64 He-appearance of Scurvy 



scorbutic patients— arid thus agrees with, what Sir G-. Blane 

 found, that white meal was best— and both Cook and Blane pre- 

 fer white wheaten flour to oatmeal. This is not only useful in a 

 curative point of view, but is valuable as bearing out what the 

 history of the disease had shewn, that Scurvy has for its cause 

 the absence of vegetables. 



Blane is very decided in his opinion as to the superiority of 

 wine over spirits as an article of the diet of seamen. I can oifer 

 no opinion of my own on this subject from experience ; but I am 

 induced to think it a very important matter, and while beer from 

 its bulk cannot well be carried on long voyages for large bodies 

 of men, I feel assured that colonial wine of good quality would 

 be far superior to grog. 



I have mentioned the obscure forms of disease produced by 

 Scurvy. I cannot enter into a full description of these, but there 

 is one, and in my opinion the most important of that obscure 

 form of Scurvy which I desire to direct attention to. 



In most of the fatal causes of Scurvy in which I made post 

 mortem examinations, I found disease of the large intestines of 

 greater or less extent, and they were found thickened, ulcers, and 

 granulations of the mucous membranes ; sometimes the ulcers 

 perforating all the coats, and often patches of ecchymosis — 

 numerous black dots, sometimes over considerable parts of the 

 inner coat of the colon and rectum 



In many of these cases there were not any external marks of 

 Scurvy about the body, or in the jaws — often the health good 

 during all the voyage. The first symptoms being of diarrhoea, 

 in others, dysentery ; many fatal cases had not any dysenteric 

 symptoms, merely ordinary diarrhoea. 



From having often seen in bodies of convicts who died some 

 months- after arrival, marks of healing of ulcers in the large 

 intestines — from often seeing the same condition of bowel from 

 men dying from other diseases shortly after arrival, I am con- 

 vinced that a most common complication of Scurvy is this con- 

 dition of the large bowels, and that it often is the only morbid ap- 

 pearance after death, and the only part affected with the local 

 effects of Scurvy during life. 



If reference is made to the histories of Scurvy, it is always 

 accompanied by diarhcea and dysentery ; and large numbers of the 

 deaths under those heads were, I believe, really due to Scurvy, 

 of which the diarrhoea and dysentery were only symptoms and 

 complications. Bead by this light, the deaths in convict ships 

 from Scurvy, were more than those entered as dying from that 

 disease, and its ravages in fleets and armies more than has been 

 supposed 



That the condition I have described as affecting the large 

 intestines does arise from Scurvy, is borne out by other facts. 



