[13] Carel reports an interesting case which points to the importance of staleness. A baby was taken to the country with a supply of sterilized milk sufficient to last for some weeks. At the end of this time it did not thrive, but regained its health when a fresh supply of milk was used. When this second supply became stale the infant again developed the same signs, and the condition was diagnosed as scurvy.
[14] In making tests of dried milk particular attention should be paid to the age of the milk before it is desiccated. Investigators should also be certain that the milk has not undergone heating previous to the drying process. Some well-known brands of dry milk have been not only pasteurized, but subsequently evaporated before drying.
[15] Ausset reports a definite case of scurvy developing in a baby nine months old, which had received buttermilk almost since birth. At the time of admission to the hospital it was getting 900 c.c. a day. This case is interesting on account of the acid nature of the food.
[16] Malt soup is prepared by dissolving the alkaline malt soup extract in water, and mixing wheat flour with milk. These two mixtures are then boiled together for about three minutes. According to some directions, 11 ounces of milk are used; in our formula 16 ounces were employed.
[17] It would seem, however, that the growing infant requires relatively more antiscorbutic vitamine than does the adult. We know that its caloric requirement is fully a quarter to a third greater. In regard to vitamine, judgment cannot be based on experimental evidence, but on comparative figures. For example, unless we take this viewpoint, we must believe that, as an infant of six months weighing 15 pounds requires 15 c.c. of orange juice daily to furnish its antiscorbutic quota, an adult weighing 160 pounds requires 180 c.c. daily—the juice of three good-sized oranges. On this basis the adult would require six quarts (6000 c.c.) of fresh milk daily, twelve times the minimum requirement for an infant, which is one pint (500 c.c.) a day. These figures are manifestly too high.
[18] It would be of interest to know whether the negro infant is more susceptible than the white baby, in view of its markedly heightened susceptibility to rickets. There are, however, no reports or statistics to enlighten us on this point.
[19] “Where the indisposition is but beginning, and even when the gums have been pretty much tainted, there have been numerous instances of a perfect recovery without having the benefit of fresh vegetables; provided the patient is able to use due exercise. . . . When it is advanced to what I have called the second stage it is hardly to be cured without their (fruits and vegetables) assistance.” (Lind.)
[20] Caillé has described a case of scurvy in an infant suffering from Mongolian idiocy, and we have also seen a similar case.
[21] Many of the older authors believed that mercurial drugs were especially prejudicial in cases of scurvy.
[22] Vitamine is used throughout this monograph as synonymous with “accessory food factor” or “food hormone” as a convenient descriptive term, without any intention of connoting a definite chemical substance.