Scurvy

There are other facts which seem to show that too much is attributed by Dr. Trotter to fresh vegetables. Linnæus informs us, that the Laplanders are unacquainted with the scurvy ; they feed all the winter on the fresh flesh of the reindeer. This exemption of the Laplanders from the general distemper of the north , says Pringle, “is the more observable, as they seldom taste vegetables, bread 'never.' ( Cook 's Voyages, from 1772 to 1775. vol. ii. p. 376 .)

A discourse upon some late improvements of the means for preserving the health of mariners. Delivered at the anniversary meeting of the Royal Society, November 30, 1776. By Sir John Pringle, Baronet, President. Published by their order:

Pringle, John, Sir, 1707-1782.

https://quod.lib.umich.edu/e/ecco/004801344.0001.000/1:2?rgn=div1;view=fulltext

It hath been said, that the scurvy is much owing to the coldness of the air, which checks perspiration; and it is therefore the endemic distemper of the Northern na∣tions, and particularly of those around the Baltic*. The fact is partly true, but I doubt not so the cause. In those regions, by the long and severe winters, the cattle destitute of pasture can barely live, and are therefore unfit for use; so that the people, for their provision during that season, Page  10are obliged to slaughter them by the end of autumn, and to salt them for half the year. This putrid diet then, on which they must subsist so long, and to which the inha∣bitants of the South are not reduced, is the chief cause of the disease. And if we reflect, that the lower people of the North have few or no greens nor fruit in the win∣ter, little fermented liquors, and often live in damp, foul, and ill-aired houses, it is easy to conceive how they should become liable to the same indisposition with seamen; whilst others of as high a latitude, but who live in a different manner, keep free from it. Thus we are informed by LINNAEUS, that the Laplanders, one of the most hyperbo∣rean nations, know nothing of the scurvy*; for which no other reason can be assigned than their never eating salted meats, nor indeed salt with any thing, but their using all the winter the fresh flesh of their rain-deer.

This exemption of the Laplanders from the general dis∣temper of the North is the more observable, as they seldom taste vegetables, bread never, as we farther learn from that celebrated author. Yet in the very provinces which border on Lapland, where they use bread, but scarcely any other vegetable, and eat salted meats, they are as Page  11much troubled with the scurvy as in any other country*. But let us incidentally remark, that the late improvements in agriculture, gardening, and the other arts of life, by extending their influence to the remotest parts of Europe, and to the lowest people, begin sensibly to lessen the fre∣quency of that complaint, even in those climates that have been once the most afflicted with it.

It hath also been asserted, that men living on shore will be affected with the scurvy, though they have never been accustomed to a salt-diet; but of this I have never known an instance, except in those who breathed in an air that is marshy, or otherwise putrid, and who wanted exercise, fruits and green vegetables: under such circumstances it must be granted that the humours will corrupt in the same manner, though not in the same degree, with those of ma∣riners. Thus, in the late war, when Sisinghurst Castle in Kent was filled with French prisoners, the scurvy broke out among them, though they had never been served with salted victuals in England; but had daily had an al∣lowance of fresh meat, and of bread in proportion, though without greens or any other vegetable. The surgeon Page  12who attended them, and from whom I received this information, having formerly been employed in the navy, was the betterable to judge of the disorder, and to cure it. Besides the deficiency of greens, he observed that the wards were foul and crouded, the house damp (from a moat that surrounded it) and that the bounds allotted for taking the air were so small, and in wet weather so sloughy, that the men seldom went out. He added, that a representation having been made, he had been empowered to furnish the prisoners with roots and greens for boiling in their soup, and to quarter the sick in a neighbouring village in a dry situation, with liberty to go out for air and exercise; and that by these means they had all quickly recovered. It is probable, that the scurvy sooner appeared among these strangers, from their having all been taken at sea, and con∣sequently being the more disposed to the distemper. My informer farther acquainted me, that in the lower and wetter parts of that county, where some of his practice lay, he had now and then met with slighter cases of the scurvy among the common people; such, he said, as lived the whole winter on salted bacon, without fermented li∣quors, greens, or any fruit, a few apples excepted; but, he remarked, that in the winters following a plentiful growth of that fruit, those peasants were visibly less liable to that ailment.

Among the Africans, of whose sufferings on board the slave ship Dr. Trotter has given so particular and affecting an history, corpulence seems to have been , as it were, the first stage of scurvy. “When a negro was becoming rapidly fat,'” says he, “it was no difficult matter to determine how soon he would be seized with the scurvy; so that corpulence seems here to have been the harbinger of the scurvy. Writers have been particular in noticing that this disease seldom or never produces emaciation. Dr. Trotter, upon whose information we may place full reliance , tells us, that having purposely inquired among his medical acquaintances in the navy, he did not find one who considered the wasting of the flesh or absorption of fat as a symptom congenial to scurvy . He immediately subjoins some observations of his own, that clearly indicate a connection between the scurvy and obesity (p. 98 , 99.). "In a corpulent state of the body,” he says, “the most hideous features of the disease are expressed; such are the bloated looks and countenance, & c. In a mess of midshipmen, who lived altogether on the ship’s fare, the only one he ever saw affected with the scurvy was a young man remarkably corpulent. From the whole of his observations it appears clearly that obesity predisposed his patients to scurvy, or rather was to them what cachexia is to dropsy.

Considering fresh meat, or the muscular part of animals, chemically, I see no reason why it should not be efficacious in preventing or curing the scurvy. Oxygene it contains, when raw , in a state of loose combination , though probably not in such large proportion as vegetable substances, even such as are not acid. I had noticed in travellers of great respectability passages that confirm this idea. The nations inhabiting the cold and dreary regions on the eastern shores of Asia , and the opposite coasts of America, seem to have learned from experience, that fresh, or at leaſt unsalted fish is a preventative of the scurvy, or a remedy for it .

Thus Dr. Pallas (Reise, iii. 47) describes the Ostiack Tartars of the Oby, as preparing their winter stores altogether without salt. “They are extremely apt, when disabled by age or infirmities, to become scorbutic. In winter they ravenously devour their frozen fish raw, a practice which the neighbouring Russians imitate , esteeming them a preservative against the 'scurvy.' (46.) 

Mr.Meares (Voyage, Introd. p. 30 .) speaking of an American tribe, says, “She made us sensible that the same disorder (scurvy) prevailed in her nation; and that whenever the symptoms appeared, they removed to the southward, where the climate was more genial, and where plenty of fish was to be obtained, which never failed to prove the means of their recovery.”

The reader will probably agree to consider the frozen as fresh fish. If it were possible to preserve meat on ship board, in this simple manner, one great source of the scurvy would probably be cut off. Cookery combines the oxygene anew; would our sailors eat raw animal food?

Dr. Lind, though he has full confidence in green vegetables, and affirms that the scurvy never can become a general, fatal, and destructive calamity, where they abound, and the proper method of treatment is known and pursued (p. 541.); he concludes from a number of comparative trials (p. 538), that certain patients in Haslar hospital in general grew better, notwithstanding they abstained altogether from vegetables.

"This strict abstinence from the fruits of the earth," says he, "was continued long enough to convince me, that the disease would often, from various circumstances, take a favourable turn, independent of any diet, medicine, or regimen ." We have nothing, I presume, to oppose in point of conclusiveness to such experiments made by a physician so intelligent and so experienced in this particular disease.

SECT. III

Of the appropriate Treatment of the Diabetes Mellitus.

THE principles of the treatment, as established by our cases of the disease, by the view we have given of the proximate cause, and we may further add, by the general success, consist;

1. In the prevention of the formation or evolution of the saccharine matter in the stomach.

2. In the removal of the morbidly increased action of the stomach and in its restoration to a healthful condition. 

Whatever may be the cause of the formation of the saccharine matter, it is necessary to prevent it, as on its general stimulus in the system, and particularly on the kidneys, very general affections are maintained. Besides, the means employed to prevent such formation may tend to the removal of the morbid action of the stomach and lacteal absorbents, and the increased and altered state of the gastric fluid, on which its production probably depends. Animal food, and confinement, with an entire abstinence from every kind of vegetable matter, afford the general means ; but which may be facilitated by the daily use of alkalines, calcareous and testaceous substances. The quantity of animal food should be restricted, and given in as small quantities as possible to satisfy the stomach : see page 54. 

When the urine points out the absence of the saccharine matter, and at the same time its quantity continues more than natural, containing likewise more of the extractive matter in a viscid, or tenacious form, while the appetite remains keen, it may be presumed that the increased morbid action of the stomach is not removed. It becomes then necessary to exhibit the hepatifed ammonia, with an opiate and antimonial at night, and to continue them until the morbid condition of the stomach is removed; the marks of which are, a scarcity and high coloured state of the urine, with turbidness, furnishing on evaporation an offensively smelling and saltish tasted residuum, without tenacity, accompanied with a want of appetite and loathing of food. At this time the tongue and gums will be found to have lost their florid colour, and to have become pallid. 

When such a state occurs, exercise is to be enjoined, a gradual return to the use of bread, and those vegetables and drinks which are the least likely to furnish saccharine matter, or to become acid in the stomach, with the occasional use of bitters, &c. Should this period of the disease be overlooked, and the confinement and animal food rigidly persevered in, scurvy, or something akin to it, might be produced. That such might be the termination of Diabetes, the appearances which arose, more especially in Captain Meredith's case, render extremely probable. The gripings, and offensive stools; the oiliness on the surface, and the high colour of the urine; the foetid breath and saltish taste; the great latitude and heaviness, with indifference to either eating, drinking, or moving; were strong marks of a state approaching to scurvy.

When the disease has continued long, it may leave local effects, which may prevent the entire restoration of health ; the most ample form of which might be supposed to consist in mere dilatation, or enlarged capacity of vessels, as those of the kidneys; or in a habit acquired by long continued action. Our first case shows, that these, when the disease has not been of very long duration, may be soon removed. They may, however, prove one of the circumstances retarding recovery in such a length of disease as that of our second case ; but even in this, the kidneys very early partook of apparently their ordinary action. Dissection has shown some morbid condition or derangement of the mesenteric or lacteal absorbent glands, and some altered appearance of the kidneys. There may also arise some derangement of stomach structure, of pancreas, spleen, liver, and possibly of lungs. Such sequelae would probably be sooner and more certainly formed in scrofulous habits. Whenever they occur, recovery must be retarded, if not finally prevented. They, however, will not interfere with the actual removal of the diabetic disease. We suspected some affection of the mesenteric glands, and of the stomach, in our second case; but we are warranted in alleging, that want of steadiness in the patient solely prevented the complete removal of the complaint. The nature of its sequelae, or whether they will remain, so as to maintain a state of chronic disease depending on them for its cause, requires still to be determined. Of this determination we must now continue entirely ignorant, as the patient from unsteadiness died, and was not examined after death. 

These are the general means of treatment, and they will be found adequate to the most common circumstances of the disease. We think it, however, necessary to particularise certain cases and states of the complaint. The former, are those of short, or long continuance, acute or chronic in degree; the latter comprehend the progress and fleps of recovery. It is necessary to attend to these distinctions, as they must direct the remedies and regimen to be employed. 

When the disease has been of short duration, an entire use of the animal diet may be immediately pursued, with an abstraction of all vegetable food and fermented drink which may have been formerly taken. In this state of the disease it may be acute arid then the diet should be spare; blood-letting and blistering may be necessary, with the use of opening and diaphoretic medicines. But when the disease has been of long continuance, especially in persons advanced in years, and whose habits have been luxurious in point of living, it may be proper to regulate the plan of cure by gradually adopting the animal diet: see the case of the Gentleman of 77 Page 179 and Dr. Stoker's continuation, page 253. 

On the removal of the general symptoms, and the return of the urine to a natural condition, which may be ascertained by a comparative examination with the healthy standard of it, as described by Mr. Cruickshank, vegetable substances may be cautiously tried. In the selection of which, the preference should be given to those least likely to furnish sugar, or excite disturbance in the stomach. The urine should now be very frequently examined, and on any appearance of a return of the diabetic state of it, the animal diet must be again strictly renewed. In this way the diet must be varied, until we are certain not only of the removal of the disease, but of the disposition to it. In the prosecution of the plan much steadiness and perseverance are required. We have to lament, that our mode of cure is so contrary to the inclinations of the sick. Though perfectly aware of the efficacy of the regimen, and the impropriety of deviations, yet they commonly trespass, concealing what they feel as a transgression on themselves. They express a regret, that a medicine could not be discovered, however nauseous, or distasteful, which would superfede the necessity of any restriction in diet. 

The vegetable substances we have hitherto found the safest, in the change from the animal diet, are, broccoli, spinach, cauliflower, cabbage, and lettuce. These do not seem to furnish sugar when prudently used in the diabetic stomach, after a proper adoption of the animal diet ; but under certain circumstances they have been supposed to produce an acid urine : see the Cases of Mess. Houston and Thomas. When these vegetables have been safely taken, a return to a very small quantity of bread has reproduced the saccharine matter in the urine, and the general symptoms of distress, as thirst, &c. It becomes, therefore, a principal object in the treatment, to vary the articles of diet, so as to gratify the earned desire of the patient, without bringing on a return of the complaint.

[Translated from French]

All Paris has recently been upset about milk made from animal brains; which does not prevent all Paris today from drinking without disgust, and without remembering its forgotten emotion, the unhealthy beverage called café au lait.

Like adulterated milk, horse flesh, at a time when butcher's meat is so expensive, is said to enter Paris fraudulently in large quantities, and is sometimes sold for beef. It is curious and useful to examine whether this flesh in fact deserves the reprobation with which it is subjected.

Let us first seek what is the primary cause of the prejudices preserved to this day against horse flesh, used as food. Keysler, in his work entitled: Antiquitates selectœ septentrionales, after having demonstrated the good qualities and excellence of this flesh, teaches it in these terms:

— " The ancient Celts, northern peoples, sacrificed horses to their gods, and as the flesh of these victims composed the principal dish of the solemn feasts which followed these sacrifices, the horror which one had of these false acts of religion spread to all that entered into them; hence the zeal of the clergy, who, to destroy the heretical custom, believed it necessary to regard horse flesh as impure, and those who used it as filthy.
" The passage from a letter addressed on this occasion by Pope Gregory III to Saint Boniface, bishop of Germany, is too remarkable not to be quoted here.
"You have shown me," said this pontiff, "that some ate wild horse, and most of them domestic horse; Do not allow this to happen henceforth, most holy brother; abolish this custom by all means possible to you, and impose on all horse-eaters a just penance. They are filthy, and their action is execrable."
"It is since that time," adds Keysler, "that our ancestors have continued to be deprived of horse flesh, and this to their great detriment, magno rei familiaris de trimento."

This shows that horse flesh was very good and much sought after in those remote times. Let us prove that it has not changed in nature, and that it suits the stomachs of our contemporaries as well as those of our ancestors.

We owe the following documents to Mr. Baron Larrey, one of the most distinguished witnesses and instruments of our ancient military glory.
"The muscular flesh of the horse, especially that of the hindquarters, can be used to make soup, especially if a certain quantity of bacon is added; it can also be used in grilling and in beef à la mode, with the appropriate seasoning.
" Liver can also be used and prepared in the same way as that of horned beasts; it is even, it seems, more delicate than that which comes from them. This dish, continues Mr. Larrey, was especially sought after by our companions in the Russian campaign, who all spoke highly of it.
"Everyone knows, moreover, that horse flesh is the principal food of the peoples of Asiatic Tartary. I myself have very often had the soldiers and wounded of our armies use it with the greatest success.

"In some of our campaigns on the Rhine, Catalonia and the Maritime Alps, I have had it given to our soldiers on several occasions; but it was especially during the siege of Alexandria, in Egypt, that this meat was used to great advantage. Not only did it preserve the life of the troops who defended this city, but it also contributed powerfully to the healing and recovery of the sick and wounded, whom we had in great numbers in the hospitals; it also contributed to the disappearance of a scorbutic epidemic (scurvy) which had seized the whole army. Regular distributions of this meat were made daily, and fortunately the number of horses was sufficient to lead the army until the time of the capitulation. These animals, of the Arab breed, were very thin, due to the shortage of fodder, but they were generally young. To answer the objections which had been made by many prominent figures in the army, and to overcome the repugnance of the soldier, I was the first to have my horses killed and to eat this meat.
"At the siege of El-Arych in Syria, after having consumed the camels that we had, to feed the sick and wounded that were left in the fort, we were obliged to resort to horse meat, which served us very well.
"At the battle of Eylau, during the first twenty-four hours, I had to feed my wounded again with horse meat prepared in soup and in beef in the fashion; but, as we did not lack seasoning objects on this occasion, the wounded hardly distinguished this meat from that of beef. We must also say that the horses that were dedicated to this use were young and in satisfactory shape.
"After the battle of Eslingen, isolated on the island of Lobau, with the greater part of the French army and about six thousand wounded (the communication bridges having been broken), we were deprived of all resources for three days. To calm, in this critical circumstance, the hunger and impatience of these unfortunates, I had them make soup with the flesh of a fairly large quantity of horses scattered on this island, and which belonged to generals and senior officers. The breastplate of the dismounted and wounded horsemen themselves served as a pot for the concoction of this meat, and instead of salt, of which we were entirely devoid, it was seasoned with gunpowder. I only took care to decant the broth by pouring it from one breastplate into another through a cloth, and after having left it to clarify by rest. All our soldiers found this meat and this broth of a very good quality. Here I also gave the example by the sacrifice of one of my horses, and I made use of this same food, with this difference that I had been able to keep some salt and a little biscuit, which I used to make soup. Marshal Masséna, commander-in-chief of these troops, was very happy to share my meal, and seemed very satisfied with it.
"Thus," says Mr. Larrey, "experience shows that the use of horse meat is very suitable for human food; it seems to me especially very nourishing, because it contains a lot of osmazome. The taste is also pleasant; only this flesh is more or less stringy, according to the leanness and age of the animal. Why, adds this famous surgeon, not take advantage for the poor class and for the prisoners, of the horses that are killed every day in Paris? "

Doctor Berthollet, nephew of the famous chemist of the same name, and who practiced medicine for a long time in Taranto (kingdom of Naples), wrote that the people of this city ate horse flesh with pleasure; that it was sold there publicly by the pound, and that the sale was always prompt. The liver was considered a delicate piece; it was prepared in the same way as that of other livestock.

Géraud, a distinguished physician of the last century, advances in a very remarkable work, "that one would derive a very great utility from horse flesh, by using it as food."... After some developments, he adds: "A considerable quantity of horse and donkey flesh stealthily enters the large cities, and especially Paris, which, after the barrier, is sold under the name of beef, veal, and this meat is given at a lower price than that under the name under which it is sold... Why should we not have butcher's stalls where this meat would be publicly sold? It would be a great resource, especially in these times, when the flesh of ordinary animals is at a price that hardly allows the unfortunate to feed themselves with it. "

Géraud attributes several illnesses of the workers to the deprivation of meat... He would prefer horse flesh for them to the viscera of animals, such as the lungs, liver, spleen, stomachs, which the tripe sellers provide them... "If the sale of horses were free," he says, "it would be better and more advantageous, because the animal would be killed while still in good health, without waiting for an illness, an accident or old age to make it perish."

Let us add to these notions that at the time of the revolution, Paris was fed largely, for the space of three months, only with horse meat, without anyone noticing it and without the slightest accident resulting from it. Mr. Huzard has the proof; no one was any more able by their position to know what was happening there in this respect.

These precious details of facts observed on a large scale, at points of the globe far removed from each other, and in completely opposite circumstances, tend to demonstrate that horse flesh can be used, without inconvenience, as food.