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 Medicine and Naval Surgeons 
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Post Medicine and Naval Surgeons
I just finished reading Zachary Friedenberg's Medicine Under Sail. While it was a good, readable, general overview of diseases and medical treatments, I wish it had been fleshed out just a little more. It's probably just me, but, I also had a problem with the way the information was organized. There were also some minor errors in terms of naval terminology.

Has anyone else read it? Any thoughts?

I have Harold Langley's A History of Medicine in the Early U.S. Navy, which is excellent in terms of detail and organization. I also have Naval Surgeon (thanks to Dan for the recommendation!) which is a selection of journal entries and watercolor paintings by Dr. Edward H. Cree, who was a surgeon with the Royal Navy. It's a really fascinating book.

Can anyone suggest other books about medicine/naval surgeons?

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Mon Aug 08, 2005 7:31 pm
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Post Scurvy
"Scurvy: How a Surgeon, a Mariner, and a Gentleman Solved the Greatest Medical Mystery of the Age of Sail" by Stephen R. Brown

This is in-depth since it deals with only one subject. I read it last year and two things that stood out for me were:

The East India Company, who were forced to make long trade voyages, discovered that diet, especially the consumption of citrus fruits successfully combated scurvy and made that discovery many years before the Royal Navy. This information was not shared with the Royal Navy or maybe not shared successfully would be a better concept. Then, over time, mysteriously, the East India Company stopped enforcing these dietary rules allowing scurvy to re-establish itself on their ships.

The second thing was that the Admiralty insisted on testing the consumption of sea water as a cure. Well, I guess someone figured it was plentiful and free. Imagine long lines of seaman awaiting their doses of sea water.

Don


Last edited by timoneer on Mon Aug 08, 2005 10:19 pm, edited 1 time in total.



Mon Aug 08, 2005 9:38 pm
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Post Re: Scurvy
timoneer wrote:
Then, over time, mysteriously, the East India Company stopped enforcing these dietary rules allowing scurvy to re-establish itself on their ships.

Was it related to cost? To feed the men properly, a bit more effort and money were required.

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Mon Aug 08, 2005 9:41 pm
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Post Scurvy
Susan, here are some quotes from the book (pages 74-75):

In the early years of the seventeenth century, the East India Company and the Dutch East India Company were able to keep scurvy at bay on many of their trading expeditions. But as the century progressed, scurvy reappeared as a mysterious and significant killer of crews. Somehow, lemon juice, or "lemon water," faded as the known and trusted remedy, Sea captains, still aware of the need for fresh produce, organized their voyages as a series of desperate dashes between foreign ports, instead of carrying bottles of "lemon water" with them.

Unpredictable delays, ill winds, or bungled navigation resulted in terrible suffering and the loss of countless lives. The directors of the English and Dutch companies became complacent after years of effective prevention, and as the incidence of scurvy declined a new generation of corporate directors and sea captains began to question the value of expensive lemon juice - they might have thought they were paying handsome sums to greedy lemon merchants who revived the "myth" of scurvy to drive up the cost of a cure that was little other than a hoax.

The sailors themselves complained about having to drink the bitter juice, as it was foreign to their northern palates, and the inconsistent quality and quantity issued to the sailors made it unreliable. By the 1630s, merely three decades after Lancaster successfully prevented an outbreak of scurvy on his pioneer voyage to the East Indies by issuing a small daily ration of lemon juice to each sailor, the East India Company was avidly pursuing tamarinds and oil of vitriol as the best antiscorbutic remedies.


Obviously, cost was one factor but the author goes on to point out that "preventive medicine" was an alien concept during this period of history.

The concept of preventative medicine also appears to have fallen out of favour. The thought of spending money to treat a disease that had not yet appeared in the crew was as foreign to seventeenth-century merchants as it later was to the national navies of England and France. Although lemon juice was sometimes carried aboard ships, it was usually kept in small quantities under the direct control of the surgeon and was to be used as a "cure" when scurvy appeared.

But the problem of reserving lemon juice was that the quantities issued to the sick sailors were invariably too small. By the time symptoms of scurvy appeared, much greater amounts of ascorbic acid were needed to halt the inevitable decline and death. For a sailor who exhibited the classic symptoms, a spoonful of lemon juice would have had little beneficial effect, perhaps leading surgeons and captains to discredit it further.


I was very impressed with Stephen R. Brown's research and would recommend his book for anyone's library.

Don


Mon Aug 08, 2005 10:13 pm
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I just finished reading this book a couple of weeks ago, and I, too, recommend it. It certainly offers a lot of insight into medical thinking of the time and just how disposible the crew was considered. It was an awful way to die. Naval history from a different point of view.

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Wed Aug 10, 2005 5:00 am
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I just picked up a book called Limeys by David Harvie. It looks quite interesting. Has anyone read it?

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Thu Dec 15, 2005 5:03 am
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If you are still looking for additional texts, you might take a look at Naval Surgeon by J. Worth Estes. It is a discussion and analysis of the journal of Peter St. Medard, a French emigre to America. Medard was surgeon about the US frigate New York during the Barbary Wars in the Mediterranean. His journal is from a 16 month cruise in 1802. Estes is a professor of pharmacology in Boston and has written at length about the history of medicine in America.
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Thu Dec 15, 2005 5:52 pm
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Post Treatment for Scurvy
From Thomas Pasley’s "Private Sea Journals"

The following excerpt might be the strangest AoS account that I have ever read.

To set the stage, Captain Pasley in HMS "Jupiter" has been suffering from one to three deaths per day for weeks due to scurvy. One of the deaths was his surgeon.

Thursday, January 3rd (1782)….To day my Garden (which it has been my Practice to raise daily Salad in) I have given up, and Buried as many Men in it as possible, greatly to their Satisfaction. They are happy and seem to have faith in it. So have I, not for an absolute cure on board, but as putting an undoubted check to the Scurvey's progress -- God Grant it! It will be Monday ere we can reach this Island of Fernando (de) Noronha.

Friday, January 4th. Yesterday the Garden did wonders; the Men who were carried and lifted in and out of it, incapable of moving a Limb, walked of themselves to day -- wonderful effect. I have dismantled my third Tray of Earth likewise. An hour is the time, and from Six in the morning till Six at night I can receive 36 Men -- it may save lives. How fortunate my having a Garden! Little did I think of its answering so valuable a purpose -- it affords comfort to my heart, the first and best of Salads.

Amazing! How would you like to stretch out in a large tray of soil as a treatment for scurvy?

Don


Sat Apr 29, 2006 5:08 pm
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Post Re: Treatment for Scurvy
timoneer wrote:
From Thomas Pasley’s "Private Sea Journals"

To set the stage, Captain Pasley in HMS "Jupiter" has been suffering from one to three deaths per day for weeks due to scurvy. One of the deaths was his surgeon.

How would you like to stretch out in a large tray of soil as a treatment for scurvy?

I wanted to post a follow-up to the "garden" incident above. Obviously, the soil treatment was not a real treatment for scurvy. Any improvement was obviously some sort of psychological response. The mind is a powerful force. If the crew "thought" they were getting an effective treatment, then some of them might have exhibited some signs of improvement. In addition, three days later they reached the island which would have been another positive psychological event.

Here are some additional journal excerpts:

January 3 and 4: as noted above, "garden" treatment
January 5: Three or four men in very serious condition. None died.
January 6: One of the quartermasters died.
January 7: Reached destination, anchored, unable to land sick due to surf. No deaths.
January 8: Surf higher still, sick despondent as they cannot reach shore, none died, caught a 312 pound turtle
January 9: turtle soup for all, no deaths noted, Governor sent one bullock, two sheep, and some greens to ship, still unable to land sick
January 10: Served out fresh food from Governor. Pasley went ashore to settle price of fresh meat, surf still very dangerous
January 11: attempted to land 15 sick crewmen in a catamaran, it upset but all 15 made it ashore safely, moved ship to another bay and landed 78 safety
January 12: landed the rest of the sick, total ashore 146, crisis over

Don


Sun Apr 30, 2006 12:48 am
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Has anyone read Rough Medicine: Surgeons at Sea in the Age of Sail?


Sat Sep 22, 2007 10:18 pm
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Post Re: Treatment for Scurvy
timoneer wrote:
timoneer wrote:
From Thomas Pasley’s "Private Sea Journals"

To set the stage, Captain Pasley in HMS "Jupiter" has been suffering from one to three deaths per day for weeks due to scurvy. One of the deaths was his surgeon.

How would you like to stretch out in a large tray of soil as a treatment for scurvy?

I wanted to post a follow-up to the "garden" incident above. Obviously, the soil treatment was not a real treatment for scurvy. Any improvement was obviously some sort of psychological response. The mind is a powerful force.
[snip]
Don


My wife, Janet West, has often told me of mentions of this "treatment" in her readings about the history of whaling. She has just shown me a specific reference to this belief:

"The best anti-scorbutic was pure lime-juice; but fresh provisions were also essential, especially potatoes and onions. When land was within reach, an earth poultice was sometimes applied by depositing the patient in a shallow grave, with only his head and shoulders exposed, for several successive days."

Quoted from "The American Whaleman: a study of life and labor in the whaling industry". By Elmo Paul Hohman. Longmans Green & Co, 1928. See pp 138-9.

In support of the above statement, Hohman cites the following (which I have not yet checked):

Wilkes, C. "Narrative of the U.S. Exploring Expedition", V. Chap. 12;
Bennett, F.D. "Narrative of a whaling voyage round the world", p. 193;
Jarman, R. "Journal of a voyage to the South Seas", p. 229;
Nordhoff, C. "Life on the Ocean", p. 214.

It is interesting that there was such a widespread belief in the efficacy of burial in sand or soil as a treatment for scurvy. I think that the references cited above are but a few of many such assertions. With our current knowledge of ascorbic acid (Vitamin C) it is difficult to give this old idea much credit - one possibility is that the men were being fed fresh fruit & veg while they were buried on the shoreline. There seem to be a few instances of men stating that they got relief if they were buried in soil or sand carried aboard, before the ship reached land.

Martin


Mon Aug 29, 2011 2:48 pm
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Post Re: Medicine and Naval Surgeons
Also interesting to note that Limes were the preferred fruit. I understand that lemons have three times the ascorbic acid content, but perhaps limes were easier to get hold of?

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Tue Aug 30, 2011 6:18 am
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Post Re: Medicine and Naval Surgeons
I too understand that lemons are much richer in ascorbic acid than limes are. It seems that limes were more readily available, especially in the W. Indies and Mexico area, and that limes were much cheaper than lemons.

It is interesting that Hohman was quoting the "earth burial" treatment as late as 1928. Although the chemical structure of Vitamin C was not defined until the early 1930s, it was clearly known by the 1920s that the treatment for, and prevention of, scurvy was some antiscorbutic factor present in citrus fruit and other vegetables.

Martin


Tue Aug 30, 2011 1:40 pm
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Post Re: Medicine and Naval Surgeons
Martin Evans wrote:
I too understand that lemons are much richer in ascorbic acid than limes are. It seems that limes were more readily available, especially in the W. Indies and Mexico area, and that limes were much cheaper than lemons.



Martin



Perhaps the cheapness outweighed everything else.

It is odd that the beneficial effects of lemons/ lemon juice had been known to experienced sailors for hundreds of years (vide Sir Richard Hawkins' advice in 1593 - and it must have been known earlier) and yet never been fully accepted. The knowledge surfaced periodically and was then lost sight of.


Wed Aug 31, 2011 7:41 am
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Post Re: Medicine and Naval Surgeons
I think we need to be a little more precise on the subject of scurvy, lemons and iimes. From earliest times, mariners had invented all sorts of bizarre cures for scurvy, some of which (like burying in the earth) seemed to work for reasons that no-one could or can undestand. That cirus juice cured the disease was known by users of the sea early.
Unfortunately, no-one knew why it worked, so the evidence was dismissed by the medical establishment as being anecdotal and unscientific. The idea of vitamin deficiency was unknown and unknowble at the time, and physicians (including the much vaunted Lind) had therefore developed a theory of their own to account for the diseaase. Thus, they believed that scurvy was a disease of internal putrifaction caused by bad food and water in a damp atmosphere where it was difficult to sweat. The 'cures' which they insisted on imposing on the public and navy therefore comprised methods of gingering up the inert digestive system by taking what amounted to fizzy drinks - elixir of vitriol (ie weak sulphuric acid) at the beginning of the 18th century and then fermented malt and wort, which dominated medical thinking from 1760 (and was endorsed by Captain Cook!). It was only in the 1790s, when the admiralty and the admirals rejected the medical establishment's theories and ineffectual solutions in favour of the navy's own practical experience of citrus, that lemon juice was issued regularly on warships and the problem was cured. (Incidentally, the documentary evidence for this version of events was only established in 2007, so books on the subject written before that date have got it wrong!)
Limes came into use when continental supplies of lemons became difficult to obtain during the second half of the Napoleonic Wars. Alternatives were sought elewhere and the lime was discovered in the West Indies. The fruit looked the same as a lemon and the idea of using limes which could be found on British colonial soil and in the Americas became a more attractive one than relying on the 'foreign' lemon. Today they call this type of thinking 'food security'! Thus limes began to dominate. No-one knew at the time of course that their anti-scorbutic properties were much inferior.

Brian


Wed Aug 31, 2011 11:49 am
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