348 ASCORBIC ACID 



IX. Effects of Deficiency in Human Beings 



RICHARD W. VILTER 



A. INTRODUCTION 



The winter had been unusually cold and unpleasant. Joe S., a bachelor 

 and pensioner at the age of 65, had stayed almost entirely in his room ex- 

 cept for occasional visits to the store down the street for hamburger, frank- 

 furters, eggs, condensed milk, bread, and coffee. He had beer almost daily 

 in the bar downstairs, but it had been at least six months since he had had 

 any fruits or vegetables. Oranges and tomatoes were fit only for pigs in his 

 estimation, and since he usually ate alone, he prepared only those foods 

 that were simplest and cheapest. In March, he noticed that he was grow- 

 ing weaker and somewhat short of breath. In April, though the weather was 

 mild, he seldom went out because of fatigue and apathy. He was surprised 

 one evening to see tiny red spots around his ankles and an unexpected 

 bruise or two around his knees. There was deep, dull, aching discomfort 

 in his legs. After several days more he had become too weak even for his 

 simple routine and remained in bed most of the time. Much larger bruises 

 had appeared on his legs. The right caK was completely discolored and had 

 become swollen, hard, and tender. An old ulcer on his right ankle had 

 broken down and was infected. By the first of May, the bruises had ex- 

 tended to his thighs and abdomen and his gums were sore and swollen. The 

 tissues bled when he tried to chew what little food the neighbors brought 

 in. His color became sallow, his eyes tinged with yellow, and his weakness 

 so great that he could no longer get out of bed. At the insistence of neigh- 

 bors, the city hospital amulance was called and Joe S. was carried to the 

 admitting department. He might have been sent to the vascular service or 

 the dermatology ward had not a medical resident spied him and made the 

 correct diagnosis. Joe S. had scurvy. 



He had a disease that was described in the Ebers Papyrus discovered 

 at Thebes about 1500 b.c; a disease well known to Hippocrates (460-370 

 B.C.), who reported that large numbers of men in the army suffered from 

 pains in the legs and gangrene of the gums accompanied by loss of their 

 teeth; a disease which decimated the armies of the Crusaders more than the 

 Saracans did and which spread over Northern Europe and the low countries 

 with the black plague during the Renaissance. It was not described on 

 shipboard until 1492 when seafarers set out on long voyages. Magellan lost 

 nine-tenths of liis crew as a result of scurvy; Vasco da Gama, 100 out of 

 160 men; and Lord Anson four-fifths of a crew of 1200 men.^- ^ Jacques 



1 R. H. Major, Classic Descriptions of Disease with Biograj)hical Slcetclios of the 



Authors. Charles C Thomas, Springfield, 111., 1945. 

 * A. r. Hess, Scurvy, Past and Present. Lea and Febiger, Philadelphia, 1920. 



