In general, the importance of scurvy diminished during the nineteenth century. It no longer posed a problem to mariners (the greater rapidity of sea vessels was a contributory factor in this respect), and it no longer occupied a position of importance in the medical texts. The eighteenth-century tendency to use the term “scorbutic” indiscriminately with reference to almost any unidentifiable or challenging condition seemed also to be dying. And an increase in the intake of vegetables (and to a lesser extent, fruit) reduced the possibility of scurvy occurring among the general population.
Nevertheless, sporadic outbreaks of scurvy occurred from time to time, and a number of these led to detailed reports in the medical press - some of them substantial ones, such as that by J. O. Curran in 1847 of cases of scurvy following the potato famine in Ireland (Curran 1847) and that of R. Christison describing a similar outbreak in Scotland in 1846 (Christison 1847).
Scurvy outbreaks occurred most frequently in “closed” communities subjected to the same (inadequate) dietary pattern - hospitals, prisons, and workhouses. The numerous reports presented to Parliament in the nineteenth century on conditions in the prisons and workhouses provide useful information on the adequacy of the diets in these institutions (Johnston 1985). The availability of potatoes - and to a lesser extent, vegetables - was of paramount importance in this respect; fruit was almost totally absent from the normal prison and workhouse diet. Thus, the outbreaks of scurvy among convicts at Millbank in 1822 and in Pentonville in 1847 were a direct result of a lack of vegetables.
W. Baly, in 1843, in a simple type of controlled experiment, was able to show that outbreaks of scurvy at Pentonville Prison could be eliminated by including adequate amounts of potatoes in the diet (Baly 1843). In 1851, R. Boyd described two cases of scurvy (a female aged 38 and a male aged 59) in the Somerset County Pauper Lunatic Asylum resulting from “a continued diet of one meal of bread and cheese daily for three months.” Of particular significance to Boyd was the observation that this occurred “despite a plentiful allowance of cider (nearly 3 pints daily), which is supposed to be antiscorbutic” (Boyd 1851: 520; see also French 1982).
In the second half of the century potatoes were a regular feature of such institutional diets and outbreaks of scurvy diminished, although some cases still occurred among sailors despite the official adoption of lemon juice as a prophylactic. “It is very rare for London physicians to see cases of scurvy such as they are presented at our seaports,” wrote P Black in 1876 (12), confirming Boyd s earlier statement that “Scurvy is now seldom seen in ordinary hospital practice in this country except in the [naval] hospital ship Dreadnought”’ (Boyd 1851: 520). Nevertheless, there were still isolated epidemics in communities deprived of fresh food supplies for long periods - as among British soldiers in the Crimean War and among some of the persons on Arctic expeditions.
World History
