Some people do not need actually to be in the water to experience the flexible boundary between life and death. For them it is enough to be on the sea in a boat. They are the victims of seasickness and frequently claim, while in the throes of this ailment, that they would far rather be dead. In this they are in august company. Cicero, having fled to sea to escape Mark Antony’s sentence of beheading, was so seasick he gave up and returned to Gaeta, preferring execution to the unconsummated death sentence passed on him by the ocean. Given how long human beings have been seafarers, it must be one of the oldest forms of illness to be described, consistent in its symptoms from culture to culture as across the centuries. No doubt its cause was occasionally attributed to malevolent sea spirits or witchery, but even in Antiquity people were quite capable of being rational about it. Plutarch was curious as to why it occurred only on the sea and not on rivers. He blamed the smell of the sea and the apprehensiveness of the sufferer, perceiving the psychological component which seems to play a large part in the condition. Apparently he never made the connection between seasickness and motion.
There are several seventeenth-and eighteenth-century treatises on seasickness with titles like Dissertatio de Morbo Navigantium, for it must always have been recognised as a problem for navies as well as for ordinary travellers, and therefore worth serious medical attention. One suspects it only attracted more general and popular concern during the nineteenth century, when there were enough passengers taking part in the mass emigrations to the New World. By the time tourism proper started, especially with excursions from England to the continent in the latter half of the century, seasickness was the subject of dozens of booklets and articles. Most were more interested in remedies than in causes, the majority admitting that these were not well understood. Among the theories might be any of those suggested by doctors of the day:
(i) an ‘afflux of blood’ to the spinal cord;
(ii) disorientation caused by the rolling or heaving;
(iii) ‘depression of the circulation’;
(iv) ‘displacement of the abdominal viscera’;
(v) the influence of ‘changing impressions made upon the vision’; (obviously a fallacy, one writer remarked, since the blind are just as seasick);
(vi) the influence of a ‘marine miasma’ or ‘miasmatical intoxication’;
(vii) ‘sanguine congestion in the brain, provoked and entertained by the deranged centre of gravity’;
(viii) ‘centrifugal force within the blood vessels’ produced by the oscillation of the ship.
As for treatment, this generally amounted to heavy sedation. Thomas Dutton, a popular medical author writing in 1891, presumably thought travellers also needed the placebo effect of a bizarre regimen. His ‘cure’ began a fortnight before sailing and consisted of a light diet, a digestive pill at night, a glass of salt water twice a week before breakfast and a four-mile walk daily. Three days before travelling his patients began taking a medicine of ammonium bromide and chloroform. Once aboard ship they were to reduce the bromide as far as possible, avoid ship’s food and subsist on strong beef essence, dry biscuits and whisky or brandy and soda. In addition, Dutton recommended any or all of the following: chloral hydrate (favoured ingredient of the Mickey Finn or ‘knockout drops’), dilute prussic acid, iodine, amyl nitrite, cocaine in quarter-grain doses, creosote, cerium oxalate, soda bicarbonate, caffeine, eucalyptus and Nepenthe (a proprietary solution of opium in alcohol, dosage as per laudanum). The amyl nitrite was taken orally, diluted in alcohol. Any sufferer on this regime would be doing well if he was even aware of being on board a ship. Many travellers must have spent entire voyages in deep narcosis. In the meantime, starting a ‘cure’ two weeks before any possible onset of the ailment might be presumed to have the effect of almost guaranteeing seasickness. The sufferer had thoroughly prepared himself to be ill, whether from the sea or the prussic acid. The glasses of salt water are odd. They were no doubt emetic, but they might also have had a homoeopathic function, as if small doses of salt might make one immune to the briny. That might also go for the iodine, which was derived from seaweed.
Several Victorian experiments were made in which cabins, restaurants and entire passenger areas of a ship were mounted on gimbals so as to remain steady, but these were not a success. The engineering problems were considerable, the boundaries between the ‘stable’ and the ‘moving’ parts obviously being zones of great danger. Such things reflected the consensus that at the root of seasickness was the ship’s motion. This was not quite as banally obvious as might seem. It had not occurred to Plutarch, after all, and until the mid-nineteenth century conditions on board most ships could induce sickness even if the vessel were tied up in port. The food was foul, the sanitation facilities fouler, and contagious disease easily transmitted in the cramped and generally overcrowded conditions. In the circumstances, any number of acute symptoms might mask or exacerbate those of ordinary seasickness. M. Nelken, in his advanced and sensible book Sea-Sickness (New York, 1856), added an appendix in which he gave details of the safety regulations made necessary by the flood of emigrants leaving Europe for America. The new regulations were an attempt to ‘apply a remedy to the gross abuses which have caused such vast numbers of persons to be swept into the grave, during the few short weeks of transit across the ocean’. In 1848 Congress finally passed an Act which for the first time regulated the amount of space allotted to each passenger as well as their total number. Even before Nelken published his book these new laws had effected a dramatic change and ‘already showed a great drop in the number of deaths aboard to an average of less than 1 per vessel’.
Nelken, like Dutton nearly forty years later, ascribed seasickness to motion, but unlike Dutton did not relate it to other forms of travel and perceived it as a special case of motion sickness. ‘The same symptoms,’ wrote Dutton, ‘are often felt by some people, particularly children, when journeying by train or a vehicle, so we may have train-sickness, carriage-sickness etc.’ This only needs updating with the addition of car sickness and airsickness. Airsickness used to be a much greater problem than it is now because earlier aircraft, like earlier ships, were smaller and lighter. They had only a limited ability to avoid or fly above bumpy weather. Nowadays, airsickness bags are sordid but touching relics of a bygone age. As such, they are similar to those few remaining drinking troughs for horses in towns and cities. Once in a blue moon one might be used, filling onlookers with curiosity and pleasure.
The latest medical thinking about seasickness, according to a naval surgeon in Plymouth, is agreed. It is caused by ‘a discordant clash of information between the organs of balance and the eyes’. This diagnosis is charming, being wholly nineteenth century in its phraseology and vagueness. (It even begs the question of the blind.) Evidently the advances of the past 100 years are all in the field of medication, though many people would vastly prefer cocaine to Kwells. One is left to wonder why, among other things, a clash of information in the head should provoke sickness in the stomach. Each of our two inner ears contains three semicircular canals which are set at right angles to each other in three planes. The canals are filled with liquid whose movement stimulates receptors in the ampullae at the ends of the canals. The swirling of minute particles of chalk suspended in this fluid generally enables the brain to maintain our balance in relation to a stable exterior world. When that world becomes unstable, medical theory suggests, the brain-as-computer (always a doubtful model for that organ) goes into overload, confused by too many variables and a surfeit of conflicting messages from the inner ears, the eyes, the soles of the feet, etc. Why some people should be more sensitive to this than others is unclear. It is not the same as wondering why some people are allergic to shellfish, because seasickness is not obviously a matter of pure physiology. Psychology clearly plays a significant role and so does habituation. Even poor sailors can in time acquire a degree of immunity or at least control if they have to. To most sufferers, however, the ailment remains like an advance symptom of death. It would surely be hard for such a person to view the sea at all impartially or shorn of its mortal associations.*
Ever since he failed to find the reef he thought he saw and the boat he was sure he had glimpsed, the lost swimmer has become conscious of the gulf he hangs over. At least the empty but navigable plain which surrounds him horizontally spreads itself beneath the sun’s broad eye. Finding his way home again, back to life, will be a matter of simple luck or simple physics. A puff of wind here, an eddy there, and he will be reunited with his boat. If for a moment he were able to raise himself only 50 feet above the water he would spot it at once and the entire traumatic incident would be at an end.
Beneath him, though, lies a dimension which absolutely refuses to reduce itself to a matter of simple physics. The seabed is several hundred metres away – perhaps 1,000 if he is further from land than he thought. Up to a mile of water, in short. The swimmer tries to remember what a mile looks like. The entire length of Oxford Street, Centre Point to Marble Arch, but stood on end. As he contemplates this, something unseen like a gush of sepia roars soundlessly up at him from below, without warning, blotting out the sunlit layer which swathes him. This chill black torrent is overwhelming in its despair. It is as though a microscopic ghost had arisen from every test and skeleton of the uncounted radiolaria and plankton bedded on the bottom and had suddenly joined in a great upward fume. Far, far below, the basalt itself is calling in a language of aeons, and its empty message echoes up and spreads around him in a freezing, inky pool. This tectonic voice paralyses him. It mocks all human hope. It is worse than his first panic, worse even than the threat of death.
* ‘Sensory conflict’ theories of motion sickness are still the most favoured, although no neurophysiological evidence has yet been found to explain how or why the stimulation of brain regions dealing with spatial orientation should affect those that mediate nausea. A good deal of effort is now being expended on research into space motion sickness or SMS, which is merely the twenty-first century’s version of the nineteenth century’s preoccupation with seasickness. And the approach to alleviating the symptoms is scarcely different. Like Thomas Dutton before them, today’s NASA doctors are reduced to trying a series of pharmaceutical blackjacks.