SYMHC Classics: Scurvy

This 2020 episode covers scurvy, a deficiency in vitamin C. Its story goes way back in history – all the way to our evolutionary ancestors living more than 60 million years ago. See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  This is an iHeart Podcast. Guaranteed Human.

• 0:04Tracy V. Wilson?

  Deanna Flores is a flag football star, a trailblazer, an entrepreneur, and now host of a new podcast.

• 0:10Holly Frey?

  In Born to Become with Deanna Flores, she's sitting down with people from every corner of culture to find the whole person behind the public identity.

• 0:18Tracy V. Wilson?

  Every episode, you'll get to know Deanna, her guests, and even yourself a little better. No lectures, no know-it-all hosts, just real people being real.

• 0:26Holly Frey?

  Listen to Born to Become with Deanna Flores out now on the iHeart Radio app or wherever you get your podcasts. Created in partnership with Geico.

• 0:35Tracy V. Wilson?

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• 1:09Holly Frey?

  A rare disease diagnosis can change your life, but it doesn't have to define your future. In season seven of Untold Stories: Life with a Severe Autoimmune Condition, host Martine Hackett continues the conversation with people living with MG, CIDP, and the broader rare disease community, exploring what comes after diagnosis through stories of hope, progress, and connection. Produced by Ruby Studio in partnership with Argenx. Listen on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts.

• 1:40Tracy V. Wilson?

  The Old Gays are back with Silver Linings, their lovable podcast from iHeart's Ruby Studio in partnership with ViiV Healthcare. Robert, Mick, Bill, and Jessa strut back down memory lane for season two, sharing lessons on life, love, and loss. These are the kind of insights that only come from experience. So tune in to Silver Linings with The Old Gays on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Workplace chaos. We've all been there. Deadline Are slipping, projects are piling up, and suddenly you realize the missing piece is the right person. That's when you say, this is a job for sponsored jobs. With Indeed Sponsored Jobs, your job post gets a boost so you can connect with quality candidates

• 2:22Tracy V. Wilson?

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• 2:46Tracy V. Wilson?

  Happy Saturday. Our recent installment of six impossible episodes talked about Nellie Cashman's efforts to get fresh vegetables to some miners who were starving and developing scurvy. I don't remember if we mentioned it in that episode, but we do have a whole episode on the history of scurvy in its today's Saturday classic. It came out on December 30th, 2020, and you can tell we were a little frazzled after months of relative isolation in that first stretch of the COVID-19 pandemic.

• 3:17Holly Frey?

  We got a couple of corrections after this first came out. We talk about the genetic mutation that kept our long ago ancestors from being able to produce their own vitamin C, but that wasn't a big issue because overwhelmingly, they were living in tropical areas and eating lots of fresh fruits and vegetables. We say that had they not been eating lots of foods that were rich in vitamin C, they would have died out. One letter writer noted that only the people carrying the mutation would have died out. Everybody else would have been fine.

• 3:46Tracy V. Wilson?

  Another correction from another listener pointed out that we did not explain that heat breaks down vitamin C. We talked about vitamin C being destroyed by cooking and by pasteurization and by concentrating juice down into a rob, which is done by boiling. So heat is the common element among all those things.

• 4:05Holly Frey?

  And the last is that we read the full title of the reference book, The Surgeon's Mate, which was full of the word ye, spelled Y-E. This correction noted that the Y there was in place of the character thorn, which would be pronounced T-H, which is true, but would not have been nearly as funny.

• 4:22Tracy V. Wilson?

  So enjoy.

• 4:26Holly Frey?

  Welcome to Stuff You Missed in History Class, a production of iHeartRadio.

• 4:36Tracy V. Wilson?

  Hello and welcome to the podcast. I'm Tracy V. Wilson.

• 4:40Holly Frey?

  And I'm Holly Frey.

• 4:41Tracy V. Wilson?

  Uh, this episode is the last episode I am writing for the year 2020. It's been a year.

• 4:48Holly Frey?

  Hooray.

• 4:50Tracy V. Wilson?

  Yeah, hooray. Also, I've just, I've had minimal contact with anybody besides my spouse in almost nine months. And then for some reason, my brain keeps being like scurvy. And

• 5:03Tracy V. Wilson?

  that connection doesn't make sense really, because if I were to get a vitamin deficiency because of the pandemic, it would probably be about vitamin D from the not going out into the sun.

• 5:16Holly Frey?

  Is that what you're saying? Is that your brain is making a weird jump of concern of vitamin deficiency?

• 5:22Tracy V. Wilson?

  Maybe not concerned, but maybe more like, at least I don't have scurvy. Like, huh. But brain, that doesn't make any sense.

• 5:31Tracy V. Wilson?

  Anyway, that's what we're going to talk about today is scurvy, because just for some weird reason, my brain keeps coming back around to it in these times of winter and pandemic.

• 5:43Holly Frey?

  So scurvy, in case you don't know, and you probably do, is a deficiency in vitamin C or ascorbic acid. And its story goes way, way back in history, all the way to our evolutionary ancestors living more than 60 million years ago. With a few exceptions, including guinea pigs and bats, most mammals can generate their own ascorbic acid. And that included those primate ancestors. But somewhere along the way, a random genetic mutation broke the ability to produce an enzyme known as L-galunolactone oxidase, or Gulo, which is a necessary part of making ascorbic acid.

• 6:21Tracy V. Wilson?

  Ascorbic acid is also necessary. The body uses it to synthesize the protein collagen. And collagen is a crucially important part of our connective tissue. We need it to do really important things like hold our skin and blood vessels together. So if the body cannot replace worn out collagen, it causes serious problems.

• 6:41Holly Frey?

  The first symptoms of scurvy involve fatigue, lethargy, and aching joints. People start to bruise easily. Wounds won't heal and old wounds reopen. The gums start to bleed and the teeth start to loosen and can in fact come out entirely. This is also accompanied by foul odors, including very bad breath. Without treatment with vitamin C, scurvy is eventually fatal, often because of acute internal bleeding around the brain or heart.

• 7:11Tracy V. Wilson?

  But when our ancestors stopped being able to produce gulo, this really did not matter. They were living in tropical areas and their diets included lots of fresh fruits and vegetables, so they were getting plenty of vitamin C through their food. If this had not been true, this genetic mutation that shut off the ability to synthesize gulo would have wiped them out. But since their diets were rich with vitamin C, they continued to thrive.

• 7:38Holly Frey?

  As people started living farther from tropical areas, they started eating more foods that did not necessarily contain as much vitamin C. But most of the time, this was still not a big problem. Most dietary recommendations call for significantly more vitamin C, but it doesn't actually take that much just to prevent scurvy. Only about 10 milligrams a day are all you need. And although vitamin C is mostly associated with fruits and vegetables, it is found in other foods as well. Most meat contains a little if it hasn't been cooked too long. And liver and kidney meat in particular contain quite a bit of it. So as one example, the practice of eating raw organ meat in far northern indigenous communities provides protection from scurvy, even when plant-based foods

• 8:23Holly Frey?

  are unavailable or out of season.

• 8:26Tracy V. Wilson?

  So as communities established themselves around the world, people had to have some kind of vitamin C in their diets. Otherwise, that community just could not survive. But anytime that access to food was cut off in some way, say because of a war or a famine, people could start to develop scurvy. And this was also true for people with diseases and conditions that kept them from eating or kept them from absorbing the nutrients in their food.

• 8:53Holly Frey?

  And the word scurvy comes from older terms that mean lazy, scabbed, or skurf, which used to be used to describe dandruff. People started using it to describe this disease in about the 16th century. But written descriptions of scurvy that predate that word are much older. The earliest likely description of scurvy is found in the Egyptian document known as the Ebers Papyrus, which dates back to about 1500 BCE. Past podcast subject Sheshruda described a condition involving bleeding gums and loosening teeth around 800 BCE. Roughly 400 years later, Greek physician Hippocrates described what was probably scurvy.

• 9:35Holly Frey?

  And while he did not go into detail about the cure he knew for it, he did note that it wasn't effective and that patients usually died. Traditional Chinese medicine texts describe collections of symptoms that very much resemble scurvy as well.

• 9:51Tracy V. Wilson?

  So today, scurvy is associated with long sea voyages. And as humanity took to the sea, people worked out some ways to prevent it, although really without necessarily knowing that that was what they were doing. Many of the earliest seafarers stuck close to the coasts or they island hopped, and that gave them plenty of opportunities to stock up on fresh food. But as voyages got longer, many also had foods onboard that were rich in vitamin C. It's possible that Polynesian wayfinders introduced sweet potatoes to Central and South America. They would have brought them with them over thousands of miles of ocean, and sweet potatoes contain vitamin C.

• 10:33Tracy V. Wilson?

  Scandinavians stocked their ships with cloudberries, which have about four times as much vitamin C as oranges do. Unpasteurized milk also contains vitamin C, so seafarers who had dairy animals onboard could get it that way.

• 10:49Holly Frey?

  While scurvy was common enough to be documented in ancient medical literature, one of the first specifically documented outbreaks happened in the 13th century. During the Eighth Crusade, King Louis IX lay siege to Tunis. Although there were plenty of fresh fruits and vegetables available in the area, the king and his fighting force were mostly eating fish, and many were also undertaking religious fasts. The king and about a sixth of his men died of disease during this siege. For a long time, their deaths were attributed to plague, but more recent research has found evidence of scurvy in the king's jawbone.

• 11:26Tracy V. Wilson?

  Not long after this, scurvy started to become a serious problem on European ships during long sea voyages. And most of the literature that's related to scurvy in history today is focused primarily on Europe and its colonies, mostly during the Age of Exploration, which was from about the 15th through the 17th centuries. But of course, Europeans were not the only people taking to the sea at this point. It's possible that other nations aren't as represented in English-language literature because of language barriers or prejudice. But it's also possible that scurvy was just not as much of a problem outside of European fleets.

• 12:05Holly Frey?

  Most of the time, it takes between two months and 12 weeks without vitamin C for a person to develop scurvy. And while sailors from parts of Africa and Asia were taking voyages that lasted much longer than that overall, often, they were not going that long between stops to resupply. It also seems like they may have been doing a better job at providing their crews with foods rich in vitamin C. Past podcast subject Ibn Battuta, who was from what's now Morocco and traveled extensively during the 14th century, described green vegetables and ginger being grown in tanks on Chinese vessels. He also wrote about salted ginger, pepper, lemons, and mangoes being loaded onto ships in preparation for long voyages.

• 12:49Tracy V. Wilson?

  Another previous podcast subject is Zheng He, who led fleets of treasure ships from China all the way to Africa in the 15th century. And we don't have lists of exactly what provisions he took, but we do know that his fleets included huge supply vessels whose whole purpose was sustaining the voyage itself, and that the ships had kitchens that prepared meals for crews and passengers. There are also multiple references to tea in relation to his voyages, and tea does contain some vitamin C. For the most part, written records of scurvy on Chinese vessels don't really start until the 19th century, when people left China bound for California during the gold rush.

• 13:31Holly Frey?

  But European ships were another story. Especially as European ships crossed whole oceans, people's diets were often restricted to salted meat and hardtack and not much else. Typically, any vegetables grown on board were only for the officers.

• 13:48Tracy V. Wilson?

  Consequently, it's estimated that scurvy killed 2 million European sailors between the 15th century and the 19th century, which is when navies started to more consistently connect scurvy prevention to things like citrus juice. During these centuries, scurvy was the leading cause of death among sailors at sea. It was also a major cause of death among enslaved Africans during the transatlantic slave trade, although the details of that aspect have not been nearly as specifically documented as with ships' crews.

• 14:22Holly Frey?

  And we're going to talk about some more specific scurvy information after we first pause for a little sponsor break.

• 14:31Speaker 03

  First thought is like, wow, how are we going to do all this?

• 14:34Tracy V. Wilson?

  Hey, everybody, it's Tracy from Stuff You Missed in History Class. That's Alan Goya, a planning engineer at AT&T. He's talking about Intuit Dome, home of the Los Angeles Clippers, where every seat, screen, phone, and transaction is connected with AT&T fiber and 5G, defining the fan's experience. And Alan's master plan made it all possible.

• 14:55Speaker 03

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• 15:02Tracy V. Wilson?

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• 15:09Speaker 04

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• 15:15Tracy V. Wilson?

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• 15:23Speaker 03

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• 15:26Tracy V. Wilson?

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• 16:12Tracy V. Wilson?

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• 16:39Tracy V. Wilson?

  Guess who's back in the house? The old gays return for season two of Silver Linings, their hit podcast from iHeart's Ruby Studio in partnership with ViiV Healthcare. Just wait until you hear what hosts Robert McMillan and Jessa have in store this time around. They strut back down memory lane navigating life, love, loss, and everything that shaped them along the way. And as usual, someone just might break into song. From leather bars to bathhouses, dance floors to drag brunch, nothing stays off limits. These are the kinds of insights that can only come from experience. So listen to your elders, honey, and discover the silver linings you can take with you. All sass, zero filter, and decades of perspective from four friends

• 17:22Tracy V. Wilson?

  proving that queer joy only gets better with age on the podcast that never gets old. Listen to Silver Linings, available on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

• 17:38Holly Frey?

  Deanna Flores, flag football star, trailblazer, broadcaster and entrepreneur, knows what pressure feels like. She knows what it takes to step up in the moment, and she knows that even the biggest achievement is never the end of the story.

• 17:51Tracy V. Wilson?

  In the new podcast, Born to Become with Deanna Flores, she's sitting down with people from every corner of culture, including sports, business, wellness and entertainment, to find the whole person behind the public identity.

• 18:03Holly Frey?

  Whether she's talking to an athlete on the field, a founder heading into a pitch, or a musician before a show, the conversation starts with the official bio ends.

• 18:12Tracy V. Wilson?

  Every episode, Deanna shares her own experiences, questions and even doubts. Her guests learn from her, she learns from them, and you might pick up something along the way. No lectures, no know-it-all host, just real people being real.

• 18:25Holly Frey?

  Come curious and leave with something you can use.

• 18:28Tracy V. Wilson?

  Listen to Born to Become with Deanna Flores out now on the iHeart Radio app or wherever you get your podcasts. Created in partnership with Geico.

• 18:40Tracy V. Wilson?

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• 19:22Tracy V. Wilson?

  to help solve hiring challenges and find people who can help drive results. Spend less time searching and more time actually interviewing candidates who check all your boxes. Less stress, less time, more results. Get your $75 sponsored job credit today at indeed.com/podcast. Terms and conditions apply. Hiring now, then this is a job for Indeed Sponsored Jobs.

• 19:56Tracy V. Wilson?

  Today, scurvy is treated almost like a punchline in pirate jokes, but it was an enormous problem for hundreds of years. Scurvy killed 100 of the original 170 crew during Vasco de Gama's voyage to the Indian subcontinent that started in 1497. Ferdinand Magellan left Spain with a fleet of five ships in 1519, searching for a way to reach Asia from Europe by traveling west by sea. Only 18 of his original crew of 270 made it back to Spain in 1522, with scurvy being a major cause of death.

• 20:37Holly Frey?

  Here is how one of Magellan's crew described conditions in his journal. Quote, "We ate only old biscuit reduced to powder and full of grubs and stinking from the dirt which the rats had made on it when eating the good biscuit. And we drank water that was yellow and stinking. The men were so hungry that if any of them caught a rat, he could sell it for a high price to someone who would eat it."

• 21:01Tracy V. Wilson?

  In 1535, French explorer Jacques Cartier established a fort across the St. Charles River from the Iroquois village of Statacona. That's near what's now Quebec City. That winter was extremely harsh. Cartier's ships became icebound. They were not able to return to France as planned. And when they heard of an illness that was spreading through the indigenous population, they tried to cut off contact with them. But then that same illness started to spread through Cartier's own men.

• 21:31Holly Frey?

  In an account translated by Richard Hacklet, it's described as this, quote, "Some did lose their strength and could not stand on their feet. Then did their legs swell, their sinews shrink as black as any coal." Others also had all their skin spotted with spots of blood of a purple color, then did ascend up to their ankles, knees, thighs, shoulders, arms, and neck. Their mouth became stinking, their gums so rotten that all the flesh did fall off, even to the roots of the teeth, which also all fall out. About the middle of February of a hundredth and ten persons that we were, there were not ten whole. There were already eight dead and more than fifty sick,

• 22:14Holly Frey?

  and as we thought, passed all hope of recovery.

• 22:17Tracy V. Wilson?

  So at some point, Cartier went for a walk and encountered Domogaya, who was the son of Doncona, who was the chief of Staticona. Domogaya told Cartier about a treatment for this disease, which was to prepare a tea from the leaves of a local tree. This tree is not conclusively identified today, but the most likely candidate is the eastern white cedar, whose leaves always contain some vitamin C, but have a whole lot more of it in the new growth that comes out in the early spring. Although at least twenty-five men in the fort died of scurvy, this cure was effective for the ones who survived.

• 22:56Holly Frey?

  There is, of course, a whole lot more to this story outside the part about scurvy. Cartier had actually abducted Domogaya and his brother on his earlier voyage and forced them to accompany him back to France, bringing them back to North America with him in 1535. And at the end of his second voyage, Cartier abducted them for a second time, along with their father and seven other indigenous people. All but one of them died before Cartier returned to North America for his third voyage in 1541.

• 23:26Tracy V. Wilson?

  Probably the most dramatic and notorious outbreak of scurvy at sea was during George Anson's four-year voyage around the world, which started in 1740. Britain was at war with Spain, and because of the war, Anson had a serious labor shortage. Even press gangs, who were abducting men off the street to force them to serve in the Royal Navy, could not provide him with enough men for his fleet. Eventually, this gap was filled with men from Chelsea Hospital, most of whom were sick, injured, or elderly, to the point that they weren't able to just leave on their own when they got released from the hospital. The people who did have the capacity to just walk away...

• 24:09Tracy V. Wilson?

  Did that. So he was left with like the oldest, sickest men from the hospital.

• 24:15Holly Frey?

  And then there were delays in outfitting the ships and the crews ate nothing but ships rations for months as they waited. And while there were treatments for scurvy onboard, none of them contained much, if any, vitamin C. So they did not actually work. For the most part, they were also really unpleasant, like drinking a bunch of straight vinegar.

• 24:36Tracy V. Wilson?

  I, I like vinegar and vinegary things, but the idea of just gulping down a whole bunch of it does not sound great to me.

• 24:43Holly Frey?

  Hard pass.

• 24:45Tracy V. Wilson?

  Once they finally got underway, they sailed through terrible storms and were blown off course. By April of 1741, most of the men who had survived those treacherous seas had then developed scurvy. By June, they were down from six ships to only three, with only 335 survivors out of about 1,300 original crew.

• 25:08Holly Frey?

  Finally, they reached the Juan Fernandez Islands off the coast of Chile. These were home to plenty of fresh fruits and vegetables. And as the ships took on fresh provisions and the men ate these foods, they gradually began to recover. But because their conditions were so dire when they started getting more vitamin C into their bodies, it actually took more than a month before men stopped dying of scurvy.

• 25:32Tracy V. Wilson?

  Anson's dwindling fleet was struck by scurvy again in the Pacific Ocean in the summer of 1742. That was obviously after they had run out of the fresh provisions that they brought onboard. When his two remaining ships finally got to China, there were only 227 of the original crew still living. In spite of that, they managed to capture a Spanish galleon that was bound for Manila on June 20th of 1743. And then with only 145 of the original men, they made it back to Britain.

• 26:06Holly Frey?

  Because they had captured the Spanish galleon, they were treated as heroes, with treasures from the galleon paraded through the streets of London, and Anson named First Lord of the Admiralty in 1751.

• 26:19Tracy V. Wilson?

  At this point, I mean, it might seem a little weird for the person who was in charge when all of these people died to then become the first Lord of the Admiralty. But at this point, European naval officials had long seen scurvy as an almost inevitable side effect of sending men out to sea for long periods, and they really did not know what was going on with this disease. They did not know about vitamin C or about vitamins at all. It would be more than 150 more years before Casimir Funk would coin the word vitamin to describe specific chemical substances that the body needed to survive. They did not know about collagen either. The molecular structure of collagen was not discovered until the 1930s.

• 27:04Holly Frey?

  Complicating all of this, diets that lacked vitamin C often lacked other essential nutrients as well. And outbreaks of scurvy frequently happened alongside outbreaks of contagious diseases. So it wasn't always clear exactly what disease was at work. And often, multiple conditions were getting lumped together and described as scurvy.

• 27:25Tracy V. Wilson?

  So over the centuries, various people noticed that an assortment of foods seemed to cure scurvy. Sometimes, they did put that discovery in writing. But it took a really long time before navies started consistently keeping effective treatments for it on ships. This was not just a matter of people forgetting that citrus fruits cured scurvy, though. It is definitely described that way sometimes. Like, people kind of frame it as people in the past were great big dummies who just kept forgetting that all they needed was oranges. In hindsight, it is really easy to see that the things that treated scurvy effectively all have vitamin C in them. But at the time, not only did people not know why any of those

• 28:10Tracy V. Wilson?

  things actually worked, but their explanations for why they worked were totally off-base. So as people tried to come up with cures that were easier to keep fresh on ships than fruits and vegetables are, it just kept going down the completely wrong track.

• 28:26Holly Frey?

  Often, James Lind is the one who gets credit for solving the scurvy problem. But it's, of course, history, so that means it's way more complicated than that. And we're going to get into all of that after we pause for a sponsor break.

• 28:42Tracy V. Wilson?

  Guess who's back in the house? The old gays return for season two of Silver Linings, their hit podcast from iHeart's Ruby Studio in partnership with Vive Healthcare. Just wait until you hear what hosts Robert McMillan and Jesay have in store this time around. They strut back down memory lane navigating life, love, loss, and everything that shaped them along the way. And as usual, someone just might break into song. From leather bars to bathhouses, dance floors to drag brunch, nothing stays off limits. These are the kinds of insights that can only come from experience. So listen to your elders, honey, and discover the silver linings you can take with you. All sass, zero filter, and decades of perspective from four friends proving that queer joy

• 29:27Tracy V. Wilson?

  only gets better with age on the podcast that never gets old. Listen to Silver Linings, available on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts.

• 29:41Holly Frey?

  Deanna Flores, flag football star, trailblazer, broadcaster, and entrepreneur, knows what pressure feels like. She knows what it takes to step up in the moment, and she knows that even the biggest achievement is never the end of the story.

• 29:54Tracy V. Wilson?

  In the new podcast, Born to Become with Deanna Flores, she's sitting down with people from every corner of culture, including sports, business, wellness, and entertainment, to find the whole person behind the public identity.

• 30:06Holly Frey?

  Whether she's talking to an athlete on the field, a founder heading into a pitch, or a musician before a show, the conversation starts with the official bio ends.

• 30:15Tracy V. Wilson?

  Every episode, Deanna shares her own experiences, questions, and even doubts. Her guests learn from her, she learns from them, and you might pick up something along the way. No lectures, no know-it-all host, just real people being real.

• 30:28Holly Frey?

  Come curious and leave with something you can use.

• 30:31Tracy V. Wilson?

  Listen to Born to Become with Deanna Flores, out now on the iHeart Radio app or wherever you get your podcasts. Created in partnership with Geico.

• 30:43Tracy V. Wilson?

  For any small business owner, there's a moment when you realize the next hire could be the difference between staying busy and actually growing. The challenge is finding the right person without wasting time sorting through candidates who aren't the right fit. That's where Indeed Sponsored Jobs comes in. When workplace chaos hits and you need someone who can step in and make a difference, this is a job for sponsored jobs. It helps put your job in front of candidates who match the criteria that matter most to you, whether that's skills, experience, certifications, or location. And you're certainly not alone in using Indeed. Join the 3.3 million employers worldwide that use Indeed to connect with quality talent that fits their needs. That's millions of businesses turning to Indeed to help solve hiring challenges and

• 31:27Tracy V. Wilson?

  find people who can help drive results. Spend less time searching and more time actually interviewing candidates who check all your boxes. Less stress, less time, more results. Get your $75 sponsored job credit today at indeed.com/podcast. Terms and conditions apply. Hiring now, then this is a job for Indeed Sponsored Jobs. Long hours, work deadlines, family commitments, you give so much to everyone else, isn't it time to invest in yourself? The University of Arizona Global Campus is built for working adults with flexible online degree programs designed to fit your life. Your previous education, training, and eligible experience may even help you earn college

• 32:12Tracy V. Wilson?

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• 32:25Speaker 05

  Livrite, publishers of John U. Bacon's New York Times bestseller, The Gales of November, a chronicle of the S.S. Edmund Fitzgerald's 1975 shipwreck. "Never has it been told better than by Mr. Bacon in this colorful book," writes John J. Miller of The Wall Street Journal, while author Hampton Sides proclaims that it's destined to be a classic. The Gales of November, now in paperback.

• 32:59Tracy V. Wilson?

  For hundreds of years, medicine in Europe rested on the idea of humors. And this drew from Greek physicians and philosophers like Galen and Hippocrates. It also appears in the work of Persian polymath Ibn Sina. Similar concepts are part of traditional Chinese medicine and Ayurveda as well. And in terms of the understanding of scurvy in much of Europe, for hundreds of years, it was believed to be due to putrefaction of the humors. And then that putrefaction was made worse by bad food, bad air, bad hygiene, or sometimes just laziness.

• 33:37Holly Frey?

  And there were a lot of people who figured out something that worked to treat this. In 1574, Baldwinus Rancius wrote about oranges curing scurvy in Dutch sailors. In the late 16th century, Enric Oyer wrote about cloudberries treating scurvy in Norse sailors.

• 33:55Tracy V. Wilson?

  In 1617, John Woodall published a reference book called The Surgeon's Mate, or Military and Domestic Surgery: Discovering Faithfully and Plainly Ye Method and Order of Ye Surgeon's Chest, Ye Uses of the Instruments, the Virtues and Operations of Ye Medicines with Ye Exact Cures of Wounds Made by Gunshot, and Otherwise as Namely Wounds, Apostphumes, Ulcers, Fistulas, Fractures, Dislocations with Ye Most Easy and Safest Ways of Amputation or Dismembering, the Cures of the Scurvy, of Ye Fluxes, of Ye Belly, of Ye Colic and Iliaca Passio, of

• 34:39Tracy V. Wilson?

  Tenasimus and Exitus Ani, and of the Callenture with a Treatise of Ye Cure of Ye Plague, published for the service of his master and of the Commonwealth by John Woodall, Mr. in Surgery. As that very long title mentioned, it had an entire section on scurvy and its treatment.

• 34:59Holly Frey?

  I think we should bring back the days where we basically include the index in the title.

• 35:03Tracy V. Wilson?

  Yeah. Well, I looked at the, um, the table of contents for it. And at, at one point I had the table of contents for what the section of, on scurvy included in here, but it was really just like scurvy. It's description, it's treatment.

• 35:18Holly Frey?

  Yeah. Uh, Woodall's descriptions of scurvy are similar to what we talked about earlier in the show. And as for its cure, he wrote that, quote, "As a famous writer named Johannes Actius, in a treatise, De Scorbuto, affirmeth, consisteth chiefly in four things, namely, in opening obstructions, evacuating the offending humors, in altering the property of them, and in comforting and corroborating the parts late diseased."

• 35:45Tracy V. Wilson?

  Woodall stresses the need to keep the cruise quarters clean and sweet with as much high-quality, comfortable food as possible. But if someone does get scurvy, they should be bled and given some, quote, "pills of euphorium or otherwise pibula ruffie or cambogia." And then after that, some spoon meat, or some oatmeal, or egg yolk, or a broth of currants and other fruit, or some sugar or spices, or some barley water, or some oil of vitriol, which is sulfuric acid, or putting some dried wormwood in the patient's drink. And then, quote, "Further, the surgeon or his mate must not fail to persuade the governor

• 36:27Tracy V. Wilson?

  or purser in all places where they touched in the indies and may have it, to provide themselves of juice of oranges, limes, or lemons, and at bantham of tamarins."

• 36:38Holly Frey?

  In the surgeon's mate, Woodall makes lots of references to citrus fruit. But he's really focused on when crews are in places where those fruits grow because, quote, "The sea surgeon shall do little good at sea with them, neither will they endure."

• 36:53Tracy V. Wilson?

  Yeah, he had stuff about citrus fruit in here, but it was really about when they were on land. And he also included so many other things that would not have been effective at all.

• 37:03Tracy V. Wilson?

  Oil of vitriol was a very common scurvy treatment. It was literally sulfuric acid. It was, that was not helpful. In 1622, Sir Richard Hawkins, who called scurvy, quote, "the plague of the sea and the spoil of mariners," wrote that sour lemons and oranges could treat it. In 1635, Ambrosius Rodeus defended and published the first Scandinavian doctoral thesis, and it was on scurvy. It describes treating scurvy with scurvy grass, common chickweed, watercress, mustard plants, and the cloudberries that we mentioned earlier on in the show. Ambrosius Rodeus did seem to understand that scurvy was connected to nutrition, but his

• 37:46Tracy V. Wilson?

  ideas on how that worked were a little bit fuzzy. It was connected to the idea of cancelling out opposites.

• 37:53Holly Frey?

  Schwer. By the late 1600s, people were using the word "anti-scurbutic" to describe things they believed to be useful against scurvy. Dutch physician Johannes Bokstrom used the term to describe fresh fruits and vegetables in 1734. Also in the 18th century, Baron Gerhard van Sweeten talked about scarcity of greens and vegetables as contributing to scurvy. But he also attributed it to, quote, "noisome vapors arising from marshy grounds and stagnating waters, inaction, drinking of corrupted and stagnating waters, the use of salted and

• 38:31Holly Frey?

  smoked flesh and fish, damp and low lodgings, as well as sorrow, nostalgia, and homesickness."

• 38:39Tracy V. Wilson?

  According to van Sweeten, treatment for scurvy involved, quote, "correcting the impure waters," and also purging. He also made dietary recommendations, quote, "the food should be broth with chervil, sorrel, spinach, lettuce, andive, succury, cabbage, especially red cabbage, young nettle buds and tops, or any other sort of tender herbage boiled in it. The preference to be given to those easiest to come at. Fruit, quite ripe, used moderately, always produces a good effect. But if neither fruit nor greens can be procured, the patient must have his broth with barley, oats, or rice. He may eat likewise a little veal or fowl, but it must be moderately."

• 39:24Holly Frey?

  So a lot of people had noted fresh fruits and vegetables, including citrus fruits, as a treatment for scurvy by the time James Lind had entered the British Royal Navy as a surgeon's mate in 1739. He became a full surgeon in 1746, and he was aboard the HMS Salisbury in 1747, when there was an outbreak of scurvy.

• 39:47Tracy V. Wilson?

  Lind did an experiment, which is sometimes described as the world's first controlled clinical trial. He selected 12 sailors, all of whom had scurvy, that he described as being at a similar point of progression. And he paired them up, and he gave each pair a different treatment over the course of two weeks. These were treatments that already existed for scurvy, except for seawater, which was apparently more of a placebo. Don't drink seawater. It's not a good plan. But these pairs were each given a quart of cider per day, 25 drops of elixir of vitriol three times a day, half a pint of seawater a day,

• 40:30Tracy V. Wilson?

  a nutmeg-sized paste of garlic, mustard seed, horseradish, balsam of Peru, and gum myrrh three times a day, two spoonfuls of vinegar three times a day, or two oranges and one lemon each day.

• 40:47Holly Frey?

  I mean, I might opt for the nutmeg-sized paste of garlic, but that's just me. I mean, I kind of do that anyway.

• 40:57Holly Frey?

  The men who were given cider improved somewhat. Because of the way cider was made at the time, it probably did have some vitamin C in it. But the two men who got oranges and lemons improved so dramatically that they were determined to be well after six days. And from that point, they actually helped take care of the others.

• 41:16Tracy V. Wilson?

  While he was writing about this, Lind referenced Baldwinus Rossinius writing about oranges curing Dutch sailors from like 200 years before. And he said, quote, "Here indeed is a remarkable and authentic proof of the great efficacy of juice of lemons against this disease. But these fruits have this particular advantage above any theory that can be prepared for trial, that their experienced virtues have stood the test of near 200 years."

• 41:44Holly Frey?

  Lind left the Navy in 1748. In 1753, he wrote "A Treatise of the Scurvy," containing an inquiry into the nature, causes, and cure of that disease, together with a critical and chronological view of what has been published on the subject. And while this did include the sentence, "oranges and lemons were the most effectual remedies for this distemperate sea," that was only one tiny part of a 400-page work that talked about a lot of other stuff related to scurvy. For example, he did not think there was a direct cause-and-effect relationship between the fruit and the scurvy. He actually thought scurvy was a digestive disease that was caused by blocked sweat glands, and that the fruit, and to a lesser extent, the cider,

• 42:29Holly Frey?

  were all clearing those blockages. And he also thought that other blockage-clearing substances could potentially have the same effect.

• 42:38Tracy V. Wilson?

  Lynde also recognized that you cannot really just keep citrus fruits fresh on a ship for a lengthy sea voyage. So he recommended concentrating the juice into a rob. But because of the way that rob was concentrated, the end result would not have actually contained much vitamin C at all.

• 42:59Holly Frey?

  I'm thinking of people who drink orange-flavored drink and make jokes about not getting scurvy, and I'm like, there's not really much orange in that.

• 43:08Tracy V. Wilson?

  Yeah.

• 43:09Holly Frey?

  Over the next decades, other people writing about citrus fruits and scurvy attributed their effectiveness to their being a stimulant, or because they were full of a "vital air" that was leaching out of sailors' bodies at sea. Irish Dr. David McBride tested malt wort, which he believed provided "fixed air" as a scurvy treatment, although his results were clouded by the fact that he also gave some of his patients citrus fruit.

• 43:36Tracy V. Wilson?

  Another person who claimed to conquer scurvy was Captain James Cook. And although there were some scurvy outbreaks on his voyages, there weren't any deaths because of it. His preferred scurvy preventives were portable soup, which was basically bullion powder, which I am calling portable soup from now on. As well as malt and sauerkraut. And of those three things, only the sauerkraut would have contained much vitamin C, as long as they were eating it raw. He also insisted on bringing fresh provisions onto the ship at every possible stop, which would have kept them supplied more with fresh fruits and vegetables. And he also insisted on keeping the ship really clean,

• 44:19Tracy V. Wilson?

  which would have helped slow the spread of communicable diseases.

• 44:23Holly Frey?

  Finally, after hundreds of years of various people suggesting that citrus might play some part in curing scurvy, in 1795 Gilbert Blaine got the British Royal Navy to issue lemon juice to every sailor. This worked to Britain's advantage during the Napoleonic Wars. And during the 19th century, more and more European explorers and naval officials started stressing the need for lemon or lime juice, or for some kind of fresh vegetables onboard. In 1821, William Perry's expedition to the Arctic took, quote, "a shallow tray filled with mold on which to grow mustard and cress." And their party's only death from scurvy was an officer who refused to eat them.

• 45:08Holly Frey?

  Sir John Franklin's expedition in 1845 kept scurvy at bay for 27 months with lemon juice, with scurvy outbreaks beginning only after that supply of lemon juice ran out.

• 45:20Tracy V. Wilson?

  For the most part, the British Navy had started out using lemon juice, made from lemons from the Mediterranean, to prevent scurvy. In the mid 19th century, they instead started using limes from the Caribbean islands of Montserrat and Bermuda. Part of the rationale here was the idea that lime juice was more acidic and would thus be more effective at clearing out purported blackages. It was also because Britain had claimed those islands as territories, so there was, they could get things from them.

• 45:51Holly Frey?

  That was a free asset to them.

• 45:53Tracy V. Wilson?

  In their minds, for sure.

• 45:55Holly Frey?

  To them is the very, very important part of that phrasing. But scurvy outbreaks kept happening in other places besides European navies. Scurvy was a problem during the Great Famine that started in Ireland in 1845, which would later lead people to incorrectly conclude that it was connected to potassium deficiency. When pasteurization was introduced in the late 19th century, there was an outbreak of scurvy in babies whose families were wealthy enough to be feeding them pasteurized milk.

• 46:26Tracy V. Wilson?

  In the early 20th century, researchers at the Lister Institute in London realized that guinea pigs could develop a condition that seemed identical to scurvy. As we mentioned up at the top of the show, guinea pigs also cannot synthesize their own vitamin C. Axel Holst and Theodore Froelich discovered that if the guinea pigs were fed only grains, they became ill. But then if they were given cabbage or lemon juice, they got better. They published their work on this in 1907. And then five years later, in 1912, was when Casimir Funk coined the term vitamin, which later morphed into vitamin.

• 47:05Holly Frey?

  At this point, the Lister Institute was doing a lot of research into nutritional deficiencies, with many of the researchers being women. At the institute, Harriet Chick and Margaret Hume started identifying more and more foods that had antiscorbutic properties, including cabbage, onions, carrots, fruit juices, and potatoes. Alice Henderson Smith also researched exactly which fruits had historically been used in British Navy treatments and their efficacy.

• 47:35Tracy V. Wilson?

  By the 1920s, it was clear that scurvy was a deficiency in a specific nutrient, but nobody had been able to isolate the nutrient itself. Then in 1928, Albert Zent Giorgi isolated a compound in paprika that he named hexyronic acid, but it was later renamed ascorbic acid because of its whole antiscorbutic effect. In 1937, he was awarded the Nobel Prize in Physiology or Medicine, quote, "for his discoveries in connection with the biological combustion processes with special reference to vitamin C and the catalysis of fumaric acid."

• 48:13Holly Frey?

  Today, it is of course, common knowledge that vitamin C prevents scurvy, but it can still develop anytime people cannot get enough vitamin C.

• 48:22Tracy V. Wilson?

  Yeah, it's a...

• 48:25Tracy V. Wilson?

  I read lots of articles about various outbreaks in various places for everything from like refugee camps where there just are not adequate provisions to like fad diets where people have tried to cut all fruit out of their diet, like just all over the place. And you know, as we said at the top of the show, people who have, whether it's a physiological condition or a psychological condition, who either aren't able to eat or aren't able to absorb nutrients from their food, lots of cases still happen today.

• 49:02Tracy V. Wilson?

  Thanks so much for joining us on this Saturday. If you'd like to send us a note, our email address is [email protected]. And you can subscribe to the show on the iHeart Radio app, Apple Podcasts, or wherever you listen to your favorite shows.

• 49:24Tracy V. Wilson?

  Deanna Flores is a flag football star, a trailblazer, an entrepreneur, and now host of a new podcast.

• 49:30Holly Frey?

  In Born to Become with Deanna Flores, she's sitting down with people from every corner of culture to find the whole person behind the public identity.

• 49:38Tracy V. Wilson?

  Every episode, you'll get to know Deanna, her guests, and even yourself a little better. No lectures, no no at all host, just real people being real.

• 49:46Holly Frey?

  Listen to Born to Become with Deanna Flores, out now on the iHeart Radio app or wherever you get your podcasts. Created in partnership with Geico. A rare disease diagnosis can change your life, but it doesn't have to define your future. In season seven of Untold Stories: Life with a Severe Autoimmune Condition, host Martine Hackett continues the conversation with people living with MG, CIDP, and the broader rare disease community, exploring what comes after diagnosis through stories of hope, progress, and connection. Produced by Ruby Studio in partnership with Argenx. Listen on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts.

• 50:26Tracy V. Wilson?

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• 51:11Tracy V. Wilson?

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• 51:33Speaker 05

  Live Right, publishers of John U. Bacon's New York Times bestseller, The Gales of November, a chronicle of the S.S. Edmund Fitzgerald's 1975 shipwreck. "Never has it been told better than by Mr. Bacon in this colorful book," writes John J. Miller of The Wall Street Journal, while author Hampton Seitz proclaims that it's destined to be a classic. The Gales of November, now in paperback.

• 52:01Speaker 00

  This is an iHeart Podcast. Guaranteed Human.