Medicine at Sea

[Salty Dog]

The Medicine Chest
In 1720 Bartholomew Roberts and the pirates who sailed with him found themselves in a heated battle with pirate hunters. His only option was to “cut and run,” so the pirates dumped their guns and cargo overboard. They eventually escaped, but not without severe damage to the Fortune and her crew. Half were dead or wounded, and many more would die, for their surgeon Archibald Murray had left the ship and no one else knew how to amputate limbs or prevent gangrene. Having no other options, the wounded were given enough rum to lessen their pain and left to die.
This is but one account of how sailors fared without a doctor to tend them. If the ship possessed a medicine chest, the captain designated someone to tend patients. That person needed to be able to read and write, but if he lacked knowledge of Latin, deciding which medications to give became a problem since bottles were labeled in that language, rather than the language of the tender. If the ship lacked a medicine chest, a wounded or ill pirate found his fate in God’s hands. When William Phillips injured his leg, Captain John Phillips allowed John Rose Archer to tend the man. Archer had some skill with a saw, but cauterization was beyond his understanding. The red-hot axe he used to burn the stump destroyed too much and William was left with even worse wounds than before.

Surgeons who plied their trade at sea, rather than on land, were not new. They sailed with Roman warships, and during medieval times, they accompanied nobility and prelates on their voyages. When the Spanish Armada sailed in 1588, the eighty-five surgeons and their assistants were unable to stop the dysentery and typhus that swept the ships.

[Salty Dog]

John Woodall’s The Surgeons Mate, first published in 1617, aided many in treating what ailed a ship’s crew. The manual listed the instruments and medicines found in the medicine chest, and explained how to use them. Special instructions explained what to do for medical emergencies, such as an amputation. Various ailments were also discussed, especially scurvy. Woodall provided his readers with 281 remedies, but of the herbs used, he warned that only fourteen were “most fit to be carried:” rosemary, mint, melilot, clover, horse radish, comfrey, sage, thyme, absinthe, blessed thistle, balm mint, juniper, hollyhock, pyrethrum, and angelica. Among the tools and supplies found in medicine chests were knives, razors, “Head-Sawes,” cauterizing irons, forceps, probes and spatulas for drawing out splinters and shot, syringes, grippers for extracting teeth, scissors, “Stitching quill and needles,” splints, sponges, “clouts” (soft rags), cupping glasses, blood porringers, chafing dishes, mortar and pestle, weights and scales, tinderbox, lantern, and plasters. This was why medicine chests were prized almost as much as gold. In fact, when Blackbeard blockaded the port of Charleston, South Carolina, he demanded such a chest in exchange for his hostages – leading citizens of the town. Contemporary accounts detailing the incident placed the value of the medicine chest at between £300-400.

[Salty Dog]

Unlike today, medicines of the past had to be put together similar to how a cook bakes a cake. The recipe for a medication consisted of a curative agent, water or oil, flavoring, and the compound used to comprise how the medication was given, for example as a pill or an ointment. The base for the latter might have been glycerin or lard. Wax sometimes held a pill together. Ingredients in ointments and liniments might include mercury, turpentine, sassafras, thyme, hemlock, eucalyptole, and/or sulfur. Medicines that were ingested usually needed some flavoring to make them palatable; vanilla, honey, licorice, sugar, nutmeg, ginger, and mint are some that were used. Depending on what ailed the patient, the pirate might endure bloodletting to remove toxins from the blood, blisters (a caustic agent applied with flannel or leather), salves, clysters (medicines given rectally), or hot, moist cloths used to relieve pain.

[Salty Dog]

Perhaps Blackbeard required the medicines and instruments to treat syphilis, a common plague among sailors and pirates who frequented brothels when on shore. Of course, his crew might also have suffered from any number of other problems, for danger lurked almost everywhere aboard a wooden ship. Aside from the rats, weevils, lice, and cockroaches, livestock was kept aboard and sometimes had free reign of the deck, making for unsanitary conditions. The pirates’ clothing was often wet or damp. Depending on where they sailed, nature might also inflict hardships: sunburn, heat exhaustion, sun stroke, hypothermia, exposure, or frostbite. Their work was equally hazardous and sores, cuts, and bruises were the norm. Scurrying up or down the rigging and the frequent movement of both the ship and the mast sometimes caused sailors to lose their footing and fall. Landing in the water often meant the man drowned, for knowing how to swim wasn’t a requirement for being either a sailor or a pirate. If he was lucky enough to be retrieved from the water, sailors held the victim by his heels and shook him to remove any water in his chest.

[/img]

[Salty Dog]

Landing on the deck might fracture a person’s skull or kill him. In 1833 Billy Bridle1 was aloft in the topmast crosstrees. When he tried to slide down the topgallant halyards, he burned his hands, lost his grip, fell to the deck (a distance of twenty feet), and died instantly. Those who didn’t die from a fall often exhibited symptoms of “lethargie or frenzie, madnesse, losse of memory, deadish sleep, giddinesse, apoplexie, paralysis, and divers other like accidents.” (Friedenberg, 14) From the seventeenth through the nineteenth centuries, surgeons treated such head wounds with desiccation and cicatrization. When the skull bone collapsed, he raised the depressed fragments and removed any splinters. Wounds to the chest and abdomen, however, were left in God’s hands.

Pirates, who visited lands not explored before, also encountered additional dangers. Alexandre Exquemelin wrote of the insects on Hispañola:

The gnats of the third species exceed not the bigness of a grain of mustard. The colour is red. These sting not at all, but do bite so sharply upon the flesh as to create little ulcers therein. When it often comes that the face swells and is rendered hideous to the view, through this inconvenience. (Esquemeling, 33)

[Salty Dog]

The plants could be equally dangerous. He encountered a dwarf apple tree near the shore. Although similar to apples back home, the fruit was poisonous.
…these apples being eaten by any person, he instantly changes colour, and such an huge thirst seizes him as all the water of the Thames cannot extinguish, he dying raving mad within a little while after…. This tree affords also a liquor, both thick and white…which, if touched by the hand, raises blisters upon the skin, and these are so red in colour as if it had been deeply scalded with hot water. One day being hugely tormented with mosquitos…and as yet unacquainted with the nature of this tree, I cut a branch thereof, to serve me instead of a fan, but all my face swelled the next day and filled with blisters, as if it were burnt to such a degree that I was blind for three days. (Esquemeling, 32)
Depending on a pirate’s ailment, the surgeon might prescribe one of nine different types of medicines. Aquae – such as cinnamon water, licorice juice, and fortified peppermint water – cured hiccups and “stoppeth vomiting, cureth choler, griping paine of the belly…” according to John Woodall. (Druett, 7) Spirits, salts, and tinctures – like salts of wormwood, vinegar, and quicksilver – cured a variety of ills from urinary problems to fever. Balsams and resins were given orally or applied to the skin. Sanguis Draconis, also known as Dragon’s Blood, was the resin made from the agave and rattan palm. Garnet in color, the ground powder was an astringent and “closeth up wounds.” (Druett, It was also used to make the varnish used on violins. Around 1640 Jesuit priests introduced Peruvian bark (quinine) to Europe from South America. It was used to cure intermittent fevers, such as malaria.
It should be taken in the intermissions between the hot stages, in the dose of a grain every hour, an emetic at the commencement of the chill, and a purge of Calomel and Jalap afterwards having been given before commencing with the quinine. (Druett, Rough Medicine, 61)

[Salty Dog]

Syrups were made from almonds, red roses, saffron, lemons, and other plants. On board a ship, the surgeon might mix vinegar of squills (hyacinth) with sugar and honey, before giving it to a pirate to clear mucus from his bronchial tubes. Oleum or oils, like oil of St. John’s Wort, were applied to the skin. Scottish surgeons may have used this to treat wounds. The Scots believed that St. Columba favored the plant because it was associated with John the Evangelist and the Virgin Mary, although the plant was used long before Christianity came to Scotland in sacred ceremonies and to prevent “fairies from spiriting people away while they slept.” (Darwin, 96) Opiates and theriacs were also used. An early patent medicine with opium in it was “Methridatum,” which Woodall recommended for those “fearfull of waters” and to cure “the bites of serpents, mad dogs, wild beasts, and creeping things” (Druett, , all of which a pirate might encounter when visiting exotic places. Unguents were used to treat burns and abrasions.

[Salty Dog]

Plasters drew bad humors from the body or to treat open infections, such as wounds received in battle. In 1500 Giovanni de Vigo, a Roman doctor, treated syphilis with a poultice called Emplastrum de Ranis cum Mercurio. Its ingredients consisted of frogs, “earthworms, viper’s flesh, human fat, wine, grass from northern India, lavender from France, chamomile from Italy, white lead, and quicksilver.” (Druett, 9) One of the oddest plasters was Pracelsi and was used to treat wounds sustained in battle. The ingredients, brewed in autumn, included “burnt earthworms, dried boar’s brain, pulverized Egyptian mummy, crushed rubies, bear’s fat, and moss from the skull of a hanged man which had been collected from the gibbet at moonrise with Venus ascending.” (Druett, 9) One might think the plaster was then applied to the soldier’s wound, but in fact it was applied to the sword that sliced him.

[Salty Dog]

The last type of medicine came from herbs and roots. Chamomile flowers soothed headaches and helped with kidney problems. Other examples included wormwood, cinnamon, saffron, rose petals, juniper berries, sarsaparilla root, mustard seeds, and ginger.

[Salty Dog]

Disease

The most common type of ailment that surgeons treated was a disease of some kind. To men like John Woodall, sin was the primary cause of disease, although the noxious fumes emanating from bilge water ran a close second. Aside from living a moral life – not something usually associated with pirates – the best way to stay healthy was to avoid stinking vapors and cemeteries whenever possible, and protect oneself from the night air. Diseases, however, had a nasty habit of invading ships where large numbers of people were gathered together in confined places. Surgeons recognized this fact early in the fifteenth century. It was one reason that Sir Francis Drake had to curtail some of his expeditions against the Spaniards in the West Indies. He wrote in his journal:

Sir Francis Drake…we were not many dayes at Sea but there began amongst our people such mortality, as in a few dayes there were dead above two or three hundred men. And until some, seven or eight dayes after our coming from Saint Jago, there had not dyed any one man of sicknesse in all the Fleet: the sicknesse shewed not his infection, wherewith so many were stroken untill we were departed thence, and there seazed our people with extreeme hot burning and continuall ague, whereof some very few escaped with life and yet those for the most part not without great alteration and decay of their wits and strength for a long time after. In some that dyed were plainly shewn the small spots, which are often found upon those that be infective with Plague. (Friedenberg, 16)The actual disease Drake described remains unknown, but it might have been typhus, cholera, yellow fever, or bubonic plague. He believed the night air was the culprit for the affliction. Even the surgeon died, and Drake returned home without any plunder to make up for the sacrifices he and his men endured.

[Salty Dog]

Among the artifacts recovered from the wrecks of Black Sam Bellamy’s Whydah and Blackbeard’s Queen Anne’s Revenge were pewter syringes. These were used to administer mercury to those who suffered from syphilis. First described in Europe in 1494, the name stems from a poem Girolamo Frascatoro wrote in 1530 about a shepherd named Syphilisive Morbus Gallicus. The term “syphilis” wasn’t really applied to the disease until the 1800s. Spanish sailors called it the French pox, while the French called it the Spanish Disease.

[Salty Dog]

What did a pirate endure if he contracted syphilis? The disease has three stages.

• Chancres form where contact with an infected person occurred. These often heal, leaving small scars.
• Six to eight weeks later, the pirate seemed to contract the flu and developed a skin rash. Doctors often misdiagnosed this stage because of its resemblance to small pox and measles. The patient soon recovered and believed himself cured. During this stage, syphilis was contagious, and the pirate often infected many others. After two years, the disease entered a dormant stage.
• The final stage occurred when syphilis attacked the body’s systems many years later. Many went mad or blind before they died.

[Salty Dog]

An early treatment2 for syphilis came from the native peoples in the West Indies. They used a resin found in evergreen holy wood or guaiacum. The more effective treatment, though, was to administer mercury orally, through a vapor bath, or in the case of pirates, by injecting the medication into the penis with a syringe. A salve was applied to the chancres that developed when first contracted.
Since syphilis was more or less an occupational hazard, surgeons treated most pirates over a long period of time. Whether the mercury was ingested orally or absorbed through unguents, it often produced a metallic taste in his mouth that caused patients to salivate. They didn’t complain overmuch since many thought it was just the price they paid for contracting the disease in the first place. Mercury poisoning, however, sometimes occurred. When this happened, the pirate lost weight, drooled, had foul breath and blurred vision, and slurred his speech. He also had trouble maintaining his balance. If the treatment for syphilis wasn’t stopped, his kidneys eventually ceased functioning and he died.

[Salty Dog]

Another disease that plagued anyone who remained at sea for long periods of time was scurvy, which killed more mariners than all the other diseases, natural disasters, and fights combined. Historians conservatively place the number of deaths at more than 2,000,000 between Columbus’ first voyage to the New World and the mid-nineteenth century. Even physicians of Ancient Greece didn’t know what caused it. A variety of folk cures were developed, some of which were more deadly than the disease. Among these were swallowing sea water to purge the illness, bleeding, digesting sulfuric acid, anointing open sores with mercury paste, and increasing the sailor’s workload. The thinking on the last cure was because scurvy made the sailor lethargic.

Scurvy usually struck about four weeks after a ship left port. In 1596 William Clowes, an English surgeon at sea, described what his men suffered:

Their gums were rotten even to the very roots of their teeth, and their cheeks hard and swollen, the teeth were loose neere ready to fallout…their breath a filthy savour. The legs were feeble and so weak, that they were not scarce able to carrie their bodies. Moreover they were full of aches and paines, with many bluish and reddish staines or spots, some broad and some small like flea-biting. (Brown, 34)

[Salty Dog]

Just like the pirates and sailors, those who treated them sometimes endured the same disease. Another surgeon who sailed on an English ship in the sixteenth century wrote:
It rotted all my gums, which gave out a black and putrid blood. My thighs and lower legs were black and gangrenous, and I was forced to use my knife each day to cut into the flesh in order to release this black and foul blood. I also used my knife on my gums, which were livid and growing over my teeth…. When I had cut away this dead flesh and caused much black blood to flow, I rinsed my mouth and teeth with my urine, rubbing them very hard…. And the unfortunate thing was that I could not eat, desiring more to swallow than to chew…. Many of our people died of it every day, and we saw bodies thrown into the sea constantly, three or four at a time. For the most part they died without aid given them, expiring behind some case or chest, their eyes and the soles of their feet gnawed away by the rats. (Brown, 34)