SCURVY 389 



t 



When, after the discovery of America, shipping acquired new interest, 

 when voyages which formerly were limited to the coasts of countries were 

 extended over the open, wide sea, the brave seafaring men were confronted 

 with new and quite peculiar conditions of life. Cut off for many months 

 from land, exposed to the mercy of the winds and the waves, limited to the 

 narrow confines of their ship, where they huddled together in large numbers, 

 often exposed to great hardship, in the choice of food and drink they were 

 entirely restricted to that brought from their homes, and particularly to such 

 food as could be kept for a long time. Frequently they were compelled to 

 subsist on food more or less tainted. It is obvious that such conditions would 

 inevitably result in disease; and, great and brilliant as are the discoveries of 

 that time, the great and hideous figure of scurvy, the disease which developed 

 from these voyages of discovery, and which caused the failure of many expedi- 

 tions, cannot be forgotten. 



In the year 1498, when Vasco de Gama undertook his celebrated voyage 

 around the Cape of Good Hope, the crew was attacked by scurvy, and of 160 

 persons he lost in a short time more than one-third. We know well the deci- 

 mating character of the disease which occurred in the expedition of Cartier 

 in 1535, and in those of v. Monts, Pontgrave and Poutrincourt to Canada 

 toward the end of the sixteenth century; in the French expedition of Dellon 

 to India; in the journey of the English fleet under Lord Anson around the 

 world (1740-1744), in which voyage the disease recurred repeatedly in various 

 latitudes, and 380 out of 500 men succumbed to the malady; in the North 

 Polar expedition of Ellis (1746-1747) in search of the northwest passage to 

 Hudson Bay; in the fleet of the English admiral, Gleary, who in 1780 re- 

 turned with 2,400 scurvy patients, and in other expeditions. 



The reports of these expedition^ are so definite that there can be no doubt 

 of the identity of the disease. We have less information regarding the occur- 

 rence of scurvy upon land, the first relialjle report of which dated about a 

 hundred years later, at which time the name scurvy or " scharbock " for the 

 first time appeared. Our knowledge of the occurrence of the disease in an- 

 tiquity is very limited, although it may be assumed that the peculiar condi- 

 tions which favored the appearance of the pest, as later investigation has 

 taught, must also have produced scurvy in earlier epochs. 



The best historical accounts of scurvy we owe to August Hirsch, whose 

 description we have mainly followed. 



He succeeded, however, in finding in old medical writings only one form 

 of the disease described which so far corresponds to the picture of scurvy 

 that their identity may be assumed; namely, in the Hippocratic collec- 

 tion, an affection described as dX^oi ai/iarmys. Although the disease des- 

 ignated as STrXiyves /xeyoAai [Magni lienes] by Hippocrates, Aretseus, Cel- 

 sus, CjeUus, Aurelianus, Paulus JEginefa, Avicenna and others has been 

 by some authorities taken for scurvy, Hirsch demonstrates that this disease was 

 malaria. Pliny mentions two diseases, stomatokake and skalot3rrbe, the first 

 in particular running its course with an affection of the mouth resembling 

 scurvy. 



But it is quite as likely that this was " stomatite ulcereuse," an army dis- 



