Scurvy, Past and Present

by Alfred F. Hess

Fig. 12.—Hay, oats, water ad libitum, and 7 g. of dehydrated carrots dried at a room temperature of about 130° F. about 1 month previously. 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. We should not sweepingly condemn the principle of dehydration, as very possibly some slight modifications in the process may be devised which will counteract the deteriorating influence. In their paper of 1912, to which reference has been made so often, Holst and Froelich reported that potatoes, carrots, peas, lentils and almonds have practically no protective value after they are thoroughly dried. In two reports—one giving the results of feeding various brands of dehydrated carrots to guinea-pigs, and the other of an attempt to cure scurvy in babies by means of these carrots—we also came to the conclusion that the antiscorbutic factor had been almost completely destroyed. Givens and Cohen (1918) found that even cabbage dried at a low temperature retained only a small amount of its potency after a month, and Delf and Skelton came to practically the same conclusion, also noting that the cabbage on being kept, steadily lost what little of the antiscorbutic factor had survived the drying process. The same was true of the fat-soluble factor. These authors made an observation which may prove of value in helping to solve this problem, namely, that “the residual amount is distinctly greater if the cabbage is plunged into boiling water before drying.” This protective action of heat they suggest may indicate that: “Some at least of the destruction may be due to the activity of an enzyme or other body originally present in the living tissue.”

Another observation which may prove of practical value in rendering dehydrated vegetables the nutritional equivalent of the fresh vegetable is that when the carrots selected for dehydration are young and fresh a product is obtained which possesses decided antiscorbutic power. In this connection the following statement by Falk and his co-workers in a study of the enzyme action of vegetables and the effect of dehydration is significant: “In considering these enzyme results, it may be pointed out that the state of ripeness and the age of the vegetable undoubtedly influence the activities.”

The most promising dehydration experiment has been conducted by Holst and Froelich and was published in 1916 in a paper which has passed unnoticed. They dried white cabbage so that it retained its antiscorbutic properties, and, to a large extent, its color and taste, for a period of two years. This result was accomplished by keeping out all moisture and preventing hydrolysis,[44] a method which is employed in preserving antitoxins, toxins and agglutinins. It is by far the most encouraging test reported, and should be made the basis of further work by those actively interested in perfecting dehydration.

Fig. 13.—Cure of scurvy by the addition of canned tomato. In this case, as frequently, the alleviation of symptoms preceded the gain in weight.

Canned Food (Tomatoes).—In the course of canning, as in dehydrating, most vegetables and fruits lose their antiscorbutic properties. A general denunciation, however, of all canned foods is incorrect, as there are exceptions to this rule. It has been shown by Hess and Unger that canned tomatoes possess a high degree of antiscorbutic power (Fig. 13), and it is probable that most of the acid fruits and vegetables are able to withstand the canning process. It was found, in an experiment embracing many series of guinea-pigs, that 4 c.c. daily of strained, canned tomato are sufficient to afford protection, even when a lot was used which had been prepared a year previously. This is indeed remarkable, considering that the food undergoes a two-fold heating in the course of canning, during one of which (“processing”) the temperature is raised to fully 230° F. Tomatoes have another advantage over most other vegetables in that they are richly endowed with the water-soluble vitamine, as shown by our tests on pigeons suffering from polyneuritis, and by the experiments on rats of Osborne and Mendel, who found tomatoes far superior in this respect to turnips, onions, beetroots or beans. They are also rich in the fat-soluble vitamine. In view of the availability of canned tomatoes and their excellent keeping quality they are well suited to an extended use as an antiscorbutic. In the subsequent chapter we shall discuss their employment in infant feeding and in the army ration.

Germinated Cereals and Pulses.—In 1912 Fuerst reported that although the resting seed—the cereal grain, the pea, bean and lentil—are poor in antiscorbutic vitamine, they develop this principle as soon as they germinate. They possess, in other words, latent antiscorbutic properties, and are potentially antiscorbutic. This observation is not only of scientific interest but of practical value, as these pulses are well suited for transport and do not readily deteriorate. For this reason, Chick and her co-workers at the Lister Institute, who were searching for an antiscorbutic foodstuff for the army, directed their attention to the utilization of the pulses. In the course of a thorough investigation (1919) they found that although it required 30 to 40 g. daily of dry green peas to prevent scurvy in the guinea-pig, a consumption of 10 g. of the germinated peas afforded satisfactory protection.[45] The soaked seeds have an antiscorbutic value comparable to many of the fresh vegetables; by no means as great as cabbage, but somewhat greater than that of carrots. As the result of cooking, their potency was found to be reduced about 75 per cent. We shall have occasion to refer to this antiscorbutic food in the chapter on treatment in connection with the rationing of armies.

Meat and Eggs.—As has been stated, animal tissues are distinctly inferior to fruits and vegetables in the antiscorbutic principle. As there has been no accurate evaluation of these foods—the only test being one by Chick, Hume and Skelton, where 10 c.c. of raw beef juice failed to protect guinea-pigs—we have to depend upon clinical experience for our knowledge. Beef juice is highly rated by physicians in the prevention of infantile scurvy, but it is probably far less potent than vegetables or fruit juices. The Arctic explorers, and many who have lived in the Arctic regions, agree that the inhabitants are protected from scurvy during the winter months by their diet of fresh meat and fish. The Admiralty Enquiry on the outbreak of scurvy in the Arctic Expedition of 1875 reported that a large ration of meat is necessary to afford protection. Curran (1847) described three cases admitted to the hospital in the great Irish epidemic of that year, where the diet previously had included three-quarters of a pound of meat on five days of the week. From these and similar experiences the conclusion is manifest that the divergence of opinion regarding the value of meat is based upon quantitative differences in the rations. Evidently, if sufficient meat is provided, the development of scurvy will be obviated. Another factor which must be borne in mind is that those who refer to meat in the Arctic regions refer to fresh raw meat, which is a far more valuable antiscorbutic than the ordinary cooked meat.

There is almost no experimental data on the antiscorbutic value of eggs. Hard-boiled eggs were fed to guinea-pigs and it was found that 9 g. per capita daily was insufficient to protect them. An attempt was also made to cure infantile scurvy with a daily addition of one raw egg to the dietary, but without avail. It is possible that fresh raw eggs have an antiscorbutic value comparable to meat, but the large quantity required makes dependence upon them impracticable.