The ship’s surgeon was one of the most indispensable members of crew and was normally held in high esteem by them. They were always present on warships, but only occasionally on merchant vessels. Someone with medical knowledge was extremely valuable, as a ship was a dangerous place to live and work on. In the early 1700s there was a scarcity of physicians, so surgeons and apothecaries were essential. On board a ship, as well as serious accidents there were also mundane ailments to deal with such as rashes caused by constantly wet clothes, sunburn, and toothache, and common minor injuries like cuts, bruises and sores inflicted by daily work, which were usually treated by applying plasters. Also the crew needed a regular cutting of their hair, shaving, and the trimming of their beards with scissors and razors, which was also the responsibility of the surgeon. These men were often referred to as barber surgeons in society. The ship’s surgeon needed to be literate and well-educated to carry out such tasks. The crew usually addressed the surgeon as mister and not doctor, which was normally only used for academically qualified physicians, although pirates often didn’t differentiate between the two terms. Due to the scarcity of qualified surgeons, they were often forced to join the crew under threat of violence, but weren’t made to sign the ship’s articles, possibly to encourage them to accept their new role. There wasn’t always a surgeon present on a pirate ship, so the crew often had to make do with what was available, for example employing the carpenter for amputations.
Injuries on board a ship
There was a wide variety of injures that a pirate could suffer, not only in battle. In combat deadly splinters, burns, bullet wounds, cuts, broken bones, and near drowning were dangers that were always present. The day-to-day handling of the ship was also no picnic, including such injuries as broken, fractured, or crushed bones from falls or heavy objects; strains from the heavy work; burns and blisters from handling the ropes. Smaller injuries such as cuts, bruises, and smaller splinters were a common occurrence.
Diseases
In addition to injuries there were countless diseases to contend with aboard as ship, either due to unsanitary conditions or contracted on foreign shores. Scurvy, which was considered the scourge of seamen, is said by historians to have accounted for more than 2 million deaths between the first voyage to the New World and the mid-nineteenth century. Other common diseases were malaria, yellow fever, smallpox, dysentery, and typhus. We mustn’t forget the sexually transmitted diseases from visits ashore such as syphilis, which was then called the ‘Great Pox’ by the English.
Medicine in the early 1700s
Medical treatment was severely restricted in this period as antibiotics or antiseptics had yet to be developed. Although diseases were no longer considered the wrath of god, the ancient theories of Hippocrates and Galen still dominated the thought of the time. Both men felt that all the ills of mankind were due to an imbalance in the body. Hippocrates wrote a great deal on bloodletting and dietary changes. They both claimed that the body was affected when imbalances occurred in what he called the four humors: blood, phlegm, yellow and black bile, resulting in disease and even insanity. Blood was seen as related to the liver; black bile to the gallbladder; yellow bile to the spleen; and phlegm to the brain and lungs. Various unsavoury methods were used to bring the humors back into balance, including induced vomiting, urination, and diarrhoea, purging the body of just about any kind of fluid possible. Humoralism declined in popularity throughout the 1700s. At the time, the existence of bacteria was unknown with the Germ theory first being developed in the 19th century. Before germs were discovered the belief in the miasma theory was prevalent, which stated that disease was caused by noxious air emanating from decaying organic matter, or on a ship from the bilge. The lack of understanding of what caused diseases was further exacerbated by the extremely slow dissemination of new methods, which was generally only possible by word-of-mouth.
Treatments in the early 1700s
There were many long established treatments, and it was believed the way to treat a person who was ill for whatever reason was to bring the four humors back into balance. Excess blood was believed by Galen to be the biggest cause of imbalance. Unfortunately for most people, this meant the letting of blood in order to reduce fever, control delirium, and eliminate infection and restore the body back to order. A book published in 1617 by John Woodall called The Surgeon’s Mate contained many treatments and diagnoses recommended at the time. Bloodletting with leeches or cupping were common treatments for many ailments to remove excess blood. An unpleasant treatment for serious limb wounds was amputation, which was deemed necessary to prevent gangrene and other infections setting in. The cauterizing of wounds was carried out with hot tar or hot iron and then covered with linen. Trepanning was employed to mend skull fractures. Stitches and plasters were another common treatment for cuts. Unfortunately for the patient, no anaesthetic was available at the time, so they had to bite on a stick or leather strap. Rum or opiates might have been given to dull the pain, but more experienced surgeons might not want to weaken the patient by doing this. Creating medicines for any treatment was an generally an onerous task which required a high degree of knowledge.
Tools available
The medical implements available in the early 17th were limited when compared to today’s standards, but the importance of the medicine chest cannot be understated. To get his hands on one Blackbeard even blockaded the city of Charles Town in 1718. The contents of the medicine chest needed to be meticulously maintained and mixed by the surgeon, these included: concoctions, tinctures, ointments, herbs, oils, and even mercury for the erroneous treatment of syphilis. The available tools included knives, razors, saws, cauterizing irons, forceps, spatulas, syringes, and needles. Tourniquets were used to stem bleeding while wooden prosthetics and eye patches might have been used for limb and eye injuries. The importance of the cleaning and oiling of tools was well known at the time, but risk of infection was still high. The surgeon himself usually operated out of a special cabin called the cockpit, which was situated near a hatchway for easy access and below the waterline so it was safe from cannon fire.
Pirate surgeons
In the time of buccaneers and privateers it could prove lucrative to be a ships surgeon, but later it was less worthwhile and surgeons often had to be forced to serve, although they were normally treated well. Willing surgeons included Alexander Exquemelin, who learned the trade by assisting a surgeon while an indentured servant and Richard Browne was the successful surgeon of Henry Morgan on his flagship Oxford. Those who were forced onto a pirate ship included Peter Scudamore, who was captured and pressed into service by Bartholomew Roberts, and John Devine, who was probably forced by Henry Avery to accompany the mutineers when they seized the ship Charles II. Whether willing or unwilling, the surgeon was an essential and respected member of a pirate crew.
The more information on pirate surgeons and medicine at sea check out the extensive website The Pirate Surgeon’s Journals. You can find more information about diseases rampant at the time in the article Infectious Diseases in History at the Urban Rim website. It is also worth reading the following two interesting articles on the topic: Medicine at Sea on Cindy Vallar’s Pirates and Privateer site and Pirate Medicine on Tobias’s Gibson’s Pirates of the Caribbean site. I also recommend watching the informative video by Gold and Gunpowder below.