Scurvy, Or Scorbutus, a disease depending upon insufficient and faulty nourishment, which was known to the ancients, but has been more common since long sea voyages have been undertaken. Sea scurvy depends on an impoverished condition of the blood, in which the albumen becomes less easily coagulable and the fibrine less coherent. The most marked symptoms are swollen gums, pale and bloated complexion, lassitude, lowness of spirits, extreme debility, and a tendency to haemorrhages, which may take place from the intestines, under the skin, or among deeper-seated structures, even beneath the periosteum. Ulceration, sloughing, separation of epiphyses, disuniting of old fractures, and intercurrent diseases of a low type, may be observed. The scorbutic taint, when not manifest as a distinct disease, sometimes complicates other affections. Sea scurvy was formerly the scourge of a seafaring life. In 1593 Admiral Hawkins said that, within his experience, as many as 10,000 seamen had died of scurvy. Lord Anson, in his voyage round the world, at a much later period, lost more than four fifths of his men; and when he arrived at Juan Fernandez, of the 200 men then surviving, only eight were capable of duty.
The whole crew of the Spanish ship Oriflamma perished in this manner, and the vessel was discovered floating at the mercy of the winds, with the dead bodies on board. Though principally occurring during long sea voyages, it has been seen, in very destructive forms, in besieged cities, camps, prisons, and even among a destitute rural population. Dr. Joseph Jones, a confederate surgeon, estimates that nine tenths of the great mortality in the Andersonville prison was due directly or indirectly to scurvy. - Many causes, such as depressing mental emotions, fatigue, exposure to cold and wet, neglect of ventilation and cleanliness, and insufficient food, undoubtedly contribute to the production of scurvy; but its essential cause is a deficiency of some important constituent of the food. It has not been determined with chemical accuracy what the missing constituent is, though it has undoubtedly a near connection with some of the organic acids, namely, tartaric, acetic, citric, malic, and lactic. But the class of aliments which furnish the substances needed are well known, and there are few diseases which can be more completely cured, or still better prevented, by judicious hygienic management.
The aliments which have this power are mostly vegetable, though fresh meat and milk have been found to play an important part in some cases. Salt meat is not a cause of scurvy, except as excluding more nourishing and digestible food. The efficacy of lemon juice as an antiscorbutic seems to have been known in 1609, but it was not till 1795 that, by order of the admiralty, it was regularly supplied to the British navy. Since that time the amount of scurvy has vastly diminished. The lemon juice should be pure, should have 10 per cent. of brandy or rum added to prevent fermentation, and should be packed in jars, covered with a layer of oil, and sealed. Nearly all esculent vegetables, especially raw and unripe, before the acids have given place to sugar and jelly, are antiscorbutics. Potatoes are among the best. Cabbage, in the form of sour crout, in which acetic acid has been developed, water cress, and onions rank next. Gooseberries and tamarinds are useful; and a decoction of the leaves and bark of a tree, supposed to have been a spruce fir, restored to health the crew of Jacques Cartier in 1535-'6. Several other vegetables are likely to be useful in an emergency, such as sorrel (rumex acetosella), lamb's quarter (chenopodium album), wild artichoke, the American aloe (agave Americana), indigenous in Texas, California, and Mexico, the prickly pear, and the dandelion.
Desiccated vegetables may be used, but are less efficient as well as less agreeable than the fresh. Dr. Parkes recommends the issue of vinegar with the daily rations, in addition to the lemon juice, and also the citrates, tartrates, lactates, and malates of potash in bulk, to be used as drinks or added to the food.