In 1913 Bahrdt and Edelstein reported the analyses of the organs of an
infant almost nine months old who died of scurvy; an examination of the
tissues, especially of the bones, should be most valuable in checking up
determinations of the metabolism during life. This investigation runs
absolutely contrary to that of Lust and Klocman. The bones showed a
decrease of ash, especially of calcium and of phosphorus, and also a
lack of calcium in the muscles, but normal amounts in the liver and in
the kidneys. These conditions resemble the deficiency of ash and of lime
commonly associated with rickets, and it seems quite possible that this
infant had rickets as well as scurvy, and that in this way the
discrepancy between the two reports is to be explained. The fact that
the water content of the bones was two to three times the normal, also
lends emphasis to this interpretation. _In any metabolism study of
infantile scurvy, great care will have to be exercised that the disorder
is not complicated by rickets_, and the issue thereby confused. It will
be very difficult to avoid this pitfall, for there is no test by which
early rickets can be diagnosed. The danger of this complication may be
realized when we bear in mind that the majority of infants have rickets
to some degree. An investigation of the chemistry of adult scurvy has an
advantage from this point of view.
Chemical examination of the blood has yielded such valuable information
regarding metabolic diseases, that it might be expected to shed light on
the disturbances of scurvy. The only investigation from this standpoint
is that of Hess and Killian, who have reported estimations of the urea,
creatinine, sugar, CO_{2} combining power, diastase, cholesterol,
chlorine and calcium.[57] The urea content was normal, varying between
12 and 14 mg. per 100 c.c. of blood; this is the average of twenty-one
tests on ten cases of infantile scurvy. (In severe cases of beriberi
Yano and Nemoti have recently reported that the blood contains an
increase of urea, and that its excretion is frequently disturbed.) The
creatinine was estimated in two cases and was found to be 2.0 mg. and
1.7 mg. per cent., respectively,--also normal figures. The blood sugar
varied from 0.12 to 0.14 per cent. and was examined in almost all the
cases in which urea was estimated; these figures are at the upper level
of normality (no attention was paid to the interval elapsing between the
feeding and the withdrawal of the blood). The diastatic activity was
likewise normal. The CO_{2} combining power showed figures under 40 to
45, according to the Van Slyke method, and indicated therefore a mild
degree of acidosis. In six cases the chlorides were estimated, the
figures being remarkably constant at about 0.42 or 0.43. Cholesterol was
a little below normal in the four cases examined. Contradictory results
were obtained in regard to calcium. Earlier tests showed a definite
deficiency of this salt, but those carried out more recently have
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