Monday, September 30, 2013

The Scurvy Story

In the annals of the disease, two men are mostly credited with discovering a cure: James Lind and Gilbert Blane. While citrus fruits had long been anecdotally treated as a cure, so were a whole host of other naturopathic remedies, and it fell to the young surgeon’s mate James Lind to design a now-famous test of various remedies. Lind, who enlisted at the age of twenty-three without much formal medical training, became obsessed with scurvy and its effects, and in 1747 gathered together twelve sailors with scurvy, which he ordered fed the same meals for breakfast, lunch and dinner, and then divided them into six groups, administering various known cures for scurvy to each group:
· One quart of hard cider
· Twenty-five drops of elixir vitriol
· Two spoonfuls of vinegar
· Half a pint of sea water
· Two oranges and one lemon
· A medicinal paste made up of garlic, mustard see, balsam of Peru, dried radish root and gum myrrh; along with a drink of barley-water with tamarind, and finally crème of tartar as a laxative
It took only six days for those on citrus fruits to recover, though the hard cider group also saw some limited improvements in symptoms. Those who gargled the elixir vitriol had cleaner mouths and gums, but otherwise had not improved much. Lind saw no improvement in the sea water, vinegar, or medicinal-paste-and-tamarind-water groups. He concluded: “oranges and lemons were the most effectual remedies for this distemper at sea.”
Despite this undeniable conclusion, Lind’s advice didn’t immediately take hold, and scurvy rates continued to rise in the Navy. In 1780, three-thousand cases of scurvy were reported in six months in the West Indies fleet, and Admiral George Brydges Rodney appointed his friend, Gilbert Blane, Physician to the Fleet, hoping for some kind of answer. Within a few months Blane came to the same conclusions as Lind had decades earlier: “scurvy, one of the principal diseases by which seamen are afflicted, may be infallibly prevented, or cured, by vegetables and fruits, particularly organs, lemons, or limes.” The intransigence of bureaucracy kept Blane’s recommendations from being widely implemented for another fifteen years, until in 1795 he was appointed to the Board of Sick and Wounded Sailors. Soon after, lemon juice was added as a staple to English ships, and incidences of scurvy plummeted. The British Navy had finally seen the light, and from 1796 until 1814, according to Carpenter, the British Navy distributed over 1.6 million gallons of lemon juice.

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