Scurvy

What Is Scurvy?

What Is the Role of Vitamin C in the Body?

What Are the Symptoms of Scurvy?

Who Is at Risk for Scurvy?

How Is Scurvy Treated?

Resources

Scurvy is a disease that results when people do not get enough vitamin C (also called ascorbic acid) in the diet over a period of weeks or months. Some of the effects of scurvy are spongy gums, loose teeth, weakened blood vessels that cause bleeding under the skin, and damage to bones and cartilage, which results in arthritis-like pain.

KEYWORD

for searching the Internet and other reference sources

Ascorbic acid

What Is Scurvy?

Scurvy was one of the first recognized dietary deficiency diseases. During the sea voyages of the fifteenth to eighteenth centuries, many sailors suffered from scurvy. The Portuguese navigator Vasco da Gama (ca 1460-1524) lost half his crew to the disease during their voyage around the Cape of Good Hope, and the British admiral Sir Richard Hawkins (1532-1595) lost 10,000 sailors to scurvy. In 1747, the British naval physician James Lind conducted experiments to see which food or liquids might be able to prevent scurvy. He found that lemons and oranges enabled sailors to recover from scurvy. Both of these citrus fruits are rich sources of vitamin C.

What Is the Role of Vitamin C in the Body?

Vitamin C is necessary for strong blood vessels, healthy skin, gums, and connective tissue, formation of red blood cells, wound healing, and the absorption of iron from food.

What Are the Symptoms of Scurvy?

The main symptom of scurvy is bleeding (hemorrhaging). Bleeding within the skin appears as spots or bruises. Wounds heal slowly. The gums become swollen, and gingivitis (jin-ji-VY-tis), which means inflammation

Have You Ever Heard Anyone Called a “Limey”?

In Treatise of the Scurvy, published in 1753, James Lind wrote about the first example of a research experiment set up as a controlled clinical trial. To study the treatment of scurvy, Lind divided sailors who had it into several groups and then fed each group different liquids and foods. He discovered that the group fed lemons and oranges was able to recover from scurvy.

By the end of the eighteenth century, the British navy had its sailors drink a daily portion of lime or lemon juice to prevent scurvy. The American slang term for the English, “limeys,” originated from that practice.

of the gums, usually occurs. Bleeding can take place in the membranes covering the large bones. It can also occur in the membranes of the heart and brain. Bleeding in or around vital organs can be fatal.

Scurvy develops slowly. In the beginning, a person usually feels tired, irritable, and depressed. In the advanced stages of scurvy, laboratory tests show a complete absence of vitamin C in the body.

Who Is at Risk for Scurvy?

Scurvy is less prevalent today than it was in the time of Vasco da Gama and Richard Hawkins, but people who are on diets that lack a diversity of foods may develop scurvy or scurvy-like conditions. Infants who depend solely on processed cow’s milk for nutrition and are not given vitamin C supplements are at risk for scurvy. Elderly people, whose diets often lack citrus fruits or vegetables that contain vitamin C, represent another at-risk group. People who follow diets that limit them to very few food choices also may be susceptible to developing scurvy.

How Is Scurvy Treated?

To treat scurvy, people take vitamin C supplements (vitamin pills) and eat foods rich in vitamin C. In addition to citrus fruits like oranges and grapefruits, good sources of vitamin C include broccoli, strawberries, cantaloupe, and other fruits and vegetables.

See also

Dietary Deficiencies

Gum Disease

Resources

Books

Mavarra, Tova. Encyclopedia of Vitamins, Minerals, and Supplements. New York: Facts on File, 1996.

Slap, Gail B. Teenage Health Care. New York: Pocket Books, 1994.

Organization

The U.S. National Institutes of Health (NIH) has a search engine at its website that locates information about scurvy and about vitamin C research. http://www.nih.gov

Scurvy

Definition

Scurvy is a condition caused by a lack of vitamin C (ascorbic acid) in the diet. Signs of scurvy include tiredness, muscle weakness, joint and muscle aches, a rash on the legs, and bleeding gums. In the past, scurvy was common among sailors and other people deprived of fresh fruits and vegetables for long periods of time.

Description

Scurvy is very rare in countries where fresh fruits and vegetables are readily available and where processed foods have vitamin C added. Vitamin C is an important antioxidant vitamin involved in the development of connective tissues, lipid and vitamin metabolism, biosynthesis of neurotransmitters, immune function, and wound healing. It is found in fruits, especially citrus fruits like oranges, lemons, and grapefruit, and in green leafy vegetables like broccoli and spinach. In adults, it may take several months of vitamin C deficiency before symptoms of scurvy develop.

Currently, the recommended dietary allowance (RDA) for vitamin C is 50-60 mg/day for adults; 35 mg/day for infants; 40-45 mg/day for children 1-14; 70 mg/day during pregnancy ; and 90-95 mg/day during lactation. The body's need for vitamin C increases when a person is under stress, smoking, or taking certain medications.

Causes and symptoms

A lack of vitamin C in the diet is the primary cause of scurvy. This can occur in people on very restricted diets, who are under extreme physiological stress (for example, during an infection or after an injury), and in chronic alcoholics. Infants can develop scurvy if they are weaned from breast milk and switched to cow's milk without an additional supplement of vitamin C. Babies of mothers who took extremely high doses of vitamin C during pregnancy can develop infantile scurvy. In children, the deficiency can cause painful swelling of the legs along with fever, diarrhea, and vomiting. In adults, early signs of scurvy include feeling weak, tired, and achy. The appearance of tiny red blood-blisters to larger purplish blotches on the skin of the legs is a common symptom. Wound healing may be delayed and scars that had healed may start to break down. The gums swell and bleed easily, eventually leading to loosened teeth. Muscle and joint pain may also occur.

Diagnosis

Scurvy is often diagnosed based on the symptoms present. A dietary history showing little or no fresh fruits or vegetables are eaten may help to diagnose vitamin C deficiency. A blood test can also be used to check the level of ascorbic acid in the body.

Treatment

Adult treatment is usually 300-1,000 mg of ascorbic acid per day. Infants should be treated with 50 mg of ascorbic acid up to four times per day.

Prognosis

Treatment with vitamin C is usually successful, if the deficiency is recognized early enough. Left untreated, the condition can cause death.

Prevention

Eating foods rich in vitamin C every day prevents scurvy. A supplement containing the RDA of vitamin C will also prevent a deficiency. Infants who are being weaned from breast milk to cow's milk need a supplement containing vitamin C.

Resources

BOOKS

Stein, Jay H., editor. "Ascorbic Acid (Vitamin C) Deficiency." In Internal Medicine. St. Louis: Mosby, 1998.

KEY TERMS

Ascorbic acid— Another term for vitamin C, a nutrient found in fresh fruits and vegetables. Good sources of vitamin C in the diet are citrus fruits like oranges, lemons, limes, and grapefruits, berries, tomatoes, green peppers, cabbage, broccoli, and spinach.

Recommended dietary allowance (RDA)— The daily amount of a vitamin the average person needs to maintain good health.

SCURVY

SCURVY. A corruption of the earlier word "scorby," scurvy is the name given to the disease that is the consequence of a prolonged deprivation of vitamin C. The minimum daily requirement to prevent the disease is approximately 7 mg, but it takes several weeks of depletion of body reserves before the problem becomes evident. There are many descriptions of the disease as it appeared among sailors engaged in the long voyages that began to be undertaken from the end of the fifteenth century. After ten or more weeks at sea, men began to experience general pain and stiffness, while their lower body became covered with large purple spots. In addition their gums would swell and grow over their teeth, which became loose; and old wounds would reopen. Finally, sufferers would die suddenly, "in the middle of a sentence," to the astonishment of their mates. This is now explained as the consequence of impaired protein synthesis, with connective tissues weakening, so that the wall of a major artery would finally burst. It soon was discovered that the disease could be prevented, and even cured, by sailors consuming fresh fruit and vegetables. Long sea voyages were only indirectly responsible, by preventing crews from living on anything but foods that could be stored for long periods, like salt meat, dried peas, and flour that could be cooked into bread and puddings. The same disease appeared on land when fresh food was unavailable for long periods, as in the California gold rush, for example. The first "antiscorbutic" (i.e., antiscurvy) foods to be prized by sailors were oranges and lemons, but they would become moldy on long voyages, and juices preserved with brandy or rum were more stable alternatives that also proved to be more palatable. Sailors in the British navy were required, from early in the nineteenth century, to take a portion of lime juice in their daily ration of rum; men from other navies called them "limeys" as a term of abuse, implying that "real men" did not need to drink fruit juice. Another tradition among sailors on long whaling expeditions was to take a large store of potatoes. These are not very rich in the vitamin but contain enough to prevent the disease if one is eaten freshly cooked every day.

In the early twenty-first century the disease still appears occasionally in adults, typically as "widowers' scurvy," among men who have never learned to cook and, when left to fend for themselves, subsist on things like breakfast cereals and sandwiches made from bread and cheese or ham. It also has appeared in people living on very restricted "fad" diets, such as a Zen macrobiotic diet of brown rice sprinkled with sesame seeds.

With the recognition of the importance of bacteria in causing diseases, at the end of the nineteenth century, it became a practice in some cities to sterilize cows' milk by autoclaving it. Children's deaths from "summer diarrhea" were reduced greatly as a result of this practice. However, this processing also resulted in the destruction of most of the vitamin C in the milk and, when it was fed to infants with only a cereal supplement, scurvy became a common problem. The addition of orange juice to the infants' diets provided a simple solution. With modern technology, milk can be freed from pathogens and potatoes can be dried under milder conditions, so that vitamin C is preserved; alternatively, the synthetic vitamin can be added to restore vitamin C levels in foods.

See also Beriberi ; Niacin Deficiency (Pellagra) ; Nutrient Bioavailability ; Nutrients ; Nutrition ; Vitamin C ; Vitamins .

BIBLIOGRAPHY

Carpenter, Kenneth J. The History of Scurvy and Vitamin C. Cambridge, U.K., and New York: Cambridge University Press, 1986.

Hess, A. F. Scurvy Past and Present. Philadelphia: Lippincott, 1920.

Kenneth John Carpenter

SCURVY

SCURVY, a deficiency disease caused by lack of vitamin C (ascorbic acid), was once the scourge of sailors on long voyages. It afflicted the crew of Sebastián Vizcaíno when he explored the coast of California (1602–1603), and it decimated the companions of California's first physician, Don Pedro Prat (1769). Scurvy continued to flourish even though the simple remedy for its control—plenty of fresh fruits and vegetables in one's diet—was well-known by the mid-seventeenth century. Scurvy ravaged the passengers who came to California by boat during the gold rush (1848–1853), and ship captains admitted to health officers that shipowners would not permit them to stop on the way to take fresh vegetables on board. The first person in the United States to describe night blindness (1842) as one of the symptoms of scurvy was Edward Coale, who noted that deck work had to be discontinued because so many men of the frigate Columbia could not see after sundown. Modern methods of food preservation and distribution coupled with improved eating habits have made a diet rich in vitamin C accessible to most people, and scurvy has ceased to be a major American public health problem.

BIBLIOGRAPHY

Hess, Alfred Fabian. Scurvy, Past and Present. Philadelphia: Lippincott, 1920. Reprint, New York: Academic Press, 1982.

Watt, J., E. J. Freeman, and W. F. Bynum. Starving Sailors: The Influence of Nutrition upon Naval and Maritime History. London: National Maritime Museum, 1981.

VictorRobinson/c. w.

See alsoExploration of America, Early ; Food Preservation ; Gold Rush, California .

Scurvy

Scurvy is a condition characterized by hemorrhages around the hair follicles of the arms and legs, generalized weakness, anemia , and gum disease (gingivitis) resulting from a lack of ascorbic acid (vitamin C) in the diet . Early epidemics of scurvy occurred during the Renaissance (1600–1800s) among explorers and seafaring men. In 1746, James Lind, a British naval surgeon, established that eating lemons and oranges cured the disease.

Vitamin C is destroyed by heat, and thus not present in pasteurized and commercially processed foods . Children and teenagers who consume too many processed foods and few fresh fruits and vegetables may be getting inadequate amounts of vitamin C. (In 1914, an increased incidence of scurvy among infants was attributed to consumption of heated (pasteurized) milk and vitamin C–deficient commercially processed foods.) Though rare, scurvy is now frequently observed among elderly persons, alcoholics, and malnourished adults. In addition, smokers have higher requirements for vitamin C, and are therefore more at risk.

Kiran B. Misra