Sailors and Mental Health
Please note: This post is about mental health, attempts at treatment and accommodation, self-harm and suicide. If you are affected by what you have read or have current problems that you cannot deal with on your own, please contact a mental health helpline.
Do not suffer in silence.
Another type of disease affected the men as much as any other type of disease. But it was either not recognised at all or only with difficulty. We are talking about mental illnesses.
References to mental illness and their treatment can be found as early as 5000 BC with skulls showing evidence of trepanation. Texts from Ancient Egypt, China, Ancient Greece and the Romans also indicate an awareness of different types of mental illness dating from 1500 BC to 200 AD. After the fall of the Roman Empire theories of mental illness, including different personality types and temperaments (Theophrastus) and ‘rational explanations’ (Hippocrates), largelyreverted back to the belief in demons and other supernatural causes. It took nearly 1000 years before the first hospital for the mentally ill in Europe, Bethlem Royal Hospital, admitted its first patients in the 1300s. Key theories and ideologies emerged over the next 300 years largely driven by the Renaissance period that swept through Europe. Descartes’ ‘theory of mind’ and Burton’s ‘Anatomy of Melancholy’ are examples of influential works from this period.
This post, however, is mainly about an insight into the treatment and care of sick Sailors of the 18th and 19th century of the Royal Navy.
By the end of the 18th century the Surgeons had noticed an increase in the number of Sailors being admitted to one of London’s Asylums due to mental breakdown, especially after major battles. Sir Gilbert Blane (1749-1843), Physician of the Fleet, quickly realised that during the war the number of such men had increased sevenfold and the wings for such cases in the Royal Navy Hospitals were expanded during the 19th century. He recognised that the men often suffered from severe anxiety, depression and trauma. However, he did not see it as such as it is today. He only recognised the symptoms, such as partial paralysis, sleep disturbances, dysesthesia, delusions and more. As was the case with soldiers in the army, these illnesses were attributed to the war.
Most of Bethlehem Hospital by William Henry Toms for William Maitland - William Maitland’s History of London, published 1739 (x)
This was also partly the case, but the other circumstances such as malnutrition, trauma through violence and mistreatment among each other were not seen. French physician François Boissier de Sauvages de Lacroix, however, described something he had noticed in the Sailors in their normal everyday lives. He called it brain fever. The patients were restless, had severe insomnia and delusions, and their moods could go from happy to sorrowful in a short time. Despite the lack of sleep, the men were overactive and yet powerless at the same time. What he found there were the first documented cases of biopolar disturbances. Although he tried to treat them like a fever, he often had to watch the patients injure themselves or even jump into the sea.
The symptomatic treatment of such diseases was a fundamental problem. No one really knew how to deal with these men, so schizophrenia was treated like malaria or depression was dismissed as melancholic mood, which was treated with sea air, sun bathing and walks. People hoped for help in the asylums of the cities. The Admiralty sent its men to Hoxton House. Between 1794 and 1818, 1289 men were treated there, of whom 364 were discharged as recovered. 272 died as a result of the treatment and 52 simply disappeared. The more serious cases, 494, were transferred to Bethlem. There they were considered incurable. The Bethlem in London was an asylum with a terrible reputation. It had been run under inhumane conditions since the 14th century.
The hospital may have looked like a palace, but treatment of patients was hardly ideal, as shown in this etching of William Norris in 1814 (x)
106 Sailors and 20 Prisoners of War had to share two rooms 7.9m long and 4.9m wide. Basic equipment such as tables, chairs, some beds, plates and cutlery were forbidden. Sanitary facilities were almost non-existent and men were left like cattle in their own filth. The diet, which typically consisted of: 450g (16oz) red meat, 450g (16oz) vegetables, 55g (2oz) cheese, 570ml (1 pint) broth, 1 litre (2 pints) tea, and 2 litres (4 pints) 'small beer’ per day. There were no medicines, fresh clothes or even fresh air. Ultimately, the men were left to fend for themselves. Officers were therefore often placed in private institutions such as Bath, where they were given a cure to restore their health.
However, unlike really physically recognisable illnesses, mental illnesses had a stickma attached to them and many hid their problems in order to avoid social problems. Or they were not taken seriously and so depression was perceived as a mood or a woman’s problem. Sailors, who were considered to be masculine and tough, did not have such illnesses (people with mental illnesses were also called lunatics) according to society. However, the opposite was the case. The Navy had a major problem with depression, which was exacerbated by pressure and expectations in the officer ranks. Especially in the Expedition service in the early to mid-19th century, this pressure was exacerbated by the demand for results in a short time, the poor prospects for quick promotions and the desperate position some found themselves in. What pushed some to suicide, that’ s what happened to the two captains of HMS Beagle. On their first expedition, Captain Pringle Stokes shot himself and the later Vice Admiral Robert FitzRoy took his own life with a razor.
Patients in Bethlem, also called Bedlam, in the fresh air, by K.H. Merz 1834 (x)
The cases became more frequent and many an officer was taken out of service with serious self-inflicted injuries and placed in one of the naval asylums. At the beginning of the 1820s, as the conditions of the wounded in the hospitals changed, so did those of the mentally ill. The diets were changed and the accommodation became more comfortable. And labour therapy was tried, although not entirely successful, because the men who seemed physically healthy could then work in the gardens for fresh vegetables, which saved money and labour. (Only after WWI did these treatments intensify and show some success). In addition, medicines were now being tested for the benefit of mental health and experimental operations were also being carried out. But also questionable water and cage therapies were tried.
For example, William Kemp was given mercury treatment in 1830. He had been taken to the Haslar Hospital for conspicuous behaviour, violence towards crew members. William Kemp inflicted, who was brought to Haslar in 1830 for his violent and noisy behaviour and, when a mercury cure failed to cure him, was treated as follows: 'Since the commencement of his present illness his bowels have been kept open by the compound rhubarb pill, the compound aloetic pill, and small doses of sulphate of magnesia and antimontartrate. A blister was placed on his head without benefit, but the cold infusion had the effect of quieting him and making him less noisy.’
William Kiddall, a sailor who was admitted to Haslar with mania in 1826, fared differently. Six years later, on 17 August 1832 at 11.30am, he was 'observed yawning’. As he was “unable to account for his sensations”, he was put to bed, and at 2 p.m. “vomiting and purging” began on the order of the orderlies. The report continues: He was then placed in a warm bath and given brandy, aromatic ammonia [i.e. smelling salts] and opium tincture to awaken the vital forces, which were obviously very low; but there was no reaction. At 4 p.m. he was again placed in a bath and a venisection [bloodletting] was performed on both arms and on the internal carotid artery, but hardly any blood came out, and what little was found was viscous and extremely dark in colour. Then a branch of the temporal artery was opened and about a drop of blood with the same appearance was obtained. At 9.30 p.m. he was dead.
As you can see from these two examples, it was more a pure symptom treatment but not a real help. None of the men really recovered and they often died, either as a result of the treatment itself, see above, or they took their own lives. Dealing with these diseases only happened in the 20th century and during the great world wars, but for everyone before that it was often a pure torture.
