Chapter 13 - Diseases of the General System and Miscellaneous Diseases
Introduction to Diseases of the General System and Miscellaneous Diseases
Blood Aneamia
Typhoid Fever
Prevention of Typhoid
Bilious Remittent Fever
Congestive Fever
Fever and Ague
Yellow Fever
Purple Disease
Bubonic Plague

13.17 Scurvy

Scurvy. Scorbutus.

Owing to a better knowledge of this disease, and of its proper treatment, it is much less common than in former years. It chiefly affects seamen who make long voyages; but is not entirely unknown on land.

Symptoms. Languor, loss of strength, and great depression of mind, are among the first signs of scurvy. To one about being attacked work and play are alike burdensome. There is no heart even to move. The face and the whole skin look pale and bloated, and the breath has a fetid smell. The gums are swelled, soft, red, and spongy; and they bleed upon the slightest touch, sometimes the blood oozes from them spontaneously. The teeth get loose, and often fall out. The skin becomes covered with bluish or purple spots, looking precisely like bruises. These spread and run into each other, forming large patches of discoloration.
These spots appear to be formed by the bursting of the small capillaries of the veins and arteries, which have grown too weak and rotten to hold their contents, and the infiltration of dissolved blood into the cellular substance under the skin.
Ulcerous sores break out in various parts of the body, which smell badly, and discharge a thin matter. These ulcers are covered with a crust. Various parts of the body, the bones included, are twinged with pains. The pulse is weak and soft. All the secretions, including the urine, have an offensive smell, as though the whole body were approaching putridity. In truth, the whole man seems to be disintegrating, decaying; the flesh becomes soft, and dwindles; and the bones break easily, being afflicted with a decay approaching to rottenness.
In bad cases, blood is discharged from the bladder, bowels, womb, nose, and mouth; and the smallest exertion is followed by fainting, and in many cases, by sudden death.

Causes. The disease is owing to the use of food and drink beginning to be decomposed, and to living long at sea without vegetables containing certain acids. Its attacks are likewise encouraged by whatever weakens and depresses the nervous system, as long exposure to a moist, damp air, particularly when this is connected with confinement on board a ship, unclean linens, occasional loss of the usual rest, and great fatigue, as in storms. The force of these causes is increased by the loneliness, the sadness, and the despondency of the sailor's life.

Treatment. Sailors are very much protected from the disease now, by frequent returns to land, during long voyages, to procure fresh meats, vegetables, and water. This practice is very generally adopted, particularly by whale ships, which make long voyages; and the result is, very little scurvy, and general health among the men.
One of the best medicines for the disease is quinine; it may be given in from one to two grain doses twice or three times a day. Gentian and quassia are also suitable remedies; so is the muriatic citrate of iron (73).
But the best of all remedies are fresh and succulent vegetables, and also fruits. Spinach, lettuce, dandelion, sorrel, cresses, and the like, are among the very best things when they can be had. Lemon or lime juice produces the happiest effects. Potatoes are among the. very best remedies, particularly if scraped and eaten raw. They are also valuable when cooked. Spruce beer is a good antidote; and may be made at sea from the essence. Many kinds of beer may be brewed at sea, which are valuable.
When the bowels are costive, cream of tartar, dissolved in water, and drunk freely, will be found the best remedy. If there be looseness,, of the bowels, morphine, laudanum, a tea made of logwood, or geranium, or the tincture of catechu, will be suitable.
For the spongy gums, a solution of alum applied to them will be proper, or a mixture of equal parts of tincture of myrrh, catechu, and Peruvian bark; and ulcers may be washed with the same. Vinegar, which is an excellent preventive in this disease, may be made at sea from molasses and water exposed to the sun. Two ounces of nitre dissolved in a quart of vinegar, and given in tablespoonful doses, three times a day, is said to be an excellent remedy.
Every ship, on going to sea, should be supplied with dried fruit, as raisins, currants, whortleberries, prunes, etc.; and should have peas, beans, rice, flour, sugar and molasses. Beside these, ships should have essence of spruce and lemon, and dried balm, Page, pennyroyal, and other herbs.
Seamen, when down with this disease, should be moved with care, as the spark of life may be easily extinguished.

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