SCURVY 301 



was with the English troops in North Russia; in the prisons there, 

 he observed scurvy. The disease began after 4 to 7 months on a 

 diet consisting of 313 grams flour or zwieback; 250 grams rice, oat- 

 meal, peas or beans; 205 grams frozen or canned meat or salted her- 

 ring; 50 grams bacon or pork; 7 grams tea; 28 grams sugar; 21 grams 

 salt and 14 grams preserved lime juice. Of the antiscorbutics 

 investigated, the order of activity was as follows : Sour milk, fresh 

 meat, fresh lemon juice, germinated peas, canned fruit and germi- 

 nated beans. Stevenson (961) believes that in adults the disease 

 develops in 4 to 8 months, and that 200 grams cooked vegetables 

 daily may prevent the occurrence of the disease. According to Chick 

 and Dalyell (962), prolonged cooking of vegetables is frequently 

 responsible for the outbreak of scurvy. Forty such cases were 

 observed in Pirquet's children's clinic in Vienna; these cases 

 developed eight weeks after the fresh vegetables were dealt out, 

 somewhat sparingly. These investigators believed also that rapid 

 growth on a diet very rich in calories is especially conductive to the 

 development of scurvy. During and after the war, a number of cases 

 of scurvy were observed among older children, which was very seldom 

 the case in times of peace. Tobler (963) commented in particular 

 upon this, mentioning more than 200 such cases. Erich Miiller 

 (964) describes a number of these cases in the orphan asylum 

 (Frederick the Great) in Rummelsburg near Berlin, which were 

 attributed to the use of dried vegetables. Weill and Dufourt (965) 

 noted it in children between 2| and 6 years old in a zone formerly 

 occupied by German troops. 



Regarding infantile scurvy, "Barlow's disease" (cf. reviews by 

 Morse, 966), this condition occurs almost exclusively in artificially 

 fed children. There are, however, a few investigations, for example, 

 that of Netter (957), who described the disease in breast-fed infants; 

 however, from a critical survey of these cases, Hess (I.e. 918) con- 

 cluded that these data were uncertain, although theroretically not 

 impossible. The cause of the disease is to be sought in the heating 

 of the milk (pasteurization or sterilization). The feeding of artificial 

 milk products such as condensed, homogenized or preserved milk, 

 or of children's proprietary foods as chief diet (Cheadle and Poynton, 

 968) brings about the disease. After the introduction of the soxhlet 

 apparatus, the milk was not infrequently warmed for 45 minutes 

 and longer. The first extensive investigation of this disease we owe 



