306 THE VITAMINES 



Infantile scurvy 



Infantile scurvy develops between the 6th and 18th month, seldom 

 earlier or later, and Hess (I.e. 918) differentiated between the acute, 

 sub-acute and latent forms ; this view was accepted by Miller (993) . 

 The subacute form is not very well defined but growth ceases. Aside 

 from a somewhat abnormal color of the skin and an occasional edema 

 of the upper eyelids, no further pathological signs are noted. The 

 child is capricious, and the lower limbs are somewhat sensitive to 

 touch. The knee reflexes are almost always markedly accentuated. 

 All of these symptoms are promptly overcome on the addition of 

 antiscorbutics, whereupon growth is resumed, according to Hess 

 (l.c; 461). 



The latent form is even less pronounced, and the children recover 

 in an extraordinary manner after the administration of antiscor- 

 butics. According to Hess, the latent form occurs especially in 

 cities, where pasteurized milk is sold. It does not need to be 

 particularly exphasized that these less important forms of infantile 

 scurvy occur more frequently than do the acute forms. Franchetti 

 (994) described a chronic case of scurvy in an older child, with 

 bone dystrophy, painful paraplegia, cachexia, anemia, absolute 

 anorexia, but without hemorrhages. 



Muscle weakness, anemia, and anorexia, are the initial symptoms 

 noted. Pain develops in the legs; the child holds them motionless 

 and cries out when they are moved. This behavior resembles pseudo 

 paraplegia, according to the statement of Comby (995). Swellings 

 are frequently noted, sometimes only on one extremity, of a 

 periosteal nature, especially of the tibia. Besides this, swelling of 

 the muscles was noted, caused by hemorrhages. The skin on the 

 arches of the feet is frequently edematous, while the skin over the 

 swelling appears pale. If teeth are present, the characteristic gum 

 changes occur. The spongy, bleeding swellings become ulcerous 

 in some cases and the teeth may loosen and fall out. Oliguria, 

 described by Gerstenberger (996), is quite characteristic of this 

 condition, and hematuria less frequently so. The temperature 

 remains normal, occasionally going up to 39C., following blood 

 resorption after hemorrhages (Barlow fever). When no thera- 

 peutic measures are applied, death may ensue as a result of heart 

 failure or hemorrhages. Initial phases of scurvy were described by 



