The Evidence for the Cause of Scurvy: A Historical and Modern Perspective

November 16, 2025 •

4 min read

In 1747, naval surgeon James Lind conducted one of history's first clinical trials, providing compelling evidence that citrus fruits cured scurvy. However, it took decades for the medical establishment to fully accept this finding, and even longer to discover the definitive evidence for the cause of scurvy: a severe deficiency of vitamin C.

Quick Summary

This article details the historical experiments and modern scientific understanding that definitively established vitamin C deficiency as the cause of scurvy. It covers key studies, biochemical mechanisms, and the impact on connective tissue and overall health.

Key Points

Scurvy is Caused by Vitamin C Deficiency: The definitive evidence points to a lack of ascorbic acid, which is essential for collagen synthesis.
James Lind's Experiment Provided Early Evidence: In 1747, Lind's clinical trial showed that citrus fruits could cure scurvy in sailors, laying the groundwork for modern scientific medicine.
Scurvy Affects Connective Tissue: Without sufficient vitamin C, the body cannot produce strong collagen, leading to fragile blood vessels, weak bones, and skin problems.
The Cause was Identified Biochemically: Scientists isolated and identified ascorbic acid in the early 20th century, proving its role as the antiscorbutic factor.
Preventable and Treatable: The disease is now easily preventable through a diet rich in fresh fruits and vegetables, and treatable with vitamin C supplements.
Modern Cases Still Occur: While rare in developed countries, scurvy persists in at-risk populations such as the elderly, alcoholics, and those with very restricted diets.

Scurvy, a debilitating and often fatal disease, plagued sailors, explorers, and impoverished populations for centuries. While historical accounts from ancient Egypt hint at its existence, it was the age of exploration that brought this nutritional disorder to the forefront of medical investigation. The long and difficult journey to uncover the evidence for the cause of scurvy is a testament to the evolution of scientific inquiry, combining controlled experiments with advancements in biochemistry.

The Historical Evidence: James Lind's Groundbreaking Trial

Before the scientific understanding of nutrition existed, the cause of scurvy was a subject of rampant speculation. Despite anecdotal evidence pointing to fresh produce, the medical establishment often ignored these findings. A crucial turning point came in 1747 with Scottish naval surgeon James Lind.

Lind's now-famous experiment aboard HMS Salisbury stands as a cornerstone of evidence-based medicine. He conducted a controlled trial on 12 sailors with scurvy, dividing them into groups with different dietary supplements. The group receiving two oranges and one lemon daily showed significant improvement within a week, highlighting the effectiveness of citrus fruits. Despite this clear evidence, the British Admiralty did not adopt his recommendations immediately due to various factors, including cost and prevailing medical theories. Scurvy continued to affect sailors and explorers for years.

The Rise of Modern Biochemistry and Identification of Vitamin C

The definitive evidence for the cause of scurvy emerged in the early 20th century with the discovery and isolation of the specific nutrient responsible. Experiments using guinea pigs, which, like humans and primates, cannot synthesize their own vitamin C, were instrumental.

In the 1920s and 1930s, Albert Szent-Györgyi isolated hexuronic acid, later proving it was the 'antiscorbutic factor' that prevented scurvy. This compound was renamed ascorbic acid to reflect its anti-scurvy properties.

The Modern Understanding: Pathophysiology of Scurvy

Today, the evidence for the cause of scurvy is understood at a molecular level. A deficiency in vitamin C impairs the body's ability to produce collagen, a vital protein for the integrity of connective tissues in skin, blood vessels, bone, and cartilage. This impaired collagen synthesis leads to the diverse symptoms of scurvy. Fragile blood vessels cause hemorrhages and bruising, weak gums lead to swelling and tooth loss, and effects on bone and cartilage contribute to joint pain and poor wound healing.


Aspect	Historical Perspective	Modern Evidence (Post-1930s)
Causation Theory	Damp air, bad water, and internal putrefaction.	Severe, prolonged deficiency of vitamin C (ascorbic acid).
Key Experiment	James Lind's 1747 controlled clinical trial using dietary interventions on sailors.	Laboratory experiments using guinea pigs identified the essential nutrient.
Treatment	Citrus fruits, but efficacy was inconsistent and debated; often ignored by authorities.	High-dose vitamin C supplementation, with symptoms often resolving within weeks or days.
Mechanism	Unknown; sometimes attributed to 'virtues' of certain foods or balancing 'humors'.	Impaired collagen synthesis due to lack of ascorbic acid, which acts as a cofactor for key enzymes.
Vulnerable Groups	Sailors, explorers, armies during long sieges.	Elderly, alcoholics, people with restrictive diets, malabsorption conditions, and some mental health conditions.

Conclusion: From Mystery to Molecular Science

The compelling evidence for the cause of scurvy is a story of slow, incremental scientific progress, from James Lind's observations to the biochemical identification of vitamin C. It highlights the critical link between nutrition and health and the importance of evidence-based reasoning. While less common in developed nations today, scurvy still affects at-risk populations, underscoring the continued relevance of understanding its cause. A detailed resource on the history of scurvy during exploration can be found at the National Park Service's Saint Croix Island International Historic Site website.

The Biochemistry of Scurvy

Enzymatic Role: Vitamin C is a cofactor for enzymes essential for collagen synthesis.
Collagen Breakdown: Deficiency prevents strong collagen formation, leading to connective tissue breakdown.
Vascular Fragility: Poor collagen weakens blood vessels, causing hemorrhages.
Immune System Impairment: Deficiency compromises immune function and wound healing.
Metabolic Disruption: Ascorbic acid is involved in iron absorption and metabolism of certain substances.

How Scurvy Causes Symptoms

Bleeding: Fragile capillaries cause bleeding in skin, gums, and internally.
Musculoskeletal Pain: Hemorrhages near bones and fragile bones lead to pain and weakness.
Dental Issues: Weak gums swell, bleed, and teeth loosen.
Skin Manifestations: Bumpy skin around hair follicles and corkscrew hairs are common signs.
Fatigue and Weakness: Profound fatigue is an early, non-specific symptom.

Prevention and Treatment

Dietary Intake: Preventing scurvy relies on a diet rich in vitamin C from fruits and vegetables.
Supplementation: Supplements are an option for those with restricted diets or malabsorption.
Patient Education: Educating at-risk individuals about vitamin C is vital for prevention.
Rapid Treatment: Symptoms improve quickly with vitamin C supplementation.
Nutritional Support: Addressing underlying malnutrition is crucial for recovery.

Frequently Asked Questions

The primary cause of scurvy is a severe and prolonged deficiency of vitamin C (ascorbic acid) in the diet, which is necessary for the production of collagen in the body.

In 1747, James Lind conducted a controlled clinical trial on sailors with scurvy, demonstrating that those given citrus fruits recovered dramatically, providing early empirical evidence that diet, specifically citrus, was the cure.

It took several decades for Lind's findings to be implemented because his results conflicted with the prevailing medical theories of the time, and there were logistical challenges and high costs associated with providing fresh citrus fruit to the entire navy.

Hungarian biochemist Albert Szent-Györgyi isolated hexuronic acid, which was later renamed ascorbic acid, and was identified as the specific anti-scurvy nutrient in the early 1930s.

During scurvy, the body's impaired ability to synthesize collagen leads to weak connective tissues. This causes blood vessel fragility, leading to hemorrhages, and affects bone, cartilage, and teeth.

Modern risk factors include alcoholism, restrictive diets (such as those followed by individuals with certain eating disorders or mental health conditions), and malabsorptive states, which all can lead to severe vitamin C deficiency.

Scurvy is treated with high doses of vitamin C supplements. It is prevented by ensuring a diet that includes sufficient amounts of fresh fruits and vegetables, and through nutritional education for at-risk groups.