Regardless of how many articles I read on scurvy, or how many skeletons I’ve seen showing evidence of the deficiency of vitamin C, or how many times I’m reminding that this can occur to anyone around the world… my first thought is always pirates. Scurvy = pirates, right? Not just any pirates. I think about Muppet Treasure Island style pirates. There is some logic to this association (not the Muppets, but the pirates). Scurvy was historically found among sailors, pirates and others who were aboard ships for long periods of time. Being trapped on a boat for months at a time usually meant surviving on cured or salted meats, dried grains, and very little fruits and vegetables. The risk of scurvy is often what limited ocean travel since it would kill off large numbers of passengers. Despite some textual evidence that some started to recognize a connection between citrus and prevention of scurvy during the 16th through 18th centuries, it wasn’t until the 19th century that lime and lemon juice became part of the average sailors diet and scurvy was officially stopped in ships. And that is good news, because at least during the 18th century, 2/3 of sailors died from scurvy. Yikes!
So we can thank sailors and pirates for finally making the connection between citrus and scurvy, but it is important to remember that this deficiency is not just something felt by those at sea- it can happen to anyone who doesn’t have enough citrus in their diet.
A new study by Krenz-Niedbala (2015) examines the presence of scurvy in children from medieval and early historic populations in Poland. Skeletal changes in sub-adults with scurvy include both primary responses to the lack of vitamin C, and secondary effects such as trauma to the vulnerable bone. Primary changes include bleeding, weakness, new bone formation, inflammation, porosity, and lesions in the skull. The sample used for this analysis includes skeletal material from three sites located in Poland dating from the 10th to 17th centuries CE. Two of the sites are more urban and one is a rural settlement, providing different samples.
The sample includes a total of 506 individuals. Age of individuals was determined based on dental development, bone lengths, and fusion of bone.
- 110 individuals were 2.5 years or younger
- 146 were from 2.6 to 6.5 years
- 128 from 6.6 to 10.5 years
- 74 were aged 10.6 to 14.5 years
- 48 individuals were between 14.6 and 17 years.
Of the 506 individuals, 18 (3.6%) showed abnormal porosity and lesions suggestive of nutritional deficiencies, and it is important to discuss all possible diagnoses. Rickets (vitamin D deficiency), anemia (iron deficiency), and scurvy tend to occur within the same individuals and have similar patterns of bone formation and porosity. All three can be attributed to malnutrition, so there is a tendency for individuals with lack of proper nutrition to suffer from a combination of them. However, the appearance of bilateral (even on both sides) lesions, the locations of the porosity, and lack of other indicators found with anemia and rickets, suggest that these cases were scurvy.
Based on the comparison of the three sites and changes in time period, Krenz-Niedbala (2015) argues that the vitamin C status of the general popular was fairly poor and only improved with the widespread consumption of potatoes in the 19th century. Historical records from this period support this conclusion- medical publications listed possible cures despite a lack of understanding about what caused the disease and scurvy was listed as a cause of death in town records. The diet of the average person in this period would have been fairly restricted to grains and dried meats, with little access to fruits and vegetables (fairly similar to the conditions of sailors). Krenz-Niedbala (2015) proposes that the poor and rich would have been effected the most since the poor had little access to food beyond grains, cabbages and turnips, and the rich were more likely to eat meats, fish and alcohol.
This study reminds me in many ways of the recent research on the Irish Famine, which showed that scurvy was a problem in Ireland due to the decline in potatoes. When we think of scurvy, we do associate it primarily with sailors and pirates- but it is important to remember that this type of deficiency can happen to anyone with bad nutrition, regardless of social status or location.
If you’re interested in seeing what human bone looks like with scurvy, I highly suggest checking out the photograph’s from the Museum of London’s Lower St. Brides collection. They show great examples of how scurvy can manifest in human remains. Sadly since they aren’t open access, I cannot share the photos directly on my site… so head on over to their site to see them: Lower St. Brides Photographs
Krenz-Niedbała, M. (2015). Did Children in Medieval and Post-medieval Poland Suffer from Scurvy? Examination of the Skeletal Evidence International Journal of Osteoarchaeology DOI: 10.1002/oa.2454