SCURVY. 



SCURVY, in Medicine, Scorbutus, a formidable and 

 often fatal dil'eale, ariiing from imperfeft nutrition, and 

 other caufes, and charafterifed principally by extreme de- 

 prcfTion of the vital powers, together with fponginefs of the 

 gums, ecchymofes, or purple blotches, on the (l<in, and 

 Ipontaneous hsemorrhages. From its frequent occurrence 

 in long voyages, it is ioinetimes called emphatically theyi-a- 

 J'curvy ; but it is by no means pecuhar to fcamen, and 

 was defcribed as an endemic of the land by the earliell 

 writers. 



After having ftated this brief charafter of the difeafe, it 

 can fcarcely be necell'ary to remark, that the term /curvy is 

 moll erroiieoufly and abfurdly ufed- in popular language ; 

 being applied, in fact, to all d'lfeafes of the Jim, of a flow 

 and chronic nature, however various in their elfential cha- 

 racter, and poflefling nothing in common with the true 

 fcurvy. The fl<in, in fcurvy, indeed, is not the feat of the 

 dilcale, but is only deranged, like other organs of the body, 

 in the progrels of the malady ; and that derangement is 

 totally different from the mflammatory, pimply, pullular, 

 or fcaly conditions of the llcin, which occur in leprofy, tet- 

 ters, and other cutaneous diiorders, ufually mifcalled fcor- 

 bul'tc. This miftake requires correction, not merely as a 

 matter of nomenclature, but becaufe a great pra6tical error 

 refults from it ; namely, the admmillration of antij'corhiuic 

 remedies in thefe cutaneous diforders, which cannot be 

 cured, and are often aggravated, by them. The late Dr. 

 Willan conferred a benefit on the profeffion, by his definite 

 difcrimination of thefe lail-mentioned diforders. See Cu- 

 TANEOU.s D'lfeafes. 



The fcur%>y, properly fo called, was firlt accurately de- 

 fcribed, and received its name, in modern times ; and it is 

 the fnbieft of difpiite, as in the cafe of lome other difeafes, 

 whether it was known to the ancient phyficians, or is a ma- 

 lady of more rtcent origin. The firft fpecific accounts of 

 the difeafe appeared in the early part of the fixteenth cen- 

 tury, when the name of the malady ieems to have been fa- 

 miliar among the vulgar : but the lymptoms were noticed 

 by the early voyagers in the precedmg century ; for con- 

 fiderably more than half the crew, who accompaiiied Vafco 

 de Gama, in his voyage round the Cape of Good Hope, in 

 the year 1497, were deltroyed by this difeafe. Olaus 

 Magnus, in his hiftory of the northern nations, publiflied in 

 1555, has defcribed the difeafe at confiderable length, and 

 ftates that it was known to the inhabitants of Saxony by the 

 TMma of fc/jorliuk, ox fcorbiic ; whence the Latin term yi-or- 

 butus, and our aj)pellation yi'Mriij'. The term fignified yirt'- 

 mou'.hy and was probably applied to the difeaie in coufe- 

 <(uence of the fpongy ulcerations of the pums, with hxinor- 

 rhages, and loofening of the teeth, which are among the 

 more fevcre fymptoms of the complaint. Dr. Lind, how- 

 ever, fuggefts, with ftill more probability, that the name 

 was derived from a Sclavonic word,72o;i, fignifying dfcafe; 

 the fcurvy being endemic in the northern countries of 

 Europe, from whence we borrowed the appellation. 



Molt of the continental writers have maintained that, al- 

 though the ancients have not defcribed the fymptoms of 

 fcurvy, as a finglc dillincl difeafe, they have, however, 

 mentioned feveral concurring fymptoms, which can fcarcely 

 be iiippofcd to belong to any other malady: wliile Drs. 

 Freiiid, Lind, Trotter, and fome other authors of this 

 country, contend, that the Greeks, Romans, and Arabians, 

 tefidiiig ui fouthern climates, and unpradtifed in long voy- 

 ages, probably never witnelfed the fcurvy, and thence have 

 no where accurately defcribed it. The rarity of the difeafe, 

 wnder fuch circumllances, will probably account for the im- 

 perfeA defcriptions which they have left : but fiegcs and 



feafons of great dearth were not uncommon in thofe timen, 

 and gave rife at lead to the ignis facer, which appears to have 

 been nearly allied to fcurvy ; and the following obfervations 

 relate to no other known difeafe. 



Hippocrates, when dcfcribing the difeafes of the fpleen, 

 mentions fome fymptoms which accompany the enlargement 

 of that organ. " The colour of the body," he fays, " is 

 changed, and becomes black and pallid, like the rind of a 

 pomegranate ; the breath is fetid, and the gums alfo emit a 

 bad fmcU, and fall away from the teeth ; ulcerations break 

 out in the legs, refembliiig epinyclides ; the limbs are ema- 

 ciated, and the bowels do not difcharge their contents." 

 (Lib. de internis AfFeCl.) And again, in his fecond book 

 of prognoflics, Hippocrates obferves, " In thofe who have 

 tumid fplcens, the gums are difeafed, and the mouth emits 

 a fetid odour ; but thofe whofe fpleens are enlarged, with- 

 out any confequent hjemorrhages, fucii perfoiis are attacked 

 with ill-conditioned ulcers in the legs, and black fears." 

 Here we have an additional fymptoni of fcurvy mentioned, 

 %<i%. the haemorrhages, which were omitted in tlie former 

 defcription. Thofe, however, who expert to find only the 

 utmolt accuracy in the works of Hippocrates, will perhaps 

 be furpnfed to find that he has agani defcribed, ftill more 

 diftinftly, the fym.ptoms of fcurvy, under another appella- 

 tion. For in the fame book (refpefting internal difeafes) 

 in which he has noticed the enlarged fpleens, he mentions 

 the fymptoms of the ileus hamatius {'iA'.o: ai'^xTiTy- ), or 

 bloody iliac difeafe, in nearly the fame terms. " This difeafe 

 begins in the autumn, and exhibits the following fymptoms. 

 The mouth and teeth emit a fetid fmell, and the gums fepa- 

 rate from the latter, and blood flows from the nofe ; iome- 

 times aifo ulcers break out in the legs, and while fome of 

 thefe heal, others break out afrelh ; and the (kin about them is 

 of a black colour, thin, and tender." This may be deemed a 

 good brief defcription of (curvy ; and if the commentators are 

 right in their correction, the concluding fymptom is equally 

 charafteridic : " the patient is indifpolcd to walk, or to ufe 

 any exertion." The palfage, as it Hands in Hippocrates, 

 however, aflerts the affirmative, that the patient is difpoled 

 to exertion ; a circumltance fo inconfiitent with ulcerations 

 of the legs, hsemorrhages, and the other fymptoms, that the 

 commentators agree that the negative particle ^ mull have 

 been omitted. Van Swieten remarks, tiiat the epithet of 

 thin or tcndtr-Jhinned (\!rToj<f/j'/i), which Hippocrates ap- 

 plies to thofe patients, is particularly charaderiftic of the 

 fcorbutic (late ; fince " we obferve in the fcurvy, that the 

 flighted injuries break into the fkin, and leave (lubboru 

 ulcerations in it ; and this more remarkably happens in the 

 legs, where only fcratching them with the finger-nails will 

 often raife an excoriation, that is followed by an ulcer of 

 long continuance." (Comment, in I5e)erli. Aph. 114S. ) 

 Celfus, when treating of the alfeflions of the fplccn, men- 

 tions this indifpofitioii of ulcers to heal : " Ulccra ant om- 

 niiio non fanefcunt, aut ccrtc cicatricem vix recipiunt." And 

 we may add, that the opinions of tlie commentators, rclpcA- 

 ing the fentence above mentioned, is confirmed by the llate- 

 mcnt of Celfus, who didiiiAiy aflVrts, that exertion is 

 painful and difficiilt. (De Medicin.n, lib. iv. cap. g.) Paul 

 of iljlgina (lib. iii. cap. 49.). and Avicenna ilib. iii. fi-n. ij. 

 tra£t. 2.}, as well as other Greek and Arabian phylician.i, 

 defcribe the fame fcorbutic lymptoms as conneCied with 

 tumid fpleen. Modern obfervatiou has occafionally de- 

 tected enlargement of the fpleen in I'corbutical cafc^, as in 

 an indance related by Dr. Mead (Monitael Prxcox. Mcd.lS 

 but fuch an enlargement is not always prefent, and it 1* 

 probable that Hippocrates and the ancients, who faw the 

 difeafe but fcldom, had generalized too hatlily from a 



limited 



