Scurvy

Scurvy is caused by a deficiency of Vitamin C. Vitamin C is necessary for the hydroxylation of proline and lysine and, without these, collagen can not form. Collagen is necessary for the body's micro structure, the tiny slats that support the foundations of organs and vessels, even the organs and vessels themselves. Collagen knits the body together. As scurvy advances the tissues weaken, teeth come loose from gums, joint pain and swelling starts, wounds do not heal and ancient wounds re-open and begin to bleed again.

In the eighteenth century, scurvy was responsible for more deaths in the British Navy than enemy action; in 1780 alone, scurvy killed 1,600 men in a fleet of 12,000, while enemy action killed only sixty. Scurvy progressed from a disease of the edge of exploration to a problem of mainstream empire. Astonishingly, this illness had been explained 30 years earlier by a man named James Lind.

James Lind, an assistant surgeon's mate who enlisted at the age of twenty-three without much formal medical training, became obsessed with scurvy and its effects. In 1747 he did an experiment. He gathered together twelve sailors with scurvy, which he ordered fed the same meals for breakfast, lunch and dinner. Then he divided them into six groups, administering various known cures for scurvy to each group: hard cider, elixir vitriol, vinegar, sea water, oranges and lemon, and some concoction including garlic, radish root, gum myrrh, tamarind and tarter. In six days those on the citrus recovered.

But no one paid much attention to this achievement. Thirty years later the problem was virtually unchanged. In 1780, three-thousand cases of scurvy were reported in six months in the West Indies fleet, and Admiral George Brydges Rodney appointed his friend, Gilbert Blane, Physician to the Fleet, hoping for some kind of answer. Within a few months Blane came to the same conclusions as Lind had decades earlier: “scurvy, one of the principal diseases by which seamen are afflicted, may be infallibly prevented, or cured, by vegetables and fruits, particularly organs, lemons, or limes.”

Amazingly the intransigence of bureaucracy kept Blane’s recommendations from being widely implemented for another fifteen years, until 1795 when he was appointed to the Board of Sick and Wounded Sailors. Soon after, lemon juice was added as a staple to English ships, and incidences of scurvy plummeted.

Perhaps bureaucracies create emergent behavior: myopia, rigidity, passivity and obstinacy.