The great voyages of discovery, when seafarers such as Magellan and Cook conquered the world’s oceans, brought immense wealth and knowledge to Europe. But they came at a high price. More sailors died of scurvy—more than three times as many—as soldiers were killed in the American Civil War.
Today we know that this terrible ailment, which ravaged both body and mind, was caused by chronic vitamin C deficiency, brought on by lack of fresh fruit and vegetables. But that diagnosis eluded doctors and explorers for centuries, explains Jonathan Lamb in his new book, Scurvy: The Disease of Discovery.
When National Geographic caught up with the author by phone in New Zealand, he explained that scurvy had such appalling symptoms that its victims frequently kept their suffering secret; why “earth bathing” was once thought to cure a disease caught mostly at sea; and how scurvy inspired great works of literature.
You call scurvy “the disease of discovery.” Map out its causes and the scale of its ravages in the great sea voyages of the 15th to 18th centuries.
An estimated two million seamen died of scurvy during those years. These are the centuries where people are first crossing the Atlantic Ocean, the Indian Ocean, and the Pacific, and the problem incident to all of those voyages was that you were going to be at sea continuously, probably for more than three months, at some stage in the voyaging. That would be the period when scurvy would make itself apparent because everybody on the ship would be living on preserved foods. In preserved food there are no vitamins, so a variety of nutritional diseases would be likely: lack of vitamin B1 would cause beriberi; no vitamin B3 would cause pellagra; and vitamin C, of course, scurvy.
Scurvy was usually the most obvious manifestation. Sometimes it’s clear from the reports that it was mingled with other ailments, like beriberi. People would get large concentrations of fluid in their legs, a sign of beriberi. Beriberi and pellagra also both caused mental instability and personality changes. All of this can be tracked in the journals of the voyages, where people behave very oddly. The most astonishing example is Captain Cook. Everybody thought he was infatuated in the days before his death. But Sir James Watt, the famous naval surgeon, suggested that, in fact, Cook was suffering from pellagra.
There’s a terrible coyness about scurvy because it was supposed to be, and was, a filthy, noisome disease. People with scurvy stank horribly. It wasn’t something you wanted to admit. Herman Melville, author of Moby Dick, almost always called scurvy “sickness” in his memoires of whaling. People didn’t want to own up to it.
Describe the terrible physical effects of scurvy. Sensitive readers should look away.
[Laughs] The main physical symptom of scurvy is the disintegration of the body. The skin begins to break. It starts with little blood blisters and develops into full-scale ulcers. The gums begin to putrefy and become black. Bones that had previously broken rebreak. Old wounds open up. This is because one of the major effects of scurvy is that the body can no longer produce collagen, the glue of the body’s cells. The cartilage, especially around the thorax, begins to disappear. That’s why people who had scurvy creaked and rattled.
That was on the outside, in terms of the body’s scaffold. In terms of the insides, the hydraulics, what happened was that the arteries and capillaries began to decay. Blood began to leak into the muscle and coagulated inside arteries, causing terrible cardiovascular damage. The effect of this on the brain was that you could have seizures or aneurisms at any moment.
Symptoms were not just confined to the body. Scurvy also ravaged the mind, didn’t it?
The psychological facts were caused by the disintegration of the nervous structure of the brain. The function of vitamin C is to scavenge free radicals, which are what you could call the waste matter of neuronal activity in the brain, which causes oxidation. Oxidative stress occurs when there isn’t enough vitamin C to get rid of the free radicals which are, in effect, blocking the synapses, destroying the effectiveness of the neurotransmitters or causing them to operate in intermittent and explosive ways. And when the neurotransmitters serotonin and dopamine don’t function properly, the brain starts producing hallucinations.
Dreams become very vivid. And what these dreams produce is an image so exact, and brilliant, of what the body needs: namely, food. When you wake up, or when the hallucination disappears, and you find the food is not there, you are totally devastated. Thomas Willis, an expert on scurvy in the 17th century, called it “a falling down of the whole soul.” There are numerous accounts of hardened naval officers just sitting down and crying, because the food they expected to find wasn’t there.
One of the great experts on scurvy in the 18th century, Thomas Trotter, coined the term “scorbutic nostalgia.” But in her recent book, Round About the Earth, Joyce Chaplin suggests that scurvy has got nothing to do with nostalgia. It’s a longing for home. It’s about earth sickness. People in the 18th century thought that the smell of earth, the feeling of being on the land, was beneficial in cases of scurvy. This led to the practice of “earth bathing.” If you equated earth with home, you would ship English earth out, and when somebody went down with scurvy you would put them in a box and pour the earth on top of them. This was supposed to cure them.
Captain Cook is credited with solving the problem of scurvy on his ships by issuing vitamin C in the form of lemon juice and fresh fruit and vegetables. But you dispute that, don’t you?
Cook is taken to be the hero who conquers scurvy. But that’s not strictly true. He manages scurvy as well as is possible on his circumnavigations; that is, he’ll stop whenever he can to get fresh greens from the shore or buy fresh meat and fish from natives. He also keeps a very clean, dry, and as much as he can, warm ship. What were called the contributory causes of scurvy—physical misery—Cook reduced to a minimum.
But there was scurvy on all his voyages, particularly on the second one. Cook didn’t help the cause much, either, because, when he came home, he said that the current fashion for malt wort (concentrated malt) was a great preventive of scurvy. He doubted whether it could cure it, so he was honest to that extent. But he was following the line of David McBride, the doctor who said it’s not citrus that will prevent or cure scurvy, but concentrated malt. So what Cook did was recommend something that had no antiscorbutic value at all.
The great historians of medicine at sea, Jack Coulter and Christopher Lloyd, say that Cook’s achievement was not an achievement at all. It wasn’t until Sir Gilbert Blane organized the distribution of citrus to seamen, in 1795, while Britain was fighting the Napoleonic Wars, that you got a regime that kept scurvy at bay. Cook was admirable in so many ways. But on the topic of scurvy he was, you could say, actually an impediment.
Neuroscience is revealing new insights into the effects of vitamin C deficiency. What is it telling us?
It’s saying that certain mental states and mental conditions, like being subject to seizures, are cured by vitamin C. Perhaps the most dramatic example is a paper just published, which says people with septicemia (blood poisoning), if fed intravenously with vitamin C, will reduce their chances of dying by 75 percent.
Vitamin C may also help with one of the side effects of diabetes, osmotic diuresis, which is the leakage of urine into the bodily system. This produces severe oxidative stress and people with that condition could benefit enormously from extra doses of vitamin C. Scurvy itself is still a health problem in the United States and elsewhere.
Scurvy found its way into literature, most notably in Samuel Taylor Coleridge’s The Rime of the Ancient Mariner, but also Moby Dick and even 1984. Give us some of the highlights.
The highlight for me is a scene in The Ancient Mariner where the ancient mariner is looking over the side of the ship and sees water snakes. He can’t believe how repulsive they are. “Oh, Christ that this should be, for things with slimy legs did walk upon a slimy sea,” he says. He’s paralyzed with horror. Yet, a couple of stanzas later, he’s looking at the same water snakes and thinking they are marvelous creatures, shedding elfin foam as they fight in the water. His heart goes out to them. He loves them.
This alternation between horror and delight is typical of scurvy and it’s what seems to organize the literature of scurvy. You’re in a terrible state of privation, ignorance, and smell, when suddenly something happens to pull you out of it. That’s usually the arrival of food or liquid in some form, and all your joys come together in one ecstatic blast.
That is one side of the story. The other side is that scurvy is always marked in journals and literature with the problem of telling the story because what you have seen somehow belongs only to you. The reason the mariner has to keep finding new people to buttonhole, to tell his story to, is that he can’t succeed in his narrative and convey the full pressure of the experience. That feeling of being alone is remarkable. People weren’t alone. They were most always in the company of hundreds of other sailors on a ship. But that’s what they feel like. They feel entirely alone and can never explain to anybody what it’s like.
What surprised you most in your researches, Jonathan? And how did writing this book change your view of the world?
What surprised me was the poetic potential of scurvy, with its awfulness and that terrible sense of isolation, when the possibility of ecstatic delights was inconceivable and incommunicable. That kind of privacy fascinated me. I wanted to bang on that door, to find out what it was that they couldn’t tell me. Why, of all diseases, was it the most secret? I’ve become much more curious. Not just about scurvy, but about lots of things!
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Source: National Geographic