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The Dibner Library of the History of SMITHSONIAN INSTITUTION LIBRARIES
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in 1941
Chartered
bat 4 Za =a-- ao) 55
GIFT OF
Davio DIBNE
boa, MMATHIN Ge
‘ ‘ »: : My.
into the Nature, Caufes, ¢, of that’ Difeafe, - are
Soya, "Together with Sute
Critical and Chronological View of. what ~ has been publifhed on the fubject.
" Fellow of the Royal College of Phyficians in Edinburgh. : SED PNR UOR CoH?
oe by Sanps, MurRRay, and Gocurax, For A. Miucan, in the Strand, Londen. A MPGGLIIL
OE 24 \
Pee ne DS LAN Ae laa ge UIP RNAs ih i" Sas ee as
0.0.
Soc cia eer
"The Riou Honounasze, i
“GEORGE Lord ANSON, “Oc. (Ba Be.
Who, as a juf reward for the great
_. and fignal fervices done to the Bri-
tis Nation, does now prefide over her Navat AFFAIRS,
The following T RE ATISE | oe “ag INSCRIBED, ! With the greateft refpec,
By his LORDSHIP’s Moft devoted, and Moft obedient
humble fervant,
JaMeEs Linp.
Mert pe Selon?
ep se Ce
PP at og . ae”
vd
H E fubject of the flowing eets is wap great importance to this nation; the moft . a : ees in her fleets, and the moff’ | frurifbing in her commerce, of any in the world. Armies have been fuppofed to lofe more of car “men by ficknefs, than by the fword. But this ob oN ie _ fervation has been much more verified in our fleets” and fquadrons ; where the feurvy alone, during the : faft war, proved a more deftruttive enemy, and - cut off more valuable lives, than the united efforts _ of the French and Spanith arms. It has not only } -occafionally committed Jurprifing ravages in fhips ced and fleets, but almoft always affects the conftitu» — =. tion of failors ; and where it does not rifé to any ~ eee vifible calamity, yet it often makes a powerful ad= | dition to the malignity of other difeafes. It is 4 wow above 150 years fince that great Jea-officer, 4 Sir Peter Hawkins, i his obfervations made in a voyage to the South fea, remarked it to be the pefiilence of that element. He was able, in the course of twenty years, in which he had been em= | payed at fea, to give an account of 10,000 7a- | ) riners
pee
ic rats ties Sede RCE ee sec * a 4 eR ee OP oes PERE MENS Ee sek: IP Vag REN Tree grt ae Geese a Sauer Ore et ee
Vi “ ‘_ R E £ AT ONE : viners deftroyed by it. But i r fatter ae that at-will appear from the following treatife, that the calanity may be prevented, and the danger of a
S phis defirndive evil obviated: nor is there any queftion, but every attempt to put a flop to fo confuming a plague, will meet with a favourable nce ption yarn the public.
dt is a ‘Subjed in anaes all pratlitioners of phyfic are highly interefted. For it will be found, ‘that the mifchief is not confined to the fea, but is - “extended particularly to armies at land; and is an endemic evil in many parts of the world. This difeafe, for above a century, has been the Suppofed - feourge of Europe. But how much even the learned world ftands in need of farther light in fo dark a region of phyfic, may appear from the late mournful ftory of the German troops in ‘Hungary, the difafter in Thorn, and from many
~ other relations in this treati ife.
9
What gave vcealign on to my tempting this work, as Hella as follows.
ssid Babe nucblladticn Ui tha RioheHoxoayle Lord Anton's voyage, by the Reverend Mr Wal- ee the lively and elegant pictare there exhibited.
FREPAGH &
wa the diftrefs ‘occafi toned by this difeafe, which afflicted the crews of that noble, brave, and ex- B seeiour Commander, in his paffage round the world, excited the curiofity of many to inquire into , ‘the nature of a malady accompamed with fuch ‘extraordinary appearances. It-was acknowledged, that the beft defcriptions of it are met with in the ac~ counts of voyages: but it was regretted, that thofe ‘were the produGions only of feamen; and that no . ‘phyfician converfant with this difeafe at fea, had undertaken to throw light upon the fubjed, and “clear it from the obfcurity under which it has lait in the works of phyficians who prattifed only at “Tand. Some time afterwards, the Society f fur- “geons ‘of the Royal navy publifhed their laudable . plan for improving medical knowledge, by the la- bours of its feveral members; who have oppor- “tunities of infpeding Nature, and examining dif- “eafes, under the varied influence of different éli- mates, feafens, and foils. I then wrote a paper on the feurvy, with a defign of having it publifbed “by them. ‘It appeared to me a Jubjet worthy of the firitteft inquiry: and I was led upon this oc- cafton to confult feveral authors who had treated of “the difeafe; where I perceived miftakes which 7 “have been attended, in prattice, with dangerous % and fatal ese ata er appeared to mei an ‘ evident
ry
Wi «=oP-R,EB FP A-C Bm
evident neceffity of rectifying thofe errors, on ace
count of the pernicious effects they have already
vifibly produced. But as it is no eafy matter to
root out old prejudices, or to overturn opinions
which have acquired an eftablifoment by time, cuftom, and great authorities; it became there- fore requifite for this purpofe, to exhibit a full and impartial view of what has hitherto been pu- blifhed on the feuruy ; and that in a chronological order, by which the fources of thofe miftakes may be detected. Indeed, before this fubje could be Jet ina clear and proper light, it was neceffary to remove a great deal of rubbifh. Thus, what was firft intended as a fhort paper to be publi ifhed in the memoirs of our medical navy-fociety, has wow fwelled toa volume, not altogether fuitable to the plan and inftitution of that laudable anh learned fod
I cannot, however, upon this occafi om, omib ackno wledging with gratitude the many excellent prattical obfervations I have been favoured with by fome of its moft worthy members ; efpecially by the ingevious Mr Ives of Gofport; BY, Mr John Murray, an eminent furgeon at Wells, in Nor- folk. Notwithftanding which advantages, I an Jenfible of many inaccuracies and tmperfections in
this
BRP
his performance. They are perhaps the more mumerous, as it has been fent to the prefs fooner than was at firft intended. There are, however, two things that may appear exceptionable, which f ought here qetenie’y to mention. —
. me Saft is the she f the ‘works
Lam farry to find myfelf under a neceffity of offering what fome of my readers may think very
indifferent entertainment, and that at their fetting out, in the critical chapters of the firft part. But it was not eafy to fall upon a method equally ad- apted to all readers: nor indeed is the arranges ment of the feveral chapters a matter of any great importance. The order here followed, is that in which it ought to be perufed by phyficians and men of learning, who have made this difeafe their ftudy, and are previoufly acquainted with former writings upon it. It was neceflary, ix order to deevall with fome of thefe gentlemen to perufe the fecond part with le[s prejudice againft me, to endeavour firft to remove fuch objections as. might arife from doctrines imbibed in younger Dears, in Schools aud univerfities.. Others, who. are not fo well acquainted with. the fabjed, f would advi ife fo begin with the fecand part; which b
yao lt
Fes Fo Be Mp nT AER Ry on akg, SN eR RRR NS ip GU EmB, e Phe Naess Se ae: m ‘ ie Cy ae & : tea
¢ PRS: AC f: : : will enable them to form a better judgment of the 1 oe firft. The Bibliotheca fcorbutica, or the col- lefion of authors on the fcurvy, is placed at the = latter end of the book, as proper to be confulted ; in the dictionary-way. And it is to be remark- : | ed, that when, to avoid repetitions in the firft and fecond parts, an author’s name is barely - mentioned, recourfe muft be had to the Alpha- betical Index; which points out the page where the title of the book referred to, or | its abridgment in part 3. is to be found, _
In the order of the chapters, the prevention of the difeafe precedes its cure: and the firft bemg the mof? material, I have thrown great part of*the latter into it; this method of treating the fcurvy _ fiiting it better than perhaps any other. It will appear, that in the plan I have purfued, I had in view an author whofe book has met with a ge-~ neral good reception, Aftruc de morbis venereis; and were other difeafes treated ia ike manner, it would greatly abridge the enormous, and frill : increafing number of books in eur Science,
What may be deemed by critics equally excepa tionable with the order of the chapters, are fome few repetitions. But in certain cafes they were
PRE RP FG hm - 3G weceffary, in order to obviate prejudices at the time they might naturally arife, and to inforce the “argument.
Ass to the contents of the book in general : In the firft part, I have endeavoured, by a connected courfe of reafoning in the feveral chap- ters, to eftablifo what is there advanced, upon the tlearef? evidence, ‘confirmed by fome of the beft authorities ; and have laid afide all fyftems and theories of this malady which were found to be difavowed by nature and fats. Where I have — been neceffarily led, in this difagreeable part of the work, to criticife the fentiments of eminent and learned authors, Ihave not done it with a _ malignant view of depreciating their labours, or their names: but from a regardto truth, and to the good of mankind. I hope fuch motives will, to the candid, and to the moft judicious, be a fuffici- ent apology for the liberties I have affumed.
Dies diem docet.
| The Diecpal chapters of the fecond part, con- ' taining a defcription of this difeafé, its caufes,
: fe means of preventing and curing it, are alfo . b 2 founded
Pe PREF Ac RB
founded upon attefted fats and obfervations, with out fuffering the illufions of theory to influence and pervert the judgment. For, that things certaiw: may precede what is uncertain, the theory, and the
inferences from it, are placed at the latter end.
In the third part, where I have given an a- bridgment of what has been written upon the fub- get by the moft celebrated medical avthors, and others, I have always endeavoured to exprefs their fentiments with as much clearnefs and con- cifenefs as I could. I have indeed through. the whole aimed at perfpicuity rather than elegance of didion, as moft proper in a book of fcience. To know a difeafe, and to cure it, being the two things moft effential to be learned; I have there- fore tranfcribed the fymptoms and cure of the feur- vy from thofe authors, where they do uot ees copy from each sho
a Si) ree ee “BS abe Ss or ai ied ee ne “ Pe Pa Sen OS eins me Re :
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Page. C ritical ify of the di ferent accounts s i 2 FESA Phe. Bs
OF its adedal divifions, viz. into feurvies
cold and hot, acid and alealine, &e. hh
OC. H&P. coh Of the diftinétion a made into a land
and fea feurvy | 61.
sae aS Pee AV | of the feurvy being conn late, hereditary, and
infectious ery abe 73,
PART
: > eT se ns - = RR a ee OO RN ee a ose Se,
The theory Bart 272
ay CON T E'‘N T 8;
Poon Te, GH A P. Py
Pages
| CK HE true caufes of the di ifeafey, from
obfervations made upon it, both at fea and land Se.
Ca ie See aan The diagnoftics, or figns | | 147 | Cc H ian P. UT The prognoftics era ey | | 175 Cc HA P. IV.
The. prophylaxis, or means of preventing «this ie = i efpecially at fea. 130 __
CoH A. ®, Vv.
- The cure of the difeafe, and its [imptoms 240
Ce ge eee ph Wh
tl i DRE eT hy ce a SUN gas rampage Geer he Gem Sy al 9 Bere, Deeg Mir tig hd et Eee ee Pa Dee ce eee * TES as fe a 5
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| et Page,
—— Diffedions — on | - 310 CoH A & 0 Sam.
‘The nature of the fymptoms, explained and
deduced from the foregoing theory and dif- _ fetions : reat ;
PU AGRA. Un tee” ke PS I. | Ps in ancient authors, fuppofed to | refer to this difeafe; together with the
firft accounts of it Tamers
Co A BoE
Bibliotheca {corbutica: or, 4 chronological view of what has hitherto been publifhed
| on the fcurvy 7 355
APPENDIX | 445
E R-
(£0 8 Th 8 T & Sv
317
341
DAT pats 7 ce eUNe
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: CHAS By ied. _ A critical hiftory of the different accounts o this 7 aaa
by: Ronffeus, Echthius, and Wie- rus (a), it is furprifing to find, not only an accurate defcription of it, -but an enu- meration of almoft all the truly antifcorbutic medicines that are known to the world e- ven at this day.
é
(a) The firft authors on the fcurvy. Ronfeus and Echthius,
though cotemporary, wrote feparately, without having the be-
nefit of feeing each others works.
A Ronffeus,
N the firft accounts given us of this if ‘
t ts at *
; .
iq
i
i A ae arith ae in h iaL SUL Ne cis ue nh casi ache |
Bo Critical Hiftory. -¢ Pare. _ Ronffeus, who believed it to be the fame dif- eafe that is defcribed by Pliny (2), and is faid to have afflicted the Roman army under the command of Cefar Germanicus, obferved, that in his time it was to be met with only in Hol- land, Friefland, and Denmark; though he had heard of its appearing in Flanders, Brabant, and fome parts of Germany. From {eeing fome of thofe countries entirely free from this diftemper, he was induced to afcribe its fre- quency in other places to their foil, climate, and diet. In order to prove which, he wrote his firft epiltle (¢ ).
Echthius {eems to be the firft who gave rife to the opinion of its being a contagious or in- fectious /ues. He was led into that miftake, by obferving whole monafteries who lived on the fame diet, and in the fame air, at once affect- ed with it, efpecially after fevers; which no doubt might become infeftious in clofe and confined apartments. He imagined, therefore, that a {curvy might in a manner be the crifis of a fever, -which as fuch he deemed conta-_ gious.
(2) Vid. part 3. chap. 1. (¢) Intitled, Quare apud Amferodamum, Alecmariam, atque aia Vicing loca, frequentiffime infefiet feorbutus ?
: ‘But
Chap. I. Critical Hiftory, “ie
— But where Wierus tranfcribes the fymptoms from this laft author, (which he does almoft verbatim ), upon this occafion he very juftly differs from him. He obferves, that the {cur- vy is not properly the crifis of a fever; but, like many other difeafes, may be occafioned
after it by unfound vifcera, and a vitiated ftate |
- of blood. He imagines people were induced
to believe it a contagious malady, by feeing
many whole families alike affe@ted; but this he afcribed to the famenefs of their diet. He was however deceived (probably by
‘the authority of Echthius) in thinking, that
where the gums were putrid, the difeafe might
_be sa rae accordingly makes it a doubt, whether.in fome parts of the Lower
Germany, where it had lately appeared, it was
owing to their diet, or to infection. But
it fhall be fully proved hereafter, that the {curs vy is not contagious or infectious (@).
-It may be proper to obferve further, that Wierus had defcribed the various and extraor- dinary fymptoms of this malady, in fo accurate
-amanner, that the fucceeding authors for a
long time did nothing more than copy him.
It was a confiderable time afterwards, when
(4) Chap, 4. ; Ae a a ae
ER Rees pee ee Le ee me wy ae
SS ee EY Ree eee ee Sot nee we EE SEEN ee a 4 ‘ : B
4 | Critical iftory. Part ft.
Solomon Albertus wrote a large treatife on this fabject, wherein he sihithds great merit to himfelf in difcovering a fymptom not taken no- tice of by any author, and which he had once or twice obferved in this difeafe, viz. a rigor or ftiffnefs of the lower jaw. However, Wie- rus {till continued in the greateft efteem and . reputation; and his book was deemed the ftandard on this fubject, even till the time of Eugalenus, who gives it that juft character, and refers to it almoft entirely for the cure. He mutt be allowed therefore to have been a good judge of this diftemper: and as he was a per- fon of eminent learning, as well as probity, (which his writings on this and many other fubjects fufficiently fhew), his word may be
relied upon, when he tells us, that in his time
this difeafe was peculiar to the inhabitants of the countries upon the north feas: he had ne- ver met with it in Spain, France, nor in Italy ; nor was it to be feen in the large tra&t of Up- per Germany: andas to Afia.and Africa, if ever it appeared there, it would no doubt be in fuch places as lay adjacent to the fea; where
fuch a fituation, and a erofs diet, with the ufe
_of putrid water, might give rife to it, in the
fame manner as they do in the countries where ! if
Chap. 1. Critical Hiftory, ;
it was endemic. Thefe were not conjectures in our author; for he wasa great traveller, and
had vifited all the places he talks of(e). A
- book wrote in thofe times by him, De pre/fi-
_ giis demonum, adds much to his reputation; as
it fhews he was neither fo weak, nor credu- | lous, as fome later writers on the f{curvy.
. Brunnerus, who may be deemed the next judicious author after him on this fubje&, ob- ferved, that in his time, when the ufe of wine
was become more common, the fcurvy was
not fo frequent as formerly, even. in thofe
- countries where it had been endemic.
-Notwithftanding which, in a very fhort time after, we are furprifed with accounts of this
- fuppofed contagious Jwes having fpread far and
wide. In lefs than thirty years after Wierus, Solomon Albertus, in his dedication to the Duke of Brunfwick, after fome very pathetic decla- mations on the vices of the times, obferves, that he had met with the {curvy every where; and that it prevailed in Mi/iia, — on the borders of Bohemia and Silefia, &c. However, the difeafe as yet ftill retained the fame face; the fymptoms and appearances in
it the fame. For though this author (who
Ce) Vid. Melchior Adam in vita Wieri, practifed
idyb ati ihc SRC cay Piel ia e Br
a Critical Hiftory, Pare fT. practifed in a place where Wierus fays the feur- vy was uncommon) had difcovered one extra- ordinary fymptom, before mentioned, fome- times accompanying it; and which certainly was but rarely to be feen, as it efcaped the ob- fervation of every one but himfelf: yet in o- ther refpects, he, as well as his contemporary writers, gives us the fame account of it as Wie. rus had done before; and particularly, that the putrid gums and {welled legs were the moft certain and only charateriftic figns of it (f). But in eleven years after him, we are like=°
wife acquainted by Eugalenus, with the fur-' prifing rapidity with which this contagious /ues’
had made its progrefs over almoft the whole world. And what is ftill more remarkable, the face of the difeafe was in a few years fo much changed, that the putrid gums and {welled legs were no longer charatteriftical figns of it, as it often killed the patient before thefe fymptoms appeared (g). And it is highly probable from
(f) Signa mali hujus charafterifiica non alia funt, preter dug illa (quorum fupra meminimus) gemina, fymptomata pathognomice appellata, indubia morbi indicia, viz. flomacace et fceletyrbe. Cetera Syimptamata ancipitia funt et vaga. Alberti hiftoria fcor- buti, p. 546.
(g) P.10o.and 211. The Amflerdam edition of ee: publithed i in the ad 1720, is here seat
the
Chapit. | Critical Hiftory. a.
the hiftories of above 200 cafes of patients de+ livered in his book, wherein mention is made of the gums being affected in one perfon only, that fuch fymptoms did now but rarely, if at all, occur. ees
This malady was alfo greatly increafed in
_wirulence, as he gives us to underftand in dif- ferent parts of his performance: all which he
would perfuade us to have proceeded from a
very fingular caufe (+ ).
Its effeéts and fymptoms were now various and innumerable (i): and it was alfo become a much more frequent calamity than it appears to have ever been formerly; at leaft, if we
' may take this author’s word for it, who upon
(4) P. 250. where talking of the pox and {curvy as both modern difeafes, Usrique etiam peculiare hoc noftro feculo fuit, ut : quam longiffime latiffimique fua pomeria dilatent et diffundant, atque procul a generationis fuce locis et terminis, ad incognita et remota lo~ ¢a excurrant evagenturque, atque fub diametrali linea, qua fibi ine vicem, fub polorum oppofitione, oppofita Junt, Je mutuo quafi comple. Gfantur, et inter fe virus ac venesim fuum communicent. Ita fit ut hodie etiam Germania, Anglia, Gallia, hic morbus innotefcat; a- pud quos antea ne quidem auditum ejus momen fuit. ‘He fays the fame thing in the dedication of his book to the Count of Na/au. Some of his editors have taken care to have this dedication fup- prefied in the later editions. It is indeed a moft curious piece.
(i) Tam varii fant effedus quos hic morbus edit, ut minimas o: wmnium diferentias numero comprehendere uon magis fers poffibile fit, quam arena Maris numerare, P. 217, ay EL
this
Rise ee eee ASD NSE
. ~ * 2 ; z * aon cerns aS ere ia se eg a a Ses Sie ee GO Re eRe ee a Et ee ee REE ae er Ree See ee rae P Se te aR DL eh ate MORE ORE Ree OI ee eed Se GA sig IRS we REP ee eg RE Se ee en ee Panes es ae 8 ee
ee ee ee
Pea SN Tey ee SP Se en ae em
BIN Sea nt ee OS Sieg RN
o>:
ee Critical Hiftory, | - Partl.—
this occafion exprefles himfelf in very hyper- bolical terms. And we muft indeed allow him to have had a very extenfive praétice, fince- he informs us that he had feen almoft innu- merable patients afflicted with only one parti- cular fymptom of the malady (k )..
But befides the natural reafons which he af figns, he is likewife pleafed to introduce fome moral confiderations, to account for the great frequency and virulence of this diftemper, and the extraordinary fymptoms which he afcribes to it. In one place (Z) he attributes its irre- gular appearances to the operation of the de-
vil, But in another, he thinks this new and
furprifing calamity fent, by divine permiffion, — as a chaftifement for the fins of the world. And as he really thought himfelf (as appears through the whole treatife) the moft fagacious detector of this Proteus-like mifchief, lurking . under various and furprifing appearances, he
(#) Thus in a fcorbutic quotidian, Plures mendaci quotidiane
febris typo ab hoc morbo egratarunt, quam ut numero bic comprehendi
queant, p. 231. ‘Talking of fcorbutic pains in various parts of ithe body, Defcribendis nominibus eorum qui ab his doloribus varie
exercitatt elapfis hifce annis fuere, vix fufficeret praefens charta,
p. 51. Thofe patients, he again repeats, were almoft innumer- able, p. 258. 3 PENe seets 5 ver ¥
Chap.I, Critical Hiftory. 9
very religioufly thanks Heaven for the import- ant difcovery (7m).
Now, as this book has been often reprinted in different parts of Europe, has been recom- mended by the greateft authority, by Boer- haave to his pupils, by Hoffman, ec. and is looked upon at this day as the ftandard author on our fubje& (7); it may be worth while to inquire into the contents of it, as well as the merit of its author, And we hall begin with -obferving wherein he differs in his account and
defcription of this difeafe, from all preceeding —
authors, For as to thofe who fucceeded, they did little more than copy him. So that I fhall have few remarks to make upon thefe, till we come to Dr Willis, who gives us a _fomewhat different account of its fymptoms. —
(mm) Quod ides permittere Deus videtur, ut hoc modo iram fuan adverfus peccata offendat, dum novis et inufitatis morbis et egri- tudinibus, nunguam prius cognitis ac vifis, mortale genus in ira fua wifitat et caffigat ; ut etiam vulgus noflras, morborum novitate admo- nitum, intelligat differentes hujus temporis Sebres ac morbos eff, ab 445 qui ante aliquot annos homines afflixerunt. Agamus igitur Deo gratias, quod pro fua infinita mifericordia ac clementia tam benigné cos nobis revelare dignatus fit, p. 222.
(2) It is faid very lately by Haier, to be univerfally efteem- ed the beft book written on the sieht Vid. Boerhaave metha- dus fudii medici.
B } Eugalenus
escilg : - * er wie : eae a aa a se Mite Pe Serer res Bre x: ae sa pos . Siete Dai ee aoa i poe es A yt ca te a a dee POLE Ae soe ea ew oe ale
Sy ee Te eh OR, SON, ENE 2 NT a ede eee 53 ee t-
10 Critical Fiftory. Rites 5s
Eugalenus differs from all preceeding au- thors.
if?, In fappofing the malady may be far ad- vanced, before (what they judged) the moft equivocal and uncertain figns appeared in it. eT Dns, Gays lie}, ‘after a ‘long continuance - of the diftemper, the patient has a conftant . languor, a numbnefs, a fenfe of heavy pain “ in his legs, or an acute pain in any part (0 ).” But fuch fymptoms are by Echthius claffed in a feparate chapter, under the denomination of the remote figns common to this difeafe with — others. And Forrefius, who had the greateft opportunity of being converfant with fcorbutic cafes, by living in a fca-port town, mentions ~ them as the fymptoms only of the approaching evil. He fays, that upon their appearance he hefitated for fome time, till the proper and peculiar fymptoms of this difeafe appeared, viz. the putrid gums, @c. which put the matter out of all doubt. But Eugalenus fuppofes the {curvy often to deftroy the patient before the appearance of thefe latter (p ).
2dly, On the contrary, he fuppofes, that thofe reas which, according to all others, ap
Cle gees 7 fp) P10, eb ora: | pear
ere he ae eee a ee ’ aye Re sPiy ge ced ee EY At OO Oe SY Op BY Oe COR PNET S ROE Ts a) VET TENA Ome MT Ba Ee Dias CRO e an WIR Oa rae a ea i
| Be ae i
Chap. I. Critical Hiftory. las a pear only in the Jaft and moft advanced ftage ; of this malady, often occur in the very begin- ning, and without any other previous {corbutic fign; fuch as, frequent fainting-fits, atrophies, dropfies, @.; which laft are mentioned by Bruceus and others, as the confequences of the -moft inveterate and confirmed f{curvy.
So that whereas formerly the malady had a regular progreflion of fymptoms in its different ftages, accurately related by Wierus and many
others, it became in Evgalenus’s time the moft irregular and deceitful evil that we can well Jmagine. | | 3dly, Eugalenus differs from all preceeding authors in his defcription of many fymptoms peculiar to this difeafe. Thus, fcorbutic ulcers, according to him, are dry ( g): whereas thefe ulcers are defcribed formerly in this difeafe, as having quite a contrary appearance, viz. fun- gous, feetid, oc. Alfo the dy/puea in {corbutic i perfons, formerly moft troublefome upon u- - fing exercife or motion, is defcribed by Euga- lenus with very different marks; as is the di- arrbea, and almoft all the other fymptoms.
{q) Se&. 49. In the firft pages of his book, which are copied from Wierus, he defcribes the ulcers more truly,
Ba Athly,
Fai Critical Hiftory. Part 1
4thly, He has afcribed to this difeafe many new fymptoms, feemingly oppofite to the genius of it; at leaft never taken notice of by any before him: though Dodoneus, Wierus, and many other writers, may be fuppofed to have
had an opportunity of feeing it in its utmoft:
virulence, when epidemic in the year 1556, in the places where they then lived; and where in
all probability it has never fince raged in fucha _
degree. ‘The fymptoms he mentions, are can-
cers, buboes, ulcers of the penis, lofs of me«
mory, fymptoms of the plague, dc. Now, thefe different accounts and defcrip-
tions of the fame difeafe, can be accounted for.
but in two ways. This diftemper muft, in a very hon time af-
ter the firft accounts of it were publifhed, have
made an incredible progrefs, become an univerfal calamity, and aflumed quite a new appearance and different fymptoms. This was the opi- nion of Eugalenus; who, although he has given fuch a new and different relation of it, yet tells us exprefsly, it was the fPomacacia of Pliny, the difeafe defcribed by all other authors under the name of /curvy; with whom he agrees in‘affign- ing the fame caufes and cure. For which latt, in particuar, he refers us to thefe authors.
Or
Ae:
Chap. I. Critical Hiftory. a. Or we may fuppofe, that this author might be miftaken, in thinking the difeafe he has de-
{cribed, to be precifely the fame that was for- merly known by that appellation: yet perhaps
there may be found fome analogy or refem- —
blance betwixt what he deemed fuch, and the former accounts we had of the feurvy; fo that they may be faid to border on each other. Or at leaft he has given this denomination to a complication of various fymptoms firft defcri- bed by himfelf; and thus has charaéterifed un- der the name of /curvy, a particular difeafe, or
-clafs of difeafes; in which he has been follow-
_ed by fucceeding authors.
Upon the firft fuppofition, before we can * give entire credit to him, and believe fo great an alteration to have happened i in this diftem- per, it is neceflary we fhould know what grounds he had for his opinion, and what rea- fons induced him to believe, that fo many dif _eafes, various and oppofite in their appearances, were nothing more than the {curvy lurking un- der thefe different forms. It is at leaft requi-
red, that there fhould have been in the effects
er appearances of the difeafes, fome diftant a- nalogy or refemblance left; otherwife there will id be
. a ? ey * = : ~~ Sei eee " tera Bre Be nes sia eS Oia eens 6 seeming Rie atta Doe Roar ae eee | RTE. SoA OG Oe aE ee ew rn eS FS Se EPA ee Oe ie id oe cate ios bs Onsse : s ae
Sti 2 ees PRB ig 554 hes eet eer, ee Sr ie" Be m
Oe. Critical Hiftory. Part Ta
be a {trong prefumption that here he might be miftaken. | : But inftead of pointing out to us any fuch
fimilarity or refemblance betwixt the difeafes
he has defcribed, and the real {curvy as defcri- bed by all others before him; he has fallen up- on a moft extraordinary method of proving their identity, by af/uming for pathognomic and demonfirative fcorbutic figns, fuch fymptoms as
* had never been obferved in the difeafe before ; Vize
fuch a ftate of urine and pulfe as is entirely dif- ferent from the defcription given of them by the moft accurate writers (7r_). | | Now, (r) Vid. part 3. chap. 2. Forreftus tells us, that in this ma- lady the ftate of the urine deferves no regard ; and wrote three books to prove it fallacious. Although Reu/nerus does not in
this agree with Forre/fus; yet he, as well as Wierus, difters widely from Exgalenus in the defcription of the urines in this difeafe.
As to the ftate of pulfe defcribed by Eugalenus, which he af-
ferts to be the moft conftant concomitant of this diftemper, p. 30. it is remarkable, he is the firftauthor who mentions fuch a condition of pulfe to have ever been obferved in the fcurvy. Reufnerus fays, the pulfe is here inordinate; in which he like-
' wife differs from all other authors: but it is plain by his book, this was a fuppofition made from theory, and not from obfer-
vation. (Vid. Reu/ner. p. 382.). He makes it at the fame time
_ flow. ;
Notwithftanding all which, “the pulfe and urine, or either of
them, convince. Exgalenus of the exiftence of the fcurvy, though
In other eae the fymptoms thould differ from it as much as the
Chap. 1. Critical Hiftory. aS
_. Now, upon a fuppofition that the pulfe and
urine, like the reft of the fymptoms, had alfo
varied in this diftemper from their former ap-
pearances, it was then incumbent upon him to _ prove the identity of thefe difeafes by other marks, and not by thofe fymptoms wherein the difeafe differed from itfelf.
Befides the pulfe and urine, which were to him the moft demonftrative figns, he often — mentions fome other marks or diagnoftics ;
‘upon which, however, he does not depend fo ‘much as on the former; though he often in-
ee
the plague does from a dropfy. Suffciant ad denotandam mali caufam que ab urina et pulfu indicia fumuntur, p.120. De his o- anibus, certum a pullu’S urina, vel ab horum alterutro, indicium eft,
minimeque fallax, p. 8g. Citra alia indicia, non femel ad morbi ‘ cognitionem nos fola urina deduxit, p. 23.
Our author could not perhaps well have fallen upon two more uncertain diagnoftics than thofe of the pulfe and urine, by which alone he characterifes fo many various difeafes, acute and chronic. The mighty faith he had in urine, the moft fallacious of all me- dical figns, one would have thought fufficient to have deftroyed
: his credit with the judicious. As tothe pulfe, it varies fo much
in old and young, and in the different fexes; the conftitution of the body, the fituation, and other circumftances of the artery, , all what phyficians call ¢he zonnaturals, have fo remarkable an influence upon it, as to make the diagnoftics taken from it fingly, to be very fallacious in any difeafe. ! There is indeed the utmoft abfurdity in his accounts of both ;
_ and, what is very remarkable, moft of the cafes at the latter end ‘ of his book, are manifeft contradittions to the diagnoftics deli- yered in the firft part of it.
Pea? troduces
16 Critical Hiftory. Part f,
troduces them to confirm the judgment he had formed of fuch difeafes. And it may be pro- per, in juftice to him, to take notice of them all; which I think may be properly aetcined to thefe two claffes.
ift, Such fymptoms as the before vote conditions of pulfe and urine, that never were
remarked in the fcurvy by any but himfelf;
and feem indeed more peculiar to other dif- tempers ; Viz. recurring anxieties at the re-
gion of the ftomach, under the diaphragm (/) ; -——a ball in the throat (+) ;——a tumor mo- ying from one part of the body to another (x) ; —retchings to yomit in the beginning of a fe- Fea»
2dly, Such as are common to this difeafe with many others; and which the authors who preceeded him, call the remote and doubtful fymptoms ; vz. an obtufe or dull pain of the legs, which he often mentions as a convincing proof of the {curvy Cy) j—dejection ¢ of mind(z);
(/) P. 142. and in many other places. fap Pvtsas
(2) Diag. 23. p. 212.
(x) P. 235. |
(y) P. 145. 201. 206. 216. 235. and particularly p. so. {z) Obf. 15.
\
SR ch Seki cats iN) RE RR A Sad ne id ela lt oe ae! a) So i RN NAGY ¥ r' ¥ y
Chap. I. Critical Hiftory. | 4
— being worfe after purgatives (a) ;— <a lan- guor, rather than ficknefs;—a flow difeafe without any evident caufe ; —fometimes a vo- _ miting, faintings, anda change of colour in ‘the face ;—— an eruption on the face and breaft in a fever (d); ial wolaneiiata on the body after death, and not till then, he makes a demonftrative fign of the feurvy (¢), or juft at the approach of it (d).
But thefe diagnoftics he feems to rely upon no further, than to corroborate the proofs he had from the pulfe and urine.
Now, as thefe are the principal marks and | . diagnoftics of the difeafes defcribed by Eugale- | ;
wus; among which there are not to be found _ , -any of thofe fymptoms which the authors pre- ceeding him thought abfolutely neceflary to demonitrate the exiftence of the difeafe which they had defcribed under the name of /curvy; and as Eugalenus aflumed for demonftrative and conftant figns of this difeafe, fuch as were ne- ver before obferved in the true fcurvy, nor are ever feen to occur in it at this day, as after- | wards will be more fully proved: we muft og neccflarily conclude, that he has defcribed a ie (a) P. 152. | (c) P. 124. (4) Diag. 25. p. 236. (d) P. 187, et 189. ate different
OARS ITS ae PE ORT a NORA IE AERP
i 8 Critical HAiiftory. Part 1,
- different difeafe; which appears from his whole
treatife, and will be further confirmed by what follows. a
It is indeed furprifing, in fo extenfive a practice as he pretends. to have had, that in his book, containing 72 obfervations, and a- bove 200 cafes of different patients, given us by him or his editor, there is not mention made of one truly {corbutical cafe wherein the sums were affected, except in a very extraordi- nary and dubious relation of a clergyman (e ) ; who contracted his indifpofition by a coltive-_ nefs, being accuftomed when in health to have ten or twelve natural ftools a-day; whom he cured by bleeding, and fome antifcorbutics which he does not mention; and by reftoring | his belly to its ufual lax ftate.
Itis true, he maintains, that the {curvy often kills before it affects the gums or the legs (f).
But is it credible, among fuch a number of pa-
tients as he treated in this difeafe, which in many places he tells us were almoft. innumer-_ able, that in the before mentioned cafe alone the putrid gums were obferved; which for- — merly, during the moft virulent rage of this evil, — and at this day, as fhall be afterwards proved, (2). Obf. G2. Cf) Be 10,
ig |
“ Chap. T. Critical H iflory.
isthe moft conftant, chief, and charagteriftic | - fymptom of it?
For a {pecimen of the queftions he afked his patients, fee p. 32. & 98. where he reca- pitulates all his diagnoftics of {corbutic difeafes ; and it does not appear he ever looked for fuch figns. é
He gives but one inftance of the teeth being loofe (g); where he obferves there were much
_more demontftrative figns of the fcurvy, w/z. the pulfe, urine, oppreffion on the precordia, and faintings; adding it in the laft place, as a fymp-_ tom of the leaft moment (A ).
He takes notice of {pots as a fign of this dif- -eafe, only in the fcorbutic atrophy ; though he produces but one very doubtful fcorbutic atro- phical cafe (7) wherein they appeared.
We fhall compare him in this refpect once more with the authors who preceeded him. Reufnerus wrote but four years before him ; and has colleéted into a volume of confiderable bulk, almoft all that had been written upon |
(g) Obf. 47. |
(4) Ultimo, et dentium laxatio. Sed quia hec primitm fab morbi finem incidit, minus ad monftrandum morbum huuc ponderis habuit;
quod prits egrata ab hee morbo interfici potuit, quam ab hoc fi igre
morbus cognofct. (i) Obf. 34, : CS toh Gad the
20° Critical Hiftory. Part I.
the feurvy. After defcribing the putrid gums and fpots, he expreffes himfelf thus. “ Thefe * are the pathognomic figns of the fcurvy, | “ without whofe appearance the difeafe can-
& pot fubfift (2 ).”
Ir may be faid,. that though the difeafes were not precifely the fame, yet Eugalenus under the fame name has charatterifed a certain dif- eafe, or fpecies of . difeafes, in which he has been followed by all other authors; and his fuccefsful cures, to which he fo often appeals, feem to confirm it. 'This leads me to the on- ly diagnoftic which I have omitted to mention ; being referved for this place, as the moft diftin- guifhing characteriftic of all the difeafes defcri- _ bed in his book, and which is to be met with almoft in every page (/). It is there called Regula diagnoftica generaliffima (m), viz. its | being
(2) Et he figna funt feorbuti pathognomica, que fine rei in qua fita funt interitu abeffe nequeunt. Reufneri exercitat. de {corbuto, Pp. 328. |
(1) Fs 27,127. Bc. |
(1) Viz. Nam fi quis nobis in his regionibus morbus occurrat rarus, vel etiam aliquis veteribus cognitus, fubaliis, et diverfis, atque plurimum ab eorum defcriptione difcedentibus fignis, fiatim meudacem ejus fpe- ciem fufpeciam babere oportet, et huc atque ad hune morbum cogitati- ones dirigere, diligenterque cum morbi mores, et caufas ejus antecedentes,
Sus
Chap. I. Critical Hiftory. | - “being a difeafe not properly defcribed by the an-
cients : to which he often adds, its not fubmit- ting to the cure prefcribed for it by thefe old authors.
He recommends the perufil of his book to
fuch only as are converfant in the writings of the ancient Greek and Roman phyficians (x ) ; otherwife he obferves they will never be able to diftinguifh old difeafes from the new. The ‘laft of which, or what he imagined to be fuch, he has promifcuonfly clafled, without any o- ther diftinétion, under the general name of feurvy.
To give the reader the true idea the as ‘had of the fcurvy, by which he may be en-
abled to judge what particular difeafe, or fpecies _ of difeafes, he has charaéterifed ; it is precifely this.
He feems to have been of opinion, with an e- minent phyfician of that age, who takes occafion from Solomon’s faying, there was nothing new under the fun, to affert, that all diftempers were tum pulfum et urinam explorare, taliane fint que buie morbo conve- miant, eumque quadam Jud proprietate exprimant et demonftrent.
Soon after adding, Non video quis preterea dubitationi locus elje
pulfit, nifi perpetud cogitationibus noflris oberrare et incertum vagart velimus, Pp. 179,
(2) P. 227. the
fy Siastai a | LGB iat i is CU Baas Oe GAY emg RL PPro nein «Cheers Sean TE UCR Watee! Set) RONG aR eae es oii ee me ia at
‘oe. Critical Hips | Part I,
the fine formerly as at prefent. To this our author, however, makes two exceptions, in the pox and fcurvy, (p.250.); where he imagines that the one travels from the north, the other _ from the fouth ; and that, upon their meeting, | they communicate and intermingle their poifon with each other. But he was entirely unac+ quainted with hyfteric and hypochondriac ail- ments, and a train of others now going under the name of nervous. He knew very little of the rheumatifm, rickets, and many others; which, if at all, have been very imperfectly defcribed by the ancients. Hence, whenever fuch cafes occurred, with this peculiarity, of not being defcribed in ancient authors, he — dire&tly pronounced them fcorbutie. | | Thus, he imagined, that the {curvy might af fume the form of almoft all difeafes, acute or chronic, incident to the human body: or, in other words, that the numerous and various diftempers defcribed in his book, from the — plague to a fimple intermitting fever, ea be. : produced by this one fcorbutic caufe; and that each of thefe manifold difeafes eT: fub- ft fingly and feparately, without the appear- ance of any fymptom formerly obferved in the {curvy defcribed by others; or even any one : fymptom
\
LO CAME: 2, eee naa? RO RADEEY™ Be age ge SN
a BRD EA OR BDRM RE APES STE EEC OAT a CT SANE HG EW CPO tee a 7. oe ‘ a . pad : ‘ a Wee
_ Chap. I. Critical Hiftory. gg fymptom common to thofe defcribed by him- felf, except the appearances in the urine and ftate of the pulfe. The firft of which, he tells us himfelf, is often fallacious ; ; and though he mentions the pulfe as the only nie (0) jn which all fuch difeafes agree, yet, from many other parts of his book, it appears, that _the pulfe alfo was, and certainly muft be very yarious in fo many different cafes (p ). But as difference of climates muft needs have a great influence, even on the fame dif- eafe; accordingly we find the crifes and types _of fevers and other diftempers, to vary inthefe —‘ cold climates, from the defcription given of |
EAS NAB tm fan Rig eer Set ae aes ae ee
o, at Posh. .. . (p) If the criticifm on Eugalenus appears too tedious, it mutt be confidered, that it is the bafis of all the reafoning in this firft part of the work. Nor mutt the reader imagine, that although he be found to have publifhed very great abfurdities, yetheis — - but one author only, and feems not to deferve fo ferious a con- _ futation. Such as are ignorant of the hiftory of the difeafe, and have not taken the pains to look into the Bibliotheca, part 3. muft be informed, that his whole book almoft is tran- {eribed by Sennertus and Martini; and its greateft abfurdities by _ Horfttus, Lifter, and many others. Had thefe authors confirm- ed what he advances, by faéts and obfervations, Eugalenus had jufly merited the compliment they pay him. But, on the con- - trary, they affert moft things in their writings entirely upon the faith of Eugalenus; fo that, according to his fate, the credit of many authors muft ftand or fall,
them
24. | Critical Hiftory. Part I.
them in more fouthern countries, where the ancients practifed. Thefe and other incidental circumftances, muft needs vary the juft indica- tions of regimen and cure. ‘This our author makes no allowance for: but when the moft common and ufual malady deviated in the leaft from the graphical account given of it by thofe accurate authors, efpecially when it did not yield to the method of cure directed by them ; all fuch irregular and untoward fymptoms he likewife referred to the fcorbutic taint.
Now, whether the difeafe was altogether and purely fcorbutic, or the {curvy was joined or complicated with another malady, no cure could poffibly be made in either cafe, without — the common and fpecific antifcorbutic medi- cines; which, upon the laft fuppofition, were to be compounded with others proper for thefe difeafes, and which, according to his own ac- count, proved always fuccefsful (q ).
- But here we have reafon to fufpe& fome- what worfe than i ignorance, by which it would
( q) In his oe cum, propter multiplicem fymptomatum va- véetatem raritatemque, caufam fubeffe raram, et veteribus iNCOBNi x tam, confiderarem; poft varias habitas mecum deliberationes, et di- ligentem pulfuum urinarumque examinationem, tandem feorbuto ad- | feribendam inveni, conjefluram meam at soxacuiy de his, ents bante felici curationis eventu, P. 30.
ea.
Chap.J. = Critical Hiftory. 25
feem he has chiefly impofed upon the world, -He informs us, that if the difeafe was but known, it was very eafily cured (r.); and re- fers us to Wierus, who had wrote moft learn- edly on this fubjec&t before him; the inten-
tion of his book being only to dete& this.
Proteus-like malady, lurking under fo many various and fallacious appearances(/). He has indeed furnifhed us with no other antifcor- butic remedies, than what were recommended before him; as may be feen by his Therapeutic canons (t). His principal antifcorbutic medi- cine was fcurvy-grafs, and next to it, water- erefles- and brook-lime. He however fancied fome of thefe to have a more fingular and pe- culiar virtue in particular fymptoms of this dif- eafe, than others of them. For a coma (or carus as he terms it) in the fcorbutic fever, he particularly recommends wafturtium aquat.(u), and gives what may be called a miraculous in= ftance of its good effects (x ) :: whereas in con= vulfions Ree Ane {corbutic fevers, he prefers
ve JAP PAD. (/) Ibid. (7) P. 26. 42.43. (4) P. 44. Canon. ther. 11. Item, p. 124. 125, (x) Obf. 54. :
D Shee
ip ide Ria ek id Say ae Seabed
26 Critical Hiftory. Part [. _ fac. cochlear. (y), and gives an equally lumprifing
hiftory of its good effeéts (z ).
But what idea can any perfon entertain of this author's veracity, when he relates fuch nu- merous and extraordinary cures, in the mof tedious and obftinate difeafes, performed by
~ fuch fimple medicines; and in fo fhort a time
as exceeds all manner of belief? Such was then the efficacy of thofe herbs, that they refcued many long-unhappy patients from the jaws of death. ‘They removed difeafes which had re- Gifted all other methods of cure, and had baf- | fled the fkill of the beft phyficians. With fuch affertions this book every where abounds. «“ Many who had laboured under this calami- “ ty, confined to bed for weeks, months,
nay, years, (as, at the time he was writing,
* was the cafe of a widow, owing to the ig- s norance of her phyfician), were in a few “ days, by thefe powerful antifcorbutic juices, “cured of the moft obftinate and inveterate _ * ailments (¢@).” In a feemingly very bad cafe of a childbed- woman (0), the fcorbutic deliquium and anxie~ ty were put off for feveral hours when ap-<
(vy) Cahen. ther. 13. °p. 44." °° fag Po reg. Tay, {x} Obf, 53. (6) Obf. 69. | proaching,
Chap. I. | Grittcal Hiftory. i. :
proaching, by thef€ antifcorbutic medicines; which upon this account were repeated eight or nine times a-day. Any one who perufes this relation, will find as extraordinary cafes, viz. ulcers gaping and fhutting, Sc. as are to be met with in the records, or perhaps the le- gends of phyfic (c ).
_ He performed feveral cures, even in appa-
rently dangerous cafes in fevers, by an infufion — of a little fcurvy-grafs in goat-whey (d). He
removed a malignant fever, chiefly by the addi-
tion of fuc. cochlear. dr. ii.fs. to an aperient po-
tion; which, upon taking four or five times, a- bated the fever with all its untoward fymp- toms; but upon difcontinuing the medicine for two days, it returned (e ).
The vanity and prefumption of this author are indeed intolerable, when he affures us, that | he would cure beginning confumptions in four- teen days (f) ; palfies in five days (g), in four ey often, but in fourteen at moft (/) ;
(¢) P. 264. 365. Vid. ee 48, CC:8O.: bd) ODE o7. 0%: (e) Obf. so. : : ie {f) ae 192. (g) Obf. 16. et 23. (A) PB. 63. : D2 violens
2 # Gritical Hiftory. ‘Part I
violent toothachs in a few hours (i); feveral - quartan agues in ten days, otherwife not cu- rable in a year(k). In fhort, according. to him, no difeafe is any longer incurable; and by his means the art of phyfic is reftored to credit and reputation (/). 19h Sometimes indeed the patient expired before the antifcorbutic medicines could be got ready ; _as was the cafe of a young girl to whom this fatal accident happened. Here he offered to prove the wonderful effedts of his remedies, to the conviction of the whole family, in the el- deft fon, who laboured alfo under this afflic- tion. But after a fruitlefs trial of eighteen days he was difmiffed; the father being informed,
(7) P. 52.
(4) P. 40.
(1) Futurum enim eft, ut in morbi notitiam dedudius, paucis dies bus graviffimas quafque Sebres Jit curaturus, quibus nulla friy Ves gerum profuit curatio. Soon after adding, Que, quia @ nemine haGtenus fatis animadverfa Junt, quod fiam, bine fadium effe ar- bitror, quod tantopere vilefcere apud nos et in his regionibus medi- cina caperit, Baas ora nullius Sebris curationem certo fromettershe p: 36.
And repeating the fame remark in another as Hoe fine arrogantia dicere poffum, me certam harum febrium curationem pro- mittere omnibus audere, gue nofirts preceptis ac monitis obtemperare, et in affumendis bifte medicamentis confilium nofirum Segui non detree Gant: fiquidem (abfit arvogantia dito) non minus certd harum Sebrium curatio mibi nota ef, i aigitorum numerus. Obf. 56.
that
_ Chap. 1. Critical Eiiflory. . 29
that fuch medicines were hurtful and i impro-
_ per for fo tender an age (m).
_ His extreme ignorance in phyfic, appears,
_ among many other inftances, from his taking
a pronenefs to faint in childbed-women for a
demonftrative fign of the fcurvy(”). In aman
~ of feventy years, he judged a mortification of
the foot to befcorbutic, by the black and
_ purple {pots which appeared upon the morti-
fied part; and the {mall, weak, and unequal pulfe, naturally to be essen in ice a fitua-
‘tion (0).
He feems to bait known no ties diftinc-
tion betwixt the /wes venerea and feurvy, but.
the pulfe (p), and fometimes the urine (q).
Aut the fucceeding authors, for a confider-
able time after Eugalenus, follow him moft re-
ligioufly and minutely in their defcription of this difeafe. So great a compliment is paid him by Martini, Horflius, and Sennertus, that they copy out of him with a {crupulous exact-
(m) Obf. 59.
(2) P. 194. 197° Item, Obf. 11, (0) P. 108. 5
(p) P. 51. |
(7) P. 263. Vid. p. 60. 126, 137.
nefs,
/
go. its: tical. Aliffory. Part I.
nefs, not only the many fymptoms he defcribes
peculiar to the malady ; (and efpecially his great dependence on the pulfe and urine, for afcer- taining its exiftence); but where he or his edi- tors, in their extraordinary relations of {corbu- tic cafes, mention fome very uncommon and fingular appearances, thefe are likewife added by them to the diagnoftics of the fcurvy. What additional obfervations they themfelves — made, may be feen in the proper place (7). They even exceed him in abfurdities, "Their merit feems chiefly to have confifted in furnifh- ing us with cures, or at leaft with many me- dicines for the different difeafes defcribed by Eugalenus. . However, as an apology for Sex+ nertus, he informs us, that he tranfcribed chiefly from this laft author, becaufe the {cur- vy was not a difeafe fo frequent or common in his own country ( Ld. i Kean
(r) Part 3. }
(/) TraGatus de feorbuto, p. 140.
To give the reader fome idea of the confequence of fuch writings, and the high efteem thefe authors gained by their works; we find Moellenbroek, who pretended likewife to write upon this difeafe, or at leaft a {pecies of it, fetting out in his introduction thus. Lzmo nullus fere jam morbus eff, cui fe non ad- pungat feorbutus ; unde nift antifcorbutica interdum reliquis admifceat medicamenta, wvix eos curabtt medicus. Quodi in praxt mea exper-
sus wie non raro. Et noai aliquos, qui feorbutum ejufque antidota. negligentes,
Chap. I. Critical Hiffory, 31 det had not talents fufficient to form | . any fort of theory for illuftrating the nature of the many difeafes referted by him to the f{cor- _ butic taint. ‘The principles he aflumes upon particular occafions, of obftru@ions in the. liver and {pleen, overflowing of the atra dilis, and corruption of the humours, are all bor- rowed from other authors, lamely explained by him, and often contradiéted in his book. ROR CAES ie confutes itfelf. So it
jab: ac propterea meo ah edofti, maximo cum egrorum che erum emolumento, eadem poftea exhibuere. . Quamvis autem valde Srequens fit frorbutus, fymptomatibus tamen variis oculatiffimos fepe | medicos illudit et decipit ; immo éx mille medicis (ut feribit Frentag. cent. 1. obferv. 99.) ne ternos quidem invenias fcorbuti fat gnaros, ut ut fe fingant Aifculapios. Hine tante egrotorum firages, tanta mortalitas, tanta archiatrorum, necdum gregariorum errata; ut fta- tuas mereantur Fracoftoriana fplendidiores, are perenniores, viri elariffimi Sennertus et Martinus, (adderem ego Gregorium Horftium), qui, penicillo plus quam Apelleo, medicorum opprobrium nobis depinxe- gunt. Meruiffet pyramidém Eugalenus, ni curationem fubticuiffet.
This laft is certainly a falfe imputation on Eugalenus. He feems to have concealed no part of the cure that he knew. Be- fides referring to Wierus, he gives twenty-one general therapeutic canons, and twenty-nine {pecial ones; under moft of which he mentions antifcorbutic herbs, adapted to the feveral intentions of cure. Ifit was found, that in parallel cafes thefe herbs did not fucceed, it does not.follow he concealed the cure; the con- trary of which appears through his whole book.
Four years after Moellenbroek wrote, and had publifhed the fame of the preceeding authors, the world was obliged with Dr Wilks’s treatife.
was
32 Critical Hiftory. Part I.
was left to Dr Willis, with the affiftance of Dr Lower, to clear up a fubje& that lay under very great obfcurity, by reducing the whole into an ingenious fyftem, which continues efta- blifhed and adopted even at this day.
It may be worth while to take notice, that until Evgalenus’s time, as before mentioned, putrid gums and {welled legs were the pathog- nomic figns of the fcurvy. This laft author made them to bea fmall, quick, and unequal pulfe, together with a peculiar ftate of urine (7 ). But fuch a condition of pulfe is nor mentioned by Willis to have been obferved in any of the cafes he gives to illuftrate his account of this difeafe ; nor is it fo much as mentioned in his book, except under the title of the Pal/as in- ordinatus (wu); where.it is put down with fifty other fymptoms; and has no preference given it as a characteriftic of the fcurvy, more than palfies, convulfions, and the reft of the fymp- ~-toms, which he there enumerates, from the crown of the head to the fole of the foot. It is explained by him afterwards (x), when he tells us, that this inordinate pulfe, being une-
(t) Vid. part 3. — (u) P. 228. Amfterdam edition. (%) Po 254.
: qual —
-. Chap. I. Critical Hiftory. 193 ~ gual and intermitting, attended with frequent faintings, occurs only in the meft inveterate feurvy; but he no where gives any ftate of ~ pulfe as peculiar, or an index to the difeafe. And although he lays great ftrefs on the appear- ances in the urine(y); yet here he in fome _ refpect likewife differs from Eugalenus (z). There is another very material. difference in _ their accounts of this difeafe. Eugalenus, who, if we take his own word for it, had many more patients than ever fell to Dr Willis’s fhare, found — it in his time very eafy to remove(a). Ac- _ cordingly, his book abounds with fome very > f{peedy and miraculous cures. But now the {curvy is become much more obftinate, pro- ceeds from various and oppofite caufes, re- quiring very different methods of cure; and the fimple antifcorbutics fo much extolled by fugalenus, are by no means fufficient to re- move it. | “ eae Willis has alfo given a different account of this difeafe from all others; as will _ap- pear by comparing the fymptoms defcribed _ byeach(@). It is very natural then to in- A. Oy ) Be mae j Lx}; Pca,
(a) Cognito morbo, facile curatur. Eugalen. Pp. 140. (6) Vid. Part 3.
=
E aire,
1 ee Critical Hiftory. Pare quire, what fingular and. diftinguifhing marks and charaéteriftics he has given of fuch a vari-_ ety of diftempers, in order to their being with any manner of propriety claffed under one de- nomination, and referred to the difeafe we are ‘now treating of. And they are as follows. _ “ The figns of the feurvy are: Firft, Certain ¢ outward marks and cireumftances, which “ give a fufpicion of it, until the more certain. “ fymptoms appear. Thus, if one is born of « f{corbutic parents, has been converfant with <a {corbutic wife, or other fcorbutic compa~ «¢ ny; lives near the fea, or in an unwholfome « marfhy place; has had a long fever, or o- s¢ ther tedious chronic difeafes; or if he finds « benefit from antifcorbutic remedies; fuch “ a perfon, difpofed to be valetudinary, with- © out having a fever, or certain figns of any “ other diftemper, we may juftly fuppofe to “* have contracted the fcorbutic taint(c).” But it fhall be proved in another place (d), that the fcurvy does not feem to be properly a he- geditary malady, and that it certainly never is contagious or infeétious. People living near the fea, in unwholfome damp fituations, as welk as thofe who are recovering from fevers and (c) Cap. 3. p.zg7- —** (@) Chap. 4. | other
ie a ay area be Salis aN anna Sede bos SAA st A oat Nel ace 2)
. Chap. I. Critical Hiftorj. 35 | | ,
other ailments, are fubjec to many other dif ’ eafes befides this: the former, (as in 7 olland ), to | anomalous agues, with very deceitful appear- "ances. His argument, of their finding relief - from antif{corbutics, fhall be examined after- wards. But what he adds next, viz. their be- ing free from a fever, is pretty extraordinary. Exgalenus, Sennertus, and moft other authors, had included fevers in a f{pecial manner as fymp- toms of this difeafe, though Willis hardly makes mention of them. So that the marks he has _ given us as yet, are at belt but doubtful and precarious, if not moftly falfe. He indeed hintsa little at what others had {poke out more freely, when he concludes with not ae the Df ions of any other diftemper (ey. _*He proceeds (f}). “ Secondly, 'The other a figns of this diftemper, are its immediate « fymptoms and effects. As thefe are mani- “ fold, they are commonly differently divided, & and reduced into certain clafles, viz. as they © are proper to the fcurvy, or common to it *‘ with other difeafes ;— or according as they - * occur in the beginning, increafe, or ftate of _ the malady;—as they are external, or inter- nal;— or they may be diftributed according
(¢) Abjque alterius morbi certis indiciis, — (. f Oa Fe De 247: ae “« ta
36 .-~—s Gritical Hiftory. Part I. “to the different parts of the body affected, © viz. the head, breaft, abdomen, or the mem- bers, and habit. And in this laft 1 manner “© we have defcribed them.” — on
Had he taken the firft method he mentions, and defcribed the fymptoms proper and pecu- liar to this difeafe alone, as Echthius has done; — or the fecond method, that of defcribing it in its beginning, progrefs, and different ftages, as the firft and pureft writ, 5 have all done The |
Pwo
ee pe
might have given us fome light into the mat-
ter. Whereas in his manner of delivering a de-
tail of almoft all diftempers incident to the hu- ~ man body, ina progreflion from the head to
the foot, without any diftinguifhing marks to know when they proceeded from the {curvy, and when from other caufes, he has acted much more irrationally than Eugalenus; who, although he afcribes as many difeafes to the {corbutic taint, yet gives the peculiar character- iftics of pulfe and urine proper almoft to each;
‘by which they may be known to proceed from
that, and no other caufe. But this Dr Willis
no where does.
It may be afked sien, Whar idea this author 4 had of the fcurvy? This we can only ouels at from
Chap. Ji Critical Hiftory, on 97 |
- from one paflage of his book (g ), seliede he _ pretends to deliver the difcriminating marks of -fome particular fcorbutic difeafes, viz. palfies, |
convulfions, vertigo, dropfies, tumors, and ul- cers; and which conveys to us the only notion
he becti to have had himfelf of this difeafe, -if
we lay afide his theory.; which can never be ad-
mitted, until we know what he wants to ac- » count for by fuch a new and extraordinary hypothefis as he there advances.
He makes the principal diagnoftics of thefe feorbutic difeafes to be the two following.
Firft, Their yielding chiefly and principally to antifcorbutic medicines. If he hereby means only the fimple and moft approved anti-: {corbutic herbs, fcurvy-grafs, brook-lime, and — creffes; in this cafe he will gain as little credit
as Eugalenus, who afferts, that in palfies, con-
vulfions, lethargies, dropfies, gc. they. have | extraordinary. virtues. ‘The daily experience of prattitioners convinces us of the contrary. But this author cannot mean only the fimple
_and common antifcorbutics.. There is here
a greater abfurdity than may appear at firft fight. His book abounds with the moft vari- cus indications of cure, and with a great num-
(8) Cap. 5. p. 274, ber
a Critical Hiftory, —»- Part I. ber of antifcorbutic remedies of the moft op- pofite virtues. He defires, that when one of thefe does not fucceed, we fhould try another, and another, until fuch time as we luckily fall upon fomething which may give relief (/). _ For this purpofe, he furnifhes us with as many different receipts as are fufficient to compofe a — pharmacopeia. Yet, after all, makes the cure a proof of the difeafe. It is furely lefs fo of the fcurvy, as he has defcribed it, than of any other difeafe he could have well mentioned; and is, without fome other figns, an indication of no particular one whatever, _ 7 He is pleafed, however, to give us but one other mark of diftinétion, which he places in the formal caufe, as he terms it (7). And his - | meaning feems to be, that in the fcurvy, the | - . blood and other juices are principally affected and vitiated, without any fixed difeafe, defed, | or obftruction in the folids. So that here : he would fay there is no topical difeafe in | any part of the body, efpecially the vifcera; but a fcorbutic dyfcrafy of different forts, fome- times in the blood, and at other times in the animal {pirits. It muft be owned, this isa dipiniaiian e€X-
, (4) P. 277. in: Ch aa
tremely
a Chap. L. Critical H iffory. 39.
tremely nice and fubtile. One would willingly:
be informed, how it is known, when in pal:
| fies, dropfies, and fuch difeafes as he there mentions, the caufeis only in the fluids. Is it _ not abfurd to chara@erife fcorbutic ulcers and tumors in that manner (£) ? But he faves the - trouble of going farther on this head, by con- — ‘tradicting himfelf immediately after, or at leaft
| making this diftinétion hold only betwixt a
beginning, and confirmed (or, as he calls it Me
deplorable) feurvy (7). | ‘Towards the clofe of his book, he opens a
little the myftery to us, in the relation of the
cafe of a nobleman, which feems to have been
as different from the {curvy as from the pox. ~ _* As this cafe cannot properly be referred to © any other dilkale, it may juitly be deemed |
Os {corbutic (m en
Dr Willis is copied by moft of the fads _ ceeding authors, efpecially by Charleton; by — LHoffman, in the diftribution of the fymp- toms; and by Boerhaave, in the grand diftine-.
tion into a hot and cold feurvy, in the procefs | of cure, as alfo in the medicines prefcribed for it. But thefe already mentioned, having been 4 ‘ A) Piz7q, (m) P. 334. be (4) Pi 275. | deemed
, ware ee oe) tie A ep ay Ay, > he EE Pa ie Ie Ci ay pee ee Se ee nee 4 Rai PyP Re UE ee Th ae eae Gu ERT Cer OTN Ta BrOMME Caeser ve Rat Ay che Ree he ON) Oa ced We amas Pine eevENS SEru a Sage Bes mit vais, one i i at \ \ AN Nae otal De Saas 4 i ARE eee ; ‘ : ry : :
MMOD TR Sten ea aL Re eye te ee eyed:
ASE Eee ae a ey AP Is ag ee pee ey 1 VR ete Tie, BRS Ses OS ere leer Orie ne MLE PON oe nek SPRY eae Cee gl OU RAN Ba beeen Fa le eae ne ae si sie Cd m gate chs u ah bg it , Ppp fee pti Mae Roa ae PS BAT Ree hot Soya. 4)
7 Critical Eiftory. PartT,
deemed the ftandard and original writers on
this fubjeét, I fhall not trouble the reader with any farther animadverfions upon them or
their followers. I am perfuaded, that many | _obfervations will naturally occur to thofe who
perufe Part. Ill. of this treatife with attention. What were. the fentiments of a moft judi-
cious phyfician, may be there feen by looking into Sydenham; what were the dreadful con- _ fequence of fuch writings, will appear by look- ing into Kramer: but how many unhappy
patients muft have fuffered in this difeafe, be-
~ fore the flaughter of thoufands at a time (4) began to open the eyes of mankind, is too
melancholy a fubje& to dwell upon!
We are now arrived to a period of time, when many diftin@ions and divifions werein- _ troduced and made in the feurvy. An inguiry into the propriety of thefe, we fhall make the fubjeét of the following chapter. |
(n) Vid. Kramer.
Odi Aa
4t
CH A P. IT.
: Of the Wierd divifions of this d: ‘aft viz. in- to feurvies cold and hot, acid and alealine, &e.
Uthors had now gone on for near feven-
_ ty years(a), by collefting from each other, and adding fomething themfelves, te make up a very extraordinary number of fcor- butic fymptoms. ‘They had aferibed to this -modern calamity, almoft every diftemper or frailty (6) incident to the human body 5 fo that no room was here left for farther inven- tion. It became afterwards abfolutely necefla- “ry, and was a fufficient tafk for their ingenui- ty, to make diftinGtions and divifions of it. The daily experience of practitioners, \ and their obfervations in phyfic, muft foon have convinced them of the inefficacy of one uniform method of cure. The fimple anti-
- {corbutics, how much foever extolled by Ex-.
galenus, failed to remove the many various and complicated diforders that were clafled under
(2) Pian an. 1604, when Pe wrote. (4) Omnes qui ex Jenio moriuntir, moriuntur etiam ex foorbutg.
- Dolzus, | P . the
a
42 ay Of ‘the feveral Part I.
the name of feurvy. Thus they found them- {elves under a confequent neceffity of having recourfe to different diftinctions at firft, divifi- ons and fubdivifions afterwards, of the malady,
And as the Materia medica abounded with an-
tifcorbutics of different and oppofite virtues,
. taken from all parts of the animal, mineral,
and vegetable kingdoms, it was proper to dif- tinguifh for what particular fymptoms, dif- eafes, or ftages of the — each was pecu- liarly adapted.
But it may be afked, - what difeafe did fuch diftinétions become fo neceflary? And it evidently appears, in that alone which was firft defcribed by Eugalenus, and from him tran- feribed by Flarftius and Sennertus ; and has been defcribed by Willis, and his copier Charleton ; who have always been efteemed the ppinepal and ftandard authors on the feurvy.’ But if the critical remarks that have been made upon thefe original authors be found true, the dif. tinétions made here are founded in ablurdity ; and the former chapter is a fufficient confuta- tion of them.
Thefe indeed, when firft introduced by Willis, were not univerfally received. Cha- meau, with great ftrength of reafon, confutes
Willis’s
Chap. II. divifions of the feurvy. - 43 Willis’s hypothefis; as many others have done. _ Maynwaringe upon this occafion obferves, _ that there is no effential difference in {curvies ; but that the feurvy (quafi genus morborum ) hath a latitude and extent more than any {pe- | eific difference. : ol However, after a. thofe who have made the moft diftin@ions of thefe difeafes, feem to have acted moft rationally. In which Gideor flarvey, phyfician to King Charles Il. has ex- ceeded all others. He obferves, that here the exacteft diftin@tions are requifite. Thefe (he fays) are to be taken, “ 1/7, From its growth “ or different ftages; in which cafe, it is ei- “ ther a preliminary, liminary, recent, invete- “ rate, ox terminative fcurvy; the laft of which “ is the difeafe into which it pafles, and ** puts a termination to the diftemper, or life « of the patient. “ 2dly, From its origin; in which refpect i If “ is either hereditary and connate, when deri- “ ved from the parents ; or adventitious, when * got fome time after being born: and this * Jaft is either contagioufly adventitious, when “ got by infection; or xon-naturally adventi- “ tious, when contracted by fome error in the ** non-naturals. | b2 ¥; 3dly,
4a Of the feveral Part I. _ & gdly, From the part chiefly affected, this “ difeafe may be named an hepatic, /plenetic, | © or flomachic feurvy.
“ 4thly, From the internal caufe, it may be « termed either an acid, or lixivial feurvy. — .
“ sthly, From the parts where the fymp- toms concentrate, or from fome predomi- * nating fymptom, it often takes a particular “ name; as, a mouth feurvy, leg fcurvy, joint « fcurvy, an afthmatic fcurvy, arheumatic fcur- vy, a griping curvy, a diarrheous feurvy, an
“ emetic or vomiting fcurvy, a flatulent hypo-
“ chondriac feurvy, a cutaneous fcurvy, an ul- “ cerous feurvy, a painful fcurvy,’ ec. 'To which a face foura yy, and many others, may be added.
“ 6thly, It may be diftinguifhed into a /z- “ tent and manifeft feurvy. The firlt is made «¢ known by no external or manifeft fymp- * toms; only a neutrality is obfervable in point “ of health, a defect of appetite, lazinefs, dul- ¢¢ a °C.
« sthly, It is either a mild or malignant
“ fcurvy, an Engli di or Dutch feurvy, a ee “ or a land fcurvy, re.”
This writer and Charleton are almoft the on- ly authors who deliver the fymptoms peculiar
{0 -
¥
*
i
a
’
j a #
4
&
Chap. IL. divifions of the feurvy. 45 ‘to the different kinds of {curvies, by which they )
may be known and diftinguifhed from each o-
. ther. Whereas others found this a tafk too difficult for them; and that it was much eafier
to give a long detail of fymptoms and difeafes ; leaving it to the fagacity of their readers to
‘apply fewer, more, or all of them, to the dif-
ferent fpecies of {curvies conftituted by them, For this purpofe, it was alone fufficient that their theories were rightly underftood; as when the fulphurs abounded in the blood,
and when they were deprefled; when this
vital fluid was too hot or cold, or inclined to
an acid, alcaline, and briny acrimony, or an
oleous rancidity. | The firft and beft authors (¢c), whofe me-
thod of cure was fimple, uniform, and for
_ the moft part fuccefsful, having confequent-
ly no occafion for fuch various diftinétions, univerfally afcribed the malady toa fault in the
fpleen. They miftook this difeafe for a very
different one defcribed by LHippocrates (d).
. nie it ig ces. that i {curvy fince
(c) Ronflens, Pee Echthius, Albertus, Bruceus, Brun-
merus, &C.
(4) Vid. part 3. Slay 1, their
MEG MT OR CRT 8) Lon ee a NT OANA NRE MERRITT G nS MRT Nyy ek PM peer elmer tip Bea aRMRURD Tar (RA ON eet ORS e BET ee Oey aD ; .
46 | Of the feveral Part f
their days, had by contagion (e) diffufed it- felf over the whole world, infeéted the child unborn (f), and that few efcaped this modern calamity (g); (as a pimple appearing on the {kin, was thought to indicate this mifchief lurking in the blood); to fupport thefe ill- grounded conceits, theories were invented, ga- lenical, chymical, and mechanical, according to the whim of each author, and the philofo- phy then in fafhion.
Firft, The galenical qualities of heat and cold, which Wills defines a fulphureo-faline, and a falino-fulphureous fate of humours; and which the more modern writers have diftin- guifhed by the appellation of alcaline and acid feurvies, were introduced; and the diftin@ion continues to this day. By which they mean, that the feurvy occurs in different habits and conftitutions, or at different times; proceeding from as oppofite caufes as can well be imagi- ned; as from heat and cold, or the hoftile and
(¢) Tacite ferpit infidiofum virus ab hofpite in hofpitem, fpiri- tis, ledti, menfee, poculorum communione. Charleton, p. 17. 4 Contagium celere. Boerhaave.
(f) Fuere qui liberis fuis feorbutum legarent jure poffidendunh hereditario. Charleton, p.17. Vid. Willis, p. 242. : (2) Nemo fere hodie ab eo plané immunis exiflit. Dolei Ency- . clopedia. See chap. 1. p. 30. ' |
repugnant
Chap. IL. diviffons of the feurvy. ay repugnant qualities of an acid and alcali: and accordingly the different kinds of it require the
moft different methods of cure; what proves fa-
_jutary in one fpecies, being experienced hurt-
(
ful, nay, poifonous in another. 'This was the confequence of Eygalenus’s book, and other
like writings. |
Tt muft be owned, the general name of a
difeafe does not always lead us to the true nature
of it. The habit of the body, and many o- ther circumftances, are carefully to be exami- ned; asalfo, the different degrees and ftages
et. it, together with whatever other f{pecialties
may occur, in order to furnith juft prognoftics, proper indications, and a rational method of cure. But the divifions and diftinctions that have been made here, are not only altogether unneceflary and perplexing, but have a perni- cious tendency to confound it with other dif- eafes, between which there is not the leaft a-
nalogy to be found. | The term cold or acid fcurvy, is often met with in converfation, and frequently in the. writings of very great phyficians. Now I take it for granted, that they who ufe this term, da it in the fame fenfe as the moft eminent writers en the {curvy who firft introduced it, and have , evar explained
48 Of the feveral Part I.
explained its meaning. It will therefore be fufficient for our purpofe, to fhew in what fenfe it was underftood by them, and indeed by all who have attempted to explain it.
Soon after Eugalenus’s book was publifhed, it was found he had defcribed in it many fymp- toms of the hypochondriac difeafe. | Accord- ingly, Senertus, in the preface to his fo much > efteemed treatife, which has been reputed the beft on the fcurvy, tells us, as an apology for having tran{cribed this author, that if we live © in a country where the {curvy is not very com- — mon, we fhould at leaft learn from his book many fymptoms of the hypochondriac difeafe. Yet what is furprifing, this author, as well as all other fyftematic writers, has defcribed the — Jatter, in other parts of his works, as alegre different from the {curvy.
Thefe authors, by saecbanedii the two cifeafes, occafioned the utmoft perplexity to fucceeding writers on the fubjet. Willis, —
and ail the followers of Exugalenus, maintain —
that the {curvy was nearly allied to the hypo- chondriac difeafe. But to fet limits to both, and determine wherein they differed, puzzled authors not.a little. Some thought they were fo clofely connected as not to be defcribed fe-
4438 parately
Ven 2 iat ome Sura) FREI, richie ASS eas ida Si Hee Chg (rine to Deeg ar ete ee ey ie Yih Wier a £4 Bags A Oe Lage TCU Sedge ar a SO Rane Pee Pea ae
Chap. II. divifions of the fcurvy. 49
parately(4). The excellent Riverius, who knew little of this diftemper but from books, conjectured it to be the hypochondriac difeafe, complicated with a certain malignity. Some were of opinion it was this laft when begin- ning. But the more general notion of thefe miftaken authors (7) was, that the melancho- lic malady often terminated in the fcurvy, as ‘being the laft and moft exalted degree of it. The moft judicious, fuch as Drs Pitcairn and Cockburn, *(the laft of whom efpecially had great opportunities of being acquainted with the feurvy), tell us plainly, that if any thing is meant by the term of a cold fcurvy, it is nothing elfe but the hypochondriac difeafe. And any perfon will be convinced, that this is truly the cafe, by looking into Charleton; who muft mean that, if he means any thing; and is the only writer of character who has diftine ue -guifhed the acid {curvy by its fymptoms and , cure (k ). | But it is certainly paying too great a compli- “ment to Eugalenus, to extend this denomina-
ee
(h) Ettmulleras, Dolaus, &Fe.
(i) Mocellenbroek, Barbette, Deckers, &c.
(2) P. 40. He fays, it is fo nearly allied to the halal ia _ bypachoudriaca, as to differ from it only in certain degrees. |
. : G | tion
aided ek
go. Of the feveral Part I.
tion to the hypochondriac difeafe, or any fpe- cies of it; to peftilential fevers, cancers, bu- boes, ¢’c. as he has done. Nor is it fufficient to alledge, that time and cuftom have given a fanétion to fuch terms; as this is paying a de- ference to ignorance and cuftom, no ways confiftent with the improvement of arts and {ciences. | | The hypochondriac diftemper, according to
Sydenham (1), is the fame in men, that hyfte- ric diforders are in women. In this, with fome little variation, moft phyficians agree with him. But fuch difeafes have no manner of connection with the feurvy: their feat and caufe in the human body, and efpecially their fymptoms, are widely different; fo that there is hardly to be found one conftant fymptom in either, which is common to both.
mre Fs opie indeed furprifing, that fome very emi- nent authors fhould have endeavoured to per- fuade us, that from fuch oppofite caufes, as heat and cold, or alcaline and acid falts abound- ing in the body, not only the fame feries of fymptoms fhould arife, (for if they do not, they fhould certainly have noted which were
(1) Vid. Differ. epiftol. ad Gul. Cole. ¥l | peculiar —
\
BS eg i i Es i Br er gl are pal al Aa ee SI See ar ee ei gy Sta A hf ieee en Re RR Bs Se fo Dia Bee OG es Sok SS iek os hea eis or, ae Se BPE Ll ee ee Soe re Soe RS DOE FEE ad eee! eo Ce Bach Se oy eetecl a ar Z ze * : ces oop ncene aes na acer ae i ae rd eat ate <7 SON oR RSE END Doh Ste SOREN te gM ROE NIRS ee ee Sa RR TE Bee INN SN ME A TBM N ET! HPN PE DESO, TO ee RRR OTe eR aad Se Ngee eT Tn SRR FO ee aye eee Sie ak —t + % 4 : 2 - > i * * e je . _ = = = 2 ‘ t be . . % ‘ 2 ,
' Chap. II. divifions of the feurvy. | Ba
peculiar to each), but that then likewife the fame {tate of the blood fhould alfo exift. Thus, the learned Boerhaave and Hoffman, after oe ving: a regular detail of fymptoms, wherein they widely differ from each. other, both a- gree in afligning one only immediate caufe of all fcurvies; which they fuppofe to be an _ extraordinary feparation of the ferous part of the blood from the craffamentum; the for- ‘mer being diflolved, thin, and acrid; whilft the latter, or the grumous part, is too thick and
vifcid. From the predominancy of different
acrimonious falts, or oils (mm), in this ferum, the {curvy was to be denominated, according to Boerhaave, either muriatic, acids-auftere, fe- - tid-alcaline, rancid-oily, &c. (n) | Gs
(m) Vix equidem plura fulphurum faliumque geneva in berme- ticorum ergafteriis, quam in fanguine fcorbuticorum eft is dah Charleton, p. 58.
(2) Boerhaave having defcribed the fymptoms peculiar to the beginning, progrefs, and end of the malady, it may be afked, To which of the different fcurvies are the fymptoms (4pb.1151.), and their fo regular progreflion, to be applied? It would appear, to all of them, not only by his defcription in this manner, but by the prefcriptions in his Materia medica; where, for example, putrid gums, the pathognomic fign of the mala-
py, as will afterwards be fhewn, are fuppofed to occur both in
the hot and cold feurvy, which are the moft oppolite fpecies of the difeafe. Vid. Aph, 1163. , G 2 The
fess ea eta: Sea RON ie Se ee Oy ea pes pe
Pre
po ee | Of the euerat Part I.
It were to be wifhed, after having laid down as the fole immediate caufe of all {cur- vies whatever, however different in other re- {pects they might be from each other, fuch a
broken
The whole indeed confifts of {craps taken from different au- thors. He has picked the fymptoms out of one book, Sen. nertus’s colle€tion, as he acquainted the pupils in his leCtures ; the cure out of another, viz. Wilks. But it will appear to any perfon who perufes the authors from whom he has borrowed the defcription of the fymptoms, wiz. Echthius, Wierus, &Sc. that they defcribed a very different difeafe from what Wills did. Dr Willis’s method of cure may perhaps be rationally ap- _ plied to the difeafes he defcribed; but is by no means adapted
to the difeafe chara&terifed by the firft writers on the fcurvy. _ I have been told, that Boerhaave has defcribed a cacochymia under the appellation of /curvy. But if any thing elfe is meant befides a fcorbutic cacochymia, which muft be the fame thing as the difeafe called feurvy, why mifapply and confound terms? This muft occafion a confufion of the things themfelves; and hath produced very dreadful confequences, of which I will give but one inftance. Mercury may be reputed a poifon in the {curvy ; Kramer gives an account of 400 men deftroyed by it, {See Dr Grainger’s letter, part 2. cap. 2.): yet Boerhaave re- commends it; and in fuch a ftate of the ma'ady (4p). 1151.7. 4.} where it muft certainly become a very deadly one. This fatal miltake has been copied from him, and even inforced by his authority. See Heucher. It is true, he fays, what is proper for oe fcurvy, is a poi-
fon in another. But this is not eafily reconciled with the caufes — he affigns of the difeafe; all which (except the cort. Peruv.
which is a good antifcorbutic) would feem, either feparately or jointly, to produce fimilar effects. Let us fuppofe, for a mo- ment, they produced very different effefts; what criterion have we to diftinguifh, by his aphorifms on this difeafe, a poifonous from a falutary medicine? As I have before obferved, he de-
livers
LEGG orn ee Re ASE aimed Ge ere ream fF Ett Pe CMe ee: Pam Mtge ie cea roe Aah Ue Ra i aD files Ohta ae rsa ha, Lt ee | POMS Vee een Oo Py 3 artes igiab ioe ve ] bonis ‘< ie ens Cat et ? C
Rn Se ey BOTS Bae See a eS Se ee Bier eo ea gee 2 sae - Sl De SR a Re Fg Sas Se ae ee
Chap. II. divifions of the fcurvy. 53
broken texture in the blood, and a remarkable
feparation of the ferum from the grumous part, with fo great an acrimony in the firft alone, that thofe learned authors had furnifhed us with fome better reafons for this opinion. Here we muft have recourfe to the firft author of this hypothefis, Moellenbroek, in his book De varis, feu arthritide vaga feorbutica, —
But it may be proper, before we go farther, to remark, that this writer has taken upon him to defcribe a difeafe as fcorbutic, which Wie- rus, the fir who mentions it, had defcribed as
livers the moft regular uniformity of appearances; and the pa- thognomic figns feem to be the fame in every {pecies of {curvy.
To fo great an authority, which, as far as is confiftent with _ truth and the good of mankind, I fhall always refpe&, may be
oppofed a much greater, viz. the experience of a phyfician who had the greateft opportunity perhaps any one ever had, of being converfant with fcorbutic patients; woful experience _ gained by being witnefs to the death of many thoufands, when Boerhaave’s Apborifms on this fubject were of no ufe to him! Non nifi unica fpecies veri feorbuti datur, eaque fetida, putrida, bc, Graviffimus ef error, quamlibet cacochymiam, imo etiam cachexiam, Cc. fcorbutum putare, quum verus fcorbutus /pecies cacochymie fh jfite gularis fit. Kramer epiftol. p. 27.28. Such indefinite terms are indeed but a fubterfuge for ignorance, and have been long a reproach to the art of medtine. Antiquorum cacochymia, et modernoram {corbutus, «qualia habent fata; nam nomen fin in gmnibus illis affectibus dare debent, ubi caufe morborum et Sym- ptomatum nullo alia vocabulo exprimi poflunt. Et fie tanquam _ afylum ignorantie bee nomina confideronda veniunt. Yonckeri _ confpectus medicine, tab. 69.
a
* renee PAs arte eA
Pays §
4 E ‘
AE ae AN ee eter ee ered ey oy pate OM, bete BE uaa Pee ae ae Ogre MER MOE Py R DE US Ce ARTUN SE pe right a eo A 4 Sip esa et . *
54 | Of the Several Part f.
a very different one, in a treatife De morbis a- liquot hactenus incognitis; in which he tells us, _ the one was peculiar to the people of Weft- phalia, the other to Holland, ec. Forreftus, upon receiving an account of the de varen, from Henricus a Bra, ingenuoufly owns, that in fifty years practice it had never occurred to him. He thinks it a new difeafe, and very different from the {curvy (0 ).
Now it is this author, in his account of what he calls the fcorbutic wandering gout, who (~) makes the immediate caufe of the {curvy to be a volatile fcorbutic falt. He ob- ferves, that this falt muft needs be volatile, o- therwife it would too tenacioufly adhere to the parts, as in the true gout; and the pains would not move or fhift fo fuddenly as they do in the {corbutic gout (7): and for
the fame reafon it muft refide in the ferum a- _
lone, as the moft proper vehicle to circulate it fo quickly. This the other vifcid humours with which feorbutic habits abound, as is plain from the blood taken from their veins, cannot
be fuppofed to do. He afterwards affigns thefe
(co) Vid. Obf, medicinal. lib. 20.
1p) FP. un (q) P..12. vilcid
: Chap. Il: divifions of the feurvy. 55
_vifcid humours as the caufe of the putrid gums.
and fome other fymptoms (r ). The celebrated Profeflor Hoffman (/) makes ufe of pretty much the fame arguments. He _ judges the falivation, flying pains, and hemor- _ rhages ufual in this difeafe, to proceed from the ‘thinnefs and acrimony of the /ferum, and its feparation from what he calls the folid parts of the blood; and the more fixed pains, tumours, gc. to arife from the vifcidity or /entor of the latter. | ;
But the truth is, there is no fuch ftate of blood in this difeafe. It is indeed contrary to reafon, to fuppofe, in fo high a degree of pu- trefaction as appears in fcorbutic cafes, that the craffamentum of the blood fhould con- tinue thus thick and vifcid; which, by all ex- periments made on putrified blood, appears quickly to be diffolved and thinned by corrup- ‘tion(?). It certainly is fo in all putrid dif- <r) Penge” ee
(/) Medicin. fyftematic. tom. 4. part. 5. cap. 1.
(t) By Dr Pringle’s experiments, not only the craffamentum of the blood is the firft refolved by putrefaGtion, which the /é- rum yefifts for a much longer time; but the feptic or putrid par-
ticles feem principally to be intangled inthe grume: fo that fuch
. acrimony would appear to refide chiefly there, by experiment _ 42. Vid. Appendix to Obfervations on the difeafes of the
i. army,
eafes.
RE Te Oe Ne ee ne
a, 7 at ee As ‘a ie lela Bx a ia
ie
if i,
3
ny 2 A in bs 3 7" Pe * . %
a
i : é *
i
*
56 es Of the feveral Part I.
eafes. This is further made evident to a de- monftration, by the difle&tions afterwards to be related (uw); or, if thefe be liable to ob- jections, from the appearance of the blood in Lord Anfon’s {corbutic crew while alive (x ) ; which in every ftage of the difeafe, and from whatever part of the body it was difcharged, was always found in a different condition: the cra/Jamentum was altogether diffolved and broken; and there was not fo much as any re~ gular feparation (y), much lefs fuch an extra~ ordinary one, as has been by fome made the only immediate caufe of the fcurvy, the bafis of atheory, and of a practice founded upon it. The afluming likewife the chymical princi- ples of acid and alcaline falts, as the founda- tion of a method of cure, from a prefumption of the predominancy of fuch falts, or of an acid or alcaline tendency in the blood in this difeafe, is exceptionable on many accounts. We may allow the predominancy of fuch falts, or the exiftence of fuch an humour in the prime vie, as may be fuppofed to have the
(«) Part z. chap. 7.
(x) Ibid.
(v9) This is confirmed by Kramer. See Part 3. and Dr Grainger’s obfervations, chap. 5. part 2. |
phyfical
| Chap. II. divifions of the feurvy. 9
phyfical marks and properties of what is faid to be acid or alcaline. _ But as the blood of no living animal was ever found to be either acid or acaline (z), it is hard to grant the exiftence
_ of fuch qualities, latent and occult there, when they do not manifeft themfelves by any figns —
in the body, from which we can be affured of their exiftence. ‘Thefe, according to all the authors of fuch theories, ought principally to be in the firft paflages. But, in the higheft
degree of the hot, putrid, and what is called the alcalefcent fcurvy, there is generally nei-.
ther lofs of appetite, putrid belchings, nor any
other marks, delivered by thofe authors, as proofs of an alcalefeent tendency in the fto-
-mach and inteftines; nor is there commonly
)
any preternatural thirft, or heat of the body, fuppofed always to accompany an alcalefcent ftate in the blood. On the contrary, fuch
(s) Although the recent urine of thofe who took Mrs Ste-
phens’s medicine was found to effervefce with acids, yet this ex-
periment by no means authorifes us to conclude that the blood of fuch people was alcaline, for very obvious reafons. It how,
ever furnifhes one of the ftrongeft arguments againft the opi-
nion of putrid fcurvies being of an alcalefcent nature; as pills made of foap, garlic,.and fquills, was the common medicine
i given by our moft experienced navy-furgeons, and ufed at fe.
veral hofpitals, particularly at Gibraltar, for recovery of many thoufand feamen half-rotten in this difeafe.
Bo a8 Ghee eC
PR Aa ee ee
/
58 | i Of . the” feveral . ; Part],
people have for moft part a good appetite, without any heat or drought, even till their death. | -.
One would naturally have expected here, e- {pecially in the muriatic fcurvy, as it is deno- minated, (which in another place fhall be pro- ved altogether a chimerical diftinétion), a vio- lent thirft, a vehement defire of aqueous and diluting liquors. Thefe alfo would feem the moft rational and effectual remedies, in fuch a faline ftate of blood, at leaft upon chy- mical principles. Accordingly, a great chy- mift, Hoffman (a), though he admits diffe-
rent falts in the blood as the caufe of {curvies,
obferves, that nothing can be fo ridiculous as the laboured and anxious pains taken to corre thefe by oppofite falts. “For (fays he) I will ** prove it to a demonftration, there is but one “ way, and it is the moft effectual and fafef, ** to correét morbid falts of any kind; that is, “ by diluting them fufficiently with water.” His reafoning is at leaft plaufible, it being cer- tain water is the proper menftruum and folvent of all falts.
The terms of acid and alcaline, have not in-
deed been fufficiently defined and reftri€ted, fo
(a) Medicin. ration. fyftem. tom. 4. part. 5. cap. 1.
< Chap. II. divifions of the Scurvy. 59 as to be a very folid foundation for any theory of difeafes (>), beyond thofe of the prime vie. For even fuch as are generally deemed _ of either clafs, though obtained in their utmoft purity, are found to differ extremely from each other in their properties, more efpecially in their effe€ts upon the human body (c); as unfer- mented and fermented, vegetable and foffil a- cids do; fome coagulating, others attenuating * the blood: Thus likewife, volatile and fixed
alcaliecs differ extremely, though pure. But this purity being feldom attainable, their vir- tues and properties are ftill infinitely more vari- ed, according to the manner of their prepara- tion, and their different and various combina- tions with other fubftances.
But to bring this matter toa eetclMlort Such theories are entirely overthrown, upon having recourfe to experience, the only teft by which they muft ftand or fall. We find in practice, that in fuch hot, putrid fea-fcurvies, as have
(6) Frufira quarimus limites quibus utralibet fpecies contineri debiat. Hine quam re&te ii faciant, non diffcilis eff conjecura, qui theorias, non chymicas modo, fed et medicas, ex acidorum alkali- umque do&irina confingunt, dum ne vocabulorum quidem vim intel» figunt. Jo. Freind przlect. chymic. p. 12. |
(ce) Vid. wishes obferv. phyfic. chymic. lib. 2. obf. 29.
€t 30.
Hy 2 been
ae o | Of the feveral Part in a
been referred to the alcaline clafs, the hot alca- lefcent plants, viz. crefles, onions, muftard, and radifhes, prove ferviceable. Thefe, from fuch theories, have been condemned by authors, as . noxious and pernicious in the higheft degree. But the contrary is demonftratively evinced, by the deplorable cafe of the failor left behind at Greenland, related by Bachftrom and others, who was cured by fcurvy-grafs alone (ad); and by the experience of all our naval hofpi- tals, where the moft high and putrid fcurvies are daily removed by frefh flefh broths; where- in are put great quantities of celery, cabbage, colewort, leeks, onions, and other alcalefcent — plants.. In fuch cafes all acid fruits and herbs are likewife experienced to be of great benefit. So that the uncertainty of fuch theories plainly appears. And they ought the more now to be difregarded, as putrid fubftances and alcalines are proved by experiments to be different (e ). Yet it was upon a fuppofition of their bearing
(d@) ‘Though it is not fo acrid as our fcurvy-grafs, yet ithas a tendency that ‘way. See Mr Maude’s letter concerning the
_ Greenland {curvy-grafs, part.2. chap. 5.; which is a fufficient
confutation of the vulgar error, that acids alone are proper in putrid f{curvies. , | |
(¢) See Dr Pringles experiments read before the Royal So- ciety.
a
SAH RST US TY Vern gh | AnD MYC RAID UR Eirfetys Oca te Rega eee ene in ng hs POMBE RARER a REEL 8 ae ae ed NE WET cia a ae aa i batik ay tii 4) 0) \ ms :
Chap. II. divifions of the feurvy. 61
a great fimilitude to each other, or being pro- _ perly different degrees of the fame thing, that _ this theory was firft devifed. Upon the faith of which,. many improper chymical prepara- tions, and efpecially oppofite falts. highly ex- tolled in fuch cafes, have been recommended and adminiftered in the fcurvy, to the manifeft detriment of the patient. Be it remembered, Chymia egregia ancilla medicine, uon alia pejor domina.
CHAP. Il,
Of the diftindtion comriony mate into a land and | ey feurvy.
\ His sitet has been always nol com= mon at fea. It is well known there in the prefent age, by reafon of the frequent voy- ages to the moft diftant parts of the world. _ The fymptoms, though numerous, are yet ob- ferved to be regular and conftant;.. fo that the moft ignorant failor, in the firft long voyage, becomes well acquainted with it. But as many were fuppofed to die at land of the {curvy, _ though none of the moft equivocal and uncer- | tain,
62° Of the diftinBion into Part I. tain, much lefs the ufual fymptoms of the ma- fine difeafe, appeared; it became neceflary, in order to fave the credit of the phyfician, and to juftify his opinion of the difeafe, to pro# nounce it the land-/curvy, or a f{pecies of {cur- vy different from that at fea.
This is a diftin@tion often made in converfa- tion, and fometimes in books. Ini order to judge of the juftnefs and propriety of it, we fhall here confider, what certainty we have that this diftemper is the fame on both eles ments; and what particular proof can be brought at any time, to afcertain the identity _ of two difeafes, afflicting different perfons, in different climates, and at different times.
The phenomena or appearances in any dif- eafe, which are obvious’ to our fenfes, or by their affiftance may be made evident to our reafon, are the fymptoms or diagnofties of it. — Whether they be the immediate caufes or ef fects of the malady, they are properly called {ymptoms ; a fymptom being part of the difeafe ; and the whole fymptoms taken together con- > ftituting the whole difeafe; from the aggregate or aflemblage of which we draw conclufions. ©
Such appearances or fymptoms, then, as are peculiar to the nature of the malady, and are
| more
| Chap. Ill. a land aud fea curvy. 63
more conftantly experienced to accompany it,
are called pathognomonic or demonftrative igus ; and thefe conftitute the greateft medical evi- dence which can be obtained of the exiftence and identity Of difeafes. Befides which, it is - a corroborating proof of their identity, if they proceed from fimilar caufes: And, laftly, if they are removed by the like medicines or me- thod of cure. ft, Asto the Lei figns of this ait eafe: If we compare its fymptoms as defcribed by Echthius, Wierus, and all other authors till the time of Eugaleuus (a), with the accounts given of them in books of voyages, particular- _ ly the extraordinary narrative of what happen- ed tothe great Lord Aufon’s crews in their -paflage round the world (6), we fhall perceive an entire agreement in the effential figns of the diftemper, (making a proper allowance for the different defcriptions that may be expected from feamen and phyficians), and appearances fo fingular as are not to be met with in any other. Thus, putrid gums, fwelled legs, and fpots, accompanying each other, and in their pro- grefs ufually attended with rigid tendons in - the ham, are obferved in no other diftemper.
(a) Vid. Part 3. (#) Ibid. : It
Of the diftinition into Part lh It is alfo peculiar to it, that perfons thus afflict ed, though otherwife apparently healthful, are upon the leaft motion, or exertion of ftrength, apt to faint, and do often fuddenly ain down dead.
- This evil the medical writers have defctibed as peculiar to certain countries. ‘They tell us of its being epidemic one year over all Bra- bant (c); fome years in Holland(d). For- veflus, though he had frequent opportunities of feeing it in failors, yet in all his hiftories gives us but one cafe of a mariner. His moft faithful accounts of this malady, are illuftrated by patients who had always lived at'land; fome of whom muft have been infeéted in a very high degree, when they dropped down dead fuddenly, to the furprife of their relations; of which he gives an inftance. Dodoneus (e), ‘a very accurate writer on the fcurvy, relates no cafes of it in failors, but in people on: fhore, particularly in a perfon who contragted it in prifon (f). | i 5, Dodoneus, Forreftus. ty (a) Ronffeus. | (¢) Praxis medic. et obfervationes.
(f) Yet elfewhere, Angh maritimis commerciis dediti, et nauz ta@ potifimum, flomacace affliguatur, Sive id fit cerevifie potu ex paluftribus aquis code, five ex atris putredine, calique nebulis aut
waporibus, bujus nofiri inflitusi explicare non eff, Hiftoria flirpium.
It
ae ee
Chap. Tl. @ land and fea fcuryy. 65
It is indeed remarkable, that the firft juft de- {eription publifhed of this diforder in Europe, was in an account of its raging in befieged towns, by the hiftorian Olaus Magnus (g), where it was attended with fuch fymptoms as - occur always at fea.. We have likewife about the fame time a very elegant picture of it drawn by Adrian Funius, a phyfician and hiftorian in LHolland, cotemporary with Ronffeus (h ). Moreover, the fea-fcurvy is called by feveral authors the Dutch diftemper ; efpecially by the celebrated Francis Gemelli Careri, who has wrote the beft voyages in the Italian language.
And indeed the fymptoms of the malady are at.
this day uniform and the fame, both at fea and
fand; in Hlolland(i), Greenland(k), Hun-
gary (1), Cronftadt (m), Wiburg biases _ Scot-
(g) Vid. Part 3. chap. i. (4) Hollandia itaque peculiari dono Natura dedit proventum le- tum Britannice herbe, (which he afterwards calls cochlearia }, quam prejentanci remedii vim precbere in profliganda /celetyrbe et flo- “macace experiuntyr, cum incolis, exteri quoque : quibus malis dentes dabuntur, genuum compages folvitur, artus invalidi funt, gingive putrefcunt, color genuinus et vividus in facie di ifperit, livefcunt crus ra, acin tumorem laxum abeunt. Hiftor. Batavie, cap. 15. (i) Vid. Dr Pringk’s obfervations on the difeafes of the army, p. 10. 7 (&) A&. ‘Haffnien, vol, 2 obf. rie (m) Sinopaus, (4) Kramer, © (n) Nitzfb. i land
Bo oe ge SMR Eoin is ie NO Hie ery Sak As PRN eC ea eg eee ; 5 ‘ ri : : ETRE ee oe eee se eR ye eS a ee ee wes
PET MTD DERI PRE ERE gg RUNS EMR RIC AR BN Teh eee nC AT ot anne eRe ¢ ES a wee gaet * SPO hn
66 eo | of the di ‘Rigdiin into Part I,
land C 0), @c.: which fufficiently evinces the abfurdity of the affertion advanced by feveral authors, that fince the firft accounts of it were
publifhed, the face and appearances of the « ca-
lamity have been greatly changed. ; 2dly, As to the caufes of an difeafe; they are the fame on both elements: for it will be
fully proved (p), that there is not to be found
any one caufe productive of it at fea, which is not alfo to be met with at land; though fuch caufes, by fubfifting longer and in a higher de- gice, ufually give rife to its greater virulence in that element.
It is indeed a fufficient and juft confutation of many writers on the {curvy, that they pre- tend to defcribe a malady to which feamen are
peculiarly fubject, and which they fay proceeds _
from the #auticus victus, putrid water, and fea-
air. Yet their affertion, That the difeafe. defcri- . bed iby skit (viz. Pipe (q), Willis; and
their
i ) Vid. Dr Grainger’s account of the fcurvy at Fort-William, —
pa z. chap. 2. (p) Part 2. chap. 1.
(4) Eugalenus praguled at Embden, and other places of Eaft-
Friefland; where the cold, thick, and moift air, the raw un-
~ wholfome waters ufed by the inhabitants along that trad of the - fea-coaft, and the crafjus et nauticus vidtus, (as ye terms it), Oc- pected the fcurvy to be a bpayerial difeafe, But it muft be |
granted,
\
Se we
their #28 ek Is Radkday a marine difeafe, is refuted by the obfervation of all practitioners at fea, And the fame may be faid of the dif- - ferent fpecies of fcurvies alledged by Boerhaave to proceed from the caufes abave mentioned. ~ Buta heavier charge lies againtt them. When
granted, that the {curvy never was fo cunt or fatal there as in ships and fleets. Allthe caufes he afligns as produétive of it, do fubfift at times in a much higher degree at fea than at land. I have had 80 patients out of the number of 350 men afflicted with it; and have feen a thoufand fcorbutic perfons to- gether in an hofpital, but never obferved one of them to have the ‘difeates defcribed by Eugalenus. Nor did I ever hear of a pra&titi- Oner at fea, where it would have been moft allowable, who af-
fumed his principles ; and fuppofed, that almoft all difeafes there —
‘muft be complicated with the fcorbutic virus; that the moft ex- _traordinary and uncommon which occurred at fea, (as was fup- poled at Embden and Hamburg), were, this mifchief lurking un- “der deceitful appearances; and that fuch difeafes could not.be
-cured without a mixture of antifcorbutics, which feldom failed to.
- remove them. ‘This laft, furely, could never have efcaped the obfervation of our many ingenious navy-furgeons, and of our phyficians and furgeons to naval hofpitals; fome of whom had -feldom lefs than a thoufand patients from the fea. Mr IJwves’s _ ingenious journal, (placed at the end of chap. i, part 2.), isa - proof of the variety of difeafes which occur there, without the leaft connection with the fcurvy. If it often killed the patient (as it would feem always to have done in Friefand) before the gums and legs were affected, or the fpots appeared; this like- wile. muft have efcaped our obfervation. But though Eugalenus may. ‘be juftly condemned as the parent of thefe abfurdities, _ greater mifchief, however, has been done by fucceeding. au- _ thors,’ from their digefting them into a fyftem. Such remedies -and cures have been direéted, as are not only altogether unfer- _ Viceable, but for the moft part highly pernicious.
i { pf. the
Se a ky OS ey a LY ahi eae
BLED A Ty ae ry a ge nF ey Ne ae NT Oe ee a
63 Of the Affine info ~ i {Pasti
the true {curvy does really occur, their writings, {o far from being ufeful, are rather hurtful to practitioners; which I think needs no farther
proof, than Kramer's letter to the college of
phyficians at Vienna. "Their dotrines have per- verted the judgment of even fome of the beft
writers. I fhall inftanee only in Sinopeus.
That author has taken his defcription of the difeafe from nature and obfervation; but, un- luckily, his medicines from thofe authors; o- therwife I am morally certain, the calamity would not have arifen to the height it did at Cronfiadt, and ufually does every {pring ; where it feems to be abated annually more by change
of weather, than the fkill of phyficians. 34h, The cure of fcorbutic difeafes con-
tracted either at land or fea, is entirely the
fame. ‘This will appear to any perfon who
perufes Backftrom’s and Kramer's obfervations, and feveral other hiftories related in this trea- tife. And every praétitioner who has treated fuch cafes, muft be further convinced of it; as the firft remedies which were cafually found out by the vulgar, and are recommended by
the firft and purer writers on the fubject, have
preferved their reputation and efteemed virtues even to this day.
Lafily,
: ee . ae ee ere Re aE SL a nk eae eg a 1 Sy
ais Re ae ae
cee
ChapiIII. adand aud fea feurvy. : | é9
< Laftly, If to fach convincing proofs it may be neceflary to add authority, I fhall beg leave to'quote a very great one. The learned Dr _ Mead (r) informs us, that incited by the ex. traordinary events publifhed in Lord Anfon’s voyage, to make a full inquiry into this whole affair, he had not only the honour of difcour- fing with his Lordfhip upon it, but had alfo been favoured with the original obfervations of his ingenious and fkilful furgeons ; and, upon the whole, he found, that this difeafe at fea _.was the fame with the {curvy at land; the dif- ference being only j in the degree of malignity.
Ir @bjektors fhould reply, That tho’ the fea» {curvy often occurs at land, and, as has been de- monftratively proved, isthe only difeafe that - was defcribed by the firft writers on the fubjea, as amalady peculiar to the marfhy and cold countries which they inhabited ; yet that they, -neverthelefs, underftand by what may be term- ed, in contradiftin@tion to the other, a /and-/cur- . vy, adifeafe, or clafs of difeafes, different from | the: appearance of the marfh or marine fcurvy : then it is incumbent upon them, and would be much for the benefit of mankind, to define,
(r) Difcourfe upon the wishias Pp. 97
deca
pein Fe oe ee a ne ae Roe ea rom
70 a. or the di spinon into “pin i
auteribe; at) characterife this fingular ipecies, i
and diftinguifh it from the appearances of the faid difeafe, either at land or fea. This they muft know has not been attempted by. any author in phyfic. The greateft modern * wri- ters, viz. Boerhaave, Hoffinan, and Pitcairn, have made no fuch diftinGtion, either in the caufes or diagnoftics of the difeafe, nor indeed in any part of their defcription of it. And I mention thefe laft, as having had a very exten-
five practice, befides the advantage of perufi ing
all books wrote before them on the fubject. . It may be faid, "That there are certain difor-
: Te viz. many cutaneous eruptions, ulcers,
a f{pecies of toothach, %:c. which, for a confi- derable time, have pafled under the charaéter
and denomination of /corbutic; a term introdu- ced by our predeceflors in the fcience, and
which moft practitioners have agreed to make ufe of at this day, and which there may per- haps be a neceflity of retaining, as it is not ea-
fy to affign a proper appellation to every dif-
eafe, or cafe of a patient. tie This reafon is commonly urged. In anfwer to which I fhall, fir/?, inquire, how or when this
term came firft to be fo generally applied; or
-whence {uch ulcers, the itch, &c. were deno-
minated
ee
Chap, Ul @ land and fe a a
minated Jeorbutic: 24 think i it will abate of na
doubt, that i it was firft applied to fuch ulcers and eruptions on the fkin as did not readily | yield to the fkill of the practitioner (/). Dr Mufgrave (#) informs us, that all Europe was
fo much alarmed with the apprehenfions of this
evil in the laft century, as appears from the |
Recipe's of praétitioners in thofe times, that the whole art of phyfic feems to have been employed i in grappling with this univerfal cala- mity, which was fuppofed to mingle its ma-
lignity with all other difeafes whatever (u).
_ Thus the term was originally impofed through
ignorance, and a miftaken opinion of the pre-
valence of the fcurvy. There would indeed be fome difficulty in conceiving how men of
fuch wild fancies, as were they who have been
deemed the principal authors on the fcurvy, and to whom we are indebted for this general
name, could ever get into poffeffion of that de-
_ gree of fame which they have acquired, did
we not experience how much the world is dif
pofed to admire whatever furprifes; as if we ~
were endued with faculties to fee through ors
(/) Vid. Sydenham. (t) De arthritide fymptomatica, p. 98. (uz) Vid. note, p. 30.
dinary
PR PROEE 5 Cone ska teases ie a tL) uk Oeste
92, men Of the diftindion into Part I.
dinary follies, while great abfurdities {trike with an aftonifhment which overcomes the powers of reafon, and makes improbability ec- ven an additional motive to belief. There are few now who fet fo {mall a value upon their time, as to read thefe authors; and by that means their merit is little examined into, and is admitted upon the credit of - others.
2dly, If it be urged, That the denomination of fuch difeafes ought ftill to be retained, as being now generally adopted ; I anfwer, That,
upon the fame principles, the moft ridiculous
terms in any art may be vindicated. Lord Verulam, and the firft reformers of learning in Europe, met with this very objection. The learned ignorance of that age lay concealed
under a veil of unmeaning, unintelligible
jargon. But, in order to make way for the reftoration of folid learning, it was found ne- ceflary to expunge all fuch terms as were con- trived to give an air of wifdom to the impers fedtions of knowledge. |
It may be believed, that there are few peo- ple who have had opportunities of reading more upon this fubjeé&t than I have done; and that there are few books or obfervations publithed upon the difeafe, that have not fallen under 7 | omy
Chap. III. @ land and fea feurvy. 73
my infpection. If I could, with any manner _of propriety, have charaéterifed any other fpe- cies of {curvy than that which is the fubje& of this treatife, I fhould have confulted the fecu- tity of my chara&er more, than in advancing an uncommon doétrine, as all novelties are
_expofed to oppofition. But, in attempting a
thing of that fort, I did not find two authors -agree who founded their doctrine upon facts and obfervations. I obferved, that ten differ- ent practitioners pronounced ten cafes to be {corbutic, which, upon examination, did not
bear the leaft refemblance or analogy to each —
other. Upon this occafion, I might have fol- lowed the example of fome writers; and, dif- liking the former diftinétions made, might have introduced others, accommodated either to the opinion of the country, and thus, by adopt- ing vulgar errors, have endeavoured to eftablith
and confirm them ; or to fome new principles ; — and fo might have saulemice abfurdities, in like
manner as every private practitioner does, who thinks he has a right to term what he plea- fes a_fcurvy ; ; though the propriety of the ap- pellation cannot be juftified from the accepta- tion of it, by the moft authentic authors of
K facts.
9 pe ee SN Nae ae a oS ROS oe a oe eg
Pa ie aie ea,
= ar ee Re ee
: : :
Pe OES ee BTL” STADE AEE a ey ere a a RT RE ge ME LE ey ES SO TE RRR,” SUCROSE RC REET ek ey RCAC S act EE Te RS ar ees oe
v4 | -- - OF the diftinétion into Part be facts and obfervations, nor has any foundation in the genuine principles of phyfic.
It may be faid, ‘That the world would reap great advantage by having a compleat treatife of the caufes, cure, dc. of the many difeafes which commonly go under the denomination of the curvy. But this is not an eafy tafk: and it might
as well be expected, that an author, who lived.
in acountry, or ata time, when the moft obfti- nate and uncommon appearances were afcribed
to witchcraft, and had taken pains to banifh
fuch ignorant conceits, fhould be able to ac- count for the various diftempers and pheno-
mena aXcribed to that imaginary evil. It has
been ufual for ignorant and indolent praétiti- oners, to refer fuch cafes as they did not un-
derftand, or could not explain, to one or o-
ther of thefe caufes; according to the obferva- tion of a very learned and late practitioner (x ). With regard to the neceflity of retaining
the name, as if an unmeaning term was as re-
(x) Mos adeo invaluit, ut hodie medici imperitiores, fi quando ex certis fignis neque morbum nec caufam ejus rite poffunt cognofcere, fiatim feorbutum pratendant, et pro caufa fcorbuticam acrimoniam
accufent. Deinceps non raro accidit, ut adfeéius quidam fepe plane
fingularis, cui portentofa fpaftico-convulfiva junguntur fymptomata,
in artis exercitio occurrat ; et tum ufu receptum eff, ut illam vel ad
faftinum vel ad malum feorbuticum rejiciant. Fred. Hoffman. med. fyftemat. tom 4. p. 369. quifite
em, eee a a . = — Mister A a af RP ee le ee ae, Oia ne a ne 2
ee ESD MDa aby Re PAS Maze) Oe ak, Oe DROME poate GREE ®. WY TAT ve
*
Chap. III. @ /and and fea fcurvy. 75
- quifite in phyfic as pious frauds in certain re- ligions: Sz vulgus vult decipi, decipiatur. Tf the good of mankind will have no effect upon
_thefe gentlemen, I am afraid no other argu-
-ment will. We fhall however lay before them
a view of the fatal effects produced by the ufe
of fuch vague and indefinite terms.
iff, On young practitioners and ftudents in phyfic; who being provided with fuch a general name as that of the fcurvy, comprehending al- moft all difeafes, think themfelves at once ac- quainted with the whole art of medicine; as they may be furnifhed with numerous cures for it from the many Pharmacopceias with which the prefent age abounds.
2dly, Older praétitioners, by referring ma- ny various and uncommon difeafes to fuch imagi- nary caufes (y), deprive the world of the true improvement of their art: which can only be ex- pected from accurate hiftories of different cafes, faithfully and honeftly ftated ; and diftinguifhed from each other, with the fame accuracy that botanical writers have obferved in defcribing different plants. ‘The ancients have been at great
(y) Notandum eft, quid quando multa fymptomata numerantur, tune effe cogitandum de nomine congeriem morborum indicante, ut feor~ _ butus. Wald{chmid praxis medicinz rationalis.
K 2 _ pains
76 Of the diftindion into Part I. pains to diftinguifh the difeafes of the 4kin,
which at this day make up a very numerous and confiderable clafs, and have indeed treated that fubjeét with prolixity. But the moderns have clafled almoft all of them under that one very improper denomination of the /curvy (z), even from the higheft degree of the leprous e- vil, to the itch and common tetters ; and with
thefe have confounded the pimpled face, {call
head, moft cutaneous éruptions ufual in the {pring, the eryfipelas, dc.; nay dyfepulotic ulcers, efpecially on the legs, and various o- ther ailments of the moft oppofite genius to the true fcurvy, have been fuppofed to proceed fromit. ‘The different caufes of which various diftempers cannot be with propriety reduced
(z) Dr Pringle very juftly obferves the impropriety of tke appellation of /curvy generally given to the itch, various kinds of impetigo, Jc.; and remarks, that in the marfhy. parts of the Lew Countries, where the true {curvy is moft frequent, and
of the worftkind, the itch is a diftemper unknown. A real {curvy (fays he) imports a flow, but general refolution or putre- faction of the whole frame; whereas the /cabies, impetigo, or le- profy, will be found to affect thofe of a very different conftitution. The true fcorbutic {pots are of a livid colour, not commonly {cur- fy, or raifed above the fkin, &c. Vid. chapter on the itch, in Obfervations on the difeafes of the army.
In his Appendix he obferves, that the muriatic and putrid {curvy are properly the fame thing, and that the fuppofed {pe- cies of acid {curvy is at leaft very improperly denominated.
under
PO RENTON TERE TRO Nee Maat VEN ee Ro br agree ih ad? BOTS Ly etd te ta yt eee ee pm eet SOME oe: ta ar! ne ONG nana
FI ey a ge ee
“Chap. WL land and fea feurvy. 3%
under any divifion of the {curvy as yet made, nor from thence the peculiar and diftin@ ge- nius of each known and afcertained ; which, however, is abfolutely neceflary towards under- taking their cure. | 3dly, and /aftly, It has a moft fatal influence on the practice. ‘Thus the original and real difeafe has been loft and confounded amidft fuch indefinite diftin@ions and divifions of it, that it is fometimes not known by the beft prac- titioners, when it really occurs. To this was
owing the lofs of fo many thoufand Germans in
fLungary (a), not many years ago; where the
“phyfician to that army, together with the whole _ learned college of phyficians at Vienna, affifted by
all the books extant on the fubjed, were at a lofs how to remedy this dreadful calamity. And for this reafon many unhappy people are daily in- judicioufly treated at land, as muft have been obferved by every one acquainted with the diftemper. Thence likewife pernicious methods have been recommended at fea, and too often put in practice.
(a) Vid. Krameri epifola de feorbuto.
Gilde Pp.
; 98 Of the feurvy being Part lL
Co Ao Peed:
Of the fcurvy being connate, hereditary, and infectious.
Arious have been the opinions concern ing the caufes and propagation of | this evil. Some believed it to be connate, and the direful feeds of it tranfmitted from f{corbutic parents, and that fometimes it was derived from a {corbutic nurfe. | Horftius (a) had fo very accurate a difcern- ment, as to find, that the grandfather might infect a grandchild, though his own fon efca- ped the infection. He afcribes the fpreading of the contagion in Holland to the cuftom of | falutation by kiffing; and pities the poor in- fants, whom every perfon muft falute, to avoid siving offence to the family. He is not at all furprifed, that the calamity was fo frequent in the Han/e Towns, and in the Lower Saxony, i. they ufed but one cup at table; where there was rarely wanting fome fcorbutic perfon with rotten gums, who with his fava might infect the whole company. Sevnertus aflerts
(a) Tra&atus de feorbuto. a it
Chap.IV. hereditary and infectious. a
it to be infectious from venereal embraces, and mentions an inftance of its being communica- ted even froma dead body. Boerhaave, Hoff man, and almoft all authors, make it a very infections poifon ; - and Charleton was of opi- nion, that more got it in this way than i ered other. ? Several of thefe chimerical opinions deferve no ferious confutation. It is indeed far from being probable, that this is what may properly be called a hereditary or connate difeafe; as we feldom in prattice fee it rife toa great height, without the influence of fome obvious exter- nal caufes; and experience fhews, that when the taint is but flight and beginning, it may for the moft part be quickly and eafily fub- ~ dued. It isa matter of more confequence, to be rightly informed whether it is really contagi- ous, as hath been confidently afflerted by moft authors. The effeé& of contagious poifons can only be known @ pofferiori, and by no rea- foning deduced @ priori. So that thefe authors fhould have given us attefted hiftories of per- fons infected in this manner, where the other caufes that always produce the difeafe had no influence. But no fuch hiftories are to be a found,
\
Bo Of the feurvy being Part I.
found. On the contrary, where-ever the ca- lamity has been general, it was known to proceed from ae and univerfal caufes ; and, in the times of its moft epidemical ravage, per- fons properly guarded againft the influence of thefe caufes, were not infected with it. ‘Thus, when it lately raged with fuch a remarkable - devaftation among the Germans in Hungary, the phyfician to that army (6,) was furprifed to find, that not one cfficer, even the moft fubaltern, received the infection.
At fea likewife, where the frequency of the
diftemper gives the greateft opportunities of
determining this point, it never has been deem= ed infectious. If it had been fo, it could not there have efcaped obfervation. ‘Taught by” fatal experience the {peedy progrefs and great havock that all contagious diftempers, viz. fevers, dyfenteries, &c. make among. a number of men fo clofely confined, it is common to ufe. many precautions to prevent their fpreading.
They feparate the difeafed from the reft of the crew, deftroy the bedding and cloaths of thofe. who dic, fend immediately on fhore patients afflicted with fuch difeafes upon coming into port, and afterwards {moke and clean the fhip.
(a 4 Kramer. | But
4 ae NES f ‘ " > if, : < 4 te eet st aT it
Chap.IV. Aereditary and infectious, 81
But long and conftant experience having fuffi-
ciently. convinced them, that fcorbutic ailments
are not infectious, no fuch precautions are eyer
taken. In flight cafes, and eyen where the
gums are very putrid, the men are often kept
on board, and cured; there being no inftance of fuch perfons ever infeéting the reft of the crew, or of thofe who are fent on fhore car- rying the infection into the hofpitals; though, upon many other occafions, the patients in
thefe hofpitals fuffer extremely by cOnSAEIONE ’
difeafes introduced amongft them.
In an epidemic {curvy at fea, the indifpofi- tion attacks, in a regular order, fuch people as are predifpofed to it by manifeft caufes. It is for a long time confined at firft to the common -feamen: and though the officers fervants are at
fach times often afflicted with it, while ufing the fame cups and difhes with their matters ; yet it is but rare to fee this difeafe in an offi- cer, nay even a petty officer. I could produce many inftances, and well- attefted fa&ts, which prove beyond all doubt, that drinking out of the fame cup, lying in the fame bed, and the clofeft conta, does not communicate this diftemper. But to multiply moots of a thing fo univerfally known, is | mF needlefs,
PORT fe Mh ae NET
Pr. . rs pas ai ae eT ee ee ET Hy CT Sy lee ON Ee. ee oe ro as EE ea Ue ON aE OE MI OT Dm Ra TL Oe aaa Rome oY
S23. Of the fcurvy being, Re. Part 1
needlefs. Perhaps the following may fuffice.
jefty’s fhip the Sali/bury from a_prize-veflel, with the moft putrid fcorbutic gums that I ever obferved. ‘The ftench and putrefaction of his mouth were indeed intolerable, even at fome diftance. Yet though he eat and drank out of the fame difh and cup with five of his compa- nions for a fortnight, he did not infeét one of
them: they all arrived in harbour in perfect
health. |
Nor is this difeafe communicated by infec- tion from thofe that die: for the diffeétions made at Paris (c), of the moft putrid f{corbutic bo- dies, do not appear to have produced any fuch effect. |
From whence we may judge how much au- _ thors have been miftaken, when they imagined —
A French prifoner was taken on board his Ma~
this dreadful calamity to have diffufed itfelf by —
contagion over the whole world, after it had qguitted its native feat in the cold Si feta’
climates.
(¢) Vid. Memoires de V academie des feiences 1699, p. 237
ies
oe a POT ee a TESS
‘ CE Re eae Stee edie oe
ae OS a ee
FS eS Se ee ee, ee Re Se ne ee
ne vag
Z a
amok. & Awe Fe
ee OR 0 ie:
ee OG "Bg II.
CriliirAa ?. I.
&
The true caufes of the difeafe, from obfervations made upon it, both at fea and land,
HE {corbutic taint is induced chiefly by the agency of certain external and remote caufes; which, according as
their exiftence is permanent or cafual, and in proportion to the different degrees of violence with which they act, give rife to a difeafe more or lefs epidemic, and of various degrees of ma- lignity.
Thus, where the caufes produttive of it are general, and violent in a high degree, it becomes
an epidemic or univerfal calamity, and rages wba? with
pe ie a aN eae ay i ec
* Ded ee I ae Pec eft Sri = rm eat g “s x da a a nda a a kn Eg ae” 5 GR oh a al a re ke al in at on
v4
| 84 | Of tbe caufes of the feurvy. Part It.
with great and diffufive virulence: as happens often to feamen in long voyages; fometimes to atmies (a), very lately to the German foldiers
in Hungary (6); frequently to troops when clofely befieged, as to the Saxon garrifon in.
Thorn (c), the befieged.in Rochelle, as alfo Stetin (d): and at other times to whole coun- tries; as in Brabant, in the year 1556 (e); and in Holland, anu. 1562.(f).
_ 2dly, Where thefe caufes are fixed and per- manent, or almoft always fubfifting, it may be there faid to be an endemic or conftant difeafe; as in Iceland, Greenland ( &), Cronfiadt (hb), the northern parts of Ruffia (7), and in moft northern countries as yet difcovered in Europe, from the latitude of 60 to the north pole. Tt was alfo formerly in a peculiar manner en- demic in feveral parts of the Low Countries, in Holland and Friefland; in Brabant, Pomera- ia, and the Lower Saxony (k); and in fome
(a) Vid. Nitzfch. (3) Vid. Kramer. (¢) Bachfirom. (4) Krameri epifiol. p.23. — (e ) Dodencus, F Forrefius. (f}) Ronffeus.
(g) Herman. Nicolai. Vid. ad. Haffn.
(hb) Sinopeus. |
(7) Vid. Commerc. literar. Norimb. an. 1734, p.162.
(&) Wieruws, Ronfleus, €'c.
places
Chap... Of the canfés of the feuriy. 83 places of Denmark (1), Sweden, and Nor- : wy (m), chiefly upon the fea-coafts.
~Laftly, Where thefe caufes prevail lefs fre- quently, and are more peculiar to the circum-
ftances of a few, it may be there faid to be fpo-
radic, ora difeafe only here and there to be
met with; as in Great Britain (1) and Ireland,
feveral parts of Germany, &c. _ Now, by confidering the peculiarity of the circumftances, fituation, and way of life of thefe people; and by attentively obferving, what at any time gives rife tothis-difeafe, what is {een to remove it, and what to increafe or | mitigate. its malignity, we fhall be able to form a judgment, not only of the principal caufes productive of it, but likewife of the fubordi- mate, or thofe that in a lefs degree may con- tribute their influence. It is indeed a matter ‘of the utmoft confequence, to inyeftigate the true fources of this evil; as, upon the removing _ or correcting of thefe, the prefervation of the body from its firft attacks, as well as its confe- quences, in a great meafure depends. And
CL) Vid. Concilium pips mediccr bef. de fcorbuto. () Bruceus.
(2) Vid. Dr Grainger s account of the fcurvy at Fort-Wil.
| kam.
- we
* * 4 . BPE Oy SP IN EN I EE ae ETE UR ere SEMEN rene ne
as eA “ss Pere F Nici Ge TE TD UR ae aie AERA LS ne oe
EE ee Oe AEE Re Sey ee
SERN AR Le lense eh hee eee Nae a NL MR RIES Fae Reh. ey ee eee Te Ne ee cee eat
86 OF the caufes of the feurvy. Part Ih,
we fhall begin with confidering the fituation of thofe at fea, among whom it is faid to be fo often an epidemic calamity. |
In the proof of the identity of this difeafe on both elements (0), I obferved, that the cau- fes productive of it at fea, were to be found alfo at land, ina {maller degree: but before determining what are the true caufes of its be- ing fo often epidemic at fea, it may not be a- mifs to remark what they are not, although commonly accufed.
Many have shee this difeafe to the great quantity of fea-falt (p ), neceflarily made ufe of by feamen in their diet: and it has been there- fore denominated a muriatic fcurvy. |
-Whether this falt, inftead of producing the f{curvy, may not, on the contrary, from its an- tifeptic quality, become the means of prevent- ing it for fome time, I fhall not take upon me to determine, as my experiments do not autho-
rife this conclufion; though they plainly prove,
that it neither caufes the diltemper, nor adds
to its malignity. For in the cruifes after menti-
oned, where the fcurvy raged with great vio-
lence, it was then a fafhionable cuftom to (0) Bait 1 . chap. 3.
(p) Lifteri exercitatio de feorbuta, Y / — drink
“Chap. Of the caufes of the feurvy. oe drink the falt water, by way of gentle phyfic..
1 have been told, that Admiral Martin, and fe- _ veral officers in his fleet, continued the ufe of it during awhole cruife. I had at that time feveral patients under a purging courfe of this water, for the itch, and obftinate ulcers on their legs ; and have experienced very good effeéts from it, efpecially in the laft cafe: yet none of thefe people, after continuing this courfe for a month, had the leaft fcorbutic complaint.
But to put it beyond all doubt, that fea-fale is not the occafion of the fcurvy, I took two _ patients, (in order to make trial of the effects of different medicines in this difeafe, to be - more fully related afterwards), with very putrid gums, {welled legs, and contracted knees, to whom I gave half a pint of falt water, and fometimes more, every day for a fortnight: at the expiration of which time, I was not fen- fible of their being in the leaft worfe; but found them in the fame condition as thofe who had taken no medicine whatever (7). From which I am convinced, that fea-falt, at leat
(q) This experiment, of giving fcorbutic people falt wa- ter, has been often tried; and fome have thought they recei- ved benefit from it. See chap. 4.
the
: ; 2 ; ce > 5 Tha ee aad ‘ ; : er ye Sees cena RE ee Cl Rs ee ae , eS sia ae ot Se , x eae SAE ee ee “ sii eae et RA a ks ee ea as ake Ne ES z ee ae ss See et om pm Pe he RS eta, Ie RE EOE EM Cee a Bi ES es Rae inant se : Se og a = ign ea Se re SE “ <3 by
PR He Gh ef Co TERT Re Crag eae ap Rape Sale sty Bee ane e
a A Fa i ae iia NS oh ie Se re gk a it aT EN a i ie tl va Se ete ne a Se r pet, Sri coal as ee * ma AS i ae me”
ROR CG ere TAT MUN SET Oe Migs ERO MR ART TG BE ONT ee tai er ep a Res CRM RO SER
s —- \
88 Of the caufes of the feurvy. Part Tl
the drinking of falt water, by no means dif pofes the conftitution to this difeafe.
But I would not be underftood here to mean, nor does it follow from what has been faid,
that although fea-water, which is a compofi-
tion in which this falt is a principal ingredient,
has no bad influence upon the fcurvy, that a dict’ of falt flefh and fith is equally innocent.
The contrary of which will appear in the fe- quel. The brine of meats, in particular, is of a different quality from either purified fea-falt or falt water; for we find that this falt. may be fo intangled by the animal oils, efpecially in fale
pork, that it is with great difficulty difen-
gaged from them after many wafhings, and the moft plentiful dilution. ~So that as this faline
quality is inextricable from fuch food, it is ren- ‘dered improper in many cafes to afford that foft, mild nourifhment, which is required tat - Fepair the body. It is remarkable, that the ~ powers of the human machine can animalife o-
ther falts; that is, convert them into the am- moniacal fort, or that of itsown nature: while this fea-falt feems to elude the force of our fo- lids and fluids; and retaining its own unchange-
able nature in the body, is to be recovered un-
altered from the urine of thofe who have taken It
ee
: S ae ? Pe ae ee rie? Oe Nee phe th, Cee aa
Sa ere
Pea Se
Chap. Of the caufes of the feuryy. 8
Thus, fea-falt has no’ effect in producing
this difeafe; whatever meats hardened and pre-
‘ferved by it may have, by being rendered of
“hard and difficult digeftion, a and improper for.
‘ nourifhment. And this is farther confirmed
by the daily experience of feamen; who, upon.
the firft {corbutical complaint, are generally de- barred the ufe of every thing that is the leaft falted: notwithftanding which, the difear. ‘1a-
ereafes with great violence: While at other
times, it breaks out when there is plenty of
frefh flefh-provifions on board; as was the cafe - in Lord Anfon’s fhips, on their leaving the coaft _
of Mexico (r ). - Others, again, have fuppofed fuch to be the BD iieiiion of the human body, that health
and life cannot be preferved long, without the
ule of green herbage, vegetables, and fruits ;
va) Vid. Part 3. chap. 2. Dr Mead, who was thoroughly acquainted with their fituation, obferves, that, upon that occa-
fion, frefh flefh-provifions, and plenty of wholfome rain-water,
did not avail them. Difcourfe on the fcurvy, p. 100.
That falt filefh-meats have fometimes no fete’ in occafioning this difeafe, is demonftrable from the many Germans in Hungary deftroyed by it, who eat neither falt beef nor pork ; on the con- trary, they had fieth beef at a very low price. Vid. Krameri epi. p. 33.
The foldiers in the Ralf iam armies alfo had no falt provifions, Vid. Nitzjch. |
PEE Cree WEN S Sic) ae Rags OT cae Wire cee mee eRe a tie a }
i i re Sete Ble Rh Ay (ee gee ete ay apo iigs tae ealin) ig alec mano te ae An a es 8) cee ae
; x ys a a | vif AG a ‘ x *
go | Of the caufes of the feurvy. Part If;
and that a long abftinence from thefe, is alone the caufe of the difeafe (/).
But if this were truly the cafe, we muft have had the {curvy very accurately defcribed by the
ancients; whofe chief ftudy feems to have been |
the art of war; and whofe manner of befieging towns was generally by a blockade, till they had forced a furrender by famine. Now, as they held out many months, fometimes years, without a fupply of vegetables; we fhould, no
doubt, have heard of many dying of the feur-
vy, long before the magazines of dry provifions were exhaufted. The continuance of thofe fieges far exceeded moft of our modern ones;
even the five months blockade of Thorn, —
upon which Bachftrom has founded this fup-
pofition. It would likewife be a much more
quent difeafe in every country, than it really A
is: for there are perfons every where, who,
from choice, eat few or no green vegetables; a and fome countries are deprived of the ufe of © them for five or fix months of the year; as is the cafe of many parts in the highlands of | Scotland, Newfoundland, &c.; where, mera 4"
the {curvy is not a ufual malady.
Tt would be tedious to give many inftances,
= i] (1) Obfervationes circa fearbutum ; au&ore Fre. Bachftrom.
they |
nL AYA
pon Oe
See ee
Sees
ee 5a
Sey Dateien 2 eee
Chap.1. Of the caufes of the fcuruy. 7 gs
they being notorious, of fhips crews continu- ing feveral months at fea, upon their ordinary diet, without any approach of the fcurvy. I have been three months on a cruife, during which time none of the feamen tafted vege- tables or greens of any fort; and although for a great part of that time, from want of frefh water, their beef and pork were boiled in the fea-water, yet we returned into port without one fcorbutical complaint. I have known mef-
fes, as they are called, of feamen, who have.
lived, during a whole voyage of three years, on the fhip’s provifions, for want of money to purchafe better fare, efpecially greens; and who were fo regardlefs of health, as to expend what little money they could procure, in bran- dy and {pirits: fo that a few onions, or the
like, was their whole fea-ftore; and a meal” with vegetables was feldom eat by them, above
twice or thrice in a month, during the whole voyage. Notwithftanding which, they have kept free from the fcurvy, |
_ But it was remarkable, in the two cruifes afterwards to be mentioned, in his Majefty’s fhip the Salifbury, where I had an opportunity of making obfervations on this difeafe, that it
Pegen to.rage on board that fhip, and indeed
M 2 7 all
Pe US trig Se RRRBETR BE REL IOR LENA, UNCON es rt Rac OOM ASF PMS TAN UPR MNNNERRE Ie ik oe RUAN KANT NT A WCRI Bar ec ei?
92 ee OF the caufes of the feurvy. Part TI,
all the Channel {quadron, upon being lefs than
fix weeks at fea; andafter having left Plymouth,
where plenty of all forts of greens were to be
had; by which, as one would have thought,
the failors had fufficiently prepared their bodies again{t the attack of this malady. Yet here, in fo fhort a time as two months, out of 4000 men in that fleet, 400 at leaft became more highly fcorbutic (7), than could reafonably have been expected, had they all been debarred the ufe of vegetables for fix months on fhore, like our
highlanders, and many others. And what
puts it beyond all doubt, that the difeafe was not occafioned folely by the want of vegetables for fo fhort atime, is, that the fame fhip’s company of the Sa/i/bury, in much longer crui-
(t) Upon the return of the fleet to Phmsuth, Dr Huxham makes the following remark in the month of ‘Fuly 1746. Ter
gribilis jam fevit Jcorbutus inter nautas, precipue ques fecum reduxit
Martin, elaffis occidentalis prefedius. Excruciantur perplurimi ulceri- bus fazdis, lividis, fordidis, ac valde fungofis: mirum eff prefect et infolitum, quam brevi tempore fpougiofa caro, fungi ad inflar, 1s ulceri= bus fuccrefcit, etfi paulo ante fealpello derafa, eaque interdum ad ma-
gnitudinem enormem. Non folum miferis bis, at vere utilibus homini-
bus, per fe infenfa eft maxime foorbutica lues, fed et illos etiam omni pene morbo, qui ab humorum corruptione pendet, obnoxios admodum reddit ; febribus nempe putridis, malignis, petechialibus, peffimo va-
riolarum generi, dyfenterie cruente, hemorrhagiis, &c. Multo
giagis adeo bonis his fuit exitio quam bellicum Sibu: en! Obfervati-
_ ones de aére et morbis epidemicis.
ad
fe 35 |
Icke. Fe: Of the caufes of the feurvy. i 93 .
fes, kept quite free from the diftemper, where . their circumftances as to want of frefh vege- tables were fimilar. It was obfervable, that in the longeft cruife fhe performed, while I was - furgeon, there was but one fcorbutical patient on board, who fell into the difeafe after having had an intermitting fever. We were out at that time from the roth of Auguf? to the 28th of Odober; which was a twelve weeks conti- nuance at fea, and confequently as long an abf tinence from vegetables, 7 So that although it is a certain and experi- enced truth, that the ufe of greens and vege- tables is effectual in preventing the difeafe, and extremely beneficial in the cure; and thus we fhall fay, that abftinence from them, in certain circumftances, proves the occaftonal caufée of the evil: yet there are unqueftionably to be found at fea, other ftrong fources of it; which, with © re{pect to the former, (or want.of vegetables), we fhall hereafter diftinguifh by the name of the predifpofing caufes to it. The influences of which latter, at times, muft be extremely great, as in the cafe of Lord Au/on’s {quadron in paffing round Cape Horn (u), to induce fo univerfal a calamity; from which hardly any | («) Vid. Part 3. chap. z. | | | one
sae Ne ri ee a a i aes eae a ee ray
wits ee pei a) Bebe nis cae tet ae AA nad cS a ORE ASS: ic ohn, ah al tae fails leet ls a Sel SRR ne oe ie eon Sf irl ud ba rN 2 iy sat SUS tes Sf
94 OF the caufes of the feurvy. Part Is 4q
one of them feems to have been exempted, attended with the mortality of above one half of them, when they had been but little more than three months at fea: »while whole countries
are obferved to live on the fame, nay, even
a lefs wholfome dict; and many people for years abftain from vegetables, without almof any inconveniency. : Some have alledged this to proceed from fomething peculiar in the confined and polluted air of a fhip; and the ftagnation of the bilge- water in the hold has been accufed as a main caufe of the diftrefs. But had this laft the ef- feéts prefumed, they would be moft fenfibly felt by thofe who are moft expofed to it, wiz. the carpenters; who at fea are often obliged to meafure, every four hours, the quantity of bilge-water ; and do then, and at other times in mending the pumps, fuffer very great inconveniencies, being almoft fuffocated by it: nay inftances are not wanting where they have been killed at once with this noxious vapour, to which they lie the nearcft when in bed, Yet it does not appear from my own experience, - nor from the accounts which I have been able to colle@, that they are more liable to the ©
‘scurvy than others on board.
AS ~
Chap i. oft the Wits of the a 98
As to any other inconveniencies from filth,
or want of cleanlinefs, in a clofe place, and
- where the cutaneous and. pulmonary perfpira- tion of a multitude is pent up and confined; _ they are not peculiar to fhips, but common to all crouded jails, hofpitals, déc.: and what-
ever bad effects fuch a vitiated air may have on
this difcafe, yet it is certain the feurvy is not
the ufual and natural confequence of it. This is the more ‘id popes to be noted, in order
to determine the genuine effects of this pecu- liar evil difpofition of air; which are at all times, and in all places, a malignant, highly- contagious fever, known by the name of the jai/-_
diftemper. This is almoft the only difeafe ob-
“ferved in the tranfport-fhips which daily carry
_diers. And, univerfally, whenever many per- fons are confined together long under clofe-
f
over numbers of people to Virginia, few or
‘none of whom become {corbutic; as likewife
in fhips that have been crouded with fol-
fhut hatches, they will at length contra& this fever, without any approach ‘of the {curvy a-
moneft them; unlefs, as may fometimes be the
cafe, the body, weakened and exhaufted by the
preceeding ficknefs, is afterwards rendered - more fufceptible of the {corbutic taint, where
other
Dated bel ye Sieh Make RA
96 é Of the caufes of the feurvy. Part II,
other {corbutic caufes prevail. Though I have
oftentimes had occafion to fee this contagion
bred by putrid air, yet I never obferved any {curvies, either at the time, or after it.
In the latter end of the year 1750, the go- vernment contracted with a Dutch mafter of a veflel to carry over 200 Palatines to our co- lony in Nova Scotia. ‘The brutal Dutchman, contrary to exprefs orders, confined thefe poor
people below, and would not permit them to
come fo often upon deck as was requifite for their health ; by which means they contracted this malignant fever, which killed one half of them. And here it was remarkable, there was not one of thefe people who, after reco-
vering at fea, or upon land, became {corbutic;
nor had they any fuch diftemper in the fhip
The
‘
(x) Communicated by Mr Jves. This contagious petechial fever was as a plague to the fhip Dragon, of 60 guns, and 400 men, for the {pace of fix months. During which time J feldom — or never had in my lift lefs than fixty or feventy patients. Ma- ny of them relapfed to the third and fourth time. It was a dreadful, painful fcene! Not a fifth part of our people efcaped. My firft mate, Mr Béizcoqw, foon died in it. Another gentleman, whom our neceffities obliged the Commodore to warrant as mate from another fhip, died alfo. My other mate, Mr Tomas Peck,
(prefent furgeon to the fick and wounded’ at Deal), narrowly efcaped
~ Chap. I. Of the canfes of the feurvy, == gp ‘The truth really j is, a putrid air, though ne- yer obferved folely to be productive of this dif- eafe, has a pernicious influence in aggravating its feveral fymptoms: and where an epidemic -fcorbutical conftitution at the fame time fub- “fifts, they give rife toa complicated, {corbutical and malignant fever; which I fhall have occa- -fion to mention among the fymptoms of this _malady. — : «But the {curvy by el 3 is often experienced to make great ravage, where the air has been properly renewed and ventilated, and the whole fhip kept clean and fweet. I have been : told, that the Namur’s crew, in their expedi- tion to the Eg/t Indies, though very healthy vat the Cape of Good Hope, became feorbutic -at the time they arrived at Fort St David's, _notwithftanding the ufe of that truly noble
efcaped with life. ‘T’o thefe loffes I muft add my own dear bro- ther, who commanded the foldiers on board, feveral gentle.
men of the quarter-deck, and fixty of our ftouteft and beft fail- ors. Yet, amidft all this danger, through the providence of God, I efcaped untouched, to the furprife of all who knew our circumftances, and the fatigue I underwent, veo for moft part - deftitute of all affiftance. But I have not feen one inftance of this illnefs having been complicated with the fcurvy, or of the - {curvy feizing a man recovered from that fever for at leaft fix _ months afterwards ; which was indeed one of the longeft inter- , pels we ever enjoyed freedom from it.
N invention,
95 of the caufes of the feurciy. Part Ih
invention, Sutton’s machine (y). And though Lord Anfon’s fhip was kept uncommonly clean _ and {weet after they left the coaft of Mexico; yet the progrefs of their mifery was not at all retarded by it. And, what is further pretty re- markable, we know, that the fcurvy may be perfectly cured in the impure air of a fhip ; of which the following is a memorable inftance. His Majefty’s fhip the Guernfey brought in- to Lifbon, after a cruife off Cadiz, 70 of her — crew afflicted with this difeafe. Many of them were far advanced, even in the laft {tages of it. ; The plague at this time raging at Meffina, it was with great difficulty our fhips could obtain
(y) When accounts were received from that great and experien- ced officer Admiral Bofcawen, of the general healthfulnefs of his fquadron at the Cape, it was with great reafon afcribed to the benefit derived from thefe ufeful pipes; though their preferva- tion from the fcurvy in particular feems to have been owing chiefly to their having had a good paflage, and touching at different places, where proper refrefhments were procured them by their brave and wife commander. Upon their arrival at Fort St David's, the furgeon to that hofpital acquaints me, that the men of wars crews became as highly fcorbutic, as any of the o- thers, whofe fhips were not provided with the machine.
The cafe of our annual Greenland fhips, who are fo well fit ted, large, and convenient, and carry no more men than are juft fufficient to navigate them, puts it beyond all doubt, that confined putrid air, bad provifions and water, have often no -fhare in producing this difeafe. For confirmation of which, fee Mr Maude’s account of them, 2 2, ‘chap. .
Se oe
pratique
|
hap. Of the confer of the fora 69)
pratique in any port: fo that it was found impracticable to land them. There was an-
other very troublefome circumftance. For, in order to conceal fo great a number of fick
from the vifit of the officers of health, they
were under a neceflity of fhutting them up for
fome time together in a clofe place. For this purpofe they were with great difficulty remo- ved into the Captain’s ftore-room; where there — is generally worfe air than in any other part of
the fhip. This was performed with imminent danger to many of their lives. Several of
them, though moved with extreme caution, fell into the fcorbutic deliquium; whofe pre-
fervation was owing to the judgment of their
ingenious furgeon, and to the liberality of the Captain, who, upon this occafion, ordered
them to be plentifully fupplied with his richeft cordial wines. But every one of thefé men
recovered on board before they left that place,
without being landed. The fhip lay ftic
quarantaine a fortnight. After that they were.
obliged to be extremely circumfpeét in allow- ing even thofe who were pretty well recovered, to go on fhore ; as their ill looks might have
betrayed their fituation, to the Portugue/e. pe is fhip had no ventilators: and it is natural
N 2 : to
to fuppofe there might be fome remiffnefs in the article of cleanlinefs, where there was
-“ difficulty in conceiving, that as a continued
-& its obvious properties, it may be rendered
& have a tendency to render the air they are
1O0. Of the canfes of the feurvy. Part II. ,
fuch a number of fick; who, notwithftand~ ing, all recovered.
The learned writer (z) of the great Lord Anjfon's voyage, after clearly evincing the fal- fity of many fpeculations con cerning this difeafe, and juftly exploding fome opinions which ufu- ally pafs current about its nature and caufe, is — pleafed modeftly to offer a very plaufible and ingenious conjecture, well deferving confidera- tion. “ Perhaps a diftinét and adequate know- ** ledge of the fource of this difeafe may never *‘ be difcovered. But, in general, there is no
« fupply of frefh air is neceflary to all animal «¢ life, and as this air is fo particular a fluid, « that without lofing its elafticity, or any of
“ unfit for this purpofe, by the mixing with “it fome very {ubtile, and otherwife imper- “ ceptible effluvia; it may be ccnceived, I fay, ‘¢ that the fteams arifing from the ocean may
«“ fpread through, lefs properly adapted to the ‘fupport of the life of terreftrial animals, —
i f z) The Reverend Mr Walter.
eT
+ * gay P vt i, ; ; Se dapat be iia S VEIN ER Pee STRESS ae. ORM Ape bie ts He at RRM EH SOR BNR yh ye” CR EMER Bf gy HS
Chap. Of the caufes of the feurvy, 18
— unlefs thefe fteams are corrected by effluvia of another kind, and which perhaps the _ ® land alone can {upply.” ‘ | Te muft be allowed, that the air, which is a compound of almoft all the different bodies we know, has many latent properties, by which animals are varioufly affeéted; and thefe we neither can at prefent, nor evtinia ever will be able to inveftigate. We do not even know certainly what this pabulum vite is in that fluid, which preferves and fupports ani- | ‘mal life. The only means then we have to judge of the exiftence of fuch an occult quality as may be fuppofed peculiar to the air of the ocean, mutt be from its effects. Thefe, upon this fuppofition, ought to be moft noxious, and moft fenfibly perceived, in the middle of the great oceans, and at the wideft diftance from the continents and iflands, where there is the greateft want of land-air, and of its vital influences, which may be prefumed fo neceflary to the fupport of the life of terreftrial animals. ‘But it is experienced, that fhips cruifing upon certain coafts, at a very {mall diftance from the fhore, where the air confequently differs wide- _ ly from that of the main ocean, as being im- ep icenated with many particles from the land, : | and
a El i Adee She Ban ae cn. ode eS RS ee i> le y hc aia is Bs : Ae ‘ op SOL ie Sc area ih Hens Me eRe aL rk gh thine aN 2 ie Mla Sk Rar eed rgd anak ice CEA! 1g 4 Yi xy 3, *, Ww
ee Of the caufes of the feurvy. Part.
and is almoft the fame with that of the fea- port towns, are equally, if not more, afflicted with this difeafe, than others are in croffing the ocean. And it will be found univerfally to appear in a much fhorter time, and rage with ‘ greater violence, (all circumftances being other- q | wife alike), in a f{quadron cruifing in the narrow a - feas of the Baltic and Channel, or upon the coafts of Norway and Hudfon’s bay, than in another continuing the fame length of time in the middle of the Atlantic ocean. We often ~ obferved our Channel cruifers quickly over-run with the {curvy ; while their conforts, fitted out at the fame port, and confequently with the fame ftate of provifions and water, who foon left them, ftretching into the main ocean up- on a voyage to the Indies, or upon a much longer cruife off the Canaries or Cadiz, kept } pretty free from it. For my own part, I ne- ver could remark any alteration upon our {cor- butic patients, while we continued for many days clofe in upon the French fhore, with the wind or air coming from thence, or when, at a greater diftance from any land, we kept the middle of the Channel: and yet, in either of thofe f{tations, difference of weather had a re-
a markable influence upon {corbutic ailments. . Nay,
f
i ear, = % SBR M Be AN en Cee CREE MCU CN TT ETM AR SOU OPS NLD Rey Ty RR Sek ry EAI, 0 Me CL OP a ~ siete PER rena ha. ray ee ae Te NE we Ser ES Bal
— Chap.1. Of the caufes of the feurvy. 10g a Nay, fhips and fleets, without going to fea, :
are often attacked by this malady while in har- bour. Thus, when Admiral Matthews lay long in Hieres bay with his fleet, many of the fea- men became highly fcorbutic; on which ac- count fome hundreds were fent to Mahon ho- fpital. And the fame has happened to our
fleets when at Spithead, and even when lying |
in Portfmouth harbour. This difeafe is not _ indeed peculiar to the ocean, there being many inftances of its raging with equal violence at
fand (a).
From what has been faid, it appears, that _ the ftrong predifpofing caufes to this calamity at fea, are not conftant, but cafual, upon that element. For though it fhould be granted, that the fea-air gives always a tendency to the
Bie Sages tes
- fcorbutic diathefis, yet the evil proves often highly epidemic and fatal in very fhort voyages, or upon a very fhort continuance at fea, to
crews of fhips who, at other times, have con- place, and in parallel circumftances of water and provifions, and yet have kept entirely free
_ (a) Vid. the cafe of the Cae troops in rate ck and of the Ruffian armies, part 3.
tinued out much longer, cruifing in the fame |
from
104 Of the caufes of the feurvy. Part Th. from it. Thus, the great Lord nfan cruifed
for four months, waiting for the Acapulco fhip,
in the Pacific ocean; during which time, we
are told, his crews continued in perfeét heaith: when, at another time, after leaving the coaft of Mexico, in lefs than feven weeks at fea, the {curvy became highly-epidemic, notwithftand- ing plenty of frefh provifions and {weet water on board. And when it raged with fuch un= common malignity in paffing Cape Horn, it de-
‘ftroyed above one half of his crew, in lefs time
than he kept the feas in perfect health, in the
before mentioned cruife.
I had an opportunity in two Channel cruifes, the one of ten weeks, the other of eleven, anu. 1746 and 1747, in his Majefty’s fhip the. Sa- lifbury, a fourth rate, to fee this difeafe rage
- with great violence. And here it was remark-
able, ‘that thongh I was on board in feveral o- ther long Channel cruifes ; orte of twelve weeks
particularly, from the roth of Auguf? to the
28th of Odfober ; yet we had but one {corbutie patient; mor in any other that I remem- ber, had we the leaft fcorbutic appearance. But in thofe two I have mentioned, the feurvy — began to rage after being a month or fix weeks at fea; when the water on board, as I took
particular
Chap. I. Of the caufes of the feurvy. 105
particular notice, was uncommonly {weet and good ; and the ftate of provifions fuch as could afford no fufpicion of occafioning fo general a ficknefs, being the fame in quality as in for- mer cruifes. And though the {corbutic people were, by the generous liberality of that great and humane commander, the Hon. Captain
George Edgcumbe, daily fupplied with frefh pro-
vifions, {uch as mutton-broth and fowls, and e- _ ven meat from his own table; yet, at the expi-
a eg ee a nae ee a aE oe gi . 5
ration of ten weeks, we brought into Plymouth So men; out of a complement of 350, more or lefs afflicted with this difeafe. |
Now, it was obfervable, that both thefe crui- _ fes were in the months of 4pril, May, and
June; when we had, efpecially in the begin-
ning of them, a continuance of cold, rainy,
and thick Channel weather, as it is called:
whereas in our other cruifes, we had generally
very fine weather ; except in winter, when, du-
ring the time I was furgeon, the cruifes were but fhort. Nor could I affign any other rea-
fon for the frequency of this difeafe in thefe
two cruifes, and our exemption from it at o-
ther times, but the influence of the weather;
the circumftances of the men, fhip, and pro-
yifions, being in all other refpects alike. I
O have
106 Of the caufes of the feurvy. Part u.
have more than once remarked, that after great rains, or a continuance of clofe foggy weather, efpecially after ftorms with rain, the {corbutic people generally grew worfe ; but found a mi- tigation of their fymptoms and complaints, up- -on the weather becoming drier and warmer for a few days. And Iam certain it will be allowed, by all who have had an opportunity of making obfervations on this difeafe at fea
b), or will attentively confider the fituation
) hi (6) Exitraét of a letter from Mr Murray.
Of the feveral antecedent or efficient caufes of this difeafe, it is not to be doubted, but a moift air, or hazy, cloudy wea- ther, is among the principal. A particular inftance of which happened in a cruife we went upon in the Canterbury, along with another fhip ; after having laid fix months in Loui/burg harbour, where the feamen had great plenty and variety of fiifh, and where we were properly victualled with found provifions, and very good bread and water. We cruifed not far from the Bahama Ifands; the weather for moft part was ftormy, foggy, and very wet. Before we had been at fea a month, the fcurvy was very epidemical on board both fhips; and in fix weeks we had 50, the other (the Norwich) 70 patients in this difeafe: whereas | at another time, in different weather, we were at fea nigh as many months, before the like fymptoms and difeafes appeared ; and even then were nothing near fo Pecesucal. The parti- culars of that cruife were as follow.
We failed 29th Noa tember from Cape Breton, and in two days _ were in lat. 43° 18’ ;. and by the 11th December were in 29° 56’; near which latitude we kept cruifing to the 7th of Faauary. Du-
ring which time ia winds were fo variable, that it was hard to tell
Chap.1. Of the cau/és of the feurvy. 107
of feamen there, that the principal and main
_— predifpofing caufe to it, is a manifeft and obvi-
. lightning 3d and zoth. ~month cloudy and hazy. 174%, Fanuary. The weather this
ous quality of the air, vz. its moifture. The -
effects of this are perceived to be more im-
mediately hurtful and pernicious in certain con-
-ftitutions ; in thofe who are much weakened
by preceeding ficknefs; in thofe who, from a
lazy inaétive difpofition, negleé& to ufe proper
tell which point of the compafs'they inclined moft to, or conti- nued longeft in. The weather was extremely cold, foggy, and moift, the beginning of the month; but grew gradually warmer as we funk our latitude. But that its moifture-conti-. nued, will appear from the following account of rainy days, which you have here, with the other ftate of the weather. De- cember. Rain from the 1ftto the sth; 7th, 11th, 16th, 18th, 21ft to23d; 27th, 2oth. Frefh gales 1ft, ad, 3d, 4th, 6th, sth, roth, rith, 14th to 25th; 27thto 31. Thunder and A fog. the 1ft.__—Moft part of the
_ month was in general more moderate ; but, confidering our lati-
tude, not very warm. Rain the 2d, 6th, roth, 13th, 15th,
16th, 18th, roth, 24th, 2eth, 26th, 3ift. Weather cloudy
for feven days, but no fogs. Calmthe 2d, Frefh breezes 6th, sth, oth, roth, 12th, 16th to zoth; 24th, 25th, 26th, 31ft. The difeafes depending. upon this weather, were at firft, p/e- thore, from the fudden change from cold to warmth; fome a- cute fevers; and particularly two ardent ones, which carried off the patients. About the end of December, people began to complain of the {curvy ; and before the middle of Fanuary we had 16 patients in that difeafe; and by the 25th, when we ar- rived at St Thomas, we had no lefs than 50 patients in it; and our senate the Noravich 70. O 2 } exercife ;
' 108 Of the caufes of the fcurvy. Part Il.
exercife; and in thofe who indulge a difcon- tented melancholy humour: all which may be reckoned the /econdary difpofing caufes. to this foul and fatal mifchief. _
As the atmofphere at fea may always 7 fuppofed moifter than that of the land; hence there is always a greater difpofition to the fcor- _ butic diathefis at{ea, than in a pure dry land-air. _ But, fuppofing the like conftitution of air in both places, the inconveriiencies which per- fons fuffer in a fhip during a damp wet feafon, are infinitely greater than people who live at land are expofed to; thefe latter having many ways of guarding againft its pernicious effects, by warm dry cloaths, fires, good lodging, &c.: whereas the failors are obliged not only to breathe in this air all day, but fleep in it all night, and frequently in wet bed-cloaths, the fhip’s hatches being neceflarily kept open. And indeed one reafon of the frequency of the fcurvy in the above cruifes, was no doubt the often carrying up the bedding of the fhip’s company to quarters; where it was fome- times wet quite through, and continued fo for many days together, when, for want of fair _ weather, there was no opportunity of drying it,
No
jie) FE tical ba Oh a ide Alia i Neate hy ace pee Mate Gaal Fook RES OR ery NUT pe Ta RR RY Sal scene ornate fy
Chiap. I. of the caufes of the feurvy. 109 “No perfon fenfible of the bad effects of fleep-
ing in wet apartments, or in damp bed-cloaths, and almoft in the open air, without any thing fufficiently dry or warm to put on, will be fur- prifed at the havock the {curvy made in Lord Anfon’s crew in pafling Cape Horn, if their fituation in fuch uncommon and tempeftuous weather be properly confidered.
“During fuch furious ftorms, the fray of the fea raifed by the violence of the wind, is di- {perfed over the whole fhip ; fo that the people breathe, as it were, in water for many weeks together. The tumultous waves inceflantly breaking in upon the decks, and wetting thofe who are upon duty as if they had been ducked in the fea, are alfo continually fending down great quantities of water below; which makes at the moft uncomfortable wet lodging imagi- nable: and, from the labouring of the fhip, it generally leaks down, in many places, direétly upon their beds. ‘There being here no fire or fun to dry or exhale the moifture, and the hatches neceflarily kept fhut, this moift, ftagna- ting, confined air below, becomes moft offenfive and intolerable. When fuch weather continues long, attended with fleet and rain, as it gene- rally is, we may eafily figure to ourfelves the
condition »
: @ pi 3. chap. 2.
|
110 Of the caufes of the feurvy. Part IL.
‘condition of the poor men; who are obliged to
fleep in wet cloaths and damp beds, the decks {wimming with water below them ; and there to remain only four hours at a time; till they
are again called up to frefh fatigue, and hard
labour, and again expofed to the wafhing of
the fea, and rains. The long continuance of
this weather feldom fails to produce the fury at fea. |
_ As to its breaking out fo immediately in thofe fhips, upon their leaving the coaft of Mexico (¢.), it was not only owing to their finding fo
few refrefhments, efpecially fruits and vegeta-
bles fit to be carried to fea, at the harbour of
Chequetan; but alfo to the inceflant rains they
had in their paflage to Afra, and the great in- conveniencies that neceflarily muft attend fo long a continuance of fuch weather at fea. To
which it may be added, that, by obfervations made on this difeafe, it appears, that thofe who are once infected with it, efpecially in fo deep a
degree as that {quadron was, are more fubjeét to
it afterwards than others. I remember, that ma- ‘ny of them who returned to Lugland with Lord
ack om, and afterwards went to fea in other
hips,
Chap: I. Of the caufes of the fcurvy. ° xy
- fhips, were much more liable to the curvy than others.
‘It was however remarkable here, that though the calamity began fo very foon after their lea-
a ving land; yet, in fo tedious a paflage as four
months, it did not rage with that mortality as in palling Cape Horn: nor did it acquire fo. great. virulence, as appears by its being fo ; quickly removed upon their landing. And this was owing to the abfence of another caufe, which is found greatly to inforce and increafe _the diftrefs, viz. cold; the combination of which with moifture is, upon all occafions, experienced to be the moft powerful predifpo- ~ fing caufe to this malady; though indeed the latter of itfelf is found fufficient to produce it, ~ And here frequent wafhing and cleaning of the fhip, as was obferved, did not ftop the progrefs of the difeafe ; becaufe it did not remove the caufe, no more than Sutton’s machine is found to do; which only renews the air, without cor-
reéting its moifture. | Now, any perfon who has futtidiently con= fidered the fituation of a fhip’s crew, expofed _ for many weeks to ftormy, rainy, or perpetual » fogey clofe weather at fea, will not by this time be furprifed at our affigning dampnefs or moiflure, —
ia Of the caufes of the feurvy. Part Il.
moifture, as a principal caufe of the frequency. and virulency of this difeafe upon the watry e- ~ Jement. And this is not only agreeable to my own experience, but is confirmed by-all juft obfervations that were ever made on this dif temper. In the very firft juft account we ever had of it in Europe, from Olaus Magnus (d), it is remarked, That cold damp lodeines contri- buted greatly towards its production ; that its virulence was always increafed by cold and raw exhalations from the wet and damp walls of houfes; whereas people living in drier apare- ments, were not equally fubject to it. And ac- cordingly we find, that petty officers, who fleep in clofe births, as they are called, with canvas hung round, by which they are fheltered from the inclemency of the weather; as alfo feamen who go well clothed, dry, and clean, though ufing the fame diet with the reft of the crew, are not fo foon infected. This is the principal reafon why officers obliged to live on the fhip’s provifions, as the wartant-officers often do, (with this difference, that they drink a greater quantity of brandy and fpirits, which, as fhall be mentioned afterwards, fhould in a particular _ manner difpofe them to this difcafe), ns
aes 6 4) Quoted at ~ Part 3. chap. Te ‘ iY
a
sae
inns Reape a i 5
are feldom attacked by the fcurvy; unlefs up-
mon failors have been haphor almoft de- Rroyed BY iz.
It is obfervable, that fuch a fituation as has bev defcribed, together with the ufe of fuch improper dict as fhall hereafter be mentioned, produces the {curvy in any climate: but its vi- tulence will always be greatly augmented by the addition of cold. ‘Thus we find it a much
more frequent difeafe in winter than in fum-
mer, and in colder than in warmer climates.
i Ships that go to the north, as to Greenland,
and up the Baltic, are peculiarly fubject to it;
» What effeéts are produced by thefe ‘power
| Chap.l. Of the caufes of the feurvy,. 1 Ele
in warm dry cabbins, and going better clothed, «
—onits moft virulent rage, and-when the com-.-
whereas it is generally owing, in fouthern fet tudes, to the continual rains which fall there at.
certain feafons, and more particularly to the great length of thefe voyages. But a combina- tion of moifture with. cold, is the moft frequent ., _ and genuine fource of this difeafe: anda very - intenfe degree of cold, as in Greenland, @c. is ' _ experienced to have a moft pernicious sinh 4 q in in heightening 1 its ‘malignity.
- fal caufes on the human body, it is not my pre--
P 3 ent.
P oe
114 Of the caufes of the feurvy. Part Tl, fent purpofe to explain (e). It may be fuffi-
cient here only to obferve, that moifture is the parent of corruption or putrefaétion in na- ture; and, by the obfervation of all phyficians from the days of Hippocrates, a moift warm
air begets the moft malignant putrid difeafes,
even the plague itfelf. But moifture concur- ring with other peculiar circumftances, as a grofs diet, cold, Gc. difpofes in a particular manner to the {corbutic corruption. |
The qualities of the moift fea-air will cer- tainly be rendered ftill more noxious, by being confined in a fhip without due circulation; as air at all times in this flate lofes its. elafticity, and is found highly prejudicial to the health
and life of animals; but becomes much more
{o' where flagnating water is pent up along with it, as itis from thence more fpecdily difpofed to putrefaction. It is likewife heated in fhips by. pafling through the lungs of many people,
and impregnated with various putrid effluvia. ©
Hence the eagernefs and longings of {corbutic people in fuch circumftances for the land-air, and the high refrefhment to their fenfes upon being put on fhore, are very natural; but no more than what the vapour of frefh earth
(2) Vid. chap. 6, would
Chap. I. Of the canfes of the feurvy. , 116
would afford to a perfon after being long con- fined in a clofe, damp, unwholfome air; as that of a prifon, dungeon, or damp apartment at land; and what we all feel, upon taking in the freth country-air, perfumed with the va- tious odours of nature, afte: having been obli- ged to breathe in a crouded, dirty, populous city. |
1 come, in the next place, to an additional, and extremely powerful caufe, obferved at fea to occafion this difeafe, and which concurring with the former, in progrefs of time, feldom ‘fails to breed it. And this is, the want of freth vegetables and greens; either, as may be fup-
pofed, to counteract the bad effeéts of their be- _ fore mentioned fituation ; or rather, and more truly, to correé&t the quality of fuch hard and dry food as they are obliged to make ule of. Experience indeed fufficiently fhews, that as oreens OF freth vegetables, with ripe fruits, are | the belt remedies for it, fo they prove the moft ~ effectual prefervatives againft it. And the dif ficulty of obtaining them at fea, together with a long continuance in the moift fea-air, are the | pre calles OF te general and fatal malignity mupon that element. v2 The
wai 4
Cera Meg sh Sa Leen Pysh MIeee MB pe ele ane Vy cw} 4 2 " . tah ¥
116» Of the caujfts of the feurvy. Part It.
The diet which people are neceflarily obliged to live upon while at fea, was before affigned as the occaftonal caufe of the difeafe(f); as ina particular manner it determines the effects of the before mentioned predifpofing caufes to the production of it. And there will be no dif- ficulty to conceive the propriety of this diftinc- tion, or underftand how the moft- innocent and wholfome food, at times, and in peculiar
fituations, will with great certainty forma dif- _
eafe. Thus, if a man lives on a very flender
_ diet, and drinks water, in the fens of Lincoln-
Jhire, he will almoft infallibly fall into an ague. ,
All rules and precepts of diet, as well as the
. diftinction of aliment into wholfome and un-
wholfome, areto be underftood only as relative to the conftitution or ftate of the body. We find a child anda grown perfon, a valetudina- rian and a ‘man in health, require aliment of different kinds; as does even the fame perfon : in the heat of fummer and in the depth of winter, during a dry or rainy feafon. Be- twixt the tropics, the natives live chiefly on fruits, feeds, and vegetables ; whereas northern nations find a fiefh and folid diet more {uit- (f) P. 93. | | | able
Chap.I. Of the caufes of the fcurvy. oy V7
able to their climate. In like manner it ap- pears, I think, very plainly, that fuch hard dry food as a fhip’s provifions, or the fea-diet, is extremely wholfome; and that no better nourifhment could be well contrived for la- bouring people, or any perfon in perfect health, ufing proper exercife ina dry pure air; and that, in fuch circumftances, :feamen will live upon it for feveral years, without any incon- venience. But where the conftitution is pre- difpofed to the fcorbutic taint, by the caufes before affigned, (the effects of which, as fhall be fhewn in a proper place (g ), are a weaken- ing of the animal powers of digeftion), the in- fluence of fuch diet in bringing on this difeafe,
fooner or later, according to the ftate and con-
ftitution of the body, becomes extremely vi- fible.
The firft, generally, who feel its effects, are thofe who are recovering from other dif- eafes, or fome preceeding fit of ficknefs, by which the whole body, and the digeftive fa- culties, have been greatly weakened ; and are in this condition obliged to ufe the fhip’s fare. Thus, in May 1747, when there prevailed {e- veral inflammatory diforders, particularly peri-
(g) Chap. 6.
| pneumonic
PV At Se Oye Ne Pony ee gas ee mae iy See ast ae
TUTE ian eae ONCE ge eS Ey NOOR EERE eR eh aan ne Sea
418 Of the caufes of the feurvy. Part Il,
pneumonic fevers, all who were recovering from them became highly fcorbutic. ‘The next who complained, were the indolent and lazy ; fuch as are commonly called /cuikers, and ufe
Jittle or no exercife; a principal help’ to di-
geftion. As the difeafe gathered ftrength, it attacked thofe who had formerly laboured un- der it, and had been our patients in May 1746; where the conftitution had acquired a tendency
to it from being formerly deeply infected. It |
afterwards became more univerfal; but was confined to the common feamen, particularly
to the raweft. and neweft failors. Impreft men
are extremely liable to its attack, by reafon of their difcontented {tate of mind; and the ma+ rines, by not being accuftomed to the fea.
1 obferved it increafed in frequency and vi-
rulence, upon the fhip’s {mall beer being ex-
haufted, and having brandy ferved in its place ; and this laft obfervation I made in both cruifes. But it will be now proper to inquire into the diet which mariners are neccflarily obliged to live upon at fea. And as it appears to be the principal occafional caufe of their malady, it may be worth while to confider fea-provifions in their beft fate; it being found by experi- ence, that, notwithftanding the foundnefs and goodnels
Chap. I. Of the caufes of the feurvy, ‘ 119
- goodnefs of both water and provifions, the ca- lamity often rages with great fury, and can be removed only by change of diet, Now, if in this cafe they appear to have fo great an influence in forming the diftemper, what ill confequences may not reafonably be expected from a much ‘worfe {tate of them; as from putrid beef, ran- eid pork, mouldy bifcuit and flour, or bad water, which are misfortunes common at fea? all which muft infallibly have bad effeéts in fo ’ putrid a difeafe.
It muft be remarked in general, that the fea- diet 1s extremely grofs, vifcid, and hard of di- geftion. It confifts of two articles, viz. the fweet farinaceous fubftances unfermented; and
falted, or dried flefh and fith.
But more particularly, in our Royal navy,
whofe provifions, for goodnefs and plenty, ex- -eeed thofe of any other fhips or fleets in the world, every man hasan allowance of a pound
of bifcuit a-day; which, in the manner it is ba- _
ked, will be found more folid and fubftantial food, than two pounds of ordinary well-baked bread at land. And this is a principal article of their diet. But the fea-bifcnit undergoes little or no fermentation in baking, and is confe- quently of much harder and more difficult di-
geftion,
hy thc NGG a RM Cate ics ti ec a
120 Of the caufes of the feurvy. ‘Part is
geftion, than well-leavened and properly-fer- mented bread. For it muft be here under- ftood, that the meally parts of vegetable feeds, diffolved only in water, are by experience found to make too vifcid an aliment, to be conftantly ufed by the generality of mankind: . whereas, by fermentation, and the acid in the leaven, the glutinous vifcidity and tenacious - oils of thefe meally fubftances are broken and fubdued; and they become eafily diffolvable af- terwards in water, with which before they would only make a pafte or glue; and are now mifcible with all the, humours of the body. Well-baked bread, which has undergone a fufficient degree of fermentation, is of light and eafy digeftion; and indeed the moft proper nourifhment for man, as it is adapted by its acefcency to correét a flefh-diet: whereas, on the contrary, fea-bifcuit, not being thus duly fermented, will in many cafes afford too tenacious and vifcid chyle, improper for the nourifhment of the body, where the vital di- geftive faculties are weakened and impaired. The next article in their allowance of what is called fre/h provifious, is one pound and a half of wheat-flour in the week, which is made into pudding with water, and a cer-
tain -
tain prbipartion of pickled fewet. This laft does not keep long at fea, fo that they have often _ raifins or currants in its place. But flour and water boiled thus together, form a tenacious glutinous patte ; requiring the utmoft ftrength and integrity of the powers of digeftion, to
fubdue and affimulate it into nourifhment., |
- We find, that weak, inactive, valetudinary peo- , | ple, cannot long bear fuch food.
provifions, of which the allowance to each man is more than they generally can ufe. The _firft is, ground oats, boiled to a confiftence hee water, commonly called burgow. Of
‘this the Engl faitors eat but little ; though in
their circumffances it would feem to be whol- | fome enough, as being the moft acefcent part of their dict. ‘The other is boiled peas ; which
are of a mild and foftening quality ; ; but ha-
ving hardly any aromatic parts, they are apt in —
_ weak ftomachs to breed flatulencies, and occa-
. fion indigeftion ; and, like all other farinace- ; ous fubftances, give a /entor or vifcidity to wa- ter in which they are boiled. It is evident,
4
improper nourifhment. This is the allowance of frefh provifions ;
Cee and
“Chap. 1. of the caufes of the fer oo ae
There remain two other articles of frefh —
Rae Peo ah te OP ee Rk ors ee es RE rec RN a ge oe Pee! PE eee ae TAR EN, aT Ley Pe
that in fome cafes they muft afford grofs wiki
bo Of the caufes of the feurvy. Part TL
and they have, befides, a proper quantity given them of falt butter and cheefe. The latter of which is experienced to differ extremely in its qualities, or in the eafe or difficulty with which it is digefted, according to its ftrength,. age,
gc. But the Suffolk cheefe will in many in- oo
ftances, inftead of aflifting digeftion, which o-
ther cheefe is faid to do, prove a load to the -_
ftomach itfelf; as well as the falt butter, or — {weet oil, given fometimes in its place: neither of which indeed correct the qualities of theix other food. |
— Laftly, OF fleth ach man has for dloweaaies two pounds of falt beef, and two pounds of falt pork, tes week. But thefe are found by every one’s experience to be much _ harder, and more difficult to digeft, than frefh meats ; and, after all, to afford a much more We proper chyle and nourifhment. No perfon can long bear a diet of fuch falt flefh-meats, unlefs it is corrected by bread, ssi es or ve- getables. i
To the above articles, which are the provi- fions with which our navy is ufually fupplied, may be added, ftock fith, falt fith, dried or jerk- ed beef, often eat at fea; with whatever is of the - like grofs, vifcid, and indigeftible nature: all
| which
Pig
Chap.I. Of the canfes of the feuryy. 123
which will have ftill more noxious qualities when unfound, or in a corrupted ftate. | ae For drink, the government allows, where it can be procured, good found {mall beer; at other times wine, brandy, rum, or arrack, according to the produce of the country where fhips are | ftationed. Beer and fermented liquors of any fort will be found the beft antifcorbutics, and moft proper to correct the ill effects of their {ea-diet and fituation; whereas diftilled {pirits have a moft pernicious influence on this difeafe. As I fhall have occafion elfewhere (4) to | fhew the aatural confequences of fuch diet, it . ‘a will be fufficient here to obferve, that though a _ the long continuance and conftant ufe of any . one particular fort of food, without variety, has its inconveniencies, and is juftly condemn- ed by phyficians (7), nature having fupplied | us with an ample variety, defigned no doubt for - our ufe; yet the fact here truly is, that fuch food as has been mentioned, is at particular ; times, and in ‘certain circumftances, not pro- 3 ’ _perly adapted to the ftate of the body, and ~ _ the condition of the digeftive powers (& ). |
: ty x . * * 2 3 % ' see = Sone eats Seth en ees pee Becta nee Se.
PE ee
é
’ ey ot Spe ee ea a oR CRN es SRR AO Gr ETN
Our | (>) Chap. 6. on the theory of the ae ; a (i) Vid. Celfum de medicina. | (4) A learned Profeflor was pleafed to fend me the follow-
Fang aes | b.* ‘2 May
. 124 «Of the caufes of the feurvy. Pare il.
Our appetites, if they are not depraved, are, upon this and many other occafions, the moft faithful monitors, and point out the quality of fuch food as is fuited to our digeftive organs,
| and
“* May not the fcurvy be owing to fuch a caufe as other epi- demical difeafes ; that is, fomething in the air which we do not know, nor will probably ever know, though we fee its various effects in fevers, {mall pox, meafles, plague, Ec. ? And may not this be a modern miafma, as well as what pro- duces fome of thefe difeafes? By obfervations the caufz pro- egumene may be difcovered, and by diffections the effects may be obferved ; but the cau/a proxima may yet be unknown. In the plains of Stirling fhire the people live moftly on crude peafe-meal, have very bad water, and have great fogs from their own grounds, and from the Frith ; yet, among the nume- rous poor patients I have from that place when in the cour- try, I have not feen one with a genuine fcurvy.”
Anfwer, As to its being a modern migfma, I think dhis cans not, with any colour of reafon, be inferred from the filence of ancient hiftorians, who have mentioned few or no camp-difea- fes; nor on account of its being imperfectly, if at all, defcribed by ancient phyficians, for reafons aligned part 3.chap.1. The firft defcription of it I have met with, and a very accurate one, is in the year 1260 (vid. part 3. chap.1.). There is no account of it. again until after amm.1490. Yet we cannot well fuppofe, that during that period there was no fuch difeafe in the world, or that people in fuch fituations as are now to be mentioned, would not contract the {curvy. . :
It is demonftrable from the appearance of the calamity in e-
very part of the world, that no ftate of air whatever is capable
of producing it, without the concurrence of grofs viicid diet, and abftinence from green vegetables. I have known the Céan-
wel fleet bury a hundred men in a cruife, and land a thorfand More
Chap. q. Of the caufes of the fcurvy. 14 2
and to the ftate and condition of the body. For where there is a difpofition to the {corbutic corruption from a long continuance in the moift fea-air, concurring with the vifcous, glutinous,
: and
‘more quite rotten in the fcurvy ; yet, among the number, there was not an officer, not even a petty officer. |
In Hungary, where there muft have been the ftrongeft fcorbu- tic difpofition in the air (Vid. Kramer), not only the officers, and natives of the country, but even the dragoons, by having more pay, and confequently better diet, cloathing, and lod- ging, though equally fubject to the other difeafes of the coun- try, yet kept free from the fcurvy. Who were attacked by it? Only the Bohemians, who eat the coarfeft and moft grofs food. The Bohemiai.xfed no other than what was the ordinary diet of their own country, as we are informed by Kramer. ‘The fea- men in the Channel cruifers had the very fame provifions as other fhips who went upon different ftations: yet it is evident one -caufe in both places was the diet; as a different diet prevented the difeafe, and change of diet quickly cured it.
‘Now, there muft have been a quality in the air of Hungary different from that of Bohemia; fomething which rendered a diet harmlefs in the one country, hurtful inthe other. The indifpo- fition of the air in Hungary was very obvious. The difeafe pre- vailed only in the fpring, and during a wet feafon; was much more virulent in fome parts of the country than in others. Kramer enumerates the different places where it raged moft, viz. where-ever the foil was damp and marfhy. This obferva-
tion has been made not only in Hungary, but in every other part of the world; and I will venture to ae. that, without any one exception, :
Scorbutus locis aridis ignotus 68. STEGGIUS. |
. Moifture was difcovered to be one of the canfes of this malady by Ronffeus, the very firft author who ever wrote exprefsly upon it. 3 The
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126 — Of the caufes of the frurvy. Part Tl, and too folid diet ufed there, nature points otit the remedy. In fuch a fituation, the ig- norant failor, and the learned phyfician, will
equally long, with the moft craving anxiety, for
green -
The faéts he produces, feem demonftratively to prove it ; befidés having the corroborating evidence of every accurate obfervation made fince his time. All which, viz. the experience of two
_ hundred yeats, we muft contradi&, by excluding this caufe, and
referring the {curvy to occult miafmata, or fach latent caufes in
‘the air as produce fevers, and fome other epidemical difeafes.
‘There are indeed perhaps but few difeafes whofe caufés are more evident to the fenfes, and admit of more exprefs proofs. Stugart, in Germany, was formerly noted for being a place where the fcurvy raged much; but, upon drying up a large
- Jake in the neighbourhood of the town, the difeafe has fince ‘quite difappeared. Along the banks of the Rhixe, from Dour-
lachto Mentz, particularly at Philipfourg, it often fucceeds large
Ԥnundations of that river. Sinopeus obferved at Cronftadt, that
the appearance of the fcurvy, and its malignity, always depend- ed upon the wetnefs of the feafon; adry feafon inftantly ftopt it. Where we have fuch undeniable proofs of the effects of moi- fture and drinefs, I cannot fee any reafon for having recourfe to occult mia/mata in the air, or the like imaginary and uncer- tain agents, for breeding a difeafe which a perfon contraéts from moift air, by lying in a damp lodging, and ufing at this feafon too folid grofs food. Such circumftances produce the diftemper in every part of the world: and it may effectually be prevented at any time, by living in dry Abarineny going well clothed, and having proper diet. : Though I have called