Abstract
Nineteenth-century admission records to the St. John’s General Hospital have recently been made available for analysis. Records are extant from 17 May 1886 to 30 December 1899, and of the 5,995 admissions during this period, it was possible to identify 294 unique male merchant seafarers. Individuals were most frequently admitted due to traumatic conditions, respiratory diseases, and sexually transmitted infections, results which resonate with previous historical studies of seafaring health. Cross-referencing individual seafarer’s hospital admissions with crew list agreements from the Registrar General for Shipping and Seamen allowed for an examination of time spent in port before hospital admission, which provides a unique contribution to the historical literature on the health of the maritime workforce. This research sheds light upon the healthcare experience of merchant seafarers in the key port city of St. John’s, Newfoundland and Labrador, emphasizing the value of hospital records in broader studies of occupational risks and hygiene.
Merchant seafarers of the nineteenth century were heavily administered workers, and reams of data are available regarding pay, journey routes, ranks and, in many unfortunate cases, the causes of their deaths. While summary mortality statistics appeared in the British House of Commons Papers, the Medical Officer of Health for the City of London noted in 1902 that ‘there is unfortunately no reliable record of sickness in the Mercantile Marine’. 1 Reports published by the Seamen’s Hospital Society (SHS) from 1876 to 1906 summarized medical issues affecting the merchant seafarers admitted to SHS hospitals, such as the Dreadnought (Seamen’s) Hospital in Greenwich, London. 2 Dr. John Curnow and W. Johnson Smith, surgeon and physician of the Dreadnought respectively, described the range of medical cases admitted during the 1880s, with traumatic accidents and venereal disease identified as major concerns. 3 Contemporary Canadian hospitals in Quebec, Saint John, and Halifax identified rheumatic complaints, venereal disease, tropical fevers, and the effects of exposure as major medical risks to seamen, in addition to accidents caused by falls, handling cargo, and faulty machinery. 4 Details concerning merchant seafarer morbidity and health care experience are scattered between port hospital registers, ship surgeons’ journals, Port Sanitary Authority records, and notes in ships’ logbooks. While some recent scholarship has focused upon merchant seamen’s health, drawing upon sources such as newspaper reports and Seamen’s Hospital Society publications, it remains a vein ripe for exploration. 5
Through cross-referencing the hospital admission registers from the St. John’s General Hospital in St. John’s, Newfoundland, with crew agreements and log books from the Registrar General of Shipping and Seamen (RGSS), it becomes possible to address many questions concerning the morbidity of nineteenth-century merchant seafarers. For what conditions were merchant seafarers seeking care? How long did those individuals stay in hospital? To what extent was the length and type of health care received determined by the pressures of the merchant service? Examining the institutional journeys of individual seafarers allows a new question to be asked: how long had an individual been in port before they sought care? Once these contextual questions are addressed, it is possible to reflect in a more nuanced manner upon the embodiment of risk merchant seafarers accepted by choosing to work at sea.
It was clear to contemporaries that seafaring was a dangerous occupation, yet few transatlantic voyages were serviced by a surgeon. In the absence of an actual ship’s surgeon, Dr. Harry Leach’s Ship Captain’s Medical Guide was carried aboard all merchant ships following the 1867 Merchant Shipping Act (30 & 31 Vict. c. 124 SS 4-5), while the requirement to carry medicines aboard was introduced in 1844. 6 The Medical Guide outlined how incidents could ‘best be treated by a non-professional man’, recognizing that the ship’s Master or Mate would be responsible for providing medical care. 7 Captain Froud of the Shipmasters’ Society reported in 1893 that 425 foreign-going ships had surgeons aboard, leaving 5,600 vessels without qualified medical personnel; Gorski estimates that only one in 12 casualties received trained medical care. 8 The care found in port, then, was the first qualified medical attention received by most merchant seafarers, though they were not entitled to care in Royal Naval hospitals. 9 In St. John’s, the Royal Naval Hospital functioned until the early 1800s, while the Military Hospital closed in 1870 when the garrison was removed from Newfoundland. 10 Members of both the Royal Navy and merchant marine, therefore, sought care at the St. John’s General Hospital in the late nineteenth century. A seafarer could be hospitalized if ‘he [was] employed, suffered from a disability contracted in the service of his vessel, and sought medical attention with the permission of his shipmaster’. 11
Seafarers at the St. John’s General Hospital
Admission records for the St. John’s General Hospital are extant from 17 May 1886 to 30 December 1899. 12 During the period of study there was a total of 5,995 admissions to the hospital, 294 of which were males employed in the merchant service (six were admitted twice, hence the 300 admissions); the majority of the remaining individuals were from Newfoundland and Labrador. Information on the health and welfare of merchant seafarers may be gleaned through the use of published employment records from the RGSS, such as crew agreements, logbooks and employment books. 13 The Maritime History Archive (MHA) at Memorial University curates approximately 75% of the surviving crew agreements and logbooks from 1863 to 1939. 14 There are also, however, crew agreements scattered in regional archives across Britain in addition to the holdings of The National Archives and National Maritime Museum. 15
Table 1 displays the total annual admissions to the St. John’s General Hospital and the proportion comprising merchant seafarers. Merchant seafarers constituted 5.0% of the overall hospital admission sample, with a range from 0.6 to 13.6% of the annual admissions. Further studies of occupational hygiene are limited since the record keepers did not reliably record individuals’ occupations after early 1890, a fact that likely explains the decline in identifiable admissions after 1889.
Annual admissions to the St. John’s General Hospital, 1886–1899.
Admissions for 1886 are only available from May to December.
Source: The Rooms, Newfoundland and Labrador Provincial Archives, Admissions May 1886–December 1899, 10.01.001.
Nationalities/places of birth are listed for most inpatients. Table 2 displays the declared nationalities of merchant seafarers seeking medical care. The majority of individuals were from the British Isles (51.4%), while 21.4% were from Newfoundland and Labrador, and 19% originated in Europe. In the majority of cases where an individual could be matched to a particular vessel the ship was British; however, one Norwegian-registered vessel, the S.S. Björgvin, sent one individual dying of a fractured skull, Alfred Christensen, to the St. John’s General Hospital in 1899.
Nationalities/places of birth of merchant seafarers admitted to the St. John’s General Hospital, 1886–1899.
Source: The Rooms, Newfoundland and Labrador Provincial Archives, Admissions May 1886–December 1899, 10.01.001.
Figure 1 displays the age distribution of the admitted individuals; there was a range in age from 14 to 72 years. RGSS statistical reports of deaths at sea organize the ages of deceased seafarers from ‘below 20’ to ‘above 60’. 16 In Atlantic Canada, most seafarers entered the profession as young men and left in their late 30s or 40s, though the age of officers rose over the nineteenth century; ‘by the 1880s a majority of officers were over thirty and after 1890 seven out of ten officers. . .was over thirty’, a change David Alexander attributes to fewer young men joining colonial vessels in the late nineteenth century. 17 Seafarers of varied occupations appear as hospital inpatients, including able-bodied seamen, mates, cooks, engineers, firemen, carpenters, donkeymen, and stewards.
Age distribution of seafarers admitted to the St. John’s General Hospital, 1866–1899 (%).
Reasons for admission
Merchant seafarers were made inpatients for a wide array of medical and surgical reasons. The broad admittance categories in Table 3 are adapted from Risse’s landmark study of the Royal Infirmary at Edinburgh, Leach’s Ship Captain’s Medical Guide, and the Cause of Death returns from the House of Commons, in order to organize the data into meaningful comparative categories without imposing modern nosology on historical diagnoses. 18 Risse notes that physicians’ diagnoses are ‘diagnostic labels’, cautioning acknowledgment that retrospective diagnoses must be considered in their period context. 19 Dr. Charles Crowdy and Dr. Henry Shea were resident medical superintendents at the St. John’s General Hospital during the period covered by the admission registers. Crowdy was trained in England and Shea in Dublin; Shea is known for introducing cutting-edge nineteenth-century surgical techniques to Newfoundland, such as antiseptic surgery and laparotomy operations. 20 Accordingly, the diagnoses appearing in the hospital records should be assumed to be the most up-to-date assessments possible for the period.
Comparative summary of reasons for admission between merchant seafarers and Newfoundland and Labrador males.
denotes statistical significance.
These categories have been combined due to the frequent admittance for conditions such as ‘retention of urine’, ‘calculus of urethra’ and ‘urethral stricture’, which are likely to be symptoms or disease sequelae of sexually transmitted infections. This grouping also includes diagnoses of syphilis, gonorrhea, venereal disease and gleet.
Source: The Rooms, Newfoundland and Labrador Provincial Archives, Admissions May 1886–December 1899, 10.01.001.
Table 3 compares the merchant seafarer reasons for admission with those of the overall male inpatient sample (not including the merchant seafarers). Z-scores for population proportion tests (p < 0.05) were conducted to tease out any significant differences between the two groups when comparing the categories of admission. These tests revealed that the seafaring inpatients were significantly more likely than the Newfoundland males to be hospitalized for fevers, sexually transmitted infections (STIs), and trauma. 21 In contrast, the Newfoundland male inpatients were significantly more likely to be in hospital for musculoskeletal disorders, tuberculosis, tumours/cancers, and miscellaneous surgical reasons. 22
These results emphasize the occupational and environmental hazards affecting the seafarers. Acute trauma and fevers outweigh the chronic issues, such as cancerous growths and tuberculosis, that plagued the male residents of Newfoundland. The comparatively high admission of cases due to fevers, STIs, and trauma aligns with the historiography concerning the health of merchant seafarers; Cook similarly notes that fever diseases and venereal disease were more common in seafarers admitted to the Dreadnought than the general English population between 1870 and 1914. 23
Fever diseases were identified either as general categories (i.e., fever, febricule) or specific diagnoses such as typhoid and malaria (i.e., intermittent fever, ague), though the number of cases is probably not representative of the true effects of fever disease in the population since fever cases in St. John’s were routed to the Fever Hospital from the 1870s. 24 Charles Clayton, a 27-year-old English fireman was admitted to the St. John’s General Hospital with ‘malarial fever’ on 30 September 1898 and convalesced for two weeks, in which time he was discharged from the Ethelaida. 25 The ship had docked at Saint Vincent, Cape Verde, from 5–23 August 1898, an area that today still recommends antimalarials for travellers. 26
The late nineteenth century witnessed many landmark discoveries in infectious disease medicine, such as malaria’s means of transmission and the cause of typhoid. 27 The first successful use of quinine as a prophylactic against malaria occurred in 1854, 28 and it was understood through observation that ‘the risk of contracting malaria was increased as ships got closer to shore, even greater if sailors and marines went ashore and greatest of all if they slept ashore overnight’. 29 The terrible effects of infectious and tropical diseases upon the health of the Royal Navy drove the founding of the original Royal Naval Hospitals. 30 Though the Dreadnought Hospital saw 1,546 cases of ‘ague’ between 1875 and 1905, only 0.2% were fatal, while cases of ‘enteric fever’ (most of which were likely typhoid or paratyphoid) in the same period had a fatality rate of 10.8%. 31
Merchant seafarers admitted to the St. John’s General Hospital for STIs convalesced for an average of 14 days before discharge; most individuals were discharged as ‘Cured’ or ‘Relieved’. Only one case was labelled ‘Not fit case for Hospital’. The high rate of STIs is not a surprising result. Hall notes that ‘epidemiologically speaking, a seaman, being an unattached male in the prime of life with high mobility, was in a high risk group for sexually-transmitted diseases’. 32 Indeed, venereal disease – an umbrella term encompassing syphilis and gonorrhea – was characterized as the ‘chief and most enduring scourge of seamen in all parts of the world’, ‘the bane of the mercantile marine service’, and deemed a self-inflicted condition. 33 Analysis of the Dreadnought Hospital admissions between 1875 and 1905 revealed such high numbers of serious and chronic venereal disease cases (admitted for syphilis, gonorrhea, leg ulcers, and urethral stricture) that the Committee of Management was forced to rule against the admittance of patients who presented with only primary syphilis, accepting only the worst or disabling cases. 34
Traumatic admissions to the hospital comprised a variety of injuries, including fractures, wounds, contusions, cuts, burns, frostburn, gunshot wounds, and nonspecific injuries. The lower limb was the most common anatomical region affected by trauma (44.6%), followed by the shoulder and chest (24.6%), head (16.2%), and upper limb (14.9%). These results echo the hospital muster records of the Haslar, Plymouth, and Greenwich hospitals from the late eighteenth and early nineteenth centuries, in which 60.2% of all recorded fractures were to the long bones – leg (29.4%), thigh (16.3%), and arm (14.5%). 35 In the St. John’s General Hospital records, 66.6% of recorded fractures are found in the long bones: leg (43.3%), thigh (10.0%), and arm (13.3%). Similar to the St. John’s results, the Royal Naval skeletal assemblage was found to have higher fracture rates than contemporary civilian assemblages. 36
Accidental trauma was a major occupational hazard to merchant seafarers. While drowning was the most frequent cause of accidental deaths, falls from the rigging to the deck or through a ship’s hatch into the hold were major dangers. 37 Fingard highlights three categories of accidents that befell seafarers: falls, accidents resulting ‘from loading and discharging cargo and from using faulty or improperly handled machinery’. 38 Boston and colleagues, in a study of the skeletal remains of 97 males who served as sailors or marines in the Royal Navy during the eighteenth century, found that 84.5% had at least one fracture. 39 The authors proposed that occupational hazards to the sailors, such as falls and swinging booms were likely causes of many of the fractures.
Investigating individual health journeys
Marrying crew agreements with hospital admittance records allows for an examination of the time spent in port by individual seafarers before they became inpatients. In many cases, the admission registers indicated an individual’s ship of employment. Through the Crew List Index Project website, it was possible in 36 cases to match and consult the crew agreement referring to one of the inpatient seafarers. Positive matches were confirmed if the name of the seafarer and his reported age (within two years) were a match and if the recorded dates of a vessel’s time in St. John’s corresponded with the date of the seafarer’s admittance to the hospital. 40 Twenty-nine of these comparisons yielded the length of time between a ship’s arrival and an individual’s admittance to hospital, ranging from zero to 163 days. Table 4 shows that 16/29 (55.2%) individuals were admitted to hospital within three days of arrival, while the other 13/29 (44.8%) entered hospital between six and 163 days after arrival. These delayed admissions, except where noted, are suggestive of illnesses and injuries contracted or suffered in port.
Seafarers identified in hospital admission register and crew agreements.
AB = Able-Bodied Seaman; **OS = Ordinary Seaman.
Source: The Rooms, Newfoundland and Labrador Provincial Archives, Admissions May 1886–December 1899, 10.01.001.
Patients’ illnesses or injuries were differentiated according to whether or not they were developed or suffered in service to the ship. This difference was critical – a seafarer unable to perform his duties due to injury or illness received not in service of the ship was in danger of having his wages withheld, and of being discharged in St. John’s with a less than stellar exit certificate. Venereal disease and injuries sustained while drunk were considered self-inflicted. 41 In the present sample, injuries received in service of the ship (determined either because this was explicitly stated, the seafarer entered hospital the day the ship arrived in St. John’s, or if seafarer was described in the crew agreement with the acknowledgement that his wages had been paid to him) include salt water boils, a leg injury, two fractured femora, a fractured radius, a set of fractured ribs, a scalp wound, and a sore toe. The fractured ribs and scalp wound were suffered by George Porter and Peter Callaghan, respectively, two Firemen of the Ethelaida, three days before the ship reached St. John’s, on 22 September 1898. Both men were admitted to the hospital the following day and discharged before the Ethelaida departed for Rotterdam on 7 October 1898 with their wages paid to them. 42
Certain environmental maladies were identified in both the crew agreements and hospital records, such as the case of William Reid, laid low by salt water boils. This affliction is described in detail in Jones’s The Cape Horn Breed: The constant chafing of the oilskin cuffs, on wrists wet and salt-grimed, caused every man in the ship, after a week or two, to develop painful boils on the wrists, for which there was no prevention or cure. Bandages were useless, as they were quickly saturated and dried hard with the salt deposited in them by the sea-water, this being more painful than to leave the boils exposed to further fraying from the sharp cuffs. The skin peeled off, leaving raw and lacerated flesh to be stung by the salt water, a severe physical irritation which soon became a mental obsession, making the sufferer short-tempered.
43
Reid, the 26-year-old Scottish cook aboard the Fair Wind in 1893, was discharged to recover in hospital for seven days. 44
In contrast, Alexander Cruden, a 30-year-old American waiter serving aboard the Portia, suffered a fractured tibia and fibula, noted as ‘not received in service of ship’, 45 and was discharged in St. John’s to spend 52 days as an inpatient. In contemporary clinical studies, incidents that damage both lower leg bones generally result from falls from a height or motor vehicle accidents; the fibula’s anatomical position makes it particularly prone to fracture due to direct force. 46 The lack of further clinical details shrouds both the proximate (mechanical) and ultimate (cultural) causes of the fracture in uncertainty. Was Cruden involved in a scuffle? Did he simply slip and fall? Bones can break in sober and inebriated people due to accidental falls or incidents in which an individual is pushed. Without further details it can only be concluded that Cruden had an unfortunate accident that affected his immediate employment.
Spanish seafarer Albert Delaserma of the S.S. Gloriana was admitted to hospital with frostburn not received in ship’s service on 2 January 1899, two days after arrival, and discharged to St. John’s, spending 21 days as an inpatient. 47 Average January temperatures in Newfoundland hover below freezing and the frequent, punishing winds off the ocean drive down the temperature with windchill; at just -10 degrees Celsius there is a risk of hypothermia and frostbite. 48 His discharge without pay suggests this incident of exposure was the result of Delaserma’s behaviour in port. No further information is available concerning his convalescence, but frostburn could end seafaring careers. The only treatment for frostburn aboard a ship was to ‘wrap the injured parts in bandages smeared with vaseline, and hope for the best’. 49 Frostburned fingers and toes often resulted in gangrene and the loss of the digits. Inflamed hands were useless for holding oneself aloft on a ship or handling ropes; swollen toes and feet often could not be stuffed back into workboots. Injury due to inappropriate clothing was deemed irresponsible: ‘we have seen numerous instances of men joining a ship in a foreign port in the thinnest of clothing, which is soon worn to rags, and is quite unsuitable for the cold weather he encounters on reaching colder latitudes. . . illness, rheumatism, thoracic inflammations, and the like, are often directly due to this cause’. 50
Respiratory illnesses were an issue amongst individuals stationed in St. John’s. Four individuals were admitted with respiratory illnesses deemed to have been contracted on shore. Two Norwegian Able-Bodied Seamen, 22-year-old Ole Olson and 20-year-old Anrilo Kristensen of Barque Fanny, were admitted with influenza 16 days after arriving in port (13 January 1894), while 50-year-old Able-Bodied Seaman James Adams of the Cordelia spent 24 days in port before being admitted with bronchitis on 9 October 1896. John Henderson, 34-year-old Mate of the Assyrian was admitted for pneumonia 31 days after arrival (6 July 1896). 51 Despite being discharged to St. John’s for illness not sustained in service of the ship, Henderson was later re-engaged as Mate, demonstrating that injuries or illnesses were not necessarily grounds for permanent removal from the workforce. An increasing focus upon sanitation and ventilation through the nineteenth century, particularly accompanying the growing number of steamships, is a reflection of ‘the notion that all seafarers were partially responsible for their own health’. 52 Respiratory issues were understood to be the result of ‘exposure to the cold and damp’. 53 The Merchant Shipping Act of 1850 dictated that each seaman was to have nine superficial feet of personal space, while the Act of 1867 increased this to 12 superficial feet, with the further dictates that ‘quarters should be lighted, ventilated, protected from weather and. . .shut off from effluvia’. 54 These prophylactic measures may have decreased the incidence of infection onboard, but not from seafarers’ exposure to infectious agents on shore.
Fingard’s exploration of hospitals which cared for seamen in Canadian port cities contributes a binary interpretation of sickness and accidents that might befall an individual: ‘those brought to the north Atlantic ports from the seaward and those that occurred on board the moored vessel as a result of duties performed in port’. 55 It is clear from this investigation that a third, equally important, option is required to expand discussions of seamen’s occupational risks: the sickness and accidents that might be received or suffered in port not in service of the ship.
Bodies in history
This study of historical health creates an ideal space in which to foreground the body as an object of study. Historical and anthropological works discuss the complexity of characterizing the body, describing it as ‘at once the most solid, the most elusive, illusory, concrete, metaphysical, ever present and ever distant thing – a site, an instrument, an environment, a singularity and a multiplicity’, something to be queried for ‘its dangers and its disciplines, its potential for pollution’. 56 Embodiment, as defined by social epidemiologists, is the ‘cumulative interplay between exposure, susceptibility and resistance’. 57 Embodiment is literal; bodies tell stories of ‘spatial, temporal, and multilevel processes’. 58 A seafarer’s body, then, was a canvas upon which myriad risks and exposures might be layered. But the seafarer’s physical body is also present in the current study, described in the primary sources consulted as an injured or diseased object. The body of a merchant marine is certainly a potential site of ‘memory, agency and subjectivity’, 59 but the hospital records allow us to actively engage with the lived experience of a seafarer as we ‘follow the concept of “the body” and specific bodies from the workplace to the. . .hospital’. 60
Accessing expressions of individuals’ bodily experience and attempting to understand how people actually felt about their bodies is a key aspect of exploring embodied histories.
61
The crew agreements and logbooks infrequently provide details concerning individual patients. E.C. Higman (Master) and Nicholas Gunn (Mate) described the suffering of one Samuel Atkinson, a 19-year-old Able-Bodied Seaman from Norwich in the logbooks of the Sparking Glance:
62
I hereby reduce the wages of S. Atkinson to £2.10 per month for inability + unwillingness to perform his duties, also for being impudent to the Mate + Master on several occasions, particularly the night of the 14th July 1896, when it being his watch on deck the Mate could not find him to haul braces, when found was in the forecastle, from 4AM to 8AM it being his watch on deck he remained in his bed. I asked him the reason, he said that he suffered from rheumatism, and intended to look out for himself.
Samuel Atkinson have been in the forecastle, with swollen feet + pain in the limbs for two days. viz the 12th-13th of Aug.st had his limbs rubbed with Turpentine linament, to-day he being sick, I took him to Doctor Harvey who examined him + sent him to the General Hospital where he now is.
Atkinson’s insistence that he will ‘look out for himself’ despite the financial consequences can be taken as an indication of the intensity of the rheumatic pain he suffered. He refused to work from 16 July 1896, when the Sparkling Glance was still three weeks from arriving in St. John’s. Rheumatism, or ‘sailors’ curse’, 63 was a common complaint among seafarers. The Ship Captain’s Medical Guide states that rheumatism ‘may, in most cases, be prevented by dry berths and dry warm clothing. It is far safer to sweat from heat than to shiver from cold, whether in cold, temperate, or tropical latitudes’. 64
Seafarers’ labouring bodies have been examined for their masculinity, their mortality and their sexuality. 65 This research proposes problematizing a seafaring body as a potentially healing body. Overall, a seafarer inpatient spent an average of 18.7 days in the St. John’s General Hospital. Inpatient stays ranged from one day (cases of minor muscle strains, contusions, and sore throats) to 140 days for 49-year-old Charles Thomas’s fractured femur.
Table 5 displays the top five most common reasons for admission with their associated outcome or reason for discharge. Patients were declared ‘Cured’ or ‘Convalescent’, a category that includes those noted as being ‘Relieved’ or made outpatients. Discharged/Sent Away includes those labelled ‘Unfit for Hospital’, and individuals who discharged themselves or were sent to another specialist institution for treatment in St. John’s, such as the Fever Hospital or the Waterford (for mental conditions). Patients also died, though the death rates were low, at 4.3%. 66 In nearly one quarter of cases, there was no outcome listed for patients.
Five most common reasons for admission with medical outcomes.
STI = sexually transmitted infection; MSK = musculoskeletal.
Source: The Rooms, Newfoundland and Labrador Provincial Archives, Admissions May 1886–December 1899, 10.01.001.
The concept of being ‘cured’ in historical hospital records has been used for patients ‘who appeared to be on the mend’. 67 The hospital registers, for example, record an individual who was admitted for syphilis and discharged as ‘cured’ one week later. Though clearly not cured in a modern clinical sense, this individual probably displayed evidence of vast improvement. It was recognized that those exposed to STIs in a port city may be ‘suffering from some form of these diseases or their sequelae, and do not recover till the voyage is far advanced. . .some apply for treatment from the captain, others conceal their state. . .the sufferers are often for many months without any adequate medical aid’. 68 A ship was, therefore, a likely place to find infectious diseases in various active or latent states.
Considering those in the ‘Cured’ and ‘Convalescent’ categories together provides a more general, but likely more accurate picture of individuals who were responding well to medical treatment. Of the total seafarer sample, 62.0% are recorded as either cured or convalescent, indicating that some clear marker of improvement was observed in these cases, but not necessarily indicating a full recovery. Getting seafaring males back on their feet without delay was the explicit desire of George Busk FRS, surgeon aboard the hospital ship Dreadnought. He explained that the goal was to get ‘the men well as fast as [possible], and to get rid of them’. 69
Those admitted for fractures at the St. John’s General Hospital stayed an average of six weeks. This is enough time for significant bony healing to have taken place, but suggests that some seafarers were boarding their ships with incompletely healed injuries. 70 Fracture healing times depend upon the anatomical location (in addition to an individual’s age and overall health status); the distal end of the radius may be close to healed in three to four weeks, while a femoral fracture requires eight to 14 weeks. 71 Some individuals, such as German seafarer Joachim Nierendorg, did not convalesce in the hospital; he was admitted with a fractured humerus and forearm, but according to the admission register was ‘taken on board his vessel’ only six days later. 72 Similarly, Alexander Wilson, an Able-Bodied Seaman of the Corisande, was admitted to hospital with a fractured radius and ulna on 22 August 1896 and discharged on 27 August 1896, the same day the ship set sail. 73 Clearly Wilson was judged able to work with a stabilized, but unhealed injury.
A seafarer’s body, as viewed through the admission records and crew agreements, is liminal three times over. First, a sick body in hospital suffering from a non-fatal injury or illness is betwixt and between, not dead, but not fit for sea. Second, seafarers in foreign ports were outsiders, with complex relationships with port cities’ sailortowns. 74 Finally, hospitals themselves are collections of liminal spaces. 75 Seafaring bodies may then be viewed as kaleidoscopic sites of risk: as potential vectors for infectious disease, as objects in constant motion, as individuals working through pain, and as the inscriptive site for the inherent risks of seafaring such as accidents and exposure. Working bodies, then, are ‘always in the process of being created and recreated’ through the activities of a life at sea, 76 just as their cells might literally be knitting together fleshy wounds and insults to bone. Investigating morbidity, through an examination of primary sources, adds nuance to considerations of merchant marine health.
It is critical to note, however, that seafarers were not passive spectators to their bodies. Sager notes that in previous studies ‘the sailors of our past have suffered not so much from neglect as from condescension’, as they have been characterized as ‘helpless victims of landward predators, or victims of their own moral and economic weakness’. 77 He notes the high retention rate of crew evidenced in his analysis of 182,661 vessels registered in Atlantic Canada from 1863 to 1912: one in five seafarers ‘had chosen to work in the same vessel in which he had worked on his previous voyage. . .one in every three sailors had previously served in a British North American vessel’. 78 This retention should be interpreted as a marker of active choices being made by seafarers to embrace ‘the risks inseparable from a sailor’s life’. 79
Conclusion
Seafarers inhabited risky spaces on board, where damp and crowded forecastles might impede healing or exacerbate existing conditions, and on shore, where myriad temptations were on offer. The seafarer has been characterized as an individual ‘who had more in common with his fellow seafarers from other lands than with many of his own fellow countrymen’; 80 the hospital registers support this – seafarers were more likely to seek admittance for trauma, STIs, and respiratory illnesses than the Newfoundland male inpatients. Seafaring bodies are complex canvases upon which much can (and should) be written. These labouring bodies present tripartite liminality: sick, on shore, in hospital. Once aboard, a sick body might remain unwell; the physiological strain of healing should be considered in future studies of merchant marine health. The scattering of datasets – logbooks, crew agreements, port hospital records – results in a challenging research landscape. It is clear that health data must be targeted if meaningful patterns are desired rather than anecdotal evidence.
It would be to our detriment to consider seafarers as a monolith, as consultation of these documents, in some instances, allows the voices of past individual seafarers to be wholly present. One such example is 16-year-old Horace Mapplebeck, an apprentice aboard the Sparkling Glance, who journeyed from Glasgow to Newfoundland from July to August 1896. When queried why he had not followed the mate’s order to scrub the ship’s hull stated his most human medical case: ‘[b]ecause I did not feel well & want to go home’. 81
Footnotes
Acknowledgements
The research that underpins this article was supported by the Social Sciences and Humanities Research Council of Canada in the form of a Banting Postdoctoral Fellowship [201609BPF-380106-285306]. My thanks are due to the Maritime History Archive (Memorial University), particularly to Kory Penney. Many thanks to The Rooms, the National Archives (UK), National Maritime Museum, Somerset Archives, Liverpool Record Office, Whitehaven Archive, Northumberland Archives, Cornwall Record Office, Kent Archives, Southampton Archives, National Archives (Wales), Dorset History Centre, Flintshire Record Office, Glamorgan Archives, Bristol Archives, Cheshire Archives, and Gloucestershire Archives. Thank you to the Marine Studies Research Unit at Memorial University and in particular to Dr. Valerie Burton for her support and enthusiasm for this work. Many thanks to Jonathan Boffey for his research assistance and to Dr. Shannon Lewis-Simpson for her comments on an early draft.
1.
W. Collingridge, ‘Health in the Marine Service’, in Thomas Oliver, ed., Dangerous Trades: The Historical, Social, and Legal Aspects of Industrial Occupations as Affecting Health, By a Number of Experts (London, 1902), 183.
2.
William J. Smith, ed., A General Report of the Cases Under Treatment at the Seamen’s Hospital, Greenwich, Together with an Analysis of the Medical (and Surgical) Cases (Greenwich, 1876–91); William J. Smith, ed., A General Report of the Cases under Treatment at the Hospitals and Dispensaries of the Seaman’s Hospital Society Together with All Analysis of the Medical and Surgical Cases (Greenwich, 1892–5); Anonymous, Tables of Cases Under Treatment at the Hospitals and Dispensaries of the Seamen’s Hospital Society (London, 1897–1906).
3.
J. Curnow and W. J. Smith, ‘Naval and Military Hygiene: Statistics of Medical Cases Admitted into the Seamen’s Hospital, 1880–9’, Lancet, ii (1891), 452.
4.
Judith Fingard, Jack in Port: Sailortowns of Eastern Canada (Toronto, 1982), 108, 110.
5.
Gordon C. Cook, Disease in the Merchant Navy: A History of the Seamen’s Hospital Society (Oxford, 2007); Tim Carter, Merchant Seamen’s Health 1860–1960: Medicine, Technology, Shipowners and the State in Britain (Woodbridge, 2014).
6.
A. G. Course, The Merchant Navy: A Social History (London, 1963), 214.
7.
Harry Leach, The Ship Captain’s Medical Guide, 2nd ed., (London, 1868), vii.
8.
Froud’s comments: TNA, MT 9/664 File M. 1458/1901 (M.11853); R. Gorski, ‘Health and Safety Aboard British Merchant Ships: The Case of First Aid Instruction, 1881–1908’, in R. Gorski, ed., Maritime Labour: Contributions to the History of Work at Sea, 1500–2000 (Amsterdam, 2007), 166.
9.
C. Lloyd and J. L. S. Coulter, Medicine and the Navy 1200–1900 (London, 1963), 300.
10.
Paul O’Neill, The Oldest City: The Story of St. John’s Newfoundland (Portugal Cove, 2003); J. Candow, The Lookout: A History of Signal Hill (St. John’s, 2011), 24–5, 30.
11.
Fingard, Jack in Port, 115.
12.
The Rooms, Newfoundland and Labrador Provincial Archives, Admissions May 1886–December 1899, 10.01.001.
13.
14.
Valerie Burton, ‘Sourcing Maritime History Over Four Decades: Crew Agreement Scholarship at Memorial University Newfoundland’, International Journal of Maritime History, 31 (2019), 308–329.
15.
See the ‘Acknowledgements’ section at the end of this article for a comprehensive list of archival repositories consulted.
16.
For example, see the ‘Return Showing the Number, Ages, Ratings, and Causes of Death of Seamen Reported by Board of Trade as Having Died in the British Merchant Service During the Year 1867’, Nineteenth Century House of Commons Sessional Papers, 1867–68, LXIII, 281.
17.
Eric Sager, Seafaring Labour: The Merchant Marine of Atlantic Canada, 1820–1914 (Toronto, 1989), 138, 146; David Alexander, ‘Literacy Among Canadian and Foreign Seamen, 1863–1899’, in Rosemary Ommer and Gerald Panting, eds., Working Men Who Got Wet (St. John’s, 1980), 7, 11.
18.
Guenter B. Risse, Hospital Life in Enlightenment Scotland: Care and Teaching at the Royal Infirmary of Edinburgh (Cambridge, 1986), 124; Leach, Medical Guide, ix–xii.
19.
Risse, Hospital Life, 119–124; See also: J. Arrizabalaga, ‘Problematizing Retrospective Diagnosis in the History of Disease’, Asclepio, 54 (2002), 51–70; Piers D. Mitchell, ‘Retrospective Diagnosis and the Use of Historical Texts for Investigating Disease in the Past’, International Journal of Paleopathology, 1 (2011), 81–88.
20.
Nigel Rusted, Medicine in Newfoundland c. 1497 to the early 20th century (St. John’s, 1994), 26, 91.
21.
Fevers (z = 5.7523, p–value < 0.00001); STIs (z = 3.2166, p–value = 0.00128); trauma (z = 4.6764, p–value < 0.00001).
22.
Musculoskeletal (z = −1.9732, p–value = 0.04884); tuberculosis (z = −3.5495, p–value = 0.00038); tumors/cancer (z = −3.8614, p–value = 0.00012); miscellaneous surgical (z = −2.5634, p–value = 0.01046).
23.
Cook, Disease in the Merchant Navy, 374–5.
24.
Katherine Daley, Health Services in Newfoundland and Labrador Timeline 1662–2004 (St. John’s, 2004), 36.
25.
Memorial University of Newfoundland, Maritime History Archive (MHA), Ethelaida ON 99136, 1898.
26.
27.
Mark S. Bailey, ‘A Brief History of British Military Experiences with Infectious and Tropical Diseases’, Journal of the Royal Army Medical Corps, 159 (2013), 154.
28.
Jürgen Knobloch, ‘Long-Term Malaria Prophylaxis for Travellers’, Journal of Travel Medicine, 11 (2004), 375.
29.
Bailey, ‘Brief History’, 152.
30.
Bailey, 150.
31.
Cook, ‘Disease’, 463.
32.
Lesley A. Hall, ‘What Shall We Do With the Poxy Sailor?’ Journal for Maritime Research, 6 (2004), 113.
33.
Anonymous (known to be Harry Leach) ‘Reports on the Present Sanitary Condition of the Mercantile Marine: No. III: Accommodation; Forecastles and Deck-Houses; Scurvy in the Spanish Fleet; Clothing and Personal Hygiene; Venereal and Other Self–Inflicted Diseases’, The Lancet, I (1867), 94; Leach, Medical Guide, 7.
34.
Cook, ‘Disease’, 465.
35.
Ceridwen Boston, ‘The Value of Osteology in a Historic Context: A Comparison of Osteological and Historical Evidence for Trauma in the Late Eighteenth to Early Nineteenth Century British Royal Navy’ (Unpublished PhD thesis, University of Oxford, 2014), 271–2.
36.
Boston, ‘Osteology’, 265–6.
37.
Sager, Seafaring Labour, 225.
38.
Fingard, Jack in Port, 110.
39.
Ceridwen Boston, A. Witkin, A. Boyle and D. R. P. Wilkinson, “Safe Moor’d in Greenwich Tier”: A Study of the Skeletons of Royal Navy Sailors and Marines Excavated from the Royal Hospital Greenwich (Oxford, 2008), 40.
40.
Age heaping was a concern in these records; Whipple’s index was calculated to assess the data quality. The resulting index of 140 indicates that there would be an expected inaccuracy in the reporting of ages. A matched age was therefore considered a less critical source of evidence than a matched individual’s name, ship name and ship dates in St. John’s harbour. Whipple’s index resources: Colin Newell, Methods and Models in Demography (London, 1988); United Nations, Methods of Appraisal of Quality of Basic Data for Population Estimates, Manual II (New York, 1955); Crew List Index Project, 
[accessed 13 March 2019].
41.
Carter, Seamen’s Health, 19.
42.
MHA, Ethelaida, ON 99136, 1898.
43.
William Herbert Sidney Jones, The Cape Horn Breed: My Experiences as an Apprentice in Sail in the Full-rigged Ship ‘British Isles’ as told to P. R. Stephensen (New York, 1956), 73–5.
44.
MHA, Fair Wind, ON 73908, 1893.
45.
MHA, Portia, ON 91149, 1897.
46.
V. L. Wedel and A. Galloway, eds., Broken Bones: Anthropological Analysis of Blunt Force Trauma, 2nd ed. (Springfield, 2014), 288.
47.
MHA, Gloriana, ON 106988, 1899.
49.
Jones, Cape Horn, 86–7.
50.
Anonymous (known to be Harry Leach), ‘Sanitary Condition’, 94.
51.
MHA, Fanny, ON 73471, 1894; Cordelia ON 60010, 1896; Assyrian ON 82809, 1896.
52.
Elise Juzda Smith, ‘Cleanse or Die: British Naval Hygiene in the Age of Steam, 1840–1900’, Medical History, 62, No. 2 (2018), 189.
53.
Smith ‘Cleanse or Die’, 191.
54.
Course, Merchant Navy, 220.
55.
Fingard, Jack in Port, 108.
56.
Bryan S. Turner, The Body and Society, 2nd ed. (London, 1996), 43; Porter, ‘History of the Body’, 218.
57.
Nancy Krieger, ‘Theories for Social Epidemiology in the 21st century: An Ecosocial Perspective’, International Epidemiological Association, 30 (2001), 672.
58.
Nancy Krieger, ‘Embodiment: A Conceptual Glossary for Epidemiology,’ Journal of Epidemiology and Community Health, 59 (2005), 350.
59.
Kathleen Canning, ‘The Body as Method? Reflections on the Place of the Body in Gender History’, Gender & History, 11 (1999), 510.
60.
John F. Kasson, ‘Follow the Bodies: Commentary on “The Body” as a Useful Category for Working-Class History’, Labor: Studies in Working-Class History of the Americas, 4 (2007), 48.
61.
Roy Porter, ‘History of the Body’, in Peter Burke, ed., New Perspectives on Historical Writing (University Park, 1991), 218; S. Pilloud and M. Louis-Courvoisier, ‘The Intimate Experience of the Body in the Eighteenth Century: Between Interiority and Exteriority’, Medical History, 47 (2003), 451–472; Joan Lane, ‘“The Doctor Scolds Me”: The Diaries and Correspondence of Patients in Eighteenth Century England’, in Roy Porter, ed., Patients and Practitioners: Lay Perceptions of Medicine in Pre–Industrial Society (Cambridge, 1985).
62.
MHA, Sparkling Glance, ON 81538, 1896.
63.
Collingridge, ‘Health in the Marine Service’, 186.
64.
Leach, Medical Guide, 7.
65.
Valerie Burton, ‘“Whoring, Drinking Sailors”: Reflections on Masculinity from the Labour History of Nineteenth-Century British Shipping’, in M. Walsh, ed., Working Out Gender: Perspectives from Labour History (Aldershot, 1999), 84–101; Valerie Burton, ‘A Seafaring Historian’s Commentary on “The Body” as a Useful Category for Working-Class History’, Labor: Studies in Working-Class History of the Americas, 4 (2007), 55–59; R. Cohn, ‘Maritime Mortality in the Eighteenth and Nineteenth Centuries’, International Journal of Maritime History, 1 (1989), 159–191; R. Haines, R. Shlomowitz, & L. Brennan, ‘Maritime Mortality Revisited’, International Journal of Maritime History, 8 (1996), 133–172; Jo Stanley and Paul Baker, Hello Sailor!: The Hidden History of Gay Life at Sea (London, 2003).
66.
Compare to the Seamen’s Hospital: in 1880 5.9% of admissions resulted in death (Cook, Disease in the Merchant Navy, 376).
67.
See: Risse, Hospital Life, 230; Hannah Newton, Misery to Mirth: Recovery from Illness in Early Modern England, 1580–1720 (Oxford, 2018).
68.
Anonymous (known to be Harry Leach), ‘Sanitary Condition’, 94.
69.
Quoted in Cook, ‘Disease’, 468. Busk was speaking to the Committee on Venereal Disease in the Army and Navy (at the Admiralty) on 2 May 1865.
70.
M. Patrice Eiff and Robert L. Hatch, ‘General Principles of Fracture Care’, in M. Patrice Eiff, ed., Fracture Management for Primary Care, 3rd ed. (Philadelphia, 2011), 5–6.
71.
Y. F. Zheng, X. N. Gu, and F. Witte, ‘Biodegradable Metals’, Materials Science and Engineering, 77 (2014), 28.
72.
The Rooms, Newfoundland and Labrador Provincial Archives, Admissions May 1886–December 1899, 10.01.001.
73.
MHA, Corisande, ON 67912, 1896.
74.
Judith Fingard, ‘Masters and Friends, Crimps and Abstainers: Agents of Control in Nineteenth Century Sailortown’, Acadiensis, 8 (1978), 22–46; Valerie Burton, ‘Boundaries and Identities in the Nineteenth-Century English Port: Sailortown Narratives and Urban Space’, in S. Gunn and R.J. Morris, eds., Identities in Space: Contested Terrains in the Western City since 1850 (Aldershot, 2001), 137–151; Brad Beaven, Karl Bell, and Robert James, eds., Port Towns and Urban Cultures: International Histories of the Waterfront, c. 1700–2000 (London, 2016); Brad Beaven, ‘The Resilience of Sailortown Culture in English Naval Ports, c. 1820–1900’, Urban History, 43 (2016), 72–95; See also a challenge to the idea of sailors as ‘men apart’: Louise Moon, ‘“Sailorhoods”: Sailortown and Sailors in the Port of Portsmouth circa 1850–1900’ (Unpublished PhD thesis, University of Portsmouth, 2015).
75.
Dana Arnold, The Spaces of the Hospital: Spatiality and Urban Change in London 1680–1820 (Abingdon, 2013), 79.
76.
Julie K. Wesp, ‘Bioarchaeological Perspectives on the Materiality of Everyday Life Activities’, Archaeological Papers of the American Anthropological Association, 26 (2015), 141.
77.
Sager, Seafaring Labour, 4–5.
78.
Sager, Seafaring Labour, 139.
79.
British Parliamentary Papers, Report of the Royal Commission on the Loss of Life at Sea: Part II – Digest of Evidence (London, 1887), 82.
80.
Sager, Seafaring Labour, 11.
81.
MHA, Sparkling Glance, ON 81538, 1896.