=Alimentary Tract.=--The lesions of the gums so well recognized
clinically are fully discussed under symptomatology. The remarkable fact
that these hemorrhages do not appear in edentulous gums has been the
centre of the controversy as to the identity of adult scurvy and
Barlow's disease. This same lack of involvement is noted in adults whose
teeth have been extracted. Where teeth are present, the gums are swollen
and edematous, often of a livid, reddish color; less frequently, pale
and pouting. Hemorrhage is seen at the edge of the gum adjacent to the
teeth. In advanced cases the gums are enormously swollen, fungous,
ulcerated and covered with a foul, greenish, necrotic mass, which may
extend widely over the buccal mucous membrane. The teeth become loosened
and fall out. Secondary infection undoubtedly plays the chief rôle in
producing this condition, for the most severe forms are found only where
caries and pyorrhoea preëxisted. This seat of infection may serve as the
source of dissemination throughout the body, giving rise to many of the
lesions found at postmortem, especially in the lower part of the
intestinal tract.
The _stomach_ shows no characteristic changes. Congestion of the mucosa
is frequent, at times associated with small superficial erosions; the
latter gain added interest in view of their occurrence in guinea-pig
scurvy. Hemorrhages occur here also and may involve any of the mural
coats.
The _duodenum_ shows often intense congestion. This occurs with
sufficient frequency to demand attention, especially as a similar
condition has been described in other disorders grouped with scurvy.
Willcox and others found congestion of the duodenum and of the lower
intestine in beriberi, and Andrews described not only congestion but
even minute hemorrhages. Small duodenal ulcers are by no means
infrequent both in human and in guinea-pig scurvy (Holst and Froelich).
The presence of such marked congestion surrounding the papilla of Vater
would lead us to expect the occurrence of catarrhal jaundice associated
with scurvy. But, on the contrary, icterus has rarely been noted in
scurvy. Urizio has described jaundice in this connection, but it is
difficult to decide whether his cases were true scurvy, as they occurred
in an epidemic of jaundice and no histologic examination of the bones
was carried out.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account