It has been shown that during the period of infancy undernourishment
must be extreme to occasion stunting of growth in length. In animals
Aron demonstrated that lack of nutrition led to a decrease of the fat
and of the muscle of the body, but that the skeleton nevertheless
continued to grow, and the ash content of the body to increase. In
marasmus, or infantile atrophy, the baby usually grows in length,
although its weight remains stationary or decreases. In scurvy we have
shown that there is frequently a definite retardation of growth in
length, an observation which has been recently confirmed by Epstein in
babies which developed this disorder in the foundling asylum of Prague
during the war. This fact shows how profoundly the metabolism must be
disturbed by this disorder. Figure 25 portrays this retardation in
growth and the sharp reaction when orange juice was added to the
dietary. It also demonstrates that the growth impulse remains unimpaired
and capable of quick response when the essential food factor is
furnished.
[Illustration: FIG. 25.--Showing retardation of growth in length during
the period when no orange juice was given and supergrowth when it was
given once more, O. J.=orange juice. O. P. J.= orange-peel juice. Lower
curve represents the normal.]
=Fever.=--Fever frequently accompanies scurvy. It is generally of a low
grade, ranging between 100° and 101°, as may be seen in Fig. 15. There
is a difference of opinion as to whether the rise of temperature should
be considered as truly scorbutic in nature, as "scorbutic fever," or
regarded merely as a condition grafted upon the nutritional disturbance.
A phenomenon which might seem to argue for its essential scorbutic
character is the sharp subsidence on giving antiscorbutic food. On the
other hand, this may quite as well be interpreted as due to a secondary
reaction, checking the absorption of toxins or bacteria. High
temperatures--for example, fever of 103° or over--are attributable to a
complicating infection and should lead to careful examination for the
source of the trouble; pyelitis should particularly be borne in mind. In
a recent case fever of uncertain origin disappeared following the
transfusion of blood.
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