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The iconic Ship Captain's Medical Guide has had its first major overhaul for 20 years. Andrew Linington finds out how advances in technology influenced the 'complete rewrite' needed for the 23rd edition
If you think seafaring is dangerous today, spare a thought for those at sea 150 years ago. In 1869 a total of 1,460 British seafarers died as a result of disease, 2,839 by drowning, 277 in accidents and 256 by other causes.
Today, one of the initiatives launched by Victorian social reformers in a bid to cut these shocking statistics is not only still with us but is now being relaunched. The 23rd edition of the Ship Captain's Medical Guide has just been published, with its radically revised content reflecting the latest advances in treatment and care.
The original publication – written by Dr Harry Leach, resident medical officer on the Dreadnought hospital ship and inspector of lime and lemon juice for the Port of London – first appeared in 1868 and aimed to reinforce requirements introduced in the 1867 Merchant Shipping Act for British ships to carry a defined set of medicines and medical supplies.
Seeking to help shipmasters recognise, diagnose and treat sick or injured crew members, its carriage was – and continues to be – required on UK ships, and it also went on to become a course textbook for officers being trained in first aid and medical care.
Since its first edition – which ran to just over 90 pages and included advice on such things as scurvy, fish-poisoning, ague, arsenic and 'excessive drunkenness' – the Guide has undergone regular updates to keep pace with the latest medical best practice, as well as developments in the understanding of disease, new medicines and treatments, and access to radio-medical advice.
The new book is described as a complete rewrite from the previous edition, which was published in 1999. The revolution in global communications over the past 20 years has driven some sweeping changes in the contents of the Guide.
'Telemedical advice is usually available almost instantaneously, from anywhere in the world,' say the Guide's authors, intensive care consultant Dr Spike Briggs, former Maritime & Coastguard Agency chief medical adviser Dr Tim Carter, and Colonel Dr Katharine Hartington of the Royal Army Medical Corps.
'Images and medical test results can be sent to shore-based medical advisors with minimal delay,' they point out. 'Video consultations are routine ashore, and part of mainstream medicine. While not routinely available at sea, where available, the ability for the doctor to see and talk to the casualty in real time essentially improves understanding of the clinical situation, and thus better informs the decision process.'
The original Ship Captain's Medical Guide was written by Dr Harry Leach, medical officer and inspector of lime and lemon juice for the Port of London