Tag Archives: Medicine

Yellow fever, buccaneering doctors, surgical instruments from the Napoleonic War

A comment on the MARHST-L list, on which I quietly lurk, about yellow fever being a possible cause of ships found abandoned or with all crew deceased, sent me in search of confirmation via PubMed. Found a lead, via an article on illness aboard cruise ships, on a chapter in a history of naval medicine that looked promising according to the available snippets on Google Books. Further investigation will need to wait on a foray into a city with a good medical library. Along the way, I discovered an assortment of gems archived in PubMedCentral – the free archive of medical journals.

  • David Geggus considers how yellow fever, generally not a high fatality disease, caused devastating mortality in the British army in occupied Saint Domingue (Yellow Fever in the 1790s).
  • The Buccaneering Doctors (GM Longfield-Jones, 1992) who served aboard the seventeenth century privateers were valued members of the crew who could subsequently enjoy a respectable retirement or practice on land. Contemporary accounts, such as that of the wonderfully named Alexandre Oliver Esquemeling/Oexmelin (alias Henrik Barentzoon Smeeks) and William Dampier describe the hazards, hardships and medical practices of the times.
  • The successors of the buccaneers were physician-explorers such as Joseph Hooker. Botanical science was at the time an essential part of the practice of medicine, and Hooker traveled on expeditions to Antarctica and India, befriended to Charles Darwin, contributed his expertise in botany to Darwin’s developing theories, and presided at the first presentation of Darwin’s and Wallace’s work. (WE Swinton, Physicians as Explorers: Joseph Hooker, 1977, one of a series of articles).
  • JC Goddard unpacks The navy surgeon’s chest, from the time of the Napoleonic War. His conclusion: “the surgical armamentarium has changed remarkably little …”

Stories, Statistics and Survival

From the British Medical Journal Christmas issue, a fine article by Thomas B Newman on the power of stories over statistics when stories are tragic and powerfully told and statistics are predictive but just not predictive enough to tell one the absolutely right thing to do in the unique situation. As the expert, the writer-of-guidelines, he reflects on his experience …

Ironically, the more of an expert on the evidence I have become, the more difficulty I have practising according to that evidence. This is because becoming a “jaundice expert” means becoming familiar with rare but tragic stories of children with kernicterus. These stories are so powerful that it is hard to keep them from trumping other evidence in determining practice.

The Lancet has recently produced a supplement on the subject of Extreme Medicine, containing a grab-bag of articles on medicine and physiology in hostile physical environments, medicine and psychology in times of threat, war and disease outbreak, and James Thompson’s dry and informed commentary on the subject of “Surviving a Disaster” …

Survival of extreme conditions involves many factors, some of them seemingly random … And yet, there is a fascination with the character of the survivor. We are reluctant to believe that their survival was random, and we seek a moral purpose, a redeeming virtue, or an easily applicable psychological trick that we can use in our own more humdrum lives.

… It is rarely a survival advantage to be well behaved. Compliant well-mannered people, awaiting instructions on what to do, often burn passively when a rush to the door could have got them out of the plane … What journalists describe as panic is usually a sensible flight from danger, a useful survival instinct only worth curbing in the special case of a confined space with a small exit … Gawping at an entertaining disaster is usually more common and more dangerous than panic, and the real challenge is to make bystanders recognise danger and run away.