MORE ON SCURVY

16 May

Really enjoyable visit to Vervey and the British Residents Association.

Interest was expressed in scurvy, which so bedevilled the Scott expeditions, and it occurs to me that many will be unaware of the history of a disease, which killed thousands and thousands of people; in many years practicing as a doctor I never saw it (and if I had, the treatment would have been straightforward), but in Scott’s time vitamins were unknown and vitamin C (the deficiency of which causes scurvy), was not isolated till the 1930s (and then in the laboratory of the famous scientist, Sit Almoth Wright, who had been emphatic against the connection of the vitamin and the disease).

Scurvy was the dread of all long sea voyages. It was known to the Crusaders, British sailors in the American Revolution, Soldiers in W.W.1. The vitamin is necessary for collagen formation in humans. A lack of the vitamin causes, after about three months, lassitude, fatigue, swelling of the joints and lower limbs, spongy gums, lesions in the limbs that can break down and coalesce so that the victim seems to be rotting to death, also cardiac problems: a most unpleasant death that all were only too keen to avoid.

James Lind, a naval surgeon, cured scurvy in a controlled trial as early as the 1750s when he gave orange and lemons to some sufferers and alternative treatments to other sufferers. He did not think of the disease as a deficiency disease, but rather, a digestive problem. The Navy did introduce citrus fruits for its men, but by the 1900s the citrus fruit cure has lost credibility for the understandable reason (it seems to me), that men were given citrus fruits but still developed scurvy. This was because of the problem of Unintended Consequences. Limes from the Caribbean were utilised by the navy, rather than lemons from the Mediterranean. Limes have less vitamin C than lemons and the juice was transported across the Atlantic in copper containers, which damaged the vitamin’s potency. i.e. the final product was ineffective but the reason for this not understood.

So, by the early 1900s, scurvy was thought to be due to the unpleasant sounding ‘ptomain poisoning’ putrefaction in tins and Wilson’s duty on ‘Discovery’ was to sniff and taste all tins to be eaten each day (virtually everything was in tins) and to throw away any suspicious item. As we know this remedy was ineffective and scurvy broke out when ‘Discovery’ had left England for a year.

Vitamin C is present in citrus fruits and some plants and vegetables. Scurvy can now be quickly cured by oral doses of the vitamin.

I was fascinated to read that James Cook thought that one of his greatest achievements was to have avoided scurvy on his three-year voyage to the Antarctic in the 1700s. He gave his crew sauerkraut also fresh fruit (whenever they landed in a Pacific Island). I understand the Inuit apparently avoided scurvy by eating raw fish and the skin of the Beluga Whale.

We don’t know how lucky we are.

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