=Scurvy in the World War.=--The greatest advance in medicine during the
past generation has been in the fields of hygiene and preventive
medicine. One might therefore have expected that the World War would
have differed from previous wars in a notable absence of scurvy among
the troops and the civilian population. This is true to a limited degree
only. Reports which have been published in the course of the war, and
especially since hostilities have ceased, show that the troops who were
incapacitated by scurvy must have numbered many thousands. As was to be
expected, scurvy occurred most often in Russia, where it is endemic. The
largest number of cases was reported by Boerich, who as director of a
Red Cross Central Station in Russia saw 1343 cases. Other German
physicians who had charge of caring for the Russian prisoners give
accounts of the occurrence of some hundreds of cases of scurvy. An
article by Much and Baumbach gains added interest from the novel
suggestion that scurvy is transmitted by means of vermin. That scurvy
must have reached large proportions is shown by the fact that in July,
1916, a medical commission was sent by the Germans to investigate the
scurvy in a Russian army corps, and that it was necessary to establish
for this disease in every division a sanatorium comprising 100 beds.
Hoerschelman, who wrote an account of this investigation, blames the bad
hygienic surroundings, the lack of sleep, the overexertion, as well as
the deficiency of food, for the occurrence of the epidemic. As usual,
very few cases occurred among officers. He describes a number of
instances where scurvy was feigned by rubbing the gums and making them
bleed, or by irritating them with the juice of tobacco. These reports on
scurvy in Russia bring us little new from a purely medical standpoint.
They emphasize the occurrence of night-blindness as an early and
frequent symptom. It is difficult to judge whether this manifestation
was due entirely to the scurvy, or was in part the result of other
deficiencies in the diet. For instance, Hift states that the
night-blindness was cured by cod liver oil, or by the water in which
beef liver had been cooked. This would point rather to a deficiency of
the fat-soluble vitamine, as these substances could have little effect
in curing scurvy. The cases reported by Wassermann, where neuritic pains
in the legs played a considerable rôle, evidently are also not simple
scurvy, but may well be the result of more than one food deficiency or a
complicating ostitis. In the same way some reports show clearly that
"hunger edema" complicated scurvy.
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