globalmaritimehistory.com
The grim horrors of the orlop deck - Global Maritime History
The often awe-inspiring works of art immortalizing historic naval battles usually belie the harsh reality of war. Amidst clouds of billowing, black smoke and the deafening roar of cannon fire, sailors faced the real danger of life-threatening injuries. Injured sailors were carried, dragged, or stretchered to the surgeon’s “cockpit,” a dimly lit, low-ceilinged, and overcrowded space usually home to the midshipmen, and located toward the stern on the orlop (lowest) deck. They were then placed on makeshift operating tables composed of the midshipmen’s assembled sea chests, which were often simply covered with an old sail or other cloth. Conditions were nightmarish, with treatment frequently interrupted by desperate cries for relief: The first object I met was a man bearing a limb, which had just been detached from some suffering wretch … The surgeon and his mate were smeared with blood from head to foote: they looked more like butchers than doctors … Although most shipboard infirmaries were located in relative safety below the waterline, the surgeon’s job was not without danger: [The patient] was laid on the table and the operation performed in the usual way …, lucky it was that he bare [sic] it so well, as a shot at this time came into the cockpit and passed the operating table close, this startled all the women who formed the chief of my assistance. Although this particular incident at the Battle of Camperdown (October 11, 1797) did not cause any additional distress, patients were not always spared from further injury, or even death: As I was dressing a wounded man, a cannon ball struck a young gentleman on the head dashing his brains upon all sides; part of them blinded me. At this moment a splinter struck my head and rendered me insensible for [a] quarter of an hour. Upon my recovery, I could hardly persuade myself but what I was mortally wounded, from being completely besmeared with blood and brains. Whereas national navies routinely mustered qualified doctors, medical care on merchant vessels often relied on surgeons rather than physicians. Physicians were usually well-educated but lacked practical experience; (barber-)surgeons were proficient in treating common shipboard injuries. During naval battles, “amputation was the most common operation, along with sewing up abdominal wounds.” If no surgeon was available, amputations were usually performed by the ship’s carpenter—or even by the cook. Surgeons were assisted by a surgeon’s mate, a “loblolly boy,” and occasionally by additional assistants. Loblolly boys collected amputated limbs, poured sand onto blood-soaked, slippery surfaces, and prepared buckets of cauterizing tar. Their nickname referred to the thick meat and vegetable porridge (“spoon meat”) they fed the sailors in their care; their modern counterparts are the U.S. Navy’s hospital corpsmen or the Royal Navy’s medical assistants. When required, they would also immobilize patients by any means necessary so that the surgeon could do his job. In Of Wounds, Severall Chirurgicall Treatises (1676), Richard Wiseman (1622?–1676) explains: At Sea they sit or lie, I never took much notice which; nor do I remember I had ever any body to hold them; but with the help of my [Surgeon’s] Mates, and some one or two that belonged to the Hold, I went on with my work. Despite Wiseman’s dispassionate reference to the need for his assistants to restrain his patients during amputations, having access to such support was by no means a luxury. General anesthesia was not routinely administered until the mid-nineteenth century, and amputees were often in considerable pain: We held [the patient] 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. A popular myth contends that patients requiring amputation were given copious amounts of “cordial” (rum) to numb the pain; however, they often only received a mouth guard, a simple stick to bite down on when their pain became unbearable. There is some evidence that “a drachm of Cordial [was] given to the man to keep up his Spirits.” And although “[t]he Operator is to encourage the Patient, and having given him half a Glass of Wine, to enable him the better to endure his Pain,” a patient’s spirit intake was usually limited to a single shot: When you resolve to set upon this Operation [amputation], having all things necessary in a readiness upon a Table near you; first give the Patient a good Cordial, and encourage him by proper words, to suffer with patience what will conduce to his future well-being. In fact, to ease a patient’s pain post-operation, liberal consumption of alcohol was not recommended: [The operation] done, let him have another Cordial drachm, but have a care of too much, lest it inflame him, and make his blood more fluid: And have an Eye lest his Messmates come with their bottle, and prejudice him with their kindness, as I have sometimes seen. Without anesthetic, amputees were often given opiates such as laudanum—opium blended into rum—which made them groggy and dulled the pain somewhat. But perhaps the most effective means of pain management was the natural adrenaline rush caused by the battle raging upstairs. This suggested that amputations should be performed “whilst the Blood is hot, and there is Strength; then [sic: rather than] afterward when the Fever or other ill symptoms are come on.” British Navy surgeon John Atkins (1685–1757) agreed: Heat and Surprize in Action makes it the properest Time for amputating, Men meeting their Misfortunes with greater Strength and Resolution than when they had spent a Night under Thought and Reflection. Despite their training, many Royal Navy surgeons’ skills were not much more advanced than those of the common butcher. Their tools were also similar. As a case in point, the personal surgery kit of Alexander Jack, Royal Navy surgeon on HMS Shannon during the War of 1812, contained an amputating and a metacarpal saw (used to cut small bones), three amputating knives, two pairs of sliding artery forceps (for tying […]
