Scurvy, a disease notorious for causing the deaths of an estimated two million sailors during the European age of exploration, seems to be making a comeback. Recent studies have in fact shown that a surprisingly high percentage of Americans are at risk of developing scurvy.
Scurvy is caused by a lack of vitamin C or ascorbic acid in the diet. Vitamin C is important in the creation of collagen, a substance crucial for the formation of connective tissue and red blood cells, and for the healing of wounds.
The symptoms of vitamin C deficiency are subtle and may be misdiagnosed by doctors who assume that scurvy is a disease that has disappeared into history. Sadly, this is not the case, as many recent medical studies have revealed. One study of university students in Arizona, for instance, found that 24% of men and 18% of women lacked sufficient vitamin C in their diets.
Vitamin C deficiency can lead to adult acne, easy bruising, sore gums and hemorrhages around the bones. If the deficiency continues, early scurvy symptoms appear: weakness, loss of appetite, diarrhea, and tenderness or discomfort in the legs. As the condition progresses, dark spots appear on the skin of the thighs and legs. Gums become compromised and teeth to begin to fall out. Wounds become slow to heal, and ever increasing incidences of mini hemorrhages will cause bleeding under the fingernails, in the eyes, and around hair follicles, which will begin to produce corkscrew hair.
Advanced cases may lead to festering wounds, fever, delirium, and death. A sixteenth century sailor vividly described the effects of scurvy as follows:
It rotted all my gums, which gave out a black and putrid blood. My thighs and lower legs were black and gangrenous, and I was forced to use a knife … to release this black and foul blood.
Explorer Jacques Cartier recorded in his log that an autopsy on a scurvy victim revealed a withered heart, dark blood, and gangrened lungs.
However, while the symptoms of advanced scurvy can be gruesome and even fatal, it is easy to treat, and even easier to prevent.
Since the principal source of vitamin C is fresh fruit and vegetables, scurvy develops in people who do not eat fresh produce. The unfortunate sailor quoted above had undoubtedly been at sea for months, subsisting on an unrelenting diet of salt meat and hardtack.
Historically, although the cause was unknown, various treatments were recommended. Explorer James Cook prevented scurvy among his sailors by forcing them to eat onions. China embarked on great voyages of exploration in the fifteenth century, but Chinese sailors remained healthy because they ate bean sprouts.
A definitive cure was demonstrated for the first time in 1747 by Scottish physician James Lind who proved the beneficial effect of citrus fruit in a controlled study on twelve scurvied seamen. As a result of Lind’s work, the British Navy began giving lime juice to ships crews in 1795, a practice which gave rise to lime juicer or limey as a nickname for British sailors.
Vitamin C deteriorates in food that is stored for a long time. Consequently, people who rely almost exclusively on packaged, canned or frozen food are at risk of developing the disease. This could include those who depend on food banks for an extended period of time, long term hospital patients or others living in institutions, and people who habitually choose convenient meal options. Specific at-risk groups include the elderly, alcoholics, and anorexics.
Since vitamin C is also destroyed by heat, babies who are fed pasteurized milk may develop infantile scurvy, which is also referred to as Barlow’s Disease, Moeller’s Disease or Cheadle’s Disease. In the late nineteenth century, for example, an outbreak of infantile scurvy occurred when prosperous families began feeding pasteurized milk to their children. Babies with scurvy may suffer from bleeding at the lower ends of the long bones (subperiosteal hemorrhage), and, because of the discomfort caused by the disease, often lift their legs into a frog leg posture.
Scurvy is easily treated by supplying the lacking nutrient: vitamin C in the form of vitamin pills, or food naturally high in ascorbic acid such as citrus fruit or green peppers.
Of course, it is better to prevent scurvy altogether. Since the body does not store vitamin C, it is essential to eat fresh fruit and vegetables every day. Unfortunately, over 80% of American adults eat less than two daily servings of fruit and vegetables, insufficient to provide the recommended 60 mg. daily allowance.
Bottle-fed babies should be given vitamin supplements, while children and adults should eat a balanced diet containing vitamin C rich fruit and vegetables. In addition, educators and health care workers need to be aware of the need for nutrition education as a crucial preventative measure.
