WEBVTT - How Does Scurvy Work? 0:00:01.840 --> 0:00:07.560 Welcome to Brainstuff, a production of iHeartRadio. Hey brain Stuff, 0:00:07.640 --> 0:00:12.760 Lauren Vogelbaum. Here, there's a huge gulf between your standard 0:00:12.800 --> 0:00:18.439 pop culture pirates and the real life criminals who inspired them. Movies, novels, 0:00:18.440 --> 0:00:22.360 and TV shows expect pirate characters to embrace sort of 0:00:22.440 --> 0:00:27.640 rigid stereotypes, including some with no historical basis, But these 0:00:27.720 --> 0:00:31.280 narratives tend to get one thing right, just like many 0:00:31.320 --> 0:00:34.360 of their fictional counterparts. The pirates of your had a 0:00:34.360 --> 0:00:39.559 healthy fear of scurvy caused by a prolonged lack of 0:00:39.640 --> 0:00:43.120 vitamin C in one's diet. Scurvy has been affecting people 0:00:43.280 --> 0:00:48.400 since time immemorial. Symptoms include tooth loss, slow healing wounds, 0:00:48.440 --> 0:00:52.320 and arrested bone growth, and if left unchecked, it can 0:00:52.400 --> 0:00:58.120 ultimately result in death from internal bleeding. So, in other words, 0:00:58.320 --> 0:01:01.480 this ailment is far more danger than you may realize, 0:01:01.920 --> 0:01:05.360 and scurvy remains at large today, with those living in 0:01:05.400 --> 0:01:11.560 poverty being especially prone to the disorder. Many animals, including 0:01:11.640 --> 0:01:14.959 over four thousand kinds of our fellow mammals, never get 0:01:15.040 --> 0:01:18.920 scurvy because they produce their own vitamin C, but a 0:01:18.959 --> 0:01:23.080 handful of creatures are unable to manufacture it. These unlucky 0:01:23.080 --> 0:01:28.440 beasts include fruit bats, guinea pigs, and primates. Like us, 0:01:28.440 --> 0:01:31.720 Scientists don't know why our ancestors lost the ability to 0:01:31.760 --> 0:01:35.600 make vitamin C. Other species use a specific gene to 0:01:35.760 --> 0:01:40.040 create an enzyme that's needed for the vitamin's production process. However, 0:01:40.240 --> 0:01:44.720 in the human body, that gene isn't functional. We thus 0:01:44.800 --> 0:01:49.600 have no choice but to acquire vitamin C by ingesting it. Lemons, oranges, 0:01:49.600 --> 0:01:52.040 and other citrus fruits are loaded with the stuff, as 0:01:52.080 --> 0:01:55.280 are fresh green veggies like broccoli and spinach. You can 0:01:55.280 --> 0:01:58.440 also find it in potatoes, tomatoes, and red peppers, among 0:01:58.480 --> 0:02:03.840 other things that actually might help explain humankind's gene problem. 0:02:04.640 --> 0:02:08.280 Our distant ancestors lived in lush tropical areas and got 0:02:08.320 --> 0:02:11.520 plenty of vitamin C in their fruit heavy diets, so 0:02:11.800 --> 0:02:15.840 if a random mutation prevented some individuals from manufacturing the vitamin, 0:02:16.120 --> 0:02:18.959 it wouldn't have hurt their odds of survival because fruits 0:02:18.960 --> 0:02:23.519 and vegetables were widely available. Since the mutation was harmless, 0:02:23.639 --> 0:02:27.080 natural selection didn't weed it out, and over time the 0:02:27.120 --> 0:02:31.919 genetic quirk spread. Unfortunately, by the dawn of human civilization, 0:02:32.240 --> 0:02:35.280 Homo sapiens had settled in places where vitamin C rich 0:02:35.320 --> 0:02:41.200 foods weren't always easy to find. But okay, why do 0:02:41.240 --> 0:02:44.040 we need vitamin C and what happens when we don't 0:02:44.080 --> 0:02:47.639 get it? Vitamin C plays a critical role in the 0:02:47.680 --> 0:02:51.280 synthesis of collagen. Collagen is a type of protein that 0:02:51.320 --> 0:02:55.000 your body uses to add structure, strength, and flexibility to 0:02:55.200 --> 0:02:59.200 all kinds of different tissues. Tendons and bones derive much 0:02:59.200 --> 0:03:03.000 of their support opacity from collagen fibers. A Collagen also 0:03:03.040 --> 0:03:06.440 makes your skin tough but elastic, and helps blood clot 0:03:06.720 --> 0:03:09.800 and cuts to heal when injured. It also lends a 0:03:09.840 --> 0:03:12.200 hand in reinforcing the walls of your blood vessels and 0:03:12.240 --> 0:03:17.440 your internal organs to keep making collagen. A healthy and 0:03:17.520 --> 0:03:20.280 properly fed human body will burn through about eight to 0:03:20.280 --> 0:03:23.799 ten milligrams of vitamin C every day. That's about zero 0:03:23.840 --> 0:03:27.519 point zero zero zero three ounces, although it's recommended that 0:03:27.560 --> 0:03:31.320 adults eat at least ten times that amount, and if 0:03:31.320 --> 0:03:33.680 that sounds like a small number, it kind of is. 0:03:34.360 --> 0:03:36.960 You can get your daily recommended intake by eating an 0:03:36.960 --> 0:03:39.600 orange or a cup worth about two hundred and fifty 0:03:39.600 --> 0:03:42.960 milli liters of fruit or vegetables like strawberries, bell pepper, 0:03:43.040 --> 0:03:47.000 or brussels sprouts, and fruits and veggies aren't the only 0:03:47.040 --> 0:03:49.840 place you can get vitamin C. A case in point 0:03:50.600 --> 0:03:54.480 many of the Arctics indigenous peoples who for millennia subsisted 0:03:54.520 --> 0:03:57.960 on traditional meat based diets with very few vegetables and fruits, 0:03:58.360 --> 0:04:02.280 but they rarely experienced scurvy outbreaks because it turns out 0:04:02.360 --> 0:04:04.520 that some raw meats are a pretty good source of 0:04:04.600 --> 0:04:08.200 vitamin C, and lots of organ meat like caribou liver, 0:04:08.520 --> 0:04:13.000 is naturally rich in it. However, you get your vitamin C, 0:04:13.400 --> 0:04:16.640 your bloodstream is really good at distributing it around the body. 0:04:17.560 --> 0:04:20.840 But if you go sixty to ninety days without ingesting 0:04:20.920 --> 0:04:24.359 any and your internal supply dips too low, a scurvy 0:04:24.440 --> 0:04:28.760 will begin to take hold. At first, it's hardly noticeable. 0:04:29.240 --> 0:04:32.360 In the early stages, a person will feel lethargic, a weak, 0:04:32.400 --> 0:04:35.599 and achy. They may also experience weight loss and a 0:04:35.640 --> 0:04:39.920 reduced appetite. As time wears on, symptoms get more grotesque 0:04:40.160 --> 0:04:43.520 unless the person writes the ship by ingesting more vitamin C. 0:04:45.480 --> 0:04:49.240 Unchecked scurvy causes the gums to swell, bleed, and loosen 0:04:49.240 --> 0:04:51.840 the teeth at their roots. A pain breaks out in 0:04:51.880 --> 0:04:55.000 the joints and muscles. The skin loses its ability to 0:04:55.000 --> 0:04:58.839 form scar tissue, so old wounds may reopen and new 0:04:58.839 --> 0:05:03.640 ones will refuse to hear. Internal bleeding causes splotchy marks 0:05:03.640 --> 0:05:07.039 to appear under the skin, and deeper down the bones 0:05:07.080 --> 0:05:11.560 themselves will become weak. If the disorder isn't treated, a 0:05:11.600 --> 0:05:16.240 fevers arise and gangrene sets in. Slowly but surely. The 0:05:16.240 --> 0:05:19.159 person will die, often as the result of a fatal 0:05:19.160 --> 0:05:23.279 hemorrhage in the heart or brain. The explorer Robert Falcon 0:05:23.360 --> 0:05:27.200 Scott wrote that once late stage scurvy has taken hold, quote, 0:05:27.440 --> 0:05:32.400 death is a merciful release. Scott famously died in the 0:05:32.440 --> 0:05:36.200 Antarctic in nineteen twelve, by which time scurvy had been 0:05:36.240 --> 0:05:40.120 a global nuisance for thousands of years. Hippocrates was aware 0:05:40.160 --> 0:05:43.119 of it, and an Egyptian document written in fifteen hundred 0:05:43.200 --> 0:05:47.560 BCE describes the malady symptoms. A scurvy was prevalent during 0:05:47.600 --> 0:05:50.799 the Crusades, when armies were made to march across vast 0:05:50.800 --> 0:05:54.800 distances with limited access to fresh fruits and vegetables. It 0:05:54.960 --> 0:05:57.480 also claimed a number of lives during the Irish potato 0:05:57.520 --> 0:06:02.880 famine and the American Civil War. Early seafarers like the 0:06:02.880 --> 0:06:06.520 Phoenicians and the Vikings carried fresh food on voyages, and 0:06:06.600 --> 0:06:11.200 they didn't report the disease. However, scurvy became associated with 0:06:11.279 --> 0:06:15.120 sailing when between around fifteen hundred and eighteen hundred CE, 0:06:15.520 --> 0:06:19.599 some two million sailors died of it. Scurvy was the 0:06:19.680 --> 0:06:23.040 leading cause of naval death at the time, outstripping battles 0:06:23.040 --> 0:06:26.560 and disasters. This was due to the poor diet of 0:06:26.640 --> 0:06:30.599 colonial era sailors. They ate mainly food that wouldn't spoil 0:06:30.640 --> 0:06:35.039 on long voyages, like salted meats, hard biscuits, beer, and peas, 0:06:35.880 --> 0:06:39.119 no fresh fruits or veggies on the menu. A living 0:06:39.120 --> 0:06:42.640 conditions aboard ship were also cramped and damp, which worsened 0:06:42.720 --> 0:06:45.520 the disease, as research has shown that people need more 0:06:45.600 --> 0:06:50.919 vitamin C in cold, damp conditions. The affliction's prevalence on 0:06:50.920 --> 0:06:54.080 the high seas started to decline after seventeen forty seven, 0:06:54.480 --> 0:06:57.960 which is when Scottish position James Lynde conducted the world's 0:06:57.960 --> 0:07:01.440 first clinical trial to demonstrate that lemons and oranges could 0:07:01.520 --> 0:07:05.200 cure scurvy. He gave different groups of sailors a variety 0:07:05.200 --> 0:07:08.000 of treatments for scurvy, and the citrus eating group was 0:07:08.040 --> 0:07:12.119 the only one to recover. Although Lynde wasn't the first 0:07:12.120 --> 0:07:15.680 person to suggest citrus as a cure, his published writings 0:07:15.680 --> 0:07:19.640 have been credited with spreading the knowledge. Some forty years later, 0:07:19.800 --> 0:07:23.320 in seventeen ninety five, the British Navy finally decreed that 0:07:23.400 --> 0:07:26.280 each sailor be given a daily ration of lemon juice. 0:07:26.320 --> 0:07:29.480 A later lime juice, and scurvy started to disappear from 0:07:29.520 --> 0:07:35.280 its fleet. Yet, despite the breakthroughs of lind and other researchers, 0:07:35.400 --> 0:07:40.679 scurvy was never completely eradicated. Around the world, scurvy cases 0:07:40.680 --> 0:07:43.480 tend to pop up in communities where residents don't have 0:07:43.560 --> 0:07:46.240 reliable access to foods that are rich in vitamin C. 0:07:47.400 --> 0:07:50.960 For example, following a drought in twenty seventeen, an outbreak 0:07:50.960 --> 0:07:54.720 of the disorder occurred in Kenya. It's also been reported 0:07:54.760 --> 0:07:57.520 that a full ninety five percent of the houseless population 0:07:57.640 --> 0:08:01.400 in Paris, France, is vitamin C deficient and therefore vulnerable. 0:08:03.680 --> 0:08:06.600 Over in the United Kingdom, the rate of scurvy related 0:08:06.640 --> 0:08:10.200 hospital admissions rose by twenty seven percent between twenty nine 0:08:10.200 --> 0:08:15.040 and twenty fourteen with a corresponding increase in malnutrition, and 0:08:15.240 --> 0:08:18.320 in recent years, multiple cases of scurvy have been documented 0:08:18.360 --> 0:08:24.320 within the United States, usually in low income populations a children, 0:08:24.440 --> 0:08:28.400 elderly people, people with food allergies, and crash dieters may 0:08:28.440 --> 0:08:31.960 also be at risk of developing scurvy. But there is 0:08:32.040 --> 0:08:36.439 good news. Scurvy isn't hard to treat. Post diagnosis, it 0:08:36.480 --> 0:08:39.360 could be remedied by increasing the patient's supply vitamin C. 0:08:40.280 --> 0:08:42.920 One can usually expect to make a complete recovery after 0:08:43.040 --> 0:08:45.800 about three months, and bleeding in the gums and skin 0:08:45.920 --> 0:08:48.280 can stop and as little as twenty four hours after 0:08:48.360 --> 0:08:56.520 receiving treatment. Today's episode is based on the article Scurvy, 0:08:56.600 --> 0:08:59.000 The Scourge of the High Seas Remains at Large Today 0:08:59.200 --> 0:09:02.719 on House Tofforkstyle, written by Mark Mancini. Brain Stuff is 0:09:02.760 --> 0:09:05.480 production of iHeartRadio in partnership with how stuffworks dot Com, 0:09:05.480 --> 0:09:08.280 and it is produced by Tyler Klang. Four more podcasts 0:09:08.280 --> 0:09:11.479 from my heart Radio visit the iHeartRadio app, Apple Podcasts, 0:09:11.520 --> 0:09:13.400 or wherever you listen to your favorite shows.