CAUSES.——The scurvy is occasioned by cold moist air; by the long use of salted or smoke-dried provisions, or any kind of food that is hard of digestion, and affords little nourishment. It may also proceed from the suppression of customary evacuations; as the menses, the hæmorrhoidal flux, &c. It is sometimes owing to a hereditary taint, in which case a very small cause will excite the latent disorder. Grief, fear, and other depressing passions, have a great tendency both to excite and aggravate this disease. The same observation holds with regard to neglect of cleanliness; bad clothing; the want of proper exercise; confined air; unwholesome food; or any disease which greatly weakens the body, or vitiates the humours.
SYMPTOMS.——This disease may be known by unusual weariness, heaviness, and difficulty of breathing, especially after motion; rottenness of the gums, which are apt to bleed on the slightest touch; a stinking breath; frequent bleeding at the nose; crackling of the joints; difficulty of walking; sometimes a swelling and sometimes a falling away of the legs, on which there are livid, yellow, or violet-coloured spots; the face is generally of a pale or leaden colour. As the disease advances, other symptoms come on; as rottenness of the teeth, hæmorrhages, or discharges of blood from different parts of the body, foul obstinate ulcers, pains in various parts, especially about the breast, dry scaly eruptions all over the body, &c. At last a wasting or hectic fever comes on, and the miserable patient is often carried off by a dysentery, a diarrhœa, a dropsy, the palsy, fainting fits, or a mortification of some of the bowels.
CURE.——We know no way of curing this disease but by pursuing a plan directly opposite to that which brings it on. It proceeds from a vitiated state of the humours, occasioned by errors in diet, air, or exercise; and this cannot be removed but by a proper attention to these important articles.
If the patient has been obliged to breathe a cold, damp, or confined air, he should be removed, as soon as possible, to a dry, open, and moderately warm one. If there is reason to believe that the disease proceeds from a sedentary life, or depressing passions, as grief, fear, &c. the patient must take daily as much exercise in the open air as he can bear, and his mind should be diverted by cheerful company and other amusements. Nothing has a greater tendency either to prevent or remove this disease, than constant cheerfulness and good humour. But this, alas! is seldom the lot of persons afflicted with the scurvy; they are generally surly, peevish, and morose.
When the scurvy has been brought on by a long use of salted provisions, the proper medicine is a diet consisting chiefly of fresh vegetables; as oranges, apples, lemons, limes, tamarinds, water-cresses, scurvy-grass, brook lime, &c. The use of these, with milk, pot-herbs, new bread, and fresh beer or cyder, will seldom fail to remove a scurvy of this kind, if taken before it be too far advanced; but to have this effect, they must be persisted in for a considerable time. When fresh vegetables cannot be obtained, pickled or preserved ones may be used; and where these are wanting, recourse must be had to the chymical acids. All the patient’s food and drink should in this case be sharpened with cream of tartar, elixir of vitriol, vinegar, or the spirit of sea-salt.
These things however will more certainly prevent than cure the scurvy; for which reason sea-faring people, especially on long voyages, ought to lay in plenty of them. Cabbages, onions, gooseberries, and many other vegetables, may be kept a long time by pickling, preserving, &c. and when these fail, the chymical acids, recommended above, which will keep for any length of time, may be used. We have reason to believe, if ships were well ventilated, had good store of fruits, greens, cyder, &c. laid in, and if proper regard were paid to cleanliness and warmth, that sailors would be the most healthy people in the world, and would seldom suffer either from the scurvy or putrid fevers, which are so fatal to that useful set of men; but it is too much the temper of such people to despise all precaution; they will not think of any calamity till it overtakes them, when it is too late to ward off the blow.
It must indeed be owned, that many of them have it not in their power to make the provision we are speaking of; but in this case it is the duty of their employers to make it for them; and no man ought to engage in a long voyage without having these articles secured.
I have often seen very extraordinary effects in the land-scurvy from a milk diet. This preparation of Nature is a mixture of animal and vegetable properties, which of all others is the most fit for restoring a decayed constitution, and removing that particular acrimony of the humours, which seems to constitute the very essence of the scurvy, and many other diseases. But people despise this wholesome and nourishing food, because it is cheap, and devour with greediness, flesh, and fermented liquors, while milk is only deemed fit for their hogs.
The most proper drink in the scurvy is whey or butter-milk. When these cannot be had, sound cyder, perry, or spruce-beer, may be used. Wort has likewise been found to be a proper drink in the scurvy, and may be used at sea, as malt will keep during the longest voyage. A decoction of the tops of the spruce fir is likewise proper. It may be drank in the quantity of an English pint twice a-day. Tar-water may be used for the same purpose, or decoctions of any of the mild mucilaginous vegetables; as sarsaparilla, marsh-mallow roots, &c. Infusions of the bitter plants, as ground-ivy, the lesser centaury, marsh-trefoil, &c. are likewise beneficial. I have seen the peasants in some parts of Britain express the juice of the last-mentioned plant, and drink it with good effect in those foul scorbutic eruptions with which they are often troubled in the spring season.
Harrowgate water is certainly an excellent medicine in the land-scurvy. I have often seen patients who had been reduced to the most deplorable condition by this disease, greatly relieved by drinking the sulphur-water, and bathing in it. The chalybeate water may also be used with advantage, especially with a view to brace the stomach after drinking the sulphur-water, which, though it sharpens the appetite, never fails to weaken the powers of digestion.