As would be expected, the nervous system is at times the site of
hemorrhage. Such lesions cannot, however, be considered essentially
nervous. For instance, hemorrhage into the meninges may occur, as in the
case of Sammis, where there was "a general clonic convulsion" before
death, and a blood-clot 2½ inches long by ½ inch wide was found at
necropsy between the dura and arachnoid. Fife reported a similar case.
Finkelstein also has drawn attention to the occurrence of meningeal
hemorrhage, and Hess and Fish reported obtaining bloody cerebrospinal
fluid from a case with meningeal symptoms. Recently Aschoff and Koch
have depicted hemorrhages in the sheath of the sciatic nerve, which
undoubtedly must have given rise to symptoms during life.
In view of many of these symptoms, especially those involving the vagus,
scurvy must be looked upon as a disorder which may seriously affect the
nervous system. Furthermore, when we note the marked reaction brought
about by the antiscorbutic vitamine--for example, the sharp fall in the
rate of respirations and of pulse, as shown in Fig. 15, after giving
orange juice, we must conclude that the antiscorbutic vitamine
functions, at least indirectly as an antineuritic vitamine--that it must
possess this character to allay the various nervous signs of this
disorder.
The urinary system is frequently involved in the course of scurvy. Among
38 cases Still reports that 89 per cent. gave evidence of urinary
changes and that 60 per cent. showed hæmaturia. Finkelstein found
urinary signs in at least a third of his cases. Our figures, the result
of a study of subacute and mildly acute cases, correspond more nearly
with those of Finkelstein.
The occurrence of pronounced renal hemorrhage as a first symptom of
scurvy is emphasized in many descriptions of this disease, and has
impressed itself in the minds of physicians. It is true that this occurs
sometimes at the onset, as does hemorrhage into or about the joints, or
hemorrhage behind the eyeball. It is well to bear these possibilities in
mind, but they must be regarded as very exceptional early signs of this
disorder. We have encountered frank hæmaturia but once in the early
stage of infantile scurvy. The blood emanates generally from the
kidneys, although the submucous hemorrhages of the bladder as well as in
the urethra, described both in man and in guinea-pigs, indicate that the
blood in the urine may have its origin lower down in the tract. This
bleeding should be regarded not as a sign of nephritis, but rather as a
hemorrhagic manifestation. It is less frequent in adults than in
infants. O'Shea reports some degree of hemorrhage in 15 per cent. of his
cases (adults).
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account