SCURVY. 



" and what would be fcarcely credible upon any fingle evi- 

 dence, is, that the fears of wounds which had been for many 

 years healed, were forced open again by this virulent dif- 

 temper. Of this there was a remarkable inftance in one of 

 the invalids on board the Centurion, who had been wounded 

 above fifty years before at the battle of the Boyne ; for 

 though he was cured foon after, and had continued well for a 

 great number of years paft, yet on his being attacked by the 

 (curvy, his wounds, in the progrefs of his difeafe, broke out 

 afrefh, ard appeared as if they had never been healed. Nay, 

 what is ftill more aftonifhing, the callus of a broken bone, 

 which had been completely formed fur a long time, was 

 found to be hereby dilTolved, and the frafture feemed as if 

 it had never been confolidated." (A Voyage round the 

 World in 1 740 — 4, by lord Anfon, compiled by the Rev. R. 

 Walter, chaplain to the Centurion, p. 102.) The ulcers, 

 which occurred in the legs of the fcorbutic patients on this 

 occafion, are faid to have been " of the word kind, attended 

 with rotten bones, and fuch a luxuriancy of fungous flefh, 

 as yielded to no remedy." The edges of thefe fcorbutic 

 ulcers are of a livid colour, and puffed up with the fungous 

 excrefcences, which are not inaptly called by the failors, 

 bullock's liver, fince to this fubltance, when boiled. Dr. Lind 

 lays, they bear a near refeniblance, both in confidence and 

 colour. They often arife in the courfe of a night to a mon- 

 ftrous fize, and although deftroyed by caultics, or the knife, 

 (in which lall cafe, a copious bleeding commonly enfues,) 

 are found at the next drefling as large as ever. Dr. Lind 

 affirms, however, that " they continue in this condition a 

 confiderable time without tainting the bone." (Lind on 

 Scurvy, pt. ii. ch. 2.) Thefe fcorbutic ulcers, which are 

 Angular and uniform in their character, are diftinguiflied 

 from all others by being fo remarkably offenfive, bloody, and 

 fungous. 



In addition to thefe affeftions of the lower extremities, 

 (to wliich however they are not exclufively confined,) in the 

 advanced ftage of the fcurvy, " the patients moil commcmly 

 lofe the ufe of their limbs, having a contraftion of the ten- 

 dons in the ham, with a fwelling and pain in the joint of 

 the knee. Indeed, a lliffncfs in thefe tendons, and a weakncfs 

 of the knees, appear pretty early in this difeafe, generally 

 terminating in a contrafted and fwellcd joint." (Lind, loc. 

 cit. ) We have given this defcription in the words of Dr. 

 Lind, in order to ihew how didinftly it anfwcrs to the ac- 

 count of the fcehtyrbe, occurring in the Roman armies, in 

 conjunftion with \.\\t Jlomacace. 



In the progrefs of the fcurvy, the patients commonly 

 complain of pains, wliich are often moving from part to 

 part. Some complain of a general pain in their bones, 

 wliich is mod violent in the limbs and loins, and cfpecially 

 in their joints and legs; and a pain, with tightncfs and op- 

 prcffion in the bread, is very common. The head is feldom 

 or never affefted, unlefs the patient is feverilh, which is un- 

 ufual ; for, as Dr. Lind well obfcrves, the difeafe is alto- 

 gether of a chronic nature, and fever may be judly reckoned 

 among its adventitious fymptoms. It is remarkable, indeed, 

 that in the word flaijcs of the fcurvy, with all the fcvcre 

 fymptoms above defcnbed, with painful fpreading ulcers of 

 the (nrface, with contradlcd limbs, haimorrhages, fpongy, 

 putrid, dinking gums, over-run with Iprouting flelh, and 

 often deeply ulcerated, with inability to make the lead muf- 

 cular exertion, without fainting or perhaps dying ; yet the 

 patients, even in this dage, have a good appetite, with their 

 fenfes er.tire, and, though eafily dejedlcd and made low- 

 fpirited, yet, when in bed, they make no complaint of pain 

 or ficknefs, and appear to be in tolerable health. This fin- 

 gular charafterittic of the difeafe is well depifted by the 



reverend author before quoted. " Indeed, the effcfts of thU 

 difeafe," he fays, " were in almoll every inftance wonder- 

 ful ; for many of our people, though confined to their ham- 

 mocks, appeared to have no inconiidcrable fhare of health ; 

 for they eat and drank heartily, were cheerful, and talked 

 with much feeming vigour, and with a loud Itrong tone of 

 voice ; and yet on their being the lead moved, though it 

 was only from one part of the fhip to the other, and that in 

 their hammocks, they have immediately expired ; and othert, 

 who have confided in their feeming itrength, and have re- 

 folved to get out of their hammocks, have died before thejr 

 could well reach the deck. And it was no uncommon thing 

 for thofe who were able to walk the deck, and to do forae 

 kind of duty, to drop down dead in an inllant, on any en- 

 deavours to aft with their utmod vigour ; many of our peo- 

 ple having perifhed in this manner during the courfe of thi< 

 voyage." Lord Anfon's Voyage, loc. cit. 



Few of the authors, who have defcribed the difeafe, have 

 been very indudrious in the examination of the bodies of 

 thofe who have died. The mod ample account of the dif- 

 feftionj of fcorbutic patients has been given by M. Poupart, 

 in his account of the difeafe, as obferved at the hofpital of 

 St. Louis at Paris. The principal phenomena defcribed by 

 him were the refults of the general extravafation of blood, 

 and of the diffolution and feparation of parts naturally- 

 united. Thus tTie bodies of the mufcles were often found 

 fwelled and hard, from the blood fixed among their fibre*, 

 fo that the limbs remained bent or contrafted ; and the epi- 

 phyfes of the bones were found feparated, the cartilages of 

 the dernum were looiened from their union with the bony 

 part of the ribs, and the ligaments of the joints were 

 corroded and loofe. He adds, that the mefenteric glands 

 were generally obdrufted and enlarged, and the fpleen three 

 times bigger than natural, and fell to pieces as if it confided 

 of coagulated blood. 



Caufes of Scurvy.— Y\\t predifpofing caufes of fcurvy, 

 or thofe circumdances which produce a predifpofition to the 

 complaint, are various. Preceding difeafes, whether of the 

 acute or chronic kind, render perfons more liable to the 

 fcurvy, where the exciting caufes exid : and inactivity and 

 indolence greatly facilitate the attack of the malady. Thofe 

 who are recovering from fevers, or who have been weakened 

 by long attacks or relapfes, mod readily fall into fcurvy ; 

 and the marines on (hip-board, who have Kfs work, com- 

 monly fuller in a much larger proportion than the failors. 

 On the other hand, however, cxceflive fatigue and over- 

 exertion, which exhaiid the drengtli, as well as want of 

 deep, contribute to accelerate the attack of fcurvy. An 

 attention to this point was one of the mod edcAu.-il means 

 employed by captain Cook for the prevention of fcurvy 

 among his crews, as well as the avoiding of cold and moil- 

 ture, from whicii much predifpofition to the difiafe .irifes. 

 A date of defpondeiicy and gloomincfs of mind conlribiitcg 

 alfo materially to invite and aggravate the fcurvy : it at- 

 tacks the difconfented and repining, while pcrlons of more 

 cheerful difpofitions cfcape. Hence perliap;; newly-imprellcd 

 feamen are found to be particularly liable to it ; and the in- 

 habitants of befieged towns are obferved to be very fulccp- 

 tible of its impreffiaiis. 



The principal exciting caufe of fcurvy appears to be the 

 ufe of a certain Imd of diet ; and it is probable th.U every 

 fpecies of diet, which, either from being difficult of digef- 

 tion, or from containing but little nutriment, fails to nourijU 

 the body, is capable of producing the difeafe under ort am 

 circumdances : we fay, it is probable ; for we fliall have 

 occalion to fliew hereafter, that this notion 18 not entirely 

 confident with all the fads, and is lomcwhat inconl.dent 



efpceully 



