In the year 1780 I printed a small treatise for the use of the fleet, containing general rules for the prevention of sickness; and this part of the work is chiefly taken from it.

My own opportunities of experience, as exhibited in the preceding Part, have been sufficiently extensive to suggest many observations on this subject; but as my object is utility, rather than the praise of originality, I shall not confine myself to these. Great part of what is to be advanced is taken from books35 and conversation, as well as my own experience, my design being to exhibit a concise view of all the discoveries on this subject that have come to my knowledge. I have assumed nothing, however, from mere report or testimony, having had opportunities, from my own observations, of verifying or disproving the assertions of others.

More may be done towards the preservation of the health and lives of seamen than is commonly imagined; and it is a matter not only of humanity and duty, but of interest and policy.

Towards the forming of a seaman a sort of education is necessary, consisting in an habitual practice in the exercise of his profession from an early period of life; so that if our stock of mariners should come to be exhausted or diminished, this would be a loss that could not be repaired by the most flourishing state of the public finances; for money would avail nothing to the public defence without a sufficient number of able and healthy men, which are the real resources of a state, and the true sinews of war.

In this view, as well as from the peculiar dependence of Britain on her navy, this order of men is truly inestimable; and even considering men merely as a commodity, it could be made evident, in an oeconomical and political view, independent of moral considerations, that the lives and health of men might be preserved at much less expence and trouble than what are necessary to repair the ravages of disease.

It would be endless to enumerate the accounts furnished by history of the losses and disappointments to the public service from the prevalence of disease in fleets. Sir Richard Hawkins, who lived in the beginning of the last century, mentions, that in twenty years he had known of ten thousand men who had perished by the scurvy. Commodore Anson, in the course of his voyage of circumnavigation, lost more than four fifths of his men chiefly by that disease. History supplies us with many instances of naval expeditions that have been entirely frustrated by the force of disease alone: that under Count Mansfeldt in 1624; that under the Duke of Buckingham the year after; that under Sir Francis Wheeler in 1693; that to Carthagena in 1741; that of the French under D’Anville in 1746; and that of the same nation to Louisbourg in 175736.

That the health of a ship’s company depends in a great measure upon means within our power, is strongly evinced by this, that different ships in the same situation of service enjoy very different degrees of health. Every one who has served in a great fleet must have remarked, that out of ships with the same complement of men, who have been the same length of time at sea, and have been victualled and watered in the same manner, some are extremely sickly, while others are free from disease. Is it not naturally to be inferred from hence, that the health of men at sea depends in a great measure upon circumstances within the power of officers, and, indeed, upon their exertions, much more than medical care37?

It has appeared in the preceding part of this work, that the diseases most prevalent among seamen are fevers, fluxes, and the scurvy. These are indeed some of the most fatal that can attack the human body; but there is a numerous tribe of complaints, which are also some of the most severe scourges of human nature, from which they are in a manner entirely exempt.—These are the diseases to which the indolent and luxurious are subject, and which so far embitter their life as to render their portion of worldly enjoyment nearly on a level with that of the poor and laborious. The diseases alluded to are chiefly the gout, stomach complaints, hypochondriac and other nervous disorders. In all countries it is the better sort of people that are most subject to these; for they are owing to the want of bodily exercise, to the great indulgence of the senses, and a greater keenness and delicacy in the passions and sentiments of the mind. Man being formed by nature for active life, it is necessary to his enjoying health that his muscular powers should be exercised, and that his senses should be habituated to a certain strength of impression. Animal and vegetable nature may be aptly enough compared to each other in this respect; for a tree or plant brought up in a greater degree of shelter and shade than what is suitable to its nature, will be puny and sickly; it will neither attain its natural growth nor strength of fibre, nor will it be able to bear the influence of the weather, nor the natural vicissitudes of heat and cold to which it may be exposed.

It is to be remarked, however, that exercise and temperance may be carried to excess, and that in these there is a certain salutary medium; for when labour and abstinence amount to hardship, they are equally pernicious as indulgence and indolence. This is strongly exemplified in seamen; for, in consequence of what they undergo, they are in general short lived, and have their constitutions worn out ten years before the rest of the laborious part of mankind. A seaman, at the age of forty-five, if shewn to a person not accustomed to be among them, would be taken by his looks to be fifty-five, or even on the borders of sixty38.

The most common chronic complaints which a long course of fatigue, exposure to the weather, and other hardships, tend to bring on, are pulmonary consumptions, rheumatisms, and dropsies. It is also to be considered, that these complaints, particularly the last, are farther fomented by hard drinking, which is a common vice among this class of men, and they are led to indulge in it by the rigorous and irregular course of duty incident to their mode of life.

With regard to gout, indigestion, hypochondriac complaints, and low spirits, there is something in hard labour of every kind that tends to avert them, and particularly in that rough mode of it peculiar to a sea life. There is also something in the harsh sensations from the objects which seamen are in use to see, hear, and handle, which so modifies their constitutions and hardens their nerves as to make them little liable to what may be called the diseases of excessive refinement, such as those above mentioned. I have, indeed, met with such diseases at naval hospitals; but I always remarked that they were in landsmen who had been pressed, and who had been bred to sedentary and indolent occupations.

The diseases above enumerated, as well as most other chronic complaints, being the offspring of indolence and luxury, while fevers and feverish complaints fall equally on all ranks and descriptions of men, it was a saying of some of the ancients, that acute diseases were sent from heaven39; whereas chronic diseases were of man’s own creation. But I shall endeavour in the course of this work to evince, that, with regard to seamen at least, acute diseases are as much artificial as any others, being the offspring of mismanagement and neglect; with this difference, that they are imputable not so much to the misconduct of the sufferers themselves, as of those under whose protection they are placed.

If I were to add any other complaint to the three already mentioned, as most prevalent, and peculiar to a sea life, it would be those foul and incurable ulcers which are so apt to arise at sea, particularly in a hot climate. The slightest scratch, or the smallest pimple, more especially on the lower extremities, is apt to spread, and to become an incurable ulcer, so as to end in the loss of a limb. The nature of the diet, and the malignant influence of the climate, both conspire in producing them.

The diseases most frequent and prevalent at sea have this advantage, that they are more the subjects of prevention than most others, because they depend upon remote causes that are assignable, and which increase and diminish according to certain circumstances, which are in a great measure within our power.

The prevention of diseases is an object as much deserving our attention as their cure; for the art of physic is at best but fallible, and sickness, under the best medical management, is productive of great inconvenience, and is attended with more or less mortality. The means of prevention are also more within our power than those of cure; for it is more in human art to remove contagion, to alter a man’s food and cloathing, to command what exercise he is to use and what air he is to breathe, than it is to produce any given change in the internal operations of the body. What we know concerning prevention is also more certain and satisfactory, in as much as it is easier to investigate the external causes that affect health than to develope the secret springs of the animal oeconomy.

This part of the work, therefore, is chiefly addressed to those who direct the navy either in a civil or military capacity; for the general health of ships depends so much upon the victualling and manning in the first instance, and, afterwards, on the degree of discipline and order which are kept up, that I am persuaded that a certain degree of attention on their part would almost entirely eradicate disease from our fleets.

Several remarks in this part of the work will be found so obvious, that it might seem superfluous to mention them. But it has been my intention to omit nothing that I have heard of or observed as a matter of ascertained utility, and, I believe, the most experienced will find either something new, or what they had not before sufficiently attended to. Though the design of it is that of being extensively useful, yet my trouble would be compensated, should it prove the means of health and comfort to a single ship’s company; nay, I should not repent my labour, could I enjoy the conscious certainty of its being the means of saving the life of one brave and good man.

The prevention of disease has relation only to the external causes that affect health, and I shall consider these under the four heads of

I. AIR,
II. ALIMENT,
III. EXERCISE,
IV. CLOATHING.