As complications involving the gastro-intestinal tract may be mentioned
the vomiting of blood, which is stated in the above report as occurring
in 2 of the 361 cases, as well as bleeding from the bowel, which was
noted in 37 cases, in 12 of which there was bloody diarrhoea. However,
these are late symptoms, and correspond to the mycotic ulcers which are
so frequently found, especially in the large intestine, in cases of
scurvy. Mention may again be made of the fact that hemorrhages may occur
under the peritoneum and give rise to symptoms simulating appendicitis
or general peritonitis.
Jaundice has been described in connection with certain epidemics of
scurvy. To our knowledge it has not been reported in infants.
The presence of worms has been frequently reported in the bowel or in
the stool of patients suffering from beriberi. There have been no
similar investigations in relation to scurvy. It would be interesting to
inquire into this question, as it is quite possible that a lack of
antiscorbutic foodstuff may favor the presence of parasites in the
intestinal canal.
Before closing this consideration of the involvement of the alimentary
tract, we would call attention to the relation of stomatitis to scurvy.
Among adults this is a common complication. In infants it is uncommon,
due to the absence of carious teeth and secondary infection; we have
encountered it in but two instances. Stomatitis is of importance in this
connection, as it frequently develops on the basis of malnutrition,
scurvy being one of the disorders which may constitute the substratum.
Such may be the case where stomatitis occurs in epidemic form--for
example, among large bodies of troops. It may be remarked that
stomatitis at times was a very common disease among the soldiers in the
recent war.
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