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Sir Gilbert Blane, Bart, MD FRS (1749-1832)

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Sir Gilbert Blane, Bart, MD FRS (1749-1832) Annals of the Royal College of Surgeons of England (I980) vol 62 Sir Gilbert Blane, Bart, MD FRS (1749-1832) R D Leach FRCS Honorary Senior Registrar, Department of Surgery, St Thomas's Hospital, London Key words: HISTORY OF MEDICINE; NAVAL MEDICINE; SCURVY; SIR GILBERT BLANE Introduction Blane was highly thought of by his contem- Gilbert Blane was a champion of many causes poraries, who elected him President of the during his medical career, the most import- Students' Medical Society in 1775. ant of which was a change in the treatment The early intention of Blane to become a of scurvy leading to the virtual removal of the clergyman had brcught him into contact with disease from the Navy. He made no startling writers and artists in Edinburgh, and it was original discoveries but impressed upon his with references from Robertson, the Scottish contemporaries those changes which he person- historian, and Blair, the author of sermons, ally knew to be effective. and the highest commendations from his Nearly 200 years after the implementation mentor, Cullen, that he set out for London in of the reforms which effectively doubled the I 776. These commendations were presented to fighting force of the Navy his name is little William Hunter, the anatomist brother of remembered except by naval physicians, who John, with good effect. Blane attended Wil- have called him a father of naval medical liam's lectures in anatomy and surgery and science. was also advised by him about the conduct of his career. On 28th August I778, having trav- Early years elled from London, Dr. Gilbert Blane was The merchants of Ayrshire in I620 included awarded his MD degree in Edinburgh. Thomas Blane, a successful man with consider- Setting up medical practice in London in able standing in the local community at Gir- the late 17th century must have been difficult, van, which was the centre of his trade. Three but Blane returned from Scotland with this generations later, in I749, Gilbert Blane and in mind. It was a great help to be recom- his wife were living at Blanefield, part of an mended for a post by an established physician estate now owned by the Marchioness of Ailsa of the town, especially with such fierce com- which is sited one mile to the east of the vil- petition for patients. When William Hunter lage of Kirkoswald. They were still merchants, recommended Blane to Lord Holderness he consolidating the family social and financial must have been apprehensive, for this was standing. On 29th August I749 a fourth son to be a test of his competence and finesse was born to them and called, after his father, as a society doctor. Holderness was chronic- Gilbert. ally ill but well thought of both for his good He was educated at Kirkoswald and May- taste and his high standing at Court. Blane bole schools, but we know little of his early gave a good account of himself in the man- life. It is worthy of note that in I753, when agement of Holderness's case and began to Blane was four, James Lind published his treat- be accepted by London society, although it ise on the treatment of scurvy, which Gilbert is possible that his abrupt, economic manner Blane was to pursue throughout his career. was not as smiled upon as it might have been. At the early age of I4 he was accepted into This aside, Sir George Rodney (Fig. i) felt him the Faculty of Arts at Ediinburgh University more than suitable to become his private phy- and was at first destined for the Church, but sician in his flagship HMS Sandwich (Fig. 2). as a man of practicalities he soon changed It was in this capacity, with no official rank courses to that of medicine. It appears that in the Navy, that Blane sailed with Rodney The winning submission for the St Thomas's and Guy's Hospital Historical Prize, I978. Sir Gilbert Blane, Bart, MD FRS (I749-1832) 233 vations of James Lind's earlier work Gilbert Blane published 'An Address to the Officers Serving in His Majesty's ships of war in the West Indies and America'. It concerned the reduction in disease in the fleet, improved methods of cleanliness, and hygiene and was published at his own expense. It was not long before he had to justify his position and treat Sir George Rodney, who suffered from gout and the stricture, two diseases not uncommon amongst naval offi- cers at that time. Rodney returned to England from the West Indies in September 178I to recover and gather reinforcements. On his return Blane successfully acquitted himself at the examination for the Licence of the Royal College of Physicians on 3rd December 178I. His stay in London was not long, for Rodney, feeling better and with his fleet reinforced, called for Blane to go to Plymouth, from where he sailed for the Wars of the American Colonies in January I782. Before leaving London Blane had drafted a memorial to the Board of the Admiralty noting that, in a fleet of 20 ships, 7I5 men out of a total of I2 OI9 had died (59 of wounds) and 862 were in hospital. One in every I 5 was on the sick list and he noted vary- ing degrees of sickness in identical ships which he thought was due to differences in clean- FIG. I Sir George Rodney. (Reproduced by kind liness in the ships. He suggested that if venti- permission of the National Maritime Museum, lation, cleanliness, and damp were not im- London.) proved and if the supplies of lemon juice (to to raise the siege of Gibraltar on Christmas prevent scurvy), soap, bedding, and medicines Eve 1779. Both for his common sense and courage Blane became greatly admired 'by the crew and officers of the flagship. Owing to the absence of an excutive officer he had delivered mess- ages to the guns during one of the six actions in which he was involved, and was slightly wounded during this action. The officers successfully petitioned that he be appointed without delay to be Physician to the Fleet. Physicians at that time had no commission in the Navy and were warrant officers enjoying low pay as well as a bad reputation amongst doctors on land. As Physician to the Fleet Blane received monthly reports from the ships' surgeons, gathering a vast amount of practical know- FIG. 2 HMS Sandwich. (Reproduced by kind ledge about the health of seamen. Upon these permission of the National Maritime Museum, reports, his own observations, and the obser- London.) 234 R D Leach were not provided there could be little re- his treatment of sweating sickness, leprosy, duction of mortality and morbidity in the measles, venereal diseases, plague, dysentery, Navy. There was no response from the Ad- intermittent fevers, typhoid, smallpox, rickets, miralty. He was incensed and had to wait for typhus, and scurvy, noting that in I830 I5 years before he could officially put his scurvy was nearly as rare at sea as on land methods into practice as a Commissioner for owing to the improved cleanliness and gen- the Sick and Hurt Board of the Navy. eral supply of lemon juice in the Navy. He In the mean time he employed his methods also noticed that scarlet fever, consumption, in the ships of Rodney's fleet. A year later he gout, and dropsy had become more prevalent wrote again to the Lords Commissioners of at the beginning of the igth century, which the Navy that no man had died from disease he ascribed to the much greater proportion of in a six-month period and only three were the population undertaking sedentary occu- rendered sick in his ship, HMS Formidable. pations. In the whole fleet of 40 ships 350 men had Blane also mentioned the origins of St died from disease. Again there was no re- Thomas's Hospital from an almshouse run by sponse, but Rodney wrote of Blane: friars and its debt to King Edward VI and 'To his knowledge and attention it was owing William and Mary, who endowed the hospital that the English fleet was, not withstanding their with funds. The hospital was built on swampy excessive fatigue and constant service in a con- ground in Southwark, but its foundations dition always to attack and defeat the public were augmented with dry rubble, which Blane enemy. In my own ship Formidable out of goo to health. After an out- men one was buried in six months'. considered beneficial not break of fever the number of beds had been When peace came in 1783 the officers of reduced from 500 to 433, io or I2 of which Rodney's fleet wrote to the Admiralty asking were kept for emergencies. There were nine that Blane should be recompensed for his out- men's wards and six for women, as well as standing care of the men, suggesting that he three others for patients with venereal disease. be awarded a pension, to which the Commis- Admission and discharge of about 50 patients sioners for the Admiralty for once agreed. He was carried out on one day each week and was given a pension of ten shillings a day for he noted that surgical patients tended to stay life, which was doubled 20 years later. longer than medical patients owing to the protracted course of their diseases-a contrast Gilbert Blane at St Thomas's Hospital with modem-day experience. The walls were Having left the Navy, Blane busied himself whitewashed annually and to combat in- looking for backing to help an application for fection iron beds and better ventilation were appointment as physician to one of the Lon- installed.
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