James Lind and Some of his Contemporaries

Guthrie D and Meiklejohn AP (1953) James Lind and Some of his Contemporaries This is one of the Additional Notes in the republication of Lind’s Treatise. LIND’S TREATISE ON SCURVY A Bicentennary Volume containing a reprint of the First Edition of A TREATISE OF THE SCURVY by James Lind, M.D. with Additional Notes EDITED BY C. P. STEWART, Ph.D., D.Sc. AND DOUGLAS GUTHRIE, M.D. F.R.C.S.E Book reviews of the 1953 version https://doi.org/10.1056/NEJM195310012491410 https://doi.org/10.1001/jama.1953.03690150096035 https://doi.org/10.1113/expphysiol.1953.sp001028 Links to the original versions of Lind’s Treatise are at the end of this document. The Foreword to the Bicentennary Volume: https://zenodo.org/doi/10.5281/zenodo.10604636 This is a copy of the 1953 publication, pp.387-403, to make the text more widely available. This is located at: https://doi.org/10.5281/zenodo.10605214 Another series of publications to honour the 200-year anniversary of Lind’s Treatise in 1952 was in the Proceedings of the Nutrition Society. See the contents of the special issue: https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/issue/ B5C5B1FF2F5E8592C93785E85D6DE286 Digitized in 2024 by Harri Hemilä, University of Helsinki, Finland https://www.mv.helsinki.fi/home/hemila https://orcid.org/0000-0002-4710-307X 1 JAMES LIND AND SOME OF HIS CONTEMPORARIES By DOUGLAS GUTHRIE and A. P. MEIKLEJOHN James Lind, the Man AS Sir Sheldon Dudley has already said1, Lind was obviously a quiet unassuming scientist—probably with a sense of humour—content to make and describe accurate clinical observations, leaving the tumult and the shouting of naval and medical politics to those who had a taste for them. He seems to have avoided the kind of publicity on which present fame so often depends and future histories too frequently rely. ‘He was eminently a man of peace’ according to Rolleston.2 Perhaps he realised that if he simply recorded what he knew to be true about preserving the health of sailors sensible people would some day read him and give him due honour, even though it might not be for two hundred years. Though he wrote freely enough on medical matters, on all other subjects he seems to have been remarkably reticent. For twenty-five years he was medical director of the largest hospital in Europe—Haslar Hospital3—yet there is no evidence that he addressed young naval medical men in the usual valedictory terms, which, if properly published, provide useful and quotable material for the historians of the future. The fact is that we know few personal details about him. Sir Humphrey Rolleston could find little material for a proper biography. Professor Ralph Stockman4 summarised, in an admirable account, all that could be discovered up to 1926. Lind was born in Edinburgh, descended from the Linns of that ilk who had owned a small estate near Dalry in 1. Dudley S (1953) The Lind Tradition in the Royal Naval Medical Service. pp.369-386. https://zenodo.org/doi/10.5281/zenodo.10605143 2. Rolleston (1910~1919) James Lind: pioneer of naval hygiene. https://doi.org/10.1136/jrnms-1-181 https://archive.org/details/b3062129x https://wellcomecollection.org/works/me6bfg93 3. https://en.wikipedia.org/wiki/Royal_Hospital_Haslar https://www.royalhaslar.com/history 4. Stockman, R. (1926), Edin. Med. J., 33, 329 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5302666 2 p.388 Ayrshire (still marked as ‘Linn’ on the Ordnance Survey map) at least as early as 1207. Part of this property was sold early in the sixteenth century and the last of it, known as Croftfute, was sold in the reign of Mary Queen of Scots when the owner, John Lind, moved to Edinburgh. There he seems to have prospered, since his grandson James is described as ‘a merchant and burgess’ in the record of his marriage in 1707 to Margaret Smellum (variously spelled Smelum, Smellome and Smellholme). These were the parents of our James Lind, who was born on 4th October 1716, nine years after his sister Joan. We know nothing of Lind’s early schooling in Edinburgh although he must have been well grounded in Latin and Greek at least, as the bibliography of the Treatise of the Scurvy shows. At some time or other he must also have acquired a reading knowledge of French and German. At the age of fifteen he was apprenticed to George Langlands, a member of the Incorporation of Surgeons, and served his apprenticeship in Edinburgh. The systematic teaching of medicine in Edinburgh was just beginning. In 1720 Alexander Monro primus had been appointed by the Town Council the first Professor of Anatomy in the University, or ‘Town’s Colledge’ as it was then commonly called. Six years later four leading Fellows of the Royal College of Physicians of Edinburgh applied to be made Professors in the University; the Town Council appointed them, though without salary. These four were: John Rutherford (Practice of Medicine), the maternal grandfather of Sir Walter Scott, Andrew St Clair (Institutes of Medicine), Andrew Plummer and John Innes (who shared between them Materia Medica). They were all under thirty years of age and most, if not all, had studied under the great Hermann Boerhaave in Holland, as had also Alexander Monro and the Professors of Chemistry (James Crawford) and Botany (Charles Preston). Edinburgh’s medical teaching tradition therefore owes much of its initial inspiration to the famous school of Leyden. What did the student James Lind learn from all this new teaching? There is no record of his having attended a single lecture, although it is inconceivable that he should have ignored completely the presence of these young and enthusiastic teachers. The practical side of his profession was 3 p.389 probably learned through his duties as a surgeon’s apprentice, but the scholarship, application and understanding which he later displayed are unlikely to have been wholly self-taught; one or more of the new young professors lately back from Leyden must have inspired him. The mere fact that he was later to disprove Boerhaave’s mistaken notions about scurvy suggests the student’s delight in proving his teacher wrong! He himself said later that he endeavoured ‘to remove such objections as might arise from doctrines imbibed in younger years in schools and universities’. In 1739, when he was twenty-three, and nine years before clinical instruction was provided for students in the Royal Infirmary, his training came to an end, though he had no degree to show for it. Like hundreds of other Scottish medical men before and since, he set off for the south, and entered the Royal Navy in the humble civilian capacity of a surgeon’s mate. For the next ten years he sailed in various ships to the Mediterranean, to West Africa and the West Indies, carefully observing and recording everything he saw, as his later writings show. By 1747 he had been promoted Surgeon to H.M. fourth-rate ship Salisbury. It was during her cruise in the English Channel that year that Lind carried out his classic experiment on scurvy. In 1748 he had retired from the Royal Navy and had come home to Edinburgh to obtain his M.D. degree. The traditional thesis had to be submitted; his De morbis venereis localibus was probably written in the equally traditional haste and is a trivial piece of work. It was sufficient, however, for the purposes of graduation and obtained for him licence from the Royal College of Physicians to practise ‘within the City of Ed. & Libertys yrof without any tryal or Examination’ as he was ‘a Graduat Doctor of Medicine in the University of Edin.’ In 1750 he was elected a Fellow of the Royal College of Physicians of Edinburgh (F.R.C.P.E.) and in 1757 he became Treasurer of the Royal College. Lind was a member of the Philosophical and Medical Society of Edinburgh formed about 1750 from the Medical Society and the Society for improving the Arts and Sciences, and presented Two Papers on Fevers and Infections which were published in London in 1763. When, in 1783, this Society received a charter as the Royal Society of Edinburgh, Lind, as one of the members, automatically became an original Fellow. 4 p.390 During these years in Edinburgh he read all the known literature on scurvy and put together his own observations on the disease. In so doing he found that ‘what was first intended as a short paper to be published in the memoirs of our medical naval society… swelled to a volume’ and in 1753 his classic Treatise finally appeared in print in Edinburgh. It is significant that five years elapsed before the results of his experiment were published, but then he had no competitors. How much medical practice he pursued at this time is not known. There is no evidence that the publication of the Treatise created any great stir in Edinburgh, but it seems to have been at least noticed in London, if only because it was dedicated to The Rt. Hon. George, Lord Anson, by then First Lord of the Admiralty, a great and powerful man. In 1740 Commodore Anson had sailed from Portsmouth with six fighting ships and two ‘victuallers’ to challenge Spanish supremacy in the Pacific. In addition to his sailors he had on board some alleged soldiers but, owing to the administrative inefficiency and corruption of the time, these turned out to be only invalid Chelsea Pensioners and raw marine recruits. Over two thousand men were in those ships when they left but only two hundred came back; most of the rest had died of scurvy. The survivors, of whom about thirty were mere boys, lived to fight, in a single ship, H.M.S. Centurion, against the Spanish treasure ship, Cavadonga, one of the most remarkable battles in the long history of the British Navy. Then, having circled the world, they returned to port after four years at sea¨. This voyage was partly instrumental in stimulating Lind’s investigations of scurvy, and Walter’s account5 of it prompted the writing and publication of the Treatise of the Scurvy. 5. Lord Anson’s Voyage Round the World 1740—44, by Richard Walter, M.A. (1748). Abridged and annotated by S. W. C. Pack; Penguin Books, 1947. https://www.gutenberg.org/ebooks/16611 https://www.gutenberg.org/files/16611/16611-h/16611-h.htm https://archive.org/details/voyageroundworld00walt 5 Lord Anson—clearly a shrewd judge of character—was probably responsible for getting Lind appointed in 1758 (chief) Physician to the new Royal Naval Hospital—Haslar Hospital—at Portsmouth, with a salary of £200 per annum and permission to engage in private practice. In two letters, which have been preserved, addressed to Sir Alexander Dick, Bart., P.R.C.P.E. at the time of his p.391 leaving Edinburgh, Lind sounds slightly homesick. In the first he resigns his office as Treasurer of the Royal College and declares himself ‘A Sincere Well-wisher to the prosperity of the Colledge of Physicians in Edr.’ In the second he gives some account of his new place of work: ‘Haslar Hospital is an immense pile of building and tho’ of Brick will when finished have cost the Government about £100,000. It is surrounded by a high wall (to prevent desertion) containing 32 acres of ground. It will certainly be the largest hospital in Europe when finished but even then will not be able properly to receive above 2200 patients. This is owing to the Largeness of the regular wards.’ His initial professional staff seems to have consisted of seventeen men of varied qualifications and ninety ‘women nurses’; about twenty-four women were constantly employed in the washhouse: ‘all these under sober and discreet Matrons’. He sums up: ‘We are remarkably clean. No patient is admitted into the hospital until he is stripped of all his cloths and well washed with warm water and soap in tubs always kept for the purpose, he is allowed the hospital dress during the time he continues in the hospital or until his cloths are returned him quite clean, and he is regularly shifted and kept quite neat clean and sweet at the Government’s expence.’ In Lind’s first two years in office there were 5734 admissions, of which 1146 were cases of scurvy. As Stockman says, ‘the Channel Fleet might put in to Portsmouth with 1000 or even 2000 cases on board, single ships often arrived in a similar plight, and during the Seven Years’ War with France and Spain he usually had 300 to 400 cases under his daily charge in hospital, and even 1000 at one time. No man before or since has had the same opportunities of study… His position put him in touch with the naval surgeons of our own fleets on distant stations, and with them… he kept up an active correspondence regarding scurvy in all its aspects and in all climates.’ The writing of all these letters 6 in his own hand must have taken up a great deal of the time left over from his clinical and administrative duties. Nevertheless, during his years at Haslar Hospital he re-edited the Treatise, with additions derived, he tells us, from four large notebooks containing case-histories and additional observations made at Haslar; he also revised his Essay on Preserving the Health of Seamen6 as well as writing a third remarkable p.392 book, the Essay on Diseases incidental to Europeans in Hot Climates7, which ran through five editions in his lifetime. Perhaps that is the secret of his enigmatical character— that he had enough to do, think about and write about without worrying over contemporary politics or what posterity might think of him. He was the happy physician who by his own intellectual efforts did more than any man before or since to point the way for making safe the life of the sailor 6. The full title is: An Essay on the most effectual means of preserving the Health of Seamen in the Royal Navy, containing Directions proper for those who undertake long voyages at Sea or reside in unhealthy Situations with Cautions necessary for the Preservation of such Persons as attend the Sick in Fevers. https://collections.nlm.nih.gov/catalog/nlm:nlmuid-2498013R-bk (1757) https://archive.org/details/2498013R.nlm.nih.gov (1757) https://archive.org/details/essayonmosteffec00lind (1762) https://wellcomecollection.org/works/geeudjy2 (1762) https://archive.org/details/b30511410 (1762) https://archive.org/details/bim_eighteenth-century_an-essay-on-the-most-eff_lind-james_1774 https://archive.org/details/bim_eighteenth-century_an-essay-on-the-most-eff_lind-james_1778 7. The full title is: An Essay on Diseases incidental to Europeans in Hot Climates with the method of preventing their fatal consequences… to which is added an Appendix concerning Intermittent Fevers, and a simple & easy way to render sea water fresh & to prevent a scarcity of provisions in long voyages at sea. https://archive.org/details/bim_eighteenth-century_an-essay-on-diseases-inc_lind-james_1768 https://archive.org/details/b3051177x (1768) https://wellcomecollection.org/works/fnvvxq2c (1768) https://archive.org/details/bim_eighteenth-century_an-essay-on-diseases-inc_lind-james_1771 https://wellcomecollection.org/works/e2cpc5rs (1771) https://archive.org/details/bim_eighteenth-century_an-essay-on-diseases-inc_lind-james_1777 https://archive.org/details/b30544725 (1777) https://archive.org/details/bim_eighteenth-century_an-essay-on-diseases-inc_lind-james-physician-t_1788 https://archive.org/details/b21365246 (1788) https://archive.org/details/bim_eighteenth-century_an-essay-on-diseases-inc_lind-james_1792 https://archive.org/details/b33089206 (1808) https://archive.org/details/b21299341 (1808) https://resource.nlm.nih.gov/2561034R (1811) https://archive.org/details/2561034R.nlm.nih.gov (1811) https://archive.org/details/essaisurlesmalad00lind (French) https://archive.org/details/essaisurlesmalad01lind (French) 7 at sea. Should we expect any more of him ? He himself said, ‘The Province has been mine to deliver Precepts: The Power is in others to execute’. He retired from Haslar Hospital after twenty-five years’ service there, and was succeeded by his son John, who had for a short time previously been his assistant. On his retirement his portrait was painted by Sir George Chalmers (a fourth-rater, like H.M.S. Salisbury), but it is now lost, probably because it seemed at the time to have no special historical value.8 He died on 13th July 1794, and was buried in Porchester Church, which was built by the Normans within the walls of the old Roman fort. He is commemorated by a small tablet on the north wall of the nave and this also mentions his wife, Isobel Dickie. Lind must have married her during his time as a physician in Edinburgh, but except that she died on 6th March 1796 at the age of seventy-six nothing seems to be known of her. Lind, the ‘Man of Observation’ When James Lind’s pupil, Thomas Trotter, described him as a ‘man of observation’ he was recognising the essential feature of Lind’s genius: the power to observe and record the natural history of disease with an open mind, untrammelled by the preconceived notions of previous writers. Although this may seem startling, it is probably correct to say that Lind was the first of the modern clinical investigators, the first to have complete faith in the validity of his own observations and the logic of his inductions from them—even though these seldom conformed to the established ideas of his time. With no elaborate apparatus, and 8. An engraving was made by I. Wright, however, and a print of this forms the frontispiece to the copy of the 6th Edition of the Essay on Diseases Incidental to Europeans in Hot Climates in Haslar Hospital Library—apparently an addition when the volume was re-bound. https://en.wikipedia.org/wiki/James_Lind#/media/File:James_Lind_by_Chalmers.jpg https://www.jameslindlibrary.org/wp-data/themes/jameslind/images/lind-portrait.jpg https://www.rcpjournals.org/content/clinmedicine/19/1/22/F1.large.jpg [“there is no information as to its whereabouts from then until it was purchased in Johannesburg in November 1953 by Kurt and Lorna Hepner. It is not known who the seller was, but it could well have been an art dealer. Since then the portrait has remained in the Hepner family.”] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3536516 https://doi.org/10.1258/jrsm.2012.12k091 8 p.393 little but his eyes to guide him, he got nearer to the truth about the nature of scurvy, malaria and typhus than perhaps any single man before. The clinical investigator of to-day, tied to an elaborate technique and confused by a voluminous and often misleading literature, may well pause to consider Lind’s achievements—all the result of simple observation and logical thought. Lind might equally well be called a ‘man of reason’. He is a great example of that eighteenth-century habit of rational thinking by which fear, superstition and deductive speculation were to be rooted out, leaving the Rational Man in command of his own destiny. Witchcraft, for instance, which was feared in his time and haunts men’s minds even to-day, he quickly dismisses as an ‘imaginary evil’. In his Preface to the Treatise Lind says that ‘before this subject [scurvy] could be set in a clear and proper light, it was necessary to remove a great deal of rubbish’. To follow him, in the opening chapters of the book, as he burns the rubbish of the previous literature, is a stimulating intellectual experience. He lays aside ‘all systems and theories which were found to be disavowed by nature and facts’ and says: ‘Where I have been necessarily led, in this disagreeable part of the work, to criticise the sentiments of eminent and learned authors, I have not done it with a malignant view of depreciating their labours, or their names; but from regard to truth, and to the good of mankind’. Then, as now, medical writers too often copied from each other while ‘adding something themselves’, so that the standard descriptions of scurvy, when Lind began, were extraordinarily confused. The leading authority, acknowledged even by the great Boerhaave, was the Dutch physician who called himself Eugalenus, ‘the new Galen’; he believed that scurvy was a ‘Proteus-like mischief, lurking under various and surprising appearances’ and sent ‘by divine permission, as a chastisement for the sins of the world’. Eugalenus seems to have described scurvy as a kind of universal pathological process that would account for any or every clinical disorder, under the most diverse conditions. The idea of a universal ill, and of a universal panacea to cure it, was a popular notion in the seventeenth century and it keeps cropping up even to-day. Lind shows his obvious contempt for such mediæval thinking. He says that ‘the 9 Thomas Trotter (1760-1834) Trotter, who was born at Melrose, studied in Edinburgh and rose in the Naval medical service the hard way, beginning, in 1779, in the same way as Lind, as a mere civilian surgeon’s mate. He was for some time on Lind’s staff at Haslar Hospital. Ultimately, in 1794, he became Physician to the Channel Fleet. He urged that Lind’s antiscorbutic measures, which had been so successful in the Royal Navy, should be extended to the mercantile marine, and thus was probably responsible for earning the British their common nickname in America—‘limeys’ (lime-juicers). He also supported, though without success, Lind’s proposal that sailors should be supplied with a uniform. He tried and failed to get vaccination adopted in the Royal Navy, and struggled for better pay, better food and better hygiene for the common sailor. p.400 His Medica Nautica14 was published in three volumes, 1791-1803. Sir Gilbert Blane (1749-1834) Blane came of a well-to-do Ayrshire family; he studied both Arts and Medicine in Edinburgh, but graduated M.D. from Glasgow in 1778. During his student years he was President of the Royal Medical Society (1774-5) and of the Speculative Society (1775). He attended William Hunter’s15 lectures in London, and through his influence was appointed personal physician to Admiral Sir George Rodney. He distinguished himself on various naval expeditions and was appointed Physician to the Fleet. During the years 1781-2, in the West Indies, he persuaded Rodney to adopt various sanitary measures of the kind suggested by Lind and practised so successfully by Cook, as well as to make use of Lind’s antiscorbutic fruits. In 1783 he retired to practise in London and joined the staff of St Thomas’s Hospital, but, having acquired a great reputation, continued to be consulted by the Government on matters of health, particularly in connection with sailors. His Observations on the Diseases 14. Medicina nautica: an essay on the diseases of seamen. In three volumes. 2nd ed. (1804) vol. 1. https://archive.org/details/b21351879_001 vol. 2. https://archive.org/details/b21351879_002 vol. 3. https://archive.org/details/b21351879_003 15. William was John Hunter’s elder brother. 16 Incident to Seamen16 was published in 1785 and gave due credit to Lind for his work on scurvy. Through Blane’s influence the Royal Navy finally adopted in 1795 the recommendations made by Lind forty-two years before, and scurvy vanished virtually overnight. Blane introduced the free supply of soap to sailors, the better ventilation of ships and the proper supply of medicines to ships’ surgeons, and also discouraged the consumption of undiluted rum. He adopted Lind’s principle of preferring hospital ships to shore-based hospitals on foreign stations. In 1812 he was made a baronet. His cold and reserved manner earned him the nickname of ‘Chilblain’, although it appears that this manner was kept for his inferiors; towards his superiors in social status, as Sir Sheldon Dudley points out, he was reputed to be somewhat sycophantic. Captain James Cook, R.N. (1728-79) The son of a Yorkshire agricultural labourer, James Cook was apprenticed to the keeper of a little general store but p.401 was released from his indentures and, in 1746, at the age of eighteen, went to sea as an apprentice. At the outbreak of the Seven Years’ War (1755), by which time he had become mate of a collier, he volunteered for service with the Royal Navy and as an ‘Able Bodied Seaman’ was sent to America. There his own merits and ‘the interest of his friends’ soon procured him a Master’s warrant and, in command of the Mercury, during the siege of Quebec, he was assigned the dangerous and difficult task of charting the channel of the St Lawrence. Later he led two expeditions round the world. The first (1768-71), in H.M.S. Endeavour, a vessel of collier type with a complement of 84, was undertaken at the instigation of the Royal Society for the purpose of making astronomical observations of the transit of Venus as seen from Tahiti. On completion of this task Cook made a preliminary reconnaissance 16. Observations on the diseases of seamen. 3rd ed. (1799) https://archive.org/details/b2144092x https://wellcomecollection.org/works/tccjsh8c https://archive.org/details/b22041606 (1800) https://wellcomecollection.org/works/tccjsh8c (1800) https://archive.org/details/observationsondi1803blan (1803) https://wellcomecollection.org/works/wcsq9n5t (1803) 17 of Australasia, noting the suitability of New Zealand for settlement, exploring two thousand miles of the Australian coast and proving Australia (New Holland) and New Guinea to be separate. At this stage of the voyage scurvy broke out, and from this disease or from ‘fever’ and dysentery a third of the ship’s company died before England was reached by way of the Cape and St Helena. Cook set out on his second voyage (1772-5), in H.M.S. Resolution with H.M.S. Adventure in company, with the intention of amplifying his discoveries. It was considered a hazardous adventure as it was the first attempt to circumnavigate the world in the easterly direction. When therefore he returned having lost from the Resolution’s crew of 118 only one man as the result of disease17—in marked contrast to the fate of Lord Anson’s crews thirty years before and his own in H.M.S. Endeavour—his achievement created an immediate sensation. It was particularly remarkable because Cook had sailed completely round Antarctica, penetrating to high latitudes and remaining there for weeks on end, and in such conditions, susceptibility to scurvy was considered to be increased. He was asked to read a paper to the Royal Society explaining how he had prevented the scurvy and preserved the health of his men.18 He had paid particular attention to their diet, p.402 providing them with malt and sauerkraut (pickled cabbage) while at sea. These were still regarded as better antiscorbutics than the citrus fruits that Lind would have recommended. What really contributed most to his success was that he made sure that his men obtained and ate fresh fruit (including lemons, oranges and limes) and vegetables whenever they touched land. He overcame the prejudice of his men against eating antiscorbutics by having them served in full view on the wardroom officers’ table, after which the ‘lower deck’ had to be restrained from eating too much of those invaluable but limited rations, for, said Cook, ‘the moment they see their superiors set a value for it, it becomes the finest stuff in the world’. 17. H.M.S. Resolution had a few non-fatal cases of scurvy; H.M.S. Adventure, which returned separately, was less fortunate. 18. James Cook. The method taken for preserving the health of the crew of his Majesty's ship the Resolution during her late voyage round the World. https://doi.org/10.1098/rstl.1776.0023 18 It was for his practical demonstration of the means of preventing scurvy, rather than for his remarkable and spectacular feats of navigation, that Cook was awarded the highest honour of the Royal Society, the Copley Medal. The authority of the Royal Society, which had thus given public recognition to the value of antiscorbutic measures at sea, undoubtedly strengthened Blane’s hand in getting Lind’s principles accepted by the Lords of the Admiralty. Yet this strengthening was in some ways achieved in spite of Cook, for his letter to Pringle19 insists that ‘with plenty of fresh water, and a close attention to cleanliness, a ship’s company will seldom be much afflicted with scurvy though they should not be provided with any of the antiscorbutics before mentioned’—a remarkable example of a great man’s inability to discriminate between essential and contributory factors. Less than a year after returning from his second circumnavigation of the world Cook was commissioned—again in H.M.S. Resolution but now with the rank of Post Captain— to explore the western coast of North America and to search for a ‘North-East Passage’ from the Pacific to the Atlantic. It was after exploring the seas from Oregon through the Behring Strait to Icy Cape without discovering an ice-free passage to the East that Cook returned to Hawaii, where he met his death in a skirmish with the natives. He was fifty-one. p.403 Sir John Pringle (1707-82) Pringle comes into this story because he achieved for the Army what Blane was later to do for the Navy in introducing preventive medicine. But he had no Lind to guide him. The son of a Roxburghshire baronet, his life was a success from the start. He studied at St Andrews, Edinburgh and Leyden, became Professor of Moral Philosophy at Edinburgh (combining this with the practice of medicine) and afterwards accompanied various Army leaders as their medical consultant, including the Earl of Stair on the Continent and the Duke of Cumberland at Culloden. At the battle of Dettingen, or 19. A Discourse upon some Late Improvements of the Means of Preserving the Health of Mariners, London, 1776. https://wellcomecollection.org/works/q7n4y77w https://wellcomecollection.org/works/xjr3v3aq https://archive.org/details/b30790943 https://archive.org/details/bim_eighteenth-century_a-discourse-upon-some-la_pringle-john-sir_1776 19 rather, during the campaign of 1743, he succeeded in arranging that military hospitals should be respected on both sides as sanctuaries, thus providing a forerunner of the Red Cross. His Observations on the Diseases of the Army20 was published in 1752 and had a wide circulation in several languages. He seems to have been the first to introduce the word ‘antiseptic’. Though scurvy certainly occurred during warfare on land (as Lind so clearly points out), it was not the major problem for the Army. Indeed, Pringle does not seem to have known much about it, because when his protege, William Stark, died of self-induced scurvy in 1770, he failed to offer advice that he might have gained from reading Lind. Indeed he later appears to accept Cook’s views on the causes and prevention of scurvy—and Cook was profoundly and erroneously sceptical about the value of fruits and vegetables so rightly recommended by Lind. He became Physician to King George III and was later made President of the Royal Society. His wife was the daughter of Dr Oliver, of Bath and biscuit fame. 20. Observations on the Diseases of the Army. https://wellcomecollection.org/works/xj5xh2ne (1761) https://wellcomecollection.org/works/re2kkv6s (1775) https://wellcomecollection.org/works/xh37sa3v (1810) https://wellcomecollection.org/works/gxjh5dug (1812) https://archive.org/details/b30502962 (1752) https://archive.org/details/bim_eighteenth-century_observations-on-the-dise_pringle-sir-john-bart_1752 https://archive.org/details/observationsondi00prin (1753) https://archive.org/details/bim_eighteenth-century_observations-on-the-dise_pringle-john_1753 https://archive.org/details/bim_eighteenth-century_observations-on-the-dise_pringle-john_1761 https://archive.org/details/bim_eighteenth-century_observations-on-the-dise_pringle-sir-john_1764 https://archive.org/details/bim_eighteenth-century_observations-on-the-dise_pringle-john_1765 https://archive.org/details/bim_eighteenth-century_observations-on-the-dise_pringle-sir-john_1768 https://archive.org/details/bim_eighteenth-century_observations-on-the-dise_pringle-sir-john_1774 https://archive.org/details/b30522225 (1775) https://archive.org/details/bim_eighteenth-century_observations-on-the-dise_pringle-sir-john-bart_1775 https://archive.org/details/b32886901 (1810) https://archive.org/details/2567046R.nlm.nih.gov (1810) https://collections.nlm.nih.gov/catalog/nlm:nlmuid-2567046R-bk (1810) https://archive.org/details/2567047R.nlm.nih.gov (1812) https://collections.nlm.nih.gov/catalog/nlm:nlmuid-2567047R-bk (1812) https://archive.org/details/observationssurl01prin (in French) https://archive.org/details/observationssurl02prin (in French) 20 Lind J. A Treatise of the Scurvy in Three Parts (1753/1757/1772) https://doi.org/10.1111/j.1753-4887.1983.tb07177.x https://doi.org/10.1017/CBO9781107256644 https://archive.org/details/b30507054 (1st ed 1753) https://wellcomecollection.org/works/xc2t7736 (2nd ed 1757) https://archive.org/details/treatiseonscurvy00lind (2nd ed 1757) https://archive.org/details/treatiseonscurvy1772lind (3rd ed 1772) https://openlibrary.org/books/OL24970496M (3rd ed 1772) https://openlibrary.org/books/OL26752931M (3rd ed 1772) https://archive.org/details/b30511902 (3rd ed 1772) https://archive.org/details/bim_eighteenth-century_a-treatise-on-the-scurvy_lind-james_1772 (3rd ed) https://babel.hathitrust.org/cgi/pt?id=ucm.5320216006 (3rd ed 1772) https://archive.org/details/b28771308_0001 (French, 1783) https://archive.org/details/b28771308_0002 (French, 1783) https://archive.org/details/traitduscorbutdi00lind (French, 1783) https://archive.org/details/traitduscorbutdi00lind_0 (French, 1783) https://archive.org/details/TrattatoDelloScorbutoDivisoInTreParti (Italian, 1766) 21