=Symptoms.=--Scurvy begins with general weakness and paleness. The
skin is dry, and has a dirty hue. The gums become swollen, tender,
spongy, and bleed easily, and later they may ulcerate and the teeth
loosen and drop out. The tongue is swollen, and saliva flows freely.
The appetite is poor and chewing painful, and the breath has a bad
odor. The ankles swell, and bluish spots appear on the legs which may
be raised in lumps above the surface. The patient suffers from pain in
the legs, which sometimes become swollen and hard. The blue spots are
also seen on the arms and body, and are due to bleeding under the
skin, and come on the slightest bruising. Occasionally there is
bleeding from the nose and bowels. The joints are often swollen,
tender, and painful. Constipation is rather the rule, but in bad cases
there may be diarrhea, nausea, and vomiting, and the victim becomes a
walking skeleton. Mental depression or delirium may be present.
=Treatment.=--Recovery is usually rapid and complete, unless the
disease is far advanced. Soups, fresh milk, beef juice, and lemon or
orange juice may be given at first, when the digestion is weak, and
then green vegetables, as spinach (with vinegar), lettuce, cabbage,
and potatoes. The soreness of the mouth is relieved by a wash
containing one teaspoonful of carbolic acid to the quart of hot water.
This should be used to rinse the mouth several times daily, but must
not be swallowed. Painting the gums with a two per cent solution of
silver nitrate in water, by means of a camel's-hair brush, twice
daily, will also prove serviceable. To act as a tonic, a two-grain
quinine pill and two Blaud's pills of iron may be given three times
daily.
=INFANTILE SCURVY.=--Scurvy occasionally occurs in infants between
twelve and eighteen months of age, and is due to feeding on patent
foods, condensed milk, malted milk, and sterilized milk. In case it is
essential to use sterilized or pasteurized milk, if the baby receives
orange juice, as advised under the care of infants, scurvy will not
develop.
Scurvy is frequently mistaken for either rheumatism or paralysis in
babies.
=Symptoms.=--The lower limbs become painful, and the baby cries out
when it is moved. The legs are at first drawn up and become swollen
all around just above the knees, but not the knee joints themselves.
Later the whole thigh swells, and the baby lies without moving the
legs, with the feet rolled outward and appears to be paralyzed,
although it is only pain which prevents movement of the legs.
Sometimes there is swelling about the wrist and forearm, and the
breastbone may appear sunken in. Purplish spots occur on the legs and
other parts of the body. The gums, if there are teeth present, become
soft, tender, spongy, and bleed easily. There may be slight fever, the
temperature ranging from 101 deg. to 102 deg. F. The babies are exceedingly
pale, and lose all strength.
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