Illness & Disease
Scurvy is a disease resulting from a deficiency of vitamin C. Humans and certain animals require vitamin C in their diets for the synthesis of collagen. In infants, scurvy is sometimes referred to as Barlow's disease. However, Barlow's disease may also refer to mitral valve prolapse. Other eponyms for scurvy include Moeller's disease and Cheadle's disease.
Pirates knew they had scurvy when their teeth started falling out, their skin went pale, their legs got very fat and when they had to keep racing off to the toilet. Other symptoms include feeling fatigue, followed by formation of spots on the skin, spongy gums, and bleeding from the mucous membranes. Spots are most abundant on the thighs and legs, and a person may look pale, feel depressed, and be partially immobilized. As scurvy advances, there can be open, suppurating wounds, loss of teeth, yellow skin, fever, neuropathy and finally death from bleeding.
Skurvy
Sickness and diseases such as, dysentery, malaria, smallpox, and yellow fever created problems among ships and "could be fatal." Pirates, like privateers, were a little better off than those who worked on merchant or naval ships as "food was superior," "pay was higher," "shifts were shorter," and the crew's powers of "decision making was greater." Epidemics and scurvy led some to desert "naval vessels for pirates." In the event of disabilities occurring while in service to the ship, some pirates set up a "common wealth" plan to be paid to any man in the event of injury.
Dysentery
In the 1700s-1800s, dysentery was a disease causing many deaths. In fact, in some areas in Sweden 90 percent of all deaths were due to dysentery during the worst outbreaks. Symptoms of Dysentery is Diarrh, fever, cramps, vomiting and swelling of the large intestine. If you got dysentery, you lost water from your body faster than you could drink it, and after a few days you might die of dehydration. Strong adults usually lived, but babies and children and older people often died of dysentery.
Malaria
Malaria is a serious infectious disease caused by a single-celled parasite known as a plasmodium, which is generally spread through mosquito bites. This disease caused incalculable suffering for thousands of Arkansans and other Southerners through the early twentieth century.
Symptoms of malaria include high fever, chills, profuse sweating, malaise, headaches, nausea, vomiting, and diarrhea. These symptoms can appear within a week of initial infection but can vary with the different types of parasites. Complications can include anemia, liver failure, kidney failure, and breathing problems. Patients can suffer relapses years after the initial infection. If untreated, malaria can cause death.
Smallpox
Smallpox was an infectious disease caused by either of two virus variants, Variola major and Variola minor. The disease was originally known in English as the "pox"or "red plague". The last naturally occurring case of smallpox (Variola minor) was diagnosed on 26 October 1977.
Infection with smallpox is focused in small blood vessels of the skin and in the mouth and throat before disseminating. In the skin it results in a characteristic maculopapular rash and, later, raised fluid-filled blisters. V. majorproduced a more serious disease and had an overall mortality rate of 30–35 percent. V. minor caused a milder form of disease (also known as alastrim, cottonpox, milkpox, whitepox, and Cuban itch) which killed about 1 percent of its victims. Long-term complications of V. major infection included characteristic scars, commonly on the face, which occur in 65–85 percent of survivors. Blindness resulting from corneal ulceration and scarring, and limb deformities due to arthritis and osteomyelitis were less common complications, seen in about 2–5 percent of cases.
Yellow Fever
Yellow fever, known historically as yellow jack, yellow plague, or bronze john, is an acute viral disease. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains particularly in the back, and headaches. Symptoms typically improve within five days. In some people within a day of improving, the fever comes back, abdominal pain occurs, and liver damage begins causing yellow skin. If this occurs, the risk of bleeding and kidney problems is also increased.
The disease is caused by the yellow fever virus and is spread by the bite of an infected female mosquito. It infects only humans, other primates, and several species of mosquitoes. The disease may be difficult to tell apart from other illnesses, especially in the early stages. A safe and effective vaccine against yellow fever exists and some countries require vaccinations for travelers. Once infected, management is symptomatic with no specific measures effective against the virus. The second and more severe phase results in death in up to half of people without treatment Yellow fever causes 200,000 infections and 30,000 deaths every year, with nearly 90% of these occurring in Africa. In the 18th and 19th centuries, yellow fever was seen as one of the most dangerous infectious diseases. In 1927 yellow fever virus became the first human virus to be isolated.
Gangrene
Another common disease on a pirate ship was Gangrene. If a pirate got a cut on their arms or legs sometimes it got infected and the skin started to die - this is Gangrene. Then the only way to keep the pirate alive was to saw off the arm or leg. Or what about Yellow Fever? That was caught from mosquitoes and gave the pirate a high fever. Some people just got better from it, others vomited black blood and died.
Wounds & Medicine
A pirate who suffered a severe wound to his arm or leg, though, was more likely to have it amputated since the tissue and muscle were severely damaged. The last thing anyone wanted was to have the wound turn gangrenous, for that usually resulted in death. Most doctors believed the patient was more likely to survive if a clean cut was made, than if the surgeon allowed the limb to heal without surgery. John Hoxse, a carpenter aboard the USS Constellation in 1800, wrote:
"…as I was standing near the pump, with a top maul in my right hand, with the arm extended, a shot from the enemy’s ship entered the port near by, and took the arm off just above the elbow, leaving it hanging by my side by a small piece of skin; also wounding me severely in the side, leaving my entrails all bare. I then took my arm in my left hand, and went below…and requested the surgeon to stop [the bleeding in] my arm [as it] was already off. He accordingly stopped the effusion of blood, and I was laid aside among the dead and wounded, until my turn came to have my wounds dressed…. I was so exhausted that I fell asleep…until…I was…laid on a table, my wounds washed clean, and my arm amputated and thrown overboard. (Langley, 58)"
Hoxse received these wounds during the Quasi-War with France, but didn’t record the event until forty years later.
When amputation was required, it had to be done within twenty-four hours of the wounding. The seaman aboard HMS Macedonian assisted during an operation.
"We held [one man] while the surgeon cut off his leg above the knee. The task was most painful to behold, the surgeon using his knife and saw on human flesh and bones as freely as the butcher at the shambles. (Estes, 65)"
An injured pirate’s clothing was cut off and a tourniquet was applied to slow the bleeding. The surgeon gave him a stick to bite down on, and while the ship pitched and rolled, the operation began. First, the surgeon used a scalpel to cut open the skin above the wound. He sliced through the muscle to the bone with a knife. The mate who assisted pulled back the flesh to expose the bone and a leather strap encircled the bone to keep it clear of obstruction. Using a saw, the surgeon then cut the bone and tossed the removed limb into the bucket. A strip of cotton cloth about 2 feet long and 8 inches wide torn up the centre from one end for half the length is then to be drawn over the flesh closed around the bone. The ends are brought together and the whole serves to draw the skin and flesh up while the bone is sawed off. Very little pain is felt from sawing a bone – If there is any splinter or corner left it should be pinched off with nippers.
Hot tar was painted on the bloody stump or the wound was cauterized with a hot iron. This stopped the profuse bleeding that occurred. Once the surgeon removed the tourniquet, he placed two large “rounds” of linen over the stump and lashed it in place with strips of linen. If a wool stocking cap was available, this was also pulled over the stump. The entire operation took eight to ten minutes. The pirate’s chances of survival? Fifty-fifty. Peg legs were only invented in the late 19th century as cheaper alternatives to more intricate life-like artificial legs. This means pirates didn't wear peg legs like they are often stereo-typed to have,
Contrary to what most people believe, the injured underwent surgery wide awake. They weren’t given rum or other alcoholic drinks to numb them for two reasons. Anesthetics had yet to be invented and the doctors didn’t want their patients dying from weak hearts. Opiates or grog weren’t given to them until after the operation to relieve pain.
Sometimes there was nothing a surgeon could do to help a wounded man. When this happened, he often died a slow and painful death.
When a pirate lay hurt, he usually suffered from a puncture, a slash, or an amputation. Bullets, shrapnel, and splinters often caused the first type of wound, whereas a cutlass or knife caused the second. Projectiles (such as ball, shot, or chain) inflicted the last type of injury. These could inflict a variety of wounds, especially if the projectile struck wood. Splinters flew or a mast toppled, crushing anyone unlucky enough to be under it when it fell. Gunners suffered scorched burns from spilled gunpowder ignited by a spark. Descriptions of Dominique You, one of Jean Laffite’s privateers, mention powder burns over his left eye that gave him a menacing or grim appearance. If an explosion caused a fire, sailors often suffered severe burns.
When a pirate lay hurt, he usually suffered from a puncture, a slash, or an amputation. Bullets, shrapnel, and splinters often caused the first type of wound, whereas a cutlass or knife caused the second. Projectiles – such as ball, shot, or chain – inflicted the last type of injury. These could inflict a variety of wounds, especially if the projectile struck wood. Splinters flew or a mast toppled, crushing anyone unlucky enough to be under it when it fell. Gunners suffered scorched burns from spilled gunpowder ignited by a spark. Descriptions of Dominique You, one of Jean Laffite’s privateers, mention powder burns over his left eye that gave him a menacing or grim appearance. If an explosion caused a fire, sailors often suffered severe burns. Eye patches were often worn to hide and protect a wounded eye.
A wounded pirate eventually found himself placed upon planks laid across casks to form a makeshift operating table, if a real table wasn’t available. An old sail or other cloth might be draped over the planks. Nearby smaller flat surfaces or sea chests held the surgeon’s instruments and on the floor was a bucket where amputated body parts were dropped until they could be carried above deck and tossed into the sea.
Doctors didn’t know what caused infection back then, so instruments weren’t sterilized and bandages weren’t necessarily clean. Neither did the surgeon wash his hands between patients. To tend a puncture or slash wound, he removed “unnatural things forced into the wound” (a musket ball, pieces of wood or cloth), using a forceps. (Friedenberg, 11) Then he washed the wound with water or alcohol, packed it with lint scraped from linen sheets, and wrapped a bandage around it. If sutures were needed, he used waxed thread that might dangle from his lips until needed. Should infection set in, the preferred treatment was to bleed the patient.
Amputation
Dentistry
In the Golden Age of Piracy (~1685 to 1725) very little had been published in England about Dentistry. The first known English book on the topic was Charles Allen's book The Operator for the Teeth. The book focused a great deal on theories of tooth decay and other dental matters. Much of this theory is irrelevant to modern audiences. However I found that he also provided us with an interesting description of a very common tooth extraction device from this period: the dental pelican.
Dental pelicans started going out of fashion with the invention of the dental tooth key in 1742. Part of the problem with pelicans was they caused the accidental loosening or removal the teeth next to the tooth targeted to be taken out- something Allen mentions in his book. This is because the type of pelican that Allen describes would have the bolster (the part of the tool which rested on the gum beneath the tooth) positioned on the teeth next to the one being removed.
The tooth key introduced in 1742 wasn't really that much better. Modelled after a door key, the dental key was used by first inserting the instrument horizontally into the mouth, then its "claw" would be tightened over a tooth. The instrument was rotated to loosen the tooth. This often resulted in the tooth breaking, causing jaw fractures and soft tissue damage. The original design featured a straight shaft, which caused it to exert pressure on the tooth next to the one being extracted causing the same issue as the pelican had. The tooth key developed through out the years and only till the late 19th century was it replaced by the forceps.
It wasn’t until 1938 that the modern toothbrush was invented. Until then, if pirates cleaned their teeth at all it would have been with a “chew stick” which was less than effective at keeping teeth clean and plaque at bay. Pirates would have had to rely on pain as an indicator that something was wrong with their teeth. By the time a cavity is severely hurting, however, it means that tooth decay has grown so severe that enamel and dentin have been worn away exposing sensitive nerves located in the pulp of your tooth.
In the 1700s, John Hunter of England began transplanting human teeth. Hunter would pay people for their healthy teeth and then implant them in the mouths of his patients. These implanted teeth would be tied to adjoining teeth until they stabilized. However, they rarely lasted for longer than a few months. In the American colonies of the middle 1700s, many dentists implanted dentures and bridges. John Greenwood worked on George Washington's teeth, which tormented the poor man his entire adult life, though he never had wooden teeth; they were made of hippo ivory. Moreover, during the American
