Naval Medicine

When the Norwegian corvette Nordstjernen was in the North Sea bound for Port Said to be present at the opening of the Suez Canal on 17 November 1869, an officer suffered a rupture of m. triceps brachii when he was drawn into the machinery during a storm. He was put ashore in Harwich; four days after the injury he was hospitalized in Colchester. The voyage was eventful in other ways too. Another officer died from typhoid fever in Ismailia. On the Swedish frigate Vanadis, also present at the opening of the Suez Canal, one of the doctors died from lung infection and was buried in Smyrna; a twelve-feet high column of white marble was taken from the ruins of Aesculap's temple and put on his grave. Denmark was represented by the frigate Sjaelland. During a storm in the North Sea, one seaman fell down on the deck from the foresail yard and suffered contusions and a fracture of the left clavicle. These cases illustrate challenges that faced our ancestors. The accident happened when the ...

The essence of the project of pro-health attitudes promotion is the assumption that they contribute to a successful occupational career and reduce health and life hazards in the maritime work environment. The method chosen was to train students of the Maritime Academy in Gdynia, the future officers and potential health leaders among maritime employees.

A sample of 187 medically treated injuries among fishermen was the basis for this study. Nearly half the injuries occurred while shooting or hauling fishing gear. The most common injuries were in the upper extremities (48.7%). Twenty-two percent of the injuries occurred while working with winches ropes and wires and about 30% were caused by falls or slips. Seventy-five percent of accidents occurred on trawlers, where the trawl doors (other boards) are a special hazard. Medical treatment ashore was delayed for more than 24 hours in 35% of the injuries, showing the need for providing optimal treatment facilities on board. Prevention measures should include technical improvements, safety training courses and efforts to enhance the motivation for safe work. The fishermen's proposals for prevention seem to be most useful and should be used to the full extent.

Ottoman sources from the sixteenth and seventeenth centuries tell us a great deal about naval finances or dockyard operations. Indeed, the logistics of the Ottoman have been studied reasonably well. However, the Ottoman sources are virtually silent about the people involved in these naval operations. In this article the manpower will be in focus, with particular emphasis on the oarsmen who manned the galleys, the captives and criminals, and the medical treatment offered to them. The resulting discussion allows us to gain insights into the experiences of non-elite or behind the scenes Ottomans involved in the navy—whose voices are difficult to recover—toward the end of the seventeenth century. This article also indirectly contributes to the growing scholarship in recent years on Ottoman slavery.

The custom of allowing British seamen the regular use of fermented liquor is an old one. Ale was a standard article of the sea ration as early as the fourteenth century. By the late eighteenth century, beer was considered to be at once a food (a staple beverage and essential part of the sea diet), a luxury (helping to ameliorate the hardship and irregularity of sea life) and a medicine (conducive to health at sea). In particular, beer and its precursors, wort and malt, were administered with the aim of preventing and curing scurvy. This paper examines the use of malt and beer during late eighteenth century British sea voyages, particularly their use as antiscorbutic agents, focusing on James Cook's three voyages during the period 1768-1780. Cook administered sweet wort (an infusion of malt), beer (prepared from an experimental, concentrated malt extract), and spruce beer (prepared mainly from molasses), among many other items, in his attempts to prevent and to cure scurvy. Despi...

The Polish public awareness of the crucial importance of the own maritime economy to the very existenceof the national state has its historical reasons. The Polish maritime involvement has seen several dramaticcrises, but the Polish nationals have become an established group in the global marine trade workforceand are entitled to the proper health care. In this paper the main maritime health issues are mentioned.To meet the issues, also the national education system provides the opportunities for both seafarers andmedical professionals. The Polish doctors can specialise in the maritime medicine. In many cases the generalmedicine students formations include these topics as well. The psychological aspects are also takeninto account, both of the education of the seafarers and the organisational structure of the Polish healthcare system. Some recent aspects of the Polish participation in the international cooperation in the fieldof the medical support of the maritime economy are also de...

Cardiac dysrhythmias after electrical injury have been reported previously, however, atrial fibrillation after low-voltage electrical injury is extremely rare. We present a case of atrial fibrillation with rapid ventricular response resulting from a low-voltage electrical injury. A 24-year-old active duty Navy sailor presented to the emergency department after an electrical shock from a 440-V furnace. He experienced severe pain in both hands and a racing sensation in his chest. He denied other symptoms. An electrocardiogram was performed demonstrating atrial fibrillation with a rapid ventricular response (132 beats/min). After analgesia and sedation, synchronized cardioversion (100 J) was performed with complete resolution of cardiac symptoms and restoration of normal sinus rhythm (75 beats/min). Cutaneous wounds were bandaged and the patient was discharged with cardiology follow-up. At follow-up, the patient reported no symptoms and an echocardiogram revealed no structural abnormalities. Atrial fibrillation in the setting of electrical injury is rarely reported in the published medical literature. In patients without history suggestive of cardiac structural abnormalities, synchronized cardioversion is a potential option for restoration of normal sinus rhythm and resolution of symptoms after electrical injury-induced atrial fibrillation with rapid ventricular response.

When the Norwegian corvette Nordstjernen was in the North Sea bound for Port Said to be present at the opening of the Suez Canal on 17 November 1869, an officer suffered a rupture of m. triceps brachii when he was drawn into the machinery during a storm. He was put ashore in Harwich; four days after the injury he was hospitalized in Colchester. The voyage was eventful in other ways too. Another officer died from typhoid fever in Ismailia. On the Swedish frigate Vanadis, also present at the opening of the Suez Canal, one of the doctors died from lung infection and was buried in Smyrna; a twelve-feet high column of white marble was taken from the ruins of Aesculap's temple and put on his grave. Denmark was represented by the frigate Sjaelland. During a storm in the North Sea, one seaman fell down on the deck from the foresail yard and suffered contusions and a fracture of the left clavicle. These cases illustrate challenges that faced our ancestors. The accident happened when the ...

The most commonly reported injury site in rowers is the lower back. Research in recent years has focused on epidemiology and biomechanical analyses to try and understand mechanisms that contribute to this injury's onset. Injury surveillance mainly comprises retrospective questionnaires and reviews of medical records with a lack of prospective data. Of studies that reported 12-month data, the incidence of low back pain ranged from 31.8 to 51% of the cohort. Of the limited studies that specifically examined low back pain in rowers, (1) history of lumbar spine injury and (2) volume of ergometer training were the most significant risk factors for injury onset. Studies of technique on the rowing ergometer have indicated the importance of lumbopelvic rotation during rowing. Greater pelvic rotation at either end of the stroke is ideal-as opposed to lumbar flexion and extension; this tends to be poorly demonstrated in novice rowers on ergometers. Furthermore, technique can deteriorate w...

The last decades of the xix century were years of resurgence and progress in the field of Naval Health, which was in the vanguard of European health structures at that time. In this era, the navy physicians produced some documents known as "Memorias Clínicas" (Clinical Reports), previously established as obligatory in their rules and regulations. Valuable documents on medical science and the art of healing are deposited in the Archivo General de la Marina (Viso del Marqués, Ciudad Real). Although the information recorded in these Reports varies considerably, we have centred our interest on those that focus on the discovery and development of anaesthesia. The introduction of these discoveries was surrounded by immense controversy, with its defenders and critics. The exclusiveness of the documents presented here is an original testimony to the medical-surgical knowledge of the era and places Naval Health in the vanguard of European health structures at that time.

Decompression sickness (DCS) is the result of bubble formation in the body due to excessive/rapid reduction in the ambient pressure. Existing models relate the decompression stress either to the inert gas load or to the size of a single bubble in a tissue compartment. This paper presents a model that uses the gas exchange equations combined with bubble dissolution physics and population balance equations to produce a new mathematical framework for DCS modeling. This framework, the population balance model for decompression sickness (PBMDS), simulates the number of bubbles with their corresponding size distributions in a compartmental tissue array. The model has a modular structure that enables one to explore different modeling results with respect to key aspects of DCS, such as gas exchange, nucleation, and surface tension. The paper's goal is to present the derivation of PBMDS in detail, however, three simple application case studies are provided. The aim of these case studies is to suggest that PBMDS supplies additional information on bubble distribution while supporting the results from current practice.

The most commonly reported injury site in rowers is the lower back. Research in recent years has focused on epidemiology and biomechanical analyses to try and understand mechanisms that contribute to this injury's onset. Injury surveillance mainly comprises retrospective questionnaires and reviews of medical records with a lack of prospective data. Of studies that reported 12-month data, the incidence of low back pain ranged from 31.8 to 51% of the cohort. Of the limited studies that specifically examined low back pain in rowers, (1) history of lumbar spine injury and (2) volume of ergometer training were the most significant risk factors for injury onset. Studies of technique on the rowing ergometer have indicated the importance of lumbopelvic rotation during rowing. Greater pelvic rotation at either end of the stroke is ideal-as opposed to lumbar flexion and extension; this tends to be poorly demonstrated in novice rowers on ergometers. Furthermore, technique can deteriorate w...

The Navy currently employs maximum weight-for-height tables and body fat prediction equations based on circumference measurements to assess body composition. However, many Sailors believe the current method fails to accurately predict body fat percentage. As a result, the Naval Health Research Center (NHRC) conducted numerous studies in an attempt to improve the accuracy and reliability of the Navy's Body Composition Analysis program. In 2012, NHRC conducted a study that researched the feasibility of using a single abdominal circumference (AC) measurement in lieu of circumference measurements. The Air Force and National Institutes of Health (NIH) employ a single AC measurement taken at the superior border of the iliac crest to assess body composition and all-cause mortality risk. Although the Air Force and NIH use the iliac crest, NHRC is proposing the Navy use the umbilicus as the AC site since it is less invasive and easier to identify. If implemented, the Navy would use cutof...

During the thirty-five years of almost constant warfare between the start of the American Revolution and the end of the Napoleonic War, naval medicine relied on the labour of thousands of women as nurses and washerwomen to care for sick and wounded seamen in hospitals and hospital ships.  While my previous research has focused on female labour in naval hospitals, this paper will use hospital ship musters, logbooks, and pay list records to illustrate the role of women at floating medical institutions.  In addition to examining the work of female labourers on hospital ships, I demonstrate both the importance of hospital ships to British naval medicine in the late-eighteenth and early nineteenth century and showcase the wide variety of medical care provided at these installations.  Hospital ships functioned as medical transports for the sick, floating sites of control for patients deemed a desertion risk, and as overflow hospitals. The reintegration of hospital ships into the story Napoleonic Era naval medicine illustrates the complexity of the naval medical system.  This system included those ships like the Medusa which operated as transports for the sick between ships of the line and on shore hospitals with a medical staff which included female nurses and washerwomen.  By integrating the experiences of these female labourers into the historiography of British naval medicine, I highlight the important and omnipresent role of women in naval medical care while also considering the impact of female civilian labour in supporting eighteenth-century British imperial and naval ascendency.

When the Norwegian corvette Nordstjernen was in the North Sea bound for Port Said to be present at the opening of the Suez Canal on 17 November 1869, an officer suffered a rupture of m. triceps brachii when he was drawn into the machinery during a storm. He was put ashore in Harwich; four days after the injury he was hospitalized in Colchester. The voyage was eventful in other ways too. Another officer died from typhoid fever in Ismailia. On the Swedish frigate Vanadis, also present at the opening of the Suez Canal, one of the doctors died from lung infection and was buried in Smyrna; a twelve-feet high column of white marble was taken from the ruins of Aesculap's temple and put on his grave. Denmark was represented by the frigate Sjaelland. During a storm in the North Sea, one seaman fell down on the deck from the foresail yard and suffered contusions and a fracture of the left clavicle. These cases illustrate challenges that faced our ancestors. The accident happened when the ...

Conditions of work on offshore drilling platforms are particularly hard due to extreme environmental situations created both by nature and technological processes. Oil drilling workers employed on the open sea are potentially exposed to permanently high stress. Apart from the obvious objective factors affecting drilling platform employees, a great role in the general work-related stress level is played by the working conditions and work-related psychosocial factors, defined according to Karask's concept as demands, control, and social support. A total of 184 drill platform workers were examined using objective and subjective research methods. The level of subjective stress among drilling platform workers is lower than the level of objective stress and the stress resulting from prognoses related with specificity of work in extremely hard conditions (audit). The examinations of drilling platform workers reveal a positive role of stress in psychological adaptation, being a special ...

Little is known regarding the symptoms of fatigue that maritime pilots experience during shift work. Moreover, the strategies these individuals use to cope with the onset of fatigue are also unknown. The current study explored the symptoms of fatigue and coping strategies experienced by maritime pilots when on-shift. Fifty maritime pilots were recruited via an advertisement in the national association's quarterly newsletter (Mage = 51.42; SD = 9.81). Participants responded to a modified version of the questionnaire used with aviation pilots that assessed overall fatigue, and the symptoms pilots associated with fatigue on duty. Methods pilots used to cope with fatigue before shift and when on the bridge were also assessed. There were significant effects for pilot vitality on 4 categories of fatigue: cognitive dysfunction; emotional disturbance; mean physical effects; and sleepiness. There were no significant effects for vitality on any of the self-reported coping strategy factors...

The U.S. Navy is considering placing flight simulators aboard ships. It is known that certain types of flight simulators can elicit motion adaptation syndrome (MAS), and also that certain types of ship motion can cause MAS. The goal of this study was to determine if using a flight simulator during ship motion would cause MAS, even when the simulator stimulus and the ship motion were both very mild. All participants in this study completed three conditions. Condition 1 (Sim) entailed "flying" a personal computer-based flight simulator situated on land. Condition 2 (Ship) involved riding aboard a U.S. Navy Yard Patrol boat. Condition 3 (ShipSim) entailed "flying" a personal computer-based flight simulator while riding aboard a Yard Patrol boat. Before and after each condition, participants' balance and dynamic visual acuity were assessed. After each condition, participants filled out the Nausea Profile and the Simulator Sickness Questionnaire. Following exposur...