Description of scurvy by Wierus (1567)

Description of scurvy by Wierus (1567) Summary by James Lind (1753) In the 16th century, four European authors described the symptoms of scurvy in such a detail that the disease can be recognized as the disease we currently classify as scurvy: Echtius (1541), Olaus Magnus (1555), Ronsseus (1564), and Wierus (1567). Since these four texts are among the early unambiguous descriptions of scurvy, they have substantial historical relevance. All these texts were originally published in Latin. There are English translations of the sections of scurvy from the Olaus Magnus text. James Lind wrote English summaries of the texts of the three other authors. This document gives a brief background and a copy of Lind’s summary of Wierus (1567) text on scurvy. Various names of the author (1515–1588): Johann Weyer ”standard in German and English-language scholarship” Ioannes Wierus Johannes Wierius, Johannis Wieri, Johannes Wier, Joannes Wier, Jan Wier, Piscinarius Wierus ”was among the first to publish a thorough treatise against the trials and persecution of people accused of witchcraft” https://en.wikipedia.org/wiki/Johann_Weyer https://en.wikisource.org/wiki/Author%3AJohann_Weyer https://commons.wikimedia.org/wiki/File:Johann_Weyer.png https://www.britishmuseum.org/collection/term/BIOG219425 https://www.britishmuseum.org/collection/object/P_Gg-4E-49 https://www.britishmuseum.org/collection/object/P_Bb-16-246 https://doi.org/10.1056/NEJM196008042630508 https://pmc.ncbi.nlm.nih.gov/articles/PMC1036613 https://doi.org/10.17077/0006-7474.1234 https://doi.org/10.1017/9781571137937.005 https://doi.org/10.1017/9789048541041 Yellow is used to indicate the description of symptoms of scurvy. This text is available at: https://doi.org/10.5281/zenodo.17093229 2025-9-23 This annotated version was prepared by: Harri Hemilä, University of Helsinki, Finland https://www.mv.helsinki.fi/home/hemila https://orcid.org/0000-0002-4710-307X https://www.ncbi.nlm.nih.gov/pubmed/?term=hemila+h https://scholar.google.fi/citations?user=2mkomzUAAAAJ https://doi.org/10.5281/zenodo.17085738 Reports on scurvy uploaded to Zenodo by Harri Hemilä 1 Background James Lind (1753)1 wrote, p.1 In the first accounts given us of this disease, by Ronsseus2, Echthius3, and Wierus4, it is surprising to find, not only an accurate description of it, but an enumeration of almost all the truly antiscorbutic medicines that are known to the world even at this day. James Lind p.3-5 But where Wierus transcribes the symptoms from this last author [Echthius], (which he does almost verbatim ), upon this occasion he very justly differs from him. He observes, that the scurvy is not properly the crisis of a fever; but, like many other diseases, may be occasioned after it by unsound viscera, and a vitiated state of blood. He imagines people were induced to believe it a contagious malady, by seeing many whole families alike affected; but this he ascribed to the sameness of their diet. He was however deceived (probably by the authority of Echthius) in thinking, that where the gums were putrid, the disease might be infectious: and accordingly makes it a doubt, whether in some parts of the Lower Germany, where it had lately appeared, it was owing to their diet, or to infection. But it shall be fully proved hereafter, that the scurvy is not contagious or infectious. It may be proper to observe further, that 1 James Lind (1753). A Treatise of the Scurvy in Three Parts. https://doi.org/10.5281/zenodo.10685194 Selected sections of Lind’s treatise. Lind’s 1753 edition in a scanned versions: https://wellcomecollection.org/works/bg2gxrzz/items?canvas=7 https://archive.org/details/treatisescurvyt00lind/page/xvi/mode/2up https://library.si.edu/digital-library/book/treatisescurvyt00lind 2 Ronsseus, see: Lind. Part III: Chapter II. https://doi.org/10.5281/zenodo.17093314 https://archive.org/details/treatisescurvyt00lind/page/356/mode/2up 3 Echtius, see: Lind. Part III: Chapter II. https://doi.org/10.5281/zenodo.17093279 https://archive.org/details/treatisescurvyt00lind/page/354/mode/2up 4 Wierus, see: Lind. v III: Chapter II. https://doi.org/10.5281/zenodo.17093229 https://archive.org/details/treatisescurvyt00lind/page/358/mode/2up 2 Wierus had described the various and extraordinary symptoms of this malady, in so accurate a manner, that the succeeding authors for a long time did nothing more than copy him. It was a considerable time afterwards, when p.4 Solomon Albertus wrote a large treatise on this subject, wherein he assumes great merit to himself in discovering a symptom not taken notice of by any author, and which he had once or twice observed in this disease, viz. a rigor or stiffness of the lower jaw. However, Wierus still continued in the greatest esteem and reputation; and his book was deemed the standard on this subject, even till the time of Eugalenus, who gives it that just character, and refers to it almost entirely for the cure. He must be allowed therefore to have been a good judge of this distemper: and as he was a person of eminent learning, as well as probity, (which his writings on this and many other subjects sufficiently shew), his word may be relied upon, when he tells us, that in his time this disease was peculiar to the inhabitants of the countries upon the north seas: he had never met with it in Spain, France, nor in Italy; nor was it to be seen in the large tract of Upper Germany: and as to Asia and Africa, if ever it appeared there, it would no doubt be in such places as lay adjacent to the sea; where such a situation, and a gross diet, with the use of putrid water, might give rise to it, in the same manner as they do in the countries where p.5 it was endemic. These were not conjectures in our author; for he was a great traveller, and had visited all the places he talks of. A book wrote in those times by him, De præstigiis dæmonum5, adds much to his reputation; as it shews he was neither so weak, nor credulous, as some later writers on the scurvy. 5https://en.wikipedia.org/wiki/De_praestigiis_daemonum https://archive.org/details/depraestigiisdae00weye/page/n3/mode/2up 3 James Lind p.11 So that whereas formerly the malady had a regular progression of symptoms in its different stages, accurately related by Wierus and many others, it became in Eugalenus’s time the most irregular and deceitful evil that we can well imagine. James Lind p.52 [About Willis] But it will appear to any person who peruses the authors from whom he has borrowed the description of the symptoms, wiz. Echthius, Wierus, &c. that they described a very different disease from what Willis did. Dr Willis’s method of cure may perhaps be rationally applied to the diseases he described; but is by no means adapted to the disease characterised by the first writers on the scurvy. James Lind p.63 As to the pathognomonic signs of this disease: If we compare its symptoms as described by Echthius, Wierus, and all other authors till the time of Eugalenus (a), with the accounts given of them in books of voyages, particularly the extraordinary narrative of what happened to the great Lord Anson’s crews in their passage round the world (b), we shall perceive an entire agreement in the essential signs of the distemper, (making a proper allowance for the different descriptions that may be expected from seamen and physicians), and appearances so singular as are not to be met with in any other. Thus, putrid gums, swelled legs, and spots, accompanying each other, and in their progress usually attended with rigid tendons in the ham, are observed in no other distemper. James Lind p.352-355 … The author afterwards observes it to be the scurvy, a malady to which the northern nations, the Dutch, &c. are very subject; and upon this occasion, quoting a passage from Olaus Magnus6, says, “I have delighted myself 6 Olaus Magnus (1555) Historia de gentibus septentrionalibus. https://doi.org/10.5281/zenodo.13380745 English translation of the sections on scurvy https://en.wikipedia.org/wiki/A_Description_of_the_Northern_Peoples https://en.wikipedia.org/wiki/Olaus_Magnus 4 to recite the words of this author, because he speaketh thereof as being skilled, and has well described the disease; only he maketh no mention of the stiffening of the hams, nor of the superfluous flesh which groweth in the mouth.” … Olaus Magnus, in his history of the northern nations, published ann. 1555, observing what diseases are peculiar to them, gives us a long description of the scurvy. … Soon after we find three eminent physicians, all cotemporary, treating expressly of this distemper, viz. Ronsseus, Echthius, and Wierus. To whom Langius may be added as a fourth, having wrote two epistles upon this subject. What is called Echthius’s Epitome, was the first wrote, though the last published. It would appear from Forrestus to be a letter sent, in the year 1541, to Blienburchius, a physician at Utrecht; whose answer is now lost. The first book published expressly upon the scurvy was by Ronsseus, in the form of an epistle. The year is uncertain, as he afterwards corrected, and reprinted it in a different form. He is so modest as to say, that had he first seen Wierus’s accurate observations, he would not have published any thing upon the subject. There is an edition of Ronsseus put down by Mercklin and Lipenius, in the year 1564; and of Wierus’s observations in 1567. The learned Dr Astruc is of opinion, that these last were not published till 1580. It is thus far certain, that those authors corresponded together; and upon Wierus sending to Ronsseus, Echthius’s letter, now called his Epitome, he published it, together with his own work, Wierus’s observations, and two of Langius’s epistles, in the year 1583. James Lind p.445, Appendix It has been no easy matter to obtain a knowledge of the many writings on this distemper. There have been collections made from time to time, of the several authors on the plague, venereal disease, &c. but no such have been compiled of writers on the scurvy. Sennertus, ann. 1624, when he wrote his own treatise, reprinted the writings of Solomon Albertus and Martini, together with Ronsseus, and the authors which he had published ann. 1583, viz. Echthius, Wierus, and Langius; and this book, containing those seven authors, is 5 the only collection ever published of writers on the scurvy. There was here as little assistance to be obtained from medical bibliothecæ. August Hirsch (1885)7 wrote, p.513 Of somewhat later date are the first authentic accounts of the epidemic occurrence of scurvy on land… Shortly after there appeared the statements of Olaus Magnus, concerning the often observed epidemic prevalence of scurvy in the Scandinavian kingdoms, especially in times of famine; and about the same time, or a little later, the writings of Echthius, Ronsseus, Wier, Dodonaeus and Brucaeus, which testify to the comparatively common occurrence of the disease along the littoral of the North Sea and the Baltic… These excellent descriptions of the malady, more especially by Echthius, Ronsseus and Wier, leave no doubt as to its nature [as scurvy]. Alfred Hess (1920)8 wrote, p.1-4 It is probable that scurvy existed in the northern parts of Europe and Asia ever since they were settled by man. We should hardly expect to have records of this condition, in view of the low educational status of the people, their greatly restricted literature, and their lack of intercourse with the people in the southern countries. In the sixteenth century, with the development and spread of education, we begin to hear of scurvy from various sources. Olaus Magnus, in his “History of the Northern Nations,” published in 1555, described the disease which he tells us flourished among the soldiers in the camps and in the prisons. About this time Ronsseus, Echtius and Wierus wrote special treatises on this disease, and recommended many dietary measures which we recognize to-day as most efficacious. The number of monographs on this subject multiplied with great rapidity in the course of the next twenty-five or fifty years; none of them, however, added anything essential to our knowledge… 7 Hirsch A (1885) Handbook of Geographical and Historical Pathology. Vol. II. Scurvy: pp.507-568. https://doi.org/10.5281/zenodo.10104179 Section on scurvy separately https://archive.org/details/handbookofgeogra02hirsuoft/page/512/mode/2up https://archive.org/details/b28147455_0002/page/512/mode/2up https://archive.org/details/handbookofgeogra02unse/page/512/mode/2up https://archive.org/details/handbookofgeogra02hirs/page/512/mode/2up 8 Hess AF (1920) Scurvy: Past and Present. https://doi.org/10.5281/zenodo.10685195 Extracts relevant to the current context https://www.gutenberg.org/ebooks/40505 https://digital.library.cornell.edu/catalog/chla2903792 6 Anthony J Lorenz (1953)9 wrote: p.308 Lind makes the Dutch physician, Balduin Ronsseus, facile princeps10. Ronsseus11 suggests that cold damp air of the sea and the seashore is the principal cause of scurvy. His is the first book written expressly on scurvy and was published in 1564. A later edition of Ronsseus (1585) combined the epistolae of Echthius12 and Langius as well as the observatio of Wierus as a sort of compendium of the current views on scurvy. Ronsseus also held to the theory of involvement of the spleen in scurvy. Both Ronsseus and Echthius, writing separately, interpreted Pliny’s description of the disease, which afflicted the Roman army under Germanicus, as scurvy. p.309 Wier (Wierus) (1567)13, copying Echthius, and Bruner (Brunerus) (1589), copying Wierus (adding only that leg pains preceded the actual onset of scurvy) well might have justified the subhead in Lind’s preface Dies Diem Docet14, and the words: “To know a disease and to cure it being the utmost essential things to be learned, I have, therefore, transcribed the symptoms and the cure of the scurvy from those authors where they do not entirely copy from each other. I hope such motives (truth, and good of mankind) will to the candid and to the most judicious be a sufficient apology for the liberties I have assumed”. In re-reading the principal pre-Lind authors seriatim one observes the transitions from land to sea scurvy, or purpura nautica. One also sees the transition of the concept of scurvy as a winter epidemic among urban populations and its entity as a deficiency disease when studied in the isolation of the sailing ship when voyages of discovery increased in duration sufficient to permit complete deprivation of antiscorbutic stores. 9https://doi.org/10.1079/PNS19530062 10 Facile princeps. Acknowledged leader. 11 Ronsseus, B. (1585). De Magnis Hippocratis lienibits Plinique stomacace ac sceletyrbe, seu vulgo dicto scorbuto commentariolus. Accessere q‘usdem epistolae quinque ejusdem argumenti, Joannis Echtii de scorbuto epitome, Joannis Wieri de scorbuto observatio. Joanna’s Langii epistolae duae de scorbuto. Wittenberg: C. Schleich. 12 Echthius, J. (1541). De Scorbuto, vel Scorbutica Passione Epitome. Cologne. 13 Wier (Wierus) J. (1567). Medicarum Observationum Rararum Liber ( I de Scorbuto). Basle: J. Oporinus. 14 Dies Diem Docet. The day teaches the day; one learns by experience. 7 The text on the following pages is the summary by Lind (1753, 1st ed.) p.359-361 https://archive.org/details/treatisescurvyt00lind/page/358/mode/2up https://wellcomecollection.org/works/bg2gxrzz/items?canvas=381 Jo. Wierus, chief physician to the Duke of Cleves and Juliers. https://archive.org/details/treatisescurvyt00lind/page/448/mode/2up The original in Latin: Jo. Wieri medicarum observationum hactenus incognitarum lib. I. de scorbuto. https://www.e-rara.ch/bau_1/doi/10.3931/e-rara-44 https://www.e-rara.ch/bau_1/download/pdf/38282 https://archive.org/details/bub_gb_-FqKIF7hHB4C/mode/2up https://archive.org/details/hin-wel-all-00002888-001/page/n58/mode/2up https://books.google.fi/books/about/Medicarum_observationum_rararum_liber_1.html?id=xIs8AAAAcAAJ https://books.google.fi/books/about/Joannis_Wieri_Medicarum_observationum_ra.html?id=RFXRiSi36D0C “Ioannis Wieri. De scorbuto tractatus”, p.187-205. https://archive.org/details/descorbutotracta00senn/page/186/mode/2up https://www.google.com/books/edition/De_scorbuto_tractatus/W7w_AAAAcAAJ https://www.google.com/books/edition/De_scorbuto_tractatus_Acc_ejusdem_argume/f2RWAAAAcAAJ 8 A.D. 1567 Jo. Wieri medicarum observationum hactenus incognitarum lib. I. de scorbuto. p.359 He transcribes all the symptoms out of Echthius at great length, with the following additions. The weakness in the legs felt upon the approach of the disease, is attended with a stiffness there, and a small pain. The flesh of the gums is often destroyed to the roots of the teeth. Smaller spots, resembling blood sprinkled upon the part, (or flea-bites, but larger), appear on the legs, thighs, and on the whole body; but the very large, livid, and purple spots, chiefly on the legs. Sometimes this livid colour will shew itself in the fauces15 of those who are near death. In the progress of the disease, the tendons of the legs become stiff and contracted. Some are seized with a slow erratic fever. After ardent malignant fevers, and double tertians, ill cured, he has known the scurvy to follow; upon which a malignant quartan has ensued. This still left the scurvy behind it; which was at last cured by the proper method. When the legs are greatly swelled, they are sometimes altogether of a livid colour. The pulse, as in a quartan fever, varies: so that at different times, and according to the state of the disease, it is small, hard, quick, and weak. The urine is reddish, turbid, thick, and fæculent, like new red wine, resembling that which is usual in the fit of a quartan when sweating; and of a bad smell. He adds afterwards, in his prognostics, that if ulcers break out on the tibia, they are with great difficulty healed up; being extremely fœtid, of a gangrenous p.360 disposition, and so putrid, as not to feel the application of a hot iron. He assigns as causes of this distemper, unwholsome air, such bad and corrupt food as was used in the northern countries, and by their shipping, viz. stinking pork, smoked rancid bacon, mouldy bread, thick fæculent ale, bad water, melancholy and grief of mind, preceeding fevers, the stoppage of usual evacuations, &c. Though he sometimes bleeds in the cure, yet he forbids it when the disease is advanced. In this case, after evacuating the primæ viæ by a lenient of senna, or the like, (observing that it does not bear violent purgatives), 15 Fauces. The opening at the back of the mouth into the throat. 9