of saltpeter held in the mouth until it dissolves will help alleviate a sore throat. Wrapping the neck in warm flannels will hurry the process along. Given that saltpeter can be poisonous, one imagines that dosing would need to be carefully monitored.

A tablespoonful of "the brine in which rennet is preserved is extremely salutary in cases of indigestion and an acid stomach." This ancestor of Alka-Seltzer, Mrs. Child says, "is less disagreeable" if taken with a little water, "but it is better to take it clear."

"Common ashes," as from a fire, stirred into twice as much boiling water is given a teaspoon at a time "at intervals" to help control nausea and vomiting. Mrs. Child notes that "some prefer to stir it in cider" and given that cider was most often an alcoholic beverage at the time the results must have varied to say the least.

"The odor of burning feathers, horn or leather, is good for hysteric fainting fits," and "O'Meara, surgeon to Napoleon, declares that a teaspoon of salt, moistened and put upon the tongue of a patient during an epileptic fit, affords immediate relief."

Finally, both Mrs. Child and Exquemelin, in his The Buccaneers of America, agree on the cure for what they refer to as "the itch." This, of course, would have been the infestation of various crawling, biting parasites that have the habit of crawling around on the human body. Particularly in warmer climates the problem could become incapacitating fairly quickly. The recommended remedy is as follows:

... to stand half an hour, or more, in a tight barrel, cover to the throat with old blankets or carpets; two or three lighted brimstone matches should be placed inside the barrel, by means of a small hole near the bottom, and every crevice stopped, that no smoke may escape. It is well to take moderate doses of sulphur, night and morning, for some days after.

Exquemelin notes that this cure was risky at best at sea and generally reserved for times ashore, such as when careening or plundering.

Header: The Astrolabe and Zelee Aground in the Torres Strait by Louis le Breton c 1810s via Wikimedia

Tools of the Trade: Stanger's Fever

In a rush this morning (not a Benjamin Rush, thankfully...) so here's one from the archives circa August 2011:

The yellow jack was indeed a killer: it was difficult to fix upon any satisfactory figure, though he had heard well-authenticated accounts of a mortality amounting to eighty in a hundred. ~ from The Commodore by Patrick O'Brian.

This is just a bit of the musings that go through Doctor Stephen Maturin's mind upon realizing that he has contracted yellow fever off the coast of West Africa. The disease, which we now know is transmitted like malaria by mosquitoes, was the scourge of tropical areas all over the world. To this day there are pockets of swampy land that still harbor the deadly aedes mosquito and travelers to certain parts of the globe are advised to get vaccinated before leaving home.

In the Great Age of Sail, it was people from out of town, so to say, that tended to contract yellow fever. Locals often suffered a milder form of the disease, which did not reach the so called "toxic state" in childhood, thus building up a relative immunity. This meant that sailors from Northern shores would find themselves sick after spending time in places like the Gulf of Mexico, the West Indies, the Indian Ocean or, as O'Brian notes, the African Coast. Maturin's figures are generally accurate; mortality among sufferers was about 80% over all.

Symptoms follow a fairly recognizable path, with the patient experiencing a fever as high as 103 degrees and all the accompanying miseries: head and body aches, chills and loss of appetite. The toxic phase was experienced when internal organs began to shut down. Stomach bleeding let to the tell-tale "black vomit" along with bleeding from the nose, mouth and sometimes even the eyes. The skin and eyes took on a yellow hue as the liver and kidneys ceased to function. General lividity of the skin ensued and the patient suffered temperatures as high as 106. In these cases, death was a virtual certainty.

In the 17th and most of the 18th century the disease was treated like any other fever. A sufferer was put to bed, or in the case of a sick berth aboard ship strapped into a hammock, and given clean bedclothes whenever possible. Bathing with a cloth dipped in cool water and vinegar was often recommended with the head and hair being included in the process. Sometimes the patient was wrapped in woolen blankets and put near a fire to help "sweat out" the fever. Quiet and calm around the sick person was always thought best. Unfortunately, so was bleeding.

In the late 18th century, the rise of the medical profession pushed aside the homey, comforting remedies of mothers and wives and began aggressive treatment for yellow fever. One of the most famous proponents of hitting the fever hard was Dr. Benjamin Rush, signer of the Declaration of Independence. Rush was a physician in Philadelphia when the famous epidemic of the summer and fall of 1793 hit the city. While other doctors were prescribing barley water and Peruvian bark (quinine), along with the cooling baths mentioned above, Rush was vigorously removing liters of blood. He also prescribed purges to induce vomiting and diarrhea as soon as the fever came on.

Though Rush's proactive treatment may have appealed to the idea of "doing something" that the sick and their loved ones frequently harbor, it was in fact something akin to a death sentence to his patients. The aggressive bleeding combined with regular purging took out the much needed fluids that would have helped the patient battle the disease. While Rush blamed any patient's death on his not being called soon enough, other physicians in Philadelphia grumbled that Rush was as fatal as the disease.

Well into the 19th century, people from cooler climates blamed yellow fever on the hot, humid "miasmas" common to more southern latitudes. The yellow jack, as it was frequently called in the American South and the Caribbean, became known as the Stranger's Fever in Britain and the northern U.S. While the British never seem to have developed a specific prejudice in this regard, people in the United States definitely did. By the 1820s the Stranger's Fever was considered to be just another example of how filthy and backward the South really was. Forgetting the horrors suffered in Philadelphia, the northern states imagined themselves capable of keeping their cities clean and avoiding pestilential disease.

Meanwhile, men at sea continued to experience yellow fever into the 20th century. Even after the discovery and partial eradication of the aedes mosquito which occurred in large part thanks to efforts begun during the building of the Panama Canal, some areas of the world continue to experience infection. Modern scientists worry about two possible scenarios that could bring the killer back with a vengeance: global warming and biological warfare. Perhaps it's best that none of us forget about warm bedding and barley waters quite yet. Better still: get vaccinated.

Header: Nuns nursing yellow fever patients in Philadelphia, 1793 via Dipity's timeline of the epidemic

History: Ancient Medicine

Over at WTVM.com, which seems an unusual place for nautical news, this interesting if brief article speaks to the ingenious ways that our ancient ancestors kept themselves healthy at sea.

Among the items found in a shipwreck off the coast of Tuscany was a metal cylinder, hermetically sealed after so long under salt water. The wreck, a Roman vessel named Relitto del Pozzino, was originally found in the Gulf of Baratti in 1974. Studies are ongoing on its cargo and contents, and the vile of green-gray tablets is just one of the many amazing bits of ancient medicine still being analyzed. From the article:

[Archeologist and lead researcher Gianna] Giachi said that the composition and shape of the tablets suggest they may have been used to treat eyes, perhaps as an eyewash.

The issue of dry eyes, particularly out in the elements at sea, is still a concern and evidently the Romans had a bit of relief for those exposed to wind, salt and sun. The tablets were made with a mixture of olive oil, pine resin and starch as a binder along with various herbs that have been proven to encourage eye health. How the tablets were used is not discussed, but one can imagine that they were perhaps dissolved in a saline solution and administered much like modern eye drops.

The article ends with comments from Dr. Mark Fromer, an ophthalmologist, who said:

... it makes sense that medicine that was discovered on the ship was an eye wash to treat dry eye, a common condition even today. "It's easy to make: it's saline, which has a pH... close to tears," he explained. "It's fascinating to realize that the problems that faced men and women thousands of years ago haven't changed."

I couldn't agree more.

Header: Odysseus and the Sirens, a Roman mosaic from Tunisia c 2nd century CE via Wikipedia

History: Rough Medicine

The day is spent, the night draws on. Chiurgion, look to the wounded, and wind up the slain, with each a weight or bullet at their heads and feet to make them sink. ~ Captain John Smith, Governor of Virginia

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

Horror on the High Seas: Dead

The word dead has a lot to do with Hallowe'en, which if we're honest is a celebration of the dead. So what better word for our Sailor Mouth Saturday during Horror on the High Seas week? I mean, we did devil last year.

We've discussed dead reckoning before, that amazing ability of our ancestors to make an educated guess about the positioning of their ship in blue water without reference to the stars or the planets. A keen trick if you could pull it off, but potentially deadly if your guess was wrong.

Many times the word dead has to do with components of a ship or her rigging. Dead doors are those attached to the inner bulwark of a ship's quarter gallery, this being the private latrine of the commanding officer. Since the quarter gallery is shifted slightly outward from the hull - for obvious reasons - dead doors are set in place to keep water out should the quarter gallery proper be, as Admiral Smyth puts it, "carried away." Wooden blocks, often made of elm, are used as stationary harnesses for rope to pass through; these blocks are known as dead eyes which comes from the older term, dead man's eyes. It is thought that the "dead" in this instance refers to the blocks' lack of movement.

The timber just at the midship bend, about a third of the length from her head, is known as a dead-flat. The dead-rising, by contrast, is the area of a ship near the stern post and is usually a reference to her bottom rather than her deck. Dead ropes are those which do not run through a block. Dead wood is used to correct certain inherent aberrations in a ship's keel; the blocks used were known individually as dead wood knees.  Dead works refers to the entire part of the ship which is above the water line when that ship is fully laden.

Dead lights are the shutters which can be attached to the outside of the stern windows which light the commanding officer's cabin in larger ships. These are fastened shut in anticipation of dirty weather. Dead lights is also a term for swamp gas or the elusive jack-o-lantern.

Dead can also be applied to weather conditions and navigation. A dead calm indicates no wind whatever, a sailor's nightmare. This is similar to a dead-lown, which Admiral Smyth tells us in The Sailor's Word Book is a "completely still atmosphere." Dead on end refers to a full backing wind blowing in the exact opposite direction from the ship's course. Dead upon a wind is to slightly better advantage with the ship braced up and close hauled while hard tacking.

The dead months signified winter, and a dead lift was the act of moving a "very inert body" - perhaps your fallen mate. Dead weight is the amount a merchant vessel must pay for goods she did not ship. Dead pay was that given for a man on a ship's books who did not appear when compensation was handed out; as the Admiral puts it "as was formerly practiced with widow's men."

Dead men's effects were those sold via auction at the main mast when a mate died. The purchaser would often have his pay docked in the ship's books to compensate for whatever he had won at auction. This was not always done for each man, but was often reserved for those who had no family to return any belongings to.

A dead ticket is a document, signed by surgeon and commanding officer, that certifies the man is in fact dead at sea. This was the first step to clearing the seaman off the ship's books.

Finally there is the curious ritual of the dead horse, which was performed on merchant vessels. When work for which the seaman were paid via advance, such as preparing to put out to sea, was completed, the men - at least in theory - would once again begin earning new funds. At this point the effigy of a dead horse was dragged around the decks to represent the end of "fruitless labor." The doll horse was sometimes run up the yardarm thereafter and cast overboard, according to Admiral Smyth "amidst loud cheers." Now there's something most of us have never heard of but that was probably witnessed by more than one traveler in the 19th century.

And so an end to our discussion of dead. Horror on the High Seas week continues on the morrow and marches right on to Hallowe'en. Don't miss a minute, Brethren.

Header: Moonlit Night by Stefan Popowski c 1910 via Old Paint

History: Harsh Medicine

The work of a surgeon aboard ship in the Great Age of Sail was no picnic. Men were more often ill than injured; statistics kept by the Royal Navy on their Jamaica station from the late 18^th century until the end of the War of 1812 bare this out. More men died of yellow fever than of any other cause. In war or peace, men still managed to contract illnesses.

Until the mid-19^th century, the essential approach to such issues was one of “imbalance.” The humors, as originally specified by Galen in the first century CE, had to be in perfect order for the body to be healthy. Thus such treatments as bleeding and purging, incomprehensible to the modern mind, were commonly applied to draw out the ill-humors and right the body’s functions.

One of the most wince-worthy treatments of the time was blistering, which is not as often spoken of as bloodletting but was equally popular. This application was used to draw heat out of the body and was therefore applied in the case of fevers, swelling and sepsis. If an area of the body was red and hot to the touch, then it stood to reason – at least when applying the theory of humors – that the heat needed to be taken away with a form of like heat. Enter blistering.

Blistering agents, sometimes referred to as epispastics, were generally made of a wax or lard base. The key ingredient in almost all blistering plasters was cantharide beetles dried and then ground to a fine powder. The beetles, often called Spanish flies, had an irritant in their exoskeleton to discourage predators which would cause inflammation.

Along with use as a blistering agent, Spanish fly was also sprinkled on food or in wine as an aphrodisiac. The painful result, unfortunately, was an irritation of the urethra. Since this would sometimes lead to prolonged erections both in the male penis and the female clitoris, the use of Spanish fly has persisted into the modern era. (Don’t try that at home kids; you can end up needing to be catheterized in order to urinate. Nobody wants that.)

Mrs. Child, in her 1830s publication The Family Nurse, gives a straight forward recipe for a blistering ointment as well as instructions for application:

The common blistering plaster is made of fresh mutton tallow, yellow wax, resin of pine, cantharides, or Spanish flies; equal portions of each. The flies are finely powdered and added to the other ingredients previously melted together and removed from the fire. Usually spread on soft leather or kid, somewhat larger than the hand. If the surface be spread with powdered flies, it is more irritating. If this fails to draw a blister, Venice turpentine, powdered mustard and black pepper are sometimes mixed with it.

The optimal result saw large blisters breaking out on the “cherry red” skin. Mrs. Child goes on to up the teeth-gritting quotient by advising that, should the blisters formed by the plaster refuse to pop in a timely manner, they should be snipped “with sharp scissors” before linen is applied to absorb the desired discharge. She does mention that one should go light on the cantharides in plasters made for children.

The generally soft-hearted and homeopathic-leaning Mrs. Child also gives a number of ways to relieve the inevitable pain brought on by this treatment. These include cabbage or plantain leaves soaked in milk and used as a “soothing dressing.” It is doubtful that any navy surgeon would have troubled himself with such coddling of a patient; one shudders to think of the application of a blistering aboard a pirate vessel.

The distasteful regimen of blistering fell out of favor by the late 19^th century, but a far less harmful remnant of the treatment remained. It is no doubt that most of our great-grandmothers applied a “mustard plaster” to their sick children. This smelly but harmless treatment was meant to clear up clogged nasal passages. A form of such home-brewed medicine remains today in the familiar application we know as Vicks Vapo Rub.

Header: Subtraction by H. Heath via Wikimedia (it will take more than a blistering plaster to help those sailors…)

Meta: Triple P Hiatus

I had hoped to put up a "real" post today but, most unfortunately, things are happening very fast aboard our ship.  I have been diagnosed with cancer and will be undergoing a left-sided mastectomy and ovarictomy tomorrow morning.

Because of the unknowns surrounding my recovery time, Triple P will be on hiatus until further notice.

One of my greatest joys is researching and writing the posts I offer here, along with all of the Brethren's wonderful feedback and support.  At this time, I ask only for your continued support as my family and I sail on into unknown waters.

I'll be back sooner than later and until then, please enjoy the archives.

Header: Rowing Home by Winslow Homer via Old Paint

History: Medicine Chest

Our mate and supporter of Triple P David brought an article over at Daily Mail UK to my attention on Tuesday.  While I'm not a huge fan of Daily Mail - really, how many of us care what Pippa Middleton is wearing? - this piece was one of their rare gems about a true historic find. 

According to the article, a magnificent "surgeon's chest" dates from 1817 and was found recently in a house in Derbyshire, England.  Virtually untouched except for a few dosings, most of the bottles and jars retain their contents and the chest, made of mahogany, is complete with its original instruction booklet.

The piece in its entirety will be auctioned in Derby this coming Saturday and speculations as to its original use are given by auctioneer Charles Hanson:

It may have been used out of hours by a doctor on call, or owned by the family of a large country house to carry with them on a long journey by horse or carriage. 

Or, if I may, by sea.  This sort of chest was exactly the type that well-provisioned naval surgeons would have had aboard ship in most of the navies of Europe and certainly the U.S. Navy by the Napoleonic Wars.  This tradition of bringing boxes of medicines - and of course implements - aboard along with a surgeon/barber probably originated with Henry VIII's English Navy.  As noted here at Triple P before, Henry's great warship Mary Rose had a similar surgeon's box aboard her. 

This type of medicine chest would also have been coveted highly by pirates and privateers.  Though a legitimate privateer might ship a surgeon (for instance, many of the larger U.S. privateers during the War of 1812 did), pirates almost unanimously never did.  Finding a surgeon's chest such as this aboard a prize would have been a boon to every man in the crew. The contents would, for the most part, have been familiar to the sailors.  Although their knowledge of doses and weights may not have been up to snuff, they would have had a general idea of what to do with the contents of the chest.

As to what is in this individual specimen, the spectrum of medicines seems to cover most ailments.  Manna, noted by Mrs. Child in The Family Nurse as a "mild, agreeable laxative that may be safely administered to children and the aged" is included.  Also available is peppermint water which would have been used not only for nausea and vomiting but also, again to quote Mrs. Child, "to cover the taste of disagreeable medicines, and diminish their griping effects."  A bottle of Cream of tartar might have been used as a laxative; Mrs. Child also recommends it mixed with lemon in a tisane to fevers. 

Of course the most popular medicine of the era, laudanum, is not forgotten.  A tincture of opium in alcohol, laudanum was the go-to medication for everything from hysteria to anesthesia.  Yes, old Doc Sawbones knew enough to give a sailor a heavy dose of opium before he cut off that gangrenous limb.  If he had any available, that is.  He might also get into the stuff himself, forming a disagreeable habit that could ruin him.  This was certainly the case with Patrick O'Brian's fictional Doctor Stephen Maturin who managed to free himself from addiction through sheer force of will.

The surgeon's chest found in Derby is a rare and important find that could give historians new insights into how our ancestors treated disease.  Let us hope, as the article notes, that it is purchased by someone who can not only appreciate it, but share it as the "time capsule" that it really is.

Header: Surgeon's chest via Daily Mail UK

Sailor Mouth Saturday: Lob

This is a word, either of itself or as part of another, which one reads a good deal in nautical fiction. There is lobscouse on the table, a loblolly boy in the sick berth, a whale lob-tailing off our larboard bow and that useless lob-cock over there. What is it all about, after all? Let us take a closer look.


Lob, as a stand-alone word, refers to a person aboard us who is of little or no use. He is a right landsman or, as Admiral Smyth puts it, “a sluggish booby.” If we’re truly contemptuous of the fellow, we may go so far as to call him a lob-cock. The Admiral opines in The Sailor’s Word Book that the word lob is the source of the more common lubber. That etymology remains in question but the possibility is there.

We’re all familiar with lobster, which was once the food of servants and is now a dining staple of the 1%. These curious “bugs of the sea” are caught in lobster boats which were once built with a purpose-fitted well in the center to keep the tasty crustaceans alive for the trip home. A lobster toad is an old English name for a type of deep sea crab.

Lob-tailing is the action of a sperm whale beating his tail against the surface of the ocean, causing formidable waves that have been known to founder a whaling boat. A lob-worm, on the other hand, is a type of creature similar to a blood worm with which the Brethren may be familiar from watching Dirty Jobs with Mike Rowe. Collected at low tide, they both make good bait.

A loblolly-boy was an untrained assistant to a ship’s medical man. Unlike the surgeon’s mate, who usually had some medical knowledge and was in apprenticeship, the loblolly-boy was more of a servant. His duties included bringing men down to the sick berth for treatment, providing food and water for those confined to their hammocks and holding men down during surgery. His appellation probably comes from loblolly, a type of gruel or potable soup that was often fed to those too ill to take meat and bread.

And then we come to lobscouse. Though it sounds like it might, this stew-like dish contained no lobster or for that matter any seafood at all in most cases. Usually made of pickled or corned beef or pork, it was an all in type of dish that was a wonderful way for the cook to use long-kept and perhaps questionable vegetables like potatoes and onions. Admiral Smyth tells us that the stew’s name came from the term lap’s course, which he calls “one of the oldest and most savoury of the regular forecastle dishes.” Anne Grossman and her daughter Lisa Thomas have another thought on this odd word’s etymology, however. In their Lobscouse & Spotted Dog they argue for a Viking origin of the word, sighting the Norwegian lapskaus, Danish labskovs and Low German labskaus – all forms of stew – as their proof. I like the ladies’ idea better, frankly. It may be, too, that even the Admiral’s lap’s course has its origin in one of the Nordic words. But that is the wonder of language; the more we know, the more we find out.

Header: Moonlit Night by Aleksey Savrasov via Old Paint

History: Laid Up at Haslar

Formalized medical treatment for service people was to a large degree pioneered by the British and by the Royal Navy in particular. In the mid-18th century, when a “hospital” amounted to nothing more than a work house for the majority of England’s population, the Royal Navy was opening impressive buildings at Plymouth and Gosport dedicated to the illnesses and injuries of sailors and marines.


The Gosport location, known as the Royal Hospital Haslar, opened in 1753 with construction continuing until 1761. The structure was large, including three stories, an attic and a basement, with wings jutting forth on either side and outbuildings to house nurses, groundskeepers, guards and cooking staff, just to name a few.

The guards may seem to stand as an unnecessary adjunct to a hospital but, in fact, Haslar was designed as much to keep invalids from running away as to cure them. The hospital was purposefully built in the middle of a murky swamp, and until the early 19th century the only reliable way in and out was by ferry. Men were divested of their clothes immediately upon arriving. After a warm, soapy bath the clean seamen were issued “Hospital Dress” which they were informed would “greatly tend to [their] recovery.” As Kevin Brown points out in his book Poxed & Scurvied, The Story of Sickness and Health at Sea, these oversized shirts were probably cleaner than the clothes the men came to the hospital wearing. They were also an excellent way to tell if a man had left without permission, essentially deserting just as he might from a ship. Men tried this trick nonetheless; Brown notes that the latrines were a particularly popular escape route. They were also used to smuggle in booze, usually by the nursing staff.

At the outset, Haslar was run by medical men. The first physician to oversee the hospital was the famed James Lind whose pioneering research on scurvy was done to a large degree at Haslar. He insisted on separating patients by illness, putting the most contagious cases on the top floor of the building. The second floor was for men recovering from fevers, STDs and the like, while the ground floor was reserved for those who were ambulatory.

The system worked rather well, and men recovered under Lind’s oversight. Unfortunately, however, discipline suffered as most of Haslar’s doctors had private practices to attend to as well. The “dispensers” and nurses began to bicker amongst themselves and the doctors could become martinets when they felt their areas of expertise had been trespassed.

Initially the nursing staff was recruited from seafaring families. Sailors’ and marines’ wives, “the most sober, careful and diligent that can be had,” were brought in to administer medicines, give baths, change bandages and take those who could get up and about on therapeutic strolls. After Dr. Lind retired in 1783, things went steadily down hill and, though there were still excellent individuals among the nursing staff, the standards in general certainly slipped.

Brown notes that the Haslar nurses “developed a reputation for stealing from patients, forging wills, and smuggling gin tied around their waists and under their stays in bladders.” Patients complained about specific women who put them in fear of their lives. In Haslar the Royal Hospital, A.L. Revel quotes invalids speaking of one Nancy Armitage:

… who treated us in such a manner that we were afraid for our lives. We have neglected taking our medicine from her less she should poison us, we never thought it was in the power of any woman to so behave and shew herself in the manner as she has done to us, and we were not able to help ourselves. She strove all she could to hurt us, she broke the poker striving to kill some of us and threatened us with drawing her knife.

What became of the psychopathic Nancy is not revealed.

Meanwhile, cases of nurses trying to assist neglected patients and being reprimanded or dismissed by doctors are also on the books. The middling road included nurses who were illiterate and could not tell which medications should be given to which men. Then there were those who were too drunk or too lazy to bother with medications or bandage changing at all. Then there was Jane Brown, who was sent packing for “going to bed with four or five patients and infecting one of them with the foul disease.”

By 1795 the Royal Navy, whose legendary system of discipline could hardly tolerate such mutinous behavior, had had enough. A position of Governor of the Hospital was established, to be awarded to a seaman of at leas post captain rank. The first at Haslar was Captain Charles Craven. It would be close to 100 years before the hospital was again run by medical doctors and Haslar would remain a functioning hospital, servicing all branches of the British military, until 2007.

Header: Early 19th c engraving of the Royal Hospital Haslar via the James Lind Library online

Tools of the Trade: Saving the Drowned

It goes without saying that drowning was always a possibility at sea and, whether we like to admit it or not in an era of harbor tours and pleasure cruises, still is. From reed fishing boats along the ancient Nile to so called unsinkable luxury liners such as the Titanic, people have lost their lives to the dark depths in their thousands throughout history.


Though the thought might surprise the modern mind, many if not most of the career sailors in the Great Age could not swim. As Patrick O’Brian notes in his Aubrey/Maturin masterpieces, there was a sort of common belief that simple drowning was better than struggling against the vast sea, only to drown anyway. This makes sense given situations like battle or storm, where no rescue would be forthcoming for the man overboard. But what of more common situations, where a man fell in while painting or doing repairs of some kind and rescue was possible?

The primary sources, such as surgeons’ diaries, are oddly silent on what was to be done with a man who had nearly drowned. That does not mean, however, that our ancestors did not know what to do in such cases.

We’ve talked about the inimitable authority Lydia Maria Child before, whose 1837 publication The Family Nurse imparts a wealth of information about the treatment of just about any ailment or injury one can think of. She spares a chapter in her book on what to do in the case of “loss of life through drowning”, and it has to be said that, with some modifications, the same procedures were applied when the unthinkable occurred aboard ship.

Mrs. Child’s foremost concern in a case of drowning is getting the victim warm. “… restore natural warmth, by hot and stimulating applications,” she says in no uncertain terms, even using italics to make her point clear. She warns that the “body” should be carried “in as natural a posture as possible” with the head lifted up. Wet clothes should be removed immediately, the victim placed in a warm bed, and warmed items such as bricks wrapped in flannel should be applied to “the bowels and feet.” The skin should be rubbed vigorously with “course cloth”; Mrs. Child highly recommends flannel mittens.

These are the initial treatments; Mrs. Child does not get around to addressing water in the throat or lungs or even breathing until after she has her patient on the road to warming up. Then she says:

Snuff or ginger [may be] blown up the nose… A strong person may hold his nostrils and blow his breath into the patient’s mouth with all his force; if the chest rises, desist from blowing, and press the breast and belly, so as to expel the air again; this operation may be repeated, in imitation of natural breathing.

The obvious comparison to modern mouth-to-mouth resuscitation goes without saying. Mrs. Child even stresses the importance of continuing the procedure despite the lack of immediate response. “Blowing into the lungs, &c., should be tried, and long persevered in.”

Once the victim is sensible enough to swallow, vomiting may be induced. This is a typical reaction of the era, where purging of some kind was used as a virtual panacea, but Mrs. Child is careful to instruct that emetics should not be used. “It is safer to induce vomiting by tickling the throat with an oiled feather.” In fact, the violent act of throwing up would probably have helped, at least somewhat, to expel water trapped in the lungs.

Mrs. Child notes that there is a good possibility of upper respiratory congestion and fever. Here, she recommends bleeding and, perhaps more soundly, rest and the administration of flax-seed tea with “a few grains of ipecac in it, may be given to loosen the cough.”

With few exceptions, the advice given by Mrs. Child is sound. A person suffering “lose of life” by drowning could indeed be saved but, as with so many other things, practical knowledge would be necessary to affect a positive outcome.

Header: The Battle of the Chesapeake 1781 by Patrick O’Brien via Marine Artists

Women at Sea: "When A Child is Ready to Be Born"

We've spoken about women aboard ship giving birth before, history showing us that it was not as unusual an occurrence as the Victorians would have us believe. We’ve also touched on the great help that Jane Sharp’s 17th century publication The Midwives Book must have been to those women at sea. Combining the two becomes an exercise in understanding just how much intrinsic knowledge our “uneducated” female ancestors really had.


While it must be admitted that women do not always go into labor at the most convenient times – David Cordingly mentions a case during the Battle of the Nile where a purser’s wife almost literally dropped her child on the gun deck as she was helping to carrying water to the gun crews – trying to hurry things along can do more harm than good. Sharp is very clear in her chapter on labor and delivery that midwives should not “force” the process. She speaks of breaking “the waters” with sharp fingernails and giving “harsh” tonics to speed up the process as uncalled for. Sharp even compares the outcome of such procedures to torture:

… there is great care and skill to be used, or the woman were as good be set upon the Rack.

Sharp makes clear that the “waters” should break of their own accord, but “if the water break away long before the birth, it is safe to give medicaments to drive the birth…” Again, she is patient in her approach, advising first that the attendant massage the mother’s back with warmed “Oyl of Poppies, water Lillies or Violets”. In this case, Sharp is dealing with the Humeral theories proposed by Hypocrites through Galen, her concern being the “heat” of the kidneys. But the error in origin does not discount the treatment; massage with warm oil – particularly if infused with a mild narcotic such as tincture of poppy or water lily – would certainly alleviate a margin of the back pain experienced by laboring women.

Regular examination of the cervix, or “inward neck of the womb”, is also recommended by Sharp. She admonishes the midwife to “[anoint her hand] with fresh butter or oyl of sweet Almonds” before this procedure. If the infant’s head is present, then delivery is imminent. While Sharp does not designate time frames for regular re-examination, she is clear that this procedure should not be attempted prior to that natural “breaking of the waters.”

Sharp does not recommend that women in labor eat or drink much of anything. Again, this is a good rule of thumb that any modern obstetrician would agree with. For long labors, when a woman is losing her strength, warm broth or a “potched egg” with an “ounce of Cinnamon water to comfort her” is permitted. These recommendations assume the best of conditions, and stories of births at sea include the mother drinking grog or wine rather than water.

If things aren’t going as planned, however, priorities have to shift and Sharp gives more than one recipe to “hasten and ease delivery.” “Featherfew or Mugwort boil’d in white wine” are recommended, as are similar “sirrups” containing tansy, pennyroyal, dittany, betony, cinnamon and saffron. Many of these herbs would have been available at sea from surgeon and cook, and doubtless some of these “sirrups” stood by in the sick birth or a lady’s personal cabinet. Some of the herbs mentioned are well known to modern medicine; “featherfew” for instance is now lumped in with its cousin feverfew which is used in migraine treatments to relieve pain and nausea via its anti-inflammatory properties. Mugwort and pennyroyal can increase muscle contraction; tansy calms anxiety.

Of course the ultimate goal of the entire process is the health of both mother and child, and Sharp keeps this in mind throughout. The knowledge that she set down on paper had been passed from one woman to another and continued to be communicated up until the mid-19th century, when male doctors replaced the helping hands of midwives and friends. It is, perhaps, a curious coincidence that women were far less often aboard ship – other than as passengers – by that time as well. Speculating on any correlation between the two is probably useless, but the rediscovery of just how intrepid our distaff ancestors actually were is gratifying nonetheless.

Header: Taking Caudle by Richard Dagley c 1821 via Ancestry Images

History: A Surgeon Aboard Us

I thank the Lord Serapis that when I was in danger at sea he straightway saved me through the good grace and constancy of our doctor… ~ letter from Roman sailor Apion to his parents, Epimacus and Philadelphia circa 100 CE.


As the above snippet from a short letter home shows, doctors have been sailing aboard ships of all kinds for centuries. Because it was not until the Napoleonic Wars that shipboard doctors were routinely recognized as part of the standing crew, many historians have glossed over or completely ignored the history that led up to that acceptance. Fortunately, some modern writers have endeavored to set the record straight.

As noted by Kevin Brown in his entertaining history of seafaring medicine Poxed & Scurvied, it may have been the Greek poet Homer who first wrote of naval surgeons in his epic Iliad. Here he mentions Machaon and Polidalirus, the medical professionals who sailed with Agamemnon’s fleet when that king set out to start the Trojan War.

As Brown notes, it was during the Imperial days of Rome that doctors aboard ship began to really become a fixture. So much so, in fact, that Caesar Augustus included them in his regulations against doctors going into battle. There were also regulations during his reign that navy physicians be over the age of 21.

In the Medieval period, a barber who could double as a surgeon – essentially, let’s face it, a puller of teeth, stitcher of wounds and hacker-off of limbs – was regularly aboard the merchant vessels of the Cinque Ports and Hanseatic leagues. It may be that at least some of the surgeons who accompanied Christopher Columbus on his post-1492 cruises to the New World were also spies for Spain. In Empires of the Atlantic World J.H. Elliott notes that Ferdinand and particularly Isabella sought to control the unruly mariner by inserting their own intelligencer on his ship in the person of royal doctor Diego Alvares Chanca y Salazar.

True finesse in medicine at sea had already bloomed in the Mediterranean with the era of the Crusades. Here the Knight of Malta and their counterparts, the Knights Hospitaller, began fitting out ships as floating hospitals to treat sick and battle wounded in the 15th century. Though the ships were merchant vessels repurposed as sick berths, they were a decided innovation that probably saved more than a few lives.

It should be noted that the Knights of St. John, an arm first of the Hospitallers and then the Maltese, extended treatment for injury or illness to their Moslem galley slaves. Brown notes that these men were treated, along with Christian sailors, at the Sacra Infermeria in Valletta. Here, such attentions as food service on silver plates and large, breezy wards were denied to no one regardless of societal status, religion or country of origin.

A tremendous amount of information regarding medicine at sea has come from the excavation of Henry VIII’s favorite warship Mary Rose. Launched in 1511 and sunk in 1545, she appears to have gone down with her entire crew (including the intrepid ratter known as Hatch) and all goods aboard. Since 1982, the Mary Rose Project has been revealing her history and what they have found tells us a good bit about the surgeon aboard.

He seems to have occupied two cabins, one perhaps for his own use and the other for any assistants he may have had and/or examinations and surgery. He seems to have been doing a good job too for, as Brown notes, most of the crew of over 400 men “… were large-boned, strong, and fit …”

Brown also gives us a somewhat chilling list of the instruments found in Mary Rose’s surgeon’s kit:

… copper alloy mortars, spoons, bandage rolls, pewter syringes for urethral irrigations in the treatment of gonorrhea and for the irrigation of wounds, wooden needles, spatulas, a maplewood feeding vessel, a leather wallet for storing instruments, ear scoops for cleaning out the ear, razors, a brass shaving bowl, and the handles of surgical instruments.

As Brown points out, the metal portions of those instruments have rusted away but they certainly included saws, forceps, probes, cautery irons and a trepan for removing parts of shattered skulls. The brutality of such necessary treatment is easily imagined, and thankfully avoided in this day and age.

Of course things were none too pleasant on the Spanish Main of a short 100 years later. Stephan Talty in Empire of Blue Water tells us that Henry Morgan shipped a surgeon on his raids of both Portobello and Panama City. Little good they seem to have done, however, as they turned up drunk and incapable on more then one occasion. Slap dash amputations by carpenters and careless cauterizations with swords led to gangrene and death, more often than not, in the humid heat of the jungle. Only the very strongest could survive the treatment, much less the injury.

As medicine improved so did its availability at sea. The surgeon became the physician, falling eventually into the general group known as warrant officers. And long before Nelson’s navy, the scientist-physician epitomized by real men like James Lind and fictional characters like Stephen Maturin was already starting to take to the sea. Morgan himself, as an aging pirate made good with gout and cirrhosis, was treated by Dr. Hans Sloane. Sloane was the epitome of the physician cum naturalist in 1687 and, though he could not save the decrepit Morgan from himself, he would go on to treat English royalty.

The history of medicine at sea continues to fascinate on so many levels. To each their own, of course, but I always wonder how one would manage to remove a cataract aboard a sailing ship at sea around 1810. The thought that it could be – and was – done is just another example of how hardy and capable our ancestors really were.

Header: Mary Rose by Bill Bishop via The Mary Rose Project

Women at Sea: Looking After the Boys

Young men at sea, as we have discussed on more than one occasion, were ubiquitous. From the Royal Navy to the humble smuggler’s pirogue, a child or adolescent of six to sixteen was not at all an unusual sight. In most of the same cases, a woman or two might be aboard as well. Up until the second quarter of the 19th century, women at sea were almost as ubiquitous as boys. It stands to reason, then, that it would be expected that the women would look after the boys. Who better to stand in for their mothers, after all?


What is often forgotten is that, just as in our modern era, not every woman was “Mom material”. More than one would come aboard a man-of war as the gunner’s wife only to find that her new role required her to look after something she may not have a lot of experience with, namely children. Although popular history tends to believe that every family prior to the 1960s was crawling with rug rats and that birth control was unheard of, that was not the case. Some women were only children, had none of their own, or simply did not have the temperament to patiently learn the necessary basics of child rearing. What to do then when a group of two, five or even ten boys was suddenly looking to you to mend their clothes, comfort them in times of trouble and, in particular, tend to their illnesses? With no web search available and the ship’s surgeon, even if he were capable, busy with the mature men, the thinking woman turned to books.

According to some of those surgeons, particularly in the Royal Navy, the book of choice well into the 18th century was The Midwives Book. Jane Sharp originally offered her collective knowledge in 1671 and she was the first woman to publish such in English. Though the book’s focus is labor, childbirth and infant care, it is full of good advice on children’s health as well. Written in plain English, with none of the Latin jargoning that would mark later medical books by men, Sharp’s treatise would have been invaluable to anyone caring for mothers and children.

As a brief example, Mistress Sharp includes remedies for “Hiccough, or Hickets, or Huckets as they call it…” which she says children are “much vexed with”. She recommends dipping a feather in oil and putting it down the throat of the child to induce vomiting. Though this seems extreme to us – wouldn’t a glass of water serve everyone better? – it must be remembered that Sharp was writing in a time when purging and bloodletting were thought to cure fevers and diarrhea. The vomiting, though unpleasant, would indeed stop the spasms of the diaphragm that are the root cause of “hickets”.

Stomach troubles such as might occur from eating something that didn’t agree with him, could be calmed in a young man via a decoction of “Lavender, Fennel and Cummin seed” taken internally. Sharp also recommends soaking a warm piece of wool in olive oil and dill seed and using this much like a hot water bottle on the stomach to calm cramps.

For congestion, Sharp recommends oil of roses and “good Pomatum” applied directly to the inside of the nose. “Gummy eyes” should be washed with rosewater, while ears should be cleaned regularly with almond oil mixed with a drop of honey. All of these remedies have antiseptic qualities, particularly the honey. The pomatum, an ointment with a strong scent made from apple skins, would at least have helped to clear up a clogged nose much like our modern Vicks vaporub.

Some of Sharp’s most helpful advice also came in her recommendations on eliminating lice. Head and body lice would have been hard to control once introduced into a cramped environment like a ship at sea. Sharp notes the commonly held belief that children “are exceedingly prone to breed Lice more than men of age” and attacks the problem with this in mind. She recommends keeping heads and bodies as clean as possible including frequently combing the children’s hair. A lotion to stop the infestation should be made of “Birthwort, Lupines, Pine and Cypress leaves” boiled in water. This decoction should be added to oil of wormwood with ox gall and “quick brimstone” and then applied regularly. Both the oil and gall would help to kill live lice, with the brimstone finishing off the eggs. The herbs probably helped somewhat too. At the very least they made a potentially vile smelling ointment a little more pleasant.

There is so much more to investigate in The Midwives Book but we’ll stop here for now. Perhaps next time we can take a look at Mistress Sharp’s recommendations for labor and delivery, another occurrence that was much more frequent aboard ship than is commonly known. You can find Sharp’s groundbreaking work, edited by Elaine Hobby, online here or it is available from Oxford University Press.

Header: Midshipman by Thomas Rowlandson

Tools of the Trade: The Surgeon's Grim Work

One has to assume that it was no treat being injured or ill aboard a seafaring vessel of any kind "back in the day". I certainly wouldn't have wanted to try it myself. Physicians and surgeons, though in fact "trained" as early as the Renaissance, were actually educated through an apprenticing system. Even actual physicians who walked the wards at teaching hospitals were not going to school in the sense that we think of it now. They were observing other doctors at work and then - if they were fortunate - putting their observations to work on illegally gotten cadavers.

Most navies, by the 18th century, had a rank of Surgeon. The ratio in the Royal Navy was one surgeon for each ship that carried 70 men with a surgeon's mate (usually a man of equal capability but, perhaps, lesser experience) added for each additional 200 men. An 800 man ship of the line could ship a surgeon and four mates along with assistants, or loblolly boys as they were known. This meant that "physic" was surprisingly available to men at sea, but many times the cure was as bad as - or worse than - the disease.

While surgeons were so called because they "did surgery" (a nice euphemism for "cut stuff off") the reality was that battle just wasn't as frequent as Hollywood would like us to believe and therefore truly gruesome wounds were not as common as one might think. Of course there were accidents. Falls were a concern but, unfortunate, most of the victims of these sorts of mishaps died out-right. There were burns, from galley stoves and gun practice, which were generally treated with olive oil and could become infected. Sprains and strains were common and commonly faked as well for a few days in the hammock. The vast majority of the surgeon's work, however, focused on illness.

By the early 19th century, a surgeon's medicine cabinet (usually looking very similar to the one above) would include treatments for fever, purging, pain relief and STDs.

The first was a tonic made from cinchona which was usually referred to as Peruvian bark. The bark was brewed into a brown tea and it contained quinine which, as we now know, does in fact help alleviate malaria symptoms. Because it worked on the fever of malaria, surgeons assumed it would work on any other fever, too. In those cases, however, it was simply a placebo.

Purges could be administered to induce elimination or vomiting, depending on the ailment. Enemas were common. Medicinal rhubarb, Castor oil, tartar emetic and ipecac were all used by mouth. Sailors were notoriously fond of purges for some reason, and surgeons kept these goodies under lock and key.

Pain relief was achieved via alcohol originally and then opium tinctured in alcohol, which is known as laudanum. Both were known to be addictive, but considering the potential pain of having an arm sawed off, no one seemed to give that much thought.

Finally STDs, which at the time were strictly considered gonorrhea and syphilis, were treated with mercury. There were oral preparations in the form of daily pills and mercuric chloride suspended in ointment for topical application. Intractable cases were treated to mercury salts injected directly into the ureter. All of these were used on both men and women, although syphilis in particular was hard to diagnose in females.

Then there were the truly grim treatments, pulled from the handy medicine chest only in life threatening situations. Blistering of the skin through the application of plasters made from mustard or cantharides beetles were used for high fevers, the thought being that the "heat" would be drawn to the painful blister formed by the plaster. Bleeding was also frequent. A surgeon would take approximately 12 ounces at a time, but much more could be collected from someone suffering from dangerous diseases such as typhus or yellow fever. Those who survived the disease and the treatment were the strongest of the strong.

Finally, there were times when this treasure chest had to be opened:Saws, knives, scalpels, syringes, probes, retractors, along with needles and cat-gut for sewing things up were all at hand for when the much feared fester of gangrene set in or when a crush injury would surely lead to infection. Of course anesthesia was not an option and most surgeons preferred to offer pain relief only after the procedure was done, for fear of trauma to the patient (I am not making that up). A man's mates or the surgeon's assistants would hold him down. A good surgeon could remove a lower leg in four minutes, bone and all.

While well funded privateers might ship surgeons routinely - Sir Francis Drake and John Paul Jones are good examples - most pirates got by with either a pilfered or make shift medicine chest. If a prize with a surgeon aboard was taken, Bones was usually "encouraged" to volunteer aboard the pirate's vessel. A notable exception is Alexander Exquemelin who voluntarily shipped with both Francois L'Ollonais and Henry Morgan as surgeon. Failing any of that hey, the carpenter had saws.

The history of medicine is frequently bleak, and I've no doubt that the seafaring surgeon's work was often grim and bloody. One thing is for sure, though. Surgeons were almost universally venerated by seaman of all ranks and levels of education, as if they were ancient shamans or medicine men. I guess, to some degree, they were. But no bleeding for me, thanks.