508 Dr. S. S. Zilva and Major F. M. Wells. Changes in the 



In a scurvy tooth the condition persists right up to the apex of the root ; 

 the change appears to start first in the odontoblastic cells at the top of the 

 pulp working down towards the apex, followed by distended blood vessels 

 and haemorrhage ; then complete fibroid degeneration follows. 



These sections are typical of the great number of teeth examined. 



It has already been pointed out that the changes in the structure of the 

 teeth is a feature observed in quite early stages of the disease. An 

 experiment was devised to demonstrate this systematically. Four sets of 

 two guinea-pigs each were put on a scorbutic diet of oats, bran, and auto- 

 claved milk. In the ordinary covirse, animals subsisting on such a diet cease 

 to grow after about 15 days and then commence declining in weight and 

 eventually succumb to scurvy within a period varying from 21 to 28 days 

 after the commencement of the experiment. After about the 15th day such 

 scorbutic symptoms as tenderness of the limbs can be observed. Animals 

 chloroformed at this stage usually show, at the post-mortem examination, 

 intramuscular haemorrhages, especially in the femoral muscles, subcutaneous 

 and subperiosteal haemorrhages, enlarged costochondral junction and fragility 

 of bone which is well marked near the epiphyseal line in the tibia and the 

 femur. The entire pathological picture is characteristic of scurvy. In the 

 experiment the following procedure was adopted. The groups of animals 

 were chloroformed after they had subsisted on the scorbutic diet for 7, 10, 12, 

 and 17 days respectively. A careful post-mortem examination was carried out 

 on the animals, and stained sections of the teeth of the respective groups 

 were examined microscopically. 



The results are summarised in the following Table. The degree of change 

 in the structures of the teeth is indicated by the number of crosses in the 

 Table. Two outstanding features are brought out by this experiment. 

 In the first place it becomes plain that the tooth is one of the first, if not 

 the first part of the system to be affected by the deficiency of antiscorbutic 

 material in the diet. The second point to be marked is that when the 

 scorbutic symptoms during life are so slight as to be almost unrecognisable, 

 profound changes in the tooth are recorded. If one considers the animals 

 No. 366, 368, 369 (367 showed the idiosyncrasy of being rather resistant to 

 scurvy), one sees that these animals were in apparent good health and gaining 

 in weight. The scorbutic changes disclosed by the post-mortem examination 

 were such as could hardly have produced any discomfort to the animals, yet 

 the change in the teeth was profound. We shall refer to this later. 



All the guinea-pigs so far examined were several weeks old, and experi- 

 ments were therefore instituted with the object of seeing whether similar 

 changes could be observed in animals put on scorbutic diet soon after birth. 



