The Sick and Hurt Board and the health of seamen c. 1700-1806

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Introduction

Haslar Hospital, Portsmouth © National Maritime Museum, London. (Neg. no. PU1074)

I am engaged in a survey of the papers of the Commissioners for the Care of Sick and Wounded Seamen and of Prisoners of War, more commonly called the Sick and Hurt Board, between c. 1700-1806, held at the National Maritime Museum. I set these dates because 1702 saw the establishment of a new Board to provide for sick and wounded seamen and the care of prisoners of war: a joint function which it exercised thereafter, and because 1806 was the year when the Board was abolished, its functions then being taken over by the Transport Board until 1817.1

I wished to test four hypotheses: that the Royal Navy regarded the health of seamen as of vital importance and through the Sick and Hurt Board, practised preventive medicine to preserve it; that the Sick and Hurt Board was an efficient and effective office in implementing policy over time and distance; that the Board took account of contemporary medical advances and that the health of seamen improved over time as a result; that local commanders-in-chief and sometimes captains modified central policies through economic necessity, strategic imperatives or specific problems, with variable success.

The subject has not been examined since 1957 when the four volume Medicine and the Navy 1200-1900, began to appear.2This was a ground-breaking study, but it is now 40 years old, much new material has become available and medical history, as a separate and highly important discipline, has developed, changing our perception of health and disease and the questions we ask of material related to them.

Material

Handwritten list of surgeons 1697.CLU/4 F53 (reverse)© National Maritime Museum, London.

The archival core of the study is the National Maritime Museum’s collection of the records of the Sick and Hurt Board. There are 80 folio volumes of letters between 1702 and 1806, from the Admiralty to the Sick and Hurt Board, (ADM/E), 52 of which relate to the health of seamen. The remainder deal with prisoners of war, but there is also much prisoner of war material in volumes concerned with seamen’s health. There are 37 volumes of letters, between 1742 and 1806, from the Sick and Hurt Board to the Admiralty, (ADM/F)3 and 49 boxes of loose papers, 1756-1806 (ADM/FP). The correspondence between the two departments; the suggestions and reports of the Sick and Hurt Board, the replies and directions of the Admiralty, can thus be read in parallel from 1727.

There are two provisos. First, the initial five volumes of letters from the Admiralty, covering the years 1702-1718, have no corresponding letters from the Sick and Hurt Board. This is partly because the Board was not a permanent feature of naval administration until the 1740s and some of its business can be found amongst the papers of the Navy Board. Second, there is a 30 year gap, between 1764 and 1794 in the Board’s letters to the Admiralty. This is a major loss. The crucial period after the Seven Years War, the years of the American war for independance and its aftermath, the decade before the war with revolutionary France are all missing and with them significant developments in the administrative system and possible advances in naval medicine. The loose papers only partly rectify this. There are no records for 1761 or 1764 and many letters are missing in the collections for individual years. In some instances the gist of the correspondence can be recovered from the Admiralty letters since when they replied to the subordinate Board, their Lordships frequently recapitulated the theme of that Board’s original letter. But the valuable enclosures, from the Board’s agents and correspondents which the Board forwarded to the Admiralty, and the petitions and suggestions which came to the Admiralty, and were passed for comment to the Sick and Hurt Commissioners, are forever lost.

Because food played a crucial part in health, I have also looked at some Victualling Board material. The Victualling Board badly needs its own study. Its papers are voluminous and I have only been able to look at abstracts of Admiralty orders to that Board (ADM/G) and some volumes of letters and boxes of loose papers from the Board to the Admiralty (ADM/D, ADM/DP). I also wanted to examine the personal letters and papers of commanders in chief, admirals and captains, to see what influence, if any, they had on determining health policy and their attitude towards seamen’s health. This has been more difficult, since although health is mentioned in some journals and letters, the references can be conventional or perfunctory. Captain (later Admiral) Charles Watson, writing from his ship, the Princess Louisa to Francis Gashry, about Admiral Hawke’s recent victory at Finisterre on 14 October 1747, refers to the considerable gunfire on both sides, and mentions, in passing, twelve of his ship’s company killed and 62 wounded, between 20 and 30 of whom had lost arms and legs and were not expected to live, but says nothing further about their state.4

Though time consuming and often disappointing this search has produced some interesting sidelights on the everyday health problems captains encountered. The letter book of Captain (later Admiral) the Honourable William Cornwallis, while in HMS Prince Edward in the West Indies 1764-66, records the onset of sickness amongst his crew, rapidly increasing when he was sent to the siege of Pensacola in June 1765. The men he drafted to digging ditches and pile-driving there all succumbed to a malignant fever and on their return to Jamaica fell victims to scurvy.5 The shortage of surgeons and surgeons’ mates for ships is recorded in the papers of several officers; William Abdy in 1763, commander of the Beaver sloop, Captain John Pulling in HMS Penguin on the Irish station between 1796 and 1797, and Jane Austen’s brother, Captain Francis Austen in HMS Neptune in 1802. All probably agreed with Pulling that it was 'a very unpleasant thing to go to sea without some medical person on board’.6

The folio volumes are not always easy to use. Those from the Sick and Hurt Board to the Admiralty sometimes have a list of contents, giving the date of the letter and an abbreviated idea, not always accurate, of its subject. They frequently contain numerous enclosures, from agents and surgeons or other officials, which give a good deal of detailed background information. The Admiralty volumes do not have lists of contents, perhaps the clerks were too busy to make them, especially in wartime. All the volumes are unindexed and unpaginated, most pages are un-numbered. Using them is time-consuming.

To cover the period and reach any conclusions I have had to select. I have chosen to look at representative peace and war years, for example 1707, 1740, 1750, 1760, 1774. Some years of peace are covered by one volume, thus ADM/E/7 deals with 1728-39. But war years were busier; 1757 is covered by six volumes, ADM/E/18,19,20,21,22,23. Inevitably such selection provides a partial picture and important developments I’m sure, have been missed. Chronologically, I have now reached the 1790s and hope to look at 1794, 1796, 1802 and 1806, with some Victualling Board material and as many private letters and papers as I have time for.7

Was the Sick and Hurt Board efficient and effective?

At first the Sick and Hurt Board only operated in wartime and was not primarily a medical body. Being responsible for surgeons and their mates supervising hospitals and sick quarters, its chief duties were administrative and financial. Subordinate to the Admiralty, each Commission was usually re-formed at the outbreak of war. In 1702 five commissioners were appointed, four at £300p.a., the chief or first commissioner at £500, plus a secretary, three clerks, a messenger and domestics in the central London office. This was first at Crutched Friars, in the City of London, then at Tower Hill and from the 1780s at Somerset House in the Strand. There were also agents of the Board, generally surgeons, at outports; Deal, Dover, Fareham, Gosport and Portsmouth, Plymouth, Rochester, Yarmouth, Guernsey, Jersey and Kinsale. Outside these named ports, surgeons who undertook the care of sick seamen were paid a uniform six shillings and eight pence per man per cure. This could amount to a considerable sum. Henry Heart, surgeon of HMS Kingston in 1706, asked the Board to repay the £50, he had laid out in medicines curing 117 of the crew set ashore at Yorktown, Virginia. The sum was equivalent to the annual wage of one of the office clerks and the Board refused on the grounds that Heart was surgeon of the ship and merely performing his duty in curing the crew.8

At the peace of Utrecht the Board was reduced to two commissioners, then to one, who was one of the Commissioners of the Navy Board, but once war with Spain began in 1739, a new Commission of three Commissioners was formed, a fourth being added in 1745 to cope with increasing work. An established secretarial post was created in 1746 and the number of clerks increased to fourteen.9 There was a similar increase in staff at the outstations, which now included an agent for prisoners of war, at Bristol, Berwick, Exeter, Falmouth, Glasgow, Hull, North Shields, Saltash, and Weymouth, in addition to those listed previously, and abroad at Gibraltar and Port Mahon. From now on the office was permanent and peace time reductions in commissioners and clerks were always made good at the beginning of a new war. In 1755, when the Seven Years War was imminent, the Board’s establishment was increased to four commissioners and as many extra clerks, at 2/6 per day (23p.), as were necessary. By that time there were naval hospitals at Haslar near Portsmouth, Plymouth, Jamaica, Antigua, Barbadoes, Halifax, Nova Scotia and Gibraltar; themselves a testimony to an expanding overseas empire. Most of these were not large establishments but all had a surgeon and a dispenser and Haslar, Plymouth and Gibraltar a physician as well.10 All provided increased job opportunities for doctors and surgeons and career and promotional opportunities in an expanding medical profession.

The Commissioners in these years were a varied and rather anonymous selection of administrators, of whom it would be interesting to know more. They were not medical men. Some had worked at the Victualling or Navy Boards before coming to the Sick and Hurt office. There were physicians at the Board during the war of the Spanish Succession, but thereafter, until the late 1760s, it was staffed by administrators. That made for admirable administrative experience; for medical advice the Board frequently consulted the College of Physicians, in particular Dr. Mead, one of the foremost physicans of the mid-eighteenth century.11 From the evidence of signed correspondence the commissioners seem to have attended regularly though not daily.12 They appear to have attended on average between eight and twelve days a month in peace, not much more frequently in wartime; an average of 14 days per month in 1744, a war year, when the office was busy. In May that year Commissioner Allix had leave to go to Bath for his health for five weeks.13 The commissioners always asked Admiralty permission to be absent from the office for more than a day or two and such requests for leave are not infrequent. They were usually for health reasons but in October 1748 Commissioner Cary asked for 12 days to visit his many friends in the neighbourhood of Portsmouth, where he had been on Board business; 'more particularly to visit Mr. Dodington who has been most affectionately pressing with me to get to him at Eastbury’.14 Such absences always left two to three commissioners as a quorum to conduct business in London, though a commissioner was regularly absent for several days every quarter, visiting the outports to pay for sick quarters, to inspect hospitals and hear complaints, and in November 1748 Commissioner Hills had leave to go to St. Malo as one of a commission for adjusting claims about prizes and prisoners of war.15

However, letters from the Admiralty were answered quickly and carefully minuted with the date received, usually the day after it was written, sometimes later in the evening of that day. The date the answer was sent, together with the dates of letters written and sent to others concerned with the matter, was also noted on the original. The Board cared about and preserved its records and there were frequent consultations about past practice when queries arose. In 1742 such a query, whether there was a precedent for the government supplying bedding to naval hospitals, resulted in a search going back to 1710, when government had done so at Mahon and to another example of 1729 at Jamaica.16 In November 1759, in a well-known incident during the battle of Quiberon Bay, Captain Keppel, commanding HMS Torbay, rescued the few survivors from the French Thesee, lost in the action. Keppel ordered his purser to issue clothes and bedding to the men who were almost naked and suffering from exposure. In March 1760 he begged that his action might not prevent the passing of his accounts and the Admiralty asked the Sick and Hurt Board whether previous allowances of this kind had been made and if so, out of which fund they had been paid. A search of the office books discovered there was no precedent, but there were instances in the previous war (1739-48) of relieving prisoners in absolute need, that it was therefore proper to pay Torbay’s purser and the Admiralty consequently issued an order to that effect.17

Was the Board effective in promoting the health of seamen?

This is more difficult to answer from a study of the correspondence. In 1743 there were 98 letters to the Admiralty, 56 of which concerned prisoners of war; in 1744 there were 208 Admiralty letters of which 167 were about prisoners, in fact well over half the letters of these years deal with matters other than health.18 Most of the remaining letters concern administration and finance. All financial matters, many of them disputed accounts presented by surgeons, or bills for extra treatment, however small the sum, were referred to the Admiralty. All appointments to any post were also referred to the superior Board. Their Lordships often appointed the Sick and Hurt Board’s recommended candidate, as agent, surgeon or dispenser, but they sometimes had a candidate of their own19. All seamen recommended to Greenwich Hospital had their names submitted to the Admiralty for approval, as did those who sought treatment at London hospitals, primarily St. Thomas’ and St. Bartholemew’s. This comprised a good deal of the Board’s business, in addition to complaints, received either directly by the Board or by the Admiralty who then referred them to the Board for report. Plans or schemes to improve health, sent by individuals to the Admiralty, or originating with suggestions of the Navy and Victualling Boards, were referred to the Sick and Hurt Commissioners for report, comment or estimates of likely cost. The Commissioners also directly received similar plans and cures for seamen’s diseases, which they sifted, referring the most promising to the Admiralty for their decision.

An analysis of the letters for March 1742 shows the staples of Board business; the subjects are Spanish prisoners of war; disputed accounts with surgeons for medicines used; the supply of bedding necessary for hospitals at Gibraltar and Port Mahon, with an estimate of the amount, cost and transport; complaints about the treatment of the sick at Plymouth hospital; the payment of travel expenses to marines discharged as incurable; the inconvenience of the Board’s agent at Leith choosing to live at Inverkeithing; whether the men discharged and paid, from HMS Ruby, and intended for another ship, but who were ill with fevers, could be sent to sick quarters.20 There is little or nothing here about the initiation or implementation of cures or health schemes. But this was not the function of a Sick and Hurt Board, constitutionally subordinate to the Admiralty and medically unqualified. It could not be. The modern belief that all disease is knowable and curable, did not apply to the eighteenth century, when most diseases from which seamen suffered were not curable since the causes were unknown.

But this does not mean that the Royal Navy, the Admiralty and the Sick and Hurt Board were not concerned about health. They were deeply concerned. Not only, perhaps not principally, on humanitarian grounds, but because of the practical problems of manning ships. Trained seamen, sick, or even worse dead, were literally a 'dead loss’ to the service and very difficult to replace. So real efforts were made to prevent that loss and the disease which caused it. In the 1740s there is a change in the attitude of administration to problems of health and control of disease. From 1740 onwards the Admiralty began to ask for accounts of numbers of sick seamen sent ashore, together with the reasons and the outcome. The Board responded. In October 1740 they reported a total of 5,740 men put ashore, world wide between March and June; 1,297 at Gosport, 1497 at Plymouth, 1,000 at Port Mahon.21

In March 1743 the Commissioners began the practice of sending the Admiralty quarterly accounts of numbers of deserters from English hospitals at the senior board’s request, for desertion was a serious, seemingly intractable problem.22 When asked why so many men (32 in a week) had deserted from Rochester hospital, in March 1743, the surgeon was baffled. The men needed for nothing, yet 'they are often gone when I have thought almost impossible for them to get out of their beds’. Significantly the Board thought many of the deserters belonged to HMS Cornwall, then at Portsmouth, who wanted to rejoin her rather than be put on any ship in the Medway or at the Nore. The surgeon thought the reason for such large numbers of deserters appearing in the lists he submitted to the Board, was because he didn’t enter men as 'run’ in the first lists he drew up, keeping their names on his books as present, in the hope that they would return, 'which several often do’, and only entering them finally as deserters when he made his third check. Other deserters were pressed men so the Board did not think it remarkable they should desert at the first opportunity 'against which our hospitals are not so contrived as to be any hindrance’.23 The figures for desertion from hospitals are significant and must have alarmed the Admiralty. Between January 1741 and December 1742, 1,000 men disappeared, between January 1742 and December 1743, 754; in 1744, 997 men deserted.24 In 1777, to try and prevent desertion from Haslar hospital a scheme was proposed of sentinels on the gates, night patrols, iron bars on the second as well as the first floor windows, since men let themselves down by the sheets from the upper floors, and the locking of wards at night with padlocks: previous locks having been filled with sand by the patients. In addition, they suggested fresh provisions be supplied to the ships at Portsmouth, which would prevent sickness and thus so many men going to hospital in the first instance.25

At first, for financial and administrative reasons, the Admiralty and the Sick and Hurt Commissioners preferred not to have their own hospitals, but to hire places suitable to accomodate sick seamen for the limited time they were ill. These places were run by a contractor who supplied everything: beds, staff and medicines for a fixed price, paid by the Board’s agent, who was often the surgeon too. In places where there were no hospitals or the numbers of sick filled the available beds in them, the agent hired sick quarters on the same basis.

The opportunities for fraud and abuse in this system were obvious and frequently taken. When there were complaints, usually from sea officers, about their men being badly treated or lodged in inns and alehouses where they were encouraged to drink, delaying their recovery, the Admiralty always investigated. In the case of local, specific complaints the Sick and Hurt Board were ordered to investigate. One of the Commissioners was sent to report and the Board’s opinion relayed to the Admiralty, who decided what action to take. This was often a dismissal of some staff and a temporary tightening of regulations. In May 1740 complaints about the contract hospital at Plymouth, visited by Captain Fytche of HMS Ruby, painted a picture of stinking wards, lousy sheets, an inattentive surgeon, inadequate food and daily deaths amongst his sick men housed there. Admiralty admonitions, via the Sick and Hurt Commissioners, to the surgeon and the contractor, and warnings that future justified complaints would be punished, saw no improvement. Further complaints in July led to a full scale investigation by Commissioner Hills and to the dismissal of the contractor as highly blameable in his ill treatment of seamen.26 In the case of complaints about the larger hospitals, usually prompted by letters from serving sea officers, the local commander-in-chief was ordered to inspect and report and the Admiralty then drew up regulations which it sent to the Sick and Hurt Commissioners for their comments and implementation. The Admiralty held the initiative and their regulations resulted from the opinions of seamen rather than the Board.

This is not to imply that medical needs were ignored. A glance at the new regulations, issued in 1740 as a result of complaints about the hospital at Portsmouth, reveal a preoccupation with the care of sick seamen, and an attempt to impose higher standards on medical as well as administrative grounds. The hospital was to be kept clean and not over crowded; bedding should be clean and well aired; clean sheets were to be provided for every man, warm, soft linen, a thoughtful personal touch, changed every three weeks or oftener if necessary. Each man was to have a bed to himself. The common practice of putting two men into a bed, with occasional reports of one sometimes being found to be dead, was to stop. Patients were to be separated according to illness, especially those with contagious fevers, and the newly sick from those recovering. Inns were never to be used as quarters if private houses were available, and no spirits were to be allowed in hospitals or quarters, 'a practice of pernicious consequence to the health of seamen’, but something very difficult to enforce. Surgeons were to visit patients at least once a day. The Sick and Hurt Board were urged to remedy the shortage of nurses and to deal with the many women so employed and said to be drinkers, 'nasty, negligent and unfit’ for employment. The Admiralty had no advice to give on how to implement this last regulation and these forerunners of Sarah Gamp remained a thorn in the side of the hospitals and the Board. Lastly, sick quarter bills were to be paid promptly, the Sick and Hurt Commissioners checking every three months, so that those who hired out sick quarters and who had withdrawn because of irregular payment would be encouraged once more to engage for them.27

But in the 1740s this system of quarters and contract hospitals was collapsing under the strain of prolonged war and from 1740 the Admiralty increasingly turned its thoughts to the Navy providing its own hospitals.28 In October 1740 they suggested turning the considerable ruins of Portchester Castle near Portsmouth, into a hospital for 1,000 men and asked the Sick and Hurt Commissioners to consider improving the method of caring for the sick and for the men’s health and comfort and whether such an experiment might not be tried there.29 In March 1741 the Admiralty was considering whether it was better to continue the contract system or build hospitals, at public expense, with a proper staff establishment to care for the sick and supply medicines. The Sick and Hurt Board were to consider this 'maturely and thoroughly’, estimating the cost of a hospital, at Portsmouth or elsewhere, housing 1,000 men in war and peace, what the cost of maintaining such numbers for a year might be, what the present cost was and the difference between them. Five days later the Admiralty secretary wrote again, urging a speedy reply. On 4 April suggestions for hospitals housing 750 men each at Plymouth and Queenborough and for one for 1,500 men at Portsmouth at government expense, were put forward.30 An order in council of 1744 confirmed these schemes. Plymouth’s hospital, to hold 1,200 men, was not finally begun until 1758, at Stonehouse, with the first patients admitted in 1760.31 New hospitals were built at Jamaica in the 1740s and at Antigua in 1761.32 Above all, the building of the Navy’s largest hospital, at Haslar near Portsmouth, begun in 1746, completed in 1761 and then the largest brick building in Europe, marked a major change in the Navy’s and the government’s thinking on health.33 If large hospital building programmes and major capital outlay are proof of concern with health care, then mid-eighteenth century British governments were deeply concerned with naval health, willing to invest in it and thereby gain greater control over the care of sick seamen.

Did the health of seamen improve over time?

The answer must be yes. Only contrast the havoc caused by disease in Admiral Hosier’s squadron in the West Indies in 1726, when out of more than 4,750 men, over 4,000 died, including Hosier himself, his successor, seven captains and 51 lieutenants, with the return of Admiral Lord St. Vincent’s Channel fleet from blockading Brest in 1801, when only 16 hospital cases were reported.34 Whether this improvement was the result of contemporary medical advances is more difficult to say since the causes of most diseases and effective treatments for them were largely unknown. In May 1744 the Admiralty wished to discover the reason for 'so extraordinay a sickness’ at Gosport and on the Blenheim hospital ship, what the diseases were, their causes and the hopes of recovery. But the Sick and Hurt Commissioners could hardly answer these questions and their reply illustrates their difficulties and their acceptance of sickness as a fact of life. There were, they declared, no greater numbers of sick at Gosport than usual, until Admiral Hardy’s squadron had arrived there. If anything 'extraordinary or epidemic’ had been discovered in that squadron the Board would have reported it, but since there was not, the usual weekly surgeons’ accounts were deemed sufficient to inform them of the state of affairs there. They agreed that certain named ships were sickly but what caused this only those on board knew nor did the Commissioners pretend to. Moreover sickness was already declining and of 1,337 men sick ashore only 391 were very ill, the rest being either not dangerously ill or recovering.35 This reply was not obstructive. In the Board’s opinion nothing unusual had happened and what could be done was being done.

The Board and its surgeons did try to mitigate illness. It is interesting to see them groping towards the cause of the intermittent fever at Jamaica hospital in 1746. This had been built, away from Port Royal and its drinking dens, in an airy situation, which it was hoped would promote the cure of seamen sent there. Unfortunately it was near a marsh. Dr. Mead, when consulted about the cause of the fever, thought the marsh to blame and the cure to drain it. But this was technically difficult, financially crippling and fraught with legal complications. The surrounding land was owned by a number of men who had duck shooting rights there and who would not hear of the marsh being drained. In giving his opinion, Mead observed that places near marshes in England were subject to similar agues and fevers and one of the Commissioners, commented that in the Hundred of Hoo and the Isle of Grain, between the rivers Thames and Medway, 'the inhabitants had agues for most of their lives, some for eleven to twenty years’. The surgeon at Jamaica reported everyone was affected by this fever, which was not caused by noxious exhalations, then commonly believed to be the cause of sickness. He thought it might be the result of the sudden temperature changes, between day and night. It was, he believed, something in the air, though it was not infectious, nor fatal if the sufferer was removed fairly quickly. But it produced weakness which allowed other diseases to take hold. The surgeon had noticed that elixir of vitriol and bark gave relief. He reported 586 men were in hospital, 165 were dead, the remainder were invalids. The surgeon’s mate, George Murray, gave similar evidence, and a detailed, accurate and interesting account of the progress of the malaria, which is what the fever was. Murray had been at Jamaica from November 1743 to December 1744 when he resigned and came home for his health, and in that period approximately 700 men were sent to hospital and all took this fever after approximately three weeks.36 Ultimately it was decided to close the hospital and move it back to Port Royal; the Board could do nothing about a cure for malaria.

I have no evidence as yet that commanders-in-chief changed or seriously modified the Board’s health regulations. But they, and other sea officers, made practical suggestions throughout the period, based on their observations or experience which did improve health, though few suggestions were strictly medical. Thus in 1775 Admiral Molyneux Shuldham suggested to the Sick and Hurt Board that sending supplies of potatoes, carrots, parsnips and onions to ships in North America would preserve the health of their crews.37 The suggestion was referred to the Victualling Board, who quoted earlier precedents of sending fresh vegetables to blockading squadrons off Brest in 1759-60, and were principally concerned with logistics. Similarly, Admiral Lord Howe advocated the use of dried kale in seamen’s diet in 1782. Impressed by trials made while he commanded the Channel fleet, he suggested to the Sick and Hurt Board that suitable quantities be supplied to ships and the Admiralty agreed.38

Admirals Anson, Boscawen and Vernon in mid-century, Howe and St. Vincent later, were deeply interested in preserving seamen’s health. As serving officers they had seen what disease could do to fleets and when they became commanders-in-chief or served at the Admiralty Board, they were often able to push their views on hygiene, diet and clothing. Lord Sandwich too, as First Lord of the Admiralty between 1771 and 1782, was interested in these problems and in improvements to preserve health. He passed letters he received about possible cures to the Sick and Hurt Board for their consideration or with a recommendation that trials be carried out.39

Captains also offered suggestions from their experience. In 1774, after two voyages to the West African coast, Captain Thomas Collingwood of HMS Rainbow, reported his surgeon, Robertson’s discovery of the efficacy of a mixture of wine and bark against fevers, when given to his boat crews before they went ashore. The Admiralty were impressed by his evidence and the Sick and Hurt Commissioners ordered trials of a similar mixture for the Pallas and Weazle, then bound for the Guinea coast. So successful were these trials that ships going to West Africa thereafter were regularly issued with extra wine and bark to protect them from fever. Eight years later Captain James Burney, who had served with Captain Cook on his second and third voyages and was bound for the East Indies, asked the Board for extra supplies of bark, since the fevers of the east were similar to those of Africa and the mixture would be equally useful on the East India station.40 In the 1770s captains regularly reported the good effect of lemon juice on the health of crews. In 1782, while at Gibraltar, Captain Roger Curtis’ enthusiasm for the juice as the best cure for scurvy was endorsed not only by his surgeon but also by the surgeon of the hospital41 though it was not issued regularly until 1795.

Practical suggestions to alleviate conditions, not always directly concerned with health were also made. In 1740 Mr Mathews, Naval Commissioner at Chatham, suggested building a decked vessel to carry the sick in shelter on their passage from the Nore to Chatham. At that time they were taken in an open boat, exposed for a tide or more to spray and rain. In 1744 regulating captains suggested to the Admiralty that a supply of trusses on board ships to alleviate rupture, a common ailment, would benefit seamen and their Lordships ordered the Sick and Hurt Commissioners to supply each ship with a number of steel trusses, five per 100 men, directing that when they were wearing them men were not to be obliged to hand or reef, in case the pressure drove the intestines into the scrotum.42 This was probably impossible to enforce, but in such relatively small ways, health was improved.

The Sick and Hurt Board also made a number of trials, usually at Admiralty prompting, to test the claims of cures or improved treatments regularly sent to them by surgeons, chemists, quacks or concerned individuals. So far I have counted 17 such claims between 1740 and 1782. There are probably more and I hope to explore them in a forthcoming paper. I include some here, to illustrate the nature of the suggestions with which the Board dealt. Elixir of vitriol was proposed in 1742 as a cure for scurvy and the Board agreed that if the elixir was prepared according to Dr. Mead’s prescription it should be issued to all ships. But in 1743 they summarily dismissed the Admiralty suggestion of the use of burnt wine to cure fluxes as 'an old woman’s remedy’. If introduced into Plymouth hospital, as the Admiralty wished, the nurses would drink more than the patients. Their alternative was the cure used by surgeons and physicians at sea, burnt hartshorn and cinammon water, or rice gruel and cinammon.43 In 1752 the Admiralty, impressed with Dr. James’ powders against flux and fevers, ordered trials, and the Sick and Hurt Board suggested tests be carried out in naval hospitals. The Society of Arts sent the Admiralty a possible cure for scurvy, carrot marmalade, with recipe, from Baron Stosch, one of their corresponding members at Berlin, 1771. The Admiralty promptly passed this to the Victualling Board with an order for trials to be made on Captain Cook’s ships, Resolution and Adventure.44

Some experiments were immediately dramatic. In 1782 Mr. Barnes, a surgeon, illustrated his method of preserving water from putrefaction in front of the Sick and Hurt Commissioners, using a bottle of bilge water, 'the stench, almost intolerable’, instantly vanishing on the addition of his salts. But Mr. Neeler’s medicinal belts were a failure. These were rolls of canvas filled with some dried herbal mixture, which Neeler claimed would cure scurvy and the itch and deter vermin. In 1747 the Navy Board, to whom they were offered, thought trials should begin with 1,000 belts which cost 2/6 (23 pence) each. Captain Robert Harland, having heard of them a few months earlier, asked to have some, 'being glad to use every expedient to preserve the health of my people’. But the reports of surgeons of the ships on which the belts were tried were negative. They were slow to cure the itch and useless for anything else. Men wearing them got caught up in the rigging, and they caused colds when they were taken off.45 A machine to stop bleeding from wounds in action, pioneered by Mr. Rymer, a naval surgeon, concerned at the lack of tourniquets, was put forward by him in 1782, and elastic trusses, invented by Mr. Brand, surgeon at Greenwich Hospital, and supported by his colleagues there; Admiral Rodney and John Hunter, the famous surgeon - though opposed by the College of Surgeons - were more practical and beneficial suggestions.46

Conclusion

Through trial and error and only slowly, naval health improved during this period. The Sick and Hurt Board practised limited forms of preventive medicine. Practical measures of cleanliness, improved diet and better hospital care gradually made headway against much sickness. Most of the things which affected health; diet, ventilation, cleanliness, over-crowding, damp and lack of clothing, were often the business of other branches of naval administration, and improvements in these areas were not within the power of the Sick and Hurt Commissioners. But the whole naval establishment was concerned to improve the health of seamen. Suggested cures and treatments for a variety of diseases and conditions were submitted to the Board from seamen and civilians, in increasing numbers from the 1770s. Efficient in its everyday business, the Board carried out trials of many of these suggestions, though how rigorous these were is difficult to judge without further research. There seem to have been no trials of surgical techniques and the Board did not initiate medical experiments. The causes of most of the diseases afflicting seamen remained unknown, though practical obervations had produced effective cures for scurvy and some fevers.

Closer examination of the records of the Sick and Hurt Board should modify the still incomplete picture of naval health in this period and the Board’s contribution to it. If the pace of experiment did quicken in the 1770s, why did it? Was there a greater interest among administrators, like Lord Sandwich, or was it the result of Captain Cook’s successes? A list of the remedies offered to the Board and the trials performed, would provide evidence of the range of interest in experiment and the genuine discoveries made. A list of naval surgeons and their appointments, drawn from Board records would be useful; not least in contributing to the debate on the emergence of the professions in eighteenth century Britain. If the answers to these and other queries are not yet much clearer, the questions to be asked of the material certainly are: much remains to be discovered.

Acknowledgments

I should like to thank the Trustees of the National Maritime Museum for awarding me a Senior Caird Research Fellowship for 1998-99; the deputy director Dr. Roger Knight and the head of research, Dr. Margarette Lincoln for help and support throughout the year; Dr. Nigel Rigby who has been constantly encouraging and helpful; the support staff and the library staff for making my research both easy and pleasant; above all the archivists Clive Powell and Alan Giddings, for directing me to material I would not have thought of and allowing me to profit by their extensive knowledge of the Museum’s unique archival collections. Without such help I could not have covered the ground I have and I am most grateful. I must particularly thank Clive Powell for letting me study the list of, as yet, uncatalogued material. During the course of my research, I have been impressed, more deeply than ever, with the wealth of primary documentary material at the Museum and I am grateful to have had access to it.

Text © P.K. Crimmin, 1999