H. S., boy, born December 15, 1915, was artificially fed until
January 4, 1916, when he weighed 6½ pounds. He was given 28
ounces of Schloss milk a day. (This was prepared from pasteurized
milk which was not heated a second time. It contains per litre
(quart) 140 c.c. of whole milk, 140 c.c. of 20 per cent. cream, 50
g. of dextrimaltose, 5 g. of plasmon, 0.2 g. of potassium chlorate,
and 700 c.c. of water.) By March 1 he weighed 9 pounds, and gained
three-quarters of a pound more in the course of this month. During
April he gained only 4 ounces. As will be seen from the chart,
there was almost a cessation of gain from April 10 to May 3,
although yeast was added to the diet. May 2, orange juice was given.
The weight advanced at once, the color and the general appearance
improved, and an eczematous condition of the face rapidly healed. It
will be noted from the chart that the gain occurred, although the
food intake remained the same.
Epicrisis: A baby 4 months old with latent scurvy, which existed
since he was at least 3 months of age.
_This condition of latent scurvy is probably the commonest type of the
disorder, especially in the larger cities where almost the entire milk
supply for infants is pasteurized._ It usually passes unrecognized. Most
infants fortunately are given orange juice by the time they are 6 months
of age, and may receive a small amount of vegetable or potato before
they are much older, so that they are protected from serious harm in
this way. But there is no doubt a considerable number, especially those
peculiarly susceptible, who quite unbeknown to anyone pass through the
state of latent scurvy.
If this large group of cases were included in the incidence of infantile
scurvy, we should not look upon it as a disorder which occurs rarely
during the first six months of life.
When scurvy goes unrecognized or untreated for a long time, or the
antiscorbutic content of the food is exceptionally small, or the patient
unusually susceptible, the disorder may progress and resemble the
advanced cases described in connection with the adult type of this
disease. Happily such instances are rare. One of the most typical and
vivid descriptions of _an extreme case_ of infantile scurvy is that
reported by Vincent:
The infant lay in its bed extremely apathetic and barely conscious.
Its face was ashy gray in color, the respirations were extremely
frequent, the pulse-rate was 144 per minute, and the temperature
103.2°. When touched it moaned feebly, and made no attempt at
movement. The mouth was kept open, the lower jaw hanging away from
the face. There was a complete absence of muscular tone, so that the
infant appeared to be quite incapable of voluntary movement.
Public-domain text, read in full here on John Shaqi.
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