385 



ANTISCORBUTICS. 



ANTISEPTICS. 



3fO 



scale of antiscorbutic power. But at the head of all, the hesperidese 

 deserve to be placed, the members of which contain citric acid : 

 accordingly, any of the species may be employed ; but the most 

 powerful belong to the genus Citrus, especially the Citrus llnumum, 

 (Risso), the well-known lemon, since the introduction of which into the 

 navy, in 1796, scurvy has almost ceased. It may be used in various 

 ways ; the best is in the form of the fresh fruit sucked by the patient : 

 but in the absence of this, lemon-juice may be employed, and this is 

 the usual mode in the naval practice. Several gallons of it, having a 

 tenth part of spirit of wine added to preserve it, are supplied to each 

 ship, and in about a fortnight after leaving port its use is begun ; each 

 sailor is allowed one ounce of it and one ounce and a half of sugar to 

 mix with; the grog, or in many instances with wine, a stated quantity 

 of which is granted in lieu of a certain quantity of spirits, which is 

 withdrawn. This has the effect of almost invariably preventing scurvy 

 affecting any of the crew ; but should symptoms of the disease begin 

 to show themselves, they quickly disappear by an increase of the 

 quantity of lemon-juice. Citric-acid, which has been crystallised 

 and again dissolved in water, is not so efficacious, neither is 

 vinegar, nor any other vegetable acid, such as tartaric, or malic, so 

 useful, though the fruits containing them (unripe gooseberries, 

 tamarinds) are the best substitutes for lemons, when these cannot be 

 procured. 



No one, as far as we know, has attempted to explain how these 

 vegetable acids produce their beneficial effects. It may be remarked, 

 however, that all acid fruits have a very cooling and soothing effect in 

 many complaints ; they are among the most useful refrigerants, and 

 often sit on the stomach and restore its power, when in a very irritable 

 or weakened state. This is particularly the case where the powers of 

 the stomach and nervous system have been much impaired by intem- 

 perance, especially from the abuse of spirituous liquors, in which tar- 

 taric acid is eminently serviceable ; even during a fit of intoxication, a 

 draught of vinegar will restore the drunken man to his senses more 

 speedily than any other means. These acids appear to exert a very 

 considerable vital action on the system generally, but especially on the 

 nervous centres. Further, lemon-juice and vinegar exercise a chemical 

 influence on many articles of food difficult of digestion, as veal ; hence 

 the practice of serving these articles to table accompanied by one or 

 other of these acids. If the salt has rendered the meat hard and 

 difficult of digestion, may not these acids produce some change in it, 

 rendering it less so by their chemical properties) as well as by their 

 general action heightening or increasing the vitality of the stomach, 

 and consequently its power of extracting the nourishment ? Some local 

 effect is produced by the direct application of lemon-juice, as slices of 

 lemon placed on the ulcers hasten the healing processes. 



Mineral acids, such as elixir of vitriol, are found less useful, though 

 they and other strengthening medicines, such as sulphate of quinine, 

 may occasionally prove serviceable, when lemon-juice is wanting, or fails 

 in effecting a cure, which has happened in some very rare instances. 

 Chloride of soda appears to have some claim to a favourable regard ; 

 but at present we have too little experience of it, in this respect, to 

 speak positively of its antiscorbutic power. 



In addition to the lemon-juice, ships intended to be sent on long 

 voyages are supplied with animal food, so prepared, as to be almost as 

 fresh at the end of six years as if it had been killed but a few days, 

 and dressed the day previous to its being used. This valuable dis- 

 covery, which tends so greatly to lessen the inconvenience of a sea-life, 

 as well as to secure the health of those devoted to it, was made by 

 Hr. Appert : the mode of effecting it, and the principle on which it 

 depends, will be explained under ANTISEPTICS. 



After every fair degree of merit is assigned to other means and 

 articles, the main instrument of banishing scurvy from among the 

 number of diseases incident to a sea-life has been the liberal use of 

 lemon-juice. The nation owes a deep debt of gratitude to those who 

 effected its universal introduction into the naval service, and who 

 lived to witness the beneficial effects of their enlightened views : these 

 were Earl Spencer, who was first lord of the Admiralty in 1795, and 

 Sir Gilbert Blane, physician to the fleet, and at the head of the Navy 

 Medical Board in 1795. But for their exertions, it seems scarcely 

 probable that our navy could, during the twenty years of the war 

 which followed that day, have achieved those victories which have 

 rendered our country so illustrious. (See paper on the comparative 

 health of the British navy, by Sir Gilbert Blane, in his ' Select Dis- 

 sertations on Medical Science/ London, 1822 ; also in vol. vi. of 

 ' Transactions of the Medico-Chirurgical Society.') 



The historian of Anson's voyage, speaking of scurvy, says, " The 

 cure seems impossible by any remedy or by any management that can 

 be employed." In the present day, instead of the remedy being un- 

 known, it is, happily, the disease ; a fact which suggests the most 

 important subject for contemplation, and justifies the reflections and 

 language of Sir Gilbert Blane : " Does it not afford a cheering and con- 

 solatory prospect, ' amidst the thousand shocks that flesh is heir to/ 

 that there may be still in store for us, in the boundless progression 

 and endless combinations of knowledge, other hidden means of 

 advancing human happiness, of mitigating human misery, and of 

 making accessions to the dominion of man over nature, which have not 

 yet been dreamt of in our philosophy." [ScUKVT.] 



The other diseases to which the name of scurvy has been improperly 



AET3 AND SCI. DIV. VOt. I. 



given, and some of the remedies for which are termed antiscorbutics, 

 have no connection with sea-scurvy, or its remedies. These various 

 affections of the skin are more or less connected with a scrofulous 

 constitution, to which are owing the disordered functions of the 

 digestion, whence these eruptions spring. Acidity in the stomach is a 

 concomitant and characteristic symptom of these diseases, for the cure 

 of which vegetable acids are unavailing, though the mineral acids, by 

 their strengthening virtues, are often serviceable. These so-called 

 scorbutic affections are of very frequent occurrence among persons 

 subject to gravel and gout, which are, at the commencement, caused by 

 acidity in the stomach : the appropriate means of cure for both com- 

 plaints are alkalies [ANTACIDS], the very opposite of the means useful 

 in true scurvy. 



The nostrums vended under the name of antiscorbutics, and intended 

 for these cutaneous diseases, though varying in their composition, 

 mostly contain, as their active principle, some preparation of mercury, 

 often a very poisonous one, which is always hurtful in sea-scurvy, and 

 can only be serviceable in particular cases of the other kinds. Its use 

 requires the greatest caution, directed by the utmost skill ; the employ- 

 ment of such articles should, therefore, be carefully avoided. 



ANTISEPTICS, from !, agaimt, and ajfiroptu, to putrefy, the means 

 of preventing those changes in organised matter which are compre- 

 hended under the term putrefaction. All organised bodies consist of 

 different materials, which are designated their proximate principles, 

 and these again are formed by the union or combination of certain 

 ultimate principles. An organised body, therefore, is always a com- 

 pound one, and the tendency of its original or natural proximate 

 principles to form others, and, at last, to be resolved into the ultimate 

 elements of which they are formed, is the occasion of putrefaction, 

 which takes place in all bodies, sooner or later, according to the circum- 

 stances in which they are placed. To give an example of each : flour, 

 prepared from what was once a living and organised body, called a 

 seed, contains two proximate principles, gluten (bird-lime) and starch : 

 each of these is resolvable into definite combinations of what are 

 termed simple or elementary bodies, of the same nature as the con- 

 stituents of inert or inorganic matter ; the most common of these are 

 oxygen, hydrogen, carbon, and nitrogen. The first or proximate 

 principles are only met with in organised bodies ; the latter equally in 

 organised and inorganic matter. Oxygen, for instance, forms a portion 

 of the air which we breathe, and also of water ; hydrogen forms a 

 portion , or is an element, of water ; nitrogen is found in the atmospheric 

 air ; and carbon exists in the diamond, in the charcoal obtained from 

 wood, or from animal matter. 



All organised bodies spring from parents similar to themselves, 

 possessed of, or endowed with, a vital principle. Every such body 

 possesses the power of assimilating to itself matter introduced from 

 without, whether inorganic, as table-salt, or organised matter, as dead 

 animal and vegetable substances, in the case of man and some other 

 animals, or merely inorganic matter, as in the case of vegetables. 

 After being received into the interior of the body, these matters undergo 

 changes previous to being distributed to that part of the frame destined 

 for the reception of the different proximate principles which are formed 

 out of them by the vital processes of digestion and assimilation. When 

 deposited in the part intended for them, they would speedily enter into 

 fresh combinations, were not their tendency to do so controlled by the 

 agency of the living principle, which counteracts the usual chemical 

 affinities of the constituent or elementary principles. When this 

 principle is weak, or does not act with sufficient energy, either through 

 the whole frame or in any particular part of it, the elementary principles 

 manifest a disposition to exert their ordinary affinities which would 

 lead to the decomposition of a part or the whole. Partial decompo- 

 sition occurs when a limb or other part of the body has been the seat 

 of such violent inflammatory action that its structure is changed, and 

 its vitality destroyed, so that it sloughs, as it is technically called, that 

 is, becomes dead : complete decomposition occurs when the vital 

 principle quits the entire frame, that is, when death of the whole 

 body takes place, and putrefaction begins. But the presence of the 

 vital principle does not always hinder the commencement of putre- 

 faction, as we see the tendency to it manifested in the worst kinds of 

 fevers several days before dissolution : on this account they were termed 

 putrid fevers, and were conceived to be owing to putrescency of the 

 fluids, a doctrine common during the prevalence of the humoral 

 pathology. But more correct views of fever have taught us that the 

 changes in the fluids, both as respects their properties and chemical 

 constitution, are consequent upon a change in the vital action of the 

 system, resulting from the impression of a powerfully morbific agent 

 on the nervous or circulatory systems. This impairs the vital force or 

 energy of the frame, and lessens the power by which the chemical 

 affinities were controlled ; and hence the early tendency to putrefaction 

 in persons affected with fevers of a typhoid type or character. 



The complete departure of the vital principle is not sufficient to 

 occasion the commencement or ensure the continuance of the processes 

 of putrefaction : the concurrence of several other circumstances is 

 necessary. These are air, heat, and moisture : if any one of these be 

 wanting, decomposition will in general be prevented. If the air has 

 an admixture of certain particles or principles, the tendency to putre- 

 faction will be greatly increased ; and, on the other hand, impregnating 

 the air with certain other principles, greatly lessens the disposition to 



