Vsauce!
Kevin here.
Sailing the high seas!
Avast ye, scurvy dogs!
Actually, I’m in a kiddie pool.
And you’re not scurvy dogs because scurvy was just some weird thing pirates got or something.
Or is it a disease everyone can still get today?
And does the centuries-long search for its cause and cure show us how life-saving knowledge
can be hidden right in front of our faces?
Yes.
Scurvy is a disease caused by a deficiency of ascorbic acid, commonly known as Vitamin
C. It’s necessary for the absorption of iron, which fortifies red blood cell production.
Red blood cells help carry oxygen from your lungs to the rest of your body.
Vitamin C is also necessary for connective tissues, muscles, tendons, blood vessels,
bones, and the formation of collagen - the glue that binds your body together.
Zombies could probably benefit from Vitamin C.
Guinea pigs are one of the only animals whose livers don’t synthesize Vitamin C -- a shortlist
that includes some primates and all humans.
For us, it’s thought to be the result of an evolutionary defect that occurred 60 million
years ago, and it means we have to get Vitamin C from someplace else - food.
Here are some foods that contain Vitamin C.
While fresh fruits and vegetables are the most common sources of Vitamin C, for the
Inuit people living in the Arctic, there’s as much Vitamin C pound for pound in beluga
whale skin as there is in orange juice.
Scurvy is so rare today that it’s often overlooked by doctors when patients do suffer
from it.
It takes only about 10 milligrams of Vitamin C a day to stave off -- eight ketchup packets.
But in a world without cheap, pre-packaged servings of sweet and tangy tomato goop, without
foods fortified with extra Vitamin C, or without any idea that vitamins even existed, men were
trapped on boats for months at a time eating salted meat, biscuits and beer.
A diet with a daily recommended allowance of Vitamin C floating right around zero percent.
The Age Of Sail, which lasted from the late 15th to mid 19th century, was defined by European
powers exploring and warring over sea supremacy.
Warships grew bigger, vessels for commerce flourished and voyages lasted longer.
Mortality rates at sea were so high that some ships would leave port with up to 50% more
sailors than they needed to try to make up for the deaths caused by scurvy.
Cannonballs, Krakens and Captain Hook can’t compare to a deficiency of Vitamin C.
So what happens when you get scurvy?
According to the National Health Service, scurvy is characterized by fatigue, pain in
the limbs, swollen gums, and the appearance of red-blue spots on the skin… which doesn’t
sound too bad.
But according to a surgeon on a 16th Century English voyage, symptoms can get a lot more
graphic.
“It rotted all my gums, which gave out a black and putrid blood.
My thighs and lower legs were black and gangrenous, and I was forced to use my knife each day
to cut into the flesh in order to release this black and foul blood.
I also used my knife on my gums, which were livid and growing over my teeth…
When I had cut away this dead flesh and caused much black blood to flow, I rinsed my mouth
and teeth with my urine, rubbing them very hard…
And the unfortunate thing was that I could not eat, desiring more to swallow than to
chew.”
Okay!
Let’s break this down.
Urine, which contains ammonia, was used as a mouthwash and teeth-whitener for centuries
- documented by 1st century BC Roman poet Catullus in a verse about a rival’s beautifully-polished
teeth:
"... the higher the polish on your teeth, the more it proclaims that you have drunk
your piddle."
And cutting out foul blood, or bloodletting, was a foundational tenet of medical reasoning
from Hippocrates in 4th Century BC Greece through the 19th century.
Despite the surgeon general of The East India Company writing in 1617 that lemon juice prevents
and cures scurvy, it took years for anyone to understand why.
Three hundred sixteen years.
Before the rise of modern medicine, ailments were thought to be treated by balancing the
four humors - blood, black bile, yellow bile and phlegm.
The scurvy-suffering surgeon thought he had too much blood so he performed a venesection
to release some.
Then along came Dr. Lime Tree.
Surgeon James Lind, whose last name derives from the Old Norse for lime tree, performed
the first controlled clinical trial in human history.
While aboard the English warship HMS Salisbury in 1747, Lind separated scurvy-afflicted sailors
into six pairs.
He then monitored the effects of treating them with cider, a sulphuric acid cocktail,
vinegar, sea water, oranges and lemons, and garlic paste.
Lind found that, “the most sudden and visible good effects were perceived from the use of
oranges and lemons,” but without knowledge of vitamins, he was forced to explain the
results through the medical worldview of his time.
He concluded that the dampness at sea blocked perspiration, which led to an imbalance of
alkalinity.
Basically, that sailors weren’t sweating properly because they were wet all the time,
and acidic fruits restored the body’s internal pH balance.
None of which is remotely true, but he didn’t know that.
No one understood the chemistry of nutrition - it was a different world with different
rules, and Lind was just trying to understand what he observed and explain it to others.
But it didn’t work.
With no scientific understanding of how a lemon could prevent and cure scurvy, other
purported remedies included mixing hydrochloric acid into drinking water or drinking wort
of malt.
A precursor to beer promoted as a scurvy elixir by Dublin Physician David Macbride with the
support of the Royal Society, wort of malt not only contained zero Vitamin C, it actually
inhibited its absorption.
It was like giving a thirsty person a cup of sand.
Despite scurvy killing over two million sailors during the Age Of Sail, there wasn’t much
motivation to find a cure.
Ship owners were more concerned about their expensive ships -- sailors were easier to
replace.
It wasn’t until the warship HMS Gloucester had to be abandoned in 1742 because there
weren’t enough living sailors to continue manning it that England put effort into a
solution.
Ships were loaded with lemon rob, a concentrate invented by Lind which unknowingly destroyed
half the Vitamin C in the process.
Storing the rob deteriorated the Vitamin C further over time, but it still worked well
enough that in 1799, the Royal Navy ordered a lemon and sugar cocktail to be administered
daily to all sailors.
Scurvy plummeted, which gave the British navy a tremendous advantage in the Napoleonic wars.
Scurvy was cured!
Until it wasn’t.
The advent of steam engines meant shorter trips, so the importance of lemons was seen
as less critical.
Lemons, which had been planted throughout Sicily to supply the British navy, were eventually
replaced in 1860 by more readily available West Indies limes.
They believed that acidity provided the cure, and while limes are more acidic than lemons
they have half the Vitamin C.
50 years later, further misunderstandings of scurvy led Robert Falcon Scott’s expedition
to Antarctica to not include any citrus at all -- and the trip was such a disaster that
Apsley Cherry-Garrard called it "The Worst Journey in the World."
But you didn’t have to be a sailor or an explorer to suffer from scurvy.
When baby formula became popular in the early 1900s, it contained no Vitamin C and thousands
of infants died.
By 1920, orange juice was mixed into the formula.
Ultimately, the knowledge that fresh fruits and vegetables cured and prevented scurvy
wasn’t enough -- we needed to understand the process that was involved.
Humanity required a shot in the arm.
Like, with a bullet.
In 1917, in the midst of World War I, a young Hungarian soldier named Albert Szent-Györgyi
wanted to get back to the University Of Budapest so badly he said he was, “overcome with
such a mad desire to return to science that one day I grabbed my revolver and in my despair
put a shot through my upper arm.”
He finished his MD later that year without a clue that a guinea pig would lead him to
a nobel prize.
While studying a deficiency disorder called Beriberi, researchers Axel Holst and Theodor
Frolich decided to switch out their pigeon test subjects for a mammal.
They fatefully chose the non-vitamin-c-producing guinea pig, which died from scurvy-like symptoms
when fed a strict diet of grain.
For the first time, an animal was observed with scurvy.
They honed their experiments, and by 1932 Szent-Györgyi had isolated ascorbic acid.
Prior to the discovery of X-rays, the electron, radioactivity and relativity, scientific learning
was largely limited by our senses.
You can see a hungry lion; you can’t see its electrons.
You can see rotten food; you can’t see if it has Vitamin C. The constraints of medical
reasoning of the era prevented James Lind from saving millions of lives.
His knowledge was imprisoned by the zeitgeist - a German word representing the dominant
ideals and beliefs of a particular period of time.
In his 1970 book, The Crazy Ape, Albert Szent-Györgyi described the zeitgeist as a cage.
He said, “The freedom of human thought is very limited.
We all live in a very narrow cage, the “spirit of our times,” in which we have very limited
freedom of motion.
If, in different ages, people thought differently, this was not because the cage got wider, but
because the cage moved.”
By discovering ascorbic acid and finally solving a mystery that plagued humans for thousands
of years, Albert Szent-Györgi moved the cage.
Today, we live in a cage created by the math, biology, chemistry, and physics of our time.
And just like James Lind couldn’t conceive the chemistry of lemons and livers -- we have
a hard time moving our own cage.
Albert Szent-Györgyi included a quote in his 1957 book, Bioenergetics, that says, “Research
is to see what everybody has seen and think what nobody has thought.”
In order to move our cage, we have to step outside its confines and see things from a
new perspective.
Whether it’s to advance science, improve our world or just better ourselves.
Like Vitamin C and scurvy, a solution that can revolutionize life as we know it exists
just outside the limits...of our own kiddie pool.
The greatness in each of us lies in our ability to move beyond limitations and find a way
to see what everybody else has seen but think what nobody else has thought.
And the fear, complacency and obstacles in our path are washed away as soon as the wall
impeding discovery is broken down.
And as always - thanks for watching.
Hey I'm really excited to announce I did a collaboration with Sesame Studios.
It's a blanket fort memory game.
It's for really really little future Vsauce fans.
So go over there - check it out.
Make sure you subscribe while you're there.
And uhh yeah.
I'll see you over there in the blanket fort.
Okay?
Bye!