James Lind and scurvy: a revaluation

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Title page of A Treatise on the Scurvy, James Lind, Second Edition 1757© National Maritime Museum (Neg. no. D9748)

The old story

The old story of the conquest of scurvy in the British Navy has been a long time dying. The story runs as follows. In 1753, James Lind published his Treatise of the scurvy.1 At the heart of his book is the record of his clinical trial of a number of potential cures for the disease. Oranges and lemons came out as the conclusive winners. However, the Admiralty procrastinated for over forty years before accepting Lind’s findings. Not until 1795 was lemon juice issued to sailors. At once, scurvy was banished from the fleet.

A number of historians of naval medicine, notably Coulter, Keevil, Lloyd and Carpenter, have shown up deficiencies in this story.2 They have shown that the simple tale of a heroic, pioneering Lind and the dilatory Lords of the Admiralty will not do. In their more complex accounts of scurvy and its treatments during the second half of the eighteenth century, Lind no longer stars as the single, decisive character in the story. He appears as just one - albeit an important one - of a number of eighteenth century contributors to the debate about the mysterious disease of scurvy.

Yet these historians, like many others, are still powerfully drawn to the five paragraphs in Lind’s 358 page Treatise that describe what he called 'experiments’, at sea in May 1747, on twelve scurvy-ridden members of the crew of The Salisbury.3 Carpenter, for example, devotes a section of his chapter on scurvy in the British navy to Lind’s experiments, even though he acknowledges that they seem 'to have made very little impression’ on researchers into the disorder during the rest of the eighteenth century. The fascination with Lind’s few pages on his experiments is, Carpenter suggests, a twentieth century phenomenon.4 Lloyd and Coulter, who, like Carpenter, have shown both that Lind’s book made no immediate and conclusive impact, and that half a century after its publication, the debate about scurvy’s cause and treatment was still wide open, are nonetheless moved, somewhat contradictorily, to say that Lind’s Salisbury experiments were 'epoch-making’.5

In 1987 and 1996, Christopher Lawrence published papers on scurvy which notably do not have Lind, the Salisbury experiments, and fruit and vegetables at their centre. Rather, they draw attention to issues of political power within the Royal Society and the Admiralty, to issues of discipline and social control in the navy, and to the contribution to research into scurvy made by Joseph Priestley. But along his way, Lawrence adds further weight to the view that the debate about the disease rumbled on, inconclusively, for decades after the publication of Lind’s Treatise, and that Lind’s book is an intrinsically puzzling text. In order to indicate how uncompelling Lind’s experiments were, and how open a text the Treatise was, Lawrence cites Caleb Dickinson and Thomas Beddoes, who, writing in the 1780s and 1790s on scurvy, drew on passages from Lind’s book that supported their own view that green vegetables do not cure the disease.6 Other late eighteenth century doctors who, like Dickinson and Beddoes, were studying scurvy, and who therefore read Lind closely, were puzzled by the Treatise. Thomas Trotter and Gilbert Blane, for example, who were generally happy to acknowledge the importance of Lind’s work, evidently concluded that Lind had not settled the issue. For them, scurvy was still a mysterious disorder. In 1786, Trotter wrote that 'notwithstanding the history Lind has given us, in several places of his work he has left us much in the dark’.7 And Blane, the doctor credited with having given the Admiralty the final push, in 1795, into issuing lemon juice to seamen, concluded that he had never been able to satisfy his mind 'with any theory concerning the nature and cure of this disease [ie scurvy], nor hardly indeed of any other.’8

Kenneth Carpenter, the author of the most comprehensive modern study of the history of scurvy, confesses, before presenting his own pioneering analysis of Lind’s text, that he has found the Treatise 'extremely difficult - even painful - to read, let alone summarise.’9 Anybody who has tackled the Treatise from cover to cover will make a similar confession. Manifestly, the text was given contradictory readings by its contemporary audience. This indicates that perhaps the Treatise is not a text that can be tidied up by a modern scholar and made to yield a single, unambiguous and coherent line of argument. The contradictory readings given by Lind’s contemporaries were not obtuse; it is the text itself that is obtuse. Maybe even Lind himself would have conceded that his own book had reached no clear and momentous conclusion. If he had really believed that his experiments were conclusive, and that his Treatise was meant to be a showcase for them, it is hard to see why the book has the structure that it has.

Any modern reading of Lind is bound to be haunted by the oranges and lemons that cured the scurvied seamen on the Salisbury, but, at the outset, we need to recognise that Lind certainly did not conceive his own project as the pursuit of a single constituent which is present, in varying quantities, in all fruit and greenstuff, and which is uniquely efficacious in the treatment of scurvy. We will move closer to Lind’s own project if we take those famous Salisbury experiments, which have regularly been taken to be the heart of the matter, and set them within their context in the book as a whole, and if we track some of the changes in Lind’s thinking and clinical practice, recorded in the second and third editions of the Treatise.