James Lind

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James Lind

James Lind (born October 4, 1716 in Edinburgh , † July 13, 1794 in Gosport ) was a Scottish doctor. He was the pioneer of on-board hygiene and discovered the therapy of scurvy with lemon juice. He also suggested distilling seawater to make potable water. He combated the dampness on the ships through ventilation, improved clothing and cleanliness of the seafarers and introduced fumigation with sulfur and arsenic. With his work he also influenced the disease prophylaxis and nutrition of British soldiers on land.

The years at sea

James Lind went to school in Edinburgh and then learned the medical trade from 1731 to 1739 with the surgeon George Langlands, a fellow of the Royal College of Surgeons of Edinburgh . He joined the Royal Navy in 1739 as a ship's doctor's mate and served in the Mediterranean, West Africa and the Caribbean. By 1746 he was promoted to ship's doctor for HMS Salisbury , which was part of the Canal Fleet. Two years later he resigned from the Navy. He wrote a doctoral thesis on sexually transmitted diseases, received his doctorate in 1748 and was licensed to practice in Edinburgh, where he also opened a practice.

Therapy for scurvy

Lind's experiment

Scurvy is a vitamin C deficiency disease, although it must be noted that vitamins were still unknown in Lind's time . Vitamin C is necessary for the cohesion of the connective tissue . If it is missing, ulcers develop on the lower legs and feet, bleeding occurs, teeth and hair fall out, old wounds open, followed by depression , hallucinations , blindness and ultimately death. In 1740, the disastrous result of Anson's circumnavigation caused a sensation when 1,400 of the 1,900 men of the crew died, most of them allegedly from scurvy. According to Lind, scurvy claimed more deaths in the navy than all French and Spanish weapons combined.

That citrus fruits against scurvy help was at least since 1600 known as a doctor of the East India Company had recommended for this purpose, but their use was never enforced. Lind was not the first to think of citrus fruits as a therapy for scurvy, but he was the first to investigate their effect in a systematic experiment in 1747. It is one of the first clinical and controlled experiments in the history of medicine.

Lind believed that scurvy was a result of putrefaction in the body, which acids could prevent. That's why he experimented mainly with acidic food additives. For his experiment he divided twelve sailors suffering from scurvy into six groups. All received the same diet and the first group also received a quart (a liter) of cider daily. Group two took 25 drops of sulfuric acid , group three six spoons of vinegar , group four half a pint (almost a quarter of a liter) of sea water, group five two oranges and one lemon daily and the last group a spice paste and barley water . Treatment of group five had to be discontinued when the fruit ran out after six days, but by that point one of the sailors was already fit for duty and the other was almost recovered. In the other test participants, a certain effect of the treatment was only seen in the first group.

Shortly after this experiment, Lind left the Navy and initially practiced as a general practitioner. In 1753 he published a treatise on scurvy ( A treatise of the scurvy ) that was practically ignored. In 1758 he was appointed chief physician at Haslar Royal Naval Hospital in Portsmouth . When James Cook set out on his first circumnavigation in 1768, he took original wort from beer (0.1 mg vitamin C per 100 g), sauerkraut (10–15 mg per 100 g) and a syrup made from oranges and lemons (juice contains 40–60 mg per 100 g) as a scurvy remedy on the trip; however, only the results on the original wort were published. In 1762 Lind's "A treatise on the best means of preserving the health of seamen" appeared ( An essay on the most effectual means of preserving the health of seamen, in the Royal Navy [...]. London 1757). Here he recommended that "lettuce", ie watercress (79 mg of vitamin C per 100 g), should be grown on damp cloths. This recommendation was actually implemented, and mustard and cress seeds were supplied to the British Army in North America in the winter of 1775. Lind continued to promote citrus fruits. Since he - like most other doctors - attributed the healing effects to their acidity, it made sense to switch to cheaper, acidic foods.

impact

It was not until Gilbert Blane (1749–1834) finally established citrus fruits in the navy. In an experiment on board the Suffolk in 1794, lemon juice was dispensed on a 23-week non-stop voyage to India. The daily ration of two-thirds of an ounce (about 20 ml) mixed with grog contained just the minimum daily requirement for vitamin C of 10 mg. There was no serious outbreak of scurvy. The following year the Admiralty included lemon juice in the catering of the entire fleet. This did not, however, eliminate scurvy in the navy, because lemon juice was initially regarded as a remedy and was therefore only given by the ship's doctor. Only after 1800 were its preventive qualities increasingly recognized. This new regulation had dramatic effects: while in 1780 seamen suffering from scurvy were still admitted to the Royal Hospital in Halsar in 1457, there were only two cases in 1806.

After 1845, the British Admiralty gradually replaced the lemons obtained from Sicily and Malta with limes that were grown on British plantations in the West Indies : It was still believed that the scurvy-healing effect of lemon juice was based on its acidity and that lime juice was even more acidic than lemon juice. In fact, fresh lime juice has only half as much vitamin C as lemon juice and due to the storage of the lime juice used in the British Navy, it only contained extremely small amounts of vitamin C. This difference between lemon juice and lime juice initially went undetected because the one around the middle Steamships, which were increasingly used in the 19th century, meant that seafarers were usually too short on the high seas to develop scurvy. Exceptions to this were seamen who were on whalers or members of a polar expedition. The crucial difference between lemon and lime juice was revealed as early as 1875 on the British Arctic expedition led by George Nares . Nares tried to reach the North Pole via Greenland, but the expedition had to be canceled after the expedition members fell ill with scurvy, even though they had all consumed the prescribed lime juice ration every day. However, this in no way led to a change in the regulations: The Jackson Harmsworth Expedition 1894–1897, Scott's Discovery Expedition 1901–1904 and the Terra Nova Expedition 1910–1913 were also affected by scurvy . Vitamin C as the decisive active component was not discovered until 1928 by the Hungarian Albert Szent-Györgyi and the American Charles Glen King .

Drinking water from the sea

In the 18th century, seafarers took water and beer in barrels and also used rain as drinking water. Under the Regulations and Instructions relating to His Majesty's Service at Sea , first issued by the Admiralty in 1733, each sailor was entitled to one gallon of weak beer a day (this measure is five sixths of the common British gallon, which corresponds to a current American gallon or a good three and a half liters ). Since beer during brewing is cooked, it is first free of bacteria and should not be like rotten water when it is kept for months in barrels. Wine was also served in the Mediterranean, often fortified with brandy .

For example, a frigate with a crew of 240 men and provisions for four months had more than 100 tons of water on board. The quality depended on the original source of the water, the condition of the barrels and the duration of storage. In normal times, seafarers were allowed to drink as much water as they wanted from a guarded water barrel, but were not allowed to take water with them. When water became scarce, it was rationed and rainwater was collected with spread canvas. Water was also taken in when an opportunity arose along the way; however, water points were often swampy and therefore contaminated with malaria in the tropics .

In 1758, Lind discovered that potable water that tasted like rainwater could be made from the steam of heated seawater. He also suggested using solar energy to evaporate the water. But it was not until 1810, when a new type of cooking stove was introduced on the ships, that it was possible to obtain a significant amount of drinking water through distillation.

The last few years at Haslar Hospital

James Lind worked as a senior physician at the Royal Hospital Haslar from 1758. In 1783 his son succeeded him in this post. He died in Gosport in 1794, where he is buried in Portchester Church. A plaque on the Medicine Department of Edinburgh University commemorates his merits. He is also the namesake for the Lind glacier in the Antarctic.

Memberships

In 1783 he was elected a member ( Fellow ) of the Royal Society of Edinburgh .

literature

  • Helena Attlee: The Land Where Lemons Grow: The Story of Italy and its Citrus Fruit. Penguin Books, London 2015, ISBN 978-0-14-196786-8 .
  • Barbara I. Tshisuaka: Lind, James. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 855.
  • Ronald D. Gerste: A ship surgeon becomes the first preventive medicine. For the 300th birthday of James Lind . In: Chirurgische Allgemeine , Volume 17, Issue 7 + 8 (2016), 385–387.

Web links

Commons : James Lind  - Collection of pictures, videos and audio files

Individual evidence

  1. ↑ Dissertatio medica inauguralis, de morbis venereis localibus (1748).
  2. ↑ Helena Attlee: The Land Where Lemons Grow. P. 62.
  3. ↑ Janet Macdonald: Feeding Nelson's Navy. The True Story of Food at Sea in the Georgian Era. Chatham, London, 2006. ISBN 978-1-86176-288-7 , pp. 154-166.
  4. ↑ Helena Attlee: The Land Where Lemons Grow. P. 63.
  5. ↑ Helena Attlee: The Land Where Lemons Grow. P. 64.
  6. ↑ Helena Attlee: The Land Where Lemons Grow. P. 65.
  7. ↑ Scott and Scurvy. On: idlewords.com. July 3, 2010, accessed February 13, 2016.
  8. ^ KR Norum, H, J. Grav: Axel Holst and Theodor Frølich - pionerer i bekjempelsen av skjørbuk . In: Tidsskrift for Den norske legeforening . tape 122 , no. 17 , June 30, 2002, pp. 1686-1687 , PMID 12555613 .
  9. ^ Fellows Directory. Biographical Index: Former RSE Fellows 1783–2002. (PDF) Royal Society of Edinburgh, accessed January 1, 2020 .
personal data
SURNAME Lind, James
BRIEF DESCRIPTION Scottish doctor and ship hygiene pioneer in the British Navy (Royal Navy)
DATE OF BIRTH October 4, 1716
PLACE OF BIRTH Edinburgh
DATE OF DEATH July 13, 1794
Place of death Gosport