CONTENTS
| PAGE | |
| Preface | [iii-iv] |
| CHAPTER I | |
| History of Scurvy | [1] |
| (a) Outbreaks on Land; (b) Outbreaks at Sea; (c) Infantile Scurvy; (d) Scurvy in the World War | |
| CHAPTER II | |
| Pathogenesis and Etiology | [23] |
| Pathogenesis: Theories; Potassium Deficiency; Acidosis; Toxic; Bacterial; Vitamine (Accessory Factor) | |
| Etiology: Breast-Fed Infants | [35] |
| Artificially Fed Infants: Pasteurized Milk; Boiled and Sterilized Milk; Dried Milk; Condensed Milk; Proprietary Foods (Effect of Alkalization) | [40] |
| Age, Season and Climate; Economic Status; Psychic Element; Predisposition; Effect of Other Food Constituents; Exciting Factors | |
| CHAPTER III | |
| The Antiscorbutic Vitamine | [62] |
| Characteristics: Relation To Heat, Drying, Aging, Ultra-Violet Rays, Shaking | [65] |
| Mode of Action—(a) Direct: As a Nutriment; Antitoxin; Catalyzer; (b) Indirect: Endocrine Action | [69] |
| Fate in the Body: Storing; Content in Blood; Excretion; Fate in Gastro-intestinal Tract; Effect on Digestive Processes | [74] |
| Irregularities of Action; Effect on Growth | |
| CHAPTER IV | |
| Pathology | [81] |
| (a) Gross: General Appearance; Hemorrhages; Anasarca; Heart; Lungs; Alimentary Tract and its Glands; Urinary Tract; Lymph Nodes; Organs of Internal Secretion; Brain and Spinal Cord; Bones; | |
| (b) Microscopic: Skin; Muscles; Blood-vessels; Lungs; Heart; Intestinal Tract and its Glands; Kidney; Adrenals; Pancreas; Thymus; Central Nervous System; Peripheral Nerves; Retina; Bones | |
| CHAPTER V | |
| Experimental Scurvy | [111] |
| Historical Review | |
| Pathogenesis | [116] |
| Pathology: Effect on the Fœtus; Scurvy in the Monkey; Microscopic Pathology; Bones; Teeth; Nerves; Blood Vessels; Interpretation of Bacteria in the Tissues | [122] |
| Symptoms | [135] |
| CHAPTER VI | |
| Antiscorbutic Foods | [143] |
| Historical Review | [143] |
| Milk: Raw; Pasteurized; Dried | [150] |
| Fruits and Fruit Juices: Dried | [153] |
| Vegetables: Cabbage; Effect of Heating. Potato. Swede | [158] |
| Dehydrated Vegetables: Canned Foods (Tomatoes) | [166] |
| Germinated Cereals and Pulses; Meat and Eggs; Beer And Alcoholic Beverages; Miscellaneous | |
| Conclusions | [173] |
| CHAPTER VII | |
| Symptomatology and Diagnosis | [176] |
| In Adults | [176] |
| In Infants: (a) Acute; (b) Subacute; (c) Latent.—hemorrhage Of Gums; Subperiosteal Hemorrhage: Skin; Mucous Membranes and Subcutaneous Tissues; Hemorrhages of Internal Organs; Nails and Hair; Eczema; Edema; Tenderness; Beading of Ribs; Separation of Epiphysis; “White Line” Cardiovascular System; “Cardiorespiratory Syndrome” Nervous System; Urinary System; the Blood and Blood-vessels; Nutrition and Growth; Fever; Complications; Epidemic Form | [183] |
| Differential Diagnosis: Rheumatism; Purpura; Congenital Syphilis; Bone Tumors; Osteomyelitis; Poliomyelitis, etc. | [219] |
| CHAPTER VIII | |
| Prognosis | [225] |
| CHAPTER IX | |
| Treatment | [230] |
| Preventative; Curative | |
| Non-dietetic | |
| CHAPTER X | |
| Metabolism | [241] |
| In Adults: Body Exchanges | [241] |
| In Infants: Body Exchanges; Analysis of Organs; Chemistry of Blood | [242] |
| In Animals: Monkey; Guinea-Pig | [245] |
| CHAPTER XI | |
| Relation of Scurvy to Other Diseases | [248] |
| Beriberi; Ship-beriberi; Pellagra; Rickets; Osteogenesis Imperfecta; Osteomalacia; Hunger Edema; “mehlnaerschaden” Exudative Diathesis; Diseases Due to a Food Excess | |
| Appendix: Lind’s Recipes for Preparing Stable Antiscorbutics | [259] |
| Bibliography | [261] |
ILLUSTRATIONS
| FIG. | PAGE | |
| 1. | Dependence on potato as antiscorbutic | [7] |
| 2. | Weight curve of scorbutic baby. Effect of alkalization of milk | [51] |
| 3. | Lumbar cord in case of scurvy | [105] |
| 4. | Lumbar cord in case of scurvy. Focal degeneration | [105] |
| 5. | Bone in scurvy. Microscopic pathology | [108] |
| 6. | Subperiosteal hemorrhage and separation of epiphysis. Roentgenogram | [109] |
| 7. | Complete restitution of epiphysis without deformity. Roentgenogram | [109] |
| 8. | Curve of fecal excretion in scurvy | [121] |
| 9. | Diagrammatic representation of guinea-pig scurvy | [130] |
| 10. | Loss of weight in guinea-pig scurvy | [139] |
| 11. | Dried milk as an antiscorbutic | [140] |
| 12. | Dehydrated vegetables as a cause of scurvy | [164] |
| 13. | Cure of scurvy by addition of canned tomato | [166] |
| 14. | Failure of yeast as prophylactic | [171] |
| 15. | Temperature, pulse, and respiration in scurvy | [186] |
| 16. | Subperiosteal hemorrhage and separation of epiphysis. Roentgenogram | [192] |
| 17. | Periosteal “tags” and “streamers.” Roentgenogram | [193] |
| 18. | Infant with marked scurvy. Characteristic position | [198] |
| 19. | Scorbutic beading of ribs. Roentgenogram | [198] |
| 20. | “White line.” Roentgenogram | [199] |
| 21. | Cardiac enlargement. Roentgenogram | [200] |
| 22. | Electrocardiogram showing “cardiorespiratory syndrome” | [201] |
| 23. | Stationary weight during cure of scurvy. Oliguria followed by polyuria | [206] |
| 24. | Development of scurvy in spite of normal gain in weight | [214] |
| 25. | Retardation of growth in length when no orange juice was given and supergrowth when given once more | [216] |
TABLES | ||
| TABLE | PAGE | |
| 1. | Fecal flora of scorbutic infants | [29] |
| 2. | Necropsy reports of scurvy | [82] |
| 3. | Relative distribution of the antiscorbutic factor in the commoner foodstuffs | [157] |
| 4. | Platelets and other blood cells in scurvy | [209] |
| 5. | Data of epidemic of scurv | [218] |
| 6. | Duration of treatment before marked improvement was noticed | [237] |
SCURVY
PAST AND PRESENT
CHAPTER I
HISTORY OF SCURVY[1]
Outbreaks on Land.—Like many other diseases, the life history of scurvy shows several distinct phases. We hear of it first as a plague, infesting armies and besieged towns; then as a dread disease, decimating the sailors of the navy and of the mercantile marine, and, since the end of the last century, more often as a nutritional disturbance, endangering the health of infants. Very recently it has acquired an entirely new interest, as the representative of a class of disorders which has revealed the essential importance to man of unknown dietary factors.
It is difficult, as may be imagined, to define with precision the earliest description of scurvy, as the older references are so vague as to be open to individual interpretation. The reference of Hippocrates to a large number of men in the army who suffered from pains in the legs and gangrene of the gums, which was accompanied by loss of teeth, seems sufficiently definite to be identified as this disease. The Greek, Roman and Arabian writers do not seem to have been acquainted with scurvy. This is as we should expect, for fruits and vegetables grew in such plenty in these southern countries that scurvy must have been a disorder of rare occurrence.