412 THE HEMORRHAGIC DIATHESES 



the years from 1856 to 1861 only 1.05 per thousand of marines were attacke 

 by the disease. In the Austrian Marine the number of affections from 1863 t 

 1870 = 1 per cent., but in 1871 and 1873 it declined to 0.34 per cent. Ii 

 the German Marine during the period from April, 1875, to March, 1880, onl; 

 16 cases of scurvy and 76 cases of scorbutic gum affection occurred, thes 

 groups collectively giving a proportion of 0.475 per cent. 



The occurrence of scurvy upon ships depends neither upon sailing in north 

 ern nor in southern latitudes, in this nor in that season, but particularly upoi 

 the supply of provisions in proportion to the length of th'e voyage. Thii 

 readily explains why conditions are more unfavorable upon sailing ships thai 

 upon steamers. In the former only the most careful ship hygiene can preven 

 an outbreak of the disease, and upon such ships general hygienic conditions ar( 

 still unsatisfactory. 



Besides proper kinds and sufficiency of food, general hygiene is most impor 

 tant in prophylaxis, particularly perfect cleanliness of body as well as of hab^ 

 itation, avoidance of excesses, protection against cold, etc. Isolation of th( 

 patients when possible, and the greatest attention to cleanliness on contact witl 

 them, form the best means for limiting the spread of the disease, that is, foi 

 arresting it. Too much stress cannot be laid upon exercise in the open air, bj 

 which the psychical condition of the patients is improved. Where a changt 

 of residence is possible we should always take advantage of it. 



I should like to mention a few points of importance from the interesting 

 book of Nansen, " Farthest North," which reports one of the greatest sea 

 voyages of all times, in which during three years no case of scurvy occurred, 

 In regard to provisions he holds the view that in prolonged Arctic expeditions 

 meat and fish that have been preserved by salting, smoking or incomplete 

 drying are to be regarded as objectionable, and are to be rejected. The lead- 

 ing thought in provisioning must be to preserve the food either by careful and 

 complete drying, or by sterilization. " What I wished to attain was to have 

 not only a nourishing and wholesome stock of provisions, but to see to it that 

 there was as much variety as possible. We took fish of all sorts in hermetically 

 closed tins, dried fish and preserved fish, potatoes, dried as well as in tins, 

 all sorts of dried and preserved vegetables, cooked and dried fruit, preserves 

 and marmalade in large amounts, sweetened and unsweetened condensed milk, 

 preserved butter, dried soups of various kinds, etc., even bread, dried vegetables, 

 etc., in zinc cases. As drink we used at breakfast and in the evening choco- 

 late, coffee and tea, occasionally milk. For supper at first beer, later lemon 

 juice with sugar or syrup. Aside from beer and some malt extract the expedi- 

 tion had no alcoholic drinks. Occasionally a grog was made from mulberries 

 or other fruit syrup with the addition of some spirits." Meat and fish were 

 carried in a desiccated condition, free from fat, cartilage, etc., and mixed with 

 kidney fat, also Vaage's fish flour; flour (previously stewed), so that it could 

 be eaten without further preparation; dried cooked potatoes, pea soup, choco- 

 late, bread (carefully dried, hard, wheat bread) and aleuronat bread (wheat 

 flour with 30 per cent, of aleuronat) and butter. 



It may be interesting to quote the menu of the 25th of December, 1893 : 

 1. Oxtail soup, 2. Fish-pudding, with potatoes and melted butter, 3. Eeindeei 



