Chapter 1 - James Lind and Scurvy

Abstract

Scurvy is a disease that results from lack of fresh fruit and vegetables, now known to be caused by vitamin C (ascorbic acid) deficiency, causing symptoms of fatigue, lethargy, limb pains, swollen and bleeding gums, joint pain, shortness of breath on exertion, skin bruising, and, if untreated, death. Identified as a disease in the 16th century and widely attributed to infection, it was common among seamen with disastrous loss of life on long voyages. In 1747, James Lind, a young naval surgeon, conducted a clinical trial of comparing nutritional treatment of sailors with scurvy, which showed the cure to be citrus fruit, and reported on his finding to the Royal Society. The Royal Navy later made consumption of lemon juice mandatory to preserve the health of sailors and to allow ships to stay at sea longer. Lind’s study is considered a first in epidemiology as a case-control study opening the field of nutritional epidemiology with vital public health implications that continue today. Scurvy gradually passed from public health consciousness but vitamin C has recently attracted attention as a common micronutrient deficiency globally with dietary intake of fruit and vegetables daily, and vitamin C fortification of basic foods as public health nutritional intervention.