Scurvy, Vitamin D deficiency or lead poisoning?

My analysis of the health experience of the ship’s company of HMS Terror under Captain Sir George Back in 1836-7 has attracted some very interesting comments. So much so that I thought I’d post an additional discussion on them. Prof. Russell Potter, ever taking the initiative to challenge and illuminate, made the following points (if I may paraphrase)

“malaise is a common feature of almost every British and American Arctic expedition of this period”

That is true. I think the evidence is mounting that these ships, HMS Terror and HMS Erebus, had a fatal flaw in their ice-melting equipment which put freshly melted warm water in direct contact with fresh lead and that this exposed the men on the ships to dangerous levels of lead when these systems were used. I suspect that the following generation of Arctic exploration vessels, Enterprise, Resolution and Investigator, had a similar flaw and that this may explain the deep malaise on them too. While malaise was a symptom of the overwinterings of the late 1840’s and 1850‘s, I would argue that it was NOT seen to anything like the same extent on the earlier generation of ships used by Parry and Lyon, for example. Nor was it seen on the later Nares Expedition. Someone needs to take a careful look at the plans of the Investigator, Enterprise and Resolution and see if the tell-tale combination of stove, ice-tank and connecting pipe is present. Perhaps our friends at Parks Canada could one day have a look at the Investigator and tell us what’s actually there.

“there is generally a quite significant time lag between the commencement of lead ingestion and the symptoms of lead poisoning, and an even longer period … between the cessation of ingestion and the alleviation of symptoms”
“rigidity of the muscles and tendons of the legs … is a commonly listed symptom of scurvy, but I can’t find any reference to it being linked to lead poisoning”

Now we do need a pathologist expert in lead poisoning to comment here – I am an amateur. But it is interesting that when I googled on ‘acute lead poisoning’, I immediately found the statement that ‘acute lead poisoning while less common, shows up more quickly and can be fatal. Symptoms such as the following may occur: severe abdominal pain, diarrhea, nausea and vomiting, weakness of the limbs, seizures [and] coma’. (http://medical-dictionary.thefreedictionary.com/lead+poisoning).

Back’s reference to “lime juice” suggests that the Terror lacked lemon juice – a much more effective anti-scorbutic. That’s true, but actually the manifest of the ship, given by Back in his book, makes it clear that the Terror carried 798 gallons of lemon juice as well as an identical 798 gallons of lime-juice.

Peter Carney added:

“lack of exposure to sunshine caus[es] a vitamin D deficiency which apparently is protective against lead poisoning”

Fair enough, but here’s an interesting point: modern archaeology is starting to provide us with new insights. I believe we now have new evidence that scurvy and Vitamin D deficiency were unlikely to have been the cause of this illness. Russell is right that an autopsy of one of Back’s dead would provide proof of this and we do not have this evidence, but we DO now have an autopsy of someone who almost certainly lived on HMS Erebus for at least two winters in the ice 1845-7: Harry Goodsir, if he is the ‘Greenwich skeleton’. And clearly he suffered not a trace of scurvy. Nor is there any trace of anything like a Vitamin D deficiency in his remains. Although they died earlier, there is no trace of vitamin C or D deficiency in the three dead from Beechey Island either. So I would say that the evidence against scurvy is starting to mount up.

While some of what Back, Franklin, Crozier and Fitzjames believed they knew about scurvy was erroneous, I believe they DID know to take lemon (or lime) juice and they DID recognise the importance of fresh meat. If I am right that lead was the cause of the illness, then as it developed they would have taken even more care to increase the anti-scorbutic component of the diet, as Back describes. And I think the Greenwich autopsy now makes scurvy or other vitamin deficiency a much less likely cause of the disaster.