A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
The operations of armies in recent times have not furnished the
frightful mortality which, from neglect of sanitary precautions,
formerly afflicted them. During the rebellion of 1861-64, out of
807,000 cases there were but 47,000 of scurvy, or 5.8 per cent., with a
death-rate of 16 per cent. The French army[1] of 103,770 men during the
Crimean struggle had 27,000 cases of scurvy, or 26.0 per cent., with a
death-rate of 1.5 per {169} cent. In the Bulgarian campaign of 1877-78,
in an army of 300,000 strong, there were, according to Pirigoff,[2]
87,989 cases of disease, of which 4234, or 4.8 per cent., were
frankly-expressed cases of scurvy. This gave a proportion of only 1.4
per cent. of the entire force--a result entirely due to the
maintenance, both before and during the war, of a high standard of
health.
[Footnote 1: Scrive, _Rélation Médico-Chirurgicale de la Campagne de
l'Orient_, Paris, 1857.]
[Footnote 2: _Krieg Sanitäts-Wesen_, Leipzig, 1882.]
ETIOLOGY.--Perhaps no disease has furnished a more fertile field for
etiological conjectures than scurvy. The father of medicine ranked the
disease in one place among those presenting enlarged spleens, and in
another with the twisted bowels. He recognized a putrescence of the
humors as the underlying factor--a theory that held sway until the
beginning of the nineteenth century. The disease attracted wide
attention in the seventeenth and eighteenth centuries from its frequent
epidemic and endemic occurrence in various parts of the north of
Europe, and was believed to be restricted to cold and particularly wet
districts--a view that has been long since abandoned with a better
knowledge of its habitats. It has been encountered alike in high
latitudes north and south, amidst sterile wastes covered with eternal
snows and ice, in the temperate zones and in the burning plains of the
equatorial regions of America and Africa.
Sex has no predisposing influence, and the fact that more males than
females are affected during an epidemic simply indicates that the
former are more exposed to the ordinary determining causes. During the
siege of Paris, according to the tables of Lasègue and Legroux, there
was a very large excess of male cases, and Hayem's figures show only 6
women in 26 cases.
Scurvy has been observed at all ages from infancy to advanced periods
of life; it is believed by certain writers that adolescence is less
predisposed than adult age.
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