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Limeys: The True Story of One Man's War against Ignorance, the Establishment and the Deadly Scurvy

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7368.841/a (Published 12 October 2002) Cite this as: BMJ 2002;325:841
  1. Druin Burch, medical senior house officer. (druinburch{at}yahoo.com)
  1. Horton Hospital, Banbury

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    David I Harvie

    Sutton Publishing, £14.99, pp 314

    ISBN: 0750927720

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    The history of scurvy is a lesson to the world on the dangers of observation without proper experiment. There were many untested treatments, including being buried up to one's neck in the ground or using a urine mouthwash. Yet as early as 1747 James Lind, a navy doctor, conducted a trial in which he gave different treatments to six pairs of mariners with scurvy. Only the two given citrus fruit improved. While Lind (who was not the first to think fruit beneficial) concluded in favour of lemons and oranges, he muddled his argument by also maintaining the efficacy of other treatments.

    The fetid conditions of shipboard life were fertile not just to vermin and microorganisms but also to medical confusion. Lind's theories seemed no more convincing to the admiralty than a hundred others, and whatever his achievements in raising the general standard of health in the navy he was not forceful when it came to pushing his beliefs about scurvy. His lack of fighting spirit made him less persuasive to his peers (and makes him less riveting to us).

    Scurvy routinely killed more men at sea than did any other hazard, including waves and warfare. Although there was a general drift over the century and a half following Lind towards the use of citrus juice as both treatment and prophylactic, the situation remained desperately confused. It was not helped by a 100 year muddle over the difference between lemons and limes. Only in the early 20th century were the experiments carried out that conclusively demonstrated scurvy was a nutritional deficiency.

    Harvie's account of the disabilities of reason that led to the deaths of millions is educational. Unfortunately, he doesn't summon up the feel of the contemporary intellectual and moral world vividly enough, nor is the story grounded in the huge general improvements taking place in health during the long 18th century. Those lacks leave a historical flatness.

    Harvie is also not a poignant writer. He is poetic over neither place nor person, and even his descriptions of the horrors of the disease are not haunting. He evokes no feeling for Lind as a man, only as a figure in an extended half-scientific controversy. Similarly he describes the other characters in the story mainly in terms of how closely their opinions agree with our modern ones—a bad way to judge the worth of people who lived in a different world.

    The story of scurvy is rich, full of intellectual and moral confusions all set against the unreliable background of human progress. This is an enjoyable book on the subject, but its flaws make it more a work of extended journalism than a stirring piece of biography or history.

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