Description of scurvy by Ronsseus (1564)

Description of scurvy by Ronsseus (1564) 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 Ronsseus (1564) text on scurvy. Various names of the author (1525–1597): Ronsseus Balduinus Ronsseus Boudewijn Ronsse https://nl.wikipedia.org/wiki/Boudewijn_Ronsse in Dutch Yellow is used to indicate the description of symptoms of scurvy. This text is available at: https://doi.org/10.5281/zenodo.17093314 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 Ronsseus, who believed it to be the same disease that is described by Pliny, and is said to have afflicted the Roman army under the command of Cesar Germanicus, observed, that in his time it was to be met with only in Holland, Friesland, and Denmark; though he had heard of its appearing in Flanders, Brabant, and some parts of Germany. From seeing some of those countries entirely free from this distemper, he was induced to ascribe its frequency in other places to their soil, climate, and diet. In order to prove which, he wrote his first epistle. James Lind p.125 Moisture was discovered to be one of the causes of this malady by Ronsseus, the very first author who ever wrote expressly upon it. 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 James Lind p.131-132 Thus, Ronsseus takes notice, that in his time it was a much more frequent malady at Amsterdam and Alomaer, than at Goude and Rotterdam; and at Dort, though in the same climate, and where the inhabitants eat the same food, it was hardly ever to be seen: but that, universally, in all parts of the country where the soil was senny, damp, and marshy, it raged with the greatest violence. This very accurate author observes likewise, the great influence which the weather had upon it; as, that along continuance of southerly and westerly winds always occasioned a great frequency of this distress; but that rainy seasons especially, rendered the mischief quite epidemic and malignant. When this physician wrote, his country was little better than a large morass, exposed to frequent inundations from floods and high tides; which, together with the gross coarse diet used by the Dutch at that time, made the scurvy perhaps the most frequent endemic of their country. But now they are become a rich flourishing republic, and have dried and improved their soil by dikes and drains, and also quite altered their way of living, the disease appears but seldom; and is to be seen chiefly among the poorer sort, who inhabit the low damp parts of the provinces, and continue in their old gross way of living, upon salt, smoked, often rancid pork, coarse bread; and are necessitated to drink unwholsome stagnating waters. They have indeed at times been subject to violent returns of their old distemper; as in several of their wars, when obliged to overflow their country with water. James Lind p.204-205 But these fruits have this peculiar advantage above any thing that can be proposed for trial, that their experienced virtues have stood the test of near 200 years. They were providentially discovered, even before the disease was well known, or at least had been described by physicians. Ronsseus, the first 3 writer on this subject, mentions them; and observes, that in all probability the Dutch sailors had by accident fallen upon this remedy, when afflicted with the scurvy, in their return from Spain loaded with these fruits, especially oranges. Experience soon taught them, that by thus eating part of their cargo, they might be restored to health. 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.” … 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 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 4 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 p.355 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. 5 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 6 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. 7 The text on the following pages is the summary by Lind (1753, 1st ed.) p.357-361 https://archive.org/details/treatisescurvyt00lind/page/356/mode/2up https://wellcomecollection.org/works/bg2gxrzz/items?canvas=379 Although Lind states that Ronsseus properly describes the symptoms of scurvy, in a similar way as Echthius and Wierus, Lind does not extract the symptoms that Ronsseus had described. Balduin. Ronfeus, ordinary physician to the city of Goude in Holland. Original in Latin: “Balduini Ronssei Gandensis De Magnis Hippocratis Lienibus, Pliniique stomacase ac sceletyrbe, seu vulgò dicto scorbuto commentarius. Ejusdem epistolae quinque, eisdem argumenti”, p.139-180. https://archive.org/details/descorbutotracta00senn/page/138/mode/2up https://archive.org/details/hin-wel-all-00002888-001/page/n8/mode/2up https://www.google.com/books/edition/De_scorbuto_tractatus/W7w_AAAAcAAJ https://books.google.com/books?id=rUepnWJ1zVwC https://www.google.com/books/edition/De_scorbuto_tractatus_Acc_ejusdem_argume/f2RWAAAAcAAJ 8 A.D.1564 Balduini Ronssei de magnis Hippocratis lienibus, Pliniique stomacace ac sceletyrbe, seu vulgò dicto scorbuto commentarius. Ejusdem epistolæ quinque ejusdem argumenti. p.357 He ascribes the frequency of the scurvy in Holland to their diet and air; to their eating great quantities of water-fowl; but principally to their living on flesh, first salted, then smoked and dried. The weather, he says, had a very great influence upon this distemper. For though it was met with in the country at all seasons; yet, by long observation and experience, he had found, that a moist air, and southerly winds, contributed greatly to increase it: and instances in the year 1556, when, during that whole year, they had almost continual rains, with southerly and westerly winds; which were followed by a great frequency of this disease; and to such a height, that many were brought in danger of their lives by it. In 1562, after a very rainy season, there likewise ensued frequent and very troublesome scurvies. So that although this malady was at all times endemic with them, from the peculiar air of the country, and their bad waters; yet, upon very slight occasions, it often became more general or epidemical during a moist season. It usually prevailed most in spring and autumn; was milder in the spring, and shorter: but in the autumn, it was of longer continuance, and more obstinate, so as sometimes to endanger the life of the patient. No age was exempted from its attack; which, though severest with old people, yet was more incident to those of a middle age. From a mistaken theory in judging it a disease of the p.358 spleen, he begins the cure by bleeding. He afterwards prescribes an aperient and attenuating decoction of a number of antiscorbutics, with the addition of senna, and some other purgative ingredients: but observing, that the more simple compositions were generally the most efficacious, he thinks, that the use of scurvygrass, wormwood, and germander, is alone sufficient; the vulgar curing themselves by scurvygrass, brooklime, and water cresses. At the end of the cure, he gives gentle physic; forbidding 9