Description of scurvy by Echtius (1541)

Description of scurvy by Echtius (1541) Summary by James Lind (1753) In the 16th century, four European authors described the symptoms of scurvy in such a detail that the disease can be recognized as the disease we currently classify as scurvy: Echtius (1541), Olaus Magnus (1555), Ronsseus (1564), and Wierus (1567). Since these four texts are among the early unambiguous descriptions of scurvy, they have substantial historical relevance. All these texts were originally published in Latin. There are English translations of the sections of scurvy from the Olaus Magnus text. James Lind wrote English summaries of the texts of the three other authors. This document gives a brief background and a copy of Lind’s summary of Echtius (1541) text on scurvy. Various names of the author (1515–1576): Echtius Johannes Echtius Jan Echt Johann Bachoven von Echt https://doi.org/10.31952/amha.16.2.2 https://pubmed.ncbi.nlm.nih.gov/30488702 https://zenodo.org/records/14296049 Yellow is used to indicate the description of symptoms of scurvy. This text is available at: https://doi.org/10.5281/zenodo.17093279 2025-9-23 This annotated version was prepared by: Harri Hemilä, University of Helsinki, Finland https://www.mv.helsinki.fi/home/hemila https://orcid.org/0000-0002-4710-307X https://www.ncbi.nlm.nih.gov/pubmed/?term=hemila+h https://scholar.google.fi/citations?user=2mkomzUAAAAJ https://doi.org/10.5281/zenodo.17085738 Reports on scurvy uploaded to Zenodo by Harri Hemilä 1 Background James Lind (1753)1 wrote, p.1 In the first accounts given us of this disease, by Ronsseus2, Echthius3, and Wierus4 (a), it is surprising to find, not only an accurate description of it, but an enumeration of almost all the truly antiscorbutic medicines that are known to the world even at this day. (a) The first authors on the scurvy, Ronsseus and Echthius, though cotemporary, wrote separately, without having the benefit of seeing each others works. James Lind p.2 Echthius seems to be the first who gave rise to the opinion of its being a contagious or infectious lues. He was led into that mistake, by observing whole monasteries who lived on the same diet, and in the same air, at once affected with it, especially after fevers; which no doubt might become infectious in close and confined apartments. He imagined, therefore, that a scurvy might in a manner be the crisis of a fever, which as such he deemed contagious. James Lind p.36 [About Thomas Willis] Had he taken the first method he mentions, and described the symptoms proper and peculiar to this disease alone, as Echthius has done; — or the second method, that of describing it in its beginning, progress, and different stages, as the first and purest writers have all done; he 1 James Lind (1753). A Treatise of the Scurvy in Three Parts. https://doi.org/10.5281/zenodo.10685194 Selected sections of Lind’s treatise. Lind’s 1753 edition in a scanned versions: https://wellcomecollection.org/works/bg2gxrzz/items?canvas=7 https://archive.org/details/treatisescurvyt00lind/page/xvi/mode/2up https://library.si.edu/digital-library/book/treatisescurvyt00lind 2 Ronsseus, see: Lind. Part III: Chapter II. https://doi.org/10.5281/zenodo.17093314 https://archive.org/details/treatisescurvyt00lind/page/356/mode/2up 3 Echtius, see: Lind. Part III: Chapter II. https://doi.org/10.5281/zenodo.17093279 https://archive.org/details/treatisescurvyt00lind/page/354/mode/2up 4 Wierus, see: Lind. Part III: Chapter II. https://doi.org/10.5281/zenodo.17093229 https://archive.org/details/treatisescurvyt00lind/page/358/mode/2up 2 might have given us some light into the matter. James Lind p.52 [About Willis] But it will appear to any person who peruses the authors from whom he has borrowed the description of the symptoms, wiz. Echthius, Wierus, &c. that they described a very different disease from what Willis did. Dr Willis’s method of cure may perhaps be rationally applied to the diseases he described; but is by no means adapted to the disease characterised by the first writers on the scurvy. James Lind p.63 As to the pathognomonic signs of this disease: If we compare its symptoms as described by Echthius, Wierus, and all other authors till the time of Eugalenus (a), with the accounts given of them in books of voyages, particularly the extraordinary narrative of what happened to the great Lord Anson’s crews in their passage round the world (b), we shall perceive an entire agreement in the essential signs of the distemper, (making a proper allowance for the different descriptions that may be expected from seamen and physicians), and appearances so singular as are not to be met with in any other. Thus, putrid gums, swelled legs, and spots, accompanying each other, and in their progress usually attended with rigid tendons in the ham, are observed in no other distemper. James Lind p.352-355 … The author afterwards observes it to be the scurvy, a malady to which the northern nations, the Dutch, &c. are very subject; and upon this occasion, quoting a passage from Olaus Magnus5, says, “I have delighted myself to recite the words of this author, because he speaketh thereof as being skilled, and has well described the disease; only he maketh no mention of the stiffening of the hams, nor of the superfluous flesh which groweth in the mouth.” … 5 Olaus Magnus (1555) Historia de gentibus septentrionalibus. https://doi.org/10.5281/zenodo.13380745 English translation of the sections on scurvy https://en.wikipedia.org/wiki/A_Description_of_the_Northern_Peoples https://en.wikipedia.org/wiki/Olaus_Magnus 3 Olaus Magnus, in his history of the northern nations, published ann. 1555, observing what diseases are peculiar to them, gives us a long description of the scurvy. … Soon after we find three eminent physicians, all cotemporary, treating expressly of this distemper, viz. Ronsseus, Echthius, and Wierus. To whom Langius may be added as a fourth, having wrote two epistles upon this subject. What is called Echthius’s Epitome, was the first wrote, though the last published. It would appear from Forrestus to be a letter sent, in the year 1541, to Blienburchius, a physician at Utrecht; whose answer is now lost. The first book published expressly upon the scurvy was by Ronsseus, in the form of an epistle. The year is uncertain, as he afterwards corrected, and reprinted it in a different form. He is so modest as to say, that had he first seen Wierus’s accurate observations, he would not have published any thing upon the subject. There is an edition of Ronsseus put down by Mercklin and Lipenius, in the year 1564; and of Wierus’s observations in 1567. The learned Dr Astruc is of opinion, that these last were not published till 1580. It is thus far certain, that those authors corresponded together; and upon Wierus sending to Ronsseus, Echthius’s letter, now called his Epitome, he published it, together with his own work, Wierus’s observations, and two of Langius’s epistles, in the year 1583. James Lind p.445, Appendix It has been no easy matter to obtain a knowledge of the many writings on this distemper. There have been collections made from time to time, of the several authors on the plague, venereal disease, &c. but no such have been compiled of writers on the scurvy. Sennertus, ann. 1624, when he wrote his own treatise, reprinted the writings of Solomon Albertus and Martini, together with Ronsseus, and the authors which he had published ann. 1583, viz. Echthius, Wierus, and Langius; and this book, containing those seven authors, is the only collection ever published of writers on the scurvy. There was here as little assistance to be obtained from medical bibliothecæ. 4 August Hirsch (1885)6 wrote, p.513 Of somewhat later date are the first authentic accounts of the epidemic occurrence of scurvy on land… Shortly after there appeared the statements of Olaus Magnus, concerning the often observed epidemic prevalence of scurvy in the Scandinavian kingdoms, especially in times of famine; and about the same time, or a little later, the writings of Echthius, Ronsseus, Wier, Dodonaeus and Brucaeus, which testify to the comparatively common occurrence of the disease along the littoral of the North Sea and the Baltic… These excellent descriptions of the malady, more especially by Echthius, Ronsseus and Wier, leave no doubt as to its nature [as scurvy]. Alfred Hess (1920)7 wrote, p.1-4 It is probable that scurvy existed in the northern parts of Europe and Asia ever since they were settled by man. We should hardly expect to have records of this condition, in view of the low educational status of the people, their greatly restricted literature, and their lack of intercourse with the people in the southern countries. In the sixteenth century, with the development and spread of education, we begin to hear of scurvy from various sources. Olaus Magnus, in his “History of the Northern Nations,” published in 1555, described the disease which he tells us flourished among the soldiers in the camps and in the prisons. About this time Ronsseus, Echtius and Wierus wrote special treatises on this disease, and recommended many dietary measures which we recognize to-day as most efficacious. The number of monographs on this subject multiplied with great rapidity in the course of the next twenty-five or fifty years; none of them, however, added anything essential to our knowledge… 6 Hirsch A (1885) Handbook of Geographical and Historical Pathology. Vol. II. Scurvy: pp.507-568. https://doi.org/10.5281/zenodo.10104179 Section on scurvy separately https://archive.org/details/handbookofgeogra02hirsuoft/page/512/mode/2up https://archive.org/details/b28147455_0002/page/512/mode/2up https://archive.org/details/handbookofgeogra02unse/page/512/mode/2up https://archive.org/details/handbookofgeogra02hirs/page/512/mode/2up 7 Hess AF (1920) Scurvy: Past and Present. https://doi.org/10.5281/zenodo.10685195 Extracts relevant to the current context https://www.gutenberg.org/ebooks/40505 https://digital.library.cornell.edu/catalog/chla2903792 5 Anthony J Lorenz (1953)8 wrote: p.308 Lind makes the Dutch physician, Balduin Ronsseus, facile princeps9. Ronsseus10 suggests that cold damp air of the sea and the seashore is the principal cause of scurvy. His is the first book written expressly on scurvy and was published in 1564. A later edition of Ronsseus (1585) combined the epistolae of Echthius11 and Langius as well as the observatio of Wierus as a sort of compendium of the current views on scurvy. Ronsseus also held to the theory of involvement of the spleen in scurvy. Both Ronsseus and Echthius, writing separately, interpreted Pliny’s description of the disease, which afflicted the Roman army under Germanicus, as scurvy. p.309 Wier (Wierus) (1567)12, copying Echthius, and Bruner (Brunerus) (1589), copying Wierus (adding only that leg pains preceded the actual onset of scurvy) well might have justified the subhead in Lind’s preface Dies Diem Docet13, and the words: “To know a disease and to cure it being the utmost essential things to be learned, I have, therefore, transcribed the symptoms and the cure of the scurvy from those authors where they do not entirely copy from each other. I hope such motives (truth, and good of mankind) will to the candid and to the most judicious be a sufficient apology for the liberties I have assumed”. In re-reading the principal pre-Lind authors seriatim one observes the transitions from land to sea scurvy, or purpura nautica. One also sees the transition of the concept of scurvy as a winter epidemic among urban populations and its entity as a deficiency disease when studied in the isolation of the sailing ship when voyages of discovery increased in duration sufficient to permit complete deprivation of antiscorbutic stores. 8https://doi.org/10.1079/PNS19530062 9 Facile princeps. Acknowledged leader. 10 Ronsseus, B. (1585). De Magnis Hippocratis lienibits Plinique stomacace ac sceletyrbe, seu vulgo dicto scorbuto commentariolus. Accessere q‘usdem epistolae quinque ejusdem argumenti, Joannis Echtii de scorbuto epitome, Joannis Wieri de scorbuto observatio. Joanna’s Langii epistolae duae de scorbuto. Wittenberg: C. Schleich. 11 Echthius, J. (1541). De Scorbuto, vel Scorbutica Passione Epitome. Cologne. 12 Wier (Wierus) J. (1567). Medicarum Observationum Rararum Liber ( I de Scorbuto). Basle: J. Oporinus. 13 Dies Diem Docet. The day teaches the day; one learns by experience. 6 The text on the following pages is the summary by Lind (1753, 1st ed.) p.355-356 https://archive.org/details/treatisescurvyt00lind/page/354/mode/2up https://wellcomecollection.org/works/bg2gxrzz/items?canvas=377 Jo. Echthius, a physician at Cologn, by birth a Dutchman. He died ann. 1554. https://archive.org/details/treatisescurvyt00lind/page/448/mode/2up The original in Latin: “Ioannis Echthii De scorbuto, vel scorbutica passione epitome”, p.181-186. https://archive.org/details/descorbutotracta00senn/page/180/mode/2up https://www.google.com/books/edition/De_scorbuto_tractatus/W7w_AAAAcAAJ https://www.google.com/books/edition/De_scorbuto_tractatus_Acc_ejusdem_argume/f2RWAAAAcAAJ 7 A.D. 1541 Joan. Echthii de scorbuto, vel scorbutica passione, epitome. p.355 He proposes it as a question, Whether the blood here may not be corrupted, without the spleen or any other of the viscera being affected? but is inclined to think the spleen often is. He assigns as causes of this disease, gross unwholsome food, of salt, dried, or putrid flesh and fish, pork, spoiled bread, stinking water, &c. He distinguishes the symptoms into two classes. The first contains such as appear at the beginning, and are common to it with other diseases; the second, the succeeding and more certain signs of the malady. Under the first, he comprehends a heaviness of the body, with a spontaneous lassitude, generally most sensibly felt after exercise; a tightness of the breast, and a weakness of the legs; an itching, redness, and pain of the gums; a change of colour in the face to a darkish hue: and observes, that where all these concur, we may foretel an approaching scurvy. But the more immediate and certain signs he enumerates under the second class, viz. a fœtid breath, a spungy swelling of the gums, which are apt to bleed, with a loosening of the teeth; an eruption of leaden-coloured, purple, or livid spots, on the legs; or of somewhat broader speckled or dark-coloured maculæ, sometimes on the face, at other times on the legs. As the disease advances, the patients lose the use of their legs, and are p.356 subject to a difficulty of breathing, particularly when moved, or when they sit erect; at which times they are apt to faint: but upon being laid down again, they recover, and breathe freely; nay, when lying, they affirm that nothing ails them. But as they cannot always thus continue without some motion, they are subject to these perpetual swoons14. The appetite is seldom bad; on the contrary, they generally have a good one. There is sometimes observed an aggravation of the symptoms; with some on the fourth or fifth day, in others on the third. Some few have it every day, but without any fever: others become feverish. Preceeding fevers may terminate critically, as it were, in the scurvy: 14 Swoon. Faint 8 and with such scurvies whole families and monasteries are together infected; which generally end either in a deadly dysentery, or, at other times, in a sudden and mortal faint. During the course of this disease, some are apt to be very costive15; while others have a continual diarrhœa. Sometimes their spotted legs swell so monstrously, as to resemble the elephantiasis of the Arabians; while others have them so extenuated, that the bones seem only covered with skin. The spots of some separate into black and duskish scales, like the morphæa and leprosy of the Greeks; while in others they remain soft, smooth, and shining; and the impression of the finger continues for some time upon the part. In those who die, the spots sometimes disappear; at other times they break out afresh. Lastly, there have been observed varicose swellings of the veins, as in those under the tongue, and of the lower lip. He afterwards delivers the indications of cure, without giving us any remedies. And it may not be amiss to remark, that this is the first description now extant of the scurvy by a physician. 15 Costive. Constipated. 9