scurvy

Scurvy was at one time common among sailors and others who were on ships, whose ships were out to sea longer than perishable fruits and vegetables could be stored and by soldiers who were similarly separated from these foods for extended periods.

In infants, scurvy is sometimes referred to as Barlow's Disease, named after Sir Thomas Barlow (1845-1945), a British physician who described it.

Scurvy is also known as Moeller's disease and Cheadle's disease.

Prognosis

Untreated scurvy is always fatal. However, since all that is required for a full recovery is the resumption of normal vitamin C intake, death from scurvy is rare in modern times.

History

Scurvy was probably first observed as a disease by Hippocrates. In the 13th century the Crusaders suffered from scurvy frequently, and it has inflicted terrible losses on both besieged and besieger in times of war.

The British civilian medical profession of 1614 knew that it was the acidic principle of citrus fruit which was lacking, although they considered any acid as acceptable when ascorbic acid (Vitamin C) was unavailable.

However, it was not until 1747 that the treatment and prevention of scurvy by supplementation of the diet with citrus fruit such as lemons and limes was introduced into the British Navy by James Lind. This major innovation ensured that not a single man was lost to scurvy during Cook's first voyage, although two did suffer from the disease for a time.

The plant known as "scurvy grass" acquired its name from the observation that it cured scurvy, but this was of no great help to those who spent months at sea. In the Royal Navy's Arctic expeditions in the 19th century it was widely believed that scurvy was prevented by good hygiene on board ship, regular exercise, and maintaining the morale of the crew, rather than by a diet of fresh food, so that Navy expeditions continued to be plagued by scurvy even while fresh meat was well-known as a practical antiscorbutic among civilian whalers and explorers in the Arctic. At the time Robert Falcon Scott made his two expeditions to the Antarctic in the early 20th century, the prevailing medical theory was that scurvy was caused by "tainted" canned food. It was not until 1932 that the connection between vitamin C and scurvy was established.

The use of limes by the Royal Navy to prevent scurvy gave rise to the name "limey" for a British sailor, which has been since extended to all British in American slang. The name "kraut" for a German soldier in World War II may similarly be based on the fact that the German Navy kept sauerkraut as scurvy prevention after the Royal Navy changed to limes.

Modern incidence

Scurvy is mostly caused by the lack of Vitamin C. However, vitamin C is destroyed by the process of pasteurization, so babies fed with ordinary bottled milk sometimes suffer from scurvy if they are not provided with adequate vitamin supplements. Human breast milk contains sufficient vitamin C to prevent scurvy on its own.

Scurvy is one of the accompanying diseases of malnutrition (other such micronutrient deficiencies are beriberi or pellagra) and thus is still widespread in areas of the world depending on external food aid. (See also the report from the WHO referenced below.)

Prevention

Scurvy can be prevented by a diet that includes limes, oranges, and lemons, or the juices of these fruits.