"The scurvy complicated with this affect hath these signs: 1. They
that labor under this affect do impatiently indure purgations; but
they who are only affected with the Rachites do easily tolerate the
same. 2. They are much offended with violent exercises, neither can
they at all endure them. But although in this affect alone, there be
a kind of slothfulness and aversation from exercise, yet exercise
doth not so manifestly, at least not altogether so manifestly hurt
them, as when the scurvy is conjoyned with the Rachites. 3. Upon any
concitated and vehement motion they draw not breath without much
difficulty, they are vexed with diverse pains running through their
joynts, and these they give warning of by theyr crying, the motion
of the Pulse is frequent and unequal, and somethimes they are
troubled with a Palpitation of the Heart, or threatened with a
Lypothymie, which Affects are for the most part soon mitigated, or
altogether appeased by laying them down to rest. 4. Tumours do very
commonly appear in the Gums. 5. The urin upon the absence of the
accustomed feavers is much more intense and increased."
Glisson's description of scurvy was entirely lost sight of, overshadowed
by his description of rickets, so that for over two hundred years no
word of infantile scurvy is to be found either in the English or other
literature. There is no doubt that from time to time cases must have
occurred, but they were looked upon probably as rickets or as a
manifestation of one of the hemorrhagic diseases.
In 1859 Moeller described some cases which evidently were scurvy, but
which he termed "acute rickets." He realized that they presented a novel
clinical picture but failed to recognize that they represented a
disorder quite distinct from rickets.[3] This article was followed
within the next few years by reports of other German writers (Bohn,
Steiner, Foerster) who, accepting Moeller's point of view, considered
these cases merely as an acute form of rickets. They were led to this
erroneous conclusion chiefly on account of the lack of marked
involvement of the gums, which they considered an essential sign,
influenced by their conception of adult scurvy. This viewpoint has
pervaded the German literature even to the present day, when it is still
considered necessary to bring further evidence that infantile scurvy in
its pathogenesis and pathology is identical with adult scurvy.
[3] Infantile scurvy is frequently termed "Die Moellersche Krankheit."
There seems to be no occasion for giving Moeller credit for discovering
this disease, as he believed that he was dealing with rickets merely in
an acute form. He recognized the clinical similarity to scurvy, but in
one of his cases sharply differentiates it from adult scurvy by the fact
that "lemon juice and fresh vegetables" were of no avail in the
treatment.
Public-domain text, read in full here on John Shaqi.
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