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A ship’s surgeon in the 17th century
The problem with good health already started with the poor provisions on board, because back in those days storing fresh foods and drinking water proved quite difficult. At first, drinking water on ships was carried along in barrels - and spoiled after about seven to nine days. Equipment for distilling water, which permitted a germfree use, did not emerge until the 18th century. The food also was only able to survive the long voyage in dried form. In addition, buying more fresh goods in ports also wasn’t always easy. The results were avitaminosis diseases such as scurvy, which occurred on most ships.
But those were by no means the only diseases that posed a serious problem for sailors. Professor Irmgard Müller (Professor Emerita of History of Medicine at the Ruhr University, Bochum) explains: “Infections from tropical diseases like malaria and yellow fever were added to the mix. Venereal diseases were also very common, since as soon as the ships laid anchor in a port, the men visited brothels, because needless to say they had suffered from long months of deprivation. And that’s where many contracted diseases. And diseases that required surgery, like for instance after someone plunged from the yardarm, were also problematic – apart from the fact that of course injuries resulting from brawls on deck occurred as well. And each wound that needed to be looked after was a risk. “Organized health care on merchant ships did not exist in the 17th century yet. Müller continues: “There were no ship surgeons like we know them today on these ships. They were barbers and barber-surgeons, respectively. “They had trade jobs, even if from those the surgeon job later developed. Back then an absolute separation between internal medicine and surgery still existed. That is to say that by all means a barber was allowed to use a knife and do some blood-letting on a patient – but he was not allowed to administer a medical potion.
The ship’s medicine chest was always on board
But what type of treatment did sailors get if they got sick on board? The most important utensil was the so-called ship’s medicine chest. At least in simple cases like seasickness, nausea or diarrhea it probably was useful. The ship’s medicine chest contained all kinds of ointments, lotions and herbs, but also dressings and bandages. Each chest also contained a kind of instruction manual, which was written by a trained physician on land. The barber could refer to it and thus avoid the occupational ban of not being allowed to prescribe internal medicine. Yet a barber didn’t always abide by these suggested treatments. The expert of Ship medicine tells us: “There are many anecdotes about barbers on ships: For example, the medicine in the ship’s medicine chest was labeled with numbers. If somebody needed the drug number 10 and it was not available anymore, then they just used number 3 and 7 instead. “Essentially that’s some creative medicine, whose success however was often questionable.
A woodcarving from a surgery book
(1537) by Hans von Gersdorff illus-
trates the amputation of a leg.
Not for the faint of heart
Hardest hit however, were probably the sailors which needed surgical treatment. For one, the facilities on board were very poor, because there was no hospital ward. At best, a table where the patient could lie down on was cleared for surgery. Hygiene also was a foreign concept. Although even in the 17th century people made sure to clean instruments as thoroughly as possible, knowledge about germs in wounds however was still non-existent.
Many a progressive procedure also was not done due to the improvised situation on deck. Already in the 1550s for instance, the physician Ambroise Pare executed and recommended ligature of arteries (ligation of arteries). But even a long time after that, many physicians relied on cauterization, meaning a branding iron. It was used to slough off the open wound, and then the wound was coated with an ointment and covered with a dressing. This may have been an easier and faster way to treat somebody on a ship – but only the strongest survived this harsh procedure. And to add to it, well into the 19th century surgery was performed without anesthesia. At best patients, particularly sailors on board a ship, received a generous helping of rum. You can imagine without much difficulty that this did little to ease the pain during an amputation, especially since patients weren’t supposed to drink too much due to the danger of either alcohol poisoning or having to vomit during surgery. Most surgeons might also have relied on their patients being released from their pain due to sudden shock.