IX. EFFECTS OF DEFICIENCY IN HUMAN BEINGS 



359 



to ascorbic acid deficiency than do the mature bones of adults. The i)re- 

 scorbutic infant becomes anorexic and Ustless for only a few days before 

 lesions aiijiear. With the onset of scurvy, the infant lies Avitli Io<i;s drawn 

 up on its ai)donien. It cries when it is touched, especially when its legs or 

 arms are moved or when it is lifted by its feet to change its diaper. Ex- 

 tremely tender swellmgs may be felt at the ends of the long bones due to 



Fig. 12. Healed scorbutic rosary in a boy wiio had had scurvy off and on since 

 infancy. The sharp edges at the costochondral junctions are easil\' visil)le. 



hemorrhage under the periosteum of the shaft, but not involving the joints, 

 and edema in the tissues overlying the hemorrhages. The lower end of the 

 femur and the upper end of the humerus are most often affected. In very 

 severe cases epiphysial separations may occur, which may be felt most 

 commonly at the costochondral junctions. The sternum may suik shghtly 

 inward, leaving a sharp elevation on the rib side of the junction. This has 

 been called the scorbutic rosary (see Fig. 12). Purpura occurs in the skin 

 in only one-tliird of the cases, and, as in the adult person, these hemor- 

 rhages are conditioned by slight trauma. If teeth have erupted, hyper- 

 plastic blue-red swollen gum lesions appear most often around the upper 



