Los enfermos en las armadas y flotas de Indias
What the Laws of the Indies required for the sick on the Atlantic crossing: a physician and a chief surgeon on the same salary, an apothecary, barbers, hospital brothers clothed at the crown's cost, the sick lodged in the ship's alcázar with people assigned to nurse them, diets and fowl that could be spent on nothing else, a two-key medicine chest with its own account book, and cure ashore in the hospitals of the ports. The medicines the sick took were charged against their wages.
Why this wins its question: The standard English sentence about health on the Carrera de Indias is that conditions were appalling and nobody much cared, which is half a fact standing in for a record nobody has read. The record exists and is specific: a physician and a chief surgeon on equal salary from 1593; an apothecary from 1556; barbers in the list of officers; hospital brothers issued three shirts and a habit and forbidden to stay in the Indies; the sick lodged in the alcázar with people told off to nurse them; a tinned-copper medicine chest under two keys with a ledger inside it; a veedor obliged to cross from ship to ship counting them; and cure ashore in the hospitals of the ports. Set beside that, this object keeps on the record the two things the rules themselves concede — that medicines were charged to the sick man's wages, and that the diets embarked for him had to be protected by law from being eaten by everyone else.
Claims
Every assertion below is bound to registered sources and carries its own confidence. Weight them; do not treat the page as uniformly authoritative.
Care of the sick was a numbered article of the generals' standing orders. Recopilación libro VIIII, título 15, Instrucción de Generales, capítulo 48 — headed "Cuiden de los enfermos" — orders the generals and other commanders to take much care of the sick, "y los alojarán en el Alcázar del Navío, y señalarán personas, que con caridad los asistan", besides the ships' chaplains, whose office it is to see to their cure and comfort, to urge them to make wills and declare their estate and debts, and to administer the sacraments.
The same article rules the diets and the medicine chest in physical detail. The sick are to be attended "con las dietas, que para ello se embarcan, y no se gasten en otra cosa, y con las medicinas de que necesitaren", for whose safe keeping "se ha dispuesto que vayan caxas bien proveidas para ida, y vuelta, con vasijas de cobre estañado, y dos llaves", one held by the chaplain and the other by the maestre de raciones; each morning they are to meet with the apothecary, "si le hubiere, y á falta, con el Cirujano", take out the medicines needed, and enter them "en un libro, que ha de estar dentro de la misma caxa, para la buena cuenta, y razon de lo que se gasta". In port the sick are to be cured in the hospitals and visited there by the chaplains.
An accounting officer was made personally responsible for them. Libro VIIII, título 16, ley xxviij, taking up capítulo 21 of the Instrucción de Veedores, orders that because much care is owed the sick "y darles sus medicinas, aves, y dietas", the veedor keep particular account of them, visiting them and "pasando para esto de una Nao en otra", having the supplies distributed, with the opinion of the physician and surgeon of the armada; and that when a man is put on the sick ration the healthy ration be taken off him. Nursing at sea was thus written as an audit duty, with fowl and diets treated as issued stores.
The armada carried a qualified medical establishment by law. Libro VIIII, título 30, ley xxxxviiij — Philip II, 8 December 1593 — requires that "en la Armada ha de haber un Médico, que atienda á la buena cura de los enfermos de ella", a person of whose letters, experience and good parts one can be confident, "y un Cirujano mayor, entendido, y exercitado en su arte", both on the same salary and both named by the general. Putting the physician and the chief surgeon on identical pay is a small thing that was not the norm ashore.
There was an apothecary too, and the sick paid for what he dispensed. Ley l of the same título — Philip II and the Princess Governor, Valladolid, 29 July and 9 September 1556 — orders that an apothecary also go in the armada, "que lleve buen recaudo de medicinas, y las dé á quien las hubiere menester por sus dineros, ó á cuenta de su sueldo, que los enfermos hubieren de gozar", with a subsidy advanced to him so that he can stock the chest, security given for repayment, and appointment by the general. Provision was compulsory; it was not free.
Nursing brothers sailed with the fleets and were fitted out at the crown's expense. Ley lj — Philip III, Madrid, 15 November 1616 — orders that the Hermanos del Hospital who go in armadas and fleets and embark in their ships be given "tres camisas, dos pares de calzones, dos jubones, dos pares de medias, otros dos de zapatos, una túnica, un hábito, y otras cosas necesarias, por menor", with the express proviso "que no se queden en las Indias". The itemised kit is the clearest evidence in the title that the hospital brothers were a standing part of the fleet's complement and not an occasional passenger.
Barbers were part of the establishment, and the chief chaplain was paid to police the care. Ley lij lists the officers who must go in the armada or fleet — masters of carpentry and caulking, contramaestres, guardianes, divers, carpenters, caulkers, coopers, water bailiffs, stewards "y Barberos" — all on the generals' appointment. Ley liij — Philip II, Madrid, 8 December 1593 — requires the chaplain of the capitana to be a sufficient priest with double the usual pay, charged "de que los Capellanes de la Armada hagan bien su ministerio, cuiden del regalo, y cura de los enfermos que hubiere en sus Navíos", his doubled salary drawn "del dinero que se proveyere por cuenta de Avería, ó caudal de provisiones" — the convoy levy on the Indies trade.
The provision for the sick sat next to provision for the dead. Capítulo 49 of the same Instrucción de Generales, printed immediately after the article on the sick, orders that if anyone carrying cargazones dies on the voyage and a second or third consignee is in the armada or in the province it is bound for, the general have an inventory of the goods made before an escribano and witnesses "en la forma mas auténtica que se pudiere" as soon as the person dies, and the goods delivered according to the registers and the masters' acknowledgements. Dying at sea was frequent enough to be routine paperwork.
None of this is evidence that the crossing was survivable, and the code does not claim it. What the Recopilación prints is what the crown ordered and the day it ordered it — repeatedly, over eighty years, which is itself a sign the orders were not self-executing: the requirement of a physician dates from 1593, the apothecary from 1556, the hospital brothers' kit from 1616, and capítulo 48's own wording ("no se gasten en otra cosa") anticipates that the sick men's diets would be eaten by the healthy. It records no mortality figure, no inspection return and no case of a chaplain punished. Whether the chest, the fowl and the surgeon reached a fevered grumete on the fortieth day out of Sanlúcar is not a question this source can answer.