Ships Surgeons as Physicians and Hygienists: Health at Sea During the Seven Years' War and Napoleonic Wars.

The rise of England as a global empire in the Seven Years' War (1756-1763) depended on the health of the seamen in the Royal Navy. Under constant danger from combat and manning a sailing battleship in open water, their greatest risk were contagious disease and dietary deficiencies, notably scurvy. During the conflict disease and desertion resulted in nearly 100 times the deaths from direct contact with the enemy. Tasked with the treatment of grievous injuries far from land, ship's surgeons had the greater responsibility of maintaining the general health and nutrition of the crew. Reformists like James Lind, Sir Gilbert Blane, and Thomas Trotter led to improvements in nutrition, especially the general issue of antiscorbutic fruit, fruit juice, and fresh vegetables; smallpox vaccination; and improved cleanliness of clothing and berths. The better overall health of its seamen was an important factor in the Royal Navy's decisive victory over France at the Battle of Trafalgar (1805).