- Author
- Pearce, Robert L., AM RFD OM(Fr) CStJ FRCS FRACS Colonel RAAMC (Rtd), Associate Professor
- Subjects
- History - general
- Tags
-
- RAN Ships
- None noted.
- Publication
- September 2009 edition of the Naval Historical Review (all rights reserved)
From the middle of the eighteenth century, when James Lind performed his famous experiment on board Salisbury to show that citrus fruit had this antiscorbutic property, it was realised that it was not only possible to prevent scurvy but that a diet which included fresh fruit and vegetables rich in vitamin C could also cure the disease.
This was not a new idea – as early as 1593 when Sir Richard Hawkins, surgeon general to the British East India Company wrote his ‘Notes for Seamen’, the use of an adequate diet including fresh fruit, especially lemons, was recommended.
The experiments of James Lind followed closely on the devastating or rather tragic outcome of Commodore George Anson’s infamous voyage of circumnavigation in the years 1740-1744. His expedition was planned as an important military manoeuvre, designed to strike at the heart of Spanish trade and commerce in the south Pacific. Only two hundred men survived from an original crew of 2000, ninety percent of them dying during the expedition from scurvy. Of six ships in his fleet that left England only one, the flagship Centurion, returned home.
Regular use of antiscorbutics
The most successful extended sea voyages of the eighteenth century, and the most convincing evidence for the regular use of antiscorbutics, were those led by Captain James Cook during the 1770s. His success led to the award of the prestigious Copley medal by the Royal Society of London in 1776.
It is generally accepted that there was a degree of reticence amongst the French to accept any new British ideas, and consequently their expeditions of exploration, and there were a number of them during the reign of Napoleon, mostly in the direction of Australia, frequently suffered from diseases affecting the ability of the crew to maintain sail, and in the case of scurvy easily preventable.
Historically, the condition of vitamin C deficiency continued to affect large populations even into the nineteenth century, most notably among the poorest Irish communities who depended upon their potato crops and suffered from scurvy during the great famine from 1846-1847. The biochemical basis for the deficiency diseases and some understanding of their pathology however did not occur until the vitamins were identified, well into the twentieth century. (Ascorbic acid was first isolated in 1932).
Unfortunately the British Admiralty was not quick to give official sanction to the addition of lemon juice or other antiscorbutics to the sailors’ diet, so that Sir Gilbert Blane, senior Medical Officer with the Royal Navy, was frustrated in his attempts to improve matters when a memorandum to the Admiralty in 1781 was ignored. However, the matter was pursued by Dr Thomas Trotter who in 1795 persuaded them to issue lemon juice to all ships. The results within a couple of years were dramatic. Lemon juice was primarily responsible for doubling the time a ship could stay at sea, and this in turn facilitated the successful blockade system of French ports during the Revolutionary and Napoleonic wars. The Royal Navy maintained a blockade of the French ports through most of the period 1793 to 1815, thereby preventing a French invasion of England.
Significant improvement
Sir Gilbert Blane was later the author of a study On the Comparative Health of the British Navy, from the Year 1779 to the Year 1814, in which he demonstrated the results of health promotion among seamen during that period from statistics obtained on admissions to naval hospitals. Significant improvements in health status within the navy were grouped with the development of copper sheathing and the discovery of longitude as being responsible for improved efficiency of the service.
Scurvy was an obvious problem, but another major illness among men crowded together with poor hygiene and sanitation was typhus, sometimes called ship fever or gaol fever or camp fever. It was caused by the organism Rickettsia prowazekii, which is louse borne and distributed by this vector in conditions of close habitation and poor hygiene.
Soap and clean clothes
Again, when James Lind was head of the Haslar Hospital, he recognised typhus as being far more prevalent than scurvy. James Lind, Gilbert Blane and Thomas Trotter were regarded as the three great sanitarians of that era, and after the death of Lind the other two advocated the use of soap and clean clothes in an effort to improve hygiene. Having regard to the clandestine methods of recruitment for the navy at the time it is reasonable to suggest that these methods were responsible for the prevalence of typhus among the crews. The ‘Quota Act’ which was passed in 1795, required each county and borough to supply a certain number of men for naval service, and they were often from the gaols and workhouses. The health of those obtained by the pressgangs from taverns and brothels was equally deplorable. While these methods continued, and they were necessary during wartime, there was a constant channel of typhus into the navy.