Description of scurvy on the Seventh Crusade by Jean de Joinville (1249)

Description of scurvy on the Seventh Crusade by Jean de Joinville (1249) This is Chapter VII of the book “Saint Louis, King of France” by Jean de Joinville. Joinville’s text is one of the very earliest unambiguous descriptions of scurvy. Saint Louis, King of France / by the Sire de Joinville; translated by James Hutton. 1892. https://archive.org/details/SaintLouisKingOfFrance/page/n13/mode/2up https://archive.org/details/saintlouiskingof0000join/mode/2up https://babel.hathitrust.org/cgi/pt?id=njp.32101015301110&seq=13 Extracts of the section about scurvy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294660 (p.207) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403999 (p.59-60) https://www.usni.org/magazines/proceedings/1951/october/million-seamen-were-slain This is another translation of the same story on p.432-442: Chronicles of the crusades, being contemporary narratives of the crusade of Richard Cœur de Lion / by Richard of Devizes and Geoffrey de Vinsauf; and of the crusade of St. Louis, by Lord John de Joinville. 1848. The crusade of Saint Louis translated by T. Johnes. https://wellcomecollection.org/works/pssvs5ry/items?canvas=446 https://babel.hathitrust.org/cgi/pt?id=umn.31951p01139215g&seq=444 https://babel.hathitrust.org/cgi/pt?id=hvd.32044037767399&seq=458 https://babel.hathitrust.org/cgi/pt?id=mdp.39015000652431&seq=446 https://archive.org/details/chroniclesofcrus00join/page/432/mode/2up https://archive.org/details/b29349461/page/432/mode/2up Yellow is used to indicate the more important sections. This text is available at: https://doi.org/10.5281/zenodo.17341538 2025-10-13 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.com/citations?user=2mkomzUAAAAJ https://doi.org/10.5281/zenodo.17085738 Reports on scurvy uploaded to Zenodo by Harri Hemilä 1 There are earlier texts that had been interpreted as scurvy. However… James Lind1 (1757) was not convinced that those older descriptions specifically indicated scurvy. https://archive.org/details/treatiseonscurvy00lind/page/296/mode/2up https://wellcomecollection.org/works/xc2t7736/items?canvas=320 “Not that I would be understood to mean, that the p.296. scurvy never afflicted armies of old; but only that the accounts we have of it are dubious and imperfect. The first description of a true scurvy that I have met with, is what occurred in the Christian army in Ægypt, about the year 1260, under Lewis IX. But there mention is made, not only of the legs being affected, but also of the spots. The fungous and putrid gums are particularly described, &c. Vid. Histoire de Lewis IX, par le Sieur Joinville.” August Hirsch2 (1885) was also not convinced that early writings described scurvy. https://doi.org/10.5281/zenodo.10104179 Section on scurvy separately https://archive.org/details/handbookofgeogra02unse/page/508/mode/2up https://archive.org/details/handbookofgeogra02hirs/page/508/mode/2up https://babel.hathitrust.org/cgi/pt?id=uc2.ark:/13960/t39022v3n&seq=526 https://babel.hathitrust.org/cgi/pt?id=mdp.39015006659547&seq=524 “The writings that have come down to us from antiquity p.508 and the middle ages give no help towards deciding whether scurvy occurred, or was known to medicine, in those times at all; or, if so, to what extent. In order to make out that the Graeco-Roman and Arabian physicians were acquainted with scurvy, special emphasis has been laid on a form of disease described under the name of “lienes magni” by Hippocrates, Celsus, Aretæus, Cælius Aurelianus, Paulus Ægineta, Avicenna and others… There is, in my view, but little reason to take that group p.509 of symptoms, characteristic of the “lienes magni,” as pointing to scurvy; firstly because swelling of the spleen, which was undoubtedly a constant occurrence in that malady according to the descriptions of observers, is by no means one of the more commonly noted phenomena of scurvy; and secondly because the Hippocratic writers themselves refer the origin of the malady in question to its true source—the malarial cachexia. This view of mine is further supported by the fact, to be afterwards adduced, that scurvy and malarial cachexia have often been confounded in later times… It is a priori highly probable that scurvy had been epip.511 demic from time to time in antiquity under the same circumstances that have given rise to it in the modern 1https://en.wikipedia.org/wiki/James_Lind 2https://en.wikipedia.org/wiki/August_Hirsch https://pmc.ncbi.nlm.nih.gov/articles/PMC2530992 2 period or in recent times. It certainly follows from the account given by Jacques de Vitry a of a disease called by him the plague, which ravaged the army of the crusaders before Damietta in 1218, and from Joinville’s b description a) Liv. iii, § 351, ‘Collect,’ Guizot (quoted by Marchand, ‘Étude histor. et nosol. sur quelques épidémies et endémies du moyen âge,’ Par., 1873, 17): “Un grande nombre d’hommes de notre armée furent en outre saisis d’une certaine peste contre laquelle les médecins ne pouvaient trouver aucun remède dans leur art. Une douleur soudaine s’emparait des pieds et des jambes: aussitôt après les gencives et les dents étatient attaquées d’une sorte de gangrène, et le malade ne pouvait plus manger. Puis l’os de la jambe devenait horriblement noir et ainsi après avoir souffert de longues douleurs pendant lesquelles ils déployèrent une grande patience, un grand nombre de chrétiens allèrent se reposer dans le sein du Seigneur. Quelques-uns étant parvenus à gagner le printemps se guérirent alors par l’effet des chaleurs.” Translation with Google translate: “A large number of men in our army were also seized with a certain plague for which doctors could find no remedy in their art. A sudden pain would seize the feet and legs; immediately afterward, the gums and teeth would be attacked by a kind of gangrene, and the patient could no longer eat. Then the leg bone would turn horribly black, and so, after suffering prolonged pain during which they displayed great patience, a large number of Christians went to rest in the bosom of the Lord. Some, having managed to reach spring, were then cured by the effects of the heat.” b) ‘Histoire de Saint-Loys,’ Par., 1617, 121. “Nousvint une grant persécution et maladie en l’ost ; qui estoit telle que la chair des jambes nous desséchait jusqu’à l’os, et le cuir nous devenoit tanné de noir et de terre à la resemblance d’une vielle houze, qui a été longtemp mucée derriere les coffres. En oultre, à nous autres qui auions cette maladie, nous venoit une autre persécution de maladie en la bouche, de ce que nous auions mengié de ces poissons, et nous pourrissoit la chair d’entre les gencives, dont chacun estoit orriblement puant de la bouche. Et à la fin guesres n’en enchappoient que tous ne mourussent. Et le signe de mort que l’on y congnoissoit continuellement estoit quand en se prenoit à saigner du neys, et tantoust on estoit bien asseuré d’estre mort de brief.” Translation with Google translate: A great persecution and illness came upon us in the army; such that the flesh of our legs dried up to the bone, and our leather became tanned black and earthy, like an old hut, which had been moldering for a long time behind the chests. In addition, we who had this illness suffered another persecution of illness in the mouth, from the fact that we had eaten these fish, and our flesh rotted between the gums, making each one stink terribly from the mouth. And in the end, hardly any escaped but all died. And the sign of death that one continually recognized there was when one began to bleed from the nose, and at that moment one was quite sure of having died of heartburn. of the sickness that broke out in 1250 among the army of p.512 Louis IX at the siege of Cairo, that scurvy had existed long before we have any medical recognition or description 3 of it as a peculiar form of disease. The history of scurvy as an epidemic malady well known to the medical profession does not begin before the fifteenth century, or the period of the Renascence—a movement which touched every relation of life, and by exciting an interest in foreign countries, gave occasion to sea voyages on a scale never before known…” Hermann Immermann3 (1878) wrote: https://doi.org/10.5281/zenodo.17302867 Section on scurvy separately https://archive.org/details/63550630RX13.nlm.nih.gov/page/n123/mode/2up https://archive.org/details/b21503230_0017/page/104/mode/2up https://collections.nlm.nih.gov/bookviewer?PID=nlm:nlmuid-63550630RX13-mvpart In the following brief historical sketch it is not our purpose p.107 to present an extended resume of this branch of our subject, but merely to point out those leading facts in the history of the disease which are important for a clear appreciation of its genesis. Although neither the medical nor the historical literature of antiquity and the earlier middle ages contains a single passage that discriminates scurvy as a distinct species of disease, or even positively indicates its existence during these periods, it is hardly to be supposed that an affection so closely connected, as scurvy appears to be, with certain widely prevalent sanitary evils—particularly improper diet, hardships, and unfavorable metereological influences—can have failed to manifest itself in p.108 all times whenever individuals or bodies of men have been subjected, under circumstances similar to those of recent times, to the influence of these noxious agents. So far, however, as historical evidence is concerned, the disease can be traced back only as far as the thirteenth century of the present era, and did not acquire actual historical importance as a frequent and widespread affection until about the middle of the fifteenth century, while its present name “scorbutus” made its appearance in medical and non-medical writings only at the beginning of the sixteenth century. Attempts have not been wanting to prove the existence of scurvy in ancient times from certain descriptions of disease by the older writers, which have been supposed to refer to the affection in question. None of the evidence, however, will bear careful examination—much of it having no bearing whatever upon the point at issue, while the rest is at least untrustworthy. The most conspicuous instance of this misrepresentation is that which pretends to recognize scurvy in the affection described by Hippocrates, and after him by Aretaeus, Celsus, Caelius Aurelianus, Paulus Aegineta, Avicenna, and others, under the term “(magni lienes)” still, as Hirsch has pointed out, there can be scarcely a doubt that 3https://de.wikipedia.org/wiki/Hermann_Immermann_(Mediziner) 4 these “enlarged spleens” are merely what is now known as the lesion of chronic malarial cachexia… … That the symptoms of this “volvulus sanguineus” strongly resemble those of p.109 scurvy cannot be denied; still, neither Hippocrates nor later writers give us any clue to the causes of the affection in question whereby the identity of the latter with scurvy can be satisfactorily established. Such an omission, moreover, when we bear in mind the marked, and indeed, characteristic etiology of scurvy, is fatal to the acceptance of supposed evidence of this kind from the ancient writers; and we can only conclude, therefore, that while the existence of scurvy in early times is a priori highly probable, direct proof of the suspected fact is still wanting. On the other hand, we possess unequivocal reports of the occurrence of scurvy at the time of the Crusades, in an epidemic form, and under external conditions completely similar to those ordinarily observed in more recent times, viz., want of food, hardship, unfavorable weather, etc., during marches and sieges. The first epidemic of this kind broke out in November, 1218, at the siege of the city of Damietta, among the forces of Count Saarbrücken,4 and continued through the entire winter with great destruction of life. Another epidemic, still more malignant, occurred in 1249, in the army of St. Louis, of France, when it was lying before Cairo and was suddenly deprived of its means of subsistence by an overflow of the Nile. The epidemic of 1218-1219 is described by Jacob de Vitry as follows: “In vasit praeterea multos de exereitu nova pestis, contra quam physici nullum remedium invenire poteraut: dolor repentinus pedes invasit et crura, et conjunctim caro corrupta gingivas et dentes abduxit, masticandi potestatem auferrens; tibias horribilis nigredo offuscavit et sie longo tractu doloris afllicti cum patientia multa migraverunt ad Dominum plurimi; quidam usque ad vernale tempus durantes, beneficio caloris evaserunt liberati.” Translation with Google translate: Moreover, many of the army were struck by a new plague, against which physicians could find no remedy: a sudden pain invaded the feet and legs, and at the same time the flesh rotted away the gums and teeth, taking away the power of chewing; the shins were darkened by a horrible blackness, and after a long period of pain, many, with great patience, passed away to the Lord; some, lasting until spring, escaped and were freed by the benefit of the heat. And Joinville relates in regard to the plague of the year 1249: “Et nous vint la maladie de l’Ost qui étoit telle, que la chair de nos jambes séehoit et étoit tardée de noir et de terre; et à nous qui avions maladie telle venoit chair pourrie aux gengives et nul n’échappoit. Le signe de la mort étoit, que là, ou le nez saignoit, it falloit mourir.” Translation with Google translate: And the disease of the Ost came upon us, which was such that the flesh of our legs dried and was tarnished with black and earth; and to us who had such a disease came rotten flesh to the gums, and no one escaped. The sign of death was that where the nose bled, one had to die. 4https://en.wikipedia.org/wiki/Simon_III,_Count_of_Saarbr%C3%BCcken 5 It is evident from these descriptions, in the thirteenth century, of what we can hardly fail to recognize as scurvy, that the disease had attracted the attention of historians long before it became the object of scientific investigation by physicians. The immediate occasion of the increased nosological importance which scurvy suddenly acquired for the civilized populations of Europe in the second half of the fifteenth century, and continued to maintain for nearly three hundred years, was the p.110 wonderful transformation in the commerce of that epoch initiated by the bold voyages of the Spaniards and Portuguese, beginning with the discovery of America and of the passage to the East Indies… Alfred Hess5 (1920) Scurvy, Past and Present, p.2. https://www.gutenberg.org/ebooks/40505 https://catalog.library.cornell.edu/catalog/2903792 https://reader.library.cornell.edu/docviewer/digital?id=chla2903792#page/9/mode/1up https://archive.org/details/cu31924073869996/page/n17/mode/2up An interesting early description of scurvy, and one which is quite convincing, is that of de Joinville, who accompanied the Crusaders in their invasion of Egypt under St. Lewis, about the middle of the thirteenth century. He refers to the lividity and spongy condition of the gums, and describes how “the barber surgeons were forced to cut away the dead flesh from the gums to enable the people to masticate their food”; he describes their debility, their tendency to faint, and the black spots on their legs. The disease broke out in Lent, during which time the soldiers partook of no meat, but consumed a species of eel which they believed “ate the dead people” and therefore led to this loathsome disease. 5https://en.wikipedia.org/wiki/Alfred_Fabian_Hess 6 General background for the Seventh Crusade: https://en.wikipedia.org/wiki/Seventh_Crusade https://en.wikipedia.org/wiki/Battle_of_Mansurah_(1250) https://en.wikipedia.org/wiki/Battle_of_Fariskur_(1250) https://www.worldhistory.org/Seventh_Crusade/ https://historylearning.com/medieval-england/the-crusades/seventh-crusade/ https://the-orb.arlima.net/textbooks/crusade/seventhcru.html https://deremilitari.org/2014/01/the-seventh-crusade-1249-according-to-abu-al-faraj-gregory-bar-hebraeus/ Scurvy in Louis IX The above authors point out that there are no unambiguous historical descriptions of scurvy before the crusades; however, with the improvements in research technology, there are archaeological evidence of scurvy in earlier skeletons.6 Recent investigations of the skeletal remains suggested that Louis IX may have suffered from scurvy7, though the interpretations have been challenged.8 In any case, the epidemic of scurvy described in Chapter VII of Joinville’s text is such short that it is a highly unlikely explanation for permanent changes in bone structure. 6https://pubmed.ncbi.nlm.nih.gov/37337361 https://pubmed.ncbi.nlm.nih.gov/30298514 https://pubmed.ncbi.nlm.nih.gov/29539463 https://pubmed.ncbi.nlm.nih.gov/16323179 7https://pubmed.ncbi.nlm.nih.gov/37884212 https://pubmed.ncbi.nlm.nih.gov/31185300 https://www.smithsonianmag.com/smart-news/fear-foreign-food-led-death-crusader-king-180972491 https://phys.org/news/2019-06-locals-scurvy-undid-crusader-king.html https://www.archaeology.wiki/blog/2019/06/26/french-king-louis-ix-had-severe-scurvy-study-finds https://archaeology.org/news/2019/06/24/190624-king-louis-scurvy 8https://pubmed.ncbi.nlm.nih.gov/31904527 https://pubmed.ncbi.nlm.nih.gov/31904525 7 Saint Louis,9 King of France by Jean de Joinville10 Chapter VII. Location of this file: https://doi.org/10.5281/zenodo.17341538 Text is from: https://archive.org/details/saintlouiskingof0000join/page/n81/mode/2up https://archive.org/details/SaintLouisKingOfFrance/page/n97/mode/2up https://babel.hathitrust.org/cgi/pt?id=njp.32101015301110&seq=97 p.77 AFTER the two battles above described the army began to experience great misery; for at the end of nine days the dead bodies of our people who had fallen rose to the surface of the water (and it was said that this happened because their gall-bladders had putrefied), and they floated to the bridge that joined the two camps, and could not pass through because the bridge rested upon the water. There was such a number of them that the whole surface of the river was covered with dead bodies from one bank to the other, and for the distance of a stone’s-throw up the stream. The king engaged a hundred of the camp-followers, who were occupied for eight days. The dead bodies of the Saracens,11 who were circumcised, they threw over to the other side of the bridge, and let them float down the current; but the Christians they buried in deep trenches, one with another. I saw there the Count of Artois’ 12 chamberlains and many others looking for their friends among the dead, but I never heard that any one was identified. We had no fish in the camp to eat during Lent13 except the karmout (a kind of eel), which preyed upon the dead bodies, for they are a gluttonous fish. And in conp.78 sequence of this misfortune, and of the unhealthiness of the country, where never a drop of rain falls, we were attacked with the army sickness, which was such that our legs shrivelled up and became covered with black spots, and spots of the colour of earth, like an old boot; and in such of us as fell sick the gums became putrid with sores, and no man recovered of that sickness, but all had to die. It was a sure sign of death when the nose began to bleed: there was nothing left then but to die. About a fortnight afterwards the Turks, in order to starve us out (at which many of our people were astonished), took several of their galleys which were above our camp, dragged them overland to a good league below our camp, and placed them in the river by which supplies came from Damietta.14 These galleys brought famine upon us, for no one now ventured to come to us from Damietta to bring us provisions by ascending the stream. We knew nothing of all this until a small vessel of the count of Flanders, which fought its way past them, brought us the news, by which time the sultan’s galleys had captured eighty of our galleys that were coming from Damietta, and killed all who were on board. There thence arose such a scarcity in the camp that when Easter had arrived an ox was worth 80 livres,15 a sheep 30 livres, a pig 30 livres, an egg 12 deniers,16 and a 60-gallon measure of wine 10 livres. When the king and the barons saw that, they agreed that the king should withdraw his army from before 9 Saint Louis https://en.wikipedia.org/wiki/Louis_IX_of_France https://www.britannica.com/biography/Louis-IX https://www.sainte-chapelle.fr/en/discover/saint-louis https://www.inquiriesjournal.com/articles/96/jean-de-joinville-and-his-biography-of-saint-louis-on-the-seventh-crusade https://catholicinsight.com/2025/08/25/saint-louis-ix-a-most-christian-king/ https://www.vaticanstate.va/en/state-and-government/general-informations/saint-of-the-day/2635-august-25-saint-louis-ix-king-of-france.html 10 Jean de Joinville https://en.wikipedia.org/wiki/Jean_de_Joinville https://www.britannica.com/biography/Jean-sire-de-Joinville 11 https://en.wikipedia.org/wiki/Saracen 12 https://en.wikipedia.org/wiki/Robert_I,_Count_of_Artois 13 https://en.wikipedia.org/wiki/Lent Period of preparation for Easter. 14 https://en.wikipedia.org/wiki/Damietta 15 https://en.wikipedia.org/wiki/French_livre 16 https://en.wikipedia.org/wiki/French_denier 8 Babylon,17 and join the camp of the Duke of Burgundy,18 which was on the river that goes to Damietta. To effect a junction of his troops with greater safety, the king threw up an outwork19 before the bridge between the two camps, so that it could be entered on horseback p.79 from two sides. As soon as the outwork was completed the king’s army was put in array, and the Turks made a fierce assault upon the camp. For all that, neither the camp nor any of the people moved until all the baggage had been carried across then: the king crossed, and with him his division, and after that all the other barons, excepting Monseigneur de Châtillon, who covered the retreat. And at the very moment of entering the outwork, Monseigneur Erard de Valery20 rescued Monseigneur John, his brother, whom the Turks were carrying off a prisoner. When the main body of the army had crossed over, those who remained in the outwork were in great danger; for the outwork was not high, so that the Turks on horseback fired at them point-blank, while the Saracens on foot flung clods21 of earth into their faces. They would all have been cut off had not the Count of Anjou,22 who was afterwards King of Sicily, gone to their rescue and brought them off safe and sound. The honour of that day fell to Monseigneur Geoffrey de Mussamboure, from out of all who were in the outwork. On the eve of Shrove-Tuesday23 I witnessed a wonderful thing, which I should like to recount to you, for on that day was interred24 Monseigneur Hugh de Landricourt, who was in my company bearing a banner. While he was lying on his bier25 in my chapel, six of my knights were leaning against some sacks of barley: and because they were talking aloud in my chapel and disturbing the priest with their noise, I went up to them and told them to be silent, and said that it was unbecoming in knights and gentlemen to talk while mass was being chanted. But they only laughed, and answered jestingly that they would find another husband for his widow. Then I rebuked them, and said that such p.80 words were neither wise nor witty, and that they had very soon forgotten their comrade. And God took such vengeance for this, that on the morrow, at the great battle of Shrove-Tuesday, they were all killed or mortally wounded; and it happened that all their six wives married a second time.26 In consequence of the wounds I had received on Shrove-Tuesday, the army sickness attacked me in the mouth and legs, besides a double tertian fever and so severe a cold in the head that the mucus ran from my nostrils,27 and on account of these sicknesses, I took to my bed until mid-Lent. My priest therefore chanted the mass in my tent in front of my bed, and he, too, had the same illness. Whence it came to pass that while in the aet28 of consecrating the elements, he turned faint. Seeing that he was like to fall, I, who had put on my tunic, sprang out of bed barefooted, and held him in my arms, and told him to complete the consecration leisurely and properly, for that I would not let go of him until he had finished. He soon recovered himself, completed the consecration, and finished chanting the mass to the end; but he never chanted it again. After these things the counsellors of the king and of the sultan appointed a day for a conference. The following conditions were agreed to:—That Damietta should be restored to the sultan, who should give up to the king the kingdom of Jerusalem; and the sultan was to take charge of the sick who were at Damietta, and the salted meat (for they never touch pork), and the king’s engines, until such time as he should send for them all. Then they asked the king’s counsellors what security they would give that Damietta should be restored. The king’s counsellors proposed that they should detain one of the king’s brothers, either the p.81 17 https://en.wikipedia.org/wiki/Babylon_Fortress 18 https://en.wikipedia.org/wiki/Hugh_IV,_Duke_of_Burgundy 19 Outwork. A minor fortification built or established outside the principal fortification limits, detached or semidetached. https://en.wikipedia.org/wiki/Outwork 20 https://commons.wikimedia.org/wiki/Category:%C3%89rard_of_Val%C3%A9ry https://fr.wikipedia.org/wiki/%C3%89rard_de_Vallery 21 Clod. A lump of earth or clay. 22 https://en.wikipedia.org/wiki/Charles_I_of_Anjou 23 https://en.wikipedia.org/wiki/Shrove_Tuesday The traditional feast day before the start of Lent. 24 Inter. To deposit (a dead body) in the earth or in a tomb. 25 https://en.wikipedia.org/wiki/Bier A bier is a stand on which a corpse, coffin, or casket containing a corpse is placed. 26 https://nobility.org/2014/04/six-knights-are-punished-for-disrespect-at-mass/ 27 In this context, “mouth and legs” indicate scurvy, whereas fever and mucus may indicate e.g. virus infection. 28 Aet. Age. 9