James Poskett: Medicine adrift at sea

You’re on board a small British merchant ship in the English Channel and you start to feel very ill. There’s no doctor on board. What do you do? If the year is 1844, you’re in luck. The Government has recently made it compulsory for all merchant vessels to carry medicines, to be kept in a small wooden chest. So open up, take a swig of the laudanum, and relax.

But before you drift off into an opiate-induced stupor, take a moment to consider the history of how a very particular set of drugs ended up on every British merchant ship. It’s a topic that started to interest me as I stumbled upon a collection of tiny pamphlets, each designed to be slipped inside one of the drawers of the ship’s medicine chest. With titles such as The Guide-Book to the Government Medicine Chest, they list the medicines to be taken aboard along with directions for use. Well before anything resembling the National Health Service, let alone the National Institute for Clinical Excellence, we have a government mandate to stock certain medicines. So, these chests, along with the accompanying pamphlets, provide a fantastic opportunity to study the early history of public health and the regulation of drugs.

Why did laudanum make the list? And why did the government decide to enact such legislation in the first place? Plausibly, the answers to these questions are best sought by considering that, once medicine found itself adrift at sea, out of the context of the hospital or dispensary, it required additional work to maintain a standard set of practices. It is no surprise then that the pamphlets are at pains to remind the reader that it is always preferable to consult a qualified doctor.

With this in mind, I started to realise just how rich a resource medicine at sea could be. It provides an opportunity to marry contemporary historiography, such as the relationship between travel and medicine, with more traditional medical historiography, such as the difference between opposing medical traditions. For instance, it’s worth comparing the ship’s medicine chest and the ship’s kitchen: both dispense consumables with the hope of improving the health of the sailors (lemons vs. laudanum). The government medicine chest could certainly be interpreted as a means for the medical elite to regain control of a world in which lemons and limes, rather than doctors and surgeons, had begun to be seen as the key to health.

For those interested in further research, I can strongly recommend the following archives. First, the National Archives ADM101 series of Royal Navy medical officer journals. Second, the National Maritime Museum Caird Library and associated object collection. Third, the Wellcome Library’s Maritime Medicine collection. Bon voyage!