recognized to be both commonplace and seasonal
throughout the whole of Europe, usually being seen
in the winter months, long after the cessation of
availability of summer fruits and vegetables.
0003 ‘Land scurvy’ became ‘sea scurvy’ during the 14th
and 15th centuries at the time of a rising spirit of
adventure, catalyzed by new technical developments
in ship design and advancements in navigational
instrumentation, and compounded by growing and
powerful commercial interests in the trading of silk
and spices. These factors cleared the way for longer
sea voyages of weeks or months in duration, without
the opportunity for the crew to land at ports where
fresh vegetables and fruits would be available. The
diaries of Commodore George Anson’s voyage of
1740–44, during which he attempted unsuccessfully
to circumnavigate the world and on which 1051 of
his 1955 men died – the majority from scurvy –
referred to the fact that ‘the scars of old wounds,
healed for many years, were forced open again’ and
stated ‘many of our people, though confined to their
hammocks, ate and drank heartily and were cheerful,
yet having resolved to get out of their hammock, died
before they could well reach the deck.’
0004 Vasco da Gama sailed from Lisbon on 9 July 1497
with about 140 Portuguese sailors. He reached the
south-eastern coast of Africa 7 months later; the
records indicated ‘many of our men fell ill here,
their feet and hands swelling and their gums grown
over their teeth so that they could not eat.’ On 6 April
1498 came the opportunity to purchase oranges from
Moorish traders. Just 6 days later it is stated ‘all our
sick recovered their health for the air of this place is
very good.’
0005 In the winter of 1536, on the frozen St Lawrence
River, the North American Indians taught the French
explorer Jacques Cartier and his men the value of
boiling the bark and leaves of the white cedar tree in
water and then drinking the juice and dregs. Three
doses on alternate days were sufficient ‘miraculously’
to cure their loss of strength and their swollen and
inflamed legs.
0006 The introduction of the potato to Europe from
South America, where it had been cultivated for
nearly 1500 years, was effected in the second half of
the 16th century by the Spaniards who invaded that
country. It is now seen to have provided a ready
means of combating the problem of low vitamin C
status in the winter months.
0007 In 1617 John Woodall, Surgeon-General of the Brit-
ish East India Company, wrote The Surgions Mate,
which contained a 23-page chapter on the subject of
scurvy. He emphasized at that time the necessity of
providing the crews of ships with the juice of oranges,
lemons, or limes. He added a recommendation of two
to three spoonfuls of lemon juice as a medicine
against scurvy, and as a preventive too, if enough
could be spared. This suggestion preceded the work
and publications of James Lind, which did not appear
until the following century.
0008James Lind was born in Edinburgh in 1716 and
eventually became Physician-in-charge of the 2000-
bed Haslar Hospital near Portsmouth, the largest and
newest of the naval hospitals, in which there was the
opportunity to study 300–400 cases of scurvy at a
time. The famous experiment of his earlier days, in
1747, involved six groups of two men each, treated as
follows: group 1 with cider, group 2 with elixir vitriol,
group 3 with vinegar, group 4 with sea water, group 5
with two oranges and one lemon each day over 6
days, and group 6 with garlic, mustard seed, balsam
of Peru, dried radish root and gum myrrh, together
with barley water, tamarinds and cremor tartar. All
received the same diet apart from the above ‘medi-
cines.’ The best response was from group 5 by the
sixth day, and group 1 came second at 2 weeks; the
other ‘remedies’ proved to be of no value. Lind pub-
lished his famous book A Treatise of the Scurvy in
1753, in Edinburgh. Nevertheless, it was not until
1804 that the Royal Navy decreed that lemon or
lime juice must be provided daily; limes were later
substituted for lemons as they were cheaper and could
be obtained from the new West Indian colonies, al-
though they are now known to contain less vitamin
C. Hence the origin of the term ‘limeys’ for British
sailors. In retrospect, one can now say that James
Lind made one major error in preparing his ‘rob of
oranges’ by evaporating juice down to 10% of its
original volume, as heat is now known to destroy
vitamin C; moreover, further storage following the
preparative procedures permits yet greater deterior-
ation in the vitamin C content.
0009The history of vitamin C is strewn with anecdotes
such as these. Others should be briefly mentioned;
they include Captain James Cook’s 1768 voyage to
the South Pacific in which his crew avoided scurvy by
his insistence on the consumption of various fresh
vegetables. An outbreak of scurvy at the National
Penitentiary at Millbank in London in February
1825, following drastic reduction of the diet of the
inmates, responded to the simple prescription of three
oranges a day; however, neither the kitchen staff nor
the prison officers suffered!
0010The Great Potato Famine of 1845–48 involved not
only the UK and Ireland but also France and Belgium;
many cases of scurvy were being reported in the Brit-
ish medical literature from 1847 onwards. Scurvy, not
surprisingly, was seen in the general population and
in the prisons and hospitals, too. The Royal Navy’s
Arctic expedition, which returned in 1876, suffered
5108 SCURVY