I was once again dreaming of fortune and success when my hopes were blasted by an attack of a terrible scourge that wrought destruction through the northern mines during the
winter of eighteen forty eight forty nine land scurvy. I noticed its first attack upon myself by swelling and bleeding of the gums, followed by a swelling of both legs below the knee, and I was laid up in my tent, obliged to feed upon the very articles that had caused the disease, and growing daily weaker without any reasonable prospect of relief. I was almost in despair. With only a blanket between myself and the damp, cold earth, and a thin canvas to protect me from the burning sun by
day and the heavy dews by night. I lay day after day enduring the most intense suffering from pain in my limbs, which were now becoming more swollen and were turning completely black. Above me rose those formidable hills which I must ascend ere I could obtain relief. I believe I should have died had not, by accident, discovered a remedy. In the second week of my illness, one of our party found strewn along a foot track, a quantity of beans which sprouted from the ground and were in leaf.
Someone had probably dropped them. He gathered a quantity and I had them boiled and lived entirely on them for several days at the same time using a decoction of the bark of a spruce tree. These seemed to operate magically, and in a week I found myself able to walk, and with two companions, walked into Coloma. There living principally upon a vegetable diet, which I procured by paying three dollars per pound for potatoes. In a very short time I recovered.
Wow, hi, Hi, I'm Aaron Welsh.
And I'm Erin allman Updyke, and.
You're listening to this podcast will kill you. So that was some scurvy, some scurves that was really fun. And also three dollars a pound for potato.
I don't even think I pay that much today.
You don't in an eighteen forty eight.
That's like gotta be like what one hundred dollars today?
I mean easily a thousand with inflation plus all the gold.
But also magical potatoes.
That yeah, truly truly, and we'll find out why.
Soon so shortly.
So today's episode we're going to be talking about scurvy.
Yeah, I'm excited.
I'm really excited.
This is our first real departure on our own from infectious disease. We've done crossovers where we talked about things other than infectious disease, but this is our first solo journey down a non infectious route.
Yeah, I'm pretty excited about it. I think it's going to be great.
I think so too.
Actually, I know it's going to be great.
Oh good.
Yeah, So we're going to cover the biology, the history, and the current status question mark, question mark, question mark of scurvy. But before we do any of that, it's quarantiney time. Oh yeah, what are we drinking today?
We're drinking the vitamin Sea Legs. I forgot it and then I remembered it and was overjoyed by the name.
Yeah. Yeah, Basically, it's a bunch of different citrus juices of your choosing, yep, vodka because it's made from potatoes exactly, and so yeah, it's great.
As always, we'll post the recipe on our Facebook, Twitter, and Instagram, which you can find us there.
So we've got our quarantini, but don't worry because we're also going to be providing a recipe.
For our plus C burritas.
I still like that name.
It's a fine name. Anyways. That's our non alcoholic version of our quarantinies, and those will also be on our social media.
Okay, so my drink's in my hand mine too. I am preventing myself from getting scurvy with this delicious cocktail. Yeah, but I want to know what the heck how is this actually preventing me from getting scurvy? And what exactly is the beast of the disease.
I can't wait to tell you.
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That's promo code this podcast for three free Daily Harvest cups at daily dash haarvest dot com Daily dasharvest dot com. Everybody knows what scurvy is, right? What do you think causes scurvy?
Lack of Vitamin C?
Lack of vitamin C boom like biology section over. Don't worry, We're gonna get into more detail than that. Okay, So the first thing that I want to say, and this is because I don't want for people to feel silly if they don't know this, because I wasn't sure that I knew the actual answer to this, And that is what the definition of a vitamin is. Like, I think I kind of knew, but I think having a good
definition is a good place to start. So, a vitamin is essentially an organic compound that we cannot make ourselves, and therefore we have to get it from our diet. So unlike most animals, actually humans cannot synthesize their own vitamin C. Did you know that most other animals in the world make their own vitamin C? That they don't have to eat oranges, They don't have to worry about it.
They just make their own from sugar glucose. The only animals that don't make their own vitamin C are primates, except for the lemurs who are special and still make their own. Guinea pigs and cabybaras and some bats and some birds and that's it. Everything else. Your dog, you don't have to share your oranges with them. Yeah, they make it themselves. That is so cool. Yeah, and we just lost that ability And so thanks A lot evolution. Now we're dependent on oranges.
Thanks evolution A way to go.
So the fancy scientific name for vitamin C is a scorbic acid. Okay, we call it vitamin C because again it's a necessary part of our diet, so that makes it a vitamin. So the question is what does vitamin C do and why is it something that's so important? How can it end up causing a disease as gnarly as scurvy.
That's why I'm sitting here.
Okay, it turns out the vitamin C actually does quite a lot of things. And because I'm not a biochemist and this isn't a biochemistry podcast, I'm not going to get too I'm not going to get too in depth on exactly the mechanisms of what it does. But the most important thing that it does and the way that you get most of the symptoms of scurvy are its effects on collagen. So collagen is this protein that makes up almost everything in your bodies. So collagen makes up
your skin, your tendons. It's the bottom layer in between all of your epithelial cells. So like in your bladder, there's collagen like lining the entire thing. It forms your bones, it's in your eyes, it's in your hair, Like everything in your body is in some way made up of collagen. Okay, so it's a really really important protein, must be. And it's a protein that's made of three different strands. So it's three single proteins that have to twist together into this triple helix.
Like a pull and peel twizzler.
Yes, like a pull and peel twizzler in order to be strong, right, So you need like strong skin, strong.
Bones, strong twizzlers.
So what happens when you have a vitamin C. So what vitamin C does is it allows for that folding, for that twisting to happen, and for the bonds between those three strands of protein to be really strong. So without vitamin C, you can still make the strands of protein that make up collagen, but they can't bind together in the right way, so they're weak.
I think everyone needs to go out buy a pack of pull on peel twizzlers and try to pull apart a single strand versus an entire rolled twizzlers.
Oh my god, that's a great idea. Yeah, it's excellent.
That shows collagen.
Collagen boom boom, Oh my gosh, Aaron, way to go right now, biochemistry outreach. Oh yes, so yeah, So that's essentially the biggest, most important role of vitamin C in your body that we know about, Like we know all of the details of this, and so when you have a lack of vitamin C and you can't make strong collagen, things in your body literally start to fall apart. So let's walk through kind of the progression of how this happens.
So another thing that's important about vitamin C is that it's water soluble, which means that when you ingest it, you can absorb a lot of it, most of it, some of it, but you can't hold on to it in your body for very long. It doesn't store in your fat tissues the way that some other vitamins do, So you pee out any excess vitamin C that you have, which means that you have to continually eat it, Like
you have to eat vitamin C every day. You're not going to be able to like store up a whole bunch like something like vitamin B twelve you can have like huge stores of that in your body. So it could take a really, really really long time of being deficient in something like B twelve before you actually see any symptoms. But with vitamin C, even just about a month of having little to no vitamin C basically less than ten milligrams a day in your diet will lead
to symptoms of scurvy. It'll deplete your stores and then you'll just be running on nothing. So here's what starts to happen. In about a month of no vitamin C. You'll start to feel really tired. You'll get lethargic, and if you're, for example, a sailor out on the rough seas, you won't be able to do things like howl in that jib or swab the deck thank you. That's what I was trying to do, and I can't remember the words word.
I saw the motion, thank you.
Yeah, your captain will be like, swab the deck and you'll be like, ugh, but I'm so tired, my muscle's hurt, and you just won't want to and they'll probably throw you overboard and you'll die that way. But if you don't, then you'll just keep getting worse. You'll probably start to notice a rash, especially on your legs.
Hence the name of our quarantini.
Yeah, vitamin sea legs. So you'll notice this rash and it'll probably look like little red or purple spots or splotches, and then those splotches might get bigger and bigger until your whole leg looks like you just went on a terrible snowboarding accident. And it's like, no, have you never been snowboarding?
Because sick reference bruh.
I'm just saying, you fall a lot, and then you end up with these bruises that are like the size of your entire butt cheek, but like you know where that came from, right, because you fell a lot. But with scurvy, you just wake up with these giant bruises and you're like, I didn't even fall, I haven't moved out of bed.
And snowboarded in my dreams.
Oh did you get bruises? Anyways, you'll have these giant bruises, et cetera. Your joints will start to hurt. Do you want to know why? Of course, your muscles are breaking down and bleeding into the spaces of your joints, and all those purple spots that you're seeing, that's tiny blood vessels just breaking and leaking blood into underneath your skin.
Is it because they can't handle the pressure of like the blood flow, and the collagen is so weak.
Yeah, exactly, because you can't make any new collagen, and so collagen literally lines all of your blood vessels, Like the bottom of the cells of your blood vessels are made of collagen, and so yeah, there's just collagen lining layers and layers of your blood vessel. So when that collagen becomes weak, then it just starts to burst and break.
Leaky pipe leaky pipes.
And then your joints are hurting, your muscles are tired, you're bleeding under your skin, and then you might go to take a bite of I don't know, that stale bread or something that you've been eating for some reason, and your tooth might fall out because your teeth are held into your gums, and your gums are full of collagen, and your gums collagen is broken down, so they're bleeding. Your gums are bleeding absolutely everywhere.
It's horrifying.
Yeah, bleeding gums is one of the sort of hallmark signs of scurvy. So it's not really a great way to go.
Are any of the diseases we've talked about a great way to go? Would you say no, really, okay, just checking.
Yeah, I mean that's pretty much what servy is. That's pretty much how it happens. You can't make collagen, all of the collagen in your body starts to break down and you bleed out. You can really fun times if you start to bleed into the sheaths that surround your nerves. So your nerves are they're all they travel and your body sort of bundled together. A nerve is a bundle of a whole bunch of like individual nerve cells, and
they're usually surrounded by these sheaths. And if your blood vessels start to leak all over the place and leak into those sheaths, you can compress the nerves and end up with paralysis and also a lot of pain because you're compressing these nerve fibers. So that's fun.
So you die by bleeding out basically.
That's one of the ways. Yeah, that's one of the common ways that you can die is just by bleeding out. You Also, it's very common to die from secondary infection because vitamin C is also important in your immune system, and also collagen is just important in helping like all of your cells work properly, and so you can die by secondary infection because your body just can't fight anything off because it's just trying to keep you alive and doing a poor job of it. So yeah, I mean
that's scurvy. Do you have a question.
I do have a question. You mentioned briefly that vitamin C is important in your immune system all of these and I know for a while there were so many studies and products that are related to vitamin C and your immune system, the emergency packets or whatever, and if you take vitamin C, your cold will be shorter. What is what is the actual verdict? What do clinical trials show?
Great question, excellent question. Here's the thing about vitamin C. We know a lot about what happens when you do not have enough vitamin C. So if you have less than ten milligrams a day, then you will end up with symptoms of scurvy and you will probably die if you don't get access to vitamin.
C for a prolonged period of time, not just a.
Day exactly, yeah, for a daily basis, for like a month, couple months, many months. So we know that you need at least ten that's like the bare minimum. Beyond that, there is no evidence that increase amounts of vitamin C are beneficial in any way. Okay, so we know that there's a minimum that you need to have in order to function normally. There is no evidence that taking things like emergency have any effect whatsoever on your immune system.
In fact, there's been many studies and meta analyzes that show there is no additional immune boosting effect whatsoever. Okay, so it's not going to help you kick that cold faster, et cetera. There is evidence that having like relatively low levels of vitamin C, so maybe you're above that scurvy level, but you're still kind of low level, it can put you at higher risk for diseases like coronary artery disease.
So it could be beneficial to have like a little more than absolutely nothing, right, But beyond that, there's no evidence that having more than say like one hundred and fifty or two hundred, which is like the equivalent of eating a bell pepper a day, it's not any better. You don't there's no impact on your overall mortality.
Right.
Yeah, there's not even a standard number for like the recommended daily value. It totally depends on the country, So every country has their own version of the recommended daily amount. Of vitamin C and it varies. Okay, okay, but yeah, So that's the best news about scurvy is that it's
totally preventable. And even if you end up with pretty severe symptoms like gums are bleeding, maybe your bones are starting to go, you're bleeding into all your joints, all of that is reversible if you give the person vitamin C. So even pretty severe symptoms are totally reversible. So it's a very preventable and very treatable disease.
Yeah, that's cool.
Yeah, so talk to me about how we figured out that scurvy was a thing and how we got to be where we are today.
When I suggested that we add scurvy to our list of episodes, I didn't really know what I expected to find. The word scurvy reminded me of pirates and sailors and oranges and how my mom used to tell me that I was going to get scurvy because of how much candy I ate, and I would only eat broccoli with cheese poured over it.
Okay, two things, Deb's nurse too, I know. But also, broccoli is full of vitamin C, one of the highest vegetables, and two a lot of gummy candies have ascorbic acid in them.
What's up, mom? Okay, I should warn you right now though, because I mentioned the word pirates doesn't mean that I talk a lot about pirates, because I talk about sailors, and in that I include pirates, So they're just kind of lumped in with all those other ones.
That's fine.
Also, pirates didn't really keep the best records as far as I know.
I'm shocked. So they just have maps, right with dots and xes. That's all they did.
Yeah, exactly, X marks the spot, Yeah, where you'll get scurvy. Okay, But when I started my research, right off the bat, I read a line that gave me an idea of just how rich and important scurvy's role in history was. Are you ready? Yeah, quote, If we exclude straightforward famine, scurvy is probably the nutritional deficiency disease that has caused the most suffering in recorded history. WHOA, Yeah, that was
a little surprising to me. I mean, I knew scurvy must have been important, but I didn't have any idea of the scope and the scale of the history of this disease. So let me tell you tell me. Let's start at the beginning. Scurvy is mentioned in several early texts, starting as early as fifteen hundred BCE in ancient Egypt. Yes, we're finally back in Egypt in the Ebers Ebers papyrus. I don't know how you pronounce it. It's a medical papyrus.
It has also been found in writings from ancient India, Greece, Rome, China, et cetera, dating back thousands of years. For the most part, these ancient texts focus on the clinical description of scurvy and recommendations for treatment, rather than identifying risk factors or any sort of pattern in disease incidents. Interesting, but it's pretty much a certainty that the disease existed during this time due to seasonal scarcity, crop failure, or during times
of crisis like prolonged sieges during warfare. Interesting that there doesn't seem to be a consistent history of the burden of scurvy throughout these early years. There could be several reasons for this. For instance, if you were in the middle of a prolonged siege with little food, you probably had multiple nutritional deficiencies, and so scurvy could have had different appearances depending on the exact conditions of your setting.
But what I find really interesting about scurvy in these texts is not the apparent gap in its history, but that effective treatment for the disease was discovered, lost, rediscovered, debunked, rediscovered, ignored, rediscovered, et cetera.
Oh, my god, for thousands.
Of years, actually thousands of years. That ancient Egyptian papyrus that I mentioned earlier, it recommends a diet of fresh fruit and vegetables to cure the condition. Whoa in fifteen hundred PCE, thirty five hundred years ago.
Wow.
And yet despite this knowledge, millions of life would be lost due to scurvy in those thirty five hundred years.
Wow.
Isn't that crazy?
That is really crazy.
I'll tell you why. I don't worry.
I was gonna say, it's just because, like nobody paid attention like that, so much of ancient Egypt was lost for so long.
It was. But it's more complicated than that.
Oh good.
Yeah. From around the fourth century AD or so, scurvy rarely shows its face and writings for about a thousand years. In the fourteen hundred, scurvy suddenly picks up steam and is everywhere. Can you guess why that might be.
Travel? Yeah, I thought I was going to get it wrong.
Because people started sailing really long distances, which meant potentially long periods of time without any fresh fruit or vegetables. As a result, descriptions of scurvy during this time and the next few hundred years focus on it as being a disease of sailors, including pirates, which would of course complicate things when trying to identify the cause of the disease. Yeah,
but I'll get to that. The more that a culture or country was involved in oversea trade, exploration, or colonization of distant lands like Portugal looking at you, the more we see scurvy descriptions. And obviously there were many names for the disease. In Portugal, it was known as the curse of the mouth, for.
Instance, bleeding those gums.
We know that scurvy started appearing more and more in the fourteen hundred, fourteen and fifteen hundreds because people were sailing longer and longer distances. But why did people start doing this? Oh, why did they start sailing longer and
longer distances? Then the simple answer is that shipbuilding technology had been greatly advanced by Portuguese sailors during that time, and better ships combined with better navigation like improved compasses, meant that you could point in a specific direction and actually go there, rather than just crossing your fingers and hoping for the best. But why this surge and navigational technology.
There's a point to this rabbit hole. Let's take a quick look at what happened between the years thirteen fifty and fifteen hundred. If you remember from the Plague episode, the Black Death took place from around thirteen forty seven to thirteen fifty two, during which time it wiped out a third to a half of the entire population of Europe. As I mentioned during that episode, the consequences of such
enormous population loss were incredibly far reaching. Oh Before the plague, most books were in Latin, making them largely inaccessible to the majority of the population, But after the plague many were translated into the vernacular, making education much more widely acceptable. Also, the economy boomed because so many people suddenly had more disposable income than they knew what to do with the result of multiple inheritances from so many of their relatives dying.
Oh my god, the overland silk road connecting to Africa, Asia, or connecting Africa, Asia and Europe was dangerous, not fast enough to keep up with demand, and there were too many middlemen to pay for your goods to be delivered. This created a demand for an alternate route between Asia and Europe, which led people to the sea to venture
on these long voyages with no end in sight. During these long months at sea, sailors primarily survived on preserved rations, stopping occasionally to restock their stores, but the lack of fresh vegetables and fruit led the way to a huge increase in scurvy. Portugal led the world in these long voyages, and so it's in the journals and ship logs of those sailors that we see scurvy debilitate and destroy a ship's crew, as it would for the next four hundred years.
Who from the Black Death to economic boom and technological development to exploration to scurvy. Everything is connected. Oh my god, isn't that thrilling?
That is awesome?
I mean, it's a it's a really oversimplification of things, many factors still, but that's why I love the historical context. Everything is stink and connected.
I love this so much. And I feel like I really wish that when I had taken history for most my entire life up to this point, that any teacher I had ever did things like this, Like it's.
Just so, I mean, it's so it's so silly to study things in isolation. Yeah, I agree, Even scurvy, even the Black Death, all of these things, everything is connected to shipbuilding technology. Who knew that had a link to the Black Death or scurvy or yeah, inheritance, and like.
Of course it does, because everything is connected. But like to see those connections is awesome. Yeah, oh that is so cool.
Back to scurvy. Scurvy is beginning to be mentioned more and more as a problem on these oceanic voyages. But exactly how big of a problem was it. Let's see this by the numbers. Vasco to Gama was a famous Portuguese navigator who side note died of malaria. Ooh, and was also a really big a hole. Just check out his Wikipedia page if you're bored. Sometime during his circumnavigation of Africa, Degama lost thirty men out of a crew
of one hundred and forty to scurvy. Es time, it's very and be a little higher, actually okay, and only a handful could operate the ships during times when everyone like seven or eight could operate the ships out of his whole crew because that everyone else was sick with scurvy.
So even those who didn't die pretty much everyone had everyone okay.
The numbers would have been a lot higher if they hadn't stopped for some oranges in Mombasa. Another name that you may have heard of is Ferdinand Magellan.
Yes, are you jelling? I'm jellin like Magellan. Look at him yelling. He's so not jelling. I'm jellying. I'm yelling anyways.
So Michellan, also a famous Portuguese explorer, is probably most famous for his attempt to circumnavigate the globe. His ships made it, he didn't ui He was killed in the conflict in the Philippines, but along the way, seventy six men out of the two hundred and thirty seven that started the journey died of scurvy. In an English expedition in seventeen forty to capture a Spanish treasure ship.
Pirates, I'm sorry, I'll stop.
Maybe there were fireates, I don't know. Eight hundred and fifty five men out of one thousand sailors.
Oh died of scurvy.
Died of scurvy eight hundred.
And fifty five out out of one thousand. That's eighty five point five percent.
It's very high.
Holy cow.
Yeah. An English sea captain named Sir Peter Hawkins in fifteen ninety said that during the twenty years he worked at sea, he could count at least ten thousand sailors that had died from scurvy during the Age of Exploration, So between fifteen hundred and eighteen hundred roughly and estimated two million sailors died of the disease.
Oh my god, that's big. I had no idea. Yeah.
Side note hashtag. Not all sailors. Not everyone who went on these voyages died of scurvy. Captain Cook, for instance, constantly restocked his ships with fresh fruit and vegetables wherever they stopped, and I think he had just like one case of scurvy.
Wow. Screw wow.
Yeah. And just because you were on land during this time didn't mean you were safe from scurvy. In fact, around the same time that people started sailing these long distances, they started to settle in unfamiliar, far off lands. Where they didn't really know how to survive. For instance, in the first year of the English settlement of Jamestown in Virginia, many people died of scurvy, along with many other illnesses
and just straight up starvation. Of the five hundred that arrived in August of sixteen oh nine, only sixty were left alive in May sixteen ten, oh so less than a year later. Holy cow, Yeah, Jamestown was almost like almost failed completely.
Wow.
Several French expeditions to the Great White North of Canada were also debilitated by scurvy when they stayed too long and had to overwinter in Quebec and around there.
Is that where our first hand account came from.
No, our first hand account came from the California Gold Rush.
Ah.
If you're interested in this, you can read all about these expeditions and so so so many more that we just don't have time for in Kenneth Carpenter's The History of Scurvy in Vitamin C. Clearly, scurvy had become a pretty big problem in a short amount of time, and its impact was only continuing to grow, especially as commercial
shipping increased throughout the sixteen and seventeen hundreds. With so many lives aka wealth at stake, finding a cure or preventative for scurvy was a pretty pressing matter, and you would think, based on the fact that valid remedies had been written about thousands of years before, and that many people on these voyages reported getting instantly better after landing somewhere and eating fruits and vegetables for the first time in ten weeks, that the issue of prevention or treatment
would be more about the logistics of keeping these fresh fruits on board, rather than actually identifying what it was that would stop a scurvy outbreak.
Yeah, but I'm guessing it's not from your tone.
But no, there was still no consensus amongst physicians and ship captains on what was the best anti scorbutic. But before we dismiss them as being stupid or unabsortant, whatever, let's consider how these scurvy patterns would have appeared. Okay, first, cause you're a ship captain. You notice that after weeks and weeks at sea, your crew has bleeding and swollen gums and their legs are full of sores. Yeah, you think, well, it's probably because they're lazy. They're not moving around and
Plus there's that stagnant, damp, dank air in the ship's belly. Okay, probably not helping things, Okay, probably true. Plus, if your diet is extremely limited for a long period of time, you're probably suffering from a number of different nutritional deficiencies in addition to scurvy, which makes these disease symptoms inconsistent. Okay, from case to case and from ship to ship and
journey to journey, I'll buy that. Okay. Now, treatment you get to land and begin to chow down on the food that's newly available because you're really tired of the same salted meat and porridge or whatever, suddenly everyone starts to rapidly improve. Scurvy's gone. Might be the air on land is different. You think back to what your captain pal has said about the restorative powers of and you're like, oh, okay, that could be it. Better take them back with us
before we set off again, And you do. You tell your crew to eat one lemon a day until you run out. But you do run out, and scurvy doesn't immediately reappear. In fact, it takes weeks before it starts to creep back. Okay, So maybe it's not the citrus necessarily that prevents scurvy, but you're not completely willing to give it up. So the next time you set off on an expedition, you try to find a way to
bring citrus fruit with you. Storing crates of fresh fruit on board isn't a realistic solution, since they would all spoil before you got to your destination. Yeah, so maybe you make a drink out of it to store it. But you have to preserve it in some way, like maybe you boil it. So the next time you go you bring barrels of boiled lemon drink, which, little do you know, is actually useless against scurvy because the boiling actually inactivates the vitamin C.
Yeah it does, guys, it does.
When your crew gets sick from scurvy even while drinking the lemon juice, you're like, well, okay, I guess it's not citrus. And the links between what caused scurvy, what prevented it, and what treated it, they just weren't very straightforward, all right. Throw into that the fact that scurvy was also successfully treated by certain plants and the consumption of fresh meat, and you can see why it remains such a mystery and problem for so long, even with all this knowledge.
It's interesting though that in Egypt their remedy was just a blanket fresh fruits and vegetables, which is more broad, right, We're not trying to get so specific, like you need to have a citrus fruit. It's interesting, but I buy it. I guess they're just like, it's hard.
It's interesting, and it's I mean, I do think, I do think that we have a tendency to look back negatively on the observational powers for sure people and I think that's not fair necessarily considering the context which they live.
Right, Yeah, and I really I think the way that you put it in context is really it makes it a lot more clear.
So thank you, of course, but people had to do something. Money and goods, I mean, lives are being lost in walks. James Lynde, an officer in the British Royal Navy who in the seventeen hundreds decides to run a clinical trial for scurvy curatives. Oh my gosh, wow, very exciting. Yeah, I'm not sure that it would pass a medical ethics
review board today. That's not really the issue. They usually wouldn't know one group of men with scurvy would be given oranges and lemons, another apple cider, and a third nothing okay, And there were other treatments in there as well. As you might predict, the ones who ate the oranges and lemons recovered the fastest, followed by the apple cider group, and the third group just didn't get better.
Did they even actually give them oranges or did they let them die?
No? I don't know. This was a pretty resounding answer though, to how to prevent scurvy eat citris.
YEA.
Lynde wrote up his results and thoughts, which were widely read, but it would take about forty years for his advice to be heated. In the late seventeen hundreds, the practice of providing lime or lemon juice to British sailors began, hence the nickname lamey. Also, the words for lemon and lime were interchangeable, both in English and many other languages. As we have leman, we have learned.
I have a question, Yeah, you keep saying that they would eat lemons. Would they just like chowed out on? Were lemons different back then? Because I cannot imagine just chowing down on a lemon.
Mostly it would be like lemon juice is that they would do.
So they would maybe add sugar or Okay, yeah, I was just picturing them like here son true on this lemon, and I was like, wow, people were bowled back then.
No, no, no, So even though sailors were being given lemon and lime juice, this didn't really mean that Scurby disappeared at all. Throughout the eighteen hundreds. It still popped up on some of the ships that were giving their crew lemon juice, mostly because during the preparation the vitamin sea was inactivated in some way. But it also started appearing more and more on land in prisons, for instance, where certain prisoners were denied potatoes and onions. I don't
know why. In California, gold rush country, like our first hand account, so if you wanted to try your hand at gold prospecting, you had to either travel by land in a wagon across the entire US. You could travel by sea from a port like Boston all the way around the tip of South America and back up. Or you could take a boat down to Panama and walk across the narrowest part of the country so there was no canal yet, and then you would take a boat on the inside of Panama up to northern California.
Wow.
But basically the journey was very long and scurvy was almost inevitable, and if you didn't come down with scurvy on your way to California, you were sure to get it once you were there. Oh God, That part of California was fairly remote at that time with few farms, so gold miners mostly ate flapjacks and molasses.
Yeah, forty nine or flapjacks. That's the thing, m h.
If you wanted to eat onions or potatoes, get ready to fork over all of the gold that you found.
That's so man capitalism right starts way back when.
Scurvy was also really common in many Arctic and Antarctic expeditions unless they found enough seals or penguins to eat, as long as they ate the meat mostly raw. Unlike humans, not all animals as we meant, and have to acquire their vitamin C through diet, and so if you ate the flesh of these animals that produce their vitamin sea like many people who actually who are native to those parts of the world, they would just eat raw or barely barely cooked meat and beautiful Planish vitamin CEA.
See your on that penguin breast. Yeah, that's all you need.
It's very cool.
I like that a lot.
Also, during the Great Famine in Ireland in the eighteen forties, scurvy appeared alongside starvation since the potato crop, which had failed, was the usual source of vitamin C for those populations. In the late eighteen hundreds and early nineteen hundreds, scurvy starts appearing unexpectedly in a strange population babies born to wealthy families.
Oh oh, I know exactly where this.
Is going from. Yep. Basically, these mothers weren't choosing to breast feed, and instead they gave their children formula which they could afford to buy, mixed in with milk which had been pasteurized and it's vitamin C inactivated.
Yeah.
In the past, these mothers would have given their infant to a wet nurse, so they kid would have gotten vitamin C that way.
Yeah, because you your breast milk is full of vitamin C as long as the mother has adequate vitamin C.
Yeah, intake. Amidst all these outbreaks of land scurvy was a renewed interest in finding out what the cause of the disease really was, and people had some nifty new ideas. In most of the episodes of this podcast, this is when germ theory pops up as a shining beacon to light the way for vaccines and antibiotics. But not so for scurvy. No, not so no, because scurvy isn't an infectious disease. Yeah, but that's not what a handful of people thought in the mid eighteen hundreds.
Ooh fun.
So when germ theory began to catch on pause for laughter, Sorry, it was trendy to call every disease contagious. I love this, isn't it amazing? Yeah?
But it also I do feel like, to their credit, scurvy has a lot of symptoms that I would totally believe seem infectious. Right, you're bleeding from your gums, You've got these sores and sores everywhere like that. It totally looks infect and you can often get secondary infections on top of it. So well.
And also it doesn't usually happen to just one person.
Yes, that's true. Yeah, it's like groups of people. Yeah.
For instance, the guy who showed that tuberculosis was contagious, his name is Jean antoine v. I mean, I don't know how you say his name said quote. Scurvy is a contagious miasm comparable to typhus, which occurs in epidemic form when people are closely congregated in large groups. It is ridiculous to suppose that a lack of fresh vegetables is the cause of the disease. And we're laughing at you. Sorry from.
Later, No, I mean, yes, we're laughing at you. But also it's an acute way.
Yeah.
Sure.
Another person suggested that lime juice was effective because it acted as an antibacterial mouth wash. Oh.
I love that.
These opinions were in the minority, but it just speaks to the fact that there was still active debate on the cause and thus the treatment of scurvy. Viewing a disease as a deficiency rather than as a positive state was a really difficult thing for people to conceptualize, especially when everyone was looking for the thing, pathogen, toxin, whatever that actively caused a disease. It was way past time
for some real experiments to begin. Fortunately, in the nineteen hundreds, experimental studies of scurvy became popular and more importantly possible, thanks to a very lucky choice of animal model.
Oh my god, I was just gonna say, how could they have done? Did they just happen to choose guinea pigs? Yeah?
Are you serious? Okay, Okay, So there's a reason behind that.
This is I am amazed right now. Yeah, because of all the animals, a freaking guinea pig you choose? Yep. Oh my gosh.
I don't remember if we've talked about what animal models are before in this podcast.
I don't know that we've kind of mentioned them, but we haven't explained them necessarily.
Yeah. Yeah, I mean basically, in medical research, if you're trying to learn more about a human disease or a treatment for a disease, you can't really do a lot of experimental research on humans directly, so it's really important to have an animal in which the disease acts similar to the way it does in humans.
Yeah.
Anyway, the issue of an appropriate animal model for scurvy had come up before, because, as I mentioned, some animals can synthesize their own vitamin C. So rats had been a popular lab animal at this time. Lab rats and pigeons actually, hm, but lab rats were viewed as like infection carrying and gross, like the tide had turned against
rats around this time and they were really gross. But guinea pigs have started to be imported as pets for children and as little just cute things, and so possibly lab animals.
Oh my god.
Says some guy named Axel Holst, somewhat randomly chose a guinea pig as a model for scurvy and it just happened to work.
The amount of coincidence in science and scientific discoveries is phenomenal.
Yeah, So now the experiments could begin and they would show that scurvy was directly related to diet, and that fresh fruits, vegetables, raw milk, some kinds of meat prevented scurvy. There are so many important names that contributed to this research, but I want to quickly shout out doctor Harriet Chick, whose lab in London consisted almost exclusively ill women because all the men were at army labs during World War One.
I love, and her research showed that the amount of raw milk fed to a guinea pig determined whether or not the animal would get scurvy.
Wow, Harry, Harriet.
So they knew what scurvy, So they knew that scurvy was related to diet. But what was the unifying thing in all of these anti screabutic foods Vitamin C, which at that point was still unknown. Yeah, it was just called vitamin C because vitamin A and B had already been found as nutritional factors which that were necessary for the growth of rats.
Wait, so they just found these compounds and they just were like, Okay, we'll call this one vitamin A, and we'll call this one vitamin B. And so with this when they were trying to figure out scurvy, they were just like, well, we know it's something different, so we're gonna call it vitamin C H. But we have no idea what it is.
I was just a numbering system, a naming system.
For things they don't know. Yeah, that's amazing.
I think A and B might have been known. I'm not sure about that.
Yeah, C was not. That is so hilarious.
Yeah. In nineteen thirty, a Hungarian chemist named Albert sent Gayorgi isolated a compound which was later named ascorbic acid, also anti scorbutic ascorbic. Oh, you just blew my brain down, what's up? And so that was discovered to be the vitamin C. That so many people had been looking for, which would get him a Nobel Prize actually for that effort. So now that the compound was isolated and described, a pharmaceutical company immediately took out patents to commercially produce the vitamin,
of course, and make a fortune no one. But eventually access to vitamin C became very cheap and easy. And it's also in a lot of fresh fruits and vegetables.
Yeah, did people figure that out pretty quickly? They were like, oh, this is in tons of everything, that right?
But oh yeah, okay, yeah, yeah, No, it was mostly it was testing these these foods, okay, such for that they were all found relatively quickly, okay throughout Once once vitamin C was discovered, though, cases of scurvy really dropped off, and there were a few cases here and there with a fad diet where you just drank green tea for that's it and honey or something seen fen fen baby.
Oh my god. But I'm guessing that scurvy didn't completely disappear. So, Aaron, tell me where do we stand with scurvy today?
I'd love to There basically are no solid numbers on how many cases of scurvy exist in the world in twenty eighteen or twenty seventeen or twenty sixteen, or the two thousands for that matter.
Okay, so it's eradicated.
It's definitely not eradicated. I've really, I feel like I've said this on a few episodes already this season. I really tried hard to find numbers on this and I couldn't.
Everyone. If you're playing a drinking game that's related to the podcasts.
Yeah, okay, anyways, CDC, who FDA, They all failed me. Nobody has numbers.
Fighting.
Yeah, I'm ready to fight with someone about this. And I have a feeling that it's in large part because because this is a disease that is so easily treatable and preventable, it's not reportable in any real way. Right, It's not something that people are necessarily keeping tabs on at national or international levels. That doesn't mean that it's gone. When you search for epidemiological information on the status of Scroovy, what you find are tons, like dozens and dozens of
case reports. Case reports are when physicians, after they see a case of something that they don't see very often, they write it up. But I found lots of these, lots of them all over the US, all over Australia, Europe. This is happening, not just in places that we in the US might think sound far away. This even happens in the United States, even as recently as the last few years. This year, I'm sure there's been cases of scurvy.
But the real question that remains about scurvy isn't even necessarily how many cases there are, but why these cases are happening. Because we know exactly what the cause is, we know exactly how to prevent and treat it, and it's very easy. You don't even need any drugs. You just need a bell pepper or a potato, or an orange or a piece of broccoli, right right, that's all it takes.
What is standing in the way of people getting heavy access to that kind of food or supplement in another way exactly.
And so that's really what it comes down to is, for the most part, the people who end up getting scurvy have a lack of access. So scurvy tends to still happen today in modern times in populations like refugee populations that might not have access to any fresh fruits
or vegetables and have a very limited diet. In terms of what they can access and what they're able to eat, because they might be getting food in like bags from organizations that send them to them right or things like that, or they might just have severe malnutrition to begin with. And so scurvy is a very very common, Like you kind of mentioned, it's a very very common syndrome that comes along with generalized malnutrition. And part of that is because since vitamin C, you can't store it in your
body for very long. It's not one of the first things necessarily that you'll end up like dyeing from, but it is something that relatively early on, like within a month or two of having not enough food, you can
end up with scurvy or symptoms of scurvy. The other populations that it can happen to are lower income populations that can't afford fresh fruits and vegetables, because the thing about vitamin C is that it breaks down relatively easily, So even if you're eating foods that in theory have vegetables in them, if they are all canned foods or they're all microwaved to oblivion, then you're not actually getting any of the vitamin SEA that might be in those foods.
So even though you're eating a can of chicken tortilla soup that has bell peppers in it, you're not getting any of that vitamin C from those bell peppers. And that's an actual real case that I found in Houston of a woman who was eating only chicken tortilla soup to try and lose weight, and she you ended up with scurvy diagnosed in Houston a couple of years ago.
Trying to wait.
Yeah, okay, yeah, yeah, And so so there's kind of we've already hit on two populations, just one kind of soup, one soup.
Did chicken see why she chose that particular soup? What brand?
And I quote chicken tortilla soup. I'm sorry, that's all I got for you anyways.
Yeah, eat your vegetables.
Yeah, I mean that's sort of the that's the long and short of it. Yeah, So it can happen in in low income populations, It can happen in displaced populations. It can happen also in populations maybe with mental illnesses who aren't eating who maybe who aren't eating at all, who, or who aren't eating fresh foods and vegetables. Maybe they're only eating toast or they're only drinking something or whatever. Yeah, so there are definitely still populations both in this country,
in every country. It definitely it is still an issue. It still happens. The only numbers that I saw some articles claimed that the overall rates of scurvy or of vitamin C deficiency rather not of scurvy necessarily could be anywhere from two percent or seven percent in countries like the US to up to forty five percent in other countries.
And the other population that it can happen to is children, whether because they're very picky eaters or because they also don't have access to foods that are fresh.
I also read something speaking of populations. Bachelor scurvy was some a term that was used frequently, and this was to refer to old older men who lived alone or widower scurvy who lived alone and this was largely in like the early nineteen hundreds and just did not eat any fresh fruit. They just ate.
Yeah, yeah, it definitely is. Older populations are especially at risk for sure, because they might not be eating much at all. As you age might be like your metabolism slows down, you're just not hungry, you're tired, or you also if you aren't working, you might not have a lot of money, et cetera. So you're eating things that Yeah, so it's definitely I haven't heard the term bachelor scurvy. Yeah, but yeah, it definitely that's a population that would definitely
be a risk for scurvy. And one thing that I found interesting is that clearly scurvy still happens, right, Scurvy still happens everywhere. All it takes is just not eating fruits and vegetables. So it's not hard to get scurvy if you think about someone only eating like toast and rice or something like jack and tortia soup. Whatever. But yeah, so that's scurvy in the world today.
Wow, Okay, very interesting. Yeah.
I had fun doing this.
I love this. I thought it was a really fun departure. I loved seeing germ theory from the other side.
Yeah we've never seen that. Yeah, how fun.
And I'm sorry there weren't more pirates.
You know, I made them enough. I just kept shoving the pirates in there.
I Mean, the thing is is that pirates were just a part of all of that. The sailors. If you want to read about sailors and pirates, let's talk about sources.
Let's okay, great transition.
By the way, So I read a book by Kenneth Carpenter which I mentioned earlier, called The History of Scurvy in Vitamin C. It is extensively well researched, is great. It's a really thorough book. Also a history of scurvy and Vitamin C by Howard Sauberlik in the book Vitamin C and Health and Disease, The Cambridge World History of Human Disease. And then a couple of articles which we'll post.
Yes, we will post all of the articles that we used on our website, This Podcast will Kill You dot com. You can find those under our episodes tab each episode. We have all of our book lists and our article lists. If you are, for some reason especially interested in any of the case reports, shoot us an email at this Podcast will Kill You at gmail dot com and I'd
be happy to send you those. You also can find us on Twitter at TPWKY and This Podcast Will Kill You on Instagram, where we post lots of pictures and cool stuff that we find about each episode.
Thank you too, Bloodmobile for providing the music for this episode and all of our episodes.
We love it.
And thanks to you for listening.
Yeah, we really like making this podcast and it makes us happy that we're not the only ones who listen to ourselves talking.
Yeah. Until next time, wash your hands
And eat a bell pepperm