One must be constantly on the watch for the first stage, for unless carefully looked for it will probably not be recognized, as the man affected can give little clue to what is wrong with him. I saw many hundreds of such cases during the war in North Russia when scurvy was common, none of them showing any local signs at all. When the better-known signs appear, such as spongy gums, blotches in the skin and lumps in the legs, the disease is in an advanced stage.
My own arrangements for prevention were published in full prior to our start in the Lancet, August 13th, 1921. I believe this is the only Antarctic expedition that on setting out has not taken chances with scurvy, though the absence of any signs of the disease from any of Sir Ernest Shackleton’s own parties is remarkable. The reason is that the necessary knowledge had not till that time been available.
Space forbids a full description here, but there are two important points to which I must refer: Dried cereals by themselves do not contain active anti-scorbutic vitamin, but if made to germinate the green shoots which sprout from them are rich in it. This is a point of immense practical value, the application of which is obvious. With regard to fresh meat, it has been shown by Stefansson in the North, and by members of the Endurance expedition in the South, that health can be maintained on a purely meat diet, and that fresh meat, if taken in sufficient quantity, is effective to cure scurvy. Stefansson, in the Friendly Arctic, says that it must be eaten raw or very much underdone, but our experience in the South showed that this is not necessary. In fact, a certain degree of cooking is advisable. He states also that putrefactive meat is an effective cure for scurvy. This I think is dangerous teaching; in any stage of scurvy anything putrefactive should be avoided if possible unless there is nothing else.
Those general readers who desire to learn more of this most interesting disease are referred to the bibliography at the end of the report.
On this expedition there was no scurvy, and no risk of it, for we were never long enough away from sources of fresh food. Yet I would emphasize the necessity of strong anti-“deficiency disease” measures in polar work, whatever the programme may be, for in the pack ice accidents may at any time occur leading to altogether unforeseen conditions as regards food supply.
Frost-bite is a condition well known to all polar explorers. If neglected it may lead to most crippling results, and, like scurvy, requires careful preventive measures.
The parts of the body most commonly affected are the exposed parts of the face, especially where the skin is drawn tight over underlying bone, e.g. the sides of the nose, the cheekbones and the chin; the ears, the fingers and the toes. In parts other than the fingers and toes the condition is usually not serious, for frost-bite of the face and ears, if neglected, may cause disfigurement, but no real crippling. It is a good practice for men in company to scrutinize each others’ faces, and a valuable piece of equipment is a small mirror in which a man without companions can examine his own face. Frost-bite of the fingers, though more serious, is usually quickly recognized and promptly treated.
Frost-bite of the toes and feet is an extremely dangerous condition and may have far-reaching results. The danger lies in the fact that its incidence is often unknown to the man attacked, and, though he may suspect its onset, he may neglect to examine his feet, for polar footgear is elaborate and cumbersome, examination of toes on the march means a halt, and a certain amount of time is consumed in unfastening and securing the foot-coverings.
Prevention is aimed at generally by maintaining health and a vigorous circulation. Anything which depresses the health and lowers vitality predisposes to frost-bite. In polar work the most important are exhaustion, hunger and vitamin deficiency. During a sledge journey vitamin deficiency, the consequent lack of resistance, and the more easily induced frost-bite create a condition of the gravest danger to the man or the party so affected.
Locally, prevention lies in providing suitable clothing. In whatever form it takes the principle aimed at is the same, viz. to provide a non-conducting air space round the skin. The head and ears are protected by woollen and windproof helmets. The face cannot be covered, for masks get so heavily iced up as to make things worse. A cowl can be fitted to the helmet which, when thrown forward, to some extent shields the face from winds. The hands are enclosed in mitts, not gloves, in which the fingers are all together. The finger portion should be large enough to allow inclusion of the thumb when the hand is not in use. Sometimes two or three pairs are worn, the outer pair being of windproof material.