Scurvy Aboard Ferdinand Magellan’s Voyage of Circumnavigation
Authors: Leonard J. Hoenig, Walter H. C. Burgdorf
Journal: JAMA Dermatology (2014)

One of the greatest feats of explorationwas FerdinandMagellan’s voyage of circumnavigation (1519-1522). The story of this Spanish expedition was chronicled by Antonio Pigafetta, who traveled with Magellan and kept a diary. Pigafetta’smostharrowingaccountconcerns their crossingof thePacific Ocean, duringwhichMagellan’s crew endured a deadly encounter withscurvy.Scurvy isadiseasecausedbyvitaminCdeficiencythatwould plague sailors for thenext3 centuries. This nightmarebeganonNovember 28, 1520, afterMagellan (1480-1521) andhis crewsuccessfully completed their crossingof the treacherous Straits ofMagellan andentered thePacificOcean. This accomplishment fulfilledMagellan’s dream, first envisioned 500 years ago, of finding a westward maritime route from Europe that would lead to the Spice Islands of Indonesia. Concerning thePacific crossing,Pigafettawrites: “Wehadbeenthree monthsandtwentydayswithout takingrefreshmentofanykind.”Magellan’s crewhadexhausted their food stores andwere forced to subsist on rottenbiscuitsandyellow,putrefiedwater. Indesperationthemenateanything: cowhides, sawdust, and even rats. Amidst starvation conditions, manyofMagellan’smenbecameill,asPigafettagraphicallydescribes: “But aboveall othercalamities thiswas theworst: in somementhegumsgrew over the teeth, both lowers anduppers, so that they couldnot eat in any way and thus they died of this sickness. Nineteenmendied....” Pigafetta’s most striking clinical observation was gingival hypertrophy, a featureof scurvy inwhichdefectivecollagensynthesis leads to the lossof support forbloodvesselwalls. Thegums, thereforebecomered, swollen, friable, andhemorrhagic. Thegingival abnormalities occur only in the presence of teeth. Other dermatologic features of scurvy include follicular hyperkeratosis associated with corkscrew hairs, perifollicular hemorrhage, petechiae, ecchymosis, and poor wound healing. On March 6, 1521, Magellan’s expedition reached Guam and procured fresh foods thatenabled thecrewto recover fromtheir illness.Unfortunately,Magellanwas laterkilled inabattle in thePhilippines.OnSeptember8, 1522, the lastshipofMagellan’soriginal fleetof5vesselsdocked inSpain, completing thevoyagearoundtheworld.Onboardwere 18survivorsof theexpedition’soriginal 266men.Mosthadperished in thePacific travels. With the adoption of James Lind’s 1753 landmark dietary recommendations for the prevention and treatment of scurvy, epidemics of thediseaseon thehigh seas subsided. Scurvy, however, can still be clinically seen in populations at risk for malnutrition, such as elderly individuals, indigentpersons,andalcoholics.Thevitaminpropertiesofascorbic acid (vitamin C) were codiscovered by Albert Szent-Gyorgyi and Charles Glen King between 1928 and 1932. Szent-Gyorgyi was later awarded the 1937 Nobel Prize in Physiology or Medicine. Magellan’s voyage of circumnavigationwas amonumental achievementand testofhumanendurance. It also illustratedour frailty andhow fatal it could be for anyone to lack even a single vitamin. Today, mankind looks toward theheavens for further spaceexploration.At thesame timewe realize that our lives are so inextricably boundwith theEarth, a planet whose surface was first circumnavigated nearly 500 years ago.