A Health to the Company: A Brief Overview of 18th Century Shipboard Medicine

Enemy Fire Wasn't A Sailor's Greatest Threat to Health

Demonstrations of 18th century medicine are fairly common at reenactments and historical sites. It’s both interesting and frightening for people as they imagine themselves in the place of an injured or sick person 300 years ago. I enjoy this particular bit of living history because, although primitive to us today, they really were practicing the height of technology of their time—and some of it obviously worked, because here we are today--at least some of our more hearty ancestors survived it, though it might have “cost them an arm and a leg.”

My shipboard medical and surgical kit, ready for action.

Oh, and a nosegay, so it smells nice.

Early 18th  century shipboard medicine and the treatment of injuries and disease sounds just as perilous to us, if not more so, than the general medicine of the times. Doctors and surgeons were mostly self-taught, with the idea of standardized medical schools still almost a century away. The distinction between medicine, surgery, and pharmacy didn’t exist in the early 1700’s, and professional societies didn’t begin regulating medical practice by examining and licensing practitioners in Colonial America until 1760. If you were not competent or if you committed malpractice, there was no board of medicine to revoke your license, because there was no oversight or governing body to test your knowledge or proficiency. 

Ivory-handled surgical chest,
Antiques Scientifica

The University Of Pennsylvania School Of Medicine was the first and only medical school in the original thirteen American colonies, beginning in 1765. Generally physicians were seen as the more skilled healers versus the surgeons who were often considered to be no better than barbers, from where the surgical profession originated.

Medicine still relied on the theory of “humors”, an archaic system dating back to the Greek physician Hippocrates (ca. 460 BCE–370 BCE) which proposed that the four humors of the body—blood, yellow bile, black bile, and phlegm—influenced the health of the physical body and it’s mental states. If these four humors were kept in balance, the body would be free from disease and mental disorder. Blood-letting and purging were common ways they attempted to equalize the body’s humors. In this regard, doctors of the time had a more holistic view of health than mainstream physicians today, considering the balance of the patients’ body, mind, and spirit. As a Chiropractor, I can appreciate this “whole picture” viewpoint, but without the messy vomiting and bleeding. Still, it is always good to keep your patient “in good humors.”

Dr. James Lind testing the use of citrus

in treating scurvy. Parke Davis & Co 1957

Sailors and pirates were more likely to be affected by common diseases or shipboard accidents than by battle wounds. Scurvy, caused by lack of vitamin C in the diet, was rampant, and diseases carried by lice such as dysentery were common as were malaria and yellow fever. Rope burns, injuries from falls, heatstroke, frostbite, broken limbs, sexually transmitted diseases, and even assault by a fellow crewmate could send a sailor to the ship’s doctor or surgeon. Syphilis was not uncommon and was treated with mercury, which suppressed the symptoms but did not cure the disease. As the saying went, “a night with Venus, a lifetime with Mercury.”

Sharing shipboard medical history and lore with patrons. The orange

is both for discussing the treatment of scurvy and a healthy snack!

After a battery of cannon fire, the injuries would be devastating and in many cases untreatable. While broken bones could be set, bullets retrieved, and bleeding staunched, compound fractures nearly always ended with amputation. They did not have the surgical prowess to repair badly shattered bones, and infection was common and expected—it was considered a sign that the wound was healing. Germ theory was still unknown, and it was commonly believed that bad odors and stale air caused disease. Once sepsis set in, they had no choice but to amputate. Many surgeons were quite adept at this, and prided themselves in their speed which reduced the risk of shock. It’s handy to know that small digits might be quickly removed by the swift hard rap of a sharp chisel. Before surgery, the deck was strewn with sand to prevent the surgeon from slipping in the blood that accumulated; those familiar with the movie Master and Commander will recall the scene in which the doctor prepares his ward room in this manner.

Vintage Laudanum label

State Library of Victoria

Pain killers were relatively unknown, although a well-stocked surgeon’s chest might include laudanum, a tincture of opium dissolved in brandy or another liquid developed in the late 17th century. A sip of rum or brandy might give a little relief, but too much alcohol causes the blood to thin and thus increases the risk of bleeding. In my medical demonstrations, when asked about drinking for the pain, I like to say that “the rum is for the surgeon—to steady his hands!”

If no doctor was available, a carpenter or even a cook might act in their place. As I tell patrons at events, “same tools, different use.” In fact carpenters were often the most highly valued members of the crew, right after the navigator, with the doctor or surgeon coming in further down the list. That person needed to be able to read and write, particularly if the ship possessed or acquired a medicine chest. If he lacked knowledge of Latin, deciding which medications to give became problematic, as bottles were labeled in that language. Sometimes the medicines were numbered instead, but too often if they were out of, for example, bottle number “10”, they might give you some “7” and some “3,” with deleterious results.

John Woodall’s The Surgeons Mate, first published in 1617, described the instruments and medicines that should be stocked in a medicine chest, and explained how to use them. He listed nearly 300 remedies, but of the herbs mentioned, he warned that only fourteen were “most fit to be carried,” such as rosemary, mint, comfrey, sage, thyme, absinthe, blessed thistle, juniper, pyrethrum, and angelica. Some of these remedies were effective, but many were poisonous and lethal if dosed in the wrong amount. Among the tools and supplies listed were knives, razors, cauterizing irons, probes, saws, and spatulas for drawing out splinters and shot, syringes, grippers for extracting teeth, scissors,

A medicine chest worth blockading

Charleston for! Smithsonian Museum

of American History

“stitching quill and needles,” sponges, cupping glasses, and blood porringers. This is why medicine chests were prized almost as much as gold. When the pirate Blackbeard blockaded the port of Charleston, South Carolina, he kidnapped some of the town's leading citizens and ransomed them not for gold, but for a medicine chest. It was believed he was suffering from syphilis.

As Voltaire said, “The art of medicine consists in amusing the patient while nature cures the disease.” This was true of 18th century medicine, and in many ways still remains true for us today.

All watermarked photos and copy are copyright Jerry A. Hedrick 2017-2018. While pretending to be a pirate is fun, actual piracy is a crime. Please respect my intellectual property.

Board medicine license battery trial testimony revoked accuse