[Andrew K Fletcher]

I would like to add something that might have been overlooked in the lime and lemon study.

1.   Gum disease, mouth ulceration and abscess are all quickly cured by swishing lime or lemon juice around the mouth. The anti-microbial qualities of  these two fruits surpasses anything on the market today. My family have used this method to great effect over many years and found it to work perfectly, in fact, I believe I added a post some time ago.
2.   Now, if the route of blood poisoning, sickness and diarrhoea is from oral infection, then the lemons and limes would undoubtedly cleanse the infections, kill of tummy bugs and assist recovery. Which leaves us with the question of what exactly scurvy is?
3.   Lemon used as a contraceptive by prostitutes during and after intercourse has been shown to prevent aids! Fact! So not only is it antibiotic, anti fungal and anti viral, it is a highly efficient ant-spermicidal, immobilising sperm and killing in around 20 seconds. 
4.   Which I believe adds a little validity to Luka’s intriguing look at scurvy

Andrew

[Bored chemist]

Personally I use high proof vodka on cotton wool to kill mouth ulcers- it stings a bit but it works. Of course, I get enough vitamin C so this has nothing to do with scurvy, just the misfortune that a scratch inside my mouth gets infected.

If lemons cured all those problems then healthcare would look a little different. On the other hand if you got anything like enough lemon juice into someones bloodstream to make it inhospitable to bacteria then you would probably kill the patient. The stomach is very acid anyway so it's hardly in need of a shot of lemon juice to kill bugs.
Way back at the start of this post there were references to diluted vitriol not curing scurvy (trust me it's just as good an acid) and to cider not curing scurvy. Thanks to the alcohol, as well as the acidity, cider is a pretty good bactericide too.
Curing scurvy is not just a matter of acidity or killing bugs.
Curing scurvy is a matter of supplying the chemical that the body needs as a co-factor for the oxidation of proline to hydroxyproline.
The fact that lemon juice will kill lots of things isn't a great shock- the stuff is really quite acidic. However since scurvy is nothing to do with infection any anti-infective properties of lemons must be a coincidence.

BTW, pure ascorbic acid works to cure scurvy. The quantities of it needed are small enough not to have any direct anti infective effect.

I don't think any effect lemons have on microorganisms can add any validity to a discussion of a disease that doesn't involve any microorganisms.

[GBSB (OP)]

Andrew thanks for your constructive and informative comment. I am glad that you find interesting to question the theory about scurvy and vitamin C.
I am trying to explain that cause of scurvy wasn’t in sailors’ diet but it was due to biomechanical factor. I think that at this stage is too early to put completely theory forward because of strong established belief that absence or insufficient content of vitamin C in sailor’s diet was factor that caused incidence of scurvy. 
I hope you will find interesting and any possible future comments from you, whether support or contradict to my theory is valuable for me.   

Bored chemist wrote:
When did oranges fail to cure scurvy?

If oranges (and lemons) never failed to prevent and cure scurvy than is question why Lind made this trial. It will be enough to give oranges and lemons to every sailor that is affected with scurvy. But I think that on this stage for majority that sound as meaningless fact.

On the other side there are a few other facts that more seriously contradict to established wisdom about vitamin C and scurvy.

Let’s take look in events that happened in Vasco da Gama voyage in year 1497

One of the earliest outbreaks of scurvy at sea was sustained by the crew of Vasco da Gama during his 1497 expedition to India. Da Gama began his expedition from Lisbon on July 9, 1497, with a fleet of 4 ships and a crew of 140 men. It took them 6 months to round the Cape of Good Hope. By the time da Gama's crew landed on the southeast coast of Africa, most of them were afflicted with scurvy. Da Gama recorded: "Many of our men fell ill here, their feet and hands swelling, and their gums growing over their teeth so that they could not eat." As they sailed farther up the east coast of Africa, they met local traders, who traded them fresh oranges. Within 6 days of eating the oranges, da Gama's crew recovered fully and he noted, "It pleased God in his mercy that ... all our sick recovered their health for the air of the place is very good."
 http://pediatrics.aappublications.org/cgi/content/full/108/4/e76

It shows that eating orange 6 days (on the land) was enough to achieve full recovery from scurvy for everyone that was affected by scurvy. On this example it is clear that orange (vitamin C) are effective to cure scurvy.

But by second outbreak of scurvy it seems that the oranges wasn’t so effective to cure scurvy and Wasco Da Gama lost more than half of his crew.

From India, da Gama returned across the Arabian Sea. Within 12 weeks of sailing, his crew was again afflicted and weakened by scurvy. Da Gama commented: "We addressed vows and petitions to the Saints ... it pleased God in his mercy to send us a wind which in the course of six days, carried us within sight of land ... at this we rejoiced as ... we hoped to recover our health there as we had done before ... the Captain-Major sent a man on shore to bring off a supply of oranges which were much desired by our sick." Da Gama lost more than half of his crew by the end of his journey.

It is to conclude that by the second outbreak the crew didn’t land but continued to sail after fruits is supplied on the ship. They’ve where eating fruits on the travelling ship hoping that citrus will again cure the scurvy.
 
I couldn’t find more information how successful was  but if we take in account that he lost more than half of his crew by the end of journey it is to conclude that by second outbreak of scurvy the orange and lemons didn’t help to much if at all.

By first outbreak of the scurvy oranges was effective to counteract to the scurvy because the sailors where on the land, Whit another words they where on stabile ground and not on unstable moving platform that on the sea provide unstable wind powered ship. 

What was difference in outcome by treating scurvy on the ship and on the land can be understand from this link.

Once on shore it was a superstition among sailors that the smell and the touch of the earth gave the surest cure. http://www.bbc.co.uk/history/british/empire_seapower/captaincook_scurvy_02.shtml

People were aware that once victims were on shore they could be recovered by eating scurvy grass, wild celery, wood sorrel, nasturtiums, brooklime, Kerguelen cabbage (Pringlea antiscorbutica), cabbage trees and other esculent plants growing on the shores of distant islands. Fruit and palm wine were also esteemed to be fine remedies,
No one had a remedy for scurvy at sea - however; the best on offer was a battery of prophylactic measures, including portable soup (a preparation of dried vegetables), malt, sauerkraut, concentrated fruit juice (rob), vinegar, mustard, molasses and beans. These were aimed at repelling any sign of scurvy from the outset, since it was impossible to control it, once it had gained a footing, other than by going ashore.
http://www.bbc.co.uk/history/british/empire_seapower/captaincook_scurvy_02.shtml

This shows that not only citrus was effective to cure scurvy but as well nearly everything that grows on the land  was effective to cure scurvy.

During the voyage in 1497Vasco de Gama lost more than half of his crew but there is no mention that he lost any officer and it is to conclude that scurvy affected only poor sailors and the officers wasn’t affected with scurvy.

His crew sustained scurvy when they had been at sea for 10 weeks or more. http://pediatrics.aappublications.org/cgi/content/full/108/4/e76

In any document about scurvy that I have looked it is always mentioned crew and scurvy and never officers and scurry or crew and officers and scurry
It shows that only the people on the ship who are not officers where affected with scurvy and that officers wasn’t.

It is to conclude that at those times it was mystery that only poor sailors were vulnerable to scurvy and that officers didn’t.
   
Theory that scurvy is caused because of absence or insufficient amount of vitamin C in sailor’s diet is established long time after scurvy disappeared. Everything that supports this theory is accepted and exaggerated and everything that contradicts or questioned this theory is overlooked and ignored.
 
In this post I pointed out on two facts;
One fact is that treating scurvy on the land was always successful and that on the ship scurvy was nearly impossible to treat.

Second fact is that only crew was vulnerable to scurvy and that officer’s wasn’t.

I will tray to explain later but before in my next posts I will take a little bit more under scrutiny Lind’s trial and guinea pigs and as well nowadays diagnosis of scurvy?

Luka Tunjic
http://www.biomechanicsandhealth.com/

[Bored chemist]

"One fact is that treating scurvy on the land was always successful and that on the ship scurvy was nearly impossible to treat."
Lemons don't grow in the ocean. Vitamin C has poor storage qualities under the conditions usually found on ships of that era.

"Second fact is that only crew was vulnerable to scurvy and that officer's wasn't. "

One of the privileges of rank was that you got a better diet. Both groups were at sea so they were the same from that point of view. These 2 groups can be thought of as a first group who were badly fed (the sailors) who got scurvy and a second group who were relatively well fed (the officers) who didn't get scurvy.
I can't see that as evidence for anything other than scurvy being related to a poor diet.


The reports of De Gama's voyage, regretably, don't include enough information to really establish what happened. It's possible that spoilage of the fruit (which never did keep well) would have destroyed its vitamin C.
What is clear is that oranges cured the disease and that returning to the restricted diet of the ship provoked the disease again. So I'm still waiting for an answer to my question "When did oranges fail to cure scurvy?" I should make it clear that I mean lots of fresh oranges.
Unless you can give a clearly documented answer to this I think you are wasting your time (and the site's bandwidth).

"No one had a remedy for scurvy at sea - however; the best on offer was a battery of prophylactic measures, including portable soup (a preparation of dried vegetables), malt, sauerkraut, concentrated fruit juice (rob), vinegar, mustard, molasses and beans."
The fact that so many things are offered seems to me to be because none of them worked or, more likely they all worked to some degree and that degree was variable.

I'm also still waiting for you to answer my earlier question about guinea pigs; do they go sailing?

Since scurvy also happened on land, particularly in places like prisons where the food was poor, any ides that it's particularly related to ships or the sea are simply wrong.

As Iko says, look at the more modern, well documented cases and see what the beautiful truth is.

[GBSB (OP)]

Guinea pig and quack-theory

The facts about experiment on which is based theory that guinea pigs can’t synthesise vitamin C.

In 1902, Axel Holst, a Norwegian professor of bacteriology and hygiene who had been concerned at the appearance of what had been diagnosed as beriberi in the crews of Norwegian sailing ships, seized an opportunity to visit Grijns in Batavia and to see his work on chicken polyneuritis. On his return to Oslo, he attempted to obtain a closer model of "ship-beriberi" by using a mammal as his experimental species, and chose guinea pigs. He fed them grains, either whole or milled, and found that they all died within  30 d. When the carcasses were opened he saw "pronounced hemorrhages" and looseness of the molar teeth. Theodor Frölich, a pediatrician with experience of infantile scurvy, confirmed that the condition appeared to be scurvy with no evidence of any kind of polyneuritis. The two men then found that the condition was not produced by semistarvation, and that it was prevented by giving two traditional antiscorbutics, lemon juice and fresh cabbage
http://jn.nutrition.org/cgi/content/full/133/4/975

Before any discusion is usefull to remind of some facts about guinea pigs.

Grass is the guinea pig's natural diet.

Guinea pigs tend to be fickle eaters when it comes to fresh fruits and vegetables, having learned early in life what is and is not appropriate to consume, and their habits are difficult to change after maturity.[

They do not respond well to sudden changes in diet; they may stop eating and starve rather than accepting new food types

A constant supply of hay or other food is generally recommended, as guinea pigs feed continuously and may develop habits such as chewing on their own hair if food is not present

Guinea pigs are prey animals whose survival instinct is to mask pain and signs of illness, and many times health problems may not be apparent until a condition is severe or in its advanced stages.

Treatment of disease is made more difficult by the extreme sensitivity guinea pigs have to most antibiotics, including penicillin, which kill off the intestinal flora and quickly bring on episodes of diarrhea and death
http://en.wikipedia.org/wiki/Guinea_pigs

Taking in account that grass is guinea pigs natural diet and that grains, either whole or milled isn’t, shows that feeding the guinea pigs with grains either whole or milled is actually exposing them to starvations to the some extent and in the same time to the some extent of slow poisoning (semi starvation combined with slow poisoning),

They didn’t prevent death of guinea pigs by giving them lemon juice by continuing to feed them with grain, either whole or milled.

They didn’t prevent death or reverse condition induced by feeding guinea pigs with the grain by continuing the feeding with grain and cabbage because the guinea pig will ignore the grains, either whole or milled and will eat only cabbage because cabbage is guinea pigs  natural diet and grain, whole or milled is not..
 
They prevented (condition) guinea pigs from death by giving them, lemon juice and fresh cabbage.

Taking in account that guinea pigs “do not respond well to sudden changes in diet; they may stop eating and starve rather than accepting new food types” it is questions how Axel Holst convinced guinea pig to eat grain at all. It is like convince lions to eat broccoli and lemons.

Lion natural diet is meat and if you fed them with broccoli and lemon the lions surly will develop scurvy if he doesn’t die before.

This experiment on which is founded theory that gunea pigs can’t syntetise  vitamin C can be simply described as; with metod of slow poisioning and semi starvation by guinea pig is induced condition that is treated by discontinuing the starvation and slow poisioning and repleaced with natural diet (cabbage) and aded a drop of snake oil (lemon juice).
 
Healing and remedial property of the lemon juice and citrus in general the humans discovered long time age only in this case the lemons juice is used as snake oil.

Luka Tunjic
http://www.biomechanicsandhealth.com/

[Bored chemist]

Your quote says
"The two men then found that the condition was not produced by semistarvation, and that it was prevented by giving two traditional antiscorbutics, lemon juice and fresh cabbage"
then you say the curative effect is due to the gabbage being their natural diet. Earlier you had pointed out that grass was their natrual diet. Last time I checked cabbage was not a grass.
Add to this the fact that you say that grain is poisonous whereas, in reallity it is part of the grass that is the guinnea pig's natural diet, and I think you are short of credibility.
I think that a lion living on broccoli and lemons might have any number of nutritional problems but I note that you have offered no evidence whatsoever that these problems would include scurvy- you have simply stated it and expect us to have faith in your opinion.

[VitaminC]

I'd like to point out, if I can, that Guinea Pigs (in a laboratory, or a domesticated form) have severe mutations in the enzyme that synthesizes vitamin C, and are not capable of doing so at a genetic level. It doesn't really matter what "remedies" this condition, the fact is that they cannot make vitamin C unless someone provides them the gene to do so.

The 'wild' guinea pigs of South America may be a different story. Until someone completes genetic a study on them, we will never know.

As for prevention of scurvy without fresh fruits and vegetables? Sure, it's possible. It's called raw meat. Plenty of vitamin C in that.

[VitaminC]

In this post I pointed out on two facts;

Not true, you pointed out two suppositions.

One fact is that treating scurvy on the land was always successful and that on the ship scurvy was nearly impossible to treat.

Plants have vitamin C. Eating any non-cooked plant will give you some vitamin C - they synthesize it constantly.

Actually the data (without your interpretation) you presented suggests to me that the second bout of scurvy was treated by the citrus, but the sailors already had depressed levels of ascorbic acid in their bodies. If they depleted their tissue stores of vitamin C the citrus infusion could only help so much. What likely occurred is that they raised their ascorbic acid levels above deficiency, but not high enough to delay the reappearance of scurvy for too long. 10 weeks is more than enough time to deplete your vitamin C tissues stores if you don't have very high levels to begin with.

Second fact is that only crew was vulnerable to scurvy and that officer’s wasn’t.

This is not uncommon. Officers likely had better diets before and during the voyage. Did they eat any potatoes? Cabbage? Rare/fresh meat? Much more vitamin C in those than what the crew got - salted meat and breads. Officers still got scurvy, just not as often.

I don't know what you are suggesting as a "biomechanic" factor that might cause scurvy. People who don't move at all still get scurvy. It's biochemistry, not biomechanics.

[iko]

Hi VitaminC,

to revive our discussion here
I have a question for you all:
how do scorbutic patients die
if they are not cured on time?

ikoD

[Bored chemist]

The simple answer is horribly.

[iko]

The simple answer is horribly.

Yes B.C.,

horribly enough, I agree with you.
Interestingly, bleeding is not reported as a major problem, in spite of decreased platelet activity, anemia and jammed collagen synthesis.
Untreated patients had been reported succumbing from heart failure and/or infections, mainly pneumonia.
In the last few centuries.
So if you find a starving or malnourished human being: alcoholic, anorectic, starvation striker or so, and heart failure seems to be a major problem, never forget ascorbic acid and thiamine.
Vitamin C and vitamin B1 are the first to go.
No efficient storage available in humans.
Mitochondria stop producing enough energy from sugar(vit.B1 deficiency), it's like having low batteries for our body: the game is almost over.
No laboratory test available on an emergency routine.
A quick injection of thiamine* and little ascorbic acid by mouth. Easy and cheap.
Only after parenteral thiamine you can feed glucose safely, without taking the risk of lactic acid overproduction and the so called 'refeeding syndrome'.
This is biochemistry for kids.

ikod  [^]

*) Thiamine 100mg i.m.: there is a limited intestinal absorption of approx. 2.5mg/day, so the oral route is unusable in acute deficiency cases. Heart response is reported to be a matter of hours.

[VitaminC]

Mitochondria stop producing enough energy from sugar(vit.B1 deficiency), it's like having

Don't forget the lack of carnitine production in Vitamin C deficiency. Fatty acids aren't burned for fuel either!

A quick injection of thiamine* and little ascorbic acid by mouth. Easy and cheap.

You could do an injection of ascorbic acid too. Bypass any problems with uptake in the gut. In this case you could do up to gram doses of vitamin C IV or IP. However, this would not likely be necessary - there haven't been that many cases of poor vitamin C uptake by oral administration.

[iko]

Hi VitaminC,

thanks for your further contribution.
I am afraid that this intensive cofactor administration protocol is not in any guideline of sort, and a bit neglected in the medical practice.
Years ago a so called 'coma cocktail' was proposed for patiens found unconscious: one of the 4 drugs in it was thiamine.  Later on this practice has been criticized and I suppose abandoned by most ICU operators.
Undiagnosed beri-beri may be a lethal reality still.
Though it probably is a rare condition, more efforts should be made to spot it and treat it (easily).

ikod

[iko]

Hi VitaminC,

to revive our discussion here
I have a question for you all:
are there simple signs of a
subclinical scurvy, available
in everyday clinical practice?

ikoD  [^]

[Bored chemist]

OK this isn't a proper, double-blind trial; but I get mouth ulcers a lot less often now that I regularly take vitamins. (My diet isn't very rich in vitamin C because I simply don't like the things that are good sources of it).
Incidentally, what's the definition of sub-clinical?

[iko]

OK this isn't a proper, double-blind trial; but I get mouth ulcers a lot less often now that I regularly take vitamins. (My diet isn't very rich in vitamin C because I simply don't like the things that are good sources of it).
Incidentally, what's the definition of sub-clinical?

Group B vitamins, Zinc or iron deficiency, coeliac disease, have been suggested as diet-related causes of mouth ulcers.  So there could be a correlation in your case.

A cofactor/vitamin deficiency can be defined 'subclinical' when laboratory examinations show low values, the diet history itself suggests lack of a certain vitamin (anorexia, starvation, faddist diets, unsupplemented parenteral nutrition, etc.), but the patient feels fine and well.  Actually, it would be better to say that the patient still does not shows the classic symptoms of a vitamin deficiency (scurvy in this case).

What could we expect in a child who had been eating for several weeks only pasta/chips and no fruit and veggies?

ikod   []

[iko]

The ascorbate and carnitine connection still needs further confirmation studies:

Is sudden death with vitamin C deficiency caused by lack of carnitine?

Okamoto M, Ueno Y.
Department of Legal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan. myok@med.kobe-u.ac.jp

We investigated the effect of carnitine supplementation during vitamin C (ASC) deficiency by measuring the levels of ASC and carnitine in plasma and cardiac muscle cells (CMC), and histological analysis with electron microscopy. The levels of carnitine were significantly decreased in ASC-deficient rats in plasma and the heart than those in the control. In carnitine supplemented ASC-deficient rats, a significant increase of carnitine levels were observed in both plasma and heart. The number of lipid droplets significantly increased in the ASC-deficient rats compared to the control rats, but did not increase in carnitine supplemented rats. These results indicate that ASC deficiency causes a generalized mitochondrial abnormality and accumulation of lipid droplets in CMC as observed in carnitine deficiency, and supplementation of carnitine prevented these changes even in the presence of ASC deficiency.

J Clin Forensic Med. 2006 Jan;13(1):26-9.

It sounds a bit odd to me: were not rats able to make their own ascorbic acid?

ikod   []

[rosy]

Strains of lab rats/mice/etc have been bred with all sorts of deficiencies, to mirror conditions affecting humans. If asked to guess I'd speculate that was why the rats in this instance weren't making their own ascorbate.

[iko]

Strains of lab rats/mice/etc have been bred with all sorts of deficiencies, to mirror conditions affecting humans. If asked to guess I'd speculate that was why the rats in this instance weren't making their own ascorbate.

Yes rosy,

they probably had 'knocked out' the enzyme gene
involved in ascorbate synthesis. This information
probably is in the full-text version which I cannot
reach.
Thanks for your reply...somebody is alive around here!

ikod   []

[VitaminC]

they probably had 'knocked out' the enzyme gene
involved in ascorbate synthesis. This information
probably is in the full-text version which I cannot
reach.

Actually, if you look in the keywords in the abstract you can see the words "ODS rat" which refers to Osteogenic Disorder Shinogi (sp?) a rat strain that has no inherent acorbate synthesis - mutation in the L-gulonolactone oxidase gene. They are often used in ascorbate depletion studies, but they do have a couple other things wrong with them - they are an inbred model afterall.

are there simple signs of a
subclinical scurvy, available
in everyday clinical practice?

No. (simple answer)

The first reported symptom of vitamin C deficiency (before the onset of full scurvy symptoms) is fatigue. As you well know, that could be a result of anything. In the case of scurvy (or vitamin C deficiency) this is likely due to carnitine levels falling. However, since vitamin C levels (or carnitine as far as I know) are not in standard laboratory tests, I'm not sure how you would diagnose this in a patient except by looking at their diet.

What could we expect in a child who had been eating for several weeks only pasta/chips and no fruit and veggies?

See for yourself:
http://pediatrics.aappublications.org/cgi/content/full/108/3/e55?ck=nck [nofollow]

Besides exhaustion and weakness, there is usually some bleeding of the gums and joint pain, but also skin abnormalities (small petechial hemmorhages) and what they have termed "corkscrew" hair growth. Even with those symptoms, many patients don't realize something is wrong with their diet...