Sturdy timber and majestic sails, the icons of the Age of Sail, trailblazing a path through the ages of masted ship warfare, now silenced.  In its place, clanking metal engines within giant hulks of iron, steam and black smoke pouring from funnels atop new ships of battle.  The age of the dreadnought has come to fruition.  The development of more powerful armaments have spurned, out of necessity, the birth of ships caste of metal shells; more effective protection for the seamen within, against an onslaught of shells so concentrated in explosive power as to turn the wooden ships of previous eras to naught but splinters and smoldering driftwood.  Harnessing the wind was no longer a task of vital importance; the will of captains may now be fulfilled to greater effect as their control over their vessel is expanded with the inclusion of engines for maneuvering and speed.  Despite these epic advancements, and the modernization of seaworthy vessels more akin to the ships known in modern times, such novel technologies and arms bring with them a menagerie of possible traumas and wounds, mostly unknown to sailors and seaman who previously sailed similar waters.  Let us dissect the means and methods of incurring wounds suffered by the sailors in the age of the dreadnought.  I have chosen, due to a huge array of potential injuries, to focus on the burn wounds caused by explosive shells.


Making ships of iron was an absolutely ingenious idea, used to great effect against wooden ships carried over from times when their lot ruled the oceans.  Most navies became keenly aware of the fact that their vessels crafted from wood would soon become obsolete in the face of unstoppable evolution.  This evolution was characterized by the progression of regular solid iron shot to the more modern, and exponentially more effective, explosive shot.  By the time of the American Civil War, and the first battle between ironclads mixed with wooden ships of war, it became abundantly clear that the ironclad had become the quintessential warship and would soon comprise the world’s fleets en masse.
There was, of course, no dearth of mutilation and injury during the age of the masted battleship-of-the-line.  Balls of iron, splintering wooden panels, and a veritable lack of means to cope with said injuries.  However, the new ironclads, though very protected from shots used effectively against previous generations of warships, including the early types of explosive shot, were soon prey to advanced types of the same weaponry.  These advanced types gained the ability to pierce armor, thus severely limiting the proposed invincibility of ironclads against conventional naval weaponry.  Should one of these breach the outer shell of the ironclads, what might occur within, and what might happen to the crew members in the immediate proximity?  The iron walls of the ship, though reasonably proficient at preventing entry of the concussive wave produced by a nearby explosion, were equally, if not more, proficient at encapsulating the explosive force should one of the shells gain entry to the ship’s innards.  The high heat and force generated in such a small area was absolutely devastating to anything living.  If one can imagine, for a moment, being on the inside of a grenade as it explodes, then we might gain a picture of what these poor souls were subjected to when a shell burst in their cabin.  This also says nothing of the hazards surrounding them.  Machinery, stoves, crowded bunks; all turned into weapons when propelled by the force of explosion, thus creating shrapnel not of wood, but metal, and thus all the more devastating.  What might happen to a human body subjected to such intense heat and concussive force?  It follows that the first, and most obvious, organ to be affected by the flames would be the skin.


Our skin covers our bodies, protecting our inner organs from exposure to the elements and disease by infection or worse.  Without getting overly medical, we can describe the skin as having three layers.  The first, and outermost, layer is the epidermis.  This is the layer we see on all humans since it lies on the outside, and should be the only layer visible at that.  The epidermis is most responsible for our skin’s protective function, and is thus the most durable due to the keratinized squamous cells that line it.  The next layer, directly beneath the epidermis, is the dermis.  The dermis cushions our skin against depression and strain, allowing it to accommodate and morph with objects, providing a separate but equally important protective attribute when compared with the epidermis.  The dermis is also home to all the glands and blood vessels supplying the skin, as well as the hair follicles.  The third layer of skin is known as the hypodermis.  This layer is, in reality, not actually considered a part of the skin proper, but it does function to attach the previous skin layers to underlying bone and muscle, as well as help supply blood vessels and nerves to the layers above.  The hypodermis is comprised of loose connective tissue, and elastic fibers which further help to give our skin the elasticity it needs to be an effective means of protecting our inner bodies.


In turn, there are generally considered to be three major classifications of burns: first degree, second degree, and third degree.  First-degree burns are usually minor, akin to a sunburn, with redness and swelling of the affected tissue, but the person is expected to make a full recovery.  Second-degree burns are obviously more serious, often penetrating past the superficial layer of epidermis down into part or the whole of the dermis.  These burns often require the care of a physician to prevent scarring, and make take 3 or more weeks to heal fully.  The third-degree burns, the most dangerous of the three, result in loss of the epidermal layer with damage to the tissues below.  Third-degree burn patients often require acute medical care, and the loss of the epidermal layer as well as the dermal appendages (glands and hair follicles) necessitate skin grafting in a large percentage of victims.  Aside from the likely increase in pain, why is that the two latter burn gradations are so much more dangerous?  The simple answer, and one which we touched upon in a previous discussion, is entry of ectopic bacteria and infectious agents.  You see, one of our skin’s most important features is its ability to prevent entry of the huge number of bacteria that live benignly on the outside of our bodies.  This was previously discussed with regard to splinter wounds from cannonshot during the age of sail, and though this type of injury if somewhat different, it still follows that any laceration or injury to the skin would provide the perfect means for the bacteria living outside our body to find their way in to areas in which they do not belong.  Infection was, in some ways, as much of a problem during the age of the dreadnought as during the age of sail.  Penicillin, discovered in 1928, and other such miracle drugs would not be discovered for many years.  Though, it is of course unclear how much benefit such victims would receive from antibiotics, due to the nature of their wounds.

Breaking the variation of burns down by proximity to the blast, we would certainly expect that the crew members closest to the point of explosion, either due to the concussive force crushing their organs or stopping their heart, or the intense heat doing instant damage to the same, would  have died instantly, some likely unknowing of their fate.  Many would likely have suffered the most grievous of burns, likely full thickness and third-degree, however, they would have been lucky enough to not have to suffer through the aftermath of such wounds.  The shrapnel from the exploding shell, as well as that provided by exploding metal set pieces, would provide another means of death, such that if the force or heat were not enough to do one in, metal shards flying at untold speed would likely finish the job.  Those sailors slightly farther, but close enough to receive very similar burns were likely some of the most grievous and painful cases during the whole of sea warfare during World War I.  Of particular note was the fuel present in these new ships, needed to power their new, mechanical engines, and all but unnecessary in the age of sail.  Should this petrol, or similar fluid ignite and make contact with the crew, the results would be gruesome as it can continue burning well after the initial explosion.  Moving further out from the point of explosion, it is possible we would see burns of decreasing intensity, yet the sectioning of the ships coupled by the relatively small spaces and the ability of the flames to travel and fill these spaces, often times caused a large dichotomy in the blasts effect on sailors.  Those nearest obviously suffered grievously, but those farther and in different section might often have been unaware of the plight of their fellow crew until after the fact.  This was quoted as being so in Keegan’s The Price of Admiralty, where sailors reported not knowing a shell had burst in the ship despite being less than 50 yards away.  This lends credence to the point that, although these ships were reasonably good at keeping the shells out, it might be argued that they were even more capable of containing a blast within a certain area.  There was very little the naval surgeons could do to provide reprieve from the pain and agony of a third-degree burn, and should the sailor’s body be robust enough to fight off death for an extended period, the bacteria introduced into the wound would more than likely take their toll.


Though the human body is covered with many different strains of bacteria, the one most dangerous in burn victims is Pseudomonas aeruginosa.  This bacteria is fairly ubiquitous, being found in the soil, water sources, and our very skin; however should it gain entry to the deeper layers of tissue, it would grow and replicate with ease due to its ability to utilize many different resources as food.  This bacteria is still a problem in burn victims in hospitals, and due to its adaptability, it can live in the most unlikely of places: medical machinery, hospital equipment, etc.  Since antibiotics are utilized during the modern era, many of the other bacterial species which also might have afflicted these unfortunate sailors can be more easily dealt with, however, Pseudomonas remains a threat.

I will conclude with a quote from Keegan’s The Price of Admiralty (page 153), one which I feel gives a true sense of the horror faced by the sailors suffering from burn wounds, and the disturbing, hopeless task faced by the naval surgeons who attempted to treat them.

“In the ankle deep flood, blood-stained bandages and countless pieces of small debris of war floated to and fro…the most dreadful cases were the ‘burns’ - but this subject cannot be written about.”

If you asked a physician during the 18th century, I imagine he would say it does.  Back in the early days of somewhat more modern medicine (my favorite era), and well before we had any real concept of what was causing the diseases that we saw, and still sometimes see, on a daily basis, many physicians and scientists drew the conclusion that that which smells bad to you, must also be bad for you.  This theory, termed the miasmatic theory of disease, is to me, one of the most fascinating, unbelievable, yet also logical components of the history of medicine.  You’re likely thinking, “I might agree with fascinating and unbelievable, but logical?”  Absolutely!  Let’s think about it, and put it into a context which might be more relevant to your average person in modern era.  If you go into a gym locker room that is never cleaned and smells just terrible, isn’t it your primary instinct to either get out of there immediately, or at least spend as little time in there as possible?  Yes, of course you now know that the bad smells might signify microbes, bacteria, and potential infection, however, what if you had no idea that those things existed?  You spend some time in the room, likely you are fine, but then another several thousand people come in and out of there over the course of a year.  It is likely that at least a few of those individuals will get sick or receive a nasty infection.  Your average 18th century physician, having no real knowledge of bacteria, viruses, or fungi, might decide that since all the people in question went into this locker room, and in turn, since noxious fumes are instinctively avoided by humans, that the two put together must therefore lead us to disease.  Just one example of this is, of course, never enough on which to base a rather grand conjecture such as the miasmatic theory of disease, however, if we compound our one example with other such instances, then we clarify the steps which many physicians likely took to get to the point of associating noxious smells with dangerous illness.

Here is another example from the same era regarding yellow fever, an infection caused by the yellow fever virus.  Many explorers, sailors, and workers who ventured into swamplands often times found themselves or their party with a most heinous illness.  Yellow fever consists of general flu-like symptoms (headache, fever, nausea, vomiting) which often subside after some days, however, in some instances the disease can progress to a more advanced state.  This “toxic phase” is often comprised of spiking fevers, jaundice (yellowing of the skin, thus yellow fever) due to damage of the liver by the infectious organism, and finally bleeding from the eyes and anywhere along the gastrointestinal tract (i.e. from mouth to anus).  This internal bleeding can cause the vomit to turn black, a product of the blood interacting with the acids in our stomach.  This infectious disease is, as I said earlier, caused by the aptly named, yellow fever virus, whose vector is the mosquito, Aedes aegypti.  Now, it follows that since these mosquitoes can carry this virus, and that swamplands and marshes are the breeding grounds of mosquitoes, it is perfectly reasonable to assume that the chances of getting yellow fever increase considerably when we spend time in such landscapes.  However, to the physician 250 years ago, with no knowledge of vectors or viruses, a very different conclusion might take form.  Since swamps are rife with noxious fumes, compounded with the fact that many individuals who went into the swamps came out sick, we might assume it was the fumes themselves that carried the disease.  If we extrapolate this pattern to world at large, we find very similar “relationships.”  For example, many captains aboard sailing vessels felt it of utmost importance to clear the ship of noxious smells by cleaning rigorously and  often, with the result being lower rates of disease compared to ships with less meticulous cleaning regimens.  Again, we know that cleaning the ship also likely reduced the amount of harmful bacteria aboard, however wouldn’t that also cause the smell to improve since fumes from bacteria can often be the source of the bad smell?  Scurvy was thought to be caused by the sea air, cholera was though to be caused by the spread of poisonous fumes, and so on.

This theory permeated the thinking of healthcare workers for much of the age of sail, often to the detriment of the sailors.  Many suffered from scurvy, beriberi, and other such illnesses, without the proper means or understanding for a cure.  Instead, the physicians, though logically so, often focused on decreasing the amount of noxious fumes for the person instead of seeking to discover what might actually cure the illness through what we might term “rudimentary experimentation.”  That is, trying out different medications or dietary changes until one proves useful in treating the disease.  This was how the discovery of vitamin C as a cure for scurvy came to fruition.  More on that topic in future postings!
*Images courtesy of Wikipedia