Dr. Andrew B. Chung, MD/PhD <
[email protected]> wrote:
> Brian Sandle wrote:
>>
>> In the British Navy in the days of sailing ships many sailors used to get scurvy. Even when it
>> was knwon that some veges prevent it there was resistance against taking them on journeys. One
>> might attribute this problem to God, or one might assume that man ought to have known better.
> When you know better but do something else, this would be free will and not God's will.
>>
>> Possibly same with vitamin D questions.
>>
> Correct.
Linkname: Barnes & Noble.com - Diffusion of Innovations URL
http://btobsearch.barnesandnoble.com-
/textbooks/booksearch/isbninquiry.asp?sourceid=00395996645644787198&btob=Y&ean=9780743222099&dis-
playonly=EXC [...] Controlling Scurvy in the British Navy
Many technologists believe that advantageous innovations will sell themselves, that the obvious
benefits of a new idea will be widely realized by potential adopters, and that the innovation
will diffuse rapidly. Seldom is this the case. Most innovations, in fact, diffuse at a
disappointingly slow rate, at least in the eyes of the inventors and technologists who create
the innovations and promote them to others.
Scurvy control illustrates how slowly an obviously beneficial innovation spreads. In the early
days of long sea voyages, scurvy killed more sailors than did warfare, accidents, and other
causes. For instance, of Vasco da Gama's crew of 160 men who sailed with him around the Cape of
Good Hope in 1497, 100 died of scurvy. In 1601, an English sea captain, James Lancaster,
conducted an experiment to evaluate the effectiveness of lemon juice in preventing scurvy.
Captain Lancaster commanded four ships that sailed from England on a voyage to India. He served
three teaspoonfuls of lemon juice every day to the sailors in one of his four ships. These men
stayed healthy. The other three ships constituted Lancaster's "control group," as their sailors
were not given any lemon juice. On the other three ships, by the halfway point in the journey,
110 out of 278 sailors had died from scurvy. So many of these sailors got scurvy that Lancaster
had to transfer men from his "treatment" ship in order to staff the three other ships for the
remainder of the voyage.
These results were so clear that one would have expected the British Navy to promptly adopt
citrus juice for scurvy prevention on all ships. Not until 1747, about 150 years later, did
James Lind, a British Navy physician who knew of Lancaster's results, carry out another
experiment on the HMS Salisbury. To each scurvy patient on this ship, Lind prescribed either
two oranges and one lemon or one of five other supplements: a half pint of sea water, six
spoonfuls of vinegar, a quart of cider, nutmeg, or seventy-five drops of vitriol elixir. The
scurvy patients who got the citrus fruits were cured in a few days and were able to help Dr.
Lind care for the other patients. Unfortunately, the supply of oranges and lemons was exhausted
in six days.
Certainly, with this further solid evidence of the ability of citrus fruits to combat scurvy,
one would expect the British Navy to have adopted this innovation for all ship's crews on long
sea voyages. In fact, it did so, but not until 1795, forty-eight years later, when scurvy was
immediately wiped out. After only seventy more years, in 1865, the British Board of Trade
adopted a similar policy and eradicated scurvy in the merchant marine.
Why were the authorities so slow to adopt the idea of citrus for scurvy prevention? Other,
competing remedies for scurvy were also being proposed, and each such cure had its champions.
For example, Captain Cook's reports from his voyages in the Pacific did not provide support for
curing scurvy with citrus fruits. Further, Dr. Lind was not a prominent figure in the field of
naval medicine, and so his experimental findings did not get much attention. While scurvy
prevention was generally resisted for years by the British Navy, other innovations, such as new
ships and new guns, were readily accepted. So the Admiralty did not resist all innovations.
Obviously, more than just the relative advantages of an innovation, even when its benefits are
clearly demonstrated, is necessary for its diffusion and adoption. The reader may think that
such slow diffusion could only have happened in the distant past, before the contemporary era
of scientific, experimental evaluations of innovations. On the contrary; consider the present-
day case of the nondiffusion of the Dvorak keyboard. [...]
So where are we at with vitamin D knowledge and its application?
From time to time I question the extent of soaping our skin that we have been doing since the 1960s.
Does that remove surface fat so vitamin D will be migrated out to the surface?
Michio Kushi said milk was a greater cancer-causer than tobacco. Does the calcium of milk rob
vitamin D?
What is the balance of vitamin A to D needed? To what extent has knowledge disseminated about
helping the body to balance its needs, eg calcium/magnesium in the diet?
Are there differing forms of vitamin D?
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