166 THE VITAMINS 



is ample. If insufficient, the scurvy may pass from the acute to the 

 latent stage. 



No primary derangement in calcium metabolism was thought to occur 

 in either latent or acute scurvy. In the earlier stages bone formation 

 is inferior quantitatively, though not qualitatively. This results in a 

 surplus of calcium with increased excretion and possible kidney damage. 

 Later, when the tissues become more or less necrotic, calcification takes 

 place in the muscles and liver, resulting in a positive calcium balance. 

 Healing is accompanied by an increased excretion of calcium. The most 

 pronounced difference in the bone system between scurvy and rickets 

 was thought by Hojer to be in regard to calcification. In rickets an 

 osteoid substance is formed which is not calcified, while in scurvy bone 

 is formed to a limited extent and rapidly calcified. 



Most important among the scorbutic changes noted in the skele- 

 ton musculature and in the tissues of various organs, including the 

 heart, liver, spleen, kidneys, adrenals, and salivary glands, was general 

 atrophy. The condition in the skeleton musculature is described as "a 

 general hyperemia, the appearance of certain giant nuclei cells, a great 

 tendency towards necrosis, and the impregnation of the necroses with 

 calcium and hemorrhages in the places exposed to mechanical strain or 

 traumata." These changes, while taking place a little later than those 

 in the teeth and bone marrow, set in during the chronic or so-called 

 latent stage of scurvy. Contrary to most investigators, Hojer consid- 

 ered the change in the adrenals to be of no greater significance than 

 in any other organ and to be simple atrophy rather than hypertrophy. 

 Hemorrhage, one of the characteristic symptoms of scurvy, is attrib- 

 uted chiefly to weakness in the vascular wall and not to changes in 

 the blood, although dilatation of the capillaries and veins is sometimes 

 so strong as to give the impression of hemorrhage. 



In 75 per cent of Hojer's animals with acute scurvy no signs of 

 infection could be detected, but more than half of the animals with 

 latent scurvy suffered from infection of one kind or another. This 

 lowered resistance to infection is attributed chiefly to weakness of 

 the lymphoid tissues. 



Throughout this entire report and a later one by Hojer and Westin 

 (1925) dealing specifically with the condition of the jaws and teeth 

 of guinea pigs on graded doses of vitamin C, the significance is empha- 

 sized of latent scurvy accompanied by no microscopic or macroscopic 

 changes. It is thought that even in animals receiving the amount of 

 antiscorbutic vitamin hitherto considered the minimum preventive dose, 

 there may be indistinct signs of general ill health resulting from a 



