Feeds:
Posts
Comments

Posts Tagged ‘James Lind’

Did you know that there was an shipboard disease that killed more sailors than all battles, storms and other diseases combined between the 16th to the 18th centuries?

This is the question that sets us off on another small, but hopefully interesting diversion to our main story line.

As we move into this age of discovery in the Pacific, there is an enemy lurking. An enemy that needs defeating – an enemy that has been killing on board ships (and on land) for centuries.

That enemy is scurvy.  A disease that has plagued sailors, pirates, passengers and more as explorers and adventurers venture deeper into the Atlantic and Pacific oceans.

So what is this disease called scurvy?

Scurvy is a disease caused by the lack of vitamin C, an essential nutrient required by humans, but only in very small amounts. The lack of vitamin C leads to the degradation of the connective tissue in the body.

Wikipedia describes its impact quite eloquently; as a disease leading to “malaise and lethargy, followed by formation of spots on the skin, spongy gums, and bleeding from the mucous membranes. Spots are most abundant on the thighs and legs, and a person with the ailment looks pale, feels depressed, and is partially immobilized. As scurvy advances, there can be open, suppurating wounds, loss of teeth, jaundice, fever, neuropathy and death”.

Scurvy, however, is not just a disease of the oceans; it has been with humanity throughout the ages. The first written account of a disease likely to be scurvy comes from the Ebers papyrus from around 1500 BC in Egypt. The Ebers papyrus not only describes scurvy, but amazingly it also prescribes a relevant remedy – that victims be treated with onions, a common source of vitamin C during those times. Much later Hippocrates of Ancient Greece also recorded the existence of scurvy, but no effective cure was mentioned other than the likely demise of the patient.

In 1497, Vasco da Gama, the Portuguese explorer from Byte 8 lost over 100 men to scurvy, providing us with one of the first recorded events of sea scurvy. A soldier on this voyage named Luis de Camoens, wrote a poem The Lusiad about the deaths from scurvy:

A dread disease its rankling horror shed,

And death’s dire ravage through mine army spread.

Never mind eyes such dreary sight beheld,

Ghastly the mouth and gums enormous swell’d;

And instant, putrid like a dead man’s wound,

Poisoned with foetid streams the air round.

No sage physician’s ever-watchful zeal;

No skillful surgeon’s gentle hand to heal,

Were found: each dreamy mournful hour we gave

Some brave companion to a foreign grave.

There is a reason why around this time scurvy becomes more prevalent on ocean going voyages. Voyages were now much more likely to be sailing the vast oceans for many months at a time, often without resupply. This timeline matches with the nature of the onset of the disease. Scurvy’s symptoms make a slow progression, usually appearing after 60-90 days of a vitamin C deficient diet.

Not that there were no attempts at a cure. Perhaps it was because of spongy gums, Vasco Da Gama orderes that sufferers wash out their mouths with their own urine. A most unpalatable, and no doubt ineffective attempt at a solution.

Scurvy increasing comes to plague major ocean going expeditions. Two scurvy outbreaks hit the Magellan expedition of 1519 that was to circumnavigate the world, once in the Pacific and once in the Indian oceans, both occurring far from land.

Moving closer to the time of the voyages of Captain James Cook, the British had one of their first major experiences with ocean going scurvy. An expedition led by Sir George Anson in 1740 to attack Spanish Galleons and ports in South America suffered significant losses from the onset of scurvy. The only upside from this tragedy was that at last it put the subject of scurvy on the agenda of the British Admiralty.

So to the cause and find a cure for scurvy…

One simple explanation for the onset of scurvy is shipboard diet at the time. And it does play a key role in the onset of the disease. But another important cause was the vast logistical challenges facing countries as they tried to support their Navies and their exploration agenda.

If we consider the current reach of just the British Admiralty at the time, it was a major task to provide provisions and establish and maintain adequate resupply points far from England.  This challenge was compounded by a focus on providing supplies at the absolute lowest cost and the endemic corruption that confounded the supply lines.

Over the years 1750-1757, it is estimated that England alone supplied it navy with over 54,000 pounds of bread and biscuit, 4,500,000 pounds of beef, 6,700,000 pounds of pork, 203,000 bushels of peas, 6,200,000 pounds of flour, 809,000 pounds of suet plus much more.

So in considering the causes of scurvy at the time we must include the quality of provisions, the lack of reliable resupply (and unpredictable voyage times), as well as the diet provided.

An example of a typical weeks ration for a sailor was:

1 lb. of biscuit (hardtack) daily

2 lbs. of salted beef twice weekly

1 lb. of salted pork twice weekly

2 oz. of salted fish three times weekly

2 oz. butter three times weekly

4 oz. cheese three times weekly

8 oz. dried peas four times weekly

1 gal. of beer daily

None of the above provided adequate and consistent protection from a deficiency in vitamin C.

It was not until 1746, not long after the losses of Sir George Anso’s voyage, that a surgeon named James Lind on the HMS Salisbry began research into a cure for scurvy. It was on this ship that Lind performed his now famous scurvy experiment. With the blessing of his captain, Lind began an experiment on twelve men with advanced scurvy. His approach was revolutionary for the time, undertaking what we would now call clinical trials; breaking the group up and trialing oranges, lemons elixir of vitriol, vinegar, cider, sea water, and nutmeg.

Based on these trials Lind published in 1753 his Treatise on Scurvy and to this date is considered a classic in medical science. Unfortunately the books impact in the short term was minimal. This was due to a number of things, but principally the small scale of the trial and his lowly rank as a ships surgeon.

It took the Royal Navy over forty years from the publication of Lind’s work to adopt Lind’s recommendations under the Physician of the Fleet, Sir Gilbert Blane, when small quantities of citrus juice were added to the shipboard diet.

So to Captain James Cook and his journey of discovery of 1768…

There is a certain mythology that Cook was involved in someway with a pioneering solution to scurvy, but this is not the case. It is true that his long voyages were remarkably free from scurvy, but this was due to the methods and approaches of Cook to his voyage, as opposed to a “regular dosing” of his crew with fresh fruit.  He banished scurvy more by his meticulous approach to cleanliness as well as the regular replenishment of food (including fresh fruit and vegetables), leading to a healthier more robust crew and a healthier shipboard environment. It is noteworthy that poor shipboard conditions were also referred to by Lind as a cause of scurvy.

So with the enemy “on the ropes”, the stage is set for Captain James Cook and others to safely venture deeper into the Pacific on more audacious, and ultimately more successful missions, both for country, and for once, crew…

Reference:

For the main source and much more go to:

http://leda.law.harvard.edu/leda/data/658/Mayberry.html

Read Full Post »

%d bloggers like this: