It is sometimes recommended that modified milk, for infant feeding, be made up with potato water, instead of barley water, since the latter has no anti-scorbutic properties, while potatoes are somewhat protective even after being cooked.
Spinach water is sometimes given, but there is doubt in some minds about its anti-scorbutic value, which seems to be more damaged by heat than that of potatoes and tomatoes.
Canned tomatoes are valuable because of being inexpensive and preserving their anti-scorbutic properties, even after heating. It is the opinion of many pediatricians that babies tolerate canned tomatoes very well, and in some cases may be given as much as four, six, or even eight ounces daily, without causing trouble.
Infusion of orange peel also is used in the prevention and treatment of scurvy and has the advantage of being inexpensive since the orange itself may be used for other purposes.
But orange juice and lemon juice are generally accepted as being the most valuable of all anti-scorbutics. Orange juice may be started early, and to be of value as a preventive, must be started early or scurvy will have started to develop. The common practice is to give a dram, daily, at three months, increase it to an ounce by the sixth month and two ounces when the baby is a year old. It should be diluted with water and given in two doses, midway between two morning and afternoon feedings.
To sum up: Scurvy in infants or adults is the result of a diet which is deficient or lacking in the anti-scorbutic substance, called water-soluble C, and may be prevented or cured by adding to the faulty diet those articles of food which contain this substance, namely, fresh milk, oranges, leafy, green vegetables, cabbage, onions, potatoes or tomatoes. Although scurvy is seldom seen in breast-fed babies it is believed that an infant nursing at the breast of a woman whose diet is poor or lacking in the anti-scorbutic substance may suffer a certain degree of starvation for this food factor.
Recent work at the University of Minnesota has shown that milk from cows on dry feeds is very much lower in anti-scorbutic properties than milk from cows on green pasture. This provides a strong argument for giving orange juice to all artificially fed babies, for one cannot always know how the cows, from which the milk is obtained, are fed.
Beri-beri is a deficiency disease, chiefly characterized by paralysis and caused by a diet which is lacking or poor in water-soluble B. The foods which entirely lack this substance are polished rice, starch, sugar, glucose, and the fats and oils from both animal and vegetable sources, while those which are poor in it are the products of degerminated cereal grains, such as tapioca, hominy, cornmeal, macaroni, spaghetti and the muscle cuts of meat, such as steak, roast, chops, ham and fish and fowl muscle. Foods which are rich in water-soluble B are beans, peas, the root vegetables as beets, carrots, white and sweet potatoes, leafy vegetables, fruits, milks, eggs and the glandular organs such as liver, kidneys and sweet breads.
The early symptoms of beri-beri are fatigue and depression; numbness and stiffness in the legs; more or less edema of the ankles and face, followed by tenderness of the calf muscles, and tingling or burning sensations in the feet, legs and arms. There are two types of the disease, the dry and the wet. In the dry type, wasting anesthesia and paralysis are the chief symptoms, while the most marked evidences of the wet type are the edema, which may be excessive, affecting the entire body. The death rate from beri-beri is usually high.
We are accustomed to thinking of this disease as occurring chiefly among the Orientals, for it was long confined to Southern China, Japan, the Dutch East Indies and the Malay Peninsula. But it may occur among any people whose diet is poor in those foods containing the particular substance which protects against it. It is common in Newfoundland and Labrador and certain parts of South America and among people who eat little aside from staple, non-perishable, cereal products, wheat bread made from bolted flour, fish and salt meats. An evidence of this near at home was an outbreak of typical beri-beri, in the jail at Elizabeth, N. J., in 1914, caused by the faulty diet of the inmates.