SCURVY. (Scorbutus)

Categories: Diseases of The Blood And Ductless Galnds

A constitutional disease characterized by weakness,
anemia, sponginess of the gums and tendencies to bleeding.



Causes. This disease has been called "The calamity of sailors." It has

been known from the earliest times, and has prevailed particularly in

armies in the field and among sailors on long voyages. It has become a

very rare disease in the United States.



Predisposing Causes. Overcrowding; dar unhealthy rooms; prolonged

fatigue; mental depression.



Exciting Cause. The lack of fresh vegetables, poisoning from slightly

tainted food, or an infection. The gums are swollen, sometimes ulcerated,

skin is spotted, bluish, etc,



[BLOOD AND DUCTLESS GLANDS 255]



Symptoms. It comes on gradually (insidiously). There is loss of weight,

progressively developing weakness and pallor, very soon the gums are

swollen and look spongy and bleed easily. The teeth may become loose and

fall out. The breath is very foul. The tongue is swollen, but it may be

red and not coated. The skin becomes dry and rough and (ecchymoses) dark

spots soon appear, first on the legs, and then on the arm and trunk and

particularly about the hair follicles. These are spontaneous or follow a

slight injury. In severe cases hemorrhages under the periosteum (the

covering of the bones) may cause irregular swelling, especially in the

legs, and these may break down and form ulcers. The slightest bruise or

injury causes hemorrhages into the injured part. Extravasion under the

skin, especially in the lower extremities may be followed by permanent

hardness (induration) and stiffness due to connective tissue infiltration

(scurvy sclerosis). There may be pains in the joints and often watery

swelling (oedema) of the ankles. Bleeding from internal mucous membranes

is less common than from the skin. The appetite is poor, palpitation of

the heart and feebleness and irregularity of the pulse are prominent

symptoms. Owing to the sore gums the patient is unable to chew the food.

The urine often contains albumin and is scanty and concentrated. There are

weariness, depression, headache and finally delirium or coma, or symptoms

due to hemorrhages within the brain; or day and night blindness may be

present.



Recovery. The patient will recover if the cause can be removed, unless it

is far advanced. Death may result from complications.



Treatment. Preventive. Fresh or canned vegetables or fruit must be eaten.



Treatment for the attack. Dr. Osler, of England, says: "I think the juice

of two or three lemons daily and a diet of plenty of meat and fresh

vegetables will cure all cases unless they are far advanced. For the

stomach small quantities of scraped meat and milk should be given at short

intervals, and the lemon juice in gradually increasing quantities. As the

patient gains in strength you can give a more liberal diet, and he may eat

freely of potatoes, cabbage, water cresses, and lettuce. A bitter tonic

may be given. Permanganate of potash or dilute carbolic acid forms the

best mouth-wash. Penciling the swollen gums with a tolerably strong

solution of nitrate of silver is very useful. Relieve the constipation by

enemas."