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AN

ESSAY.

PROEMIAL OBSERVATIONS.

On taking a retrospective view of the progress of Nautical Medicine, one cannot help being struck with the rapid improvements which have taken place in Medical Science, within the last forty years, in the Royal Navy.

During the first American war, and down to the beginning of the late French war, Sea-scurvy made such dreadful ravages in our fleets, as frequently to enervate the arm of Power; and it was not uncommon in those days, to find 300 men at once on the sick-list of a line of battle ship; and as many as 250 men have actually died in the short space of one year, by this prevailing malady. Hence, it was justly observed, by some of the most experienced officers," that the blockading system of warfare, which annihilated the naval power of France, could never have been carried on, unless sea-scurvy had been subdued; and more than one hundred thousand British seamen have thus been saved to the country, by as many thousand pounds."

Shortly after this disease was subjected in the royal navy, another very remarkable era took place in the Medical Department, which considerably changed the character and quality of the naval medical officers: viz. the late Lord Viscount Melville, by his generous interposition with Government, obtained an Order in Council, dated the 23d January, 1805, to give the medical officers of the royal navy the same rank and pay as their brethren in the army; and, from that period, better qualifications were insured, by the candidates undergoing severe examinations at the Royal College of Surgeons, and the then Transport Board; and thus the general character and professional skill of medical officers made rapid advances, under their noble and illustrious patron. Indeed, many, who had been allowed to enter the navy on the spur

of necessity, were required to mend their medical and surgical education, or be expelled the naval service; and those who now offered themselves as candidates for examination, were gentlemen of more extensive information, owing to the rank and respectability which had thus been assigned them in the British navy.

Sea-scurvy, by far the greatest calamity that ever visited the British fleet, had long been on the wane; and, at the beginning of the last French war, made its farewell visit. Since that time, the diseases which have continued to thin our ranks, have been chiefly of the inflammatory kind: viz. fevers, inflammations of the lungs and their membranes, consumptions, &c.

Indeed, the long list of inflammatory complaints had become most formidable in those days, in consequence of the difference of opinion that then existed amongst practitioners, respecting the treatment of such diseases. A small party admitted that bleeding and other antiphlogistic measures were necessary, yet had not sufficient confidence in the means they recommended to carry them into practice; and the more numerous party totally exploded depletion, and trusted to mild cathartics and antimonial remedies.

Such conflicting modes of practice were as painful to the practitioner, as detrimental to his patients; and, what between the cavil of party, and dilatory measures, great numbers were allowed to be swept off by the powerful arm of inflammatory disease.

Happily, however, for humanity, and for the British navy, one of the present Medical Commissioners' (then the principal Examiner at the Transport Board) saw the magnitude of the evil arising from such contrary and dilatory practice; and from the high public situation he held, was enabled to impress on the minds of the young medical gentlemen (whose professional tenets were reviewed by him), the great propriety of early and prompt antiphlogistic means; not only in all the different species of phlegmasia, but, also, in certain types of fever.

Such principles, from their success, as well as from the high authority by which they were stamped, soon became disseminated, and, ultimately, universally adopted; and in the present day, such inflammatory diseases are cured with nearly a mathematical certainty, by almost every surgeon in the navy.

This revolution in the treatment of inflammatory complaints ranks next, in point of consideration, to the subjugation of seascurvy; it has already saved some thousands of seamen to their country, and ought to be accompanied by a corresponding gratitude to the indefatigable labors of this distinguished individual.

'Dr. Weir.

"A wise physician, skill'd our wounds to heal,
Is more than armies to the Public Weal."

It would be unpardonable to pass unnoticed, even in this short survey, the very popular and scientific works of Dr. James Johnson: His "Essay on the Influence of Tropical Climates, more especially the Climate of India, on European Constitutions," &c. stands like a beacon for the direction of the medical officer on oriental service, while his other works are equally important to the home practitioner.

The late preference held out by the Commissioners for Victualling His Majesty's Navy, to such as may have graduated at the different universities, cannot fail to have the most beneficial tendency, by exciting more vigorous exertions on the part of the young medical officer; and, in this way, the best interests of the navy have been advanced.

In taking, thus, a rapid survey of the revolution which has lately been effected in nautical medicine, it will appear that sea-scurvy has been almost totally exterminated in our fleets; that the treatment of inflammatory diseases is now so well understood, that they are generally soon cut short, or subdued; and that some of the most formidable diseases within the Tropics, such as fever, dysentery, and liver complaints, have become, at least, manageable, under the salutary directions of certain tropical writers.'

Yet, owing to the existence of certain long-established and pernicious regulations with regard to WASHING DECKS, and the sudden vicissitudes to which sailors are exposed in consequence, this class of men is rendered peculiarly liable to repeated attacks of inflammatory disease. And it is to be, moreover, lamented, that such diseases, even when subdued, have a strong tendency to weaken the constitution, and render the individual more liable to the invasions of chronic affections and consumption afterwards the two great scourges of the British navy at the present day.'

It is with a view, therefore, of being the means of removing some of the existing causes of such inflammatory complaints, that this Essay has been written; for every one will admit, that the prevention of disease (when it can be effected) is better than its

cure.

1 See Dr. Wm. Burnett's (one of the Medical Commissioners) most excellent" Practical Account of the Mediterranean Fever;" see, also, Dr. James Johnson's Essay already mentioned, and Bampfield on Tropical Dysentery.

2 The principal part of the obituary of the royal navy, at present, takes place at our great naval hospitals, whither the men are usually sent with chronic disease or consumption, after having been frequently attacked, and worn down by the acute forms.

Before finishing these proemial observations, I have to remark, by the way, that while the medical department of the royal navy has thus been making the most rapid march towards perfection, the advancement of naval discipline and naval tactics has not been less conspicuous in the executive.

Within these last ten years, corporal punishments have been reduced to a very limited extent, without any concomitant bad effect; and the cidevant customs of black-listing, black-holding, and burnishing of bolts, bars, and cannon-balls, have all been entirely exploded.

The young gentlemen who have lately entered the navy as midshipmen, have received a most appropriate education for the service, either at the Royal Naval College at Portsmouth, or elsewhere, which not only renders them more eligible at their entry, but, also, furnishes them with a store of elementary information, which may be turned to the advancement of nautical science hereafter.

The theory of gunnery is now much better understood among sailors than it was formerly; and the practice of fencing, lately introduced into the Royal Marine Corps, has rendered them a most formidable body of men.

Furthermore, clothing has been better suited to the different climates; and pensions for wounds or servitude have been granted to seamen, regulated by the most liberal principles. Thus, it is most gratifying to observe how the health and interest of British seamen have lately been promoted by their generous countrymen, in a strong feeling of attachment, accompanied by pecuniary rewards for past services. Is there a Briton who can for a moment forget the blessings that have been enjoyed for centuries, under the safeguard of our brave tars ?—and who can look with apathy on a class of men to whom we are indebted for our riches and commerce in war and peace, and who are our only safe and permanent bulwark in the trying hour of invading hostility? Can we neglect a body of men whose energy increases with the raving of the storm, and whose constant practice and highest pride is to show the greatest dexterity in the most imminent danger? Never shall we abandon the brave tar who mounts with alacrity on the quivering shroud, when

"O'er his head the rolling billows sweep."

Besides, our gallant "sons of the waves" have not been less celebrated in human than "elemental war ;" for, when the united powers of Europe were in league against us, British seamen most undauntedly stood forward to wield our naval thunderbolts, and hurl destruction on our most malignant enemies; then, the victorious peals of our artillery resounded from one extremity of the

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