Notes on 208 cases of scurvy treated in the Victoria hospital, Lovedale, South Africa: during the 12 months Nov. 1927 – Nov. 1928

Abstract

(1) That the normal diet of the natives of this area is so poor in Anti-scorbutic elements that they live in a state of mild latent scurvy. This tends to make them less physically and mentally fit than they would otherwise be. It also lessens their resistance to other diseases Tuberculosis, Enteric Fever etc.

(2) Drought deprives them of practically all the Antiscorbutic factor that exists in that diet, viz: - milk and green food -stuffs.

(3) The greatest sufferers are (1) the adult men, who, most of them, are at work in labour centres and (2) the newly weaned children (1 - 3 yrs) who undergo a sudden change from a mildly Anti - scorbutic diet (breast milk) to an absolutely scorbutic one.

(4) The deaths that occurred were all among children and all save one in the class 1 - 3 yrs. Heart failure was the ultimate cause of death in every case.

(5) There was a conspicuous absence of cases amongst adolescents; no cases at all occurring between the ages of 14 and 18, and only 2 between 12 and 20 years.

(6) Physical exertion precipitates the symptoms. A man may be apparently well and pains and swelling come on as soon as he starts heavy work.

(7) Some points that I have not found mentioned in textbooks are as follows: - (a) In untreated cases among adults and older children fibrosis of the muscles and around joints takes place after haemorrhages by the natural process of healing. This causes crippling. (b) In parturient women scurvy tends to cause prolongation of labour and postpartum haemorrhage. (c) In small children with marked oedema the destruction of large areas of epidermis (in some as large as the palm of the hand) is common, raw septic surfaces being produced. (d) In small male children the extreme oedema of the external genitals is of fairly frequent occurrence. The prepuce is so swollen that difficulty of micturition results and even absolute retention in some cases.

(8) That lemon juice half ari ounce three times a day will cure any adult case in the course of 2 to 4 weeks. But the larger the amount of lemon juice given the more rapid the cure.

(9) Hot fomentations applied to the haemorrhagic swellings in adult cases and rubbing with Ung. Pot. Iod. after the swelling has gone down, prevents fibrosis and the resultant crippling.