{Assembled from Scott and Scurvy, Plague of the Sea, Solving Scurvy and Reality is Very Weird and You Need to be Prepared for That }
The first record of Scurvy appears to date to ancient Egypt, in 1550BCE. Our word for it almost certainly comes from the old Norse skyrbjugr — the skyr being a sort of soured cow’s milk that was thought to have caused the disease by going bad. In mid-sixteenth-century sources, scurvy was often referred to as though it was endemic to the Netherlands – a flat land assailed by the North Sea each winter, where fishing and merchant shipping employed an especially large proportion of the workforce. The Dutch thus had a perfect storm of factors to make vitamin C deficiencies more common, even though they abounded in fresh-caught fish and imported Baltic grain.
And so, over the centuries, the people of the northern climes had discovered the cure. Or rather, cures. The Iroquois ate the bark, needles or sap of evergreen trees. The Saami of northern Scandinavia prized cabbages and other leafy greens, and in the summertime filled up casks of reindeer milk with crowberries and cloudberries, to be ready for winter.
The voyage of Vasco da Gama, upon reaching the eastern coast of Africa, was stricken with scurvy. They were only inadvertently saved when they traded with some Arabian ships laden with oranges.
The traditional story of the triumph over scurvy takes place in the 1750s. In this simple telling, a heroic Scottish doctor named James Lind, when confronted with cases of scurvy on a ship, conducts the first clinical trial in history, correctly deducing that oranges and lemons cure scurvy. The Royal Navy is very slow to react to this new information, but a half century later, they get around to giving lemon juice to their sailors, before later switching to their famous limes. The British conquer scurvy, and then conquer the world.
This story is almost completely false.
There is no evidence that Lind’s clinical trial ever happened; on the journey where he supposedly conducted his study, the ship’s logs contain no record of sick passengers. Lind’s Treatise of the Scurvy does not give a clear recommendation that oranges and lemons should be the main treatment for scurvy. Moreover, Lind’s actual proposed treatment was useless.
Lind was well aware that it was impractical to carry citrus fruits on long sea voyages because, as Woodall noted, “oranges and lemons are liable to spoil”, as indeed would lemon juice. Lind therefore devised a system of almost boiling purified citrus juice, so that 24 oranges or lemons were reduced to a few ounces…
Lind’s fruit syrup was later shown to be ineffective in preventing scurvy (now known because he had boiled the heat-labile ascorbic acid), and Lind was presented no evidence for his cure, merely “the most incontestable experience”.
Nevertheless, by the time of the Napoleonic Wars, the British Navy issued a standard lemon juice ration to all sailors, and their lack of scurvy gave them a strong advantage in those wars.
By the middle of the 19th century, however, advances in technology were reducing the need for any kind of scurvy preventative. Steam power had shortened travel times considerably from the age of sail, so that it was rare for sailors other than whalers to be months at sea without fresh food. Citrus juice was a legal requirement on all British vessels by 1867, but in practical terms it was becoming superfluous.
So when the Admiralty began to replace lemon juice with an ineffective substitute in 1860, it took a long time for anyone to notice. In that year, naval authorities switched procurement from Mediterranean lemons to West Indian limes. The motives for this were mainly colonial - it was better to buy from British plantations than to continue importing lemons from Europe. Confusion in naming didn’t help matters. Both “lemon” and “lime” were in use as a collective term for citrus.
In this, the Navy was deceived. Tests on animals would later show that fresh lime juice has a quarter of the scurvy-fighting power of fresh lemon juice. And the lime juice being served to sailors was not fresh, but had spent long periods of time in settling tanks open to the air, and had been pumped through copper tubing. A 1918 animal experiment using representative samples of lime juice from the navy and merchant marine showed that the ‘preventative’ often lacked any antiscorbutic power at all.
By the 1870s, therefore, most British ships were sailing without protection against scurvy. Only speed and improved nutrition on land were preventing sailors from getting sick.
So everything was all right until 1875, when a British arctic expedition set out on an attempt to reach the North Pole. They had plenty of lime juice and thought they were prepared — but they all got scurvy.
The same thing happened a few more times on other polar voyages, and this was enough to convince everyone that citrus juice doesn’t cure scurvy. The bacterial theory of disease was the hot new thing at the time, so from the 1870s on, people played around with a theory that a bacteria-produced substance called “ptomaine” in preserved meat was the cause of scurvy instead.
This theory was wrong, so it didn’t work very well. Everyone kept getting scurvy on polar expeditions. This lasted decades, and could have lasted longer, except that two Norwegians happened to stumble on the answer entirely by accident.
They had been studying beriberi (another deficiency disease) in pigeons, and when they decided to switch to a mammal model, they serendipitously chose guinea pigs, one of the very few animals besides human beings and monkeys that requires vitamin C in its diet. Fed a diet of pure grain, the animals showed no signs of beriberi, but quickly sickened and died of something that closely resembled human scurvy.
No one had seen scurvy in animals before. With a simple animal model for the disease in hand, it became a matter of running the correct experiments, and it was quickly established that scurvy was a deficiency disease after all. Very quickly the compound that prevents the disease was identified as a small molecule present in cabbage, lemon juice, and many other foods, and in 1932 ascorbic acid was isolated.
It is worth highlighting that their study was not universally embraced at first. One of the loudest skeptics was a fellow Norwegian scientist, and not just any scientist: a successful polar explorer who had reached a record northern latitude without suffering issues with scurvy.
He believed wholeheartedly in the theory that scurvy was caused by tainted foods, and that his expeditions were proof that scurvy could be avoided by proper precautions and sanitation. In his mind, he was a real life explorer who had prevented scurvy in humans in the field, not merely done studies on rodents in a lab.
He had, in fact, inadvertently avoided scurvy in a very traditional Norwegian way – by bringing along a half ton of cloudberry preserve!
Recall that the bacterial theory of disease was very exciting at the time, and consider how the deficiency theory of scurvy must have sounded:
There’s this magical ingredient, totally essential to human life, but other animals don’t need it at all. Except guinea pigs. And it’s in polar bear meat and cloudberries and sicilian lemons but not bahaman limes. And it’s destroyed by boiling or running through copper piping, but not by the slow-heat of traditional jam-making.
Sounds ridiculous. So much special pleading. So many epicycles. And yet.
It is true that the ancients had, through trial and error, found some ways of preventing and treating scurvy, but knowledge they acquired was in practice a bit more limited in utility than one might imagine.
For example, we might think, “the Norwegians knew centuries ago that cloudberry preserves prevented scurvy”, but that statement is far too broad to describe what was actually known at the time.
It might be more accurate to say “the Norwegians knew that Norwegian cloudberries, preserved and stored and the Norwegian way, when consumed in Norway during the Norwegian winter, prevented scurvy.” They had no way of knowing if their methods would work at all outside of Norway, or if they would work with any substitutions in the preparation process, or even if conditions might change somehow in Norway in the future to make their methods useless.
Scurvy was only truly defeated once we had an accurate theoretical framework for what caused it. Once you know exactly what causes it, you can go on multi-year voyages, you can go to the South Pole, you can go to space, all without worrying about scurvy. You just need to bring along some stable source of vitamin C.
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