There can be no question whether retention of fæces of itself can bring
about scurvy; this is excluded by the marked instances of constipation
frequently encountered among thriving babies. The majority of bottle-fed
babies and a large number of the breast-fed suffer from a greater or
less degree of constipation. On looking over our records of infantile
scurvy from this point of view, and comparing them with non-scorbutic
infants, we have not been able to note a characteristic distinction.
Some of the infants had normal stools, others suffered from
constipation, while the records of a great number showed occasional
loose stools. Furthermore, in cases of latent or subacute infantile
scurvy, it was of no moment whether a laxative was given or whether
constipation was induced by means of opium. The report of the American
Pediatric Society shows that the majority have had a similar experience;
the bowels were regular in seventy-four instances, irregular in fifteen,
constipated in one hundred and twenty-six, and diarrhoeal in
seventy-seven. In this connection, it may be pointed out that the
preparation termed "malt soup," the diet which in our experience has
been most frequently associated with scurvy, is essentially laxative,
and, on the other hand, that one of the most potent antiscorbutics is
potato, which has no definite laxative property. It may be added, as
noted elsewhere, that scurvy developed in infants in spite of their
receiving cod liver oil or olive oil for long periods. It is evident,
therefore, that the retention of fæces is not the essential factor in
the etiology of scurvy. Its secondary rôle, especially after scurvy has
developed, will be considered later in this chapter.
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