Saturday, July 14, 2018

Scurvy

From Geri Walton:
Scurvy was first noticed as a disease in the time of Hippocrates, and, during the Crusades, soldiers reported suffering from some mysterious ailment that Jean de Joinville described as a disorder that “soon increased so much in the army … barbers were forced to cut away very large pieces of flesh from the gums to enable their patients to eat.”[1]

Between 1500 and 1800 some two million sailors died from the “scourge of sailors” and it appeared to be medical mystery. One twentieth-century historian provides details of what sufferers experienced:
“After about three months with no vitamin C, the sufferer begins to feel tired and listless. Within another two months, the skins is affected, first becoming rough and dry; by around the end of the sixth month, hemorrhages in the legs appear and wounds will not heal. At seven and a half months the victim’s gums soften, swell and turn purple − historical sources add that teeth became loose as well, and that old wounds opened up again. The conditions appears to become life-threatening in the period between seven and nine and a half months.”[2]
A British naval physician, named James Lind, learned about the dangers of scurvy because of the voyages of the British Commodore George Anson, 1st Baron Anson, who circumnavigated the globe. He brought it to Lind’s attention noting that he “lost 1,855 men out of his original complement of 2,000; numerous causes of death were listed, but most of the sailors had died of scurvy.”[3] Lind’s interest was piqued. He investigated scurvy and wrote “A Treatise of the Scurvy” in 1753, which he dedicated to Anson.

Around the same Lind also learned that a British surgeon named Edward Ives had given crew members cider to prevent scurvy and no one suffered from scurvy until the cider ran out. This greatly interested Lind and he decided to set up a trial in 1747 to test the efficacy of antiscorbutics. At the time, Lind and others believed beer was the best antiscorbutic, but because it was difficult to carry on ships, Lind resorted to giving his crewmen either citrus fruit, cider, or other substances. Lind used twelve sailors suffering from scurvy for his trial. To guard against bias and confounding factors, he ensured the twelve men were as similar as possible, and he maintained a similar environment for them and had them eat the same diet. (Read more.)
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