Vitamin C and Scurvy

In a sea voyage that lasted from 1740 to 1744, George Anson lost 90% of his crew of 1,854 people, mostly to a disease called scurvy that had been known about since 1500BCE, where the Ebers papyrus in Egypt described the disease and also described curing it with onions (a source of vitamin C). Hippocrates even wrote about it in the 4th century BCE. The cure for scurvy has been forgotten and rediscovered over and over.

The most obvious symptoms of scurvy are swollen gums, fatigue, pain in the limbs caused by internal bleeding, red-blue spots on the skin, shortness of breath, bruising.

swollen gums are one symptom of scurvy

In 1747, 3 years after Anson's voyage, the Scottish physician James Lind showed through clinical trial that scurvy could be curved using citrus fruits, but his results were buried as a short paragraph in a very long and complicated treatise, which was completely ignored for about 40 years.

The established medical professionals ignored the idea that citrus fruits might cure scurvy because the idea flew in the face of the current knowledge of that time. This is the same kind of blindness that Semmelweiss was to experience 100 years later when trying to introduce the idea of cleaning your hands to surgeons. Scurvy at the time was thought to be caused by a kind of "internal putrefaction", and it was not believed that the anecdotes of sailors could somehow be more correct than the knowledge of physicians.

In 1794, Commander Peter Rainier set sail for India on the HMS Suffolk. In an experiment suggested by Rear Admiral Gardner, the ship had on board lemon juice and sugar, instead of the usually recommended malt and wort. The voyage took 23 weeks, and not one person contracted scurvy.

As soon as this news arrived back in England (1795), there was an upswelling of support for using lemon juice which forced the Sick And Hurt Board to change its recommendations.

It was thought that scurvy is a disease that only affects people at sea, but the American civil war (1861-1865) demonstrated that it was poor diet that was the cause. The US Army was aware of the issue even before then, and made "dessicated compressed mixed vegetables" that it would distribute to the troops, but these were mostly just thrown away by the soldiers because it would take up to 5 hours of boiling to make edible. Even then, after 5 hours of boiling, there was no vitamin C left.

During the war, it was recorded that 3% of people died of scurvy (where the army average was 0.5% beforehand). The figure was actually likely much higher, because only people who died directly of scurvy were counted as scurvy deaths. People who had scurvy but died of soemthing else were not counted. The increase was because of difficulties in supplying food to the scattered armies.

Scurvy deaths were even higher in war prisons, as food was by priority given to fighting soldiers and not to prisoners. 25% of deaths in prisons were from scurvy.

It was noted that scurvy increased the mortality of patients that underwent surgeries, with amputees almost invariably dying after their surgeries.

The government and civilians were well aware at this point of why people were contracting scurvy, but were just unable to provide food in enough variety to stop it. In 1862, it is recorded that civilians arranged a food drive to support the troops, prioritising onions and potatoes over other foods. They would even hold events where the entry fee was one potato or onion. Mary Livermore of Chicago arranged talent shows at which there were signs saying "Don’t send your sweetheart a love-letter. Send him an onion."

It wasn't until 1932 that the essential vitamin C was isolated from citrus fruits, but it was obvious that there was something in them that was stopping scurvy.