generally yielded normal results. Further studies of the blood calcium
are highly desirable to ascertain whether it varies in amount in the
circulation, and especially in different stages of the disease. This
aspect is worthy of particular attention in view of the positive calcium
balance noted by Lust and Klocman during the active stage of scurvy, and
the negative balance during the period of convalescence.
[57] Almost all of these cases were receiving liberal daily amounts of
cod liver oil, which should exclude the possibility of complicating
rickets.
It is evident from the limited data concerning the blood chemistry of
scurvy that it is a field which has been inadequately explored and will
repay more intensive study. Investigations of this kind have recently
been made possible by the introduction of accurate methods requiring
only small quantities of blood.
Studies of the metabolism of animals suffering from scurvy are almost as
few as those on man. The work of Morgan and Beger, which is frequently
quoted in this connection, is not applicable, as it concerns rabbits,
which do not develop scurvy. They found that rabbits fed solely on oats
and water suffered in their nutrition (loss of appetite, emaciation,
paralysis of hind legs), and could be cured by the addition of sodium
bicarbonate to the dietary. In 1916 Lewis and Karr published a paper on
the constituents of the blood and the tissues of guinea-pigs fed on an
exclusive oat diet. They found the urea content several times greater
than normal, but that it fell to normal once more if cabbage or orange
juice was given. From the standpoint of scurvy, this investigation is
open to the criticism that the diet was too incomplete, and also, as the
authors suggest, that the animals suffered from partial starvation and a
lack of water.
In the following year Karr and Lewis published a paper on a different
phase of this subject, and came to the following conclusions: "No
changes in urinary elimination of phenols, nor in the degree of
conjugation of the phenols, were observed, provided the factor of
partial starvation was ruled out. This is believed to indicate that no
increased bacterial action occurs in the intestine of scorbutic
guinea-pigs despite the difficulty of evacuation of the fæces." These
results are in harmony with the bacteriological study of Torrey and
Hess, who found that there was no increase in the proteolytic flora of
the intestine in infants or in guinea-pigs suffering from scurvy.
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