Merchant Seamen’s Health, 1860–1960: Medicine, Technology, Shipowners and the State in Britain by Tim Carter (review)

Maritime historians run the risk of seeing the maritime world as insulated from the rest of society. Merchant Seamen’s Health, 1860–1960 is contributing to fill the gap between the history of the maritime industry and another subdiscipline, namely the history of medicine.

The book gives a much-needed overview of merchant seamen’s health in Britain from 1860 to 1960. Britain was a leading maritime nation in this period, and the book has interest for an international audience. The author uses the term “seamen” (instead of “seafarer”), underlining the point that this occupational group consisted solely of men.

Through an introduction and eleven chapters, the book is presented chronologically. Although seamen always have met particular challenges (chap. 1), it was the introduction of the Merchant Shipping Act in 1867 that presented “the starting point for an integrated approach to the health of British merchant seamen” (pp. 30–31). The act gave provisions for the standard of the crew accommodation, the use of lemon juice (to prevent scurvy), medical stores aboard, and the liability of the owner or master in case the seafarer became ill. In addition, medical inspectors were appointed, and they could perform a medical examination of a seaman on the demand of the owner or master (chap. 2).

The act was preceded by a campaign to improve seamen’s health, and the efforts (mainly by medical doctors) to raise knowledge and awareness about seamen’s health are prominent in the book (chaps. 2, 3, and 8). Measures to prevent and treat illness among seafarers came about as a result of this knowledge: medical manuals and first aid at sea (chap. 4), measures to prevent seafarers from contracting a contagious illness in port (chap. 5), and the improvement of the crew’s accommodation and diet (chap. 6). Fitness and the capability of the seamen were important, and laid the groundwork for the testing of vision and color vision (chap. 7).

The Second World War ushered in a change in the way seafarers’ health was perceived when it became a topic for active state and professional intervention to combat the three most important illnesses among seamen: malaria, venereal disease, and tuberculosis (chap. 9). Carter finds that after the war the seamen’s health again was neglected. In spite of this, health improved, primarily due to new treatments (penicillin being the most important).

In the concluding chapter of the book (chap. 11), Carter demonstrates that seafarers face many of the same problems today as they did in 1860, and he suggests that the health among seamen may have relied more on ships’ design and general medical knowledge, than provision of health measures targeted at seamen specifically.

As is often the case in medical history (and maritime history) the voices of the subjects are lacking in the sources; the seamen themselves are mute. Carter is well aware of this limitation of the sources. Thus, the book gives the account of the experts, the shipowners, and the government officials. In Carter’s account, the shipowners were generally reluctant to introduce measures to better seamen’s health, if it meant increasing costs. On the other hand, the medical doctors are presented as prime movers for the action taken for seamen.

As mentioned, there exists very little literature on the subject of seamen’s health, a point the author himself makes (p. 3). Nevertheless, there do exist some historical studies in the field. Scholars like Gordon C. Cook, Joan Druett, Richard Gorski, and Alston Kennerley have made important contributions, and their works are naturally referred to in the footnotes and list of literature.¹ But these studies are not presented or discussed explicitly, neither in the introduction nor in the proceeding chapters. When an author is “attempting to fill a gap in the current historical literature as well as providing a source of reference for both maritime...