Warfare, Medicine and Disease in the Atlantic World

Introduction

Disease has played a major role in the interaction between Europeans and indigenous people in the Atlantic world, often in the context of war (see the Oxford Bibliographies article “Disease in the Atlantic World”). Given that more troops died from disease than from combat during the early modern period, and that the environment of the Atlantic world exacerbated the problem of disease, historians have tended to follow contemporaries’ emphasis on disease rather than surgery or injuries. Whether from extended transatlantic voyages that gave rise to scurvy, greater distances and foreign territory that complicated supply systems, or from the virulent disease environments of the West Indies and African coast, war in the Atlantic world was accompanied by high rates of disease among European troops. Historians have analyzed responses to such challenges—logistical flexibility, scientific research, and the acquisition of indigenous medical knowledge—to gauge European adaptation to foreign environments. Similar to histories of science (see the Oxford Bibliographies article “History of Science”), early histories of medicine and medical care during war tend to stress poor provisions and a lack of knowledge. But, just as historians of science recast colonies as sites of scientific innovation, so historians of medicine identify military medicine and colonial warfare as encouraging new forms of medicine. The idea that warfare in the Atlantic world spurred medical innovation challenges an older model of understanding European medicine, one that portrayed a diffusion of European medical and military knowledge into colonial military theaters. Instead, scholars of military medicine see European medical knowledge and practice shaped in these colonial theaters through the experience of local conditions, as well as by local peoples and their military and medical practices (see the Oxford Bibliographies article “Warfare”). Given the paucity of sources on medicine and disease among indigenous peoples, and Europeans’ preoccupation with health and disease as both a strategic and moral imperative, the topic is generally Eurocentric: there is a focus on developments in European or Western medicine, and on responses to disease among Europeans in colonial settings, as the specialty of tropical medicine demonstrates. For details on European disease among African and American Indian populations, see the Oxford Bibliographies article “Disease in the Atlantic World”. Likewise, given the preoccupation with military and naval manpower, most works pay little attention to the health of children or women.

Reference Works

Wide-ranging, often multivolume reference works provide basic information on medicine and medical personnel stationed in Europe and overseas. These are organized by nation, following chronological national military histories (for Spain, see Massons 1994; for Britain see Cantlie 1974), often treating navies and armies separately (for Britain’s navy, see Keevil, et al. 1957–1963; for Portugal’s navy, see Menses 1987; for Portuguese military hospitals, see Borges 2009). As a result, these tend to follow a traditional Whiggish overview of the progress of medicine within national armed forces, highlighting poor conditions and medical care during the early modern period, thus identifying progress in the 19th and 20th centuries. Collections of individual medical men, such as Brisou and Sardet 2010, provide useful references of personnel and their individual accomplishments.

Borges, Augusto Moutinho. Reais Hospitais Militares em Portugal (1640–1834). Coimbra, Portugal: University of Coimbra, 2009.
DOI: 10.14195/978-989-26-0494-7Save Citation »Export Citation »E-mail Citation »
Concise overview of Portugal’s royal military hospitals from the 17th through the early 19th century. Although focusing on hospitals on the Portuguese mainland, it provides a useful background on military medicine during this period, examining hospitals in religious, urban, and architectural contexts. Extensively illustrated with contemporary prints and plans as well as recent photographs.
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Brisou, Bernard, and Michel Sardet, eds. Dictionnaire des médecins, chirurgiens et pharmaciens de la Marine. Vincennes, France: Service historique de la defense, 2010.
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Outlines the careers of French naval physicians, surgeons, and apothecaries, both overseas and domestic, from 1666 to the 20th century. Entries of individuals list publications and accomplishments.
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Cantlie, Neil. A History of the Army Medical Department. 2 vols. Edinburgh: Churchill Livingstone, 1974.
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Chronological narrative of the history of the role of disease in the British Army and developments in military medicine; useful for basic administrative details.
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Keevil, J. J., Christopher Lloyd, and J. L. S. Coulter. Medicine and the Navy, 1200–1900. 4 vols. London: Livingstone, 1957–1963.
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Comprehensive overview of health and medical conditions in Britain’s Royal Navy and merchant fleets. Volume 3: 1714–1815 provides the most detail on the effects of poor health on overseas campaigns.
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Massons, José Maria. Historia de la sanidad militar española. Barcelona: Pomares-Corredor, 1994.
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Four-volume chronological overview of the history of Spanish military medicine, of which Volume 1 provides details on Spain’s early modern campaigns in America.
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Menses, J. V. e. Armadas portuguesas: Apoio sanitário na época dos Descobrimentos. Lisbon, Portugal: Academia de Marinha, 1987.
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Outlines the health and welfare onboard Portuguese fleets, focusing on the 15th and 16th centuries, detailing diseases, food, medicine, and the responsibilities of surgeons and other medical personnel.
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Military Medicine

With deaths due to disease substantially outnumbering combat deaths before the 20th century, there has long been interest in the role of medicine during wartime and in how the experience of war shaped medical developments. Beginning in the 1970s works such as Mathias 1975 and Jones 1980 built on social history approaches to war and medicine, analyzing military medicine as a topic in its own right and suggesting that modern medicine and its scientific methods were shaped by the nature of early modern European war (see also Stahnisch 2013 and Innovation and Reform). With the acceptance of the study of medicine and war, Cooter 1990 encourages conceptual precision among historians, arguing that medicine and war were part of broader historical processes; Cooter also calls for historians to look beyond the debate on whether war was good for medicine. Historians also examine the role of purposeful disease spreading during war, with the infamous 1763 incident of smallpox being spread among American Indian populations by British officials (see the section Biological Warfare in Oxford Bibliographies article on Atlantic History “Disease in the Atlantic World”), enabling historians to use disease and medicine in war to assess differing ethics of war (Charters 2009).

Charters, Erica. “Military Medicine and the Ethics of War: British Colonial Warfare during the Seven Years War (1756–63).” Canadian Bulletin of Medical History 27.2 (2009): 273–298.
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Analyzes military medicine and provisions of care to claim that colonial warfare followed European ethical conventions, highlighting the role of accusations of deliberate disease spreading in wartime rhetoric and strategy.
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Cooter, Roger. “Medicine and the Goodness of War.” Canadian Bulletin of Medical History 7 (1990): 147–159.
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Seminal conceptual article that claims debates over whether war is good for medicine are both ahistorical and unhelpful. Points to the significance of military medical developments during peacetime as well as the broader social forces shaping both medicine and war.
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Jones, Colin. “The Welfare of the French Foot-Soldier.” History 65 (1980): 193–213.
DOI: 10.1111/j.1468-229X.1980.tb01940.xSave Citation »Export Citation »E-mail Citation »
Argues that by creating ever-larger European armies composed of expensive and highly trained soldiers, the “military revolution” in Europe encouraged investment in troop welfare and medical care. It portrays medicine and a concern for welfare in France’s army as a pragmatic attempt to increase recruitment and preserve expensive manpower.
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Mathias, Peter. “Swords into Ploughshares: The Armed Forces, Medicine and Public Health in the Late Eighteenth Century.” In War and Economic Development: Essays in Memory of David Joslin. Edited by David Joslin and J. M. Winter, 73–90. Cambridge, UK: Cambridge University Press, 1975.
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Seminal essay that points to 18th-century military medical antecedents for modern public health and scientific methodologies.
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Stahnisch, Frank W. “Military Medicine.” In Oxford Bibliographies Online. Edited by Dennis Showalter, 2013.
DOI: 10.1093/OBO/9780199791279-0130Save Citation »Export Citation »E-mail Citation »
Provides a bibliographic overview of histories of military medicine, from ancient times through to the 20th century. The early modern period entries focus on European warfare; the subsection on colonial war tends to focus on modern colonial wars.
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Administration of Medicine in the Armed Forces

Early histories of disease and medicine in the armed forces were often written by former medical practitioners who identified with the medical personnel under examination and highlighted the difficulties they faced, as seen in Cilleuls 1960. Likewise, Archer 1987 emphasizes logistical problems and colonial overstretch when surveying military medicine in New Spain. Kopperman 1979 reviews how colonial conditions exacerbated British military medical administration, and Crimmin 1999 identifies similar overstretch within Britain’s naval medical administration. Similarly, vast theaters of operations, uncharted and untracked territories, and a lack of local supply infrastructure adversely affected Spanish military and medical administration, as detailed by Marchena Fernández 1983 and Gómez Pérez 1992. As Pluchon 1985 and Silveira 1993 observe, medical administration thus often developed to support European maritime and imperial expansion. Historians therefore emphasize the administrative challenge of maintaining the health of armed forces overseas, which required technical knowledge and expertise, long-distance supply infrastructure, and deep financial pockets.

Archer, Christon I. “Combatting the Invisible Enemy: Health and Hospital Care in the Army of New Spain, 1760–1810.” New World 2 (1987): 49–92.
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From the perspective of a historian of the army in New Spain, this emphasizes high disease rates as well as logistical and medical weaknesses during campaigns in early modern New Spain.
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Cilleuls, Jean Lambert des. “L’oeuvre du service de santé au cours de la guerre de 1755–1760.” Histoire de la medicine 10.5 (1960): 8–55.
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One of the earliest examinations of the structure of medical provisions in New France, highlighting the shortage of supplies that exacerbated health problems such as scurvy, as well as the work and care invested by military medical men within their limited ability to act.
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Crimmin, P. K. “The Sick and Hurt Board and the Health of Seamen c. 1700–1806.” Journal for Maritime Research 1.1 (1999): 1–17.
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Detailed account of the administrative medical board for Britain’s Royal Navy. It records the navy’s concern with the health of seamen but also reveals the limited ability of the medical board to solve problems. Also outlines the relevant archival material available.
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Gómez Pérez, Mariá del Carmen. El sistema defensivo Americano: Siglo XVIII. Madrid: Editorial MAPFRE, 1992.
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This wide-ranging overview of the supporting infrastructure of the Spanish Army in the Americas includes details on military hospitals, general health care, and food supplies, while also highlighting the financial limits of the Spanish Empire.
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Kopperman, Paul E. “Medical Services in the British Army, 1742–1783.” Journal of the History of Medicine and Allied Sciences 34.4 (1979): 428–455.
DOI: 10.1093/jhmas/XXXIV.4.428Save Citation »Export Citation »E-mail Citation »
Outlines the structure of medical care, including hospitals and transportation, in the 18th-century British Army, with details on administration in North America and the role of women as supporting personnel.
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Marchena Fernández, Juan. Oficiales y soldados en el ejército de América. Seville, Spain: Escuela de Estudios Hispano-Americanos, 1983.
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Influential overview of Spanish forces in America, providing details on finances, administration, as well as on the army itself. Chapter 6 is devoted to the problem of disease and medicine, outlining medical administration, personnel, and an indication of rates of disease.
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Pluchon, Pierre. Histoire des medécins et pharmaciens de marine et des colonies. Toulouse, France: Privat, 1985.
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Useful introductory work that provides an overview of the development of medical administration that supported French maritime expansion, including personnel, medical practices, and diseases. Chapters 1 through 4 are on the ancien regime period.
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Silveira, Carlos da. “As boticas a bordo das naus de quinhentos.” In A universidade e os descobrimentos: Colóquio. Edited by V. M. Soares and Universidade de Lisboa, 237–249. Lisbon, Portugal: Comissão Nacional para as Comemorações dos Descobrimentos Portugueses: Imprensa Nacional-Casa da Moeda, 1993.
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Short overview of the history of medical provisions aboard Portuguese ships from the 16th through the 18th centuries. This also details the developing imperial bureaucracy that administered the growing trade in overseas medicine.
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Innovation and Reform

Historians have suggested various factors behind developments in early modern medicine, some identifying European influences, including European conventional warfare, while others stress the innovative aspects of colonial settings and colonial war. Riley 1987 is an account of European 18th-century disease prevention that links reformist ideologies of enlightened rule with self-styled scientific approaches to governance, in which preserving and encouraging the health of populations, both at home and in the colonies, played a crucial role (see, e.g., Warren 2010). Cook 1990 is a scientific and medical history that identifies early modern European warfare and armies themselves as agents of medical reform, experimentation, and innovation. Historians of medicine (Numbers 1987) also question the extent to which the New World substantially changed the nature of European medical practice, identifying the role of imperial institutions such as the armed forces in sustaining continuities while also providing opportunities for innovation and reform. Others argue that the colonies encouraged empirical methodologies and were sites of medical innovation (see the Oxford Bibliographies article “History of Science”). Lafuente and Peset 1982 points to military pressures and imperial rivalries in stimulating scientific innovation and broader political reform; likewise, Hernández-Sáenz 2000 identifies naval and colonial medicine as sites of administrative centralization and reform, both medical and political. Developments in British naval and military medicine have attracted the most attention from scholars tracing innovation and reform. Building on Cook’s observations, Hudson 2007 and Harrison 2010 claim that British imperial and maritime expansion encouraged medical personnel and administrators to rely on empirical and innovative medical methodologies (see also Tropical Medicine). In contrast to Britain’s decentralized and commercial empire, McClellan and Regourd 2010 highlights France’s centralized system of imperial administration, presenting science and medicine as crucial to its imperial project.

Cook, Harold J. “Practical Medicine and the British Armed Forces after the ‘Glorious Revolution.’” Medical History 34 (1990): 1–26.
DOI: 10.1017/S0025727300050249Save Citation »Export Citation »E-mail Citation »
Seminal study of military medicine that identifies Dutch and English military practices behind empirical developments in early modern medicine.
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Harrison, Mark. Medicine in an Age of Commerce and Empire: Britain and its Tropical Colonies 1660–1830. Oxford: Oxford University Press, 2010.
DOI: 10.1093/acprof:oso/9780199577736.001.0001Save Citation »Export Citation »E-mail Citation »
A wide-ranging overview of British medical reform during the 18th century, demonstrating how an expanding commercial empire, particularly in India and the West Indies, bolstered experimentation, empiricism, and practices such as morbid anatomy.
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Hernández-Sáenz, Luz María. “Seamen, Surgeons and Empire: Spanish Naval Medical Reform and Mexican Medicine in the Late Colonial Period.” Northern Mariner 10.1 (2000): 21–35.
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Examines the nature of 18th-century Bourbon reforms in the colonies, focusing on administrative centralization through colonial hospitals and naval medicine. Identifies the transformation of hospitals from religious and charitable institutions into modern medical centers, as well as the formalization of surgical education.
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Hudson, Geoffrey, ed. British Military and Naval Medicine, 1600–1830. New York: Rodopi, 2007.
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A collection of essays that focuses on the role of the British Royal Navy and imperial war in encouraging medical innovation. Britain emerges as uniquely focused on overcoming the manpower challenges of maintaining an overseas empire sustained through its navy.
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Lafuente, Antonio, and José Luis Peset. “Las Academias Militares y la inversión en ciencia en la España ilustrada (1750–1760).” Dynamis 2 (1982): 193–209.
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Highlights the role of the armed forces in invigorating scientific developments outside of universities in 18th-century Spain, particularly within the context of imperial rivalry.
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McClellan, James E., and François Regourd. The Colonial Machine: French Science and Overseas Expansion in the Old Regime. Turnhout, Belgium: Brepols, 2010.
DOI: 10.7208/chicago/9780226514680.001.0001Save Citation »Export Citation »E-mail Citation »
Comprehensive overview of French colonial science (including medicine) described as a bureaucratic colonial machine. This account portrays imperial, state, and scientific development as mutually sustaining and interdependent, operated through the combined department for the navy and colonies.
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Numbers, Ronald L., ed. Medicine in the New World: New Spain, New France, and New England. Knoxville: University of Tennessee Press, 1987.
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Edited collection, with chapters on New Spain, New France, and New England, comparing New World medical structures with those in Europe. The conclusion by Numbers highlights transatlantic continuities, contrary to common assumptions that colonial settings resulted in deregulated medical practice.
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Riley, James C. The Eighteenth-Century Campaign to Avoid Disease. Basingstoke, UK: Macmillan, 1987.
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Surveys 18th-century Enlightenment and medical theory and practice to outline changing views on humankind’s relationship with nature and the potential to prevent disease through the improvement of the environment.
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Warren, Adam. Medicine and Politics in Colonial Peru: Population Growth and the Bourbon Reforms. Pittsburgh, PA: University of Pittsburgh Press, 2010.
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Traces the effect of Bourbon reforms in late-18th-century colonial Peru, focusing particularly on attempts to improve the health and increase the size of populations and thereby enhance imperial strength.
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Warfare in the Tropics

Given the high rates of disease that plagued European troops operating in the West Indies and along the west coast of Africa, historians consider disease as a crucial factor in campaigns in the West Indies and along the west coast of Africa. Because diseases such as yellow fever were particularly fatal for newcomers (most often European troops), contemporaries incorporated their observations of disease into emerging imperial beliefs regarding both European identity and the distinctiveness of the “tropics.” The experience of disease during campaigns in the West Indies thus encouraged the development of tropical medicine as a medical subdiscipline.

The Problem of Disease

As McNeill 2010 ably demonstrates, the changing environment of the West Indies—due to deforestation, the rise of sugar plantations, and the importation of African slaves—made yellow fever and malaria endemic diseases there during the early modern period. Given that these struck newcomers and Europeans more than settled local populations, troops sent from Europe during campaigns suffered remarkably high disease and mortality rates. Geggus 1979 chronicles the debilitating effects of disease during the campaigns of the 1790s. Buckley 1998 provides an overview of British attempts to adjust to this challenging disease environment, including reliance on local recruits; Leach 1986 highlights the long-term consequences of the recruitment of American-born British colonial soldiers. Harding 1991, Buchet 1990, and Crewe 1993 focus on administrative adaptation, demonstrating different historical approaches to assessing adaptation. Similar to the West Indies, Curtin 1961 observes the role of disease rates and fear of disease for the coast of Africa in British imperial thought and activities.

Buchet, Christian. La lutte pour l’espace caraïbe et la façade atlantique de l’Amérique centrale et du Sud (1672–1763). 2 vols. Paris: Université de Paris-Sorbonne, 1990.
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A uniquely comparative analysis of rates of sickness and adaptation between British and French forces that highlights the complexity of assessing adaptation to foreign environments. A revised excerpt is published in Buchet 1997 (see Disease and Health at Sea).
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Buckley, Roger Norman. The British Army in the West Indies: Society and the Military in the Revolutionary Age. Gainesville: University Press of Florida, 1998.
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Outlines how British military officials attempted to adapt to the West Indian environment throughout the 18th and early 19th centuries, including through the recruitment of local troops. Provides a summary overview of relevant developments in British military medicine.
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Crewe, Duncan. Yellow Jack and the Worm: British Naval Administration in the West Indies, 1739–1748. Liverpool: Liverpool University Press, 1993.
DOI: 10.5949/UPO9781846317361Save Citation »Export Citation »E-mail Citation »
Detailed overview of British naval administration that argues for its ability to adapt, albeit to a limited extent, to the logistics of the West Indies in the mid-18th-century, in part by building on experience and in part through resource support.
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Curtin, P. D. “The White Man’s Grave: Image and Reality, 1780–1850.” Journal of British Studies 1 (1961): 94–110.
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Seminal article that outlines how disease and fears of disease along the notoriously unhealthy coast of Africa shaped British racial ideas and imperial strategy in the 18th and 19th centuries.
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Geggus, David. “Yellow Fever in the 1790s: The British Army in Occupied Saint Domingue.” Medical History 23 (1979): 38–58.
DOI: 10.1017/S0025727300051012Save Citation »Export Citation »E-mail Citation »
Details reasons for exceptionally high disease rates during the 1793 British occupation of Saint Domingue, providing an overview of morbidity and mortality rates during 1790s campaigns more broadly.
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Harding, Richard. Amphibious Warfare in the Eighteenth Century: The British Expedition to the West Indies 1740–1742. London: Royal Historical Society, 1991.
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Provides comprehensive assessment of mid-18th-century British West Indian campaigns, highlighting the significance of finances and resources, as well as their flexibility, for successful combined operations. In contrast with Leach, argues that American colonial complaints over disease and ill-usage reflect later grievances rather than actual misuse.
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Leach, Douglas Edward. Roots of Conflict: British Armed Forces and Colonial Americans, 1677–1763. Chapel Hill: University of North Carolina Press, 1986.
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Traces increasing unpopularity of British imperial and military demands among American colonists. Details how high rates of disease during southern campaigns encouraged American colonial disaffection with British military service.
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McNeill, J. R. Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914. Cambridge, UK: Cambridge University Press, 2010.
DOI: 10.1017/CBO9780511811623Save Citation »Export Citation »E-mail Citation »
Provides an impressive and readable overview of the changing disease environment in the Caribbean as well as the crucial role of disease in campaigns and imperial strategy up to 1914. Excellent introduction to the role of disease in war as well as to environmental history.
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Tropical Medicine

As Arnold 1996 and Harrison 2010 show, tropical medicine (or the medicine of diseases of “hot” climates) was in itself a product of defining certain overseas environments as distinct from, if not opposite to, Europe’s “temperate” environments. As their research demonstrates, the experience of early modern warfare in the West Indies was central to the development of this medical subspecialty. Osborne 2014 highlights tropical medicine’s preoccupation with labor and race, identifying a French strand that differed slightly from British models. Curtin 1989 uses army records to provide early statistical insight into European mortality and morbidity patterns overseas.

Arnold, David, ed. Warm Climates and Western Medicine: The Emergence of Tropical Medicine, 1500–1900. Amsterdam: Rodopi, 1996.
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This edited collection highlights how the notion of diseases and medicine particular to tropical or warm climates emerged before the 19th century, shaped by the context of European imperialism and warfare. The introduction by Arnold highlights European-wide connections and continuities.
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Curtin, Philip D. Death by Migration: Europe’s Encounter with the Tropical World in the Nineteenth Century. Cambridge, UK: Cambridge University Press, 1989.
DOI: 10.1017/CBO9780511665240Save Citation »Export Citation »E-mail Citation »
A comprehensive statistical overview and analysis of disease rates among European troops and their decline in the mid-19th century, covering areas such as French Algeria as well as the West Indies.
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Harrison, Mark. Medicine in an Age of Commerce and Empire: Britain and its Tropical Colonies 1660–1830. Oxford: Oxford University Press, 2010.
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Demonstrates how the experience of British commercial empire informed medical knowledge, including theories about the nature of tropical climates, alongside fears of British degeneration and the dangers of empire.
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Osborne, Michael A. The Emergence of Tropical Medicine in France. Chicago: University of Chicago Press, 2014.
DOI: 10.7208/chicago/9780226114668.001.0001Save Citation »Export Citation »E-mail Citation »
Examines the history of French tropical medicine, emphasizing its origins in 18th-century naval medicine as developed in major French ports in the provinces, rather than Paris. Such ports served as bases for colonial expeditions as well as sites of prison labor, shaping 19th-century understandings of medical geography and race.
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Disease and Health Among Soldiers

Because of the nature of early modern and colonial warfare, soldiers spent the majority of their time in camps, usually in urban garrisons or imperial outposts. Frey 1981 and Brumwell 2002 provide social histories of British soldiers in the Americas, observing how unsanitary living conditions gave rise to diseases; Charters 2009 argues that, when judged by contemporary medical knowledge, officials expended considerable resources and applied expertise to safeguard troop health. McConnell 2004 focuses on British outposts, noting diseases that arise from a lack of supplies. Likewise, Dechêne 2008 recounts the exigencies of war and colonial overstretch in New France. For Spanish forces, Marchena Fernández and Gómez Pérez 1992 details poor sanitation and so-called crowd diseases in urban garrisons. Smallpox in particular had a crucial role in imperial activities (see the Oxford Bibliographies article “Disease in the Atlantic World”); MacLeod 1992 identifies how its presence or threat of its appearance could influence recruitment, while Fenn 2001 tracks its spread during and after wars. With far more soldiers dying from disease than combat, these accounts tend to be social histories of lives of colonial soldiers, in which disease and medicine played an important role.

Brumwell, Stephen. Redcoats: The British Soldier and War in the Americas, 1755–1763. Cambridge, UK: Cambridge University Press, 2002.
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Provides an in-depth examination of the social and cultural lives of British soldiers stationed in the American colonies during the mid-18th century. Brumwell also analyses how disease distinguished between British regulars and colonial soldiers, with American-born colonial soldiers exceptionally susceptible to sickness.
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Charters, Erica. “Disease, Wilderness Warfare, and Imperial Relations: The Battle for Quebec, 1759–1760.” War in History 16.1 (2009): 1–24.
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Applies 18th-century medical theory to argue that medical and military officials invested time and resources in maintaining the health of soldiers. Observes how differences in disease rates contributed to imperial frictions over military strategy.
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Dechêne, Louise. Le peuple, l’État et la guerre au Canada sous le Régime français. Montréal, Quebec: Boréal, 2008.
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Impressive overview that emphasizes the role of war in French colonial administration, while providing glimpses into the persistence of disease among French colonists and soldiers in Canada.
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Fenn, Elizabeth A. Pox Americana: The Great Smallpox Epidemic of 1775–82. New York: Hill and Wang, 2001.
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Readable account of the effects of smallpox during the American Revolutionary War and the spread of a late-18th-century smallpox epidemic across America.
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Frey, Sylvia. The British Soldier in America: A Social History of Military Life in the Revolutionary Period. Austin: University of Texas Press, 1981.
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An overview of the daily lives of British soldiers serving in America during the mid- to late 18th century, in which Frey also identifies high rates of disease and poor medical care for the majority of these soldiers.
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MacLeod, D. Peter. “Microbes and Muskets: Smallpox and the Participation of the Amerindian Allies of New France in the Seven Years’ War.” Ethnohistory 39 (1992): 42–64.
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Provides a valuable analysis of how French alliances with Amerindian forces varied according to the threat of smallpox.
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Marchena Fernández, Juan, and María del Carmen Gómez Pérez. La vida de guarnición en las ciudades americanas de la Ilustración. Madrid: Ministerio de Defensa, 1992.
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Focuses on the daily experience of urban garrisons of the Spanish Americas, outlining the generally poor conditions that soldiers endured.
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McConnell, Michael N. Army and Empire: British Soldiers on the American Frontier, 1758–1775. Lincoln: University of Nebraska Press, 2004.
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Detailed overview of life for British soldiers serving at the outposts of the British Empire along the American frontier. Also records the diseases and poor diets of those soldiers and observes that most soldiers had better care and food than their civilian counterparts.
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Disease and Health at Sea

As with soldiers, sailors endured high rates of disease, a result of long voyages and a lack of fresh foods, poor conditions on ships, and from diseases found in foreign environments (Friedenberg 2002). Scurvy was a common problem on transoceanic voyages, and there is a long history of attempts to prevent or at least manage its incidence (with more than mere lemons). Carpenter 1988 provides a broadly contextualized overview of the disease and its role in expeditions, both military and other. Historians of science and medicine, such as Lawrence 1996, highlight the social and cultural contexts of methods to control scurvy introduced on ships. Edited collections such as Haycock and Archer 2009 and Buchet 1997 credit administrative and logistical developments with improving the health of sailors more so than medical advances. In outlining the daily lives of common sailors, historians note rates of disease and the nature of medical care on naval vessels (France: Vergé Franceschi 1996; Spain: Pérez-Mallaína Bueno 1998; Portugal: Russell-Wood 1983), disagreeing on whether these demonstrate harsh conditions for sailors (Rediker 1987) or relatively harmonious and plentiful livelihoods when compared with contemporary civilians (Rodger 1988). As slave ships were often manned by naval sailors and surgeons, see the section Health Impacts of the Transatlantic Slave Trade in Oxford Bibliographies article “Slavery, Health, and Medicine” contains relevant source material.

Buchet, Christian, ed. L’homme, la santé et la mer: actes du colloque international tenu à l’Institut catholique de Paris les 5 et 6 décembre 1995. Paris: Champion, 1997.
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Wide-ranging edited collection, mostly focused on the early modern period. Includes various essays on health and disease at sea by key French historians. Topics include the Atlantic slave trade, as well as medicine and health in other European navies, such as the Dutch, Portuguese, and British.
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Carpenter, Kenneth J. The History of Scurvy and Vitamin C. Cambridge, UK: Cambridge University Press, 1988.
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Provides a fascinating overview of the history and science of scurvy as well as remedies for it, ranging across geographical areas, cultures, and time periods.
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Friedenberg, Zachary. Medicine under Sail. Annapolis, MD: Naval Institute, 2002.
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A readable account of the range of diseases and medical practices found on ships from the late 17th century through the early 19th century. Generally focused on the Anglo-American experience, with some details on the slave trade and debates about abolition.
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Haycock, David Boyd, and Sally Archer, eds. Health and Medicine at Sea, 1700–1900. Woodbridge, UK: Boydell, 2009.
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An edited collection of essays mostly focused on British ships, demonstrating the range of approaches to medicine and health aboard ships and highlighting the problems of disease for ships in the slave trade as well as developments in naval administration that lowered disease rates.
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Lawrence, Christopher. “Disciplining Disease: Scurvy, the Navy, and Imperial Expansion, 1750–1825.” In Visions of Empire: Voyages, Botany, and Representations of Nature. Edited by David Philip Miller and Peter Hanns Reill, 80–106. Cambridge, UK: Cambridge University Press, 1996.
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Demonstrates how notions of order and discipline were central to 18th-century attempts to reduce disease on naval vessels, linking hygiene and moral reform across Britain and its empire.
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Pérez-Mallaína Bueno, Pablo Emilio. Spain’s Men of the Sea: Daily Life on the Indies Fleets in the Sixteenth Century. Translated by Carla Rahn Phillips. Baltimore: Johns Hopkins University Press, 1998.
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English translation of Los hombres del océano: vida cotidiana de los tripulantes de las flotas de Indias, siglo XVI (1992) that provides an accessible overview of the social life of sailors in Spain’s ships that sailed to the Caribbean, including details on crews, motivations, conditions on board ships, diet, and disease.
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Rediker, Marcus. Between the Devil and the Deep Blue Sea: Merchant Seamen, Pirates, and the Anglo-American Maritime World, 1700–1750. Cambridge, UK: Cambridge University Press, 1987.
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Provocative view of the Anglo-American Atlantic seaman’s labor within a Marxist paradigm, emphasizing the brutal and harsh side of life at sea while charting the rise of capitalism over the 18th century.
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Rodger, N. A. M. The Wooden World: An Anatomy of the Georgian Navy. London: Fontana, 1988.
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Seminal social history of Britain’s Royal Navy during the mid-18th century. Details the everyday life of sailors, including their diet, medical care, and diseases on ships. By comparing sailors’ living conditions with those of their civilian counterparts on shore (and highlighting the benefits of a naval career) Rodger argues against traditional assumptions regarding harsh discipline and poor provisioning in the Royal Navy.
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Russell-Wood, A. J. R. “Seamen Ashore and Afloat: The Social Environment of the Carreira da India, 1550–1750.” Mariner’s Mirror 69.1 (1983): 35–52.
DOI: 10.1080/00253359.1983.10655899Save Citation »Export Citation »E-mail Citation »
Excellent introductory article that outlines social conditions on board Portuguese vessels; includes some details regarding disease and the basic medical care available on board.
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Vergé-Franceschi, Michel. La marine française au XVIIIe siècle: guerres, administration, exploration. Paris: SEDES, 1996.
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A readable administrative and social overview of the 18th-century French Navy, providing technical details as well as broader overviews of expeditions, including the disastrous typhus epidemics that struck 18th-century French fleets in the Atlantic.
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Exchanges and Expeditions

Given the crucial role of medical knowledge in early modern natural history, Cook 2007 and Walker 2013 demonstrate how scientific expeditions and exchanges were part of European imperial and military endeavors (see the Oxford Bibliographies article “History of Science”). As Schiebinger 2009 and Parsons and Murphy 2012 identify, naval and military officials often played key roles in these voyages, not only in providing transportation but also acting as guides to foreign environments and peoples, as well as coordinating access to imperial and local networks of knowledge. At the same time, as Pritchard 1995 shows, Atlantic expeditions could result in high rates of disease due to logistical and organizational problems, resulting in long-term imperial and military weaknesses.

Cook, Harold J. Matters of Exchange: Commerce, Medicine, and Science in the Dutch Golden Age. New Haven, CT: Yale University Press, 2007.
DOI: 10.12987/yale/9780300117967.001.0001Save Citation »Export Citation »E-mail Citation »
Stimulating overview of the relationship between Dutch commerce and science, arguing that trade and overseas commerce shaped practices such as objectivity and description, encouraging developments in 16th- and 17th-century science, including medicine and natural history.
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Parsons, Christopher M., and Kathleen S. Murphy. “Ecosystems under Sail: Specimen Transport in the Eighteenth-Century French and British Atlantics.” Early American Studies 10.3 (2012): 503–539.
DOI: 10.1353/eam.2012.0022Save Citation »Export Citation »E-mail Citation »
A unique comparison of French and British natural-history specimen transportation, highlighting the advantages of France’s centralized imperial transport network.
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Pritchard, James. Anatomy of a Naval Disaster: The 1746 French Naval Expedition to North America. Montreal: McGill-Queen’s University Press, 1995.
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Detailed account of the organizational and structural problems that beset the French expedition to Louisbourg in 1746, including debilitating rates of disease and death. This provides a readable overview of logistics and administration of both the French navy and its early empire.
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Schiebinger, Londa. “Scientific Exchange in the Eighteenth-Century Atlantic World.” In Soundings in Atlantic History: Latent Structures and Intellectual Currents, 1500–1830. Edited by Bernard Bailyn and Patricia L. Denault, 294–328. Cambridge, MA: Harvard University Press, 2009.
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Highlights the exchange of medical knowledge among Amerindian, European, and African communities in the West Indies, mentioning military medical men as key to these exchanges.
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Walker, Timothy. “The Medicines Trade in the Portuguese Atlantic World: Dissemination of Plant Remedies and Healing Knowledge from Brazil, c. 1580–1830.” Special Issue: Mobilising Medicine: Trade & Healing in the Early Modern Atlantic World. Social History of Medicine 26.3 (2013): 403–431.
DOI: 10.1093/shm/hkt010Save Citation »Export Citation »E-mail Citation »
Emphasizes Portuguese receptiveness to indigenous medical knowledge alongside the development of utilitarian methods in colonial medicine, particularly as a result of limited manpower in Brazil. Some passing references to the role of military and naval officials in medical knowledge exchange, though the analysis focuses on the role of the Jesuits.
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Primary Sources

While medical practitioners often published their accounts of the effects of disease and suggestions to maintain troop health, military, naval, and colonial correspondence also provide records of disease, health, and medicine. Material and visual culture provide useful tools to understand the practice of medicine within its broader context.

Texts

Although military and naval medical personnel often wrote treatises summarizing their experiences during wartime (Paré 1575), such writings were not focused on non-European environments as distinctive climates with unique medical challenges until the 18th century. British texts were influential: Lind 1753 was considered the seminal work on scurvy for much of the period. Lind 1768 was also translated into various European languages and formed the basis of the specialty of tropical medicine into the 19th century (see also Tropical Medicine). More generally, European medical theory considered these hot climates as the cause of disease, thereby grouping areas such as the west coast of Africa (Azeredo, et al. 2016) and the West Indies (Poissonnier-Desperrières 1763) under similar modes of observation and analysis. Price 1983 provides the most comprehensive bibliography of relevant texts. Manuscript sources, such as the records of naval surgeon Peter St Medard (Estes 1997) demonstrate the opportunities for observation and independent analysis provided through overseas campaigns. Official colonial and military correspondence (Heritage–Canadiana) also highlight the obstacles in early modern long-distance communication.

Azeredo, José Pinto de, Timothy Walker, Adelino Cardoso, António Braz de Oliveira, and Manuel Marques. Essays on Some Maladies of Angola (1799). Dartmouth, MA: Tagus, 2016.
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This English translation of a classic 18th-century Portuguese medical text is sensitively contextualized by three scholarly essays. Born in Brazil, Azeredo studied at Edinburgh and Leiden before returning to Brazil, from where he was appointed physician general for the Kingdom of Angola before becoming physician at the Lisbon Royal Military Hospital in 1801. Azeredo considers diseases of all hot climates as similar, building on his experience in Brazil; his medical analysis also provides insight into African medical practices and their influence on European medical theory.
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Estes, J. Worth. Naval Surgeon: Life and Death at Sea in the Age of Sail. Canton, Mass: Science History, 1997.
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Readable account of the life and historical context of the naval surgeon Peter St. Medard, focused on Medard’s own records from his 1802–1803 voyage on a US frigate sailing to the Barbary. The appendices include details of Medard’s records of medicine, disease, and rates of sickness onboard.
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Héritage–Canadiana.
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Microforms of French and British colonial and military correspondence, otherwise held in France’s and Britain’s respective national archives, have been scanned and made available online via Canada’s Library and Archives. Mostly dating from the 17th and 18th century, these provide researchers with detailed insight into the day-to-day running of colonies and overseas military operations, well beyond the scope of Canadian history. Of particular relevance are the series from the French “Fonds des Colonies” (e.g., C11A, correspondance générale, Canada; F2C, colonies en général; D2C troupes des colonies); French “Fonds de la Marine” (e.g., B3 lettres reçues; B4 campagnes); British War Office (e.g., WO 34 Amherst Papers; WO 44 in-letters; WO 58 out-letters; and British Colonial Office (e.g., CO1 colonial papers, general series).
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Lind, James. A Treatise on [of] the Scurvy. London: Sands, Murray, and Cochran, 1753.
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Often considered the key work on early modern approaches to scurvy, Lind provides an overview of the various theories behind the incidence of scurvy, noting that the damp environments onboard ships were often to blame. His famous so-called clinical trial making use of lemon juice is contextualized by the text’s broader analysis of the range of factors that could give rise to scurvy as well as cure it.
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Lind, James. An Essay on Diseases Incidental to Europeans in Warm Climates. 1st ed. London: T. Becket and P. A. de Hondt, 1768.
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One of the first and most influential medical texts to focus on the health of laboring Europeans overseas, particularly soldiers and sailors. Categorized diseases according to their climates. This two-volume work thus provides insight into British and European views of overseas environments and culture.
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Paré, Ambroise. Les oeuvres d’Ambroise Paré. Paris: chez Gabriel Buon, 1575.
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Considered the foundational text of European surgery, in this multivolume illustrated work Paré lays out the groundwork of military surgery and the most effective methods for dealing with gunshot wounds. Various French editions are available through the Bibliothèque nationale de France’s Gallica site online. The 1585 edition is available online through the US National Library of Medicine online.
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Poissonnier-Desperrières, Antoine. Traité des fièvres de l’isle de S. Domingue. Paris, 1763.
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Serving as deputy administrator of medicine in the French Navy and colonies as well as having been royal physician at Saint-Domingue, Poissonnier-Desperrières was usefully placed to provide insight into medical experience and organization in the French empire. His analysis emphasizes the ability of humans to adapt to new environments, if care is followed in lifestyle and diet. Available through the Bibliothèque nationale de France online.
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Price, Robin. An annotated catalogue of medical Americana in the Library of the Wellcome Institute for the History of Medicine. Books and printed documents 1557–1821 from Latin America and the Caribbean Islands and manuscripts from the Americas 1575–1927. London: Wellcome Institute for the History of Medicine, 1983.
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Provides an impressive guide to an amazing collection of printed materials, periodicals, and manuscripts relating to medicine in the Americas held at the Wellcome; a collection drawn from the personal libraries of Henry Wellcome, Nicolás León, and Francisco Guerra. Full bibliography and index are included. Available through the Wellcome Library online.
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Visual and Material Culture Collections

National maritime museums generally hold impressive collections of maritime objects, including those relating to surgery and medicine onboard ships. Those in Britain (Collections of Royal Museums Greenwich) and France (Collections of the Musée national de la Marine) have made images and details of their collection available online. Other cultural institutions have intermingled textual and visual holdings, preserved through online exhibitions (Atlantic Materia Medica’) or an online database (Wellcome Images).

Atlantic Materia Medica’. John Carter Brown Library.
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This exhibition stresses the innovative aspect of European medicine in colonial contexts, highlighting both the content and form of European observations in the Atlantic world. Combining English, French, Spanish, Dutch, and Portuguese sources, the exhibition links to the John Carter Brown Library’s broader collection, including its Archive of Early American Images, thus providing online access to a range of textual and visual material.
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Collections of the Musée national de la Marine.
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France’s national maritime museum has four locations (Paris, Brest, Port-Louis, Rochefort, Toulon), preserving artefacts of France’s colonial and naval past. Many of its objects and images are online, and fully searchable by keyword.
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Collections of Royal Museums Greenwich.
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Comprising Britain’s National Maritime Museum, The Royal Observatory, Cutty Sark, and the Queen’s House, Royal Museums Greenwich holds an extensive collection of objects, including paintings, medals, and navigational instruments, across a variety of maritime themes, alongside its textual archives. Many of its objects and paintings are available online through a fully searchable database, demonstrating the wide range of maritime culture in the history of Britain.
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Wellcome Images.
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The Wellcome Library, one of the world’s foremost collections of artefacts and texts relating to the history of medicine (broadly conceived) provides open-access to its holdings of images and videos, easily searchable by date, theme, or keyword.
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