Scurvy

Scurvy is a disease resulting from a deficiency of vitamin C, which is required for the synthesis of collagen in humans. The chemical name for vitamin C, ascorbic acid, is derived from the Latin name of scurvy, scorbutus, which also provides the adjective scorbutic ("of, characterized by or having to do with scurvy"). Scurvy often presents itself initially as symptoms of malaise and lethargy, followed by formation of spots on the skin, spongy gums, and bleeding from the mucous membranes. Spots are most abundant on the thighs and legs, and a person with the ailment looks pale, feels depressed, and is partially immobilized. As scurvy advances, there can be open, suppurating wounds, loss of teeth, jaundice, fever, neuropathy and death.

Scurvy was at one time common among sailors, pirates and others aboard ships at sea longer than perishable fruits and vegetables could be stored (subsisting instead only on cured and salted meats and dried grains) and by soldiers similarly separated from these foods for extended periods. It was described by Hippocrates (c. 460 BC–c. 380 BC), and herbal cures for scurvy have been known in many native cultures since prehistory. Scurvy was one of the limiting factors of marine travel, often killing large numbers of the passengers and crew on long-distance voyages. This became a significant issue in Europe from the beginning of the modern era in the Age of Discovery in the 15th century, continuing to play a significant role through World War I in the 20th century.

Today scurvy is known to be caused by a nutritional deficiency, but until the isolation of vitamin C and its direct link to scurvy in 1932, numerous theories and treatments were proposed, often on little or no experimental data. This inconsistency is attributed to the lack of vitamin C as a distinct concept, the varying vitamin C content of different foods (notably present in fresh citrus, watercress, and organ meat), and how vitamin C can be destroyed by exposure to air and copper.

Treatment by fresh food, particularly citrus fruit, was periodically implemented, as it had been since antiquity, but the ultimate cause of scurvy was not known until 1932, and treatment was inconsistent, with many ineffective treatments used into the 20th century. It was a Scottish surgeon in the Royal Navy, James Lind who first proved it could be treated with citrus fruit in experiments he described in his 1753 book, A Treatise of the Scurvy, though his advice was not implemented by the Royal Navy for several decades.

In infants, scurvy is sometimes referred to as Barlow's disease, named after Sir Thomas Barlow, a British physician who described it. (N.B. Barlow's disease may also refer to mitral valve prolapse.) Other eponyms include Moeller's disease and Cheadle's disease.

Scurvy does not occur in most animals because they can synthesize their own vitamin C. However, humans and other higher primates (the simians and tarsiers), guinea pigs, most or all bats, and some species of birds and fish lack an enzyme (L-gulonolactone oxidase) necessary for such synthesis and must obtain vitamin C through their diet. Vitamin C is widespread in plant tissues, with particularly high concentrations occurring in citrus fruits (oranges, lemons, limes, grapefruits), tomatoes, potatoes, cabbages, and green peppers.