Surgeons and medicine

In crowded passenger ships, disease could bring disaster. The main killers were diarrhoea, measles, whooping cough and scarlet fever. The most common, minor complaints were constipation, headaches and sea sickness.

The causes of diseases were not well understood. By 1800 100,000 people in Britain had been vaccinated against smallpox using the cowpox virus but in the 1830s there was still debate between ‘contagionists’ who believed diseases were spread from person to person and ‘anti-contagionists’ who followed the miasmatic theory. They believed that disease broke out spontaneously in damp, musty and dirty places.

Pioneering work in preventing disease at sea was done by William Redfern, a freed convict and surgeon in Sydney. He was commissioned to write a report on the calamitous voyage of three ships which in 1814 arrived with appalling numbers of dead and dying convicts. His recommendations set new standards for carrying passengers. He emphasized ventilation, cleanliness, and fumigation. He called for specified diets and routines that took passengers on deck. He also called for surgeons to be appointed to each passenger ship and given clearly defined powers to regulate conditions.

Most ships carrying migrants for the Colonisation Commission hired surgeons. Two years earlier, in 1834, Charles Logan was surgeon onboard the Sarah carrying female emigrants to Hobart. It was a successful voyage and Logan wrote a summary of his methods for keeping passengers healthy. His report was circulated and became a model for others to follow.

Logan emphasized a need to look after the spiritual and moral well being of his passengers as well as their physical health. He ensured that religious services were held daily and twice on Sundays and he had women from among the cabin passengers conduct Sunday school.

He paid particular care to the virtue of single women. Logan banned them from going near the crew’s accommodation in the forecastle and had them leave the main deck at nightfall. Any woman found conversing with a seafarer was confined below deck for three days.

Logan had his passengers rise between 5am and 6am and ensured they folded their beds and blankets and washed before breakfast. After breakfast his passengers had to remain on deck to take in fresh air. A number were appointed to scrub the lower decks and ventilate them and periodically to fumigate the accommodation.

Surgeons had the power to confine passengers below decks or to restrict their diets as punishments to enable them to impose their regimes.

At the time ‘surgeon’ was a general term for a medical practitioner but it did not mean they could operate on patients. They applied treatments that seem exotic today. They carried leeches which could be used to suck bad humours from patients. They applied plasters which were bandages spread with pastes to act as poultices and draw out heat or disease. They also distributed lime or lemon juice daily to prevent scurvy.

Alcohol was believed to have medicinal properties. Passengers’ letters and diaries abound with recommendations to take whisky, porter or brandy daily to promote health and to give doses of port wine to sick children.

For many passengers in [tooltip color=”grey” text=”The area of between-decks occupied by steerage passengers, that is, those travelling at the cheapest rate.”] steerage [/tooltip] , free access to a surgeon was a benefit of the voyage to be used while it was available and they brought forward complaints that may have gone untreated at home.

Shipboard regimes and the regulation of diets did prove to be successful. Statistics on rates of disease and death show that for most of the nineteenth century, adult emigrants at sea were healthier than those in Britain.