Scurvy During the Irish Famine

During the 18th and 19th centuries there are many well documented cases of scurvy in historical records, however paleopathological evidence for disease in Britain has not found the correlating skeletal evidence. This lack of skeletal evidence is thought to be due primarily to misunderstanding and misdiagnosis of the skeletal lesions relating to the disease, especially in cases where the research was done over thirty years ago. It is only recently that extensive investigations of the manifestation of scurvy on skeletal remains have been conducted, and it is still not fully understood. Understanding nutritional diseases in the past is important for creating better interpretations of what life was like, as well as noting the impact of historical events on health. A new study by Geber and Murphy (2012) examines the rates of scurvy in a population from the Great Famine.

Scurvy is caused by a lack of vitamin C in one’s nutrition. Potatoes are rich in vitamin C, almost comparable to citrus fruits. When the potato blight and famine struck, the poorest members of society lost their access to the tuber and suffered nutritionally. Historical accounts of the disease are first recorded in 1845, noting the presence of rosy patches of skin, swollen muscles and aching bones. It also includes gingivitis, tooth loss, swelling of the lower extremities, vertigo, faintness, profuse sweating, hemorrhagic spots in the eyes, and impaired healing of wounds. In the skeleton, the swelling in the joints and limbs causes porotic and hypertrophic bone formation at the affected areas. Fractures can also occur. Since vitamin C is required for bone formation, the skeletal lesions only become apparent if there is healing. As Geber and Sullivan (2012) note “this is an important factor to consider when interpreting its prevalence in skeletal populations since individuals with no osseous lesions may have been severe sufferers who died before any scorbutic lesions had manifested”.

Due to economic constraints during the mid-19th century, the diet of the poor in Ireland was drastically reduced to primarily potatoes and dairy products. While buttermilk and potatoes can provide the majority of vitamins and protein necessary, it is estimated that one third of the poor population would have been forced to subsist on potatoes for periods of time. With the potato blight in 1845 there was increasing pauperism. People affected by the blight were forced to take shelter at workhouses like the one at Kilkenny City, and during the famine there was major overcrowding leading to disease and mass death. In order to deal with the high number of deaths, mass graves were created within the workhouses and intentionally concealed after the famine ended. The location was never marked on a map, so the discovery of the mass graves at the Kilkenny Workhouse was a complete surprise.

Porosity on the maxilla, Geber and Sullivan 2012

In 2005, excavations were conducted of a previously unknown mass burial ground that dates to the Great Famine (1845–1852). It was found on the grounds of a former union workhouse in Kilkenny City, Ireland. The excavation revealed 63 mass graves where the deceased were simply stacked upon one another. 970 individuals were recovered and examined macroscopically for lesions. They primarily looked for porosity in the jaw caused by the dental problems associated with scurvy. They also recorded new bone formation in the long bones. Diagnosis was labeled as definite, probable or possible. A definite diagnosis of scurvy was made in 16% (156) of individuals, while probable scurvy was identified in 14% (138) of the group, and possible scurvy was considered to be present in 21% (205), an overall prevalence of 52%.

Other populations from this time period and area usually show prevalence of 3 to 7%, which means that the population at the Kilkenny Workhouse had unusually high rates of scurvy. They argue that since the lesions from scurvy “only appear after a re-introduction of Vitamin C, the skeletons with signs of scurvy in the Kilkenny Union Workhouse population are therefore likely to have been individuals who had been deprived of Vitamin C as a result of the potato blight, but were then provided with the vitamin in the work- house diet once they had been admitted to the institution”. These findings are important because they are the first well documented evidence of scurvy in a famine population. It further supports their argument that the reason vitamin deficiencies are not seen in the Great Famine is due to misrecognition rather than a lack of the presence of the disease.

Works Cited
ResearchBlogging.orgGeber, J., & Murphy, E. (2012). Scurvy in the great irish famine: Evidence of vitamin C deficiency from a mid-19th century skeletal population American Journal of Physical Anthropology DOI: 10.1002/ajpa.22066

9 responses to “Scurvy During the Irish Famine

  1. I didn’t know that Potatoes are rich in vitamin C, I have found that most epidemics have been caused of a lack of nutrition, It is incredible how eating correctly can keep you very healthy, this is something that seems to me that is yet again being over looked in modern-day food!

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  3. I have to second the previous comment. I was not aware myself that potatoes are rich in Vitamin C in amounts almost comparable to citrus. By the by, even in today’s age poverty is still a leading factor that causes malnutrition and sadly, most people that are at risk are children, pregnant women and the elderly. And the world over the death toll from malnutrition is still fairly high.

  4. It is possible that the lesions appeared, as the researchers propose, because the workhouse inmates “were then provided with the vitamin in the work- house diet once they had been admitted to the institution”.
    But I have significant doubts and there are other possibilities the researchers appear not to have considered or discounted.

    – One such possibility is that the inmates with lesions were better fed prior to their workhouse entry and death, while engaged in “out relief work”. Rather than put people into a workhouse where they became an absolute drain on local resources, many make-work schemes were devised: road construction was very common (many of the roads in Ireland date from this period and there are examples of roads to nowhere, laid simply to create work), and the workers may well have had a better diet provided so they were physically capable of doing the hard work of stone breaking and road formation;
    – alternatively, we know most rural Irish in the pre-famine period lived on very poor diets for years which could have induced scurvy well before the famine began, but then their income/diet may have improved some time pre-famine and the lesions then developed; subsequently the famine began and then they entered the workhouse; or
    – we are seeing pre-famine evidence of seasonal diet deficiencies eg as the family’s food stocks ran down in spring-summer before the potato harvest was brought in, but a sufficient diet recovery for lesions to appear after the harvest helped improve the family diet;
    – or we are seeing evidence of alternating periods of better diet when people were able to obtain work and poorer scurvy-inducing diets when there was no work in the pre-famine period.

    I seriously doubt this account of a better workhouse diet than conditions outside leading to development of the lesions because of what we know of the population of workhouses and their food provision to inmates, including in Kilkenny Workhouse.

    Kilkenny Workhouse was built for 1,300, extendable to 1,700; ‘by 1849 there were 2,069 inmates in the workhouse and many cases of cholera and dysentery. The number of inmates peaked at in 1850 at over 3,000.’ Geber’s paper quotes 4,357 inmates in June 1851. So it was grossly overcrowded at precisely this time; the Kilkenny Poor Law Union’s income / resources were highly unlikely to be sufficient to enable it to feed well over twice as many people as it was originally designed for significantly better than their state of starvation before their entry.

    From studies like ‘The Great Hunger: Ireland 1845-1849’ by Cecil Woodham-Smith, we know workhouse diets and people’s health were absolutely appalling. Entry into a workhouse was a death sentence, not a route to better diet and health, for many. The Poor Law Union / Workhouse system was fundamentally unfit for purpose and incapable of coping with the overwhelming starvation and need in almost every part of Ireland.

    Geber’s page has links to several online osteological papers

    The article itself (in annoying faux-old form) is available free here

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