Scurvy

• What is scurvy?

Scurvy, also called vitamin C deficiency, is of the most serious diseases affecting teenagers today.  It is caused by a dietary lack of vitamin C (ascorbic acid), a nutrient found in many fresh fruits and vegetables, particularly the citrus fruits.   Ascorbic acid is important in the formation of collagen (an element of normal tissues), and any deficiency interferes with normal tissue synthesis.

• How can I tell if I have scurvy?

Scurvy is characterized by swollen and bleeding gums with loosened        teeth, soreness and stiffness of the joints and lower extremities, bleeding under the skin and in deep tissues, slow wound healing, and anemia.  If you experience any of these symptoms, you should consult a physician immediately — you may be suffering from scurvy.

• So what’s so special about this ascorbic acid stuff anyway?

When collagen is made, the proline amino acids are changed to hydroxyproline, by a process called post-translational modification.  An enzyme called prolyl hydroxylase catalyses this change.  This enzyme requires an Fe2+ ion to be present. Fe2+ is relatively unstable, and will become oxidized easily. Ascorbic acid, a water-soluble antioxidant, keeps Fe in the 2+ form, and not in the more stable 3+ form.

Fun fact: “ascorbic acid” comes from the New Latin “scorbutus” meaning scurvy!

Cool Scurvy Dudes

• Captain James Cook

James Cook, the great British sea captain, knew what was best for his sailors. Shortly before his death, he wrote in his journal:

Every innovation whatever, tho ever so much to their advantage, is sure to meet with the highest disapprobation from Seamen: Portable Soup and Sour Krout were at first condemned by them as stuff not fit for human beings to eat. Few men have introduced into their ships more novelties in the way of victuals and drink than I have done. It has, however, in a great measure been owing to such little innovations that I have always kept my people generally speaking free from that dreadful distemper the Scurvy.

• John Woodall

John Woodall (1556-1643) was a military surgeon in Lord Willoughby’s regiment in 1591 and later first surgeon-general to the East India Company in 1612 and surgeon to St. Bartholomew’s Hospital from 1616 to 1643. In 1617, he published the first edition of The Surgeon’s Mate, a volume containing an extensive inventory and description of the medicines and their uses and of the instruments that the chest of the Surgeon’s Mate should contain.

Woodall devoted pages 160-176 to “the scurvy called in Latine Scorbutum.” His therapeutic section considers treatments for a variety of symptoms and complications for associated conditions. The preface to this section includes the remarkable statement:

… [W]e have in our owne country here many excellent remedies generally knowne, as namely, Scurvy-grasse, Horse-Reddish roots, Nasturtia Aquatica, Wormwood, Sorrell, and many other good meanes… to the cure of those which live at home…they also helpe some Sea-men returned from farre who by the only natural disposition of the fresh aire and amendment of diet, nature herselfe in effect doth the Cure without other helps… [At sea,] the Lemmons, Limes, Tamarinds, Oranges, and other choice of good helps in the Indies… do farre exceed any that can be carried tither from England.

These observations are soundly in keeping with modern knowledge of the vitamin C content of the above remedies and of the labile nature of this vitamin when stored.

• James Lind

James Lind was born in Edinburgh, Scotland, the son of a merchant. At age 15 he was apprenticed to a physician and in 1739 passed the examination for surgeon’s mate in the Royal Navy. In 1753, he published his classic work “A Treatise of the Scurvy”.

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