Scurvy

“ The case so frequently quoted by German authors in this connection is that of Fraenkel, who described both clinically and pathologically a case of scurvy in a boy eight years of age. These cases by no means exhaust the number which are reported. Recently, Tobler has given us an account of scurvy, occurring during the war, in a Viennese foundling asylum which harbored children between the ages of two and fourteen. ”

“ When scurvy goes unrecognized or untreated for a long time, or the antiscorbutic content of the food is exceptionally small, or the patient unusually susceptible, the disorder may progress and resemble the advanced cases described in connection with the adult type of this disease. Happily such instances are rare. One of the most typical and vivid descriptions of an extreme case of infantile scurvy is that reported by Vincent:
The infant lay in its bed extremely apathetic and barely conscious. ”

“ For making a decoction of the plant as a blood purifier, and against scurvy, put two ounces of the whole plant and its roots into a quart jug, and fill up with boiling water, taking care to keep this well covered. When it is cold take a wineglassful thereof three, or four times in the day.
Another name for the plant is Scruby grass. The fresh herb has a strong pungent odour when bruised, and a warm bitter taste. Its beneficial uses in scurvy, are due to the potash salts which it contains. Externally, the juice will cleanse and heal foul ulcers, and ill-favoured eruptions. ”

“ As the data are meagre, a consideration of the chemical alterations associated with the scurvy of guinea-pigs and monkeys will be taken up in conjunction with the metabolism of human scurvy. The therapy of animal scurvy will also be deferred (chapter VI) , as the reaction to dietetic measures is practically the same in man and in animals. ”

“ There have been no histologic examinations in man at this incipient stage, but we may infer that they are similar to the bony changes found in the guinea-pig. When the scurvy has become chronic in an animal which has lived for months on a quota of antiscorbutic food sufficient to preserve life but insufficient to prevent the development of scurvy, we find a microscopic picture at the costochondral junction differing widely from that seen in the acute stage. ”

“ If, therefore, the potency of the milk is weakened, or if an insufficient quantity is fed, and more particularly when both of these factors are involved, a scorbutic condition will ensue. The reason why older children, those over one and a half or two years of age, do not develop scurvy is largely due to their varied and liberal diet, which is amply provided by the mother or guardian, so that even in times of want they receive more than their due share of the available food supply.17
From a clinical standpoint scurvy may be said to occur in infants during the second half year of their lives. ”

“ Easy Method of curing the Scurvy.—The root of the garden carrot abounds in a nutritious saccharine juice, and is slightly aromatic. These are desirable properties against the scurvy. To experience the good effects of these properties, the roots must be eaten raw. There is nothing unpleasant in this; on the contrary, it is what the common people often do by choice. These roots would keep well during the longest voyage, packed up in casks, having the interstices filled with sand. ”

“ A salt diet, without fresh vegetables, and without variety, is a predisposing cause of scurvy. Exposure to cold and wet, and living in dirty surroundings are also predisposing causes. The old wooden ships were seldom very clean, and never dry, and when once the scurvy took hold it generally raged until the ship reached port, where fresh provisions could be purchased. A wooden ship was never quite dry, in any weather, for the upper-deck planks, and the timbers of her topsides, could never be so strictly caulked that no water could leak in. ”

“ Lind and others repeatedly emphasize the fact that the indolent and slothful sailor was stricken with scurvy far oftener than the one who was active, and claimed that physical exercise even tended to bring about a cure.19 Those who have had a large experience with scurvy in adults are almost unanimous in believing that a psychic element enters into its etiology. In this way, in a measure, they account for the frequency of scurvy among defeated troops, in besieged armies, and among men depressed by homesickness, fatigue, and discouragement. ”

“ It is grown to a large extent in England, but is practically unknown in the United States.
43 “We find the College of Physicians at Vienna sent to Hungary great quantities of the most approved antiscorbutic herbs dried in this manner; which were found to be of no benefit. Many of these would have their virtues as little impaired by drying as spinage, e.g., marsh trefoil. Kramer tried almost every species of dried herbs to no purpose.” (Treatise on The Scurvy. James Lind, London, 1772, p. 143.) ”

“ Characteristic posture and swelling of right thigh.
An early sign of infantile scurvy is beading of the ribs—the development of a “rosary” similar to that characteristic of rickets (Fig. 19) . This has recently been described by Hess and Unger in an article devoted to this subject. That this rosary is truly scorbutic and not rhachitic is proved by the fact that it recedes rapidly when antiscorbutic foodstuff is given, and that it remains uninfluenced by treatment with cod liver oil. A similar scorbutic rosary occurs in guinea-pig scurvy, but has been termed “pseudo-rhachitic.” ”

“ I am not now afraid of losing any more men by scurvy while I have command over them. Whenever there are appearances of it on board, I will have every pork and beef barrel—salt provisions of every kind—headed up at once, and every man shall live upon bread and fresh provision, such as whale, walrus, seal, deer, bear, ptarmigan, duck, and the like. It is not a little remarkable that persons afflicted with scurvy seem madly inclined to salt provisions, which they know to be in their case absolute poisons. ”

“ As previously shown, when the body is in that breaking-up condition known as scurvy, the whole medical profession look upon fruit and fresh vegetables as the one and only known remedy. I believe the day will come when science will use it very much mere largely than it does now in the treatment of many of the everyday ailments. I have shown how it aids digestion. Observations in scurvy prove that it exerts a very powerful influence on the blood. But "the blood is the life": poor blood means poor spirits, poor strength, poor breath, and poor circulation. ”

“ Scurvy (and allied conditions) .—The history of scurvy in war and famine, in the early days of long voyages, and in Arctic and Antarctic exploration shows the important part which this disease has played. Fully developed scurvy is a horrible condition which renders the individual an offence to himself and to those about him. A famous Austrian physician, Kramer, described it as “The most loathsome disease in nature,” so that the demoralizing effect of an outbreak in a small and crowded ship or land base can easily be imagined. ”

“ All animals developed scurvy. The marked gain in weight when an equivalent amount of fresh carrots was substituted for the dehydrated vegetable corresponded to the disappearance of scorbutic signs. Guinea-Pig B 951 did not receive fresh carrots, as it was evidently ailing at the time the second period began.
Experimental investigation on this subject may be summarized as showing that vegetables dried according to present methods lose their antiscorbutic value as the result of dehydrating (Fig. 12) , and that they become still more impoverished as the result of aging. ”

“ Scurvy reduces the nutritional state of probably all the cells and tissues of the body. If the resistance is still further lowered by exposure, nutritional disturbances will result more readily than where the tissues are normal and well nourished. ”

“ The fact that scurvy may occur in any land and climate, even in the garden spots of the world, is strikingly shown by the epidemics reported from Algiers, and the ravages of this disease among the gold seekers in California in 1849. Nothing could be more incongruous than the occurrence of a deficiency disease in this land of plenty. ”

“ The scurvy of adults and of infants are very similar. The main difference is the subjective symptoms in the adult—pains in various parts of the body—and the fact that the gums are frequently the site of infection and ulceration, as well as of hemorrhage. It might be thought that when scurvy occurs in epidemic form it would be readily recognized, but experience shows that for months it may permeate the ranks of troops or the inmates of almshouses, and pass as rheumatism. ”

“ Scurvy is not a germ disease. It can't be caught. It's generated. As near as I can get it, it's due to an impoverished condition of the blood. Its cause is not something they've got, but something they haven't got. A man gets scurvy for lack of certain chemicals in his blood, and those chemicals don't come out of powders and bottles, but do come out of vegetables."
"An' these people eats nothin' but grass," Shorty groaned. "And they've got it up to their ears. That proves you're all wrong, Smoke. ”

“ Lind writes: “Goats, of all animals, afford the richest whey, possessed of the greatest antiscorbutic virtue . . . which in a singular manner restores the constitution when weakened and impaired by scurvy.” Human milk possesses about the same potency as cow’s milk, as mentioned in the discussion of the occurrence of infantile scurvy in countries where the adult form is endemic. Twelve ounces of human milk, from a woman on a liberal and varied diet, barely sufficed to alleviate the symptoms of a case of moderate intensity. ”

“ No wonder they got scurvy."
"But vegetarians hadn't ought to get scurvy," Shorty contended. "It's the salt-meat-eaters that's supposed to fall for it. And they don't eat meat, salt or fresh, raw or cooked, or any other way."
Smoke shook his head. "I know. And it's vegetable diet that cures scurvy. No drugs will do it. Vegetables, especially potatoes, are the only dope. But don't forget one thing, Shorty: we are not up against a theory but a condition. The fact is these grass-eaters have all got scurvy." ”

“ Seek the cure of scurvy neither in the armamentarium of the physician nor in the apothecary shops. The druggist will be of as little aid to you as the art of the surgeon. On the other hand, employ fresh vegetables, the juice of fresh antiscorbutic plants, oranges and lemons or the juice of those fruits preserved with sugar ”

“ The appetite fails; a flux frequently ensues; the urine will be thick and stinking; and the poor wretch gradually dies merely by putrefaction.
The scurvy has had many definitions, and has been divided into various classes. All the difference of the disorder is, that sometimes it is attended with a fever, only in some degrees, more in one habit, than in another; which may be owing either to the nature of the constitution itself, but principally depends on the climate the patient is in: to which I must not forget to add, that frequently the scurvy is complicated with other disorders. ”

“ The Greenlanders cure themselves of the scurvy, with the juice mixed with that of the scurvy-grass. The seeds may be sown, or the roots planted, in spring or autumn; it is not in general cultivation, but is to be found abundantly wild in meadows, &c. ”

“ A violent outbreak of scurvy among the negroes on board fixed his attention specially on this disease, with which his service in the Channel fleet had already made him familiar, and when, on his return to England, he settled down in private practice at Wooler in Northumberland, he reduced his notes to order, and published them as ‘Observations on the Scurvy’ (8vo, 1786; 2nd edit., much enlarged, 1792) . The proper treatment of scurvy had already been fully demonstrated by James Lind [q. v.] in his celebrated ‘Treatise’ of 1754. Trotter corroborated Lind's thesis by extensive observations ”

“ For, as I cannot heal, or help all Scorbutick Persons, with one only Scorbutick Herb, as Scurvy-grass, or Sorrel, or Fumitory, or Brooklime; so, much less of a certain remedy made of these diverse Species congested into one; because, between the Herbs Scurvy-grass and Sorrel, there is an Antipathy, as between Fire and Water; and so there is the same Antipathy between the Herbs Fumitory and Brook-lime.
Therefore, the Correctory of Peters Scorbutick Saline acid tinging Venome, is made with the Volatile bitter Salt of Scurvy-grass. ”

“ The hunger edema, noted in the late war and in previous wars, seems to be a complex condition, quite dissociated from scurvy, as many of the sufferers consumed comparatively large quantities of potatoes or other vegetables. The “mehlnaerschaden” resembles scurvy and the other vitamine disorders in its tendency to produce hydremia and susceptibility to infection. It also develops in spite of a liberal supply of antiscorbutic foodstuff in the dietary. As its name implies, it comes about on a diet containing large quantities of carbohydrate, of the cereal paps so commonly fed to infants. ”

“ Treatment.—For many years it was known that lime juice exerted a curative effect upon scurvy. But recently the efficiency of this fruit juice has proved to fall far short of that effected by either orange, or tomato juice.
Feeding experiments have proved that animals, fed upon rations consisting of dry food without the addition of green, will develop scurvy. And that the milk of such animals will show a deficiency in the “C” vitamine which will lead to a development of the disease in infants fed upon such milk. ”