Description of scurvy in Vyborg by Nitzsch (1732, 1734)

Description of scurvy in Vyborg by Nitzsch (1732, 1734) Summary by James Lind (1772) This is James Lind’s summary of Nitzsch’s description of scurvy in Vyborg in 1732 and 1734. Yellow is used to indicate more important sections. This text is available at: https://doi.org/ 10.5281/zenodo.17295495 2025-10-7 This 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.com/citations?user=2mkomzUAAAAJ https://doi.org/10.5281/zenodo.17085738 Reports on scurvy uploaded to Zenodo by Harri Hemilä The text below is from James Lind (1772; 3rd ed) p.395-399. https://archive.org/details/treatiseonscurvy1772lind/page/394/mode/2up https://archive.org/details/b30511902/page/394/mode/2up https://babel.hathitrust.org/cgi/pt?id=ucm.5320216006&seq=419 https://wellcomecollection.org/works/r7fpbavt/items?canvas=417 1 James Lind’s comments on Nitzsch: p.31 Moreover, the sea-scurvy is called by several authors the Dutch distemper; especially by the celebrated Francis Gemelli Careri, who has wrote the best voyages in the Italian language. The French formerly gave it the name of the land evil. And indeed the symptoms of the malady are at this day uniform and the same, both at sea and land; in Holland, Greenland, Hungary (Kramer), Cronstadt, Wiburgh (Nitzsch), Scotland (Grainger), &c. which sufficiently evinces the absurdity of the assertion advanced by several authors, that since the first accounts of it were published, the face and appearances of the calamity have been greatly changed. https://archive.org/details/treatiseonscurvy1772lind/page/30/mode/2up p.44-45 Thus, where the causes productive of it are general, and violent in a high degree, it becomes an epidemic or universal calamity, and rages with great and diffusive virulence: as happens often to seamen in long voyages; sometimes to armies (Nitzsch), very lately to the German soldiers in Hungary (Kramer); frequently to troops when closely besieged, as to the Saxon garrison in Thorn (Bachstrom), the besieged in Breda (Vander Mye), in Rochelle, as also Stetin: and at other times to whole countries; as in Brabant, in the year 1556; and in Holland, ann. 1562. https://archive.org/details/treatiseonscurvy1772lind/page/44/mode/2up p.61 This disease is not indeed peculiar to the ocean, there being many instances of its raging with equal violence at land (Vid. the case of the German troops in Hungary (Kramer), of the Russian armies (Nitsch)). https://archive.org/details/treatiseonscurvy1772lind/page/60/mode/2up 2 1732. 1734. An account of the scurvy at Wiburg1. Communicated by Dr. Abraham Nitzsch to Dr. Schulze. Commerc. literar. Norimb. ann. 1734, p. 162. p.395 It may be proper, first, to observe, that the scurvy is here a common disease. But what drew particular attention to it this year, 1732, was the uncommon number of the afflicted, and of those who died, together with its unusual duration. It persisted in its ravage from the beginning of the year until the month of August, with such remarkable violence, that I was sent thither by express orders in the month of June. I observed the appearances of the disease were not the same in all; but varied according to the different constitutions of the patients. Those who were of a lax habit, laboured under swelling of the legs, (rarely of the belly) yielding easily to the impression of the finger, but often becoming harder upon the continuance of the malady. The hypochondria2 for the most part were tumid, the flexor tendons of the leg always contracted, with livid spots on the legs, knees, thighs, and back. Those spots, particularly on the legs and if the patient was full of blood, became often inflamed, and were attended with most acute pain, and quickness of the pulse. Now and then the white of the eye p.396 altogether bloody; and sometimes the eye lids were greatly swelled, being distended with effused, stagnating blood. In some the spots were pretty large, especially upon the thighs and back; in others they resembled only flea-bites, and were accompanied with swelling of the legs, universal lassitude, swelled, bleeding, and putrid gums; as also a pale wan countenance. Several were distressed with a great difficulty of breathing, cough and spitting, giddiness, and faintings, most commonly when in an erect posture; the latter often proved fatal to those who had been long afflicted. The appetite from the beginning was somewhat impaired, often leaving the patient upon his being affected with flatulencies and nausea, but returning upon the accession of a purging. The feet, scrotum and belly were sometimes greatly distended with a transparent watery swelling, and the skin inflamed. The gums having become a mass of spungy flesh, discharged, upon squeezing, a thin fœtid matter; and the salivary glands were sometimes so stuffed, as to acquire the hardness of a scirrhus, which could not be resolved by any other means than by a natural and spontaneous salivation. Persons of a thin habit were afflicted with symptoms different from those who were corpulent. They were every day more and more emaciated, and racked with violent p.397 shooting pains on the bones of the legs accompanied with a fever. The anguish did not fix in one place, but by shifting produced gouty pains, colics, the spasmodic asthma, headachs, toothachs, and contractions. By volatile medicines having been improperly given, the bowels, the liver and spleen, became hard; upon which ensued either a dropsy3, consumption or flux, which constantly proved fatal. The gums were swelled and hard, painful to the touch, and often over-run with a cancerous ulceration. In order to put a stop to this dreadful calamity, it was necessary that the remedies should be suited to the habit and constitution of the patient.4 p.398 This present year, the Cuirassiers lately come from the Ukraine to Petersburg have 1 Vyborg. A Russian city near the Finnish border. https://en.wikipedia.org/wiki/Vyborg 2https://en.wikipedia.org/wiki/Hypochondrium 3 furnished me with several other observations upon this disease. The symptoms were as usual. It was always a salutary sign when the spots appearing continued out. In two cases their sudden disappearance proved fatal. Besides the use of a decoction of pine tops,5 I found it necessary, every second or third day, to give a pretty smart purge: which had so remarkable good effects, that though many were bloated, yet none became dropsical. Bleeding with caution near the decline of the disease, when the pulse was p.399 strong, evidently assisted in the cure. I can solemnly affirm it was followed with an increase of strength, a perfect relaxation of the tendons, which had before been attempted to no purpose by warm steams and baths, and a more speedy recovery. The disease left us in May, having acquired its virulence in February. 3 Dropsy. The historical diagnosis of dropsy – which is now obsolete – indicated simply an abnormal accumulation of fluid. The word derives from the Greek hydrops (water). Alternative or supplementary terms included hydrothorax (fluid in the chest cavity), ascites (which still indicates excess free fluid in the abdominal cavity), anasarca (still used to describe generalized edema throughout the body). https://doi.org/10.1017/CHOL9780521332866.101 An ancient medical term used to indicate different conditions including chronic heart failure. https://doi.org/10.1016/j.ijcard.2017.07.104 Scurvy can cause heart failure, eg. https://pmc.ncbi.nlm.nih.gov/articles/PMC10949735 https://pmc.ncbi.nlm.nih.gov/articles/PMC8913583 4 He therefore prescribed for those who laboured under the slow or cold scurvy, a decoction… Where there was reason to apprehend a swelling of the abdominal viscera, he gave the neutral salts, and alcaline tinctures: but where there was a fever, and inflammation on the tibia… For the stiff tendons he used… for the swelled, bleeding gums… The air was corrected three times a-day by a fume of juniper wood and berries. The paracentesis often succeeded with those who had the ascites, when free from a fever, and an œdematous swelling of the abdomen. It restored them to perfect health; as did also scarifications upon the calf of the leg and scrotum, when there appeared a tense watery swelling upon these parts; provided proper internals were administered… If there was any danger of a gangrene from these scarifications, as often happened, it was stopped by nervous and antiseptic applications. In the painful scurvy, upon account of the dry habit of body, medicines heating and exagitating the blood, formerly given, were laid aside, and emollient remedies were prescribed… which often miraculously allayed arthritic pains, and the oppressive complaints in the breast. Antispasmodics were sometimes given… When the hypochondriaca were obstructed… and for the swelling, heat, and pain of the gums, the pulp of citron proved an excellent and agreeable remedy. By this treatment, and the blessing of Heaven, a stop was put to the calamity; insomuch that the number of the diseased, and of those who died, diminished every day, and in the space of a month it quite disappeared. 5 See discussions of vitamin C content in spruce and fir trees. https://doi.org/10.3138/cbmh.7.2.161 https://doi.org/10.1001/jamadermatol.2014.4582 https://doi.org/10.1126/science.99.2563.125.a https://doi.org/10.1126/science.98.2545.325.a https://doi.org/10.1126/science.98.2541.242.a https://doi.org/10.1126/science.98.2541.241 https://doi.org/10.1126/science.98.2536.132.a https://doi.org/10.1126/science.97.2520.354.c https://doi.org/10.1126/science.92.2376.35.b 4