The Colonial Land and Emigration Commission (aka the Board) stipulated that all ships carrying over 50 of their assisted passengers must be accompanied by a surgeon. Laden with around 800 people, the Ticonderoga seems to have been significantly under-catered for, although this was not thought so at the time. The surgeons were well remunerated for their services, with the experienced Dr Sanger being paid £200 and his assistant, James Veitch, on his first voyage, receiving £80 pounds, though this would increase quickly with experience.
To a modern observer, the contents of the Ticonderoga’s medical kit appear somewhat curious. Listed under ‘medical comforts’, the inventory has survived courtesy of the Public Record Office in London. What, today, are we to make of ‘Box—125 packages, patent groats’, or the ‘100 gallons, vinegar’ it was felt necessary to bring along? The list is long and includes apparently large quantities of what was otherwise banned completely on the Ticonderoga: alcohol. For strictly medicinal use, no less than three dozen cases of Hollands gin were included, as were six dozen cases of sherry and double that of port wine. There were large supplies of brandy and porter (stout) as well as 80 gallons of oil, although the type is not specified. Other supplies included ‘62 jars, 5 gallons each, lime juice’, ‘160 lbs arrow-root’, boiled beef, boiled mutton, eight barrels of raw sugar and so on.1
In the sailing ship era, ship’s doctors, or ‘surgeon superintendents’ as they were also known, were regarded as being just as proficient, if not more so, than their counterparts on land, despite their popularity with the passengers varying from individual to individual. Occupying a unique position on board ship, they were expected to fulfil a wide variety of roles, some of which had little to do with the practice of medicine itself. As historian Robin Haines points out in her extensive study of medicine in the Age of Sail, surgeons were the chief contact between the passengers and those in charge of their destiny on the voyage—the captain and crew—performing the role of ‘agent of the state at sea’.2 They soothed quarrels, passed on passenger grievances to the captain, instigated and oversaw washing and cleaning routines, and were explicitly responsible for the general health of every passenger under their care.
However, most doctors with any experience of working at sea in emigration vessels were under no illusions about just how difficult the journey facing the men, women and families under their care would be. Dr Robert Scot Skirving, surgeon superintendent on the emigrant vessel Ellora, who would go on to become a prominent medical practitioner in Sydney, observed that:
It was horrid, even indecent for decent married people to be herded like beasts, with almost no privacy to dress or undress, and where, in the close and stuffy double beds they slept in, only a thin board separated each couple … The ventilation was very poor, and in the tropics, with a temperature of 90 degrees, the air was mephitic.3
Or, as author and historian Don Charlwood put it,
Surgeon-superintendents were just as responsible as ships’ masters for bringing emigrants safely to the new land … they needed as much skill in human relations as they did in medicine … most voyages would have been intolerable without their arbitration, and losses of life would have been very much higher without their devotion.4
It had not always been so. In the early days of convict transport, the rate of deaths on board convict vessels was high, but after the infamous 1814 arrival of the transports Surry, General Hewitt and Three Bees, in which together nearly a hundred convicts, crew and even some of the guards had died of ‘a malignant fever of a very infectious nature’,5 it was agreed that something needed to be done. Assistant Colonial Surgeon William Redfern, who himself had arrived as a convict sentenced for mutiny (though he soon earned a full pardon from Governor Macquarie, who desperately needed his skills), was asked to submit a report on the voyage. His ground-breaking recommendations made a major contribution to colonial public health. Competent and qualified surgeons, said Redfern, should be sourced and installed on all future convict transports, and be given powers to insist that ships be kept clean, fumigated and ventilated—even to the point of overruling incompetent or drunken ships’ masters. Being a navy man himself, Redfern suggested such surgeons be selected from the ranks of the Royal Navy. In a short time, convict mortality at sea plummeted from 11.3 to 2.4 per thousand per month.
Besides preventative measures and administering treatments for everyday conditions such as indigestion, constipation, sore throats and diarrhoea, a surgeon’s practical skills were paramount. They would set broken limbs and bandage sprained ankles, sew up wounds and perform minor surgery for hernias and other ‘internal obstructions’.6 They would also become obstetricians for the many babies they would inevitably be called upon to deliver, treat and even bury at sea on a long sea voyage such as the Ticonderoga’s.
As well as a daily visit to as many parts of the ship as they could manage—much like a current-day hospital doctor making the rounds—they held clinics that were enthusiastically attended by the many passengers for whom medical attention had been a previously unaffordable luxury. Once a day, too, they would report to and confer with the captain, keeping each other abreast of all that was happening on board—particularly the mood and state of the passengers—always presenting a united front of authority. Of particular importance was their task of keeping the vessel clean.
At a time in which little could be done to cure everyday diseases, the surgeon’s primary focus was prevention. Routines of health and cleanliness, it was believed, could remove the conditions where such ailments could thrive, particularly with regard to those most vulnerable on a sea voyage: children. Although the feeding of infants and newborns was the responsibility of their mothers—sometimes with tragic consequences should they be unable to do so—it was up to the surgeons to ensure that older children received adequate rations, that their berths were adequately lit and ventilated, that they could exercise, and that their clothes and bodies were washed regularly. This, of course, often came up against the physical limitations of the ship itself, but in any case involved instigating unfamiliar hygiene routines for both children and parents, and directing the sanitation of the vessel itself.
Dr Joseph Charles Sanger was one of the most respected doctors at sea of his time, and a favourite of the Board, which had several times commissioned him to accompany migrants on the long journey to Australia: ‘Dr Sanger has already given great satisfaction in four previous voyages in our service’,7 they stated in correspondence regarding his appointment to the Ticonderoga. With fifteen years at sea already under his belt, the most dramatic moment of Dr Sanger’s career thus far had occurred just the previous summer, in July 1851, when his ship, the 919-ton emigrant vessel Marion, struck a reef on the southern tip of South Australia’s Yorke Peninsula, barely hours from its destination of Adelaide following a gruelling 128 days at sea. Keeping the 350 terrified passengers on board as calm as he could, Sanger stayed on the deck as the ship’s longboats ferried the passengers back and forth to the shore a few miles away. Miraculously, not a soul was lost, and Sanger was commended for his cool-headedness. He would eventually complete twenty voyages in total, almost all for the Board, and was still sailing in 1866.
At twenty years his junior, his assistant, James William Henry Veitch, would be undertaking his first ever sea appointment with the Board—or, for that matter, anyone else. He was a young man whose star was on the rise. A descendant of two generations of naval doctors and a graduate of the London School of Apothecaries, he had already come to the attention of physicians of influence by demonstrating both high standards and calmness during a recent cholera outbreak in Portsea, near the naval base of Portsmouth. About to turn 27, with a coveted contract with the Board, he had good reason to anticipate a long career in the footsteps of not only Sanger, but his own father and grandfather—both respected and well-connected naval surgeons. However, it was not to be.
James Veitch’s voyage to Melbourne—like that of the Ticonderoga herself—would be his first as well as his last. There is no evidence to suggest that Veitch had any intention to settle in Australia when he departed Birkenhead in August 1852, yet within weeks of his arrival he had forfeited his passage money home, travelled far from the sea to inland Victoria, and for the remainder of his long life did not set foot on board a ship again. What his father made of his son’s decision can only be guessed at. James Veitch, however, no doubt had his reasons.
James William’s father, also named James, was born in 1783 in Selkirk, Scotland, and had retired by the time his son left for Australia on his first appointment with the Board, a position he unquestionably helped his son to secure. As a young assistant, he had served at sea with distinction in the Napoleonic Wars, taking part in various engagements such as the Battle of Cape Ortegal, the final chapter of the Trafalgar Campaign of 1805, then as surgeon on several ships, and finally running naval hospitals in the British territories of the Caribbean, such as at English Harbour in Antigua.
At sea, Veitch worked in the horror of the ships’ surgeries, small rooms painted red from floor to ceiling to hide the blood. And of blood there was a great deal indeed. In naval battles, cannon balls tore off heads and limbs, or sprayed shards of wooden splinters that cut through human flesh as if it were butter. Anaesthetic was a rope clenched between the teeth and, if the screaming patient was lucky, a swig of rum. The primary instrument of surgery was the hacksaw. At the height of a battle, buckets of blood and amputated limbs were emptied over the side, to be returned and filled again. More often than not, what was left of the mangled seaman was buried at sea a short time later, or after the infection had set in.
James Veitch descended from a long line of lowland Scots of Norman extraction, ‘Veitch’ supposedly being a corruption of ‘La Vache’, French for cow, derived from one William La Vache, a minor noble of the thirteenth century whose family proceeded to own cattle for the next few centuries. There is even a Veitch crest featuring a trio of long-horned Highland bulls above the Latin Famam Extendimus Factis, ‘we spread our fame through our deeds’. There is—or rather was—a castle at Dawyck on the Scottish borders which was demolished in 1830 and replaced by a somewhat gaudy house of the early Victorian style.
As his career went on, James observed enough of the horrors of primitive amputations and the horrendous associated loss of life to begin to experiment with replacing the coarse threads traditionally used to stitch wounds and arteries with fine gut sutures. As a result, he achieved both a higher survival rate and lower incidences of infection.8 His findings were put into a book somewhat gruesomely titled, Observations on the Ligature of the Arteries, Secondary Haemorrhage, and Amputation at the Hipjoint, which was published in 1824 and changed naval surgery forever. He became surgeon to the Royal Naval Hospital at Plymouth, was admitted as a member of the Royal Medical Society of Edinburgh, then as Licentiate of the Royal College of Physicians in 1822, and eventually rose to ‘deputy inspector of hospitals and fleets’ before retiring to a fine house in Ovington Square, Brompton, in the heart of London’s very fashionable West End. His travels with the Royal Navy saw him publish extensively on a wide variety of medical subjects, such as his 1818 ‘Letter on the Non-contagious Nature of the Yellow Fever’, based on his observances of that disease in the West Indies, as well as some more nuanced papers like ‘Remarks on the Necessity of Attention to the Surface of the Body in the Treatment and Prevention of Several Complaints; With a Recommendation of the more General Employment of the Vapour-Bath’, in which he espouses such notions as ‘Temperature, acting on the surface of the body like opium, and wine acting on the stomach, is capable of imparting vigour to the human frame’.9
James married one Jane Booker, and their first child, James William Henry, is listed as having been born in September 1825 in the parish of Stoke Damerel, just beside the great naval depot of Portsmouth, where James would have been stationed. The young man seems to have followed his father into medicine early, being apprenticed to a surgeon from the ages of sixteen to 21, and in 1849 the census records him as having his own practice in either Commercial Road or Commercial Way, Peckham, a suburb in London’s south-west.
While in London, James William was admitted into the prestigious Worshipful Society of Apothecaries, an institution devoted to the compounding and dispensing of medicines and a precursor to present-day pharmacy. With a lineage reaching back to the early seventeenth century, it still operates from a magnificent baroque hall built immediately after the Great Fire of London in 1666. Fully qualified as an apothecary, and with his father’s influence, James William then gained a position near his parents in Portsmouth as one of the physicians at the large Portsea Island Union workhouse, a substantial institution whose large infrastructure had been thoroughly rebuilt and upgraded by 1846. Several hundred impoverished inmates were housed in its large and intimidating rows of red-brick dormitories, with one section being designated as a workhouse asylum. An 1844 report paints a typically unsympathetic nineteenth-century assessment of its unfortunate inmates:
26 Lunatics; 15 Females and 11 Males. 7 were Epileptics and 2 Idiots. Many of the Patients, although not strictly speaking, imbecile persons, were individuals of weak intellect. Some of them, however, were decidedly Insane, and occasionally violent and unmanageable unless restrained, and some of them were labouring under delusions.10
It is unknown in exactly what section of the Portsea Island Union the young Dr Veitch worked, but it was here that he would face his first test as a physician in an outbreak of one of the most brutal and least understood diseases of the time. In July 1849, a series of inmates began to exhibit certain symptoms that sent a deep chill through the doctors of the Portsea Island Union workhouse. One after another, both men and women began to experience nausea, then vomiting, quickly followed by terrible diarrhoea and drastic fluid loss. Every sign pointed to the dreaded cholera morbus, the unstoppable disease that fifteen years previously had swept Britain in a pandemic lasting two years and killing more than 50,000 people.
First noted among the troops in Bengal in the early nineteenth century, cholera spread across India, Asia and Europe before arriving in the north of England by boat. It spread quickly across the British Isles—believed, like many other ailments, to be spread by airborne miasma, due to its terrible associated stench. It was not until the discovery of germs in 1864 that its true nature as a water-borne disease was understood.
By the time of the next outbreak in 1849, some improvements in sanitation had occurred, even though another 50,000 would again perish across England and Wales, exacerbated by the arrival of already weak and under-nourished Irish fleeing the effects of the recent potato famine.
Portsmouth at the time was lamented as having some of the most dire poverty and poorest sanitation conditions in the country, due in part to it being a walled and fortified island town with a compressed network of dank and narrow streets compounding any illness that took hold. Set a little way back from the fine high street along which the wealthy wives of senior naval officers would regularly promenade, Portsmouth’s poorer houses were badly built, allowing damp to permeate into badly clothed human bodies through broken windows and dilapidated cellars. Rates of poverty and malnutrition were high, with mortality rates—particularly for children under five—being well above the national average. Out in the harbour, rotting convict hulks housed their own cargo of human misery.
In just two months, the epidemic tore through the Portsmouth area, taking 676 victims. The confined spaces of the Portsea Island Union were not immune, but the resident doctors did their utmost to limit the impact on their inmates. In the crisis, James Veitch proved himself a resourceful and capable physician, his tireless efforts in reinforcing cleanliness and seeing—to the best of his abilities—to the comfort of his patients at great personal risk coming to the notice of the medical authorities. Letters praising the young Veitch were written, the most effusive being that of the district medical officer, countersigned by six other prominent members of the medical establishment of the day:
We the Committee of Public Health in the Portsea Island Union, do hereby certify, that Mr James William Henry Veitch, Surgeon, was engaged by us as an additional medical assistant in consequence of the prevalence of Cholera in the union in the months of July, August and September last, and that during the whole period of his engagement he shewed very considerable skill and was most attentive in the performance of his duties; and we accord to him our best thanks. Dated the first day of October, 1849, JT Pratt, Chairman11
The commendation, as well as his prestigious name, brought Veitch to the attention of the Board. In particular, his proven ability in the face of an epidemic led them to conclude that he was the perfect candidate to assist one of their most respected surgeons, Joseph Sanger. In the middle of 1852, an offer was made to the young Veitch and, to the delight of the Board, it was accepted immediately. Should this first appointment go well, he was told, there would be many more such appointments, as competent and reliable physicians were highly sought after. For this initial journey, the fee would be limited to not more than £80, but—the Board was at pains to point out—this could escalate quickly.
Veitch was told he would be travelling on board the Ticonderoga, a fast American double-decker clipper, one of four such vessels hired by the Board to sail to Port Phillip this year, each carrying close to 800 passengers to cope with the acute demand for travel to the Australian colonies due to the discovery of gold.
The regulations regarding the amount of children, it was explained, had recently been relaxed, so there would be a large number of youngsters on board and the risk of disease would be high. The ship, however, had been meticulously fitted out with many new innovations to ensure the highest standards of cleanliness and hygiene, and her master, Captain Boyle, was as capable and as conscientious a master mariner as could be found anywhere. Only when pressed, James Veitch said that he indeed felt himself qualified for the role, and the men of the Colonial Land and Emigration Commission wholeheartedly agreed.
Eight hundred people did, however, seem rather a lot for one ship.