Rough Medicine: Surgeons at Sea in the Age of Sail (review)

Joan Druett. Rough Medicine: Surgeons at Sea in the Age of Sail. New York: Routledge, 2000. x + 270 pp. Ill. $U.S. 27.50; $Can. 35.00 (0-415-92415-0).

Joan Druett's elegantly presented study of medical practice belies its somewhat all-inclusive subtitle, Surgeons at Sea in the Age of Sail. One might expect a sprightly told summary of such massive tomes as Christopher Lloyd and Jack Coulter's Medicine and the Navy: 1714-1815—but that is not Druett's goal. Rough Medicine commences with an excellent discussion of medical practices on the world's oceans in the era before 1800. It then moves on to its core concern, which is medical practice by civilian physicians who served on whaling vessels in the Pacific in the first half of the nineteenth century.

Crews of whaling ships took their lives in their hands when they attempted to harpoon the mightiest mammals in the sea—but the most serious dangers did not derive from angry leviathans that tore through the water while taking their tormentors on a "Nantucket sleigh ride." The daily lives of the crews carried constant and insidious risks. Drinking water supplies were inadequate and frequently contaminated. Rations were often spoiled or nearly so, nutritionally lacking, and, in the case of essential vitamins, critically deficient. Long after James Lind's 1753 Treatise of the Scurvy, citrus fruits and green, leafy vegetables were often unavailable to gravely weakened crewmen. Druitt's discussion of this constant crisis is particularly good. But the situation was certainly not unique to whalers: during the Mexican War of 1846-48, for example, scorbutus was rampant on several U.S. warships in the Gulf Blockading Squadron.

Seagoing physicians sometimes got lucky, even when they understood neither the nature nor the etiology of the disease. Foul-smelling bilgewater was doused with generous quantities of chloride of lime, the powdered version of the well-known modern bleach, Clorox. The wretched smell of decaying matter was thereby reduced, mosquito larvae were killed, and various microbes were eliminated. Inspired physicians lauded the "sweet-smelling" depths of the ship and spread the powder everywhere that ill-smelling air betokened rot and disease. So by blind chance did some physicians fight the vector of "intermittent fever." Mal aria, they concluded, was being resisted. So, in fact, it was.

Contusions, abrasions, and unhealed wounds were the daily lot of men who worked very hard in all types of Pacific weather. But as Druett reminds her readers, remedies for external damage and internal maladies could be as dangerous as the offense itself. Surface cuts and wounds were treated with unguents and sweet-smelling oils that had little efficacious value, but most such injuries healed despite the physician's ministrations. Many a sailor was systematically poisoned by excess purging with calomel and other mercury-laden compounds. When their horribly abused intestines had their pain eased by Dover's Powder, it was because the ipecac it contained was rich in the alkaloid emetine, which was very effective in killing several varieties of microorganisms, particularly those of amoebic dysentery—but the opium also contained in the powder helped addict some of them for the rest of their lives.

Readers seeking a more thorough understanding of nautical medicine in this era would find great benefit from Harold Langley's tour de force, A History of Medicine in the Early U.S. Navy (1995), or the very readable history, Naval Surgeon: Life and Death at Sea in the Age of Sail (1998), by J. Worth Estes. But this should not detract from the pleasures of this book. Its prose style is outstanding; its brief content is most informative; and the volume itself is a beautiful example of the printer's art.