Hektoen International

A Journal of Medical Humanities

Ship fever: A malignant disease of a most dangerous kind?

Richard de Grijs
Sydney, Australia

Figure 1. Passengers leaving quarantine. Museums & Galleries NSW.

During the Age of Sail, “road,” “workhouse,” “hospital,” “army,” “camp,” “emigrant,” “jail”/“gaol,” and “ship” were routine noun adjuncts pertaining to the deadly fevers frequently occurring in overcrowded spaces in cold weather. Although “fever” diagnoses were common, most such instances in ships’ surgeons’ journals related to typhus or typhoid fevers—until 1869, they were not usually differentiated.1

Edward Coxere (1639–1664), detailing his imprisonment in Portofarino Castle (in present-day Tunisia), revealed the main culprits responsible for the often rapid spread of typhus: “lice we had in abundance; so lousy we were that the lice made a prey of us,” continuing, “[we had] hardly time to kill them. When we had but a little time in the day, off went our clothes and to killing of lice, ...2

Although its cause remained unknown, typhus was firmly associated with cramped shipboard conditions. In modern medicine, “typhus” encompasses a group of infectious diseases, including epidemic typhus carried by body lice, scrub typhus spread by larval mites, and murine (flea-borne) typhus.3 Jail or ship fever was synonymous with endemic (epidemic) typhus, a bacterial infection caused by Rickettsia prowazekii. Rat-borne fleas more commonly carry Rickettsia typhi.4 Typhus is spread through contact with the fecal dust of lice, which can enter the blood stream through bites or scratches on the skin, the eyes’ conjunctiva (membranes), or the lungs.

Historically, Royal Navy ships were crewed in part by men recruited through impressment. As popular resistance to press gang practices grew, convicted criminals became a new, fertile source of Navy crew, particularly between 1795 and 1815 when Britain used the Quota System. If too few men volunteered, counties often offered prisoners the option of completing their sentence in or volunteering to join the Royal Navy.5

Many unfortunate souls pressed into Royal Navy service carried typhus vectors on their unwashed clothes,6 unwittingly transferring them to their often filthy bedding and healthy fellow sailors7:

The disease was hitherto almost confined to the new-raised men, …, dirty and ragged … the very dregs of jails in the metropolis. Men of this description, such as are often to be met with in ships, are the victims of all general sickness. … The usual precautions of purifying the ship were immediately put in execution, and additional clothing was ordered to those in want of it; at the same time care was taken to enforce personal cleanliness where it was necessary.8

The frequent occurrence of typhus in dark, cramped, and crowded environments was thought to come from the stench of soiled clothing,9 or perhaps from infection of human exhalation.10

The Scottish physician James Lind (1716–1794), with his apprentices Gilbert Blane (1749–1834) and Thomas Trotter (1760–1832), observed that implementing certain prophylactic precautions reduced or prevented typhus outbreaks.11 He recommended regular ventilation and fumigation of the crew quarters on Royal Navy ships, combined with the now traditional daily scrubbing of the decks. He also convinced the Navy to establish buffer zones by means of “slop ships,” where new recruits were thoroughly cleaned, disinfected with vinegar, and given new clothes:

… this fever was caused and spread by the infected clothing of these pressed men, such mischief lurked in their tainted apparel and rags, and by these were conveyed into other ships. …

The most effectual preservative against this infection … would be to appoint a ship for receiving all ragged and suspected persons, before they are permitted into the receiving guardship. This ship should be furnished with slops, shirts, bedding, and all the necessary articles of seamen’s apparel; with soap, tubs, and proper conveniences for bathing, and with a room upon deck for fumigating of clothes. … as soon as they are stripped of their rags, well washed and cleaned, they should be supplied with new clothes and bedding, and be sent on board the receiving guardship.12

Figure 2. Melbourne’s first quarantine ground at Red Bluff, ca. 1851. Engraving by Thomas Ham (1821–1870). State Library of Victoria.

Lind’s recommendations were not acted upon until 1781, however. Although his recommended measures improved the general health of Royal Navy crews, typhus remained endemic in many ports, and conditions on merchant vessels generally remained squalid. Within a week or two of exposure, infections would emerge, with symptoms including high fevers and chills, accompanied by a persistent headache, a diffuse pinpoint rash (red spots), muscle aches, and dizziness. Typhus infections frequently led to pulmonary and respiratory difficulties, gastrointestinal and nervous disorders, complications such as painful haemorrhages and encephalitis, and ultimately death.

Mortality rates of one-third or more, as high as 60%, were not unheard of prior to routine treatment with antibiotics,13–15 among both victims and their easily infected carers.16 Contemporary records describe sufferers having a “countenance grim and cloudy, [a] wildly rolling eye, delirium, startings, and threatenings of convulsion with the cerebral.”17 David Geddes (d. 1870), Surgeon-Superintendent on the Neptune, carrying immigrants to Australia in 1839, recorded

… a sense of giddiness and weight in the head, dullness of the eye and … drowsiness … Ultimately diarrhoea and dysentery … came on and terminated fatally about the third or forth [sic] week from the invasion of the complaint. The fever … was almost entirely confined to women and children … in a part of the ship where the people were particularly disposed to indolence, filth, and insubordination.18

The disease spread rapidly in the squalid conditions on warships, convict ships, and emigrant ships alike. For instance, in 1758 some 300 crew members from several Royal Navy vessels arriving at Spithead from the territory of present-day Canada were admitted to the Royal Naval Hospital Haslar, many with typhus-like fevers; almost thirty died.19 During the American War of Independence (1775–1783), one-tenth of sailors enlisted died from fevers.20

During the first half of the nineteenth century, typhus outbreaks occurred frequently on convict ships,21 often in tandem with outbreaks of scurvy. For instance, in 1814 the transports General Hewett, Surry, and Three Bees arrived in Port Jackson (Sydney) with convicts suffering “from the ravages of scurvy or typhus.”22 Other outbreaks occurred on the Hercules in 1802,23 arriving in Port Jackson, and on the Marquis of Hastings in 1839,24 destined for Hobart (Van Diemen’s Land, present-day Tasmania).

Typhus was brought to Australian soil from the onset of British colonization: on visiting the Alexander in Portsmouth (England), prior to her departure as part of the First Fleet (1787–1788), Surgeon John White (ca. 1756–1832) was told, “Your people have among them a malignant disease of a most dangerous kind.” Although White recorded that “the complaints were neither malignant nor dangerous,” on arrival in Sydney Cove he noted that “the sickness which has, and still does prevail on the Alexander transport gives me a great degree of concern.”25 Conditions on the Second Fleet (1790) were far worse, however, as recorded by the Rev. Richard Johnson (ca. 1756–1827):

Went down among the convicts, where I beheld a sight truly shocking …, a great number of them lying, some half and others nearly quite naked, without either bed or bedding, … The misery I saw amongst them is inexpressible … Their heads, bodies, clothes, blankets, all full of filth and lice. Scurvy was not the only nor the worst disease that prevailed amongst them.

When, upon arrival of the Third Fleet (1791), more than 200 convicts were recorded to have succumbed in transit, with ongoing infections eventually resulting in 436 deaths, the authorities ordered medical supervision at embarkation and mandatory appointments of ships’ surgeons. Widespread outbreaks were consequently curtailed, undoubtedly aided by the surgeons’ enforcement of a regular routine of bathing, washing, and changing clothes. Nevertheless, the yellow flag of contagion continued to fly on many vessels. In fact, ventilation in cool conditions may have discouraged convicts and emigrants from washing or changing their clothes.26

Despite decrees that British port authorities should screen passengers for transmissible diseases, checks were often done haphazardly—or not at all. Many convicts and emigrants alike thus continued to die at sea; emigrant vessels soon gained the nickname “coffin ships.” This should not have been a surprise, however. For instance, following the 1837 arrival of the Lady MacNaughten, with more than 100 of her 412 passengers infected, the Sydney Gazette reported that “without question in the case of this ship the immigrants were packed together with a most reckless regard to human life.”27 The captain later admitted that “there was no medical examination of the passengers prior to embarkation and that a boy brought into the ship, on the back of his mother, died three days after [departure] of scarlet fever.”28 An inquiry concluded that “many of the women were very dirty from want of a change of clothes … there was no general order to enforce their washing their persons.”29

Typhus and other infectious diseases (scarlet fever, measles, or whooping cough) often occurred simultaneously. This was frequently exacerbated by undernourishment (for instance, in relation to the Irish potato famine in the 1840s30)—hence the common moniker, “famine fever.”

One of the worst typhus outbreaks on an emigrant vessel occurred in 1852 on the Ticonderoga,31 bound for Melbourne during the Victorian gold rush. Of her 814 passengers, 96 died en route from “the worst form of typhus fever, and nearly every soul on board of her, including even her crew, were sick.”32 Eighty additional souls perished in post-arrival quarantine. The Ticonderoga’s story was not an exception, however, prompting James Reed, Superintendent of the local Sanatory Station, to conclude in 1858, “Whenever I found typhus fever, I invariably found a bad captain, an inefficient doctor, and a dirty ship.”33

Although typhus outbreaks seem like bad memories from a distant past, even today the poorest communities and those affected by wars, social unrest, and humanitarian disasters continue to be at risk.

End notes

  1. Staniforth, M. “Diet, Disease and Death at Sea on the Voyage to Australia, 1837–1839”. International Journal of Maritime History, 8 (1996): 199–156. Typhus and typhoid fever are distinct diseases, although their symptoms and incubation times are similar. Typhoid fever is caused by Salmonella typhi bacteria and spread through food contaminated by (human) fecal matter. See also Cumpston, J.H.L. “The Typhus Ships: A Tragedy of Migration.” The Argus (January 7, 1933), 4: https://trove.nla.gov.au/newspaper/article/4518071.
  2. Coxere, E., and Meyerstein, E.H.W. (ed.). Adventures by Sea of Edward Coxere. (Oxford: Clarendon Press, 1945), 89.
  3. Centers for Disease Control and Prevention. “Typhus fevers.” (2020):       https://www.cdc.gov/typhus/index.html.
  4. Mercer, A. “Protection against severe infectious disease in the past.” Pathogens and Global Health, 115 (2021): 151–167.
  5. Cook, G., and Pavlov, A. Disease in the Merchant Navy: A History of the Seamen’s Hospital Society. (London: Taylor and Francis/CRC Press, 2008), Ch. 3.
  6. Lice feces can remain infective for up to 100 days; McClain, M.T. “Epidemic typhus.” UpToDate (2024): https://www.uptodate.com/contents/epidemic-typhus. It has been argued that the incidence of typhus fever on slave-trading ships was lower given the slaves’ general lack of clothing; for a review, see Blakley, C.M., “Ship fever, confinement, and the racialization of disease.” Studies in History and Philosophy of Science, 95 (2022): 96–103.
  7. Hudson, A. Edward, A., and Herbert, A. “James Lind: His Contributions to Shipboard Sanitation.” Journal of the History of Medicine and Allied Sciences, 11 (1956): 1–12.
  8. Rubinstein, H.L. Catastrophe at Spithead: The Sinking of the Royal George. (Barnsley, UK: Seaforth Publishing, 2020).
  9. Friedenberg, Z. Medicine under Sail. (Washington, DC: Military Books, 2002), 75.
  10. Jackson, R. A sketch, (Analytical) of the History and Cure of Contagious Fever. (London: Burgess and Hill, 1819), 80: https://wellcomecollection.org/works/m8cee8y4; Chan, C., and Demetriades, A.K. “The contributions of James Carmichael Smyth, Archibald Menzies and Robert Jackson to the treatment of typhus in Royal Naval vessels in the late 18th century”. Journal of Medical Biography, 31 (2023): 4–9.
  11. Lloyd, C.C. “The Health of Seamen.” Navy Records Society, 107 (1965): 70–106: https://www.navyrecords.org.uk/members_blog/the-royal-navys-fight-against-contagion-during-the-age-of-sail/; Rubinstein (2020), Op. cit.
  12. Cited by Hudson et al. (1956), Op. cit., 6.
  13. Reperant. L. Fatal Jump: Tracking the Origins of Pandemics. (Baltimore, MD: Johns Hopkins University Press, 2023), 161.
  14. Mercer (2021), Op. cit
  15. Ekirch, A.R. Bound for America: The Transportation of British Convicts to the Colonies, 1718–1775. (Oxford: Oxford University Press, 1990), 103–105.
  16. Chan and Demetriades (2023), Op. cit.
  17. Jackson (1819), Op. cit., 14.
  18. Geddes, D., 1839. “Surgeon-Superintendent Journal on Board the Government Emigrant Ship Neptune.” Australian Joint Copying Project, Public Records Office, 3189–3214 (Mitchell Library, State Library of New South Wales).
  19. Rubinstein (2020), Op. cit.
  20. Ibid.; Chan and Demetriades (2023), Op. cit.
  21. Cumpston (1933), Op. cit.; Bateson, C., The convict ships, 1787–1868. (Glasgow: Brown, Son, and Ferguson, 1959), 46, 48, 59, 63; Staniforth (1996), Op. cit.
  22. Bateson (1959), Op. cit., 381.
  23. Ibid., 48.
  24. Goldsmid, J. The Deadly Legacy: Australian History and Transmissible Disease. (Kensington, NSW: New South Wales University Press, 1988), 33.
  25. Cumpston (1933), Op. cit.
  26. Riley, J.C. The Eighteenth Century Campaign to Avoid Disease. (New York: Palgrave Macmillan, 1987), 56.
  27. Cumpston (1933), Op. cit.
  28. Staniforth (1996), Op. cit.
  29. Hawkins, J.A. “Surgeon-Superintendent’s Journal on Board the Bounty Emigrant Ship Lady MacNaughten, 1837” (July 7, 1837). Mitchell Library, State Library of New South Wales: A1267-15, microfilm reel CY 895.
  30. Linn, M.B. From Typhus to Tuberculosis and Fractures in between: A visceral historical archaeology of Irish immigrant life in New York City 1845–1870. Ph.D. Thesis (2008), Columbia University.
  31. Veitch, M. Hell Ship: The true story of the plague ship Ticonderoga, one of the most calamitous voyages in Australian history. (Sydney: Allen and Unwin, 2018).
  32. Cumpston (1933), Op. cit.
  33. Ibid.

RICHARD DE GRIJS, PhD, is a professor of astrophysics and an award-winning historian of science at Macquarie University (Sydney, Australia). With a keen interest in the history of maritime navigation, Richard is a volunteer guide on Captain Cook’s (replica) H.M. Bark Endeavour at the Australian National Maritime Museum. He also regularly sails on the Museum’s replica Dutch East Indiaman, Duyfken.

Spring 2024



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