Page 29 - Delaware Medical Journal - May 2017
P. 29
BOOK REVIEW
century English prisons, particularly London’s notorious Millbank penitentiary, were known as the “nurseries of scurvy.”
In that era, Millbank’s disease was another name for scurvy. When Captain Arthur (present day Sydney Harbor) in early 1788, the 736 convicts aboard merely traded one prison for another.
The frequent rebellions in Ireland against English rule provided a steady stream
of convicts for the increasing number of ships leaving Irish and English ports for Australia. The massacre of many captured rebels after the Irish Rebellion of 1798 and the harsh treatment meted out on convict ships led to attempted mutinies on several ships. Lamb asks: Why were the Irish convicts more likely to suffer from scurvy than other prisoners?
He points to recent research that indicates
disease as it has a close relationship with iron metabolism and an individual’s genetic makeup. Several investigators have shown
a high frequency of the gene mutation
in hemochromatosis, C282Y, in the Irish population, close to 14 percent. Some
have dubbed it the “Celtic curse.” The iron overload reduces vitamin C stability in vivo, along with other factors that make scurvy more likely.
James Lind is credited with carrying out the
ship, Salisbury. He treated several of the crew with signs of scurvy with oranges and lemons and the rest with various concoctions. Symptoms abated in those treated with citrus. Curiously, Lind’s research results were not adopted by the British Admiralty for several decades. Eventually, Sir Gilbert Blane (a senior British Fleet physician) persuaded the Admiralty to include lemon juice as a part of
the diet of seamen on British warships. The success of the British Navy in conquering scurvy came just in time, as the Napoleonic Wars were several years in the future.
Unfortunately, parts of this book are
loosely organized and have a cut and paste presentation, particularly when the author aimlessly wanders from the main theme. Quite frankly, this book needed better editing. In several of the narratives, the diagnosis of scurvy is often questionable and merges with and beriberi. Despite that criticism, the author’s meticulous research gives the reader an unusual look at a disease that ravaged the world’s navies centuries ago.
■ JAMES F. LALLY, MD is a retired Radiologist and a member of the Medical Society of Delaware Editorial Board.
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