When life gives you lemons…

In this week's "An Eye for an I", we learn about the case of scurvy, a disease we learned to cure before we fully understood.

How are you spending your summer holidays? Are you huddled in front of the TV or computer, punching away on your joystick or keyboard determined to complete the last level of the latest game you purchased? Or do you brave the worsening heat and go out to play with your friends?

If you do a bit of the latter, you probably know that you are not only getting physical exercise, but also giving yourself the chance to synthesise vitamin D which is produced by the skin using natural ultraviolet radiation from sunlight.

Talking about vitamins, did you know that almost all of them were discovered only during the first half of the twentieth century? Till about 1910, no one knew about vitamins. . Then how is it that scurvy, a disease that we now know is caused by the lack of vitamin C, had a treatment much before that? Let’s find out.

Even though its cause remained unknown, scurvy is well documented through history. Its symptoms, which included loose teeth, swollen gums, haemorrhages, fatigue and wounds that didn’t heal quickly, were known. It was also known that it affected sailors and those out on voyages and a long way from the shore the most. What was not known to the Europeans who were expanding their empires in the 18th century was how to cure it.

James Lind, born in Edinburgh on October 4, 1716, was the son of a merchant whose wife had connections in the world of medicine. Even though Lind wasn’t formally enrolled in Edinburgh University, he attended lectures in an ad hoc basis and took particular interest in the human anatomy. After a surgical internship, he joined the Royal Navy as a surgeon's’ mate in 1738. It was during this tenure, when he was aboard the Salisbury that Lind was able to put some of his theories into practice.

Lind believed that dietary supplements would be able to tackle scurvy and therefore performed a controlled trial. Lind divided 12 men who had scurvy into six groups of two each and administered specific supplements to each of these pairs. Lind made sure to keep all the participant’s clinical condition, basic diet and environment constant to avoid false results.

At the end of six days, the pair that was supplied with oranges and lemon recovered, and one of them was sufficiently fit to report for duty before Salisbury docked. Following what happened in this voyage in 1747, Lind assimilated more data and by 1753 first published A Treatise of the Scurvy in which he described his findings.

Even though Lind had suggested in this book that citrus fruits had medicinal properties which could cure scurvy, it took decades for the Royal Navy to accept and implement his recommendations. Lemon or lime juices were included as part of the standard ration for sailors only from 1795 and from then on scurvy almost completely disappeared. Since this episode Americans and Australians began to use the slang nickname “limey” to refer to the British, especially sailors.