Key inquiry questions
• What was the role of the ship's surgeon?
• How did Cook work and think scientifically to address scurvy?
Medical practice
As far back as Roman times, ships carried surgeons. Originally Barber-Surgeons, they were apprenticed for seven years but the prime qualification was to be able to stand the sight of blood. It was commonly believed that a bloody apron was a sign of experience and therefore respect. In 1747, the Society of Naval Surgeons was formed, attracting young men with medical degrees.
Preparing for amputations
Surgeons and their Mates prepared for amputations of limbs by stretching canvas or sailcloth across a makeshift trestle table. Instruments were laid out for easy reach. They placed buckets filled with sand nearby to catch and soak up the blood and to hold the amputated stumps. The advice given for amputating a leg was to cut quickly, less than two minutes, with a ‘crooked' (serrated) knife. Originally wounds were sealed with a hot iron or pitch. Later stitches were used to reduce bleeding and the stump was covered with the remaining skin.
Patients were fully conscious during amputations and other types of surgery. It was only in the healing process that sedation using opium-based laudanum or alcohol was used. Things changed in 1846 with the use of general anesthesia and again in 1867 when antiseptics were widely used to control infection.
Toothache
Toothache was a common ailment onboard an 18th-century sailing ship. Toothache was the result of a sailor's poor diet, tough or stale meat and along with bad breath and rotting teeth was an early sign of scurvy. The ship's surgeon would treat toothache by dulling the nerve with arsenic or would pull the tooth out with a tooth key. To clean their teeth, the officers and gentlemen may have used a tooth stick, boar-bristle brush or tooth powder made from brick dust, charcoal, salt or crushed shell which was used as an abrasive.
The practice of bleeding
Bleeding was used to treat fevers, cholera and rheumatism. The methods included scarification, cupping and bleeding. Dr John Coverdale's bleeding kit circa 1830-1870 consists of one brass scarifier (cutter), five glass cups, one brown leather tourniquet, one glass spirit bottle and a brass taper.
Haemophagic leeches were also used. They were attached to the body until they became full and fell off. Leech saliva contains chemicals that prevent blood clotting so a wound might bleed for hours after the leech was removed.
Death onboard the Endeavour
Although Cook claimed that he had not lost a man to scurvy on the Endeavour's three-year journey, he did in fact lose almost a third of the 94 men and boys on board to dysentery known as the ‘bloody flux' and malaria.
After leaving Australia, the Endeavour arrived in Batavia, the capital of the Dutch East Indies in what is now Jakarta, Indonesia. Tall houses on long canals were designed to resemble life in Holland but the tidal waters and tropical climate meant there were frequent outbreaks of cholera, typhus and malaria. Despite this, Batavia was the only site equipped to do the major repairs necessary to get the Endeavour back to England after running into the Great Barrier Reef.
The Endeavour departed Batavia on December 26, 1770 carrying contaminated fresh water which increased dysentery onboard. On the voyage home much of the crew died including William Monkhouse the ship's surgeon, Tupaia and his servant Taiata, the astronomer Charles Green, Cook's secretary and draughtsman Herman Spöring, the artist Sydney Parkinson, the master of the ship Robert Molineux and 20 other crew who were buried at sea.
Question: How has science and technology changed the way we practice medicine?
A scientific approach to scurvy
Investigating scurvy
The biggest risk to sailors travelling during Cook's voyage was illness, especially scurvy. During the 18th-century up to fifty per cent of sailors could die from scurvy and many ships carried twice the number of crew, in order to replace those killed. The symptoms of scurvy included:
• weakness
• fatigue
• sore arms and legs
• gum disease
• bleeding from the skin
• significant decrease in immune system/ability to heal oneself
• personality changes
• eventual death
Questioning and predicting
By the late 18th-century physicians suspected that scurvy was due to a dirty environment or foul air, from dampness or by eating a sailor's favourite pudding made of ‘slush', the fat skimmed off the water in which salted beef was boiled. They did not know that it is mainly caused by a deficiency of Vitamin C, or ascorbic acid. Vitamin C is important for many biological processes and making chemicals within the human body. Lack of Vitamin C leads to your biological systems not functioning properly.
In the 18th-century the Navy thought that scurvy could be prevented or treated by consuming some of the following things. They did not know why.
• sauerkraut (pickled cabbage)
• portable soup, a soup made from dehydrated meat products (similar to making broth from a stock cube)
• malt (called wort when mixed with water)
• rob of orange and lemon (a form of orange and lemon oil).
Conducting investigations
Cook was tasked with testing the various methods for preventing scurvy. As he tested all the methods at the same time the results were inconclusive. Scientific investigations need to test one variable (remedy) at a time to gain reliable results. It was therefore unknown what remedy was most successful.
Banks under the advice of Dr Hulme (not on board) who had been investigating scurvy treatments took lemon and lime juice when he noticed that he had the first signs of scurvy. Banks noticed a quick improvement in his symptoms and credited it to the citric fruit juice.
Results and conclusions
Only three cases of scurvy appeared during the Endeavour's first voyage to the Pacific and all survived. Cook's insistence on keeping the men and ship clean, providing ‘spruce beer' and taking on fresh food and water at every opportunity became standard practice in the Navy as was carrying supply of fresh lemons and limes.
After Cook's second voyage he believed that it was the wort that prevented scurvy. In 1776 Cook was awarded the Copley Gold Medal for his work on finding the prevention of scurvy. His belief that wort prevented scurvy was one of the factors that led to wort being one of the most relied upon methods to treat or prevent scurvy. Wort is now known to be ineffective in the treatment of scurvy.
Engage with the scurvy pages at Virtual Endeavour Teacher Resources.
Question: What errors were made in Cook's scientific investigations? Why is scurvy no longer a common disease for modern sailors?
Further reading:
https://maas.museum/sydney-observatory/astronomy-resources/transit-of-venus/
https://www.rmg.co.uk/discover/behind-the-scenes/blog/medicine-and-health-sea
Main image: Surgeon's case belonging to Dr John Coverdale, ANMM Collection 00028793
• What was the role of the ship's surgeon?
• How did Cook work and think scientifically to address scurvy?
Medical practice
As far back as Roman times, ships carried surgeons. Originally Barber-Surgeons, they were apprenticed for seven years but the prime qualification was to be able to stand the sight of blood. It was commonly believed that a bloody apron was a sign of experience and therefore respect. In 1747, the Society of Naval Surgeons was formed, attracting young men with medical degrees.
Preparing for amputations
Surgeons and their Mates prepared for amputations of limbs by stretching canvas or sailcloth across a makeshift trestle table. Instruments were laid out for easy reach. They placed buckets filled with sand nearby to catch and soak up the blood and to hold the amputated stumps. The advice given for amputating a leg was to cut quickly, less than two minutes, with a ‘crooked' (serrated) knife. Originally wounds were sealed with a hot iron or pitch. Later stitches were used to reduce bleeding and the stump was covered with the remaining skin.
Patients were fully conscious during amputations and other types of surgery. It was only in the healing process that sedation using opium-based laudanum or alcohol was used. Things changed in 1846 with the use of general anesthesia and again in 1867 when antiseptics were widely used to control infection.
Toothache
Toothache was a common ailment onboard an 18th-century sailing ship. Toothache was the result of a sailor's poor diet, tough or stale meat and along with bad breath and rotting teeth was an early sign of scurvy. The ship's surgeon would treat toothache by dulling the nerve with arsenic or would pull the tooth out with a tooth key. To clean their teeth, the officers and gentlemen may have used a tooth stick, boar-bristle brush or tooth powder made from brick dust, charcoal, salt or crushed shell which was used as an abrasive.
The practice of bleeding
Bleeding was used to treat fevers, cholera and rheumatism. The methods included scarification, cupping and bleeding. Dr John Coverdale's bleeding kit circa 1830-1870 consists of one brass scarifier (cutter), five glass cups, one brown leather tourniquet, one glass spirit bottle and a brass taper.
Haemophagic leeches were also used. They were attached to the body until they became full and fell off. Leech saliva contains chemicals that prevent blood clotting so a wound might bleed for hours after the leech was removed.
Death onboard the Endeavour
Although Cook claimed that he had not lost a man to scurvy on the Endeavour's three-year journey, he did in fact lose almost a third of the 94 men and boys on board to dysentery known as the ‘bloody flux' and malaria.
After leaving Australia, the Endeavour arrived in Batavia, the capital of the Dutch East Indies in what is now Jakarta, Indonesia. Tall houses on long canals were designed to resemble life in Holland but the tidal waters and tropical climate meant there were frequent outbreaks of cholera, typhus and malaria. Despite this, Batavia was the only site equipped to do the major repairs necessary to get the Endeavour back to England after running into the Great Barrier Reef.
The Endeavour departed Batavia on December 26, 1770 carrying contaminated fresh water which increased dysentery onboard. On the voyage home much of the crew died including William Monkhouse the ship's surgeon, Tupaia and his servant Taiata, the astronomer Charles Green, Cook's secretary and draughtsman Herman Spöring, the artist Sydney Parkinson, the master of the ship Robert Molineux and 20 other crew who were buried at sea.
Question: How has science and technology changed the way we practice medicine?
A scientific approach to scurvy
Investigating scurvy
The biggest risk to sailors travelling during Cook's voyage was illness, especially scurvy. During the 18th-century up to fifty per cent of sailors could die from scurvy and many ships carried twice the number of crew, in order to replace those killed. The symptoms of scurvy included:
• weakness
• fatigue
• sore arms and legs
• gum disease
• bleeding from the skin
• significant decrease in immune system/ability to heal oneself
• personality changes
• eventual death
Questioning and predicting
By the late 18th-century physicians suspected that scurvy was due to a dirty environment or foul air, from dampness or by eating a sailor's favourite pudding made of ‘slush', the fat skimmed off the water in which salted beef was boiled. They did not know that it is mainly caused by a deficiency of Vitamin C, or ascorbic acid. Vitamin C is important for many biological processes and making chemicals within the human body. Lack of Vitamin C leads to your biological systems not functioning properly.
In the 18th-century the Navy thought that scurvy could be prevented or treated by consuming some of the following things. They did not know why.
• sauerkraut (pickled cabbage)
• portable soup, a soup made from dehydrated meat products (similar to making broth from a stock cube)
• malt (called wort when mixed with water)
• rob of orange and lemon (a form of orange and lemon oil).
Conducting investigations
Cook was tasked with testing the various methods for preventing scurvy. As he tested all the methods at the same time the results were inconclusive. Scientific investigations need to test one variable (remedy) at a time to gain reliable results. It was therefore unknown what remedy was most successful.
Banks under the advice of Dr Hulme (not on board) who had been investigating scurvy treatments took lemon and lime juice when he noticed that he had the first signs of scurvy. Banks noticed a quick improvement in his symptoms and credited it to the citric fruit juice.
Results and conclusions
Only three cases of scurvy appeared during the Endeavour's first voyage to the Pacific and all survived. Cook's insistence on keeping the men and ship clean, providing ‘spruce beer' and taking on fresh food and water at every opportunity became standard practice in the Navy as was carrying supply of fresh lemons and limes.
After Cook's second voyage he believed that it was the wort that prevented scurvy. In 1776 Cook was awarded the Copley Gold Medal for his work on finding the prevention of scurvy. His belief that wort prevented scurvy was one of the factors that led to wort being one of the most relied upon methods to treat or prevent scurvy. Wort is now known to be ineffective in the treatment of scurvy.
Engage with the scurvy pages at Virtual Endeavour Teacher Resources.
Question: What errors were made in Cook's scientific investigations? Why is scurvy no longer a common disease for modern sailors?
Further reading:
https://maas.museum/sydney-observatory/astronomy-resources/transit-of-venus/
https://www.rmg.co.uk/discover/behind-the-scenes/blog/medicine-and-health-sea
Main image: Surgeon's case belonging to Dr John Coverdale, ANMM Collection 00028793