[3] Infantile scurvy is frequently termed “Die Moellersche Krankheit.” There seems to be no occasion for giving Moeller credit for discovering this disease, as he believed that he was dealing with rickets merely in an acute form. He recognized the clinical similarity to scurvy, but in one of his cases sharply differentiates it from adult scurvy by the fact that “lemon juice and fresh vegetables” were of no avail in the treatment.
[4] The writer adds that he believes that the health of the natives at home is protected by Kaffir beer, which they consume even to the amount of 3 gallons a day, and which is made from germinated Kaffir corn. This cereal is germinated by steeping it in water for forty-eight hours and is then dried in the sun. Only enough is prepared for one brew. The French prepared a similar fermented beverage for these South African laborers; the sole difference in its mode of preparation was that the corn had not been germinated.
[5] The cases on which Wright based his theory were soldiers who developed scurvy during the siege of Ladysmith. It is probable that the men were suffering from starvation, purpura and dysentery. That they did not have scurvy is proved by the fact that they were cured by giving lactate and bicarbonate of soda.
[6] In chronic mercurial poisoning the following suggestive symptoms occur: anemia, bleeding and spongy gums, loosening of the teeth, a quickened pulse, ulcers of the extremities. At times mercury attacks the nervous system, producing palsy. The resemblance is heightened by the fact that calcium metastases have been found in the muscle in experimental scurvy (Hart and Lessing) comparable to those characteristic of mercurial poisoning.
[7] These figures constitute an irrefutable argument against the statement frequently made that a monotonous diet leads to scurvy. It is only when the monotonous diet does not contain an adequate quantity of antiscorbutic vitamine that it is to be feared.
[8] This is not literally correct, as Doepp described an epidemic of scurvy in the St. Petersburg Foundling Asylum occurring in 1831.
[9] During 1919 in Aruba there were 293 births and 30 deaths under one year, most of these deaths being due to intestinal diseases. The mothers subsist mainly on maize or guinea small corn, with some goat and sheep meat, and a little fresh fish, but no vegetables or fruit. The water is brackish.
[10] Moore raises the interesting question as to whether a diseased condition of the cow may decrease the vitamines of the milk—whether a certain outbreak of scurvy among guinea-pigs might have been due to their having been fed on the milk of a cow suffering from experimental streptococcus mastitis. If such proves to be the case, it would have an important bearing on the question of scurvy and pseudo-scorbutic conditions in nursing infants.
[11] In the case of the “lait maternisé,” which is a milk of high fat content, the dilution of the preparation also must have been a factor. Ounce for ounce, cream is poorer in antiscorbutic vitamine than an equal quantity of milk. It is also possible that the mere dilution of milk—quite apart from the absolute amount consumed—is not immaterial in affecting this highly sensitive vitamine.
[12] It is to be noted, however, that Variot remarks that these infants frequently develop anemia unless additional diet is given, so that it must be considered open to question whether some of these babies did not have latent scurvy. Of course, unless it is certain that these infants were receiving only sterilized milk, and absolutely no other food, for a period of at least six months, they cannot be considered apposite to the question.