The local signs usually disappear quickly without leaving any trace. The
hemorrhages are absorbed and the eczema heals within a few days. The
fractures unite promptly with the formation of an unusually large
callus. The urine, which may have contained red blood-cells or have been
markedly hemorrhagic, quickly becomes normal and, in our experience,
gives no further evidence of renal damage. Still reports, however, the
case of a frail child who had a trace of albumen in the urine two years
after an attack of scurvy. A rare local injury, which may lead to death,
is cerebral hemorrhage. Recently Sammis reported a case of this kind,
which was characterized by convulsions during life, and in which
subdural hemorrhage was found at necropsy.
If we acknowledge an individual idiosyncrasy to scurvy we should expect
a tendency to a recurrence of the disease. Lind was of this opinion,
stating that "by observations made on this disease, it appears that
those who are once afflicted with it, especially in so high a degree as
that squadron was, are more subject to it afterwards than others." It is
difficult at the present day to express a personal opinion on this
matter, as clinical experience is meagre and the scurvy of guinea-pigs
is so acute that it cannot be used for comparison. Some of the
recurrences have been due probably to the fact that the patient had not
been completely cured of his first attack. We have met with two cases of
recurrences in infants, one of which is of particular interest as it
happened in spite of giving lemon juice in the intervening period. The
history was as follows:
In September, 1914, one month after the baby was admitted to the
institution, it developed scurvy of a moderate grade. It was then
six months of age and weighed 10¼ pounds. It was put on a simple
mixture containing from 24 to 30 ounces of pasteurized milk and was
given in addition ½ ounce of lemon juice a day. It improved, but
during the winter had bronchitis, otitis, enteritis, and later
furunculosis. In spite of the fact that it had been receiving an
antiscorbutic for almost this entire period, it developed scurvy
once more in February, at the age of 11 months, and when it weighed
14½ pounds. It was evident that this baby was peculiarly
susceptible to scurvy. It may be added that the second attack was
complicated by nasal diphtheria.
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