294 
PATHOLOGY. 
took a little brandy; but her nourifhment confifted 
chiefly in good old wine, hot and well fugared. She of¬ 
ten took this in fufficient quantities to make her tipfy. 
It is believed that the exceflive cold of the night (14 0 
Fahrenheit) had led her to drink to excels.” 
Genus XII. Porphyra, [Gr. purple, or livid.] Scurvy. 
Generic chradters—Livid fpots on the (kin from extra- 
vafated blood; languor, and lofs of mufcular ftrength; 
pains in the limbs. 
The term fcurvy has been moft erroneoufly and abfurd- 
ly ufed in popular language; having been applied, in fait, 
to all difeafes of the Jk'in , of a flow and chronic nature, 
however various in their eflential character, and pofl'efting 
nothing in common with the true fcurvy. The fkin, in 
fcurvy, is not the feat of the difeafe, but is only deranged, 
like other organs of the body, in the progrefs of the 
malady; and that derangement is totally different from 
the«inflammatofy, pimply, puftular, or fcaly, conditions 
of the fkin, which occur in leprofy, tetters, and other 
cutaneous diforders, ufually mifcalled fcorbutic. This 
miftake requires correction, not merely as a matter of 
nomenclature, but becaufe a great practical error refults 
from it; namely, the administration of antifcorbutic re¬ 
medies in thefe cutaneous diforders, which cannot be 
cured, and are often aggravated, by them. The late 
Dr. Willan conferred a benefit on the profeftion, by his 
definite difcriminatio.n of thefe lad-mentioned diforders. 
The fcurvy, properly fo called, was firft accurately de- 
fcribed, and received its name, in modern times; and it 
is the fubjeCt of difpute, as in the cafe of fome other 
difeafes, whether it was known to the ancient phyficians, 
or is a malady of more recent origin. The firft fpecific 
accounts of the difeafe appeared in the early part of the 
fixteenth century, when the name of the malady feems to 
have been familiar among the vulgar: but the fymptoms 
were noticed by the early voyagers in the preceding 
century; for confiderably more than half the crew who 
accompanied Vafco de Gama in his voyage round the 
Cape of Good Hope, in the year 1497, were deitroyed 
by this difeafe. Olaus Magnus, in his Hiftory of the 
Northern Nations, publifhed in 1555, has defcribed it at 
confiderable length, and dates that it was known to the 
inhabitants of Saxony by the name of fchorluk, or Jcorbuc ; 
whence the Latin term fcorbutus, and our appellation 
fcurvy. The term fignified “fore-mouth; and was pro¬ 
bably applied to the difeafe in confequence of the fpongy 
ulcerations of the gums, with haemorrhages, and loofen- 
ing of the teeth, which are among the more fevere fymp¬ 
toms of the complaint. Dr. Lind, however, fuggefts, 
with Hill more probability, that the name was derived 
from a Sclavonic word, Jcorb, dignifying “difeafe;” the 
fcurvy being endemic in the northern countries of Eu¬ 
rope, from whence we borrowed the appellation. 
Moft of the continental writers have maintained, that 
although the ancients have not defcribed the fymptoms 
of fcurvy, as a fingle diftindt difeafe, they have, howe¬ 
ver, mentioned feveral concurring fymptoms, which can 
fcarcely be fuppofed to belong to any other malady; 
while Drs. Freind, Lind, Trotter, and fome other authors 
of this country, contend, that the Greeks, Romans, and 
Arabians, refuting in fouthern climates, and unpradtifed 
in long voyages, probably never witnefled the fcurvy, and 
thence have no-where accurately defcribed it. The ra¬ 
rity of the difeafe, under fuch circumftances, will proba¬ 
bly account for the imperfedt defcriptions which they have 
left: but fieges and feafons of great dearth were not un¬ 
common in thofe times, and gave rife at leaft 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 defcribing 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 fe- 
1 
tid, and the gums .alfo emit a bad fin ell, and fall away 
from the teeth ; ulcerations breakout in the legs, refem- 
bling epinydlides; the limbs are emaciated, and the bow¬ 
els do not difcharge their contents. (Lib. de Internis 
Affedl.) And again, in his fecond book of Prognoftics, 
Hippocrates obferves, “ In thofe who have tumid fpleens,. 
the gums are difeafed, and the mouth emits a fetid odour; 
but thofe whofe fpleens are enlarged without any confe* 
quent hemorrhages, fuch perfons are attacked with ill- 
conditioned ulcers in the legs, and black fears.” Here 
we have an additional fymptom of fcurvy, viz. the he¬ 
morrhages, which were omitted in the former defeription. 
Thofe, however, who expedt to find only the utmoft accu¬ 
racy in the works of Llippocrates, will perhaps be fur- 
prifed to find that he has again defcribed, fti 11. more dif- 
tinftljq the fymptoms of fcurvy under another appella¬ 
tion. For in the fame book (refpedting Internal Difeafes) 
in which he has noticed the enlarged fpleens, he men¬ 
tions the fymptoms of the ileus hematites (cAeo; 
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 feparate from the latter, and blood 
flows from the nofe ; fometimes alfo ulcers break out in 
the legs, and, while fome of thefe heal, others break out 
afrefh ; and the fkin about them is of a black colour, thin, 
and tender.” This may be deemed a good brief deferip¬ 
tion of fcurvy ; and, if the commentators are right in their 
corredtion, the concluding fymptom is equally charadler- 
ittic: “ the patient is indifpofed to walk, or to ufe any 
exertion.” The paflage, as it ftands in Hippocrates, how¬ 
ever, aflerts the affirmative, that the patient is dilpofed to 
exertion; a circumftance fo inconfiftent with ulcerations 
of the legs, hemorrhages, and the other fymptoms, that 
the commentators agree that the negative particle a mull 
have been omitted. Van Swieten remarks, that the epi¬ 
thet of “ th.in or tender fkinned,” Aetttgoe^oi, which Hip¬ 
pocrates applies to thofe patients, is particularly charac- 
teriftic of the fcorbutic ftate; fince we obferve in the 
fcurvy, that the flighted injuries break into the fkin, and 
leave ftubborn ulcerations in it ; and this more remark¬ 
ably happens in the legs, where only fcratching them with 
the finger-nails will bften raifean excoriation, that is fol¬ 
lowed by an ulcer of long continuance.” (Comment, in 
Eoerh. Aph. 1148.) Celfus, when treating of the affec¬ 
tions of the fpleen, mentions this indifpofttion of ulcers 
to heal : “ Ulcera aut omnino non fanefeunt, ant certe 
cicatricem vix recipiunt.” And we may add, that the 
opinions of the commentators, refpedting. the fentence 
above mentioned, is confirmed by the ftatement of Cel¬ 
fus, who diftindtly afierts, that exertion is painful and 
difficult. 
A difeafe is alfo mentioned by Strabo and Pliny, as oc¬ 
curring in the Roman armies in particular fituations. 
wdiich can only be referred to fcurvy. In this difeafe, 
which Pliny aferibed to drinking the water of a certain 
-well, when it occurred in the army of Germanicus while 
encamped near the Rhine, an affedtion 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 affedlion being called Jtomacace, (quafi crropiciris 
x-eiKiu., forenefs of mouth,) and the latter fccletyrbe. (Nat. 
Hill. lib. xxv. cap. 3.) Similar affedlions, to which the 
fame appellations are given by Strabo, are faid to have 
prevailed in the army of Ailius Gallus, when in Arabia. 
(Geograph, lib. xvi.) Some authors, however, have de¬ 
nied that this fceletyrbe could be a fcorbutic fymptom; 
becaufe Galen has ftated Jcelelyrbe to be a kind of para- 
lyfis, in which the patient is unable to walk ftraight: but 
fuch a term might be fufficiently appropriate to that ri¬ 
gidity of the joints .which often occurs in fcurvy. 
On the whole, therefore, we are difpofed to believe, 
with the early writers upon this fubjedt, that the fcurvy 
was known to the Greek, Roman, and Arabian, phyfi¬ 
cians; although, from its comparative rarity in fouthern 
climates. 
