Disease in the nineteenth-century merchant Navy: the Seamen's Hospital Society's experience.

The life of the seafarer in the twenty-first century is by no means devoid of health hazards; present day medical and surgical problems have been clearly documented.1 Provision of competent medical and surgical management, however, remains less satisfactory and more unpredictable on board ship than on land. The diseases and injuries afflicting members of the Mercantile Marine (then at its zenith) a century ago have not been well recorded. In 1867 Harry Leach,2 resident Medical Officer on the Dreadnought hospital-ship, provided a valuable summary of the health of sailors in the merchant service.3 The following year he published The Ship Captain’s Medical Guide4 – which has since gone through numerous editions and remains in use today. It was ‘written solely for the use of Masters and Mates of vessels at sea’ and covered ‘accidents and diseases that occur[red] on board ship ...’. It also emphasized how cases could ‘be best treated by a non-professional man’. The entry regarding ‘Ague, or intermittent fever [most cases were probably caused by malaria]’ illustrates the clarity of Leach’s advice: