SCURVY. 



limited experience, when they pronounced thefe fymptoms 

 as exchifively connefted with enlarged fpleen. 



A difeafe is alfo mentioned by Strabo and Pliny, as oc- 

 curring in the Roman armies in particular fituations, which 

 can only be referred to fcurvy. In this difeafe, which Pliny 

 afcribed to drinking the water of a certain well, when it oc- 

 curred in the army of Germanicus while encamped near the 

 Rhine, an afFeftion of the gums, with a falling out of the 

 teeth, is faid to have been combined with a lofs of mufcular 

 power in the lower extremities ; the former affeftion being 

 cA\eAJ}omacfice, (quafi a-ro/j^-i; /.xKifx, oris vitium,) and the 

 Iztter/celetyrie. (Plin. Nat. Hift. lib. xxv. cap. 3.) Similar 

 afFeftions, to which the fame appellations are given by 

 Strabo, are faid to have prevailed in the army of iElius 

 Gallus, when in Arabia. (Geograph. lib. xvi.1 Some authors, 

 however, have denied that t)\\% fceletyrbe could be a fcorbutic 

 fymptom ; becaufe Galen has ftated fcektyrbe to be a kind 

 of paralyfis, in which the patient is unable to walk ftraight : 

 but fuch a term might be fiifficienlly appropriate to that 

 rigidity of the joints, which often occurs in fcurvy. 



On the whole, therefore, we are difpofed to believe, with 

 the early writers upon this fubjeft, that the fcurvy was 

 known to the Greek, Roman, and Arabian phyficians ; 

 although, from its comparative rarity in fouthern climates, 

 it did not occur fo often, or fo extenfively, ar to claim their 

 attention very ftrongly. That it may occur in any climate 

 where there is a dearth of fre(h foad, is very obvious ; for it 

 18 found equally at fea and on the land, in Greenland or in 

 the great South fea, in befieged towns, in frozen countries, 

 and in (hips, when fre(h food is not to be obtained. Poupari 

 has very correftly remarked, that the malignant fcurvy of 

 Paris bore a confiderable refemblance to the peftileiitial ignis 

 facer, defcribed by Lucretius (lib. vi. ) ; an opinion which 

 Dr. Lind, confounding this ignis facer with the plague of 

 Athens, defcribed by Thucydides, confiders as deferving 

 no ferious confutation. But the ignis facer was extremely dif- 

 ferent from the true plague, as well as from the peftilence 

 defcribed by Thucydides (fee Plague) ; it feems to have 

 been, hke fcurvy, the refult of dearth, the X.oi,uo,- /xsTa Xi^o/, 

 of which we hear fo much in ancient hiltory ; it had feveral 

 fymptoms in common with fcurvy, but was a febrile difeafe ; 

 and has been afcribed in modern times to difeafes of corn, 

 inftead of the fcarcity and deficiency of that nutriment. 

 See Ergot; \ghis Sacer ; Kriebel Krankheit; &c. 

 For the obfervations of Poupart, fee Memoires de I'Acad. 

 des Sciences, an. 1699. 



Symptoms of Scurvy — The firll indication of the approach 

 of fcurvy is an averfion to any fort of mufcular exertion ; a 

 lazinefs, or ftrong inchnation to fit Hill i)r lie in bed ; which 

 is accompanied with a fpontaneous laffitude, or a fenfe of 

 heavinefs and pain throughout the body, and efpecially in 

 the mufcles of the limbs and loins, like that which arifes 

 from great fatigue, which foon becomes aAual feeblenefs, fo 

 that the lead exercife, efpecially in afcending or defcending 

 a declivity, induces fatigue and (hortnefs of breath. With 

 this averfion to motion and diminifhed power of exertion, 

 there is alfo very early a change of the complexion, which 

 becomes pale and bloated, or fallow, efpecially about the lips 

 and comers of the eyes, where there is a greenifh tinge. 

 Thefe two fymptoms, indeed, the difinclination to exertion, 

 and the fallow countenance, often portend the approach 

 of fcurvy, while the patient eats and drinks heartily, and 

 feems otherwife in good health : and the fpeedy laffitude 

 and difficulty of breathing upon motion, are among the 

 moft conflant concomitants of the diftemper throughout its 

 courfe. 



As the difeafe advances, other fymptoms appear. Among 



thefe the flemaeaee, or morbid condition of the mouth, is one 

 of the firft that prefents itfelf. The gums become hot and 

 painful, and foon fwell, growing foft and fpongy, and of a 

 livid hue, and afterwards extremely putrid and fungous, 

 conftituting one of the moil didiuguilhing features of the 

 difeafe. This occafions great fetor of the breath, and the 

 loofening of the teeth, which become moveable in their 

 fockets, and may be taken out without force or pain, and 

 even fall out fpontaneoudy. Haemorrhages alfo take place 

 from the flighted preffure on the gums, or even with- 

 out any apparent caufe, as well as from the nofe ; and 

 ultimately from other parts of the body, where the cuticle 

 is delicate, or the furface broken, in confequence of the 

 apparent lofs of cohefion in the folids, and efpecially in the 

 vafcular fyftem. 



From this caufe the fhin alfo exhibits fome of the mod 

 driking chara(fteriltics of fcurvy. It becomes dry, and 

 fpotted over with difcolourations of a red, blueifh, purple, 

 and black hue, of various fizes, from the petechia, or fpots 

 like flea-bites, to the mod extenfive ecchymofes, of the fize 

 of a hand-breadth, or larger, fuch as are produced by the 

 fevered bruifes. Thefe appear chiefly on the legs and 

 thighs ; but often alfo on the arms, bread, and trunk of the 

 body ; and fometimes, though more rarely, on the head and 

 face. They confid, in faft, of effufions of blood under the 

 cuticle, from the rupture of the fmall veffels. As the dif- 

 eafe advances, this laxity and lofs of cohefion in all the folids 

 becomes dill more manifed, by the frequent and profufe 

 bleedings which are liable to occur from different parts of 

 the body ; efpecially from the nofe, gums, ftomach, bowels, 

 lungs, kidnies, and bladder, and from the ulcers and fungous 

 excrelcenccs which arife on the furface. In fome patients, 

 the hzmorrhages from the bowels are accompanied by fevere 

 pains and diarrhoea ; while others, without either a purging 

 or gripes, difcharge great quantities of pure blood by the 

 anus. Other marks of laxity appear in the cedematous fwell- 

 irig which takes place in the legs, beginning firlt about the 

 feet and ankles ; which, however, is more painful than com- 

 mon anafarcas, and retain longer the imprelTion of the finger. 

 They appear remarkably alfo, in the great facihty with 

 which the flighted bruifes and wounds degenerate into foul 

 fungous ulcers, as well as in the fpontaneous appearance of 

 fuch ulcers, and the breaking out of long-healed fores, and 

 even the difunion of old fratlures in bones. " Whatever 

 form.er complaints," Dr. Lind obferves, " the patient has 

 had, efpecially bruifes, wounds, &c. ; or whatever prefent 

 diforders he labours under, upon being afflifted with the 

 fcurvy, his old complaints are renewed, and his prefent ren. 

 dered worfe." Indeed the fcurvy often fird fliews itfelf by 

 the changes in difeafed parts. " Thus, when a perfon has 

 had a preceding fever, or a tedious ficknefs, by whieh he 

 has been much exhauded, the gums for the mod part are 

 fird affeded, and a laflitude condantly attends ; whereas, 

 when one has been confined from exercife by having a frac- 

 tured bone, or from a bruife or hurt, thefe weak and de- 

 bilitated parts become almod always fird fcorbutic. As 

 for example, if a patient labours under a drain of the ankle, 

 the leg, by becoming fwelled and painful, and foon after 

 covered with livid fpot?, gives the fird indication of the dif. 

 eafe. And as old ulcers on the legs are very frequent 

 among feamen, in this cafe likewife the legs are always fird 

 affefted, and thefe ulcers put on a fcorbutic appearance, 

 although the patient feems otherwife perfectly healthy, and 

 preferves a freli good colour in his face." (Lind.) The 

 effeil of the dfeafe upon former maladies is drongly de. 

 pitted by the elegant writer of lord Anfon's voyage. " But 

 a moft extraordinary circurodance," fays that gentleman, 



" and 



