REVIEW — -TEOPICAL MEDICINE, ETC. 167 



Scurvy. Coplans,' in a paper on Scurvy in South Africa, endeavoured to show that 

 the disease was due to an infection for which food may act as a vehicle under conditions of 

 dirty storage or dirty preparation, and that its infectivity depended on the insanitary habits, 

 the degree of intimacy, the overcrowding and, perhaps, the unwholesome occupation of those 

 who were its victims. In the discussion on this paper, Wright upheld the view that scurvy 

 is neither a bacterial disease nor that it is associated with dirt, but that it depends upon a 

 diminution in the alkalinity of the blood. Hence the administration of potatoes, fruits, raw 

 meat juice, etc., is scientifically justified as supplying all the elements which are turned into 

 alkalies in the body. A much more rapid result can, however, be obtained by the exhibition 

 of lactate of soda, lactic acid being the acid most easily converted into carbonic acid in the 

 body. Lime juice ought to be eschewed as containing citric acid, which can only decalcify 

 the blood, and is useless as an anti-scorbutic, because it breaks up into CO., and HoO without 

 leaving any residue. The quantity of citrates in lime juice is too small to be of any 

 value. The rest of the discussion, though interesting, yielded little of definite value. 

 Kenwood thought that infantile scurv)' was probably a different disease from that described, 

 and Willoughby cited the theory of Tonk ! (sic) of Christiania, who believes scurvy to be 

 simply a chronic ptomaine poisoning. This, it is said, is the only theory which adequately 

 explains all cases of the disease. (Vide infra) 



A different view is that taken by Barnardo- as the result of experience in Somaliland. 

 He is inclined to think that scurvy is a toxfemia, due not to any new specific organism but 

 to the bacteria normally present in the alimentary canal which have taken on an abnormally 

 active development and toxin formation consequent on the diminished vitality of the 

 mucous membrane there, and a diminished bactericidal power of the tissues generally. 

 This, if true, indicates the exhibition of intestinal antiseptics. Barnardo agrees with 

 Wright as regards the blood change and the uselessness of lime juice. He regards pickles 

 as a useful addition to the dietary, and recommends fresh meat juice combined with 

 potassium citrate and calcium chloride. 



An interesting paper is that by Ekelof,^ on the Swedish Antarctic Expedition, wherein 

 he, like Willoughby, alludes to the theory of Torup (not Tonk) of Christiania, as to scurvy 

 being a chronic ptomaine poisoning due to the introduction into the body of some non- 

 organised matter, foreign to, and dangerous for, the human organism. This must be of the 

 nature of a poison due to a peculiar and slow decomposition taking place in badly preserved 

 {e.ij. badly salted) meat and fish. While Ekelof thinks this is the only theory giving an 

 intelligible explanation which, in its leading features at least, is compatible with the actual 

 circumstances, he is careful to point out that it cannot be true in its entirety, for scurvy has 

 attacked expeditions furnished with provisions of first-rate quality. 



Hoist and Frolich,^ already quoted in connection with beri-beri, conducted feeding 

 experiments on guinea pigs, and their results may be tabulated : — 



A one-sided diet consisting of various sorts of grain, groats and bread, produces in 

 guinea pigs a disease that corresponds, macroscopically as well as microscopically, to human 

 scurvy. 



On the other hand, they found that this disease does not occur after a one-sided diet 

 consisting of fresh cabbage or fresh potatoes, whereas it again is produced by dried potatoes. 

 That is, the disease originates in guinea pigs as well as in man as a result of a diet confined 

 to some special nutriments. 



They have further observed that the disease is favourably influenced by different sorts 

 of nutriments known, from human experience, as " antiscorbutics." They have, however, 

 also found that at least one of these nutriments, that is cabbage, loses a deal but not all of 

 its preventive power when boiled for half-an-hour at 110° C. 



Finally, they quoted several examples showing that the same or similar one-sided diets 

 that produce the disease in guinea pigs have repeatedly produced scurvy in man. 



However, they have not, hitherto, been able to produce the disease that has been the 

 proper aim of their experiments — that is, the younger brother of scurvy or ship beri-beri — 



' Coplans, M. (1903-4), " On the Etiology of Scurvy." Trans. EpuJ. Soc. London, pp. 79-94. 



- Barnardo, .J. P. (.July, 1904), " Scurvy in Somaliland." Notes on the Condition of the Blood Serum. Indian 

 Medical Gnzclte, Vol. XXXIX. 



' Ekelof, E. (October, 1904), " Jledical Aspects of the Swedish Antarctic Expedition, Oct., 1901-Jan., 1904." 

 Journal of Hygiene, Vol. IV. 



•• Hoist, A., and Friilich, T. (October, 1907), '■ On the Etiology of Scurvy." Journal of Hygiene, VoL VII. 



