4 Vitamin C deficiency, scurvy

Scurvy is the clinical manifestation of severe deficiency of vitamin C and causes depressed osteoblastic activity and defective collagen formation, resulting in damage to blood vessels with associated haemorrhagic phenomena. It is the skeletal responses to haemorrhage (porosity and / or sub-periosteal new bone formation) that are key to the identification of scurvy in skeletal remains; the exact expression of such changes varies with age. Guidance on diagnosis using macroscopic, radiographic and microscopic techniques is provided using the approaches set out in Chapter 2 and consideration of the basic biological mechanisms that underlie lesion formation discussed in Chapter 3. Cases of scurvy are likely closely linked to food preparation and storage techniques and the insights offered on both current and past communities are discussed. A series of bullet points are used to summarize the core concepts covered.