SCURVY. 



water, and an acid acrimony from bad forts of bread or 

 vegetable gluten, combined with a fedentary life. (See 

 Boerluavc, Aph. tijj.) Dr. CuUen, too, though he re- 

 liaquifhed much of the humoral pathology, was of opinion 

 that fcurvy was the effeft of " a preternaturally faline, and 

 confequently diffolved ftate of the blood," which was oc- 

 cafioned by a greater advance towards putrefaction, from 

 the abfence of the correftive of vegetable matters. (See 

 Firll Lines, par. 1812 — 13.) And fir John Pringle main- 

 tained a fimilar doftrine, that fcurvy was the refult of " a 

 gradually accumulating putrefaftion" in the blood, from 

 the putrefcency of falted food, which he deemed the chief 

 caufe of the difeafe. ( See liis Obf. on Dif. of the Army, 

 Appendix, p. xci.) In fact, the general opinion, for a 

 long period, deemed fcurvy the molt characleriilic example 

 of a putrid difeafe. And this putridity of the fluids was 

 inferred from the fetor of tlie breath, and of the ulcers ; 

 from the black colour and loofe confiftence of the blood ; 

 from the extenfive haemorrhages ; from the purple blotches 

 on the lliin, &c. But this is a gratuitous and erroneous 

 inference : for we have no lefs authority than that of Dr. 

 Lind, who made numerous experiments on the fubjeft, for 

 aflerting that blood, drawn from fcorbutic patients, even in 

 a dying ftate, difcovers no fenfible teft of either acrimony 

 or putridity, by the tafte or the fmcU ; that the ferum of 

 fuch blood is as taftelefs as the white of an egg, and without 

 odour ; that it corrupts in the air no fooner than the blood 

 of healthy perfons ; and that thin dices of mutton, immerfed 

 in this ferum, continued fweet and free from taint, as long 

 as In the ferum of perfons in health. We know, indeed, 

 from aftual experiments, that if the fmalleft quantity of 

 putrid matter be injefted into the blood-veffels, it is fol- 

 lowed by fpcedy death. (See a Diff. by Dr. Scybert, on 

 the Putrefaftion of the Blood, Philadelpiiia, 1793.) The 

 ordinary fecretions from the blood are not putrefcent, as has 

 bees aflerted. Dr. Lind affirms, " the urine in this difeafe 

 was not found to be more offenfive to tlie fmell, nor to 

 corrupt fooner, than that of a perfon in health ; and their 

 fweat is not fetid, or more difagreeable than when they are 

 ill health: the fame may be faid of their ilools." (Poll- 

 fcript, p. 5 1 5') The fame experienced phyfician juftly ob- 

 ferves, " the offenfive fmell from the mouth of fcorbutic 

 perfons, when ahve, feems to me to proceed folely from the 

 corrupt ftate of the gums. For in their dead bodies I 

 never perceived any unufual marks of putrefaftion ; they 

 were neither more offenfive, nor liable to corrupt fooner, 

 than any other corpfe." In a word, the notion of a putri- 

 dity of the circulating blood is not only unfupported by 

 aftual evidence, but is refuted by all fober faft and obfer- 

 vation ; and thefe experiments of Dr. Lind prove that there 

 is not even a pronenefs to putridity exiiting in either folids 

 or fluids. 



Can we account, then, for the phenomena of fcurvy upon 

 the other hypothefis, which afcribes the malady to certain 

 morbid conditions of the living folid ? This view of the 

 fubjeft was ably advocated by doftor, now fir Francis 

 Milman, in one of the moft elegant medical efTays in the 

 Englifh language, publifhed in the year 1782, (Enquiry 

 into the Source of the Symptoms of Scurvy and Putrid 

 Fevers, &c.) ; and, in taft, it affords the moft rational expla- 

 nation of moil of the^fymptoms of the difeafe, according to 

 the phyfiological and pathological doftrines which modern 

 inquiries have tftabhflied. It is not at prefcnt, therefore, 

 ueceffary for us to enter into any minute detail of the 

 iymptoms, with the view of explaining them upon the 

 principle of a weakened and impaired condition of the ner- 

 vous fyilem, and of the mufcular irritability. This has been 



accomplifhed at great length by Dr. Milman, taking this 

 ample enumeration of Boerhaave, in his 1151ft aphorifm, as 

 the text, to which we refer the reader. 



This view of the fubjeft appears alfo to accord better, on 

 the whole, with our knowledge of the pre-difpofing and 

 exciting caufes of the difeafe above detailed. The various 

 kinds of diet, under which fcurvy occafionally originates, 

 is ill calculated to produce any particular acrimony of the 

 fluids ; and the dry pulfe and glutinous pudding of the 

 Bohemians on (hore could not have the fame tendency to 

 putrefaftion as the falted animal diet of feamen. Yet all 

 thefe fubflances might equally fail, from their indigeftibility, 

 or from the defeft of nutritious matter which they contained, 

 to fupport the ftrength and vigour of the moving fibre, and 

 would equally contribute, therefore, to produce that lan- 

 guor of the vital powers, which is fo conlpicuous in the 

 progrcfs of fcurvy. The analogy of fcurvy with the ignis 

 facer, admirably defcribed by Lucretius, which appears to 

 have been commonly the refult of famine, and often called 

 peftilence, (whence M. Poupart was correft in comparing 

 the epidemic fcurvy of Paris with fome of the ancient . 

 plagues) feems to fupport the fame doftrine. (See Ignis 

 Jacer.) And all the pre-difpofing caufes, on the one hand, 

 which arc principally debilitating caufes, fatigue, indolence, 

 want of fufficient fleep, cold and moifture, and the means of 

 prevention, on the other, which are fuch as fupport the 

 general vigour of the conflitution, moderate exercife, fuffi- 

 cient fleep, frefli air, warmth, &c. concur in eiiincing the 

 ftate of the moving fibre to be the fource of the morbid 

 fymptoms. The fame opinion is alfo farther fupported by 

 the extraordinary influence of mental impreffions in pro- 

 ducing and in preventing or curing the difeafe. Thefe im- 

 preffions cannot fuddenly change the chemical condition of 

 the fluids j but their influence upon the hving iohd, through 

 the medium of the nervous fyftem, is manifeft both in 

 health and difeafe, to a degree that unlearned perfons will 

 fcarcely credit. (See Imagination, Influenci of, and Imi- 

 tation. ) The difcharges of blood from the relaxed and 

 enfeebled orifices of the veffels, the gangrenous and confe- 

 quently putrefcent tendency of the gums, and other dehcate 

 parts, the fainting and even dying on the fiighteft exertion, 

 the dropfical fwellings, the labouring breath, the oppreffion 

 about the heart, &c. &c. appear to be the refult of dimi- 

 nifhed ftrength in all the mufcles, and of enfeebled aftion 

 in all the veflels, the confequences of a general failure of 

 the vital or nervous power. 



Such, then, appears to be the advantage, in point of 

 argument and analogy, which the doftrine of difeafed folids 

 poffclTes over that of acrimony and putrefaftion in the fluids. 

 Neverthelefs this theory is by no means fatisfaftory : it is 

 in fome meafure, indeed, incompatible with the moft ftriking 

 and well afcertained faft, that the fcurvy is not curable by 

 thofe means which appear to contribute in general to the 

 ftrength and aftivity of the folids, fuch as fref.i animal 

 food, wine, bark, foups, &c. ; while it is fpecdily and cer- 

 tainly removed by the ufe of vegetable acids, which con- 

 tain no nutritive quality, and are fo far deftitute of corro- 

 borating power, that they even induce emaciation, while they 

 cure the difeafe. In truth, we can give no fatisfaftory 

 theory of this difeafe : but our pofleffion of a certain remedy, 

 and our knowledge of the means of prevention, may fairly 

 fuperfede all hypothefes upon the fubjeft. In this, and in 

 all other difeafes, experience and obfervation are the only 

 guides which the judicious phyfician will follow. The in- 

 iiinftive demands of the fick point out the fource of relief, 

 as hunger and tliirft lead us to food and drink ; and it is 

 enough to have obferved, that, by gratifying thefe demands, 



the 



