\u201cA disease caused by prolonged severe dietary deficiency of ascorbic acid, in which the breakdown of intercellular cement substances leads to capillary hemorrhages and defective growth of fibroblasts, osteoblasts, and odontoblasts results in impaired synthesis of collagen, osteoid, and dentine; it is characterized by haemorrhagic gingivitis affecting especially the interdental papillae (in the absence of teeth, the gums are normal), subperiosteal hemorrhages, bone lesions (including the corner fraction sign, a ground-glass appearance, and trabecular atrophy) seen on radiography, perifollicular hemorrhages, and frequently petechial hemorrhages (especially on the feet).\u201d – World Health Organization <\/a><\/p>\n\n\n\n \u201cAn illness of the body tissues that is caused by not having enough vitamin C\u201d – Cambridge Dictionary <\/a><\/p>\n\n\n\n \u201cScurvy is a disease that results from a vitamin C deficiency. It can lead to anemia, exhaustion, spontaneous bleeding, limb pain, swelling, and sometimes ulceration of the gums and loss of teeth.\u201d – MedicalNewsToday <\/a><\/p>\n\n\n\n \u201cVitamin C deficiency, also known as scurvy, is a disease primarily associated with socioeconomic status and access to food.\u201d – Maxfield<\/a><\/p>\n\n\n\n This is because vitamin C is\u201d\u2018necessary to make collagen, an important component in connective tissues.\u201d 1<\/sup> <\/strong>Connective tissues are \u201cessential for structure and support in the body, including the structure of blood vessels.\u201d 2<\/sup> A \u201clack of vitamin C will also affect the immune system, iron absorption, cholesterol metabolism, and other functions.\u201d 3 <\/sup><\/p>\n\n\n\n Scurvy is caused by not having enough vitamin C in your diet \u201cfor at least 3 months\u201d. <\/strong>2 <\/sup>Several risk factors that can contribute to the development of scurvy: <\/p>\n\n\n\n Scurvy is a \u201cprogressive disease; the longer it’s left untreated, the more symptoms you’ll experience.\u201d 5<\/sup> <\/strong>Some of the most common symptoms include:<\/p>\n\n\n\n It has been estimated the disease killed more than \u201c2 million sailors between the 16th and 18th centuries.\u201d 6<\/sup> <\/strong>Vasco da Gama lost \u201c116 of 170 men on his first voyage to India in 1499, almost all to scurvy while Commodore George Anson returned from a four-year circumnavigation in 1744 with only 188 of the 1,854 men he had departed with, most losses because of scurvy.\u201d 6<\/sup> <\/strong>According to historian Stephen Bown, \u201cscurvy was responsible for more deaths at sea than storms, shipwrecks, combat, and all other diseases combined.\u201d 7<\/sup> <\/p>\n\n\n\n Scurvy has been known since ancient Greek and Egyptian times, with the \u201cfirst observations on scurvy first appearing in Egyptian medical scrolls 3500 years ago\u201d. 8<\/sup> <\/strong>The disease continued to be \u201calluded to in many historical texts from Hippocrates in the 5th century all the way to the Crusades, where the first comprehensive description of the disease was recorded\u201d. 9<\/sup> Despite its recognition, its causes were largely unknown. The lethargy caused by scurvy was \u201cso intense that people once believed that laziness was the cause of the disease.\u201d 5<\/sup> <\/strong>Moreover, the fact that other mammals can synthesize vitamin C, and therefore cats and dogs on ships remained healthy despite eating no fruit or vegetables, \u201cseemed to point away from diet as scurvy\u2019s cause\u201d. 6<\/sup> <\/p>\n\n\n\n 1847 <\/p>\n\n\n\n James Lind<\/p>\n\n\n\n Throughout the early 20th century, the understanding that consuming foods rich in vitamin C could effectively treat scurvy underwent a cycle of frequent neglect and rediscovery. <\/p>\n\n\n\n In 1747, an \u201cimportant milestone in the history of clinical research was set, as the Scottish surgeon James Lind conducted the first randomized controlled trial of 12 sailors.\u201d <\/strong>16<\/sup> He formally demonstrated that a \u201cdietary intervention with oranges and lemons, rich in vitamin C, was effective in recovering from scurvy.\u201d 16<\/sup> However, Lind was \u201cstill wedded to the established humor-based view of health and tried to shoehorn his findings into it.\u201d 6<\/sup> The result of his studies was published in 1753 \u2014A Treatise on the Scurvy\u2014in which \u201conly a few paragraphs were devoted to his shipboard experiment\u201d, and \u201cpoor diet was identified as just one of several causes\u201d. 6<\/sup><\/p>\n\n\n\n Throughout history, various foods have been employed to treat scurvy, a debilitating disease caused by vitamin C deficiency. As early as the 11th century, \u201cseafarers were advised to carry a range of fruits and vegetables such as apples, pears, pomegranates, cucumbers, citrons, lemons, muscats, and pickled vegetables as preventive measures against scurvy.\u201d 17<\/sup> Early explorers in North America also noticed that Native Americans, \u201cconfined to a diet of dried meat during the winter, supplemented their diets with tea made from pine needles and scurvy grass\u201d. 6<\/sup> Following these observations, several European countries experimented with \u201cpreparations of various conifers, such as spruce beer, as cures\u201d for scurvy. 18 <\/sup><\/p>\n\n\n\n By the end of the 18th century, sprouted beans and beer were recommended as antiscorbutics, though both proved to be of minimal value after processing (e.g., dried, powdered, boiled). 17<\/sup> In \u201cthe 19th century, Native Americans helped save some newcomers from scurvy by directing them to eat wild onions.\u201d 18<\/sup> Then, Following Lind\u2019s discovery that citrus juice cured the disease, \u201cthree-quarters of an ounce of lemon juice per day was mandated to be given to every sailor serving throughout the Royal Navy,\u201d essentially eradicating scurvy. 5 <\/sup><\/p>\n\n\n\n Source: Vitamin C – Health Professional Fact Sheet<\/a> <\/p>\n\n\n\n The U.S. Department of Agriculture\u2019s (USDA\u2019s) FoodData Central<\/a> lists the nutrient content of many foods and provides a comprehensive list of foods containing vitamin C arranged by nutrient content and by food name.<\/p>\n\n\n\n Vitamin C Content Database:<\/strong> USDA National Nutrient Database for Standard Reference Release 28<\/a> <\/p>\n\n\n\n The contemporary understanding of scurvy started to emerge in the 20th century. In 1907, Holst and Fr\u00f8lich found they could \u201ccure scurvy in guinea pigs with the addition of fresh foods and extracts.\u201d 20<\/sup> Then, in 1927, Hungarian biochemist Albert Szent-Gy\u00f6rgyi isolated a compound he called “hexuronic acid,” which he suspected to be the \u201cantiscorbutic agent\u201d, but he could not prove it. <\/strong>21<\/sup> In 1932,\u201d the connection between hexuronic acid and scurvy was finally proven by American researcher Charles Glen King\u201d. 22<\/sup> Finally, everything became clear in 1933 when Norman Haworth showed that \u201cvitamin C is fundamental for our body, and since the human body is not able to produce it, vitamin C has to be obtained through the diet.\u201d 23<\/sup> <\/p>\n\n\n\n Treatment involves administering vitamin C supplements.<\/p>\n\n\n\n The recommended dosages are :<\/p>\n\n\n\n Adults: <\/strong>\u201c1 to 2 grams of vitamin C be administered daily for the first 2 to 3 days, followed by 500 mg per day for the next week. Afterward, a daily intake of 100 mg of vitamin C should be given for 1 to 3 months.\u201d 24<\/sup><\/p>\n\n\n\n Children: \u201c<\/strong>100 mg 3 times daily for at least one week, followed by 100 mg daily until symptoms have resolved.\u201d 25 <\/sup><\/p>\n\n\n\n Within \u201c24-72 hours, people can expect to see an improvement in fatigue, lethargy, pain, anorexia, and confusion\u201d. 26<\/sup> Meanwhile, \u201cfull recovery can be expected in 1-3 months.\u201d 26<\/sup> <\/strong><\/p>\n\n\n\n Modern cases of scurvy are \u201crare in the United States or Europe due to the wider availability of fresh fruits and vegetables.\u201d 3<\/sup> <\/strong>However, it can still occur in \u201ceconomically exploited regions and some low or middle-income countries.\u201d 27<\/sup> For example, \u201cin developing countries such as northern India, the incidence can be as high as 73.9% due to limited access to Vitamin C-rich fruit and vegetables.\u201d 26<\/sup><\/p>\n\n\n\n As understanding of the relationship between vitamin C deficiency and scurvy deepened, public health efforts expanded to address the broader population, including: <\/p>\n\n\n\n \u201cOne puzzle for 19th century students of scurvy, who believed in the special properties of fresh fruits and vegetables, was that despite lack of access to these foods Inuits normally remained scurvy free. Inuits eat large quantities of meat and fish in a raw, or only slightly cooked, state. A considerable amount of vitamin C is thereby contributed to the diet even if the average con-centration is relatively low (see annex for the vitamin C content of some traditional Inuit diets). Inuits have been reported to eat the raw liver of both seals and caribou, and even a small amount of such organ meat would satisfy a day\u2019s requirement for the vitamin.\u201d 17<\/sup><\/p>\n\n\n\n \u201cLimey is a US slang for British person since the late 18th century and is an abbreviation of lime-juicer, which dates from the 1850\u2019s. Originally, the term referred specifically to British sailors because of their enforced habit (since 1795) of drinking lime juice to prevent scurvy\u2026 By that time, the Americans, and indeed sailors everywhere, followed suit and adopted well-established rules. Thus, for Americans, Brits have retained limeys ever since.\u201d 31 <\/sup><\/p>\n\n\n\nRole of Vitamin C<\/strong><\/h2>\n\n\n\n
Causes & Risk Factors <\/strong><\/h2>\n\n\n\n
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Symptoms <\/strong><\/h2>\n\n\n\n
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History <\/strong><\/h2>\n\n\n\n
Early Observations<\/strong><\/h3>\n\n\n\n
When was Scurvy discovered? <\/strong><\/h3>\n\n\n\n
Who is attributed with connecting the disease or deficiency to food as medicine?<\/strong><\/h3>\n\n\n\n
Discovery of its connection to nutrition <\/strong><\/h2>\n\n\n\n
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Food as Medicine – Historical approaches to treating the disease <\/strong><\/h2>\n\n\n\n
Food as Medicine – Antiscorbutic foods<\/strong><\/h2>\n\n\n\n
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Contemporary Understanding <\/strong><\/h2>\n\n\n\n
Modern Medical Intervention<\/strong><\/h2>\n\n\n\n
Scurvy Today <\/strong><\/h2>\n\n\n\n
Public Health Interventions<\/strong><\/h2>\n\n\n\n
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Anecdote- Inuit Diets <\/strong><\/h2>\n\n\n\n
Inuit\u2019s Puzzling Diets <\/strong><\/h3>\n\n\n\n
Why do Americans Call the British Limeys? Scurvy!<\/strong><\/h3>\n\n\n\n
Research Studies <\/strong><\/h2>\n\n\n\n
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News and Media <\/strong><\/h2>\n\n\n\n
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