Where this practice came from
The Disease of Long Voyages
Health 8: Deficiency ยท Episode 1 · the first of eight stories
For most of the age of sail, going to sea for long enough meant a specific kind of dying.
It started with tiredness that no rest fixed. Then the gums swelled and bled and the teeth loosened. Old wounds, long healed, opened again, which is the detail that has always stayed with me, because it means the body had been holding those closed by continuous effort and had stopped being able to afford it. Bruising. Joint pain. Then, eventually, death.
Scurvy killed enormous numbers of sailors (one historian's estimate puts the toll above two million between 1500 and 1800), and on a long voyage it could take most of a crew: when George Anson's squadron set out to circle the world in 1740 with nearly two thousand men, around thirteen hundred of them were dead before it returned in 1744, the great majority of scurvy. It was the limiting factor on how far a ship could go, and it was completely mysterious. Ships carried plenty of food. The men were eating. Something in the eating was missing, and nobody had a concept for a thing being missing from food, because food was understood as fuel and the men were fuelled.
James Lind, a Scottish naval surgeon, ran what is often described as one of the first controlled clinical trials at sea, aboard HMS Salisbury in May 1747: he took twelve sailors with scurvy, divided them into six pairs, and gave each pair a different candidate remedy (cider, dilute sulphuric acid, vinegar, seawater, a medicinal paste, or two oranges and a lemon a day). The pair given the citrus recovered, one of them fit for duty within about a week.
I want to sit on the strangeness of this from the inside, because we have lost access to how strange it was.
A man is dying. You give him an orange. He recovers.
There is no framework in which that makes sense in the eighteenth century. Oranges are not medicine. Medicine acts on the body, adds something, purges something, corrects a humour. An orange is food, and the man has been eating. The only way to make sense of the result is a concept that does not yet exist: that there is a substance the body requires in a small quantity, that it cannot make, that ordinary food usually supplies without anyone noticing, and that its absence, specifically its absence, is a disease.
That idea is the foundation of everything in this season, including the parts I am going to be hard on. It arrived slowly, and it arrived through a series of diseases that all had the same shape.
Something missing. Add it back. The person recovers, completely, as if nothing had happened.
That is about as dramatic as medicine gets. It is not managing a condition. It is not slowing a decline. It is a total reversal produced by a small amount of an ordinary substance.
Once you have seen that happen, once, it is very hard not to wonder what else might be missing.
Next episode: the polished rice, and the chickens.
Wren
The record says this much; the scenes between are imagined. The rest of the season, and the sourcing behind it, runs a few times a week at Wren. One page for the whole practice: /practice/.