The modern version of chlorosis is hypochromic anemia, a condition for which the blood consists of a large number of immature red blood cells. The resulting low cell count can cause a patient to look greenish or chlorotic. There are several common causes for this during the colonial period. The major cause is poor diet. A lack of vitamin B12 in association with poor iron intake will result in delayed blood cell productivity or the early release of immature blood cells into the blood stream. Addition causes include poor diet and minor iron deficiency, complicated by some other reason for increased blood loss, such as the onset of menses in teen age girls, or the development of intestinal worms or hookworms resulting in significant blood loss through the intestinal lining.
Osborn warns us that prolonged cases can cause great pains and convulsions. This suggests he may have experienced cases in which hookworm causing extreme blood loss through the stools resulted in ionic (Na+, K+, Ca++, Mg++) imbalances in the blood causing muscle cramping and convulsions to ensue. Some types of metal consumption can also cause this condition, especially lead, a possible occupation disease hazard for the Hudson Valley during the Colonial and War years.
For the most part, since Osborn is associating the disease with children and does not distinguish its occurance between sexes, this is probably a malnutrition-based syndrome for the most part, due mostly to a high grain and starch, high vegetable “poor farmer’s” diet for which meat was a scarce commodity.
Osborn’s use of the astringent herb tormentil (a potentilla) suggests he was trying to prevent fluid loss (phlegm, blood) via the intestines. About the time Osborn wrote this vade mecum, the diascordium electuary could be provided in two forms–with and without opium. If used with opium, it would have prevented any diarrhea and fluid loss, but been potentially fatal to a child. Diascordium without opium seemed safer, but either form was difficult to make. Most likely, Osborn made his own version of this recipe, or obtained a proprietaryversion of this recipe already manufactured for him back in Europe. One recipe for this medicine included: scordium, tormentil roots, dittany, bistort, gentian (these 5 mostly for use as bitters), the spices traditional cinnamon, cassia lignea (a coarse bark of the relative Cinnamomum cassia), long pepper, and ginger, the resins storax and galbanum, red roses and mel rosatum (rose honey), amber, two earths–bole (a ‘wad’ of clay) and terra sigillata (officially stamped clayey powder from a specific site, pressed into a block), and a sweet wine for its base. The efforts of making such a formula was no doubt an instigator of its more common supply as an imported product–at risk of course of being counterfeited or adulterated.