Metabolism in Scurvy 



ALFRED F. HESS 



NEW YOBK 



Studies of the chemical exchanges in scurvy have been surprisingly 

 few. It is a field that should repay investigation, promising to afford a 

 clearer insight into the intermediary metabolism in this disorder. One 

 of the first to touch upon this question was Garrod, who in 1848 reported 

 that there was a diminution of potassium salts in the urine and in the 

 blood of scorbutic patients. In 1877 Ralfe confirmed the potassium de- 

 ficiency in the urine, but denied its importance from an etiologic stand- 

 point, as he was unable to benefit these patients by administering potas- 

 sium nitrate. He reported an increase of uric acid in the urine, a 

 diminution of the total acidity, and a reduction of the alkaline phosphates. 

 Litten found the analyses of the urine very contradictory in respect to 

 potassium, but stated that beyond a doubt its uric acid content is increased 

 at the height of the disease, although this diminishes rapidly with con- 

 valescence. These few and scattered articles comprise the sum of meta- 

 bolic studies up to the last decade, and even during the succeeding period 

 they have been very few so few, indeed, that they furnish insufficient 

 data from which to draw conclusions. 



The first careful study of the mineral metabolism in a case of scurvy 

 is that of Baumann and Howard, published in 1912. Its conclusions are 

 not very definite. They may be summed up by their statement that 

 "chlorin and sodium were retained during the fruit juice period, but 

 excreted in excess of the intake during the preliminary period," and that 

 "more potassium, calcium and magnesium were retained during the fruit 

 juice period." 



This sanae year Lust and Klocman published the first metabolism 

 study of a case of infantile scurvy. The baby was eighteen months old, 

 and the metabolic changes were investigated during the active, the con- 

 valescent, and "the healing stage" of the disorder. This study seems to 

 have been carefully carried out. The fact, however, that the infant re- 

 ceived 800 c.c. daily of slightly boiled milk during the active stage, and 

 was improving at this time, may also have had a beneficial effect on the 

 metabolism in respect to scurvy. The results of these writers are sur- 



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