(and a short history of scurvy, beriberi, and pellagra)
Our knowledge of the chemical composition of vitamins and their importance in nutrition is relatively young, whereas the history of vitamin deficiencies goes back centuries.
Scurvy is probably the first illness to be recognized (though not right away, as you will see) as a nutritional deficiency disorder. Its main symptom is massive hemorrhaging; one’s arteries, lacking sufficient vitamin C begin to pit and then finally break open causing internal hemorrhaging. Prior to this, the individual feels exhausted and weak, his gums start to bleed, and diarrhea sets in. Death was far too common the final result. (For more on vitamin C and its connection to arterial health, you might wish to peruse our category Cardiovascular Care.
Hippocrates first described scurvy as bleeding gums, hemorrhaging and death in the 5th century BC. Outbreaks of scurvy were reported in 1500 BC Egypt, during the winters when fresh produce was scarce. In 1250, during the Crusades, rampant scurvy forced the retreat and eventual capture of St. Louis and his knights. However, it was the age of exploration and extended sea voyages that scurvy earned its deadly reputation.
From Dr Mark R. Anderson’s article A Short History of Scurvy [removed from the web], I learned of a legend involving the voyages of Christopher Columbus. It seems some Portuguese sailors had come down with scurvy and asked to be dropped off at one of the nearby islands. They preferred to die there rather than on board where they would be fish food. On the return trip months later, the crew were all shocked and surprised to see the men, who everyone thought were dead, waving to them from the shores, alive and healthy. The island was named Curacao, meaning Cure. It is abundant with fresh fruit.
Native Americans had concocted the first cure for scurvy. They drank a tea consisting of pine bark and needles. Jacques Cartier, a French explorer who had lost 25 members of his crew before the natives taught him this remedy, brought this marvelous cure back to France in 1536 where it was immediately dismissed by the medical profession who knew better than a bunch of wild savages.
Dr Anderson’s article points out that “as early as 1593, during a voyage to the South Pacific, Sir Richard Hawkins recommended the following treatment for scurvy:
That which I have seen most fruitfull for this sicknesse, is sower [sour] oranges and lemmons.
One of the most interesting bits of information ever laid before my eyes is an unintentional controlled study performed in 1601 by Captain James Lancaster. He captained one ship among a fleet that set sail in late April, and by the time they had arrived at their destination in September of that same year, the other ships had been so devastated by scurvy that Lancaster’s men, healthy and whole, had to assist the other ships into the harbor. Lancaster sent a report to the Admiralty explaining that he had brought on board bottles of lemon juice and every man took three spoonfuls each morning.
John Woodall published his book The Surgeon’s Mate in 1636 wherein he stated in reference to scurvy:
The juyce of lemmons is a precious medicine and well tried; being sound and good. Let it have the chief place for it will deserve it. The use whereof is: It is to be taken each morning two or three teaspoonfuls, and fast after it two hours. Some chirurgeons also give of the juyce daily to the men in health as preservative.
However, it wasn’t until 1747, when the Scottish physician James Lind aboard the Salisbury experimented with a number of food combinations on patients suffering from scurvy that the British Admiralty started to pay attention. Lind discovered that those who were given an orange and lemon combination recovered, and recovered quite swiftly. Even with this information, it wasn’t till 1770 that the British Navy began recommending that ships carry sufficient lime juice for all aboard. When the colonies revolted, the Colonial Army too used fruit to keep their soldiers healthy, while some were treated to the Native American infusion of pine bark and needles when fruit was out of season. “In 1795,” Dr Anderson tells us, “the Admiralty finally mandated lemon juice for all sailors.”
Louis H. Roddis’s A Short History of Nautical Medicine tells us, “In the 200 years from 1600 to 1800 nearly 1,000,000 men died of an easily preventable disease. There are in the whole of human history few more notable examples of official indifference and stupidity producing such disastrous consequence to human life.” Stick around for the story on pellagra (in this article), and you’ll see another example of governmental foot dragging.
History books tell us of two Norwegian scientists who were able to produce scurvy in guinea pigs in their laboratories. The irony is that they were trying to produce beriberi. Another irony is that guinea pigs and humans share one very similar trait: neither of us can synthesize vitamin C. All other animals have an “enzyme that catalyzes the oxidation of L-gluconactone to L-ascorbic acid, allowing them to synthesize vitamin C in amounts adequate for metabolic needs.” [Original reference UC Berkeley College of Chemistry . . . but now removed from the web.]
In the late 1800s a Dutch physician Christiaan Eijkman discovered that substituting unpolished rice for polished rice would prevent beriberi, a terrible disease which caused anemia and paralysis and was found mainly among the poor. But it wasn’t till 1911 when a Polish chemist discovered the actual substance in unpolished rice that prevented the disease. It was a substance categorized as an amine, a type of nitrogen-containing compound. Funk realized that it was a substance vital to proper body function and thusly named it a “vital amine” or vitamin.
Ironically, it was Eijkman who was awarded the Nobel Prize in 1929 for the discovery of vitamins, when he had actually spent a good portion of his career trying to prove that beriberi was caused by an infection. His nemesis, a general practitioner by the name of Evart van Dieren held onto the opinion that beriberi was caused by a poison. Squabbles developed into full blown battles as these two fought each other through letters filled with invectives and papers published that were extremely polemical [passionate] as Dr van Dieren held his ground claiming that Dr Eijkman had failed to pinpoint the cause of beriberi. What this amounted to was simply a battle between two egos who held their ground and fired volleys at each other vis-à-vis the scientific community, while Casimir Funk persevered in his laboratory to find the actual cause. Eijkman had found a preventative measure for beriberi in using unpolished rice, but stuck to his guns that this somehow prevented an “infection” rather than a nutritional disorder.
In 1912, Funk and the British biochemist Sir Fredrick Hopkins (one of the founders of modern biochemistry) proposed the Vitamin Hypothesis of Deficiency, theorizing that the absence of a particular vitamin in one’s diet could lead to certain diseases.
Sir Hopkins had established his methodology in an experiment whereby he fed mice “a synthetic diet of pure carbohydrate, pure protein, fats, and salts, Hopkins observed that the mice would stop growing unless their diet was supplemented with milk. The milk, he concluded, must contain small amounts of what he called ‘additional food factors’ in order for growth and the maintenance of health…. Hopkins succeeded in isolating what became known as vitamins A and D.” [Hopkins, Sir Fredrick Gowland.”Microsoft® Encarta® Encyclopedia 2001. © 1993-2000 Microsoft Corporation. All rights reserved.]
Thus, by depriving animals of different types of foods in controlled experiments, scientists could now identify a number of substances that would be soon classified as “vitamins.” Here we have both the beginning of the nutritional sciences and the initial roots and reason to the formation of the organization: People for the Ethical Treatment of Animals (PETA).
But not all of these vitamins were vital amines. Ascorbic acid wasn’t an amine. It was an acid. So what? The word vitamin became popular and the name stuck.
Ascorbic acid was the third substance found (actually, theorized) so it was given the third letter of the alphabet: C. Hence it’s new name, vitamin C. Actually ascorbic acid wasn’t discovered till 1928 by an Hungarian scientist, Szent-Gyorgyi who isolated the substance that could treat scurvy. But an anti-scurvy (antiscorbutic) vitamin was postulated in 1911, just in time to be considered the third (or “C”) vitamin discovered. Since it was anti-scurvy or a-scorbutic, it got the name ascorbic acid.
Interestingly enough, ascorbic acid, by itself, does not cure scurvy. One needs to add some bioflavonoids to potentiate the ascorbic acid. Today you will see dictionaries referring to vitamin C as ascorbic acid, while many in the naturopathy and nutritional sciences feel that all vitamins are not just a single entity but that they are all complex entities. In health food stores, when you purchase vitamin C you will see varieties called Vitamin C Complex, which is closer to the actual vitamin than ascorbic acid alone. Modern science loves the theory of the “active ingredient.” Modern science lives and dies over the philosophy of reductionism: reducing something to its active ingredient. In nature, we use every part of an herb and not just the active ingredient. An herb is more than the sum of its parts. If you want to read more on this, read: An Herb is More Than its Active Ingredient. This is one reason we always recommend whole foods over supplementation.
Now, back to Christiaan Eijkman: how the heck did he get a Nobel Prize? Well, it seems that he discovered that it was a particular B vitamin that caused beriberi (even though he, himself, didn’t actually accept his test results for a time), and that was B1 or thiamine, a true amine as you can see from its name.
Eijkman and Hopkins shared the 1929 Nobel prize in medicine, but Eijkman’s greatest contribution to medicine was discovering how wrong one can be while blindly sticking to one’s guns; he learned to allow the scientific process to determine truth, and he learned to play nicely with his little friends.
Pellagra is a disease that was common throughout the world, and still is in some parts. It had been a little too common in the poor south, and with the economic downturn and crop failures in the early 1900s, pellagra had blossomed into a full blown epidemic. The disease causes skin rashes, especially when exposed to sunlight, mouth lesions, diarrhea, and if left long enough, mental deterioration.
In 1914 the surgeon general appointed Dr Joseph Goldberger, a member of the public health service for fifteen years, to tackle the crisis of pellagra.
Goldberger first merely observed the disease. He took notes, asked questions, and watched. He noted that the diet of the poor in the region consisted of cornbread, molasses, and some pork fat. The poorer the people the more likely they were to get pellagra. He noted that institutions, prisons, orphanages, and asylums had many cases of pellagra.
At the time, the germ theory of disease had taken hold of medical thought, and it was assumed that pellagra was an infectious disease. Additionally, society is hardly ever ready to accept the idea that poverty could possibly cause a disease. So, when Goldberger concluded that pellagra was a nutritional disease, the medical community was less than happy to receive this news.
So, in order to prove his theory, Dr Goldberger approached a prison to ask their aid in conducting a nutritional study. The prisoners who volunteered for the experiment would be pardoned. He did his best to separate the two groups so that infectious disease could be ruled out. Because it was a farm prison and their basic nutrition was good, there were no cases of pellagra. Goldberger separated his two groups, gave his experimental group the diet of the southern poor: cornmeal, molasses, and pork fat, and sure enough, within a few months, his experimental group came down with pellagra. Then to test whether pellagra was infectious, the researchers tried to “catch” the disease from the ill prisoners, but were unable. Finally, when given meat, fresh vegetables, and milk, the pellagra symptoms all vanished.
Still, given this evidence, the medical community was unwilling to accept his study. Goldberger tried repeatedly to convince others, but eventually gave up and spent the rest of his life looking for the “exact” nutritional factor that caused pellagra, but it would be discovered only after his death. Goldberger’s career carried him to Washington DC where he had researched infectious diseases for an organization that would eventually become the National Institute of Health.
Finally, in 1937, Conrad Elvehjem discovered that a B vitamin, nicotinic acid, or niacin, prevented and cured pellagra in dogs.
In the 1930s many more discoveries were made in the world of biochemical nutrition. All the vitamins were named and classified.
Today we have the Required Daily Allowances put forward by the Food and Nutrition Board of the National Research Counsel. The RDAs are the minimum wage of nutrition: you can barely survive on them. The RDA for vitamin C will keep you from getting scurvy, but doesn’t protect you well from the onslaught of environmental toxins.
According to Albert Szent-Gyorgyi the Nobel-prize winner for his discovery of vitamin C, “The medical profession itself took a very narrow and very wrong view. Lack of ascorbic acid caused scurvy, so if there was no scurvy there was no lack of ascorbic acid. Nothing could be clearer than this. The only trouble was that scurvy is not a first symptom of a lack but a final collapse, a premortal syndrome and there is a very wide gap between scurvy and full health.”
Your dog creates (synthesizes) the human equivalent of 2800 milligrams of vitamin C per day, yet your government, at the prodding of the medical community, recommends a mere 60 milligrams per day for human beings. What’s wrong with this picture?
Today, with our environmental pollution, veterinarians are telling us that our pets should be supplemented because they cannot make enough vitamin C. What does this say for humans?
There are many nutritionists who would like to see the RDA replaced with ODA, or Optimum Daily Allowances which would be based upon an individual’s age, lifestyle, and location (since the quality of our air and water changes from location to location).
And there are a few purists, like myself, who want you to eat plenty of fresh organic fruits and vegetables, and supplement only when necessary.