It's the archaic sickness that struck down 18th century sailors, but dreaded scurvy has resurfaced in modern day Sydney.
Penelope Jackson became the first of a number of people in western Sydney to be diagnosed with the scourge of the seas.
"I couldn't believe it. I thought, hang on a minute, scurvy hasn't be around for centuries," Ms Jackson said.
"It's something you associate with the First Fleet and the days of Arthur Phillip and Captain Cook. You don't expect it to be around in the 21st century," she said.
Ms Jackson had become a human anachronism. She had all the signs; an ulcer wound that had not healed for months, bleeding gums, sore muscles and loose teeth.
But it wasn't until her endocrinologist decided to investigate her diet that her scurvy was discovered.
She ate very little fruit and cooked her vegetables until they disintegrated to the touch, essentially straining out the nutrients.
Ms Jackson's blood tests showed she had a vitamin C level of 10µmol/L, well below the bottom threshold of 40µmol/L for healthy vitamin C levels.
"The thought of having such an old disease was scary. I couldn't believe you could be obese and malnourished," she said.
Her doctor, Professor Jenny Gunton, found several patients in her diabetes clinic in Westmead Hospital had developed the severe vitamin C deficiency and believes the condition could be going undiagnosed in countless more people.
Seven of the 11 patients screened had a significant vitamin C deficiency, Professor Gunton reported in a research paper published on Tuesday in Diabetic Medicine. Their average vitamin C level was 17µmol/L.
"I've found another six or seven additional patients [with the condition]," said Professor Gunton, an endocrinologist and Director of the Centre for Diabetes and Obesity Research at the Westmead Institute for Medical Research.
Professor Gunton said diabetes patients would often avoid fruit because they were concerned their glucose levels could spike.
"In people who do not eat fresh fruit and vegetables, it is unfortunately possible to achieve vitamin C deficiency even in the presence of overweight or obesity," she said.
The telltale symptoms of severe vitamin C deficiency are wounds that won't heal, bleeding gums, loose teeth, or teeth that are falling out, corkscrew-shaped hairs on the legs and weak bones and muscles.
Vitamin C is essential to the body's healing process, acting as a stabiliser for collagen, which supports the skin's structure.
Though scurvy could kill sailors aboard the tall ships of centuries past, vitamin C deficiency is very easy to treat, and its effects are rapidly reversed after about a week of taking vitamin C tablets.
"They also need to make sure they eat enough fruit and vegetables … it's just about following basic healthy eating advice, and not overcooking vegetables" she said.
Capsicum, particularly yellow capsicum, broccoli, spinach, kale, berries and citrus fruit were all rich in vitamin C.
Professor Gunton suspected vitamin C deficiency may be going undiagnosed in other clinical settings across the country, but patients and doctors don't know to look for it.
In most cases, patients were probably being inadvertently treated for scurvy when they were admitted to hospital for their wounds or other illnesses.
"There's a lot of not so complimentary things said about hospital food ... but it will give you your dose of vitamin C," she said.
