Saving lives and limbs on the high seas: The extraordinary world of early modern ship’s surgeons

Psychological distress

The challenges and risks of life at sea were not just physical but also psychological. Ships could be claustrophobic, with little privacy or personal freedom. Months at sea, with no sight of land, was disorientating. Warfare was emotionally taxing. Storms were terrifying.

This may seem strange to us, but in the 17th century the human body was believed to be composed of four “humors” (blood, phlegm, yellow bile and black bile). Bloodletting and purging “balanced” the humors and rid the body of so-called corrupt humors, which was understood as the cause of disease. Surgery, such as amputation, was very risky in an era before antibiotics, antiseptics and anesthetic, and only undertaken as a last resort.

My research explores texts written by British ship surgeons to get a deeper understanding of medical care at sea, and the emotional and psychological challenges of shipboard life for surgeon and crew.

A surgeon was necessary for hazardous long-distance merchant voyages that lasted weeks, even months, across the Indian and Atlantic oceans. The Royal Navy grew substantially during a series of major wars from the mid 17th century—and with it the medical needs of naval seamen.

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Scottish ship’s surgeon William Ferguson wrote of scurvy sufferers who were unable to walk, “so emaciated and breathless,” with rotten gums and “livid yellow Swellings on their joints.” John Woodall recommended the use of citrus fruits to combat the “lamentable disease” of scurvy—though this advice would not be widely adopted by the Royal Navy until the late 18th century.

Ships at sea were a challenging working environment for crews and their surgeons. Accidents were frequent, especially in wet and windy conditions. Seafarers fell from masts, slipped on the deck and were injured by nautical equipment. The ship’s surgeon Henry Watson, aboard British naval warship HMS Tyger in the Mediterranean, recounts how Thomas Story, an unfortunate crew member, fell from the fore-topmast to the deck and fractured his skull. In his log, Watson added the grisly detail of Story’s brain matter “flying out upon the deck” on impact.

Ship surgeons had a weighty responsibility. As well as treating illnesses and injuries, they equipped the medicine chest (containing surgical tools and medicines), made their own remedies, and were often responsible for the ship’s sanitation. Surgeons were trained by apprenticeship, on ships or on shore.

The writings of ships’ surgeons give us access to some of these emotional experiences and mental health challenges. Moyle described states of psychological distress in which confused sailors believed the sea “to be a Meadow, and will endeavour to go into it.” This would usually end in tragedy.

The manual nature of the surgeons’ craft, and his contact with diseased bodies lowered his social status in pre-modern society. Unfavorable comparisons were made between surgeons and butchers—both carved bodies and handled flesh. Surgeons were also presented as ignorant by contrast to university-educated physicians.

As well as the very real risks of serious injury, diseases such as typhus, dysentery and malaria spread quickly in the confined and poorly ventilated space of the ship—especially in hot climates. Diets were limited and lacking in fresh fruit and vegetables. Scurvy (caused by a lack of vitamin C) was a serious problem on long-distance voyages.

The accounts of ships’ surgeons enrich our understanding of medical care at sea at a time of unprecedented maritime activity and expansion. Their writings also provide fascinating insights into the everyday experiences and challenges of early modern shipboard society.

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