104 RHEUMATISM. 



SCURVY-SCORBUTUS. 



Definition. " Scurvy is a subacute or. chronic trophic disorder 

 characterised ])y debiHty, inanition, anaemia, swelhng and bleeding of 

 the gums, gingival ulceration, dropping of the teeth,- and petechial or 

 more extensive hfemorrhages and exudations in the skin, serosa, and 

 solid tissues." 



Causes. " Among the lower animals, pigs especially suffer, when 

 kept in close, foul quarters and fed on a monotonous and insufficient 

 ration. Formerly scurvy . . . was attributed to an exclusive diet of 

 salt food ; to excess of sodium and deficiency of potassium salts ; to the 

 absence of fresh vegetables ; to tainted food, etc. In pigs the food and en- 

 vironment are usually chiefly at fault, the subjects have been kept . . . 

 in foul buildings, in a hot, moist atmosphere, and with an uniform diet 

 of maize or other unvarying and insufficient ration. Eoll attaches 

 great importance to putrid food. Benion has found the affection 

 mainly in obese swine, the forced feeding and intestinal fermentations 

 manifestly operating as factors. Hess and others attribute the disease 

 in pigs to the germ of erysipelas. Stengel has produced purpuric disease 

 in animals by inoculation of the extravasated blood from human scurvy 

 patients. Miiller and Babes found a slender bacillus and streptococci in 

 the tissues of scorbutic gums. . . . There is considerable presumption 

 of the existence of a microbian cause, the efficiency of which is dependent 

 on the unhygienic conditions above stated, while these unwholesome 

 conditions are equally non-pathogenic in the absence of the microbe." 

 Lesions. " The blood is black and incoagulable or clots loosely, rigor 

 mortis is slight, changes may be found in the number and character of 

 the white and red blood globules, but are not constant ; there is usually 

 an excess of sodium salts and deficiency of potassium ones, and there is 

 marked petechiation of the skin, mucosae and serosa. The bone marrow 

 may be abnormally red and the bones fractured at the epiphyses, or 

 carious. . . . The gums are softened, swollen, red and uneven, with 

 hasmorrhagic discoloration, erosions, necrotic areas and ulcers." 



Symptoms. " Anorexia or fastidious appetite, prostration, debility 

 and sluggish, indifferent movements, are followed by the local lesions on 

 the skin and gums. On the skin appear petechiae and extravasations, 

 which often implicate the bristles, so that they may be shed or pulled 

 out with ease, the bulbs appearing dark and bloodstained (bristle rot). 

 These may be followed by necrotic sloughs, and deep ulcers that are slow 

 to heal. The gums are red and swollen, with hsemorrhagic spots, and 

 bleed on the slightest touch. Erosions, sores, and ulcers are not 

 uncommon ; the tongue is dry and furred, and the mouth exhales a foetid 

 odour. The teeth may become loose in their sockets. Swelling of the 



