Scurvy

Page 369:

During the winter of 1866-7, and following summer, Captain Libby, of our Telegraph Service, with nearly forty men, stopped at this inaccessible place. At Grantley Harbour, a good titation, and other houses (which have been left there), and portions of the telegraph line, were built by these men. It was, as before stated, the spot intended for the Bering Strait cable “landing” on the American side, and it has been already mentioned as the central point at which the natives of Kotsebue and Norton Sounds, and the neighbouring country, meet the Tchuktchis from the Siberian coast. Many whalers annually visit this harbour for trading purposes, and I expect to hear of a permanent white settlement being formed there. The experience of the earlier Arctic explorers, as of our telegraph men, shows that it is a good spot to winter in. Some of our men there, at one time very short of provisions, lived for months at an Indian village near Cape Prince of Wales. Supplies from the resources of the country were very uncertain. In 1866-7, the natives in the neighbourhood were almost starving, and were at one time reduced to boiling down their old boots and fragments of hide, in order to sustain life. “ Yet,” said a correspondent (a member of our expedition), writing from thence, “ the party under Captain Libby although without bread or flour for some weeks, escaped the scurvy entirely. The generally received opinion that scurvy is generated from want of flour, does not seem to be correct. At the station (Fort St. Michaers), where plenty of flour was received, and freely used, they wore afflicted with this disease; while at Port Clarence, where they were almost entirely dependent upon the resources of the country for some weeks, living upon walrus and seal meat, without flour or bread, no symptom of scurvy made its appearance.”

Page 293:

https://archive.org/details/in.ernet.dli.2015.37317/page/n293/mode/2up?q=Scurvy 

Some few of the workmen had suffered from frost-bite and scurvy. A propos of the latter terrible scourge, it is to be remarked, that our men at Port Clarence, the worst fed of all our parties, who had lived for a long time on a native diet of walrus and seal blubber, had not suffered from it at all, while those in Norton Sound, who got a fair amount of flour, &c., from the Russian posts, suffered severely from the disease.

Leaving Camp Daly on the 10th of February I arrived at Marble Island on the 14th. I shall not dwell long on the various commonplace incidents encountered, the kindnesses of the officers of the whaling ships, the wonderful but pleasant change to a civilized abode once more. However, it was a suffocating feeling which first accompanied that change, as I had left the temperature of the igloo for that of the ships, generally kept at about 77 * F. I found a great deal of scurvy, that bane of the Arctic sailor, prevailing among the ships and the large number of crews. 

The greater variety of animal life in the frigid zones over the vegetable (the latter having hardly an edible representative in the whole arctic flora) makes it the main dependence on which the polar voyager must rely to secure exemption from that disease. Every exertion should be made to make the procurement of game as certain as possible by being well provided with the very best of arms, ammunition, and hunting implements and above all good native hunters. 

Sir John Ross thought scurvy was produced by the want of fresh bread, yet my party was without fresh bread for two years, and nearly a year without bread of any kind, certainly a fair enough test to exclude it from any of the essential causes. Still the use of fresh bread as an auxiliary prophylactic can not be too strongly dwelt upon. Sir Edward Perry believed that scurvy's principal cause was in the clammy moisture of the ships' quarters, especially when the crew were compelled to sleep in damp bedding. Yet I found no dampness whatever in most of the whaleships suffering with the disease. Innumerable cases where large parties of men have been long subjected to this inconvenience without incurring it makes it a mooted question whether such value can be attributed to it as was by such eminent authority as Sir Edward. 

In the employment of a fresh animal food in the Polar zones a great obstacle is the antipathy with which such a diet of fish- eating animals is received. The flesh of the reindeer and musk-ox is at once acceptable, but the walrus, seal and polar bear, have peculiar flavors which with some people it is almost impossible to overcome. The most tenacious epicures are to be found in the forecastle. The educated officer, whose mess table in the past may have been a animated market report, can, with an honorable incentive ahead of him, more readily relinquish his bill of fare than can the foremast hand with his hard tack, salt junk and bitter coffee, to which he is so firmly wedded.

p331, John Lucas: "Sir, —A propos the annotation appearing under the above heading in The Lancet of June 24th, pp. 1048-9, I would beg permission to observe that almost every medical man in India will be able to endorse the views of Dr. Moore, to which you refer. Medical officers of native regiments notice almost daily in their hospital practice that—to use your writer's words—"insufficient diet will cause scurvy even if fresh vegetable material forms a part of the diet, though more rapidly if it is withheld." Indeed, so far as my humble experience as a regimental surgeon from observations on the same men goes, I am inclined to think that the meat-eating classes of our Sepoys—to wit, the Mahomedans, especially those from the Punjaub—are comparatively seldom seen with the scorbutic taint ; while, on the contrary, the subjects are, in the main, vegetable feeders who are their non-meat-eating comrades, the Hindus (Parboos from the North- West Provinces and Deccan Mahrattas), especially those whose daily food is barely sufficient either in quality or quantity. A sceptic may refuse to accept this view on the ostensible reason that though the food of the meat-eating classes be such, it may, perchance, contain vegetable ingredients as well as meat. To this I would submit the rejoinder that as a matter of fact, quite apart from all theory and hypothesis, the food of these meat-eating classes does not always contain much, or any, vegetables. In the case of the semi-savage hill tribes of Afghanistan and Baluchistan, their food contains large amounts of meat (mutton), and is altogether devoid of vegetables. The singular immunity from scurvy of these races has struck me as a remarkable physiological circumstance, which should make us pause before accepting the vegetable doctrine in relation to scurvy et hoc genus omne."

http://www.empiri.ca/2017/02/#id2

"Sir, I was struck by two independent observations which occurred in your columns last week in regard to the etiology of scurvy, both tending to controvert the generally received opinion that the exclusive cause of the disease is the.........

prolonged and complete withdrawal of succelent vegetatables from the dietary of those affected. 

Thus Mr. Neale, of the Eira Arctic Expedition, says: "I do not think that spirit or limejuiceis of much use as an antiscorbutic ; for if you live on the flesh of the country, even, I believe, without vegetables, you will run very little risk of scurvy."

Dr. Lucas writes: "In the case of the semi- savage hill tribes of Afghanistan and Beluchistan their food contains a large amount of meat, and is altogether devoid of vegetables. The singular immunity from scurvy of these races has struck me as a remarkable physiological circumstance, which should make us pause before accepting the vegetable doctrine in relation to scurvy." These observations do not stand alone. Arctic voyagers have long pointed out the antiscorbutic properties of fresh meat, and Baron Larrey, with regard to hot climates, arrived at the same conclusion in the Egyptian expedition under Bonaparte, at the end of last century."

President's Address: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC2036671/pdf/medcht00012-0097.pdf

"Dr. Charles Henry Ralfe, the son of a naval officer, was born in 1842. He received his medical education at the Bath United Hospital and King's College, London. After having been House Surgeon at the Lock, he entered at Caius College, Cambridge, and graduated with honours in Natural Science. He first came before the public as a general practitioner at Doncaster, but in 1869 he established himself as a physician in London. He soon obtained the appointment of Registrar at Charing Cross, and availed himself of the opportunities there afforded to work at Physiological Chemistry. His labours bore fruit in 1873 in the shape of a small but useful handbook on that subject. Shortly after this he became attached to St. George's Hospital as Demonstratorof Physiological Chemistry, and to the Seamen's Hospital at Greenwich as Physician. He used his special knowledge and his clinical opportunities in the investigation of scurvy, a disease which cannot be said, as yet, to have given up its secret, but which Dr. Ralfe threw light upon in pointing out the deficiency in it, not only of potash, but of the alkaline phosphates. He left St. George's and Greenwich on becoming in 1880 Assistant Physician to the London Hospital, which he continued to be until within a few months of his death. Dr. Ralfe died of phthisis, sequent on diabetes, on the 26th of last June, at the age of fifty-four. He was a type of the best kind of physician. He used his opportunities for advancing knowledge with ability and success, and without the purpose of an advertiser. He was cultivated and well-read, upright and honorable, kindly and personally attractive. His loss will be regretted by all who knew him.

p495 - https://www.google.com/books/edition/The_Lancet/MJFPAAAAYAAJ?hl=en&gbpv=1

SCURVY. 

Dr. Buzzard, in a letter which appeared in our columns last week, considers the fact that the crew of the Eira were supplied with preserved vegetables tells against the supposition advanced by Mr. Neale, that if Arctic voyagers were to feed only on the flesh of the animals supplied by the country they would be able to dispense with lime-juice. The truth is, it is an open question with many as to the relative antiscorbutic properties of preserved vegetables, and whether under the circumstances in which the Eira's crew were placed they would have been sufficient, in the absence of lime-juice and fresh meat, to have preserved the crew from scurvy. 

A case in point is the outbreak that occurred on board the Adventure, in the surveying voyages of that vessel and the Beagle. The Adventure had been anchored in Port Famine for several months, and although "pickles, cranberries, large quantities of wild celery, preserved meats and soups, had been abundantly supplied," still great difficulty had been experienced in obtaining fresh meat, and they were dependent on an intermittent supply from wild-fowl and a few shell-fish. Scurvy appeared early in July, fourteen cases, including the assistant-surgeon, being down with it. At the end of July fresh meat was obtained; at first it seemed to prove ineffectual, but an ample supply being continued, the commander was able to report, by the end of August, "the timely supply of guanaco meat had certainly checked the scurvy." This is an instance in which articles of diet having recognised antiscorbutic properties proved insufficient, in the absence of lime-juice and fresh meat, and under conditions of exceptional hardship, exposure, and depressing influence, to prevent the occurrence of scurvy. So with the Eira, we believe that had they not fortunately been able to obtain abundant supplies of fresh meat, scurvy would have appeared, and that the preserved vegetables in the absence of lime-juice would have proved insufficient as antiscorbutics. 

This antiscorbutic virtue of fresh meat has long been recognised by Arctic explorers, and, strangely, their experience in this respect is quite at variance with ours in Europe. It has been sought to explain the immunity from the disease of the Esquimaux, who live almost exclusively on seal and walrus flesh during the winter months, by maintaining that the protection is derived from the herbage extracted from the stomach of reindeer they may kill. In view, however, of the small proportion of vegetable matter that would be thus obtained for each member of the tribe, and the intermittent nature of the supply, it can hardly be maintained that the antiscorbutic supplied in this way is sufficient unless there are other conditions tending in the same direction. And of these, one, as we have already stated, consists probably in the fact that the flesh is eaten without lactic acid decomposition having taken place, owing either to its being devoured immediately, or from its becoming frozen. The converse being the case in Europe, where meat is hung some time after rigor mortis has passed off, and lactic acid develops to a considerable extent. This seems a rational explanation, and it reconciles the discrepancy of opinion that exists between European and Arctic observers with regard to meat as an antiscorbutic. In bringing forward the claims of the flesh of recently killed animals as an antiscorbutic, it must be understood that we fully uphold the doctrine that the exclusive cause of scurvy is due to the insufficient supply of fresh vegetable food, and that it can be only completely cured by their administration ; but if the claims advanced with regard to the antiscorbutic qualities of recently slaughtered flesh be proved, then we have ascertained a fact which ought to be of the greatest practical value with regard to the conduct of exploring expeditions, and every effort should be made to obtain it. Everything, moreover, conducive to the improvement of the sailor's dietary ought to receive serious consideration, and it has therefore seemed to us that the remarks of Mr. Neale and Dr. Lucas are especially worthy of attention, whilst we think the suggestion of the former gentleman with regard to the use of the blood of slaughtered animals likely to prove of special value."

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