Seasonal variation in night blindness incidence among Union soldiers in the US Civil War.

BACKGROUND: During the US Civil War, medical officers typically attributed night blindness among soldiers to malingering. A dietary basis was not generally suspected or appreciated. DESIGN/METHODS: Incident cases of night blindness, scurvy, and diarrheal diseases, as well as mean troop strength among Union troops, were abstracted by month and race from tabulations of the US Surgeon General for the period from July 1861 through June 1866. Monthly incidence rates and annual incidence rates are presented as time series by race. RESULTS: Night blindness incidence was seasonal. Seasonal patterns of night blindness incidence were similar for white and black soldiers, although the peak incidence rates were approximately 2-3 times higher in black soldiers. The seasonal effect for white Union soldiers increased progressively to 1864. The seasonal pattern for night blindness roughly parallels that for scurvy and for diarrheal diseases. The peak season for night blindness incidence was summer, and the next highest season was spring. The mode of monthly incidence rates for diarrheal diseases slightly anticipated that for night blindness and scurvy. In addition, there was greater relative variation in monthly incidence for night blindness and scurvy than for diarrheal diseases. CONCLUSIONS: Nutritional night blindness occurred in a seasonal pattern among soldiers forced to subsist on nutritionally inadequate diets. The seasonal pattern is consistent with seasonal variations in the availability of foodstuffs with high vitamin A or provitamin A content, superimposed on marginal vitamin A reserves, and possibly exacerbated by co-occurring seasonal patterns of diarrheal disease.

From convicts to colonists: the health of prisoners and the voyage to Australia, 1823-53.

From 1815, naval surgeons accompanied all convict voyages from Britain and Ireland to the Australian colonies. As their authority grew, naval surgeons on convict ships increasingly used their medical observations about the health of convicts to make pointed and sustained criticisms of British penal reforms. Beyond their authority at sea, surgeons' journals and correspondence brought debates about penal reform in Britain into direct conversation with debates about colonial transportation. In the 1830s, naval surgeons' claims brought them into conflict with their medical colleagues on land, as well as with the colonial governor, George Arthur. As the surgeons continued their attempts to combat scurvy, their rhetoric changed. By the late 1840s, as convicts' bodies betrayed the disturbing effects of separate confinement as they boarded the convict ships, surgeons could argue convincingly that the voyage itself was a space that could medically, physically and spiritually reform convicts. By the mid-1840s, surgeons took the role of key arbiters of convicts' potential contribution to the Australian colonies.