Scurvy

Scurvy is a disease that results when people do not get enough vitamin C (also called ascorbic acid) in the diet over a period of weeks or months. Some of the effects of scurvy are spongy gums, loose teeth, weakened blood vessels that cause bleeding under the skin, and damage to bones and cartilage, which results in arthritis-like pain.

What Is Scurvy?

Scurvy was one of the first recognized dietary deficiency diseases. During the sea voyages from the 15th through the 18th centuries, many sailors suffered from scurvy. For example, the Portuguese navigator Vasco da Gama (ca 1460-1524) lost half his crew to the disease during a voyage around the Cape of Good Hope, and the British admiral Sr Richard Hawkins (1532-1595) estimated that during his career, 10,000 sailors under his command died due to scurvy. One legend maintains that men sailing with Christopher Columbus developed scurvy and asked to be left on an island to die, but when Columbus returned, he found the men healthy. He named the island, which was rich in various kinds of fruit, Curacao, meaning cure in Portuguese.

To deal with dietary deficiencies, ships began to carry all manner of remedies, including sauerkraut, mustard, and dried vegetables for soup, but nothing seemed to work consistently to prevent scurvy. In 1747, the Scottish naval physician James Lind (1716-1794) conducted experiments to find out which foods or liquids were good treatments for scurvy. Sailors had long known the benefits of lime juice, but Lind's work was the first to confirm that citrus-and in particular lemons and oranges--was an effective treatment. Eventually, all ships embarking on long voyages carried a supply of citrus fruits or juice, and a British Navy mandated daily rations of lime juice.

What Is the Role of Vitamin C in the Body?

Citrus fruits are rich sources of vitamin C, and vitamin C is necessary for strong blood vessels; healthy skin, gums, and connective tissue; formation of red blood cells; wound healing; and the absorption of iron from food. Scientists first learned about vitamin C in the late 1920s to early 1930s when an Hungarian research team and an American research team independently discovered the vitamin and identified it as ascorbic acid.

What Are the Symptoms of Scurvy?

The main symptom of scurvy is bleeding (hemorrhaging). Bleeding within the skin appears as spots or bruises. Bleeding can take place in the membranes covering the large bones and in the membranes of the heart and brain. Bleeding in or around vital organs can be fatal. Other symptoms include: slow and poor healing of wounds; swollen gums and gingivitis (jin-ji-VY-tis), which means inflammation of the gums; nausea; muscle and joint pain; loosening and sometimes outright loss of teeth; dry skin; and a general feeling of tiredness.

Scurvy develops slowly. In the beginning, a person usually feels tired, irritable, and depressed. In an individual in the advanced stages of scurvy, laboratory tests show a complete absence of vitamin C in the person's body.

Who Is at Risk for Scurvy?

Scurvy is less prevalent in modern times than it was in the time of Vasco da Gama and Richard Hawkins, but people who are on diets that lack a diversity of foods may develop scurvy or scurvy-like conditions. This statement applies to the following groups:

* infants who depend solely on processed cow's milk for nutrition and do not receive vitamin C supplements

* elderly people, whose diets often lack citrus fruits or vegetables that contain vitamin C 

* people who follow diets that limit them to very few food choices.

How Is Scurvy Treated?

A simple blood test that checks for vitamin C levels can confirm whether a person has scurvy. If so, a medical professional will recommend vitamin C supplements (vitamin pills) and a diet that includes foods rich in vitamin C. In addition to citrus fruits such as oranges and grapefruits, good sources of vitamin C include broccoli, tomatoes, raw spinach, baked potatoes, red and green bell peppers, strawberries, cantaloupe, mangoes, and other fruits and vegetables.

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