The Bloodless Revolution

by Tristram Stuart

  But there was one factor that set Cocchi out from the rest. Cheyne and Hecquet encouraged an abstinence verging on asceticism, sometimes limiting themselves and their patients to meagre diets of milk and seeds or even bread and water. Their focus was on the harmful qualities of meat rather than the beneficial effects of vegetables. This may have been attractive to a society burdened with consumer guilt and searching for means of purifying bodies and souls, but Cocchi wanted to appeal to the palate and the imagination as well as morality. Laying before his readers a kitchen-garden feast, Cocchi announced that nature provided not just necessities but ‘even splendid Luxury’.18 Indeed, Cocchi insisted that fresh vegetables were an essential nutritional requirement. In this lay the seed of the modern ideas about diet, and it was the path to discovering the cause and cure of scurvy.

  In January 1740 Commodore George Anson led an attack on the Spanish trade ships in South America. This state-funded act of piracy met undreamed-of success: the Spanish treasure galleon they captured was laden with golden booty from the Mexican port of Acapulco and Anson’s fame was assured. But by the time the fleet docked in England, three of Anson’s ships were lost and of his 1,000-strong crew only 145 returned alive. Most of the rest had perished, not in fighting with the Spanish, or in shipwrecks, but slowly and painfully from a sickness with the simplest of cures. Scurvy, wrote one lieutenant in Anson’s fleet, ‘expresses itself in such dreadful symptoms as are scarce credible’. Gums went black and decayed, oozing blood and breeding foul breath; teeth started to drop out and the skin erupted into large purple blotches and raw ulcers. Legs swelled and an extraordinary lassitude seized every limb. Weakness eventually degenerated into an inability to move at all, breathing became difficult, fevers, tremors and ‘violent terrors at the slightest accident’ would take hold and eventually all would end in a ghastly death. With men dying all the way across the Pacific, Anson’s fleet finally reached the Mariana (Ladrone) Islands. Knowing that ‘vegetables and fruit are his only physic’, the lieutenant recorded the crew’s relief on finding fresh meat, lemons and oranges, ‘the only treasure which we then wanted’.19

  Grim tales such as these punctuate the history of navigation from its inception right up to the nineteenth century. On land, diets were often nearly as nutrient-deficient and scurvy was considered the root cause of epidemic diseases suffered by thousands of city-dwellers across Europe – as Cheyne had noted.20 Scurvy had been dubbed the Proteus of diseases: it appeared in innumerable shapes, constantly throwing up new symptoms like the many-headed Hydra.21 Several of the disorders gathered under the name would not today be diagnosed as scurvy, the condition deriving from vitamin C deficiency and easily cured by eating citrus fruit or fresh greens. But with little accurate knowledge of nutritional requirements and limited access to fresh vegetables, scurvy and other deficiency disorders were common in Europe on land and at sea.22

  Until the causes and cure of scurvy were universally accepted, sailors continued to die in their hundreds.23 It was an inhibiting factor to voyages of discovery; and once the new lands had been discovered, the colonists left behind to promote international trade dropped off like flies, some of them from the dreaded scurvy.24 Finding the cause and the cure was one of the most pressing international questions of Enlightenment medicine.

  Ironically – as Anson showed – the citrus cure for scurvy was widely known among sailors. As early as 1498 Vasco da Gama’s men were struck with scurvy on their way to India and were saved by a fortuitous encounter with an orange-laden Arab ship. Da Gama himself attributed the sickness to bad air, but when thirty men died on the way home and only seven or eight were fit enough to navigate each ship, the crew themselves knew what they needed and cried out for more oranges.25 Francis Drake carried citrus fruit on his voyages; Francis Bacon had mentioned blood oranges as ‘an assured remedy for sickness taken at sea’;26 and in 1603 François Pyrard asserted confidently that ‘There is no better or more certain cure than citrons and oranges and their juice.’ The Dutch planted citrus orchards on Mauritius and St Helena to supply east-bound traders, and even tried constructing vegetable gardens on the decks of their ships.

  Recognition of the citrus secret was hampered by the deficient technology for preserving fruit juice. The juice went bad and every time poorly stored juice failed to take effect it looked like evidence that citrus did not hold the answer. Besides, learned doctors were always reluctant to accept the testimonies of mere sailors. Old-school physicians floundered around blaming the disease on melancholic humours, raw wheat and even cold water and fruit, and they prescribed quackish apothecaries’ pills to cure it.27 Chemists thought scurvy was caused by the corrosive effects of vitriolic salts in preserved meat and recommended abstaining from sex and taking laxatives.28 Medical mechanists like Pitcairne thought it was caused by dilation in the blood and advised patients to drink water and milk.29 Others said laziness, tobacco and intemperance were responsible and thought mercury or ground millipedes held the cure.30 The British navy – acting under the recommendation of the Royal College of Physicians – customarily treated scurvy with an elixir of sulphuric acid, alcohol, sugar and flavourings.31

  To others, who noted that sailors ate a lot of meat preserved in salt, it seemed obvious that therein lay the cause of their malady. Cheyne had been sure that excessive alcohol and salt meat were the cause – and he was not the first to build this into an argument for vegetarianism. Evelyn argued that ‘raw Sallets and Herbs have experimentally been found to be the most soveraign Diet in that Endemical (and indeed with us, Epidemical and almost universal) Contagion.’32 Tryon blamed flesh for causing scurvy and delightedly pointed out that regularly eating green vegetables prevented it.33 None of them conceived of scurvy as a deficiency disease; even those who knew the effectiveness of oranges, fresh greens and ‘scurvy grass’ (Cochlearia curiosa and officinalis) regarded these as a herbal remedy rather than a dietary requirement.34

  In 1734 Johann Bachstrom made a breakthrough by establishing that scurvy was a disease caused by the deficiency of fruit and vegetables. His conclusion was drawn from observations made in India, and in Greenland, where victims of scurvy were treated with nothing but herbs and acid fruit and experienced a ‘miraculous convalescence’. This led Bachstrom to ‘conclude with mathematical certainty’ that ‘Since herbs and fruit manifestly remove the sickness, therefore it is caused by a withdrawal from them.’35

  Cocchi latched on to Bachstrom’s theory and realised that it held the only reasonable solution. Usually a supporter of Cheyne’s, Cocchi made it clear that on this matter he was a step ahead. Systematically refuting all the competing theories about scurvy – including Cheyne’s – Cocchi insisted that ‘It is not a Northern Climate, not the Air of the Sea, nor the Salts of Flesh, but only an Abstinence from Vegetables which produces it.’ Withdrawal symptoms, he insisted, occurred among sailors and land-dwellers who did not eat enough vegetation. This constitutes an unambiguous recognition that scurvy was a nutrient-deficiency disease which could be easily relieved by supplying those foods that were wanting. It was not just lime juice acting as a specific remedy, Cocchi noted, but any fresh vegetable, even leaves off a tree, would do the trick.36 In the ensuing decades, many physicians hailed Cocchi as the saviour of scurvy.37

  One French physician, apparently Jean-Baptiste Sénac (1693–1770), doctor to the King of France and member of the Académie Royale des Sciences, was so impressed that when he edited the French translation of Cocchi’s Vivre Pythagoricien he appended the account of Anson’s dreadful voyage and added his own notes which endorsed Cocchi’s claims for vegetarianism. Vegetable food, observed Sénac, ‘totally disdained as it had been on every other occasion, was devoured [by Anson’s men] with the utmost avidity’. Scurvy, he concluded, struck ‘in proportion to the degree of deprivation from simple and soft vegetable food’. Eating vegetables was so potent that it could ‘bring back to life nearly dead and suffering men’; it seemed to Sénac entirely logical that vegetables must also
be the best food for people in good health.38 Anson’s men were a microcosm of society as a whole, deprived of what their bodies needed and naturally craved: the answer, he agreed with Cocchi, was to return to the natural vegetable diet.39

  The discovery of the cure for scurvy is usually attributed to the Edinburgh naval surgeon James Lind whose Treatise of the Scurvy was published in 1753, ten years after Cocchi’s work. Lind’s groundbreaking achievement was to conduct a controlled experiment on twelve sailors suffering from scurvy on a ship under his care. Dividing them into six pairs, he gave each pair one of six trial remedies: cider, elixir-vitriol, vinegar, sea water, citrus fruits, and a potion containing mustard and garlic. The citrus pair were back on duty after six days; those on cider and vitriol seemed slightly better; and the others were as bad as patients who had not been treated at all. With his outstandingly careful experiment, Lind had proved, once and for all, ‘that oranges and lemons were the most effectual remedies for this distemper at sea’. Anson was so delighted that he made Lind physician to the naval hospital in Portsmouth where he remained until 1783.

  The remarkable thing is that twentieth-century medical histories – and even the Encyclopaedia Britannica40 – have given Lind the credit not just for finding the cure but also for showing that scurvy was caused by dietary deficiency. But Lind thought scurvy was more to do with bad, moist air and blocked perspiration than the vegetable-free diet of sailors. He had no idea why lemon juice cured scurvy and insisted that warm dry air or vinegar could cure it without any help from vegetables.41 Although Lind quoted Cocchi’s conclusion that it was caused by a lack of vegetables and repeated the idea about balancing alkalescency with vegetable acids, he emphatically rejected the argument, made by Bachstrom, that ‘the constitution of the human body, is such that health and life cannot be preserved long, without the use of green herbage, vegetables, and fruits; and that a long abstinence from these, is alone the cause of the disease.’42 Cocchi was incensed that his discovery had been rebuffed once again and he replied to Lind by publishing a new edition of Bachstrom’s treatise in 1757.

  Despite Cocchi’s efforts and even Lind’s demonstrations, it was decades before the cure was universally accepted. Captain Cook helped the cause by successfully using sauerkraut (rich in vitamin C if well preserved) and encouraging his men to eat fresh vegetables whenever they could. By the time Nelson was fighting Napoleon, the British navy had gained a military advantage by reducing scurvy with the help of lemon juice, but even then provisions were often inadequate.43

  Cocchi was instrumental in the final recognition that scurvy was a deficiency disease, and thus he contributed to the modern understanding that fruit and vegetables contain nutrients that are essential for a healthy diet. This in turn played into the hands of the vegetarians: these hitherto despised foods were a dietary necessity. The fetid body of the scurvied sailor crying out for fresh vegetables came to stand as an epitome for corrupt society thirsting for their long-forgotten natural diet.

  EIGHTEEN

  The Sparing Diet: Scotland’s Vegetarian Dynasty

  It has been said that after George Cheyne’s death, vegetarianism retreated to the ‘irrational fringe’ of animal-loving revolutionaries.1 But in fact the late eighteenth century was the heyday of medical vegetarianism and it flourished in the most prestigious medical faculties of Europe.

  Several leading physicians believed that vegetarianism was simply the healthiest diet, and many more accepted that abstinence from flesh was an effective cure for a range of diseases.2 Some practitioners and their patients drew a line between their diet and the ethical questions of vegetarianism, but for others there was a moral aspect to abstinence. Patients trying to cure their physical malaise could be drawn into the ethical ideology of vegetarianism; with a hotbed of dieticians, moralists and eccentrics preaching the same dietary code, there was bound to be a substantial cross-over in their ideas. In the late eighteenth century Scotland in particular was home to numerous advocates of the ‘sparing’ diet – sparing both to animals and sparing in its sparse frugality. A dynasty of medical professors at the universities of Leiden and Edinburgh lectured their students and patients on the dangers of eating meat, while radical Pythagoreans stalked the surrounding countryside preaching the moral implications of vegetarian science. It was just another part of the Scottish scenery when Johnson and Boswell found themselves face to face with a nudist Scottish laird insisting that men should learn to live like orang-utans.

  Standing before packed lecture houses in Leiden and Germany, quietening the buzz of black-clad students who thronged to hear the world’s foremost medical lecturer, Hermann Boerhaave (1668–1738) struck a blow to the counter-vegetarian claim that it was unhealthy to live solely on vegetables. At the beginning of the first lecture of each academic year at the greatest medical faculty in Europe, in the very first words each successive wave of students heard him speak, Boerhaave reminded his audience that ‘in the first Ages of Mankind … our Species liv’d entirely upon the Fruits of the Earth.’3 Boerhaave explained that the biblical and classical records – such as Pythagoras’ command ‘to abstain from Flesh’ – were fully exonerated by the herbivorous human origins exhibited in ‘the Nature of Things’.4 Boerhaave was not trying to convert his students to vegetarianism, but he did want them to understand that all foods were chemically the same, and all animal bodies were essentially built from a digested ‘aggregate of vegetable Substances’, and thus it made little difference whether one lived on meat or vegetables.5

  That vegetables were perfectly adequate to sustain life, he announced, was proven by the Greek philosophers, pre-colonial Brazilians and the ancient and modern Brahmins whose ‘Lives were … of the greatest Extent, and their Minds fitted for Meditation, and the Culture of every thing curious and learned’.6 Boerhaave’s empirical data was inextricably bound up with theology; his information on the Brahmins, for example, was partly derived from the Dutch botanist Joannes Bodæus Stapel who had collated a mass of evidence that the naked ‘sages of India’ still lived on the banana which ‘the Protoplasts in Paradise tasted’.7 Indian and prelapsarian vegetarianism was still a serious topic for the medical practitioners of the Enlightenment.

  Boerhaave also noted that the contemporaneous relevance of man’s original diet had recently been exhibited in a shocking form, in the extraordinary discovery of feral children, one of whom had grown up with sheep and cattle, bleated like a cow and ‘lived upon nothing but Grass and Hay’.8 The healthiness of vegetarianism, he added, was testified by several finer examples: a famous magnate in Holland lived only on peas, while an unfortunate German tourist, arrested in France, had been forced to survive on horse beans and now ‘often declared in Company … that he hardly ever enjoy’d better Health and Spirits than when he lived under Confinement upon that Diet’. The salubrity of living without flesh was absolutely proven, said Boerhaave, by the fact that it was ‘a common thing for People to live many Years upon nothing but a Milk-diet, for fear of the Gout’.9 It transpires from his personal correspondence that Boerhaave prescribed the milk diet to patients with smallpox, ulcers and gout, and in his medical textbook he declared that ‘I myself have lived a considerable Time upon the poorest Whey and Biscuit, without the least Prejudice to the Strength and Action of my digestive Organs.’10 Boerhaave’s opinion provided an authoritative rejection of the stubborn notion that the vegetable diet was unnatural or unhealthy.

  Boerhaave’s star pupil, the neurologist Albrecht von Haller (1708–77), continued his master’s legacy at the University of Göttingen. Like Boerhaave he was influenced by Pitcairne’s hydraulic model, which he adapted to his ground-breaking discovery of the ‘irritability’ of muscular fibres and nerves. Haller agreed that humans originally ‘lived contentedly on the tender roots and plants’;11 he thought that eating too much flesh caused hyper-alkalinity in the blood and that the acidity of vegetables was the only antidote.12 Like Cocchi, he traced Hippocratic dietary medicine back to Pythagoras, who ‘seem
s deserving of much praise, for having endeavoured to reduce the quantity of animal food in a hot climate’.13 He even encouraged benevolence to animals in his popular sentimental novel, Usong (1772), in which the Oriental heroine, Liosua, ‘took pleasure in providing for the happiness even of the dumb creation’.14

  But surprisingly, Haller twisted Boerhaave’s thesis round into the counter-vegetarian argument that living on vegetables alone could be extremely dangerous and that the gelatinous lymph in animal flesh was an indispensable nutritional requirement. The vehemence with which Haller launched his refutation of vegetarianism illustrates just how powerful an idea it had become. The constant tussle between the vegetarians and their antagonists split medical departments asunder, and Haller was determined to make the case against it as strong as possible. He noted that eating animals was an economic necessity, for, as many had pointed out before him, if we did not they would overpopulate the earth. Besides, human guts and teeth were carnivorous not herbivorous, and furthermore, ‘abstinence from animal food … generally causes great weakness to the body and the stomach, being perpetually attended with a troublesome diarrhoea or purging.’15

  Yet Haller’s hostility to and bad experiences with vegetarianism did not stop him instructing his students to read the canon of vegetarian authors – Porphyry, Plutarch, Hecquet, Linand, J. Samuel Carl, Lémery, Cocchi and Cheyne, who, he said, ‘seems to me to excel among all the writers on diet’. Most astonishing of all, he included on his reading list six works by Thomas Tryon, including the Way to Health.16 Radical vegetarians had achieved a substantial coup by persuading the most serious intellectuals of the period to consider their arguments; the dietary mainstream, on the other hand, had taken the sting out of their critiques by absorbing them into the curriculum of the scientific Enlightenment. Haller saw no fixed boundary between the ethical, scientific and religious debates, and clearly recognised that vegetarianism was still a major player in the open questions about diet and health.