Scurvy: a Nutrition Detective Story

Sail back in time with us as we unravel the mystery behind scurvy, the historical scourge of sailors. In our next episode we explore the link between this once-mysterious malady and the discovery of vitamin C. From the gripping tales of sea voyages to the groundbreaking science that saved lives, join us for this nutrition detective story. 

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Shownotes: yournutritionprofs.com

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Transcript

Uncover the hidden menace that plagued sailors for centuries – scurvy! Today we’re taking a journey through history and nutrition as we explore the mysterious disease that once haunted the high seas. From its baffling symptoms, controversial theories of cause, and centuries-long search for a cure, this episode has it all.  

M: I’m Professor Megan 

S: and I’m Professor Susan, and we’re

Both: Your Nutrition Profs!

M: We are registered dietitians and college professors who have taught more than 10,000 students about health and nutrition. We have answered a LOT of questions about nutrition over the years – 

S: Some questions we get asked every year and some are rarely asked but very interesting.

M: We’re here to share our answers to these common (and uncommon) nutrition questions with you.

S: So bring your curiosity and let’s get started. 

Both: Welcome to our class!

M: Welcome everyone to episode number 31! 

S: Wow! 

M: Thank you to all of our listeners – we couldn't do it without you.

S: You know, in one of our first episodes, we discussed the discovery of a cure for pellagra, the disease caused by severe deficiency of niacin, or vitamin B3. 

M: That episode was so popular that listeners have asked for another “nutrition detective story”. So here it is!

S: ARGGGH - That’s right! Today we’re telling the story of how the cure for the medical mystery of scurvy was discovered.

M: Let’s set the stage… Between the time of Christopher Columbus’ famous transatlantic voyage in 1492 and the rise of steam engines in the 1800s, there was a widespread dependence on sailing for exploration, colonization, and global trade. This period of time is now referred to as the Age of Sail. 

S: You know, and while sailing was quite perilous, maritime travel was necessary and commerce depended on it. One particular danger for sailors was scurvy… In fact, an estimated 2 million sailors died from scurvy during this Age of Sail.  

M: It was so common that ship owners and governments assumed that at least half of sailors on any long voyage would die of this terrible disease.

S: Can you imagine- 

M: No.

S: ….you get on a ship and by the time you get home, half of your coworkers are dead?

M: That’s horrifying!

S: It is horrifying to think about. Oh my gosh.

M: It doesn’t seem real.

S: It really doesn’t. Well according to Stephen Bown, he’s an author. He wrote a really detailed book about scurvy. During this time scurvy killed more sailors than storms, shipwrecks, combat, and all other diseases combined! 

M: We’ll post a link in our show notes to this fascinating book! But to give you an idea of how terrible this disease can be, we’re going to share an excerpt from Bown’s book describing scurvy from a sailor who survived:

 “It rotted all my gums, which gave out a black and putrid blood. My thighs and lower legs were black and gangrenous, and I was forced to use my knife each day to cut into the flesh in order to release this black and foul blood. I also used my knife on my gums, which were livid and growing over my teeth. . . . When I had cut away this dead flesh and caused much black blood to flow, I rinsed my mouth and teeth with my urine, rubbing them very hard. . . . And the unfortunate thing was that I could not eat, desiring more to swallow than to chew. . . . Many of our people died of it every day, and we saw bodies thrown into the sea constantly, three or four at a time.”

S: That’s so awful, I just can’t even imagine.

M: And such a vivid… explanation for….

S: You’re right. Poor guy. 

M: Yeah. 

S: But these sailors weren’t the first known victims of scurvy. Scurvy was described in writing by the Egyptians as early as 1550 BCE and they described it as a relatively rare and mysterious condition. It struck during long military campaigns and over land journeys when fresh food was hard to find. 

M: Around 460 BCE, Hippocrates and others in Ancient Greece described these symptoms and devised theories and proposals for both cause and treatment. Causes included exposure to foul vapors, dampness and cold, an excess of what was called “black bile”, laziness, copper poisoning, inherited predisposition, blocked perspiration, and punishment from the gods. 

S: Of course… Well, 800 years later in 406 AD the Chinese monk Faxian wrote that Chinese ships used to carry ginger to prevent it. 

M: “Land scurvy” was also considered the “curse of the Crusaders” as they trudged through Egypt in 1217. One Crusader described it this way: “Soldiers with violent pains in the feet and ankles, their gums became swollen, their teeth loose and useless, while their hips and shin bones first turn black and putrefied. Finally, an easy and peaceful death, like a gentle sleep, put an end to their suffering.”

S: And Jean de Joinville, a Frenchman with the 7th Crusade. He reported in 1254, “the disorder very soon increased so much in the army that the barbers were forced to cut away very large pieces of flesh from the gums to enable their patients to eat…”

M: But it was even more common in sailors. From the mid 1400s to 1500s, countries like Portugal, Spain, the Netherlands, England, France, and Italy were competing for the riches of the East, namely tea and spices, which were highly prized in Europe. 6.20

S: And mostly they sailed East from Europe around the tip of South Africa to get to India and the Java and Spice Islands. 

M: You know, I love those names! 

S: I know! 

M: Java and spice!

S: They sound so exotic!

M: The Indonesian island, Java is supposedly called Java because the Dutch planted coffee plants there and it was one of the most successful coffee producers in the world! And it still is. And the Spice Islands (now called Maluku) were named for the nutmeg, mace, and clove that were at the time exclusively found there. 

S: Wow! 

M: But you know, back to scurvy…. 

S: Ok, so back to scurvy. Yes, so the trip through the Cape of Good Hope around South Africa was really treacherous. As these sailors are doing it, they’re thinking there has to be a better way to get to the East. 

M: And it was suggested that they sail west… Portuguese Captain Christopher Columbus was convinced he could get to Asia by going west instead of east to find gold and other riches, but he couldn’t convince the Portuguese government to fund him. So he asked Spain instead. King Ferdinand and Queen Isabella said yes,  the cost to fund his voyage wasn’t great. 

S: And they were sending ships out in all different directions so what’s one more? 

M: Yeah. If the trip was successful the benefits would be incalculable as Spain would have access to all the Asian resources and wealth… and if it failed, well  they wouldn’t be out too much. 

S: Yeah, just a few dollars here and there. Or whatever they used.

M: Yeah, I don’t know.

S: I don’t either… So Columbus and his 3 ships sailed westward in 1492 from Spain. He thought he would hit Japan because he thought it was on the same latitude as the Canary Islands – 

M: But… oops! He landed in the Caribbean, instead.

S: And he thought he had missed Japan entirely and landed in China…but no, he was wrong.

M: Again.

S: Again.

M: Columbus went on several more voyages, but never found the riches he thought he would. He did, however, instigate exploration westward. 

S: A few years later Magellan, another Portuguese sailor, was convinced there must be an easier way to get to the west. Spain financed his voyage in 1519 with 250 sailors on 5 ships to look for a passage. 

M: They sailed westward and finally found a passage by going around the southern tip of what is now South America in late 1520, but it was extremely difficult, it took 38 days to get through, and only 3 of his 5 original ships made it.  

S: Here’s a fun fact for you… That strait is now called the Strait of Magellan, and the sea on the other side was so calm he named it the Pacific.

M: I didn’t know that. That’s cool.

S: I like little fun facts like that.

M: Me too.  But Magellen and his crew had no idea exactly how large the Pacific was. They sailed northwest from the tip of South America for 14 weeks without finding land. 

S: 14 weeks! My gosh, you’re on a ship for three and a half months and you see nothing? 

M: I would have such anxiety!

S: Oh my gosh! I think I would too. Well eventually they, of course, ran out of food so the sailors began to eat sawdust mixed with ship’s biscuits and chewed on the leather parts of their gear in order to stay alive. The crew also captured and ate rats and mice whenever they could, but unfortunately those things could not prevent scurvy. 

M: Scurvy sickened and killed so many of the crew they only had enough sailors for 2 ships by the time they actually found the Spice Islands. They loaded the ships up with spices like nutmeg, and cloves and headed home to Spain.

S: One ship attempted to sail back across the Pacific and failed. The other decided to go west through the Indian Ocean, around the Cape of Good Hope, and they did make it back to Spain… 3 years later. The voyage that began with 5 ships and 239 European sailors on board, ended with 1 ship with 17 Europeans and 4 Indians.

M: I mean, this is just one example of how scurvy decimated sailors. There are accounts of Spanish galleons found floating in the sea, staffed “only by the dead”.

S: Can you imagine? It’s just mind blowing!

M: Yeah. 

S: The French didn’t fare any better. In the mid 1500s French colonists, led by a seasoned explorer named Jacques Cartier, crossed the Atlantic looking for land and riches in what is now Quebec. 

M: When winter came they ended up on Saint Croix Island along the border between Maine and Canada. They built a tiny settlement and wintered on the island. 

S: And it was a super harsh winter and the island got iced in, so they were unable to hunt or find fresh food. All of them began to suffer the debilitating symptoms of scurvy. And they didn’t understand this illness and thought they may have contracted it from some of the Indigenous Peoples that they had traded with. They called the sickness “mal de la terre”. 

M: Over that terrible winter half of the colonists died. 

S: Wow, half!

M: And those that didn’t die were terribly ill, unable to work or even get out of bed.  

S: Their leader, Cartier, he was sick, but not as sick as most of the others. So while he was out looking for food one day, he spotted a man he knew named Domagaya. And Domagaya was the son of a local Iroquois leader who had served as their guide.

M: Domagaya had also become sick with scurvy while living with the French. He left them and returned to his family. He had been almost dead two weeks earlier, but when Cartier saw him again he was healthy and strong. 

S: Domagaya agreed to show him the cure used by locals in the area. Consume the juice and sap from the branches of a white cedar tree. So he gave them some and they boiled it – supposedly it smelled really, really terrible – but some of the sick men decided to try it and were cured within 6 days! 

M: I mean, I’d try it!

S: I would too, if I was on death's door! For sure. But that’s not the only time scurvy was an issue for colonists.

M: Nope. The 124 passengers and crew on the Mayflower that arrived in Cape Cod in November of 1620, they didn’t fare well either. It was another harsh winter and they had very little food or shelter. And they didn’t have the luck Cartier did of finding help. Almost half of them were dead by Spring due to the cold, and infectious diseases like tuberculosis…..and, of course, scurvy. 

S: Wow, so half! 

M: This is a theme!

S: It is!

M: Like half of everybody!

S: Yeah.

M: Oh my gosh. 

S: Crazy! So what exactly is scurvy? Well the word scurvy comes from the Latin word scorbutus. It was known as scorbuto, scarby, scorbuck, or the scorbutic taint. We now know that it’s caused by a severe deficiency of vitamin C, which is now called ascorbic acid. But for hundreds, maybe thousands of years it was just known as a terrible, terrible way to die.

M: Vitamin C is an essential micronutrient. So remember, the term “essential” in nutrition means that your body needs it but can’t make it yourself so you have from food or drink. Surprisingly only a few mammals are unable to manufacture their own vitamin C including guinea pigs and hamsters… and humans. That’s actually one of the first little bits of trivia I remember learning in my undergraduate nutrition class.

S: I know! I love that little trivia! This and that you can’t eat a polar bear liver because it's too high in vitamin A….

M: Oh yeah, I remember that too!

S: Nutrition is fascinating, isn’t it? And of course, we’re talking about vitamin C today, an extra fascinating vitamin. 

M: One of the most important functions of vitamin C is as a super effective antioxidant. We’ve mentioned the importance of antioxidants several times on this podcast in previous episodes... But we know they’re vital for good health. Vitamin C is also part of several enzymes such as signaling molecules in the brain like dopamine and serotonin, but also some hormones, and some amino acids. And it also plays a significant role in the immune system.

S: One of the most well known functions of vitamin C is its role in the immune system. So many people I know take megadoses of vitamin C, especially in the winter, in an effort to prevent colds. Unfortunately, more than 50 years of research has shown that it doesn’t work… sorry! 

M: Although there is some evidence that vitamin C may reduce the duration of cold symptoms once you’ve got one, but as always… more research is needed. So not prevention, but maybe you don’t feel miserable for quite as long? Maybe?

S: Maybe, but for another podcast at another time. Another important role of Vitamin C is that it’s necessary for the development of collagen which is really having a “moment” right now! 

M: Oh my gosh it is! Collagen supplements are everywhere,  all over the internet, all over the grocery stores. But supplementation and whether or not that is helpful is not what we’re discussing today. 

S: Another episode. A different episode. Ok, so we are focusing today on scurvy. So collagen is the most abundant protein in the body and used for many different things. It’s the structure for ligaments and tendons, blood vessels, and it’s also used in scarring which binds wounds together. Vitamin C acts is the glue that holds collagen fibers together. 

M: You're going to want to keep these functions of collagen in the back of your mind as we continue our story.

S: Yes, yes!

M:Vitamin C is a water-soluble vitamin which means our bodies don’t store it very well. The level of ascorbic acid in a healthy human ranges from 900-1500 mg and the body uses about 50 mg per day so we need to consume it regularly and often. In fact, the recommended daily intake of vitamin C is 90 mg/day for men and 75 mg/day for women. But if you smoke or are around smoke, you need to add, an additional 35 mg/day is recommended.

S: So in terms of food, ½ cup of red bell pepper provides 95 mg and a medium orange provides 70. Really, it’s found in most fresh fruits and veggies, particularly the brightly colored ones, including citrus (which most people know about, especially lemons, oranges), broccoli is a good source, Brussel sprouts, and strawberries. Even white potatoes have some vitamin C but there’s maybe not so much in french fries.17.25

M: Unfortunately! But we can’t stock up on it for later use. Excess water-soluble vitamins leave the body in urine. So if you’ve ever taken megadoses of vitamins and noticed that your urine color gets a little bit more yellow, those are the water-soluble vitamins being excreted. 

S: So without adequate vitamin C sources on board, scurvy would usually develop about 6 weeks into a long voyage when the base level of vitamin C in the body dropped below 500 mg. The older and least healthy sailors would typically develop symptoms sooner. Because as we age we have a much higher risk of having micronutrient deficiencies. Plus most of these sailors likely weren’t very well nourished before they even got on the ship!

M: Unfortunately! Scurvy was sometimes called “purpura nautica” because of the purplish bruises that were often the first physical symptoms of the condition. In early stages, beyond bruising easily, sailors would develop aching joints, weakness, and begin to have issues with coordination making it difficult to do their jobs.

S: They can also develop psychological symptoms like weakness, sadness, irritability, or lack of motivation. 

M: As the condition progressed small blisters would develop into painful, large, bleeding sores. 

They might develop worsening joint and muscle pain and their gums would become swollen and begin to bleed. Sometimes teeth would fall out. Internally, they might begin to bleed as the blood vessel walls would begin to break down.

S: Terrifying.

M: Yeah.

S: In later stages previously mended broken bones might rebreak! I cannot even imagine. I’ve had some broken bones in my body and if I woke up one day and they were just broken again- I can’t even imagine that! And scar tissue of old wounds would deteriorate so much that the wounds would reopen. 

M: Oh my gosh!

S: Remember those functions of collagen we asked you to remember? Well all of these awful symptoms are a result of the body’s inability to produce collagen because they lack vitamin C.  

M: Eventually the structure of the brain would deteriorate causing cognitive impairment, personality changes, hallucinations, and even seizures. Remember vitamin C is necessary for some hormones and neurotransmitters and the central nervous system in general. 

S: Finally, internal hemorrhaging near the heart and brain, especially after a sudden exertion such as moving from seated to standing, would cause death. I mean there were actually stories of men standing up and then dropping dead. 19:50

M: It’s just truly terrifying.

S: I mean yeah. It’s awful. Because it was so common, and as we said before at least half of sailors on long voyages died from it, it was the #1 health issue from 1500-1800. An there were scores of physicians trying to figure out what was causing it and how it could be remedied.

Why so much scurvy on sailing ships?

M: So why were sailors, in particular, so susceptible to scurvy? Well, many reasons….

S: So many reasons… Well in general, I mean think about it, life at sea was not conducive to good health. You’d have dozens or hundreds of men would be living together in horrible, unsanitary conditions. The work was laborious and difficult and there was a lot of opportunity for injury. 

M: Ships were full of vermin like rats, mice, and lice.

S: Ick…

M: Food brought on these long voyages would eventually run out or spoil. And some ships, – especially those from Catholic countries,would be full of corpses due to the importance of burial of the dead in this religion. Bodies were not to be “buried at sea” so to speak. 

S: So they just left them on the ship? 

M: Yep. Until they got –

S: So Protestants threw their dead over but the Catholics –

M: Apparently. 

S: Oh gosh, that must have been terrible! Sailors would wear the same clothing for months and sleep in dirty bedding. 

M: And they’re bleeding….

S: Ugh, terrible! Most of the ships leaked and getting the water out was almost impossible. Can you even imagine what it smelled like?

M: Honestly, I hadn’t thought about it until just now.. and it’s terrible!, I don’t want to think about it. 

S: I don’t want to think about it either.  So they suffered from so many debilitating diseases and conditions. Conditions caused by food poisoning, nutrient and energy deficiency, contaminated water, bites from the vermin, like the infected fleas and lice, and just generally increased transmission of infectious disease. I mean, they lived in such close quarters with poor hygiene. In fact, many ships set sail with extra men in anticipation that many would die. 

M: I mean, I guess that’s good planning.

S: But the reason’s so terrible. 

M:  Oh my gosh! So as for scurvy, living on a ship actually promoted its development. The body uses more ascorbic acid or vitamin C in cold, damp conditions with poor ventilation, when sleep patterns are insufficient or erratic, I mean, they’re all sleeping together in close quarters, crammed together like sardines!

S: Oh yeah.

M: We use more vitamin C during stress and there was always fear of battle, violent punishments, or storms and while fighting infections – and in a closed space like a ship, infectious diseases were common – smallpox, tuberculosis, yellow fever, typhoid fever  – and of course we need more vitamin C for wound healing and as we’ve said, jobs on ships were dangerous and wounds were common.

S: So sailors need more vitamin C than the average human.

M: Wow.

S: Wow.

M: But their diets were limited by what could be preserved or stored for several months. There may have been fresh foods available in small amounts for the crew for the first couple of weeks…. 

S: Right, but once that fresh food ran out, the crew would survive on hardtack biscuits. These are like a cracker made up of flour, water, and sometimes salt. They’re cheap and they last a long time. They have a long shelf life. Additionally, they might have dried and salted beef or pork, they might have a little bit of dried peas or grains, some pickled vegetables, and they always had beer, usually about 1 gallon per sailor per day, and they drank beer because it’s hard to get fresh water when you’re out in the middle of the ocean.

M: Yeah… But even these provisions would begin to mold and rot in the damp of the ship. 

S: It just sounds horrible. It would have been common knowledge about the terrible conditions right? And your chances of surviving a long voyage were not great! Who would volunteer to be on one of these ships?

M: Well there often weren’t enough volunteers. So, governments would at times clear out jails and prisons, and even military hospitals just to get enough bodies on board to sail. Or if they couldn’t find enough men this way they would “press” people into service. This is really just another word for abduction.

S: Wow! So fishermen and merchant seamen lived in fear of “press gangs,” and this was groups of ruffians –

M: Oh that’s a good word!

S: I love that word – ruffians. So these groups of ruffians who would roam the nighttime streets, searching for victims to “impress” into the British navy. You could be English, Irish, American, or Canadian, any subject of the British Empire with any seafaring experience or just any subject of the British Empire was vulnerable to abduction.

M: So you’d be attacked, abducted, beaten, and you’d wake up on a ship that’s out to sea! That’s unbelievable.

S: It is! And there’s – Once you’re there, there’s only a 50/50 chance you’re going to make it home. 

M: Wow!

S: Terrible, terrible!

S: Just like with all medical conditions before science figures it out, there were many, many theories about what causes scurvy. And, of course, scurvy is a little bit different because if vitamin C is consumed, the patient who was formerly at death’s door would “bounce back” fairly quickly, like – within a couple of days.

M: It’s a miracle!

S: A miracle! There was no reliable explanation as to how anyone could possibly rebound from an affliction that ravaged the body like scurvy did except, of course, for divine intervention.

M: Yes, it was considered “God’s will”. Other possible theories included “bad air”, exposure to seawater, poor genetics, extreme heat, vapors of the night, and loose morals. 

S: Oh, you gotta watch out for those loose morals! 

M: But others thought it was infectious since so many of the crew would be sickened around the same time. 

S: Well, makes sense, I can see that. Some others said it was caused by laziness. Is this the cause or the actual effect of the scurvy? One of the early signs is fatigue and sadness and inability to work. So some people argued that more work should be given to counteract this laziness and that would cure scurvy. In fact, one doctor in 1736, suggested that idleness hinders digestion and that was the cause of scurvy. 

M: Scurvy was so hard to nail down – it happened in hot climates, in cold climates, good weather, bad weather, sunny conditions, cloudy conditions, close to land, in the middle of the ocean, and on all sorts of ships carrying all sorts of cargo. 

S: You know, it did seem to afflict Europeans more than the people they encountered on their voyages. Neither the Inuit of the Arctic nor the other Indigenous Peoples of North and South America seemed to suffer from it. Nor did the Arabic desert dwellers of the Middle East. 

M: The only common denominator to scurvy was that it almost always occurred after several months at sea and mostly in Northern Europeans. But why? Occasionally someone would postulate that maybe diet was to blame. But interestingly not because of a possible deficiency in the diet, but rather they thought it might be a toxicity. 

S: In fact, one doctor in 1712, suggested that fresh fruit was a direct cause of GI issues and that when ships reached countries with tropical fruits such as oranges, lemons, and pineapples, those should be avoided. 

M: Which is literally the worst advice ever!

S: It is! 

M: But still others thought salty or rancid food was to blame as it weakened the body which allowed the disease to take hold. But you can’t really avoid those things when you’re out on a ship…

S: For sure. Sometimes a sailor, as we said before, would be cured by accident by consuming foods like watercress,, saffron, ginger and a plant that is now known as scurvy grass – hmm, I wonder why? – but even then usually the cure was deemed “miraculous” and “divine”. 

M: But what about an actual cure for this insidious condition? As we mentioned earlier, this was an important and expensive public health problem for kings and queens, and for merchants. 

If you’re losing half of your crew on each voyage you may not have enough sailors to get those riches home. So even if you make it to your destination, those kings and queens are missing out on all that gold.  

S: Yeah. I mean, it was the #1 health problem to solve and there were so many people looking for a cure. 

M: But there had been “cures,” or at least ways to postpone development, well before scurvy became such an issue. Early seafarers like the Vikings and the Chinese knew the value of taking fresh cranberries, ginger, or seaweed on trips. Consuming this would help keep scurvy at bay for shorter voyages.

S: And for hundreds of years the First Peoples of what is now Quebec knew that drinking a tea made from white cedar branches would prevent the illness, like we talked about with Domagaya, they told some settlers, but the knowledge wasn’t always passed on. 

M: And it was known that fresh foods could help. 

S: Right, in 1593, British Admiral Richard Hawkins recommended the use of citrus as a preventive measure.

M: Finally!

S: Finally!

M: Well in 1601, Portuguese ship captain James Lancaster carried bottles of lemon juice on 4 British ships on a voyage to the Spice Islands. This was not a common practice as it was considered too expensive to restock often but it did stave off scurvy on these ships and this voyage.

S: And in 1614, the Dutch East India Company published a pamphlet called “The Surgeon’s Mate,” which prescribes fresh food, citrus, and sulfuric acid to prevent scurvy. John Woodall was the Surgeon General of the Dutch East India Company and he prescribed lemon juice as daily preventive on company ships. But it often didn’t work well because the tiny amount given to each sailor was not enough. 

M: And unfortunately, that led people to believe that lemon juice was not the answer and the practice was abandoned by many ship captains. But the Dutch did think that fresh foods might work. So they tried to grow gardens on some of their ships, but the rolling – I know, I can’t imagine – the rolling waves, of course, made this impossible…

S: Yeah, I would think so. 

M: …so that practice was also abandoned.

S: I’m just picturing – trying to picture that on a ship, and you know –

M: I know!

S: And like the mice and rats

M: I know, exactly!

S: Wow! But the Dutch East India Company kept trying, because it was such an important issue. Because citrus juice was so difficult to keep on the ships, they changed to tamarinds, which is a legume like fruit from Africa and Asia, and something called oil of vitriol which was a combination of sulfuric acid and alcohol. They also sent various plants and berries including gooseberries, turnips, radishes, and nettles. 

M: Finally- some more good news!

S: Yeah! But these plants would be brought on board dried rather than fresh so that they would have a longer shelf life while they were out on these long voyages. But because vitamin C is water-soluble, some or even much of the vitamin C is lost during the drying process. So the vitamin C in these dried foods was enough to prevent scurvy on short journeys, but not on the longer ones.

M: By the early 1700s there was a general increase in knowledge about fresh foods, citrus, and some acids – so that of vitriol –  to help with scurvy, but the specific cause was still hotly contested and a definitive cure remained a mystery.

S: But nothing spurred the desperate search for a cure like the disastrous voyage of Lord George Anson in the mid 1700s. It was one of the worst medical disasters at sea ever!

M: So picture this… it’s 1739 and England and Spain are fighting to determine who will control the West Indies, what we now call the Caribbean.

S: And thanks to Magellen and others, the Spanish had lucrative trade routes on the Pacific coast of South America and the British wanted to break this trade up!

M: The British Navy put the now Commodore George Anson –

S: He got a promotion!

M: Nice! … in charge of a 6-ship mission to the Pacific Coast of South America.

S: Their mission, to aggravate the Spaniards by attacking Spanish settlements, sinking their ships, and capturing the treasure galleon that transported silver from Acapulco to the Philippines and this galleon was called “the prize of all the oceans.”

M: Lord Anson’s voyage seemed doomed from the start. The ships needed repairs and he needed 2,000 men to sail them. Since his mission was a lower priority for the British Navy, he ended up a few hundred men short. So to fill out the crew the Navy gave him inexperienced and untrained young marines (who had possibly been abducted) and elderly naval invalids from a naval hospital, many of whom were incapable of even walking. I mean what are they doing on the ship if they’re not walking?

S: I don’t know. But they’re numbers.

M: Yeah… 

S: They had to wait 6 months for the ships to be repaired and ready to sail. And during this time the crew was living on the ships moored offshore and they were consuming primarily ship rations with no access to fresh fruits and veggies. 

M: So they’re eating all of the food before they even are setting sail!

S: Right, right. 

M: Wow… So they finally do set sail in September 1740 they were already weakened by again, that combination of older age, illness, wounds, and malnourishment, and they were anticipating years at sea. Little did they know that their biggest threat was not Spanish warships, but scurvy. 

S: The Navy gave them outdated so-called scurvy cures and preventatives to prevent scurvy including vinegar, that oil of vitriol we mentioned previously, and a product called Ward’s Drop and Pill that was supposed to cure all kinds of ailments. 

M: Can you say “snake oil”?

S: Right! 

M: I mean, sheesh.

S: Ward’s Drop and Pill was a product that contained metals like cobalt, antimony, and arsenic. None of which should ever be consumed. It also induced violent sweating… not great for sailors!

M: I mean, maybe the metal poisoning would kill them before scurvy?

S: Maybe, I don’t know! 

M: I don’t know. But back to the journey.. they left in September. The following March, about 6 months into the voyage, they got through Cape Horn at the Southern tip of South America. They made it through the treacherous passage, but once into the Pacific they hit storms which blew them off course. 

S: And the storms lasted for 3 months. Huge waves, rain, snow, and hail damaged the ships and a few men were swept overboard and the ships got separated in the storms. 

M: So now they’re 9 months into the trip. Two of Anson’s 6 ships turned around and headed back to Europe. 

S: They said “Screw this, I’m out of here!” 

M: “I’m out!” I’d be on that ship. By this time most of the young marines and the elderly crew from the hospital were already dead. 

S: That’s sad. By the end of April almost all of the remaining crew were afflicted with scurvy and in that month alone 43 sailors on just one ship died of it. In May, that number doubled. Most of the crew were too weak to even deal with the dead. 

M: One of the ships called The Wager had a mast broken in a storm leaving her almost incapable of sailing. It wrecked along the coast of Chile killing even more men. The ship, however, had basically already been decimated by scurvy at that point. 

S: Yeah, yeah. So we have 3 remaining ships and they arrive at Juan Fernandez island, which is directly west of Santiago, Chile. And they were there to regroup and recuperate before continuing with their mission, but they were several weeks later than they thought they would be.

M: By the time they arrived, 5-6 men were dying of scurvy every day. 

S: Wow!

M: One half to 2/3 of the crews had already been lost. On the smallest ship only the captain, a lieutenant, and two sailors were well enough to work the sails.

S: Again, oh my gosh! Fortunately, Juan Fernandez Island is lush. It’s got vegetables and fruits and fresh fish was abundant. So the remaining 3 ships stayed there for several months and they fixed their ships and nursed themselves back to health. 

M: I would probably stay.

S: I know!

M: I’m not getting back on the ship, it’s nice here. But when it came time to continue on there really weren’t enough sailors to sail all 3 ships and man the guns. Of the 1200 who should have arrived on Juan Fernandez Island, only 335 were alive! That’s a 28% survival rate! 

S: Wow, three out of four died!

M: Yeah, that’s way worse than half!

S: Yeah it is! 

M: They sank one of the ships and continued on with just two.

S: And for several months things went well. They captured Spanish ships and sailed along the South American coastline and they didn’t have any scurvy. 

M: They then headed across the Pacific to China,  a two month journey. Scurvy returned even though they still were using some of those “cures” that they were provided. About 5 sailors were dying every day. 

S: By the time they reached China they had abandoned and destroyed one of their two remaining ships because there were only 227 crew left alive and of those, only 27 were still able to stand. 

M: I mean, my gosh. In China they filled the hold with cargo, including lots and lots of oranges!

S: Yea! 

M: Finally! And then they headed home. Amazingly, on the way home they encountered the “prize of all the oceans”. 

S: OMG! 

M: They captured her and brought home amazing riches!

S: But… by the time they got back to Britain no more than a few hundred of the 2000 men who had left 4 years earlier had survived. And of those who did survive, many were maimed or never regained their health entirely. 

M: The British Navy may have been OK with the loss of life, I mean men can be replaced.

S: Well yeah, of course…(sarcasm)

M:  But ships, especially war ships, were expensive to build! So their loss really pushed scurvy research in England. They were more determined than ever to find a cure.

S: Right, because they lost 5 ships. Five out of 6, wow! So James Lind, he’s a British naval surgeon, he conducts what is widely considered to be the world’s first clinical trial. Here’s what he did. He tested scurvy cures on 12 scurvy-ridden sailors. He divided them into pairs and then each pair was given a course of one of these things: cider, sulfuric acid, vinegar, seawater, oranges & lemons, spices & barley water.

M: They ran out of fruit in just 6 days, but all results indicated that team oranges & lemons were the clear winners.

S: Go team!

M: Lind published these findings in 1753 in his book “A Treatise on Scurvy” which he dedicated to Lord Anson.

S: Oh that’s nice. 

M: Lind postulated that citrus fruits is the cure for scurvy. 

S: So finally, the British Navy began to take note. In 1772, Captain James Cook packed watercress seeds for his second epic voyage and he didn’t have any scurvy on his ship. 

M: You may have heard of Captain Cook, not to be confused with Captain Hook... Captain Cook, he sailed extensively in the Pacific and had the first recorded European contact with the Eastern coastline of Australia and sailed around New Zealand. He also made first contact with the Hawaiian Island, which actually didn’t end well for Cook at all... He was killed in a violent confrontation that he most likely instigated. 

S: Yeah, but that story is for another day… and probably a different podcast.

M: Several other British naval voyages administered rations of lemon juice to the crew and suffered no scurvy. 

S: So finally in 1795, after several centuries of looking for a cure, and millions of deaths from the dreaded malady, the British Royal Navy instituted mandatory rations of citrus fruits for sailors on long voyages. 

M: But lemon juice was expensive, so in the early 1800s the British substituted cheap and easy-to-get limes from the Caribbean instead of using lemons and oranges which do have more vitamin C. Then they boiled the limes in copper vessels. Copper oxidizes vitamin C which basically breaks it. So cooking in copper reduced the vitamin C content even further. 

S: Wow! So even though they brought along this citrus lime juice on long voyages, scurvy came back…..

M: And citrus as a cure for scurvy was again in question. In fact, the Americans made fun of the British calling them “limeys” because the American Navy didn’t believe in the cure. 

S: But finally what really cured scurvy was technology! Steam engines reduced the length of voyages so scurvy was no longer much of an issue. 

M: But scurvy wasn’t completely eradicated. Several Arctic and Antarctic expeditions in the 19th and 20th century suffered from it. Most only had poorly tinned food, pemmican (which is made from animal fat, dried meat, and sometimes dried berries), they had hard tack, tea, and whiskey… so crews developed scurvy.

S: Today it’s really rare to see someone with scurvy, and if it is diagnosed, it’s easily cured. But you may still see it in places like refugee camps, war torn areas, or in unhoused populations. 

M: You may also see it in people with very limited diets who don’t consume fresh foods, or in those missing teeth because it’s difficult to chew fresh foods. 

S: Right. Other at-risk groups include those with alcohol use disorder, those who abuse drugs, those who live alone with little social support or income, and the mentally or chronically ill. 

M: Even a fast food hamburger comes with enough vitamin C as long as you eat the onion, lettuce, and tomato, and this can help ward off the most debilitating signs of scurvy. 

S: But vitamin C – it’s pretty fragile. Cutting or bruising vegetables and fruits can cause some vitamin C loss. And as fruits and veggies age after they’re harvested, vitamin C starts to be destroyed. Cooking, as we mentioned earlier, can also cause losses, especially when water is pulled from the fruit or the veggie, so, like, boiling.

M: Which makes sense – vitamin C is water-soluble!

S: Right and as we mentioned earlier, cooking in copper pots destroys between 50-75% of the vitamin C, but if you cooked it in an iron pot instead you’d only lose less than 20% instead. And guess what? Copper pots for cooking were standard on naval ships before the 1800s.

M: Of course. Even though many cultures already knew how to prevent it, James Lind is usually credited with finding the “official” cure for scurvy in 1753. In fact, there’s a plaque at the Medical School at Edinburgh University placed there in 1955 by the Sunkist Growers of Citrus Fruit in California and Arizona calling Lind “The Hippocrates of Naval Medicine” because of his work leading to what they called “the conquest of scurvy”.

S: We’ve actually got a picture of the plaque in our show notes, so check it out. It was over 150 years later in the 1930s that Albert Szent-Gyorgyi, a meticulous Hungarian biochemist, discovered ascorbic acid, or what we now call vitamin C. 

M: He called it ascorbic acid because of its anti-scorbutic or anti-scurvy properties based on experiments he did with guinea pigs.

S: Yeah, that’s right… guinea pigs, like humans, don’t make vitamin C so they have to get it from food.

M: Right. He fed one group of guinea pigs boiled food and the other group, food that was enriched with what is now called vitamin C. Because vitamin C is water-soluble, boiling the food pulls the vitamin C out of the food and into the water, like we said before. Guinea pigs fed the boiled food got scurvy and died, while the vitamin C enriched group thrived.

S: You know, he also discovered the metabolic mechanism that enables the vitamin to be used within cells. And he was awarded the Nobel Prize in Physiology or Medicine in 1937 for these discoveries. 

M: Well deserved. 

S: Yes it was. 

M: The best way to avoid scurvy is to never allow the body’s ascorbic acid level to drop below normal. Once symptoms occur it takes a lot more vitamin C to cure it than to avoid it.

S: And that’s it for our deep dive into the discovery of a cure for scurvy. We hoped you enjoyed this nutrition detective story! 

M: And don’t forget to celebrate International Scurvy Awareness Day on May 2 every year. It’s a way to celebrate vitamin C and all its amazing functions, and to remember the millions who have died from scurvy over the millennia. 

S: Well put that on your calendar! I can’t believe there’s an International Scurvy Awareness Day but there is. Well join us next time when we will look at the relationship between some prescription medications and foods like grapefruit. 

BOTH: Class Dismissed.

S: We hope you enjoyed this episode. You can find the show notes and a list of sources on our website, yournutritionprofs.com. 

M: Your homework is to follow us at your nutrition profs on Instagram and to listen to our next episode. You can listen on Amazon Prime, Apple Podcasts, Spotify, YouTube, or anywhere podcasts are found. We’d appreciate it if you’d “like” us, write a review, subscribe, and invite your family and friends to join us too. 

S: If you have a nutrition or health question you’d like answered, let us know! We may even do a show about it! Send an email to yournutritionprofs@gmail.com or click on the “Contact Us” page on our website.

M: Thanks to Brian Pittman for creating our artwork. You can find him on instagram @BrianPittman77

Both: See you next time!