SCURVY 399 



pends upon a kind of acid intoxication, owing to the fact that the diet which 

 experience shows is a cause of scurvy contains a great excess of mineral acids 

 in comparison with the bases. This agrees with the fact that antiscorbutic 

 remedies in general contain a superfluous amount of bases in comparison to 

 mineral acids. In conformity with this view the readily oxidizable salts con- 

 tained in organic acids would be particularly adapted to the prophylaxis and 

 therapy of the disease. Wright tested this in 7 cases of scurvy (for the most 

 part_ in soldiers during the siege of Ladysmith). He gave appropriate salts, 

 particularly sodium lactate (also acetates, carbonates and oxalates), and tested 

 simultaneously the alkalinity of the blood by a method which he proposed, now 

 known as the " hemoalkalimetrie." In all of these cases the alkalinity of the 

 blood was at the onset very low ; and by this treatment an increase almost or 

 quite to the normal occurred remarkably soon in all (with the exception of a 

 fatal case) and at the same time a retardation of the other symptoms of the 

 disease. These results confirm the view that there is an acid intoxication in 

 scurvy. 



However fascinating the potassium theory may be, it is by no means abso- 

 lutely proven, and it does not contradict the view that scurvy may, in spite of 

 this, be an infegtious disease. Scurvy may perhaps be assumed to he an infec- 

 tious disease of a non-contagious nature produced by a microorganism which 

 finds in a lody deficient in potassium a favorable culture medium for its 

 development. 



PATHOLOGICAL ANATOMY 



The cadavers are characterized usually by only a slight degree of post 

 mortem rigidity, and by the appearance of numerous livid areas. There is 

 also a tendency to rapid cadaverous alterations. The various cutaneous hem- 

 orrhages present during life remain distinctly visible after death. The lower 

 extremities are frequently edematous. Upon microscopic investigation of the 

 hemorrhagic areas we note that in the smaller (petechife) the point of exit 

 of the blood is usually the capillary network in the area surrounding the hair 

 follicle; the larger hemorrhages (suggillations and ecchymoses) originate 

 quite differently from superficial or deeper layers of the corium according to 

 their seat and their extent. The erythrocytes which have exuded show all 

 stages of decolorization and of decomposition. The surrounding tissue is per- 

 meated by hemoglobin of vai-ious colors. 



As the cause of the hardenings and ecchymoses in the subcutaneous con- 

 nective tissue and in the muscles, various infiltrations of blood are found, 

 partly diffuse, in part sharply demarcated, and, according to the time of their 

 appearance, of different colors and consistence. In the old foci where the 

 tissues are not yet regenerated, instead of the fibrin coagula we find tough 

 cicatricial masses of connective tissue in the surroundings of which the mus- 

 cular tissue is partly rigid, partly atrophic, and the tendons either to a great 

 extent adherent to the muscles or so hardened that movement is impossible. 

 In this way ankylosis and deformities occur, such as club-foot, which will be 

 discussed later. In the cavity of the joints a serous or even hemorrhagic effu- 

 sion is occasionally found. The walls are frequently unchanged. If, how- 



