Medicine and Health
DISEASE
THROUGHOUT THE HISTORY of warfare, disease has killed more combatants than enemy action, and this was certainly true of seventeenth-century naval warfare. Placing up to several hundred men together in cramped, low, damp conditions was a sure recipe for sickness, or for the fate which befell Francis Forrest, seaman on the Royal Oak in 1679, who ‘as ‘tis said [was] eaten to death with lice’ .1 The Mordaunt, serving on the West African coast in 1685, lost sixty-five of her men – over a third of her crew – to scurvy and other diseases within twenty days.2 Her exceptional death toll was undoubtedly exacerbated by the unhealthy nature of the station where she was serving, but there were still frequent outbreaks of epidemic disease, particularly typhus, in the fleets deployed closer to home. By September 1689 599 men had died aboard the fleet at Torbay, and another 2,588 were sick.3 The strategy of the third Anglo-Dutch war took a particularly heavy toll; James Pearse, the surgeon-general, considered that the endemic sickness aboard British ships during the 1672 campaign could be attributed to the fleet lying off Holland for so long, with the gunports having to be kept closed during the long periods of bad weather. However, he also blamed the large number of aristocratic volunteers who had flocked to the fleet, claiming that they were unused to the diet and to the ways in which seamen kept themselves clean at sea – presumably a delicate way of suggesting that landsmen with diarrhoea were relieving themselves between decks.4 Others made the same distinction between professional seamen, who were often fastidiously clean, and pressed men ignorant of the ways of the sea. In 1664 Commissioner Pett bemoaned the arrival at Chatham of large numbers of‘filthy and destitute’ pressed men,‘who are fit for nothing but to fill the ships full of vermin’ and smallpox.5
Sir John Narbrough, who witnessed and survived epidemics of scurvy in the Pacific and the North Sea, but died of fever in the Caribbean in 1688. It was impossible to preserve his body for a voyage to England, so only some of his internal organs were brought home, and his other remains were buried at sea.
(PRIVATE COLLECTION)
Scurvy was widespread, but it was less of a scourge than it became in later years, primarily because so few ships ventured abroad for long periods. Most ships served only in the summer and chiefly in home waters, where it was usually easy to obtain fresh supplies. The most common overseas deployment was to the Mediterranean, and for most of the period most of the major ports there were friendly or neutral, making it equally straightforward to keep the crews healthy with fresh provisions; in 1655, for example, the purser John Weale was able to stock up with green ginger, sugar, lemons, muskmelons and watermelons.6 Even so, scurvy could quickly take hold. In the Pacific in August 1670, John Narbrough’s ship had eleven cases of scurvy, one of whom had died (and a few weeks later, it was found that rats had got into the bread room and eaten fourteen weeks supply). On the following 15 May, Narbrough noted in his journal that ‘my men begin to droop and incline to have the scurvy: seven of my company are sick, but a timely call at the Azores to buy fresh fruit and vegetables relieved the problem.7 Narbrough was captain of the fleet flagship in August 1672, when scurvy began to ravage the fleet; as his friend James Pearse observed, the weather in the summer of 1672 was dreadful, and as well as having to keep the hulls closed up, it was often impossible for the victualling boats to bring out fresh supplies. Over 1,000 sick men had to be sent ashore, most of them suffering from scurvy. Relief finally arrived on 31 August in the form of 3,950 cabbages, twenty-one and a half bushels of carrots and 189 bunches of turnips, which were distributed in the proportion of one cabbage for every four men and a bushel of carrots for every ten.8
The Plague of 1665 might have had an even more devastating effect on the fleet, which was based in the Thames and manned largely from London, but a combination of prompt action and good luck averted a potential catastrophe. Sick men were landed immediately, men who seemed to have recovered were not allowed to return to their ships, and any vessels which developed suspected cases of the plague were quarantined. Naval custom undoubtedly helped: the regular cleaning of the ships, and the fact that they rarely came alongside wharves where infected rats could get aboard, considerably reduced the risk of plague spreading to the fleet. However, even the dockyards remained largely free of infection, thanks to a rigorous policy of isolating any suspected cases.9 The Navy Board moved to Greenwich, though Pepys, famously, stayed in London through the worst of it all.
WOUNDS AND INJURIES
Some men survived the most appalling wounds. In 1667 John Heylen was said to be suffering from ‘back broke and belly burst .10 Hugh Ryder, a naval surgeon who went on to be surgeon-in-ordinary to the king, kept alive a man who had suffered a deep cutlass wound to the brain, though subsequently he had ‘but little right use of his senses’ .11 Inevitably, the effects of old wounds, and perhaps also of inadequate treatment, stayed with men for life. Samuel Giles, a woolcomber of Lympstone in Devon, was pressed into the navy in 1666, but in his first battle splinters knocked out almost all his teeth and tore and dislocated the joints and toes of his left foot, leaving him unable to work at his trade when the war ended.12 Samuel Hawks, captain of the Arms of Holland in the first Anglo-Dutch war, had his arm amputated after ‘by a great shot [he] had his breast bone, shoulder and arm broken’. He survived to take the ship to the Caribbean, but the wound kept discharging, more bone had to be extracted, and he gradually became weaker, though he still managed to remain in command of the ship for some months.13 The nature of much of the work aboard a ship was bound to lead to the prevalence of certain kinds of injury. Hauling on heavy ropes and tackle inevitably generated many cases of hernia, while Thomas Finch of the Antelope ‘lost his eye sight by extending his strength in bearing off one of the anchors that belonged to the said ship’ .14 Venus often contributed as much as Mars to the downfall of naval men. In 1661, the crew of the Montagu used a period of leave at Lisbon to head en masse to ‘Mount Whoredom’, the hilly street that contained the seamen’s brothels, and thirty-seven men (well over a tenth of the ship ’s company) were infected with VD.15
THE SURGEON AND HIS ENVIRONMENT
Prospective naval surgeons were examined at Barber-Surgeons Hall, which provided them with their medical chests (at a price), and were then appointed by Navy Board warrants. Once the first appointment to a ship had been made, the Barber-Surgeons lost control over a man’s subsequent promotions, which proceeded in much the same way as those of other warrant officers.16 Naval surgeons suffered from low professional status, derided by both their colleagues ashore and their fellow officers at sea; the ability of captains to appoint anyone, no matter how unqualified, to the surgeon’s post if no qualified man was available did little to enhance the status of the office.17 In 1665 the Barber-Surgeons’ Company also had to give way on the principle of nominating only its own members to posts at sea, leading to an influx of unqualified provincials (or so the metrocentric Barber-Surgeons claimed).18 Nevertheless, some naval surgeons became leading members of their profession. Pepys’s friend James Pearse, surgeon of the Naseby in 1658–60, subsequently became surgeon-general of the navy (in name from 1664, officially from 1675), as well as surgeon to the Duke of York and the king’s household. James Yonge of Plymouth, who served in the navy early in his career and also made several voyages in merchant ships, also had a successful career. Yonge eventually became an eminent practitioner who made major advances in amputation and served as mayor of Plymouth.19 He and another sometime naval surgeon, John Moyle, wrote several treatises in the 1680s and 1690s that were specifically directed at naval surgeons.20
Others had rather less successful careers. The surgeon of the Baltimore in 1666 was said to be ‘a pitiful fellow of a barber, who knows nothing’.21 Some naval surgeons were clearly themselves in need of medical care; Richard Woodall, a Bedfordshire man who served as surgeon of five ships in the 1670s and 1680s, had damaged eyes which made him unfit for further service, and was described as old and feeble (despite being only fifty-seven).22 Others found their naval service almost unbearable. Robert Moore, surgeon of the Bonetta Sloop, spent four years in her but received no pay, which he said had thrown him into ‘a deluge of misery and a labyrinth of sorrow’.23 Edward Barlow damned the sea surgeons of his time, claiming that their idea of diagnosis and treatment was a perfunctory check of the pulse and a couple of questions about ‘when he was at stool, and how he feels himself, and how he has slept’, followed by a quick administration of some medicine on the point of a knife,‘which doeth him as much good as a blow upon the pate with a stick’.24 Given the resources available to them, and the undoubtedly variable nature of their own training, seventeenth-century naval surgeons often achieved remarkable results, healing terrible wounds, compound fractures and other serious injuries, as well as contending with the full range of diseases to be found ashore (and, on foreign voyages, some rather more exotic ones as well).
Medicine bottles and a pill box, salvaged from the ‘Great Storm’ shipwrecks on the Goodwin Sands and now preserved at Ramsgate Maritime Museum.
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Despite this, naval surgeons were not well paid. From 1653, when pay rates were increased, they received £210s a month, regardless of the size of the ship. A surgeon might have one or more mates; Yonge was one of three on board the Montagu in 1661. By 1686 only First and Second rates were permitted to have two mates; other ships had one, but all were paid at £1 10s a month.25 Additionally, surgeons received allowances for their instruments and medicines; some of these have been recovered from wrecks of the period, and include syringes, ointment jars and balance weights.26 The allowances came in three forms: a gift ranging from £10 on a First Rate to £5 on a Fourth and £3 on a Sixth, an imprest on a similar sliding scale (effectively an advance of pay at the beginning of a voyage) and a levy of two pence a month from the wages of every man on board.27 These amounts were wholly inadequate to meet the costs involved, which had risen substantially since the rates were first set in 1626. In 1668 it was estimated that during the most recent war, the medicine chest of First and Second rates cost about £50, that of a Third cost £40, and even that of a Sixth cost about £15.28 The surgeons of the ordinary at Chatham, Deptford and Woolwich earned just over £30 a year, those at Portsmouth at Sheerness £28 13s 10d, though again these sums were boosted by the twopences from men on ships in the yards.29
There was no dedicated sick bay per se. Under the 1673 cabin establishment, the surgeon had a cabin at the gunroom bulkhead, and his mate had one in the cockpit; the latter could be used as a sick bay in normal conditions, as it was reasonably spacious, unimpeded by guns, and thus would interfere less with the work of the ship. However, a larger space was needed in time of action. Yonge recorded that aboard the Montagu in 1661, the beds for the sick were placed on a platform in the hold, and men had to descend through a scuttle onto a heap of cloth positioned to give them a soft landing. Yonge also provided a vivid picture of the activity in this impromptu sick bay after a sharp action, and of his role as a very junior surgeon’s mate:
Men wounded were the lieutenant, wounded deeply on the buttocks with a splinter; a reformado gent named Wm Gregory had the upper part of his foot torn with a splinter; one Patrick, an Isle of Wight man, had both buttocks much lacerated by a shot; a boy had the calf of his knee torn by a splinter, and a Scotsman had the pan of the knee torn by a bullet, with Mr Robinson dressing up without amputation till the next day cost the poor man his life. All the rest recovered; some few were scalded, bruised, and had slight hurts not worth minding. Here began my slavery, for boiling gruel, barley water fermentations, washing rollers, and making lint, spreading plasters and fitting the dresses, was wholly on my hands, besides often emptying the buckets which they went to stool in, a nasty and mean employment ….30
During the Four Days’ Battle of 1666, Edward Barlow was struck in the leg by a cannonball that came through the side of his ship, the Monck. Luckily for him, the force of the ball was almost spent, but his leg swelled up and ‘was forced to go down amongst the wounded men, where one lay without a leg and another without an arm, one wounded to death and another groaning with pain and dying, and one wounded in one manner and another in another …’.31
BILLETS AND HOSPITALS
Hospital ships were provided on a limited scale during the Anglo-Dutch wars, while provision for maimed seamen ashore was delegated to the Commission for Sick, Wounded and Prisoners.* Many men were billeted in private houses in coastal towns, and in several wartime years (notably 1653) the sudden influx of huge numbers of sick and wounded men simply overwhelmed East Anglian communities and the provincial surgeons who attended them.32 The crisis brought forth the remarkable (and distinctly rotund) Elizabeth Alkin, commonly known as ‘Parliament Joan’, sometime Parliamentarian spy, who nursed seamen at Portsmouth until about the spring of 1653, when she seems to have moved to Harwich. She paid her own expenses for the men’s care and for that of Dutch prisoners of war, and had received only partial recompense from the state before her efforts broke her health and brought about her death in about 1655.33 A decade later, Barlow’s leg wound brought him a spell in quarters at Rochester, where he stayed for three weeks (although, like the other sick men, he had to visit the doctor when he needed his dressings changed, rather than the doctor coming to visit him).34
Regardless of the provision in the provinces, and the efforts of ‘Parliament Joan’ and her fellows, the most serious cases needed hospital treatment, and inevitably the great London hospitals bore the brunt. Since 1646 they had received two shillings a week for each serviceman that they treated.35 St Bart’s took a large number of seamen, but the main burden fell on St Thomas’s, the closest to the river and the nearest to the sea. In 1664 all of its beds were reserved for the seamen who would be wounded during the imminent war, and many of the beds both there and at Bart’s were again reserved for the same purpose during the third war.36 In the three days after the battle of Solebay on 28 May 1672, St Thomas’s received exactly one hundred men from the fleet, fifteen of whom died almost immediately; it received fifty-one in the aftermath of the battle of the Texel just over a year later. Many of those who lived subsequently discharged themselves.37 Other institutions were also made to take naval casualties, notably Ely House and the Savoy Hospital, and the increasing use of such hospitals led to a gradual decline in reliance on private housing in the provinces.38 The idea of a dedicated naval hospital was mooted from time to time, but the Anglo-Dutch wars were too short, and funds too lacking, to make it a reality (although a small establishment was set up at Plymouth during the third war, with Yonge in charge). In 1666 John Evelyn presented a detailed proposal for a naval hospital at Chatham, but nothing came of it. The scheme was revived in 1686, when it was proposed to add a wing to the existing buildings at Greenwich, but this project had to wait several more years before Queen Mary II ordered the establishment of the royal hospital there.39
The Royal Hospital at Kilmainham, Dublin. The first dedicated military hospital in the British Isles, it was established in 1682, pre-dating Chelsea Hospital by two years. It would be another decade before seamen had anything remotely comparable.
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BURIAL
Men were buried at sea if their ships were too far from land to permit burial ashore. The method was already long established; in 1661 the trumpeter of the Adventure was ‘sewed up in canvas, with a culverin shot at his head and another at his feet’ and sent over the side at daybreak.40 In 1678 the body of Captain Anthony Langston of the Royal Oak was carried out into Alicante Road in his own barge, accompanied by eight other boats. As his body was committed to the deep, his ship fired a 40-gun salute, and the Dutch ships in the harbour fired at least a hundred. After the committal, the whole company returned to the ship for a wake with ‘an excellent collation and plenty of wine’.41 Burials ashore were equally impressive. The boatswain of Teonge’s ship was given a coffin covered in a Union flag, on which his whistle and crossed pistols were placed, and the ceremony was attended by an honour guard of sailors with muskets.42 When Captains Martin and Saunders were buried at Aldeburgh after the St James’s Day fight of 1666, they were attended by the bailiffs and trained bands, who fired three volleys of musket shot and six cannon in their honour.43 Pepys bemoaned the fact that British sea-captains were not given grand monuments at public expense as the Dutch were (such as Tromp’s at Delft, van Ghent’s at Utrecht and de Ruyter’s at Amsterdam), and recorded that the funerals of several prominent commanders were distinctly modest affairs; Sir John Lawson was buried ‘without any company at all’.44 But others had far grander interments. Sir Thomas Teddeman’s service took place at Lorimers’ Hall in Moorgate before the body was taken downriver by barge for burial at Rotherhithe, while Sir William Berkeley, Sir Frescheville Holles, Sir Edward Spragge and the Earls of Marlborough and Sandwich were all buried in Westminster Abbey amid much pomp.45 So, too, were the generals-at-sea Richard Deane and Robert Blake, both of whom were given grand state funerals, only to be unceremoniously exhumed and thrown into a common grave-pit after the Restoration.
The elaborate memorial in the Domkerk at Utrecht to the Dutch admiral Willem Van Ghent, killed at the battle of Solebay in 1672.
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