Nelson's Sawbones

To many the view of Nelson’s saw bones is that of clutter, dirt, unhygienic conditions, rapid amputations with legs and arms flying everywhere and gore by the bucket load.

The reality was far from this popular, vicarious view much as the idea that the Navy of Nelson’s day functioned on rum, the lash and men ripped from their homes and the merchant marine

Careful research into the ‘press’ has shown that on most ship’s of the line less than 10% of the ship’s company were entered in the ledgers as ‘pressed’. For many skilled merchant navy seamen of the day being ‘pressed’ was far from a dreadful fate but actually meant better pay and conditions combined with the opportunity for promotion to ‘petite’ or warrant officer and prize money, plus the Navy knew that one of the most important factors for an efficient ship was ensuring the men were well looked after hence the three square meals a day including at least one helping of fruit or vegetables to keep scurvy at bay. The Royal Navy’s fastidious approach to cleanliness on board had much to do with the evidence of the Fleet’s sick rate rather than martinet Captains. Grog was an effective way of ensuring water was fit to drink as well as a daily issue that the men looked forward to. It is on record that Captain Cook agreed to a request, from his ship’s doctor, to have a Royal Marine given 15 lashes for refusing to eat his daily portion of ‘sauerkraut’ 15 days on the turn.

Recently released doctor’s logs, found at the closure of RNH Haslar, demonstrate clearly the sort of highly intelligent, observant and inquisitive person who was appointed a RN ship’s doctor in Nelson’s day. They were indeed more like Jack Aubrey’s friend Steven Maturin in Patrick O’Brien’s renowned series of novels than the drunken boors of many a film or television scripts.

Victory’s ship’s surgeon, William Beatty, had a team as well trained in the then current knowledge of dealing with traumatic wounds as a RN triage officer did during the Falkland’s conflict, further William Beatty would have seen many of the same sorts of wounds as were seen during the Falklands conflict but what he would have been fascinated by would have been the application of antibiotics, opiates and primary closure along with the well proven triage system that was in place in 1982 to ensure survivability was put ahead of complexity of injuries or the first come first served system that he operated under.

We are also lucky that Dr Beatty left a diary in which his view of Trafalgar was written in some detail. To help you understand the role of Nelson’s Surgeons please allow me to combine my imagination with the facts.
An early breakfast was taken by Victory’s wardroom prior to the ship’s galleys being damped down and at 0600  through out ‘Victory’ the orders were given and the ‘Bootneck’ drummers ( so called for the leather stock they were forced to wear) beat the decks to action stations.

Down in the after cockpit, deck head clearance around five foot six inches, the medical officer and his team (Padre, Pusser, surgeon’s mate and the loblolly boys) would prepare a space for receiving the wounded and slightly forward on the orlop deck they would be laying out ‘clean’ sails and straw palliasse’s to taken the severely wounded and those not long for this world; be they lords of the fleet or powder monkeys.

By 0630 the medical team would be able to report ‘closed up for action to the First Lieutenant. Scalpels would be sharpened and polished, amputation saws sharpened, cleaned and oiled, stocks of linen bandages checked and distributed, precious stocks of opiates (laudanum) prepared for use, tourniquets checked for fraying, decks sanded and spare sand buckets available along with tallow lamps and their replacements in place and by 0730 all that was left was the wait as the fleets closed at a walking pace.

Officers and men would have put on clean clothes that morning prior to going into action because experience had shown that dirty clothes delayed healing even though Naval Doctor’s did not understand why.
Just after noon Dr Beatty would hear the dull boom of the first French and Spanish ships opening fire on ‘The West Country Wagon’ as the Royal Sovereign was known to its men for its plodding performance under sail. Beatty could imagine the men on board being hits by wooden splinters as they stood by their guns and the slow but steady stream of the wounded going below to the cockpit – it would ten long minutes before Royal Sovereign would be able to open fire, raking double shotted ball through the stem and stern of the French and Spanish ships as she ‘crossed the T’, her one hundred cannon causing mayhem and destruction on the decks of the enemy.

As the firing intensified Beatty would start to hear the first balls striking Victory’s hull and, as she closed with the enemy, the trickle of wounded would become a stream as men he knew and officers who were his friends passed under his hands.

At 1315 a sharp shooter on Redoubtable hit Nelson, the one ounce ball was fired from no more than 100 feet, hit and probably broke Nelson’s left clavicle and drove down diagonally across his cheat cavity until it struck his spine somewhere around the junction of his thoracic and lumbar vertebrae. Immediately the concussion of the shot caused paralysis of Nelson’s lower limbs –

“They have done for me, Hardy.

I hope not, sir -  

 Yes, my back bone is shot through.”

Dr Beatty got the same refrain from Nelson:

“Ah Mr Beatty! You can do nothing for me. I have but a short time to live as my back bone is shot through.”

Beatty carried out a thorough examination, placed a trochar, a steel rod used for cleaning out needle bores, in the wound and the line and angle (plus the sound gurgling through his ear trumpet against Nelson’s chest) confirmed what Nelson had said to him and he ordered Nelson to be placed upright in the Orlop deck to reduce the chances of Nelson dying from drowning in his own blood. The entrance wound would have been sealed with an oil skin cloth to ease Nelson’s breathing.

As a RN Triage Officer I would also be aware of the collateral damage caused in the soft tissue either side of the bullet’s track and the flattening effect on the bullet of hitting bone and the spin then imparted which would have reduced any lung tissue and blood vessels in a three to nine inch radius to a mush - some thing that Beatty would not have been aware of. Nelson was now in the dying room. Nelson’s chaplain attended him there and the scene he saw was ‘like a butcher’s shambles’ and haunted him in his dreams for years afterwards – a condition the modern Triage Officer would recognise as Post Traumatic Stress. The true nature of Nelson’s wounds was only told to those who ‘needed to know’ and all were sworn to silence.

During one of Beatty’s forays to keep Hardy up to date of Nelson’s condition he took time to note, “.. that to diminish the potential damage to HMS Termeraire ...” which was now on the other side of Redoubtable “...the officers of the lower deck had reduced the amount of powder and triple shotted their cannons while having men with buckets standing by to damp any flames on Redoubtable’s side and with it the potential for all three ships becoming flaming wrecks. .... which showed in a striking manner the cool intrepidity of the officers and men stationed on the lower deck of Victory”.

Beatty would then return to looking after the continuing flow of wounded. Beatty would assess the wounds looking after the most serious him self and passing the others down to his assistant surgeons and surgeon’s mates. Beatty would have carried   amputations on those who had wounds including fractures. The process was simple, the man would be given a leather gag to bite on, a tourniquet would be applied to the offending limb, a very sharp catling – a large semi-circular knife – down to bone and around the limb. A loblolly boy would then retract all the soft tissue to expose undamaged bone, this would then be sawed through and the soft tissue released to cover the bone end. The tourniquet was then eased slightly to identify arterial ends which were tied off with silk ligatures, these also acted as drains to release tissue fluid build up in the wound postoperatively. The wound would then be dressed with clean linen soaked in turpentine, some surgeons then applying coal tar layer on top of the linen and the casualty would be given a dose of laudanum to reduce the post operative pain which Royal Naval Surgeons had identified as key to preventing ‘shock’ and reducing immediate post operative death – all state of the art treatment for the time.

The catling would then be cleaned with turpentine, the saw blade cleaned of debris and wiped clean with turpentine to prevent clogging or sticking on their next use and the operating table brushed down with more turpentine and then the next casualty would be placed ready for assessment and treatment.

Beatty was there at Nelson’s end and was impressed by Nelson’s constant concern for Officers and men that were close to him. Nelson became increasingly agitated over whether Captain Hardy had survived or not and in response Beatty sent many messages to Hardy asking him to attend on ‘his lordship’ – “will no one bring Hardy to me? His is killed, he is surely destroyed!” to those who attended him. Even after being told that the state and disposition of the fleet required Captain Hardy to be on deck did little to avail his padre of Nelson’s peevishness on the state of his Captain.

On Hardy’s penultimate visit he reported in response to; “How goes it?”

“Very well, my Lord, we have twelve or fourteen of the enemy ships in our possession .... None of our ships have struck? ...  No, my Lord, there is no fear of that.”

For me part of the heroic nature of Nelson’s death was that he faced it with a degree of interest and, having refused any Laudanum for his pain, reported to Beatty the changing sensations as the effect of the original concussion gave way to a return of nerve function. Nelson was able to state that he now had no feeling or power of motion below his breast and that he was aware of a gurgling sensation in his left chest he challenged Beatty to admit he was beyond help – “You know I am gone” and eventually Beatty admitted to Nelson what they had both known all along “Unhappily for our country, nothing can be done for you.”

On Hardy’s final visit Nelson told him of the urgent need to anchor in the face of the oncoming storm and during this final meeting Nelson requested “Don’t throw me overboard – Hardy”.

At 1630 Dr Beatty attend Nelson for the last time to confirm his death but it was not the last duty the Beatty had to carry out for Nelson, some one had to work out how to get Nelson’s body back to the UK - as the Admiral had requested – this type of repatriation was an action not then repeated until the Falklands in 1982 and similarly taxed medical personnel as to how it would be achieved in line with the legal requirements of the Coroners in England and Wales and the Procurator Fiscals in Scotland.

First was the immediate preservation of Nelson’s body – sadly this was not done in ‘Nelson’s Blood’ (rum) but in Brandy. There are also tales of the sentries guarding the barrel tapped it to draw off liquor but Beatty’s careful assessment of the levels in the cask show this just to be a story. Collingwood, now in charge, wanted to take the cask home with him but was prevented by a near mutiny on Victory so Nelson remained on Victory and under the care of Dr Beatty. The cask had to be ‘vented’ on to occasion to allow the release of post mortem gasses and to be topped up with ‘spirits of wine mixed with camphor and myrrh’. Dr Beatty used his recently gained knowledge of Egyptian mummy’s preservation which was in circulation amongst the scientific community of the day. I do not doubt if he knew what ‘Salts of Natrum’ were he would have used them as well.

Beatty had one last duty of care to Nelson. The Sea Lord’s wished Nelson to be buried at Westminster Abbey but it was largely due to Beatty’s protestations in support of Captain Hardy that ensured Nelson wish to be interred at St Paul’s happened.

Nelson’s surgeon, Dr Beatty, reflects the caring tradition of Royal Naval Surgeons down the years since Trafalgar. We look after the living to keep them fit and healthy, the wounded to give them the best chance for survival and full recovery and the dead to ensure they are treated with care and respect.
As one of Beatty’s lineal descendants, a retired Surgeon Lieutenant, I would like to propose the toast:
‘Nelson’s Saw bones’.