ABSTRACT
The suffering and the toll of human lives taken by vitamin C deficiency over the ages cannot even be estimated, but we can be sure, by reading old accounts of scurvy, that it must have been a common catastrophe, especially among sailors on long sea voyages, but also as a winter epidemic among urban populations; it ravaged whole armies and occurred among the inhabitants of besieged cities. It appeared wherever man relied solely on food held in storage. The early literature on scurvy was reviewed by Bourne in 1944; he showed hieroglyphs (Figure 1) from Egyptian papyri as convincing evidence that this disease, characterized by bleeding gums and hemorrhages in the skin, existed about 3000 years ago. He also refers to the writings of Hippocrates (500 B.C.) where there is the description of a disease which can unequivocally be regarded as scurvy. Scurvy occurred at the siege of Damietta in the First Crusade and was described by Jacques de Vitry as follows (Guizot, 1825). “A large number of men in our army were attacked also by a certain pestilence, against which the doctors could not find any remedy in their art. A sudden pain seized their feet and legs; immediately afterwards the gums and teeth were attacked by a sort of gangrene, and the patient could not eat any more. Then the bones of the legs become horribly black, and so, after having continued pain, during which they showed the greatest patience, a large number of Christians went to rest on the bosom of our Lord.” There is also a first-hand account by Jean Sire de Joinville in 1250 of scurvy disabling and killing the soldiers of Louis IX near Cairo in the Seventh Crusade; this was published in Menard’s 1617 edition of de Joinville’s writings and was translated into English by James Hutton in 1910; the account reads as follows: “We had no fish in the camp to eat during Lent except the karmout (a kind of eel), which preyed upon the dead bodies, for they are a gluttonous fish. And in consequence of this misfortune, and of the unhealthiness of the country, where never a drop of rain falls, we were attacked with the army sickness, which was such that our legs shrivelled up and became covered with black spots, and spots of the colour of earth, like an old boot; and in such of us as fell sick the gums became putrid with sores, and no man recovered of that sickness, but all had to die. It was a sure sign of death when the nose began to bleed: there was nothing left then but to die.” Ancient Egyptian hieroglyphs believed by <xref ref-type="bibr" rid="ref1_12">Ebbell (1938)</xref> and by <xref ref-type="bibr" rid="ref1_05">Bourne (1944)</xref> to represent scurvy; hieroglyphs iv, v, vi, vii, and viii indicate a disease characterized by petechial hemorrhages in the skin. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781351077569/4be67222-321e-426a-8e44-03c29fefed7c/content/fig1_1.tif"/> (From Bourne, G. H., [1944], Proc. R. Soc. Med., 37, 512. With permission.)
