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Emergency Medicine News


When Spring Fever Was a Real Disease

Janson, Paul A. MD

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doi: 10.1097/01.EEM.0000484361.70086.35

    Illness struck patients in the springtime for centuries, rendering them weak with joint swelling, loose teeth, and poorly healing wounds. The name given this disease of listlessness and weakness was Spring Disease or Spring Fever, and that name has continued into our time to describe the listless loss of ambition that accompanies the first few days of warm weather. A few centuries ago, however, it was actually scurvy that caused this illness, precipitated by the lack of vitamin C, and it was a major threat to life in the 18th Century.

    The affliction was unoriginally called Spring Disease because of the season in which it occurred. When no fresh vegetables were available in the winter, people depleted the vitamin C stored in their bodies. By the end of winter, before fresh food became available once more, people began to show signs of scurvy. The advent of urbanized society with its general decline in available fresh produce — fresh food had to be transported to cities — made vitamin C deficiency a serious problem.

    Vestiges of this disease are still present in our language, although the illness that gave rise to them has largely disappeared. One of the most common is the adage that an apple a day keeps the doctor away. Apples are a source of vitamin C, can be stored through winter, and a daily dose would prevent Spring Disease. Johnny Appleseed, who supposedly planted apple orchards across the United States, could have been one of the major public health figures of his time, and his work may have enabled the settlement of the trans-Appalachian region in the 19th Century.

    I can still remember getting an orange in my Christmas stocking each year, a tradition continued by my parents from their youth when oranges were far less common, even though we usually had oranges in our house at Christmas time. An orange would help keep away Spring Disease, and it was a fitting treat and medicinal at the beginning of winter.

    Working as a physician in Appalachia in the 1970s, I remember various spring tonics were used to clean out the body after the winter. I don't recall all the ingredients in these, but onions and sauerkraut were common and provided vitamin C. Fresh vegetables were plentiful when I was in Appalachia, but those tonics persisted.

    Scurvy struck ships of the 17th and 18th centuries as well. Originally, it was believed to be a different disease than land scurvy. Urbanization brought changes that made Spring Disease more common on land, but changes on the sea made scurvy more prevalent. Longer sea voyages were taking place, and sailors were being kept on board their ships when in port to avoid the desertions inspired by the hard life at sea, particularly on warships. Even here it was noted that ships sailing in the spring were more prone to scurvy. It was not suspected that the reason might be the winter's deficient shipboard diet, and therefore the sailors had less vitamin C than when they sailed during the summer or fall.

    Instead, historians noted that the officers were unlikely to be affected by scurvy, but the sailors were. The social elitism of the time led to the conclusion that scurvy was a deficiency of character, not diet, and ironically may have been used to justify the better diet afforded the officers aboard these ships. Some even suggested that it was sloth that led to the disease because listlessness was one of the earliest symptoms. Nonetheless, it was sea scurvy that led to the first insight into the disease.

    Read Part 2 of the history of scurvy in the June 28 EMN enews. Sign up to receive it free at

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