- Naval Surgeon: Life and Death at Sea in the Age of Sail
What can we learn about health, disease, death, and medical practice at sea by focusing on the fragments and records prepared by one individual who spent most of 1778–1822 on dry land? According to Worth Estes, we can learn much about late-eighteenth- and early-nineteenth-century medical practice in general.
The exemplar for practice during the period is Peter St. Medard (1755–1822). Born in France, he served a medical apprenticeship and by the mid-1700s found appointment aboard vessels in the Caribbean, some of which were involved in the lucrative slave trade. Captured by the British in 1778, he soon found himself in revolutionary Boston where he offered his services to the Continental Navy. Later, during the Quasi-War with France, he served on the first tour of the newly commissioned USS Constitution, 1798–1802. During 1802–3, St. Medard served as surgeon in the US Frigate New York, sailing to the Mediterranean and into the theater of the Barbary Wars. As the author points out, one of the ironies here is that casualties of battles occupied very little of his professional time at sea, although while posted to marine and naval facilities on land he did treat wounded and indigent sailors.
This is not traditional biography. Rather, Estes uses what little is known about St. Medard to assemble around him secondary materials and chapters that contextually explore medical practice on land and at sea during that time, with special reference to the evolving nation’s naval establishment. With virtually nothing known for sure about St. Medard’s practice in Boston while not in service, the author relies upon the manuscript journal in which St. Medard details his experiences while aboard the New York.
Much of this volume derives from Estes’s earlier published work on St. Medard’s experiences, but here he can offer even greater detail and analysis of the day-to-day medical encounters. We learn that of 370 crew and passengers on the New York in 1802–3, 64 percent (239) were recorded on the sick list by Dr. St. Medard and his colleague Dr. Nathaniel T. Weems, which means that 36 percent required little or no medical attention. The author uses many graphs and charts to document that officers fared better than others, that few cases required surgical intervention, and that few died of any injury or disease. One appendix lists the surgical equipment and drugs taken on the New York, and Estes points out that there are no surprises here: civilian practitioners and army surgeons generally utilized similar instruments and drugs. The health records of the crew constitute another appendix, with yet another chart that details how long people were on the sick list, with what affliction, and how and what medication or treatment was administered. As the author observes, with some obvious exceptions sailors on the New York present health profiles quite similar to those of their land-locked counterparts, and they underwent similar therapeutic procedures. He helps us understand how healers and others believed in the efficacy of drugs that today we know do not work as their advocates claimed.
In most respects the contents of this volume are true to its title. There is the [End Page 508] romance of a time under sail aboard some of the great vessels that we associate with independence and the emergence of the early republic. The author’s skill at analyzing data such as St. Medard’s contributes to our knowledge of how healers understood illness and injury, and how they responded therapeutically.