Comments re my Medical History
The history of medicine is fascinating and we often lose sight of how little we knew before the last 50 or 100 years. I've written a few short articles and I'm web-publishing a few more that I've collected. I hope these are of interest. Obviously they're not to be taken as current medical practice, though it's also interesting how little the basics have changed.
Sincerely, Mark R. Anderson, M.D.
A Short History of Scury
© Mark R. Anderson, M.D. 2000
I think it's particularly amazing that the information on the cure of scurvy was available a long time before it was acted upon.
Hippocrates described Scurvy: bleeding gums, hemorrhaging and death, as early as the 5th c. BC. During the Crusades the disease became widespread. In 1250 it forced the retreat and capture of St. Louis with all his knights. It didn't become a major problem, however, until the age of exploration. Long sea voyages lacking in fresh food led to vitamin C deficiency.
There is a legend that during one of Christopher Columbus's voyages some Portuguese sailors had scurvy and wanted to be dropped off at one of the nearby islands and die there rather then dying on board and being fed to the fish. While the men were on the island they ate some of the island's fresh fruits and plants and to their amazement began to recover. When Columbus's ships passed by several months later, the pilot was surprised to see the men waving from land alive and healthy. The island was named Curacao, meaning Cure.
During Jacques Cartier's second voyage (1535-36), he used two indian interpreter-guides to pilot him up the St. Lawrence River to Stadacona (the site of modern Quebec). Wintering in Stadacona, 25 members of his crew died from scurvy before the indians taught them to drink a brew of white cedar which saved the rest.
As early as 1593, during a voyage to the South Pacific, Sir Richard Hawkins recommended the following treatment for scurvy: "That which I have seen most fruitfull for this sicknesse, is sower [sour] oranges and lemmons." In 1601 Captain James Lancaster unintentionally performed a controlled study of lemon juice as a preventive for scurvy. His fleet of four ships departed an April 21, 1601, and scurvy bagan to appear in three of the ships by August 1 (4 months after sailing). By the time of arrival, September 9, the three ships were so devastated by scurvy that the men of Lancaster's ship had to assist the rest of the fleet into the harbor. Lancaster's men remained in better health than the men on the other ships because he brought to sea bottles of lemon juice, which he gave to each one as long as it would last, three spoonfuls every morning. The Admiralty received Lancaster's report.
John Woodall, the 'father of naval hygiene', a "Master in Chirurgerie" published "The Surgeon's Mate" in 1636. He unequivocally wrote that scurvy could be prevented by the use of fresh vegetables and the use of lemons and oranges. "The juyce of lemmons is a precious medicine and well tried; being sound and good. Let it have the chief place for it will deserve it. The use whereof is: It is to be taken each morning two or three teaspoonfuls, and fast after it two hours., Some chirurgeons also give of the juyce daily to the men in health as preservative."
This was 111 years before Lind's famous experiment on the Salisbury in 1747 and 159 yrs. before lemon juice was made a requisit in the British Navy. "It is estimated that 5000 lives a year were needlessly lost from scurvy during this period: that is a total of nearly 800,000. In the 200 years from 1600 to 1800 nearly 1,000,000 men died of an easily preventable disease. There are in the whole of human history few more notable examples of official indifference and stupidity producing such disastrous consequence to human life." (Louis H. Roddis, A Short History of Nautical Medicine)
In 1740 George A. Anson set off on a circumnavigation with six ships and 1,955 men. By the end of his voyage 1,051 sailors had died, mostly of scurvy!
In 1747, James Lind, a Scottish physician performed the following experiment aboard the Salisbury: He took several groups of sailors dying of scurvy. He prescribed several diets, one of which consisted of: "two oranges and one lemon given every day". Within a week or so, these sailors had recovered so much that they were caring for the others, all of which died. The results were presented to the admiralty.
In the 1768-9, Cook circumnavigated the world in 3 years and only lost one man from disease, TB. His diet relied on malt and sauerkraut, but treated cases of scurvy with orange and lemon juice that the surgeon kept.
In 1795 the Admiralty finally mandated lemon juice for all sailors.