SHACKLETON’S SCURVY —- OR ITS ABSENCE

5 Oct

.I make regular presentations on Shackleton and the question of scurvy (or more particularly its absence) on the expeditions that he led to Antarctica comes up frequently.

Scurvy is a disease resulting from a lack of vitamin C (ascorbic acid), which is needed in humans to make the building blocks for collagen. A lack of vitamin C results in disease that develops in approximately three months. Early symptoms include weakness, tiredness and painful limbs. Without treatment the red blood cells decrease in number, gum disease and bleeding from the skin occurs and, as the condition progresses, there is poor wound healing. Personality changes may follow as may death due to infection or bleeding.

Scurvy was the dread disease of all long voyages. In the 18th century it killed more British sailors than enemy action – for example, in 1740 on his ‘mission to ‘Annoy and Distress’ the Spaniards, Admiral of the Fleet, George Anson, lost nearly two-thirds of his crew (1,300 out of 2,000) to scurvy, within the first 10 months of his voyage.

But in 1747, James Lind, a naval doctor, showed that supplementing the diet with citrus fruit could treat scurvy – this was one of the first controlled clinical trials reported in the history of medicine.

Lind treated sufferers with: cider, vitriolvinegarseawaterorangeslemons, and a mixture of balsam of Perugarlicmyrrhmustard seed and radish root). In his Treatise on the Scurvy (1753), he concluded ‘the results of all my experiments was, that oranges and lemons were the most effectual remedies for this distemper at sea’. However, Lind did not appreciate that scurvy was a deficiency disease. He thought it resulted from ill-digested/putrefying food.

Citrus fruit as a cure fell out of favour for several reasons. The navy began buying limejuice from the Caribbean (lass vitamin C) and transporting it in copper vats that probably destroyed its potency. As a result, men developed scurvy on expeditions during which ineffective citrus fruit had been given out. Eminent medical authorities disbelieved the ‘citrus fruit theory’ in the early 1900s.

By Shackleton’s first voyage on Discovery, poor hygiene, damp, food and numerous other theories were considered to be the cause of scurvy. He became painfully conscious of the problem when he suffered from the disease, along with Wilson and Scott, during their ‘Southern Journey’ on the 1901-1904 expedition led by Scott. On Wednesday 24th December 1902, Edward Wilson, the doctor of the expedition wrote (when the three were marching south on the Ice Barrier), ’As a result of today’s medical examination I told the Captain that both he and Shackleton had suspicious looking gums’. In January 1903, Wilson wrote, ‘there is no doubt that we all three have definite, though slight symptoms of scurvy’. The symptoms improved with an increased allowance of dried seal meal and no bacon (which Wilson believed was responsible for scurvy), but by the 14th January Shackleton wrote (later), that he had collapsed completely. Wilson wrote on the following day that Shackleton had had a very bad night and was very breathless (he thought Shackleton might die). On the 28th January Shackleton was breathless, restless, unable to move and, for the first time he seemed to lose his courage.

When the three returned to base, Scott sent Shackleton home on medical grounds. There is no doubt that Shackleton WAS suffering from scurvy though it is now thought likely that he had, in addition, an intermittent cardiac problem.

 

How did Shackleton avoid scurvy on his subsequent expeditions?

Before he set off on the Endurance expedition Shackleton wrote that, on his own Nimrod expedition of 1907-1909, there was not a single case of scurvy. He was convinced that as much fresh food as possible would be an answer to the problem. He took hermetically sealed tins of vegetables, compressed cubes of dried vegetables and as much fresh food as he could.

He explained his precautions in an article in the Daily Telegraph dated 7 July 1914. His aim was that the expedition diet should incorporate the latest scientific advances. He consulted Colonel Beveridge, Director of Hygiene at the Royal Army Medical College, for help in working out the best food supplies for the prevention of scurvy – he wrote that this was the first occasion that Polar Explorers would have the benefit of science as well as practical experience.

Important considerations were:

1) The food must be wholesome and uncontaminated. Only the most nutritious and (as far as possible), most varied food could keep the dreaded disease of scurvy at bay.

2) The food taken on sledging expedition should be as light as possible, but also be substantial, as ‘excessive concentration’ diminishes its nutritive value and renders it ‘less easy of assimilation’. Shackleton wrote that bulk was as essential as nutritive value.

3) Fatty and farinaceous foods in as liberal quantities as circumstances allowed should be included because in very low temperatures the heat of the body which, he stated, is the life of the body, could only be maintained with these nutrients.

4) Sledging food must not need much cooking, as the amount of fuel that could be carried was limited (and if it ran out, there was no means of replenishing it).

5) If no fuel was available the food should be of a character that could be eaten without cooking.

6) Shackleton also commented on the benefit of the greater variety of food in the winter quarters.

In 1912 Kazimierz Funk (1884 – 1967), a Polish biochemist had suggested the concept of vitamins (called “vital amines” or “vitamines”). He was consulted about the proposed sledging rations.

In the event, in his 1914-16 Endurance expedition Shackleton did not reach the Antarctic for his proposed stupendous sledging journey, but the rations suggested were an important guide, though presumably not used throughout the expedition. The diet emphasized the importance Shackleton had learnt to place on nutrition as one of the means of maintaining his men’s wellbeing and morale.

For sledging the diet provided 5,512 calories per day for each man – since a man’s usual daily diet was approximately 2,500 calories, in Polar conditions there would be a surplus 3,000 calories daily.

The ‘hooch” had a large fat and carbohydrate content, protein with meat fibre (provided by Bovril), vitamin C, and A, sugar and raisins. Advice was given to eat as much fresh meat as possible and to grow vegetables – mustard and cress for its vitamin C content. Penguin eggs were advised for a supply of vitamin B.

Colonel Beveridge’s rations

(Glidine is a vegetable protein. Trumilk had the advantage over ordinary dried milk in that has not been subjected to a heat that destroyed vitamins)

 

 

BREAKFAST

 

Wt. oz     Protein. g     Fat. g           Carb. g        Cals.

Bovril B ration

Oatmeal,                      2            12.94           5.34           33.02         236

Lard                             3½                0         99.23                   0         923

Sugar, 1oz                   ½                   0                0             14.17           58

Beef powder              1½            35.29           2.37                  0 .       166

Glidine,                         ½            11.78           0.14               0.82          53

Raisins

Biscuits                       1                  9.21          0.85             14.45         105

Trumilk                        1                  6.70         8.00              11.68         150

Sugar lump,               1½                     0                  0          42.51        174

Total                           11 ½             75.92         115.93        126.55     1,805

 

 

 

 

LUNCH

 

 

Biscuits                          1             46.05            4.25             72.25       525

Nut-food +Trumilk      1+6           27.20           54.15             81.03       948

Trumilk                             ¼           1.74              1.99              2.90          35

Total                               11¼          75.09           60.38          156.18     1508

 

 

SUPPER

Bovril S ration

Oatmeal                             2            12.94           5.34             33.02        236

Lard                                   4½                0        127.57                     0      1187

Sugar                                   ½                0                0               14.17         58

Beef powder                      1½         35.29            2.37                    0        166

Glidine                                  ½         l1.78              0.l4               0.82          53

Biscuits                               1             9.21             0.85             10.85         105

Trumilk                                1            6.70             8.00             11.68          150

Sugar lump                          ½                0                 0              14.17           58

Total                                  11 ½          75.92          144.27            126.55     2139

 

Meat extract, ½ oz, at supper.

Tea, ½ oz. at lunch.

Concentrated Lime Juice, ½ oz.

Cerebos Salt ½ oz.

Virol (extract of meat)

Total Calories per day = 5,512.

Total Fat per day = 320.58 grams

Total Protein per day = 226.93 grams

Total Carbohydrates per day = 409.28 grams

The rations were packed in oblong boxes of Venesta wood (light and durable) weighing 60lb. each. They were refrigerated until arrival at the first destination. Lime juice was concentrated down at a temperature of not more than 93 degrees Fahrenheit, to preserve its anti-scorbutic properties.

No alcohol was taken save a small quantity of brandy for medicinal emergencies (given apparently, to combat frost bite or surgical procedures such as a tooth extraction), plus the occasional celebration.

Beveridge thought that the men would like the diet and be healthy on it. He was right. There was no apparent scurvy on Shackleton’s party as they drifted remorselessly around the Weddell Sea. The men on Shackleton’s Ross Sea party however seem not to have followed the scientific advice so conscientiously. Scurvy took its hold on the depot-laying mission to the Beardmore Glacier and the Reverend Spencer-Smith died.

Nowadays scurvy is prevented by a diet containing vitamin C (preferably in the food but sometimes as a supplement).90 mg is recommended for men.

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9 Responses to “SHACKLETON’S SCURVY —- OR ITS ABSENCE”

  1. Bill Alp January 6, 2019 at 10:38 pm #

    Hi Isobel
    Your article provides a comprehensive introduction to the subject of scurvy. I am sure readers will find it helpful.
    However, it leaves me wondering if Colonel Beveridge’s diet was successful in avoiding scurvy – it seem rather similar to earlier diets that proved to be unsuccessful. Do you have any information about how Beveridge’s diet worked in practise?
    To gain a deeper understanding of scurvy in polar explorations, your readers may be interested in reading about the impact that a continuous levels of high physical exertion has upon the speed of onset of scurvy. The best paper I have seen on the subject is: THE “SCURVY DISPOSITION”: HEAVY EXERTION AS AN EXACERBATING INFLUENCE ON SCURVY IN MODERN TIMES, by John Norris – an old article but sound. It can be accessed via:
    https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=10&cad=rja&uact=8&ved=2ahUKEwikhdbBmNrfAhVVfd4KHQ2XBOEQFjAJegQICBAB&url=https%3A%2F%2Fwww.jstor.org%2Fstable%2Fpdf%2F44441613.pdf&usg=AOvVaw3LOHgFPVMKxxleNkfxJzge

    • isobelpwilliams January 12, 2019 at 9:11 pm #

      Dear Bill
      Thank you
      I will definitely reply but am presently checking as many facts as I can
      Isobel

    • isobelpwilliams January 19, 2019 at 8:17 am #

      Bill re SCURVY

      I suppose the first thing to say is that there were no reports of Shackleton’s Endurance crew getting scurvy and it is unlikely that this information would have been suppressed –we know there was scurvy amongst the Ross Sea party.

      Also since Shackleton HAD suffered from scurvy on the Discovery expedition, he was extremely keen to avoid it. Colonel Beveridge, (of the Royal Army Medical Corps), worked out tables for food supplies for the sledging journeys, which, in the event, hardly took place on the Endurance expedition, but there is no reason to suppose that the advice would not have been incorporated into the general diet. Shackleton thought that this was the first occasion where Polar explorers had had the benefit of scientific experimentation.

      I have already listed the diet. This was said to contain concentrated lime juice. It seems likely that this was actually effective lime juice in contrast to the juice taken in the beginning of the century. James Fisher, and his wife Margery wrote a biography of Shackleton in 1957 (Shackleton and the Antarctic). Fisher stated that Beveridge had consulted Funk. “I thought it over for a few days and I went and saw Funk”. Funk, as you know, discovered that vitamins B1, B2, C and D were necessary for human health. His work led to the prevention of beriberi, rickets and scurvy. Fisher wrote that Beveridge stated that Funk approved of the Beveridge diet, including presumably, the lime juice.

      Beveridge added raisons to the diet and suggested that the crew grew mustard and cress

      There were plenty of tinned vegetables at the base. Hawk and Bergeim’s Practical Physiological Chemistry states that the canning methods of the time were less destructive to vitamin C than kettle cooking.- canned spinach could be heated to 115° C for 1 to 2 hours and still leave a product several times richer in vitamin C that the kettle cooked article. Canned cabbage could be autoclaved for 30 minutes at 100°C and canned peas for 50 minutes at 120°C without their vitamin C content being significantly lowered.

      I have also read, but cannot source the reference, that Shackleton took compressed squares of vegetables to ward off scurvy. For their midwinter celebration meal, whilst stranded in the Weddell Sea, they had figs, dates and crystalized fruits after their mince pies and Christmas pudding!

      I think it most likely that Shackleton, by these precautions, did indeed avoid scurvy on his ‘Endurance’ expedition.

      • Bill Alp February 1, 2019 at 4:03 am #

        Hello Isobel

        I will try to look at your question from Shackleton’s point of view, having used his book “South” as a primary reference.

        Prior to his Imperial Trans-Antarctic Expedition (ITAE) Shackleton already had an excellent understanding of scurvy symptoms and preventative measures, and he had devised a successful sledging ration for his Nimrod Expedition. Shackleton was no novice. The following notes apply to his intended Trans-Continental Party, which became the Elephant Island Party.

        In “South”, he described the normal daily food allowance on Elephant Island thus, “At breakfast each [man] had a piece of seal or half a penguin breast. Luncheon consisted of one biscuit on three days a week, nut-food on Thursdays, bits of blubber (from which most of the oil had been extracted for the lamps) on two days a week and nothing on the remaining day. On this day breakfast consisted of half-strength sledging ration. Supper was almost invariably seal and penguin, cut up very finely and fried with a little seal blubber.” The period on Elephant Island was characterised by extreme physical hardship and deprivation – conditions under which scurvy could be expected to emerge, but it did not. So, how come Shackleton’s men did not develop scurvy on Elephant Island?

        Several Antarctic explorers had known the answer for many years. Frederick Cook, the doctor on the Belgica expedition 1897-1899 was the first. His book “Through the First Antarctic Night” tells how he helped save the lives of its crew members when their ship became ice-bound during the winter, and they had not prepared for such an event. It became the first expedition to over-winter in the Antarctic region. To prevent scurvy, Cook went hunting to keep the crew supplied with fresh meat.

        Roald Amundsen wrote in his book “The South Pole” about the same subject, “Scurvy, the worst enemy of Polar expedition, must be kept off at all costs and to achieve this it was my intention to use fresh meat every day. It proved assay to carry out this rule [with adequate dog power to haul the meat]…”

        When the Endurance became trapped in the Weddell Sea ice, Shackleton had to overcome several setbacks. He had sledging rations (presumably to Beveridge’s formula, but not acknowledged) enough for his estimated 120 day trans-continental journey with a party of four or five men. This would amount (with safety margin) to something between 480 and 800 man-days’ worth of provisions. Now he had to feed his full 28 man crew for a period of many months, yet the sledging rations would not last much more than two months if the men received half rations. He wrote about his plans as they drifted on the ice (Patience Camp), “We were, of course, very short of the farinaceous element in our diet. The flour would last 10 weeks. After that, our sledging rations would last us less than three months. Our meals [therefore] had to consist mainly of seal and penguin [meat]; and though this was valuable as an anti-scorbutic, so much so that not a single case of scurvy occurred amongst the party, yet it was a badly adjusted diet, and we felt rather weak and enervated in consequence”.

        Shackleton describes in “South” how some of the sledging rations were set aside for use in boat voyages (where it would not be feasible to slaughter seals and penguins) whist the rest were sparingly used as ‘luxuries’ to add variety to the portions of seal and penguin meat.

        Therefore, the short answer to the question about why Shackleton’s men in the Endurance Party did not get scurvy is “because they consumed plenty of fresh meat”.

      • isobelpwilliams February 1, 2019 at 3:12 pm #

        Thank you
        Fresh meat obviously played a part because the men definitely felt the benefit of it (as is shown by Cook’s experience), but the problem with your explanation that ‘plenty of fresh meat prevented scurvy’, is that fresh meatactually contains very little vitamin C and could therefore give only a minor benefit. However the offal -liver, kidney, heart and lung do, and these dishes were recorded as being served. It is likely they ate vegetables with the meals (see next para).

        I am impressed by Beveridge’s approach to Funk who was THE expert on vitamins and I think that the capsules must therefore have contained ‘active’ vitamin C and I also like the concept of the vitamin being retained in autoclaved tins. Shackleton also took fresh veg. and mustard and cress.

        When the sledging rations ran out he would have had to make do with offal and fresh meat. He set aside some of the sledging rations for use in boat voyages
        .

    • isobelpwilliams February 4, 2019 at 3:22 pm #

      Dear Bill
      Briefly:
      As a Doctor I absolutely understand that ‘fresh meat’ means meat, NOT offal. It is often suggested that ‘fresh meat’ was the answer to scurvy by people with absolutely no understanding that meat itself contains virtually no vitamin C, in contradistinction to kidneys/liver etc.
      The fact that the autoclave results were reported in the 1920s does not mean they were not valid a decade earlier.
      I referred to capsules of vitamin C (not vegetable capsules), which I think would have contained active, rather that inactive vitamin, because they had been approved of by Funk who was THE authority on vitamins.
      There are images of tins in Shackleton’s ‘Nimrod’ hut and Shackleton was very proud, in his Daily Telegraph article (7th July 1914) that the ‘Nimrod’ expedition did not suffer from scurvy. He would have taken these provision on ‘Endurance’ and had them as ‘Endurance’ drifted around the Weddell Sea from December 1914 to October 1915. Scurvy appears when vitamin C has been absent from the diet for 3 months. This does not seem to be the case here.
      Clearly a trans continental party would not be growing mustard and cress-this would be absurd (though in the Fisher Papers (MS1456/64) which relate to the ‘Nimrod’ expedition the suggestion IS made of growing vegetables and mustard and cress in the tents!). Mustard and Cress, though admittedly in small amounts, was grown on the ‘Discovery’ expedition and could have been grown by the crew whilst’Endurance’ survived.

    • isobelpwilliams February 8, 2019 at 5:15 pm #

      In 1940 a brave American Scientist went on a diet which contained no fruit or vegetables, having previously been on a diet with plenty of vitamin C. Signs of scurvy did not appear for about sixteen weeks – skin drying and skin thickening, followed by small skin petichiae. Problems with healing of cuts came later.
      There is no suggestion that the crew of ‘Endurance’ were saturated with vitamin C prior to November 1915, but neither, to my interpretation (see previous correspondence), is there any suggestion that they were not taking the vitamin in their diet, before they went onto the ice floes.
      In the 6 months it took them to get to Elephant Island they may well have had sub-clinical scurvy – blood levels of vitamin C can reach low levels well before clinical signs develop, but once on Elephant Island they COULD eat ‘fresh meat’ and, hopefully, offal until they were rescued.
      Of course nothing is certain after this length of time, but I also reiterate my original comment. If members of the crew had been suffering from the clinical signs of scurvy (which is all too horribly apparent), it is inconceivable to me that this would not have leaked to the eager press reporters and thence to the waiting world.
      With all good wishes
      Isobel
      Crandon,J.H.Lund,C.C.and Dill,D.B.’Experimental Human Scurvy’, New England Journal of Medicine, 1940, vol 233 p 353-369

  2. Bill Alp February 4, 2019 at 12:34 am #

    Hello Isobel

    When Amundsen and Shackleton wrote about “meat” (as quoted above), I am sure they were not restricting their comments to flesh alone. A word search of Shackleton’s book for “liver” shows several references, all very positive about liver, which seems to have been treated as a premium cut. If I had the chance to write my previous response again, it would conclude: “because they consumed plenty of fresh meat (including, flesh, liver, kidneys and other edible parts of the animal)”. My bad.

    It appears you and I have quite different perceptions about the quantity and nature of vegetables that were taken onwards from the stricken Endurance. I believe it is important when re-telling the men’s stories that we should be as factual as possible and should avoid any temptation to “fill in the gaps” with current knowledge or personal beliefs. In my previous responses, I have used Shackleton’s book “South” as the main research source. Unfortunately, it seems that some of your statements are not supported by Shackleton’s book.

    You wrote, “It is likely they ate vegetables with the meals”. Can you quote a contemporaneous source that supports the statement? My reading indicated that many meals included no vegetables at all, with only occasional dried vegetables added to the hoosh and occasional treats from the sledging rations.

    You wrote about the merits of tinned vegetables and autoclave processing. However, it seems clear from Shackleton’s book that the only vegetable products taken onwards from the ship were dried vegetables and nut food, and that some of the dried vegetables had to be abandoned to reduce weight when they launched the boats. It is not clear if the dried vegetables mentioned by Shackleton are the same as the vegetable capsules to which you refer. Shackleton had some knowledge of the calorific value of different food types, and appears to have given priority to high-calorie, low-weight foodstuffs where possible, hence the dumping of dried vegetables (in favour of foods like dog pemmican for human consumption).

    You wrote, “There were plenty of tinned vegetables at the base”. Which base did you have in mind with this statement, and when were you thinking the trans-continental party would be picking up the tinned vegetables from that base? Shackleton’s book does not mention this idea.

    You wrote, “When the sledging rations ran out he would have had to make do with offal and fresh meat”. My interpretation of Shackleton’s book is that they did not commence with heavy consumption of sledging rations but instead commenced with heavy reliance on seal and penguin, in order conserve the sledging rations.

    The idea that the trans-continental party could germinate, grow and harvest a significant quantity of mustard and cress whilst trekking in sub-zero temperatures seems (to me) absurd. Is there any evidence that such seeds can indeed germinate and thrive in frozen water, with air temperature in the region of minus 20 degrees Celsius?

    It may be that some of my comments above are based upon a mistaken understanding of Shackleton’s book or your comments. It would be great if you could point out the mistakes, or if you could provide supporting information for your stance from the journals of other members of the Endurance Party.

    • Bill Alp February 5, 2019 at 11:52 pm #

      Hello Isobel
      Our discussion has covered a fair bit of ground. Your opening comment in your initial post is about questions you receive during presentations about Shackleton’s journeys. I have responded from a historic research perspective, looking for primary evidence from Shackleton and his contemporaries and his predecessors.

      I am guessing that the most common questions are about the period after the Endeavour was abandoned and the men were on the ice, then in the boats and then on Elephant Island. That period of 10 months, from November 1915 to August 1916, appears to be a period of high risk of scurvy. Do you have a short explanation for why there were no reported cases of scurvy in that period?

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