Scurvy is a deficiency disease that results from lack of vitamin C, which is required for correct collagen synthesis in humans. The scientific name of vitamin C, ascorbic acid, is derived from the Latin name of scurvy, scorbutus. Scurvy leads to the formation of liver spots on the skin, spongy gums, and bleeding from all mucous membranes. The spots are most abundant on the thighs and legs, and a person with the ailment looks pale, feels depressed, and is partially immobilized.

Vitamins are parts of enzymes you can’t live without, and your body can’t make. We take them for granted today, but vitamin deficiency diseases plagued our ancestors and took a long time to figure out. Scurvy, wasn’t identified until people were separated from plants for long periods of time – and that first occurred when they built ships that could go on long voyages.

The crew of Magellan’s voyage around the world in 1519 got scurvy, and in 1600 a British report showed 10,000 sailors had died of scurvy in 20 years. In 1747, James Lind, the ship’s physician aboard the HMS Salisbury, conducted an experiment on 12 sick men. He divided them into six groups and fed them all the same diet, but gave each pair a different supplement: apple juice, sulfuric acid, vinegar, a mix of spices, sea water, or citrus fruits.

The two men given the oranges and lemon recovered immediately and were back at work in 6 days. The men who had apple juice improved, but not enough to work. None of the others got any better. Lind’s report led to lemon juice rations on long voyages – and sailors called “limeys.”

Description

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

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

Causes and symptoms

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

Diagnosis

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

Treatment

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

Prognosis

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

Prevention

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

What about the Eskimos? Most animals, except humans, make their own vitamin C and it’s possible to get enough vitamin C to sustain you from fresh meat, especially liver. The word “eskimo” means raw flesh eaters.

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