390 THE HEMORRHAGIC DIATHESES 



ease, as the herba Britaimiea was used for stomatokake and skalotyrbe. Some 

 have considered oscedo (a disease mentioned by Mareellus) as probably scurvy, 

 although the nature of this aiiection is otherwise not known, and we do not 

 know what plant was meant by herba Britannica. 



The occurrence of scurvy in the Middle Ages is quite certain. Several 

 descriptions exist of decimating diseases which followed the massing of great 

 armies, as during sieges, etc. 



Thus, Jacques de Vitry reports the outbreak in 1218 and 1219, in the 

 Army of the Crusaders while besieging Damiette, of a disease in the course 

 of which the gums became gangrenous, the extremities painful, the tibia later 

 turned frightfully black, and the patients were unable to eat ; thus the disease 

 ran its course, the patients suffering intense pain from which most of them 

 were only relieved by death. Joinville explicitly describes a similar disease 

 which appeared in the army of Louis IX while besieging Cairo in 1250. If 

 we can conclude from these descriptions that the disease was scurvy, we may 

 also assume that this disease had certainly occurred previously. 



Cordus was the first to use the term " scharbock " for this malady. But 

 Hirsch believes it questionable whether he himself ever observed the disease. 

 On the other hand, quite accurate descriptions are given by Olaus, Magnus, 

 Echthius, Eonsseus, Wierus, Dodonaeus, and Brucseus. Most of these ac- 

 counts refer to epidemics that occurred in northern countries bordering on 

 the sea, in North Germany, Scandinavia, and The Netherlands. From these 

 descriptions it also appears that the disease usually occurred under circum- 

 stances of great stress, such as famine, war, sieges or other unfavorable social 

 conditions. Descriptions of certain diseases as scurvy, to which their symp- 

 toms show only a partial similarity, are unreliable. This is the case with an 

 epidemic which is said to have occurred in the year 1486 in Saxony, Thuringia, 

 and some neighboring countries. 



The earliest description of scurvy by Fabricius, rector of the princely 

 school of Meissen, is found at the beginning of the eighteenth century, but 

 Hirsch proves that the condition was ergotism, the nature of which was still 

 unknown to physicians of that time. Medical history of the seventeenth cen- 

 tury, and especially that of the eighteenth, inclines us to believe that during 

 this entire period Europe was afflicted with scurvy which was more prevalent 

 than any other disease. The fact that during so long a period of time a single 

 disease should have predominated to such a marked extent is at once sus- 

 picious, and close investigation has shown that the exact opposite was really 

 the case; that persons who had rarely seen scurvy declared almost everything 

 to be scurvy, and thus brought about tremendous confusion in medical sci- 

 ence. The cause of this must be ascribed to Eugalenus, whose book, "De 

 morbo scorbuto liber," which appeared in the year 1720, Hirsch declared to 

 be patchwork which could not be equalled in medical literature, either in the 

 ignorance of its author, or in the results which it nevertheless achieved, since 

 for more than a century it remained the canon regarding scurvy, and the best 

 physicians of the age were unable to free themselves from its influence. The 

 book made a great sensation, particularly the teaching that all children were 

 born with a predisposition to scurvy (Drawitz), and that the cause and root 



