1. Poxed and Scurvied
The Story of Sickness & Health at Sea
Kevin Brown
Hardback 256 pages
ISBN: 9781848320635
Published: 4 May 2011
US Edition: US Naval Institute Press
ISBN: 159114809X
Published: August 2011
£25.00
When European sailors began to explore the rest of the world, the problem of
keeping healthy on such long voyages became acute. Malnourishment and
crowded conditions bred disease, but they also carried epidemics that decimated
the indigenous populations they encountered – and brought back new diseases
like syphilis.
As navies developed, the well-being of crews became a dominant factor in the
success of naval operations, so it is no surprise that the Royal Navy led the way
in shipboard medical provision, and sponsored many of the advances in diet and
hygiene which by the Napoleonic Wars gave its fleets a significant advantage over
all its enemies. These improvements trickled down to the merchant service, but
the book also looks at two particularly harsh maritime environments, the slave
trade and emigrant ships, both of which required special medical arrangements.
Eventually, the struggle to improve the fitness of seamen became a national
concern, manifest in a series of far-reaching – and sometimes bizarre – public
health measures, generally directed against the effects of drunkenness and the
pox.
In this way, as in many others, an attempt to address the specific needs of the
seafarer developed wider implications for society as a whole. It also produced
scientific breakthroughs that were a universal benefit, so far from being a narrow
study of medicine at sea, this book provides a fascinating picture of social
improvement
Nominated for Mountbatten Award for Best Maritime Literature, 2011
Maritime Foundation (http://www.bmcf.org.uk/awards/)
Reviews
… shows an attempt to address the needs of the seafarer developed wider
implications for society as a whole. It also produced scientific breakthroughs that
were of great benefit, the eradication of scurvy being one. The book not only
details a history of naval medicine, but of a wider social health improvement.
The Nautical Magazine

2. Many years ago I visited the Royal Naval Medical School in Hampshire. Staff
were playing croquet and pink gins were offered. Kevin Brown's book captures
the flavour of these relatively recent, more expansive and expensive times, as
well as that of the long-distant past. His history starts with the Black Death and
moves to syphilis, but primarily has a strong naval focus - making extensive use
of Royal Navy records in an authoritative account of maritime medicine and
diseases spread by sea. Infections either dominate or lurk just under the surface.
After all, amputations during naval battles were often done in an attempt to
reduce the risk of death from gangrene. The book brings this to life very well,
with its lurid account of the surgery and the knives and saws, as well as covering
quarantine and the great pandemics of the past.
Well-referenced, and well-written, this account is a good read as well as a useful
source of in-depth information. I was particularly pleased to see the Court of the
Baillies of Aberdeen minute for 24 April 1497 that 'licht weman' (prostitutes)
should desist 'under the pain of a brand on their cheeks' was quoted. The
stimulus for this measure - 'to control infirmities come out of France and strange
parts' - didn't get mentioned. Perhaps the author was being diplomatic.
Hugh Pennington, Microbiology Today
The impressive 36 pages of detailed notes and bibliography mean that Poxed
and Scurvied will find itself at home with academics of maritime history.
However, its written in such an accessible form that it should also appeal to
anyone curious about life – and death – at sea in the last millennium
Who Do You Think You Are Magazine, September 2011
It details the devastating diseases carried by early travellers and colonists. For
example, the Black Death, which killed a third of Western Europe's population,
was brought back by Genoan merchants returning from the Crimean.
...
There is also a chapter on emigrant and slave ships, where the need to keep the
'cargo' healthy while manacled for much of the voyage led to bizarre practice of
forcing slaves to dance in their chains.
Poxed and Scurvied ends at the Falklands War which Brown describes as: " The
last of the colonial wars in which ships are isolated at sea"
Norwich Evening News, 23rd July 2011
Despite its gimcrack title this is a serious work by an author well qualified in
medical matters. The first half describes health problems in the Royal Navy
during the sailing ship era; there is little on the mercantile marine or on foreign
seafarers. It is a story of gradual improvement, but from a low base.
The main task of ships’ surgeons was treating battle casualties, usually by
amputation (without anaesthetic). Arthur Devis’s painting of the death of Nelson
in the gloomy cockpit of the Victory gives an idea of the conditions in which
surgeons carried out their bloody task.
However, many more seamen died from sickness than in battle, and in treating
disease most surgeons were even more ignorant than their counterparts on
shore. Although scurvy was notorious as the scourge of the sea, its ravages were
chiefly confined to long voyages, and on routine cruises typhus, dysentery and
yellow fever killed many more men.

3. The lot of the sick and wounded at sea was appalling, as they languished below
deck amid filth and stench. Reformers at sea and on land slowly introduced
improvements: better diet (the Admiralty authorised the issue of lemon juice in
1795 to combat scurvy), an emphasis on cleanliness and adequate ventilation,
and the building of naval hospitals on shore.
The rest of the book ranges from descriptions of the dire conditions on slaving
ships and emigrant vessels to life on the passenger liners and cruise ships of the
20th century, where the doctor’s role could be more social than medicinal. In
today’s navy, serious casualties are air-lifted ashore for specialist attention.
Kevin Brown's wide reading is shown by the number of quotations that enliven his
text. There is space for only one here, Nelson's cautionary remark that " the
great thing in all military service is health, and it is easier for an officer to keep
me healthy than for a physician to cure them".
Glyn Williams, BBC History Magazine, September 2011
this book provides a fascinating picture of social improvement.
ICSM Gazette, The Medical Schools Magazine, Summer 2011
A thoroughly researched story of how mankind has kept well at sea from the
earliest times to the present, written in an anecdotal style, and should interest
any maritime or medical historian.
Worshipful Company of Spectacle Makers From the Master and Wardens
A fascinating insight into the history of maritime medicine ... Brown has
excavated fascinating diary material ... offers vivid contemporary accounts of the
sick bays on warships during battle.
Ham & High
A fascinating and wide-ranging history of health, hygiene and the sea.
The rapid increase in global exploration and trade from the fifteenth century
brought with it similarly rapid increases in the spread of diseases like the Plague,
smallpox and syphilis. In effect, there was a two-way trade in such diseases –
smallpox from the old world to the new and vice versa.
Lengthier voyages, as the author explains, worsened the problem of scurvy. It
was not until the early nineteenth century that enough was known to prevent that
dreaded disease. Typhoid, tuberculosis and even skin cancer were all diseases of
the sailor.
Really, until the end of the Second World War, seafarers generally remained a
“poxed and scurvied” lot. While rare examples of such diseases continue to recur,
however, modern sailors seem to suffer more from psychological diseases.
This is a great narrative of an important but often hidden aspect of seafaring .
Baird Maritime
The author is curator of the Alexander Fleming Museum and an expert in the
history of medicine. This fascinating book traces the problems of malnourishment,
disease and injury faced by the seafarer from fifteenth century right up to the
modern period.
The Royal Navy's role was very significant in improving the fate of the seafarer.
Brown goes into some detail about Lord Nelson's real concern for Jack Tar's

4. welfare - and the specific actions he took in such areas as shipboard diet,
hygiene, morale and naval hospitals ashore.
Brown also shows how in many ways attempts to address the specific needs of
the seafarer developed wider implications for society as a whole; a number of
scientific breakthroughs were in fact of universal benefit.
Julian Stockwin
(http://www.julianstockwin.com/BS%20Sea%20Reference.htm)
A wide-ranging general history of disease, medicine and the sea.
Guardian Bookshop
Poxed and Scurvied: The Story of Sickness and Health at Sea by Kevin Brown
was really great. At first, it seems a bit unorganized, but as you continue to read
the chapters, a pattern emerges. Each chapter is a new topic (or two) but always
covers disease prevention, nutrition, diet, exercise, treatment aboard and
treatment ashore. Usually in that order. Brown covers from the 14th century
through today.
I'm not sure if it is because I worked at the Country Doctor Museum for a year
during grad school or if it is that weird fascination that most people have about
tragedy, but I really enjoyed this book. I found it interesting and insightful in so
many ways. For example, most scholars reference the transmission of epidemics
from old world to new world and the return-favor disease of syphilis. Brown goes
farther, explaining why epidemics break out on ships, the development of
maritime hospitals and quarantines to deal with these diseases, and the ground
breaking work of ship surgeons. He explains that ships were the ideal control
group with diseases accelerated by conditions, hygiene and lack of treatment
options. Also the patients were all very similar-men, youngish, and had the same
diet and environmental conditions=perfect control group!
Brown doesn't just focus on the sailors. Many have learned about the horrible
conditions of slave ships. Brown presents some of those conditions and takes it
further. He explains the motivating factor of money on health in the slave trade.
It is cheaper to throw sick slaves into the sea before they die rather than report a
sickness related death. And there is no monetary reason to treat sailors as they
are less valuable than the slaves. He goes on to discuss emigrants on passenger
ships-sometimes just as crowded as slave ships. He talks about the health exams
before boarding, women and children's health aboard (first time large numbers of
women and children were crossing oceans), and the infamous health exams at
Ellis Island.
I learned a lot, and gathered some of the missing pieces in maritime medicine! I
would recommend it to anyone interested in medical history or sickness at
sea.
Whitney Rose Petrey
(http://maritimeculturenews.blogspot.com/2011/11/book-review-
poxed-and-scurvied-sickness.html 30 November 2011)
A professional archivist, museum curator specializing in the history of
medicine and author of The Pox: The Life and Near Death of a Very Social Disease
describes the history of maritime medicine, particularly the on-board deficiency of
vitamin C.
Probook, Israel
(http://www.probook.co.il/BookPage.aspx?BookId=9781591148098)

5. In summary, Kevin Brown’s Poxed and Scurvied, decorated with an
outstanding dustcover illustration, is a well-written scholarly work that should be
a part of any serious maritime historian’s library.
Sea History, Winter 2011
With chapters on every malady and danger the seaman’s flesh is heir to, Poxed and Scurvied
tells the story of the struggle to improve the fitness of the not always jolly jack tar, and of the
various scientific breakthroughs that would be of great benefit both on the high seas and dry
land.
Family History Monthly, Feb 2012
KEVIN BROWN is the Curator of the Alexander
Fleming Museum at St Mary’s Hospital,
Paddington, and Trust Archivist at Imperial
College Healthcare NHS Trust. He is an expert
on the history of medicine. He is the author of
Penicillin Man, which tells the story of the
antibiotics revolution that began in the
laboratories he now curates, The Pox, a history
of venereal disease, and also Fighting Fit, a
history of military medicine in the wars of the
twentieth century. He lectures and speaks
widely on the history of medicine at home and
abroad.