Scurvy—a “Disease of the Past”

A man in his early fifties showed up at a hospital in Western Australia with a painful rash extending from his abdomen to his ankles. It had the pinpoint splotches associated with bleeding between skin layers.

Doctors at the medical center, Sir Charles Gairdner Hospital in Nedlands, got to work on a diagnosis. According to a writeup of the incident, published in BMJ Case Reports, multiple tests for autoimmune diseases, blood disorders, and blood vessel inflammation all came back negative. There were no signs of trauma, internal bleeding, or arthritis.

Finally, the doctors solved the mystery: He had no detectable levels of vitamin C. The culprit was scurvy, the disease that ravaged sailors from the 15th to the 19th centuries.

In cases of scurvy, a severe lack of vitamin C leads to general bodily dysfunction, which can manifest as anemia, gum disease, poor wound healing, skin hemorrhages, and general weakness, and can be fatal if left untreated. The human body is unable to synthesize vitamin C itself and must gain it from food. Fresh fruits and vegetables are good sources.

The sailors of yore subsided on mostly salted meat and ship’s biscuits until scientists gained some understanding of scurvy, starting in the late 1700s, and prescribed lemons, limes, and oranges for long sea voyages. This “disease of the past,” as the Australian study’s authors called it in a statement, faded from view as research into Vitamin C and nutrition advanced in the early 20th century.

But today, scurvy might be making a comeback.

Researchers suggest it’s due to some consumers’ inability to afford fresh food, as well as other factors. A review of 19 million pediatric patients in the United States, published in July 2024, found that between 2016 and 2020, the rate of of scurvy in children more than tripled from 8.2 to 26.7 cases per 100,000. Patients with scurvy were more likely to be low-income and experience food insecurity, but the most significant correlation was a diagnosis of autism spectrum disorder (present in nearly two-thirds of cases).

A 2023 study of a mostly socioeconomically disadvantaged population in New South Wales, Australia, found vitamin C deficiencies in more than 50 percent of cases. Half of those were a significant deficiency.

In the case of the man in Western Australia, doctors noted that he “had financial constraints and therefore neglected his diet. His meals mostly comprised processed food, lacking in vegetables or fruit. Sometimes he would skip meals, which occurred more frequently in recent weeks.” He also stopped taking the vitamin and mineral supplements prescribed after gastric bypass surgery because he couldn’t afford them.

The clinicians who wrote the report noted that, over the course of 12 months, food prices in Australia had risen 5.9 percent. The cost of food underwent a similar increase in the U.S. in 2023—part of a 20 percent increase in grocery prices since 2020. Several factors have contributed to a worldwide rise in food prices, including the COVID-19 pandemic and the Russian invasion of Ukraine.

Scurvy can be reversed with a regiment of vitamin C, and patients often see relief within 24 hours. But fixing the societal factors behind scurvy’s reappearance is much more challenging.

Read More About the History of Health and Medicine: