Dr Johnson famously declared that being in a ship was like being in jail, but with the chance of being drowned. He may not have known that the seamen of those days had an even greater chance of dying of disease, for reasons that are explained in this book. Its title should be read with care: it is literally concerned with medicine, less attention being devoted to surgery, the horrors of which will be known to any reader of the naval history of the period. The author, himself a Professor of Surgery, found it difficult to establish the precise facts about his subject, since many of them were not adequately recorded in contemporary writings. This inadequacy arises from the low status of medical men on board ship, when there were any; until the nineteenth century they were normally surgeons, not physicians, and therefore looked down upon by officers (whose ranks the Royal Navy did not admit them to until 1805). Not many had the chance, or the inclination, to write about their work in detail. Dependence on a limited range of sources inevitably lends the book to an anecdotal air in places. When systematic information is available, it is often startling. A Parliamentary report after the Seven Years’ War calculated that for every seaman killed in battle, not far short of 100 had died of disease, and two‐thirds of these deaths were a result of scurvy.
These horrendous casualties are less surprising in the light of the author’s explanation that as late as the eighteenth century, there was no real understanding of the causes of disease: epidemics, for instance, were thought to arise from tainted air. Sometimes, doctors approached more advanced knowledge without realising it. One textbook recommended that off a marshy shore, ships should anchor no less than a mile and a half away; we now know this to be the range of the malarial mosquito. Towards the end of the period, matters began to improve. It was established that fruit and vegetables would prevent scurvy (though again, nobody knew why) and more attention was paid to an adequate diet and even to cleanliness. These measures, combined with a better qualified medical profession, resulted in a great improvement in the health of the Navy, even before the introduction of antiseptics and anaesthetics in the nineteenth century, at which period the book rather abruptly ends. While most available evidence comes from naval surgeons, attention has also been devoted to medicine on board merchant ships, where sick sailors were (and sometimes still are) often dependent on the captain’s use of a rudimentary medical manual.
A full bibliography and references are provided, which demonstrate that few sources, either in manuscript or print, are available for the subject before the eighteenth century. All those quoted appear to be in English. Among them Smollett’s Roderick Random is consistently misprinted as “Roderick Ransom”, thus confirming the popular prejudice about the illegibility of doctors’ handwriting. There is an index and a section of illustrations, though some of the latter are not really medical, presumably because few such illustrations can be found. This useful work fills a significant gap in the literature of maritime history.
