So, You Have Scurvy: Vitamin C Deficiency, Prevention, and Treatment in a Hurry

This week, cure the black-tongued plague of the open ocean

 

Overview

 

Sanitation and proper hygiene aren’t the only aliments haunting the corridors of history. Do you have a black tongue and bleeding gums? If you haven’t been in an unlicensed temporal warp recently, these are the typical symptoms of the ancient plague of sailors and the malnourished alike: scurvy. As it lacks the ability to produce vitamin C—a vital component in the preservation and health of cells, nerves, and the immune system—the human body is destined for this prolonged and painful death without its inclusion in foods or supplements.

 

Causes and Prevention

 

The human body is incapable of producing vitamin C (C6H8O6) and as it is not stored in the human bodyinstead it is removed through the kidneys as urineit will rapidly become depleted without replenishment within a month. The anti-scurvy remedies found in ciritus* lead to the vitamin’s name “ascorbic acid” or “without scurvy” from the latin term for scurvy: scorbic. Scurvy can typically be avoided with a daily dose of 15 milligrams, but upwards to 75 and 90 milligrams are typically recommended. This is especially common when diets are limited, like those eating few vegetables, living primarily on meats and fish, and those living at sea. Prevention is distinctly diet, as the human body continually needs ascorbic acid to maintain healthy working order and it is not preserved in the tissues.

 

Symptoms

 

Early symptoms of scurvy include fatigue and impaired wound healing as well as dry skin and anemia. As the disease progresses, symptoms evolve to include follicular hyperkeratosisbumps of skin where hair on the body grows—and a coiling of body hair, as well as the pooling of blood in the lower body, in particular the upper thighs, giving rise to scurvy’s less common historical name “Black Legs”. As health deteriorates, bleeding becomes common from the skin, joints, and gums, leading  to scurvy’s most classic symptom: a black tongue and gums. Bleeding and swollen gums often cause loose teeth that eventually fall out. The final stages of the scurvy include the expulsion of rotten blood from the nose, stomach, lungs, and veins. Eventual death will often follow as the result of organ failure.

 

What Scurvy is Not

 

As early as the 1700’s, the source of scurvy was being narrowed down. With limited knowledge of nutrition, it was determined by firsthand accounts and research not to be an infectious or genetic disease. As scurvy is a disease described in antiquity, it is worth mentioning it is also neither a curse nor an imbalance in “humours”. While living conditions can impact an individual’s susceptibility to many diseases and recovering from illness, it will not directly cause scurvy. Scurvy is a single disease caused by vitamin deficiency, although the discovery of vitamins wouldn’t take place until 1912 with the Polish biochemist Dr. Kazimierz Funk. 

 

Historical Rob

 

Experiments in the 1700’s by a Scottish doctor proved the controlled nature of a valid cure with the use of fresh greens and citrus, long before the discovery of vitamin C. On May 20, 1747, Dr. James Lind began a six day experiment on the English ship HMS Salisbury of various antique methods of scurvy cures to determine their efficiency. Twelve scurvy patients were placed on diets ranging from meat broth, wine, elixir vitriol (sulfuric acid diluted with water), sea-water, vinegar and two lucky patients were placed on a gentle course of oranges and lemons. Among the patients, those present with citrus fruits were able to resume ship duties at the end of the six days. Among Dr. Lind’s continued experiments, oranges and lemons were the most effective treatments, with a preference for oranges that he would make into a concentrate (or “rob”) to store long-term. He considered it an infallible cure for scurvy to treat all stages of the affliction and prevent the worst of the symptoms from manifesting. While he had developed a controlled experiment to prove the efficiency of citrus fruit in curing scurvy, Dr. Lind would remain ignorant of the reason for their effectiveness, misattributing what purpose they served in the body and continuing to believe the predisposing cause was the moisture in sea air and a lazy disposition. Regardless, by 1790’s, citrus juice was issued as part of ship rations, radically reducing and oftentimes outright eliminating outbreaks of scurvy among seamen.

 

Cure and Treatment

 

Post-1900’s treatment consisted of 1 gram of vitamin C daily, for a week, split into smaller doses and consumed during meals. Should the case be caught early enough for treatment, once supplements have begun, improvement will continue over a few days or weeks, until full recovery. Untreated scurvy will eventually lead to slow agonizing death. Careful preparation of food is important, and ideally sources of vitamin C are to be eaten raw, as the heat from cooking can greatly reduce the presence of vitamin C.

 

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*Africa: Baobab (Powder: 173 mg), Roselle Hibiscus (12 mg), Spider Plant (63 mg)

 

Arctic and Ocean: Kelp (28 mg), Caribou liver (24 mg), Seal brain (15 mg), Ringed Seal liver (35 mg),  Beluga Whale “Muktuk” skin (38 mg), Mountain Sorrel (36 mg)

 

Asia: Blackcurrant (181 mg), Kale (94 mg), Kiwifruit (93 mg), Lemon (Juice: 39 mg, Peel: 129 mg), Oranges (Juice: 45 mg, Peel: 136 mg), Limes (29 mg), Lychees (72 mg)

 

Australian fruit: Kakadu plum (3000 mg), Indian Gooseberry (316 mg), Cheeky Yam “Air Potato” (3 mg), Cynanchum pedunculatum (119 mg)

 

Europe: Rose Hips (425 mg), Blackcurrant (181 mg), Thyme (Fresh: 160 mg, Dried: 50 mg), Fresh Parsley (133 mg), Broccoli (90 mg)

 

Mediterranean: Thyme (Fresh: 160 mg, Dried: 50 mg), Parsley (Fresh: 133 mg), Kale (94 mg), Brussels sprouts (85 mg), Lemon (Juice: 39 mg, Peel: 129 mg)

 

North America: Chili pepper (144 mg), Rose Hips (425 mg)

 

South America: Acerola cherry (1680 mg), Chili peppers (144 mg), Guava (228 mg), Persimmons (66 mg), Papayas (61 mg), Strawberries (59 mg), Tomato (23 mg)

 

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