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The battle with scurvy
  1. JOHN PUNTIS
  1. Neonatal Unit
  2. Clarendon Wing
  3. The General Infirmary at Leeds
  4. Belmont Grove
  5. Leeds LS2 9NS

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    Editor—Professor Dunn gives a fascinating account of James Lind and scurvy.1 The official weekly provisions for a sailor in Lind’s time consisted of 7 lb of biscuits, 7 gallons beer, 4 lb of beef, 2 lb of pork, 2 pints of pease, 3 pints of oatmeal, 8 oz of butter and 12 oz of cheese.2 Lind considered this to be a “fuller and more wholesome diet” than that provided for seamen of other nations, although it appears to have been designed for cheapness and durability rather than nutritional balance. As well as recommending oranges and lemons at sea, Lind also suggested spruce beer, portable soup (probably the first ever “instant” soup), raw onions, salted beans, bottled gooseberries and pickled cabbage, together with salads grown in boxes on deck. Gilbert Blane, appointed physician to the fleet by Rodney in 1780, not only takes much of the credit for seeing that Lind’s measures to eradicate the disease were finally implemented,3 but also recognised that heating the juice (as directed by Lind) impaired its effectiveness. In the nineteenth century more readily available (but far less effective) limes were substituted for lemons. Ships of the East India Company came to be called “limejuicers” and their crews “limeys.”

    Apart from the expense of fresh fruit, the continuing refusal by the Admiralty to adopt Lind’s advice can be explained in part by the epic voyages of Captain James Cook. This remarkable navigator took a keen interest in the health of his men, and missed no opportunity to take on board fresh vegetables.4 No ship had ever been so well provided as Cook’s Endeavour when she sailed from Deptford in 1768. Although one third of the crew were to perish from dysentery, malaria, and accidents on this circumnavigation, none died from scurvy (the youngest on board was only 12 years of age). Supplies for the second pacific voyage (1772–5) included 20 000 lb of sauerkraut, which has been estimated to contain about a quarter of the vitamin C found in an equivalent weight of lemon juice.3Cook returned to England with a scurvy free crew, was elected to the Royal Society, and contributed a paper on the health of seamen to the Society’s Philosophical Transactions. The following year, before setting out on his third and last voyage he read a paper on the methods he had used to preserve the health of his men and was subsequently awarded Sir Godfrey Copley’s annual gold medal. Interestingly, another recipient of the Copley medal was Joseph Priestley, who proposed using carbonated water as an anti-scorbutic. Thankfully, since his suggestion was not adopted, British sailors are still known as “limeys” rather than “bubblies”!

    Those on long voyages were undoubtedly at risk of multiple nutritional deficiencies. From 1773 onwards Cook himself was chronically unwell with abdominal pain, pallor, vomiting, poor appetite, constipation, weight loss, irritability, lack of concentration, depression and change of personality. It has been suggested that all these symptoms might have been related to vitamin B 12 deficiency as a consequence of ileal parasitic infection, ultimately contributing to his death at the hands of natives in Hawaii.4 Cook’s obituary in theLondon Gazette mentioned that “His successful experiments to preserve the healths of his crews... and his Discoveries will be an everlasting Honour to his Country”. Conversely, the death toll from scurvy stands as an everlasting indictment both of official indifference to the health and welfare of ordinary seamen and the days when victualling the navy was a “privatised” industry.2

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