It has been supposed by many that Hippocrates described scurvy under
the name of _enlarged spleen_, an affection attributed to the use of
stagnant water and characterized by tumefaction of the gums, foul
breath, pale face, and ulceration of the lower limbs. But the study of
this Hippocratic passage leads us to think that these symptoms were
more of the character of scrofula than of scurvy. The recital by Pliny
of the diseases of the Roman soldiers while on an expedition to Germany
seems to indicate scurvy, which Coelius Aurelianus, and after him the
Arabian physicians, claims presented only a slight analogy to that
affection.
Springer thinks that we may find the first traces of scurvy in the
expedition of the Normans to Wineland, in the first years of the
eleventh century. In admitting that the men commanded by Eric Thorstein
were obliged to winter on the western shores of Wineland and almost
all succumbed to an endemic malady of that country, proves that it was
nothing but scurvy, although that word’s only signification, in Danish,
is ulceration of the mouth.
We have, besides, another document, which has great authentic value,
a proof transmitted to us by our earliest and best chronicler of the
Middle Ages, by Joinville, the friend and companion of Saint Louis in
his Crusade into Palestine. In his memoirs he gives a very succinct
recital of the epidemic of famine and scurvy which attacked the French
army on the banks of the Nile in 1248, just after the battles of
Mansourah. Says Joinville: “After the two battles just mentioned,
commenced our great miseries in the army; at the end of nine days
the bodies of our dead soldiers arose to the surface of the water
(their tissues were corrupted and rotten), and these corpses floated
to a point between our two camps (those of the King and the Duke of
Bourgogne), at a point where a bridge touched the water. So many had
been slain that a great crowd of corpses floated on the stream for a
long distance. The bodies of the dead Saracens were sickening; the army
servants threw open a portion of the bridge and permitted the dead
infidels to float down the river, but they buried the dead Crusaders in
great pits dug in the ground. I saw among other dead the body of the
Chamberlain of the Count D’Artois, and many other friends among the
slain.
“The only fish we had eaten for four months were of the variety called
_barbus_, and these _barbus_ fed on the dead bodies, and for this cause
and other miseries of the country where never a drop of rain fell
sickness entered our army of such a sort that the flesh on the limbs
dried and the skin on the legs became black and like old leather boots,
and many sick rotted in their groin; and all having the last named
symptom died. Another sign of death was when the nose bled.”
The relation of Joinville leaves no doubt as to the nature of the
epidemic that attacked the Crusaders. Here we have a pen picture of
the debility, the hemorrhages, the livid ecchymosis of the skin, the
fungous tumefaction and bleeding of the gums, which characterize the
disease known as scurvy.
According to the writings of some German physicians of the fifteenth
century, this malady was endemic in the septentrional portions of
Europe upon the shores of the Baltic Sea. In Holland numerous epidemics
of scurvy were observed among the lower classes of the population,
coinciding with bad conditions of public hygiene. Food consisting
of salt and smoked meats, dwellings located on marshy ground, cold
atmospheres charged with fogs, etc., etc.
This was the same affection that attacked our colonies in Canada, but
at that time we had no knowledge of the therapeutic indications in such
emergencies, and quote as a proof of this a remarkable observation
inscribed on the registers of Cartier on his vessels during his sojourn
in Canada: “The disease commenced in our midst in a curious and unknown
manner; some patients lost their flesh and their limbs grew black and
swollen like charcoal, and some were covered over with bloody splotches
like purpura; after which the disease showed itself on the hips,
thighs, arms, and neck, and in all the mouth was infected and rotten
at the gums, so that all the flesh fell off to the roots of the teeth,
which also most often dropped out; and so terrible was this plague that
on my three ships by February only ten healthy men were about out of a
crew of over a hundred.
“And, as the disease was unknown to us, the Captain of the ships was
asked to open a few bodies to see if we could possibly detect the
lesion and thus be able to protect the survivors. We found the hearts
of the dead to be white and withered, surrounded by a rose colored
effusion; the liver healthy, but the lung black and mortified and all
its blood retired to the sac of the heart. The spleen likewise was
impaired for about two finger-lengths as though rubbed by a rough
stone.”
From this autopsy rudely made[26] it is true we discern most of the
signs of scrofula; a profound alteration of the blood and an effusion
of the liquids into certain viscera, denoting a diminution in the
amount of fibrin and the number of globules, alterations that also
serve to explain the tendency to hemorrhages observed in very serious
cases of scurvy.