Our current knowledge of the vitamin C requirement of the body allows us, in a perverse way, to assess the validity of some historical claims of dietary interest. L. Cornaro, who reputedly attained a century of life by prudent living, recommended for the poorer and older members of the community a diet of bread, panada, and eggs. A diet so structured, however, would be almost completely lacking in vitamin C and almost certain to produce scurvy in a matter of months (Cornaro 1768: 98). Similarly, the numerous accounts of survival for considerable periods on diets, which simple inspection indicates to be completely vitamin C-free (such as that of John Ferguson, who in the eighteenth century lived, allegedly for 18 years, only on water, whey, and barley water [Umfreville 1743]), must now be regarded as largely apocryphal.
The life, and untimely death, of William Stark was more in keeping with what we now know of scurvy and vitamin C. Stark, perhaps the best known of all dietary masochists, achieved historical immortality by experimenting on his own body. He may be regarded as the founder of the now firmly rooted “Death by Diet” brigade. A 29-year-old unmarried physician living in London, he decided to test whether very simple diets would support health. From July 1769 to February 1770 he subsisted on diets such as meat, bread, and water; or bread and cheese; or honey and bread; or sugar and water. This highly scorbutigenic regime was relieved only by a small amount of fruit on one occasion in December 1769. Stark died on February 23, 1770, almost certainly from scurvy, judging by the entries in his detailed diary of the study. It is interesting to note, despite his general lassitude and fatigue, entries such as “had strong desires,” “Venus semel,” and “Venus bias,” which appeared at least weekly in his diary up to within a fortnight of his death, suggesting little impairment of the procreative capacity even in severe scurvy (Smyth 1788; Drummond and Wilbraham 1935).
Scurvy is today a rare condition - so rare that individual cases usually merit a short note in the medical press. Persons on a mixed, balanced diet would normally be expected to daily ingest more than the amount of ascorbic acid required to protect them against the disease. Thus, in the United Kingdom the mean ascorbic acid intake is some 60 mg daily - 50 percent above the current U. K. Reference Daily Intake of 40 mg. The only persons likely to fall into a scurvy-risk category are those who, for economic or dietary reasons, subsist on a diet deficient in fruit, vegetables, and fresh meat - such as a diet based primarily on nuts and grain and dairy products or the proverbial American scorbutigenic diet of doughnuts and black coffee.
Indeed, even the ingestion of large amounts of fresh meat (particularly liver) will provide sufficient amounts of vitamin C to prevent scurvy in the comparative absence of fruit and vegetables. This explains why Eskimos (the name of which, apparently, means “raw flesh eaters”) remain scurvy-free even though their intake of plant sources is minimal. A turn-of-the-century account underlines this fact:
In 1893, at Kharborova, a Samoyad settlement on the Yugor Straits. . . six Russian priests, whose religion forbade them to eat reindeer or other such meats, but allowed salted fish, were left in a hut by a wealthy mine-owner to pass the winter. . . . A small Russian peasant boy was left to wait on them. The priests lived almost exclusively on tea, bread and salted fish; the boy lived upon similar food, except that instead of the salted fish he ate fresh reindeer meat. None of them had any vegetables. In the following May, when the Samoyads and peasant traders returned, they found that all the six priests had died of scurvy, whereas the little boy, who had lived upon fresh meat and had not eaten salted fish was alive and well, and had buried all his late masters in the snow. . . . (Jackson and Harley 1900: 252-3)
Recently reported cases of scurvy include that of a 9-year-old. American girl who consumed nothing but tuna sandwiches and iced tea (without lemon) (Ellis, Vanderveen, and Rasmussen 1984), and that of a 24-year-old British male whose main form of sustenance was peanut butter sandwiches (Pozniak and Tomson 1983).
Epidemics of scurvy have been equally rare in the twentieth century. They occurred on a limited scale among soldiers in World War I (Smith 1919) and, particularly, among Indian personnel fighting in Iraq, where some 11,000 cases were reported (Willcox 1920). J. D. Comrie stated that he had personally examined 600 cases of scurvy in 1919 in North Russia (Comrie 1920).
Even today, however, we have the occasional reminder that the history of scurvy is not as completely closed a book as modern science would perhaps lead us to believe. Recently it has been reported that scurvy remains a serious public-health problem for Ethiopian refugees in Sudan and Somalia, where the incidence of scurvy in six camps ranged from 14 percent to 44 percent. It was found that the standard relief food (mainly cereals, legumes, and oil) distributed to the refugees was almost completely deficient in vitamin C (Desenclos et al. 1989).
The condition sometimes described as “chronic scurvy” or hypovitaminosis C (in which a person subsists on a suboptimal intake of vitamin C but without the emergence of the clinical features of overt scurvy) may affect substantial sectors of a population and, in particular, the institutionalized elderly; but its clinical significance, if any, is a matter of continuing dispute that need not concern us here.
R. E. Hughes
World History
