In former times this disease was extremely common among sailors, and gave rise to a frightful amount of mortality. It is now, however, of rare occurrence at sea, its cause being well understood and its prevention readily secured by simple measures. Scurvy has also frequently broken out among soldiers on campaign, in beleaguered cities, as well as among communities in times of scarcity, and in prisons, workhouses, and other public institutions. In all such instances it has been found to depend closely upon the character and amount of the food. It has been supposed that a too limited diet, either in amount or variety, might induce the disease; but an overwhelming weight of evidence goes to prove that the cause resides in the inadequate supply or the entire want of fresh vegetable matter. The manner in which this produces scurvy is not quite clear. Some high authorities have held that the insufficient supply of potash salts, in which vegetables are rich, is the procuring cause; but it has been found that the mere administration of these salts will neither prevent nor cure scurvy. Hence, while it is probable that this may be one of the factors concerned in the production of the disease, the want of other vegetable constituents, especially vegetable acids, is of still greater importance. Besides this essential defect, a diminution in the total amount of food, the large use of salted meat or fish, and all causes of a depressing kind, such as exposure, anxiety, bad hygiene, &c., will powerfully contribute to the development of the disease. See Dietetics, vol. vii. pp. 207-208.

The symptoms of scurvy come on gradually, and its onset is not marked by any special indications beyond a certain failure of strength, most manifest on making effort. Breathlessness and exhaustion are thus easily induced, and there exists a corresponding mental depression. The countenance acquires a sallow or dusky hue; the eyes are sunken; while pains in the muscles of the body and limbs are constantly present. The appetite and digestion may be unimpaired in the earlier stages and the tongue comparatively clean, but the gums are tender and the breath offensive almost from the first. These preliminary symptoms may continue for weeks, and in isolated cases may readily escape notice, but can scarcely fail to attract attention where they affect large numbers of men. In the further stages of the disease all these phenomena are aggravated in a high degree and the physical and mental prostration soon becomes extreme. The face looks haggard; the gums are livid, spongy, ulcerating, and bleeding; the teeth are loosened and drop out; and the breath is excessively fetid. Extravasations of blood now take place in the skin and other textures. These may be small like the petechial spots of purpura (see Purpura), but are often of large amount and cause swellings of the muscles in which they occur, having the appearance of extensive bruises and tending to become hard and brawny. These extravasations are most common in the muscles of the lower extremities; but they may be formed anywhere, and may easily be produced by very slight pressure upon the skin or by injuries to it. In addition, there are bleedings from mucous membranes, such as those of the nose, eyes, and alimentary or respiratory tracts, while effusions of bloodstained fluid take place into the pleural, pericardial, or peritoneal cavities. Painful, extensive, and destructive ulcers are also apt to break out in the limbs. Peculiar disorders of vision have been noticed, particularly night-blindness (nyctalopia), but they are not invariably present, nor specially characteristic of the disease. The further progress of the malady is marked by profound exhaustion, with a tendency to syncope, and with various complications, such as diarrhoea and pulmonary or kidney troubles, any or all of which may bring about a fatal result. On the other hand, even in desperate cases, recovery may be hopefully anticipated when the appropriate remedy can be obtained. The composition of the blood is materially altered in scurvy, particularly as regards its albumen and its red corpuscles, which are diminished, while the fibrine is increased.

No disease is more amenable to treatment both as regards prevention and cure than scurvy, the single remedy of fresh vegetables or some equivalent securing both these ends. Potatoes, cabbages, onions, carrots, turnips, &c., and most fresh fruits, will be found of the greatest service for this purpose. Lime juice and lemon juice are recognized as equally efficacious, and even vinegar in the absence of these will be of some assistance. The regulated administration of lime juice in the British navy, which has been practised since 1795, has had the effect of virtually extinguishing scurvy in the service, while similar regulations introduced by the British Board of Trade in 1865 have had a like beneficial result as regards the mercantile marine. It is only when these regulations have not been fully carried out, or when the supply of lime juice has become exhausted, that scurvy among sailors has been noticed in recent times. Besides the administration of lime or lemon juice and the use of fresh meat, milk, &c., which are valuable adjuvants, the local and constitutional conditions require the attention of the physician. The ulcers of the gums and limbs can be best treated by stimulating astringent applications; the hard swellings, which are apt to continue long, may be alleviated by fomentations and frictions; while the anaemia and debility are best overcome by the continued administration of iron tonics, aided by fresh air and other measures calculated to promote the general health.