The exact etiology of scurvy is unknown. It is variously ascribed to a deficiency in the potash salts of the food, to a deficiency in the alkalinity of the blood (acidosis), to ptomaine poisoning, and to a specific infection. Whatever the cause may be, it is known that a plentiful diet of fresh vegetables and of fresh meats cures the disease, and it is essentially therefore a dietetic disorder.
In this connection the important distinction between vegetable foodstuffs on the one hand, and meat and cereal foods on the other, must be borne in mind. The former contains an excess of base over mineral acid, the latter contains an excess of mineral acid over base. A diet which contains little or no vegetarian foods will therefore diminish the alkalinity of the blood, tending to produce a condition of acidosis, while a diet rich in vegetables will increase the alkalinity of the blood. In the sporadic cases of adult scurvy met with in this country, we invariably find that the diet has been radically defective in the following directions: - (1) Vegetables and fruits have been absent, or taken in too fractional amounts; and (2) the meat foods taken have not been sufficiently of the fresh meat variety, tinned foods having been too largely used.
The condition can be easily cured. In severe cases associated with a painful septic state of the mouth and gums, frequently with diarrhoea or constipation, the food should be fluid or semi-solid, so long as mastication is difficult. For such a case, in a boy of twelve or fourteen years of age, the day's dietary may with advantage be - Fresh milk, 2 to 3 pints, thickened with some invalid food. Beef-tea, 1 pint, thickened with some fresh-meat juice, or the white of egg. The juice of a lemon, or lime, or orange.
As soon as the difficulties in mastication have been overcome, the diet can be increased by the addition of red meat, white meat, and a liberal supply of vegetables. The nature of the vegetables is not material. Cabbage, lettuce, potatoes, cress, and onions are among the most useful, and among fruits, lemons, limes, oranges, and apples may be specially mentioned. A good lemonade drink is described on page 276. The lime juice should be reasonably fresh, as after being stored for a long time it partly decomposes into citric acid and carbonates, thereby losing much of its value. Infusion of malt has been credited with possessing valuable antiscorbutic properties; it must, however, be fresh. The following is a suitable dietary for an ordinary case of adult scurvy in which there is no marked gastric intestinal derangement: -
Fruit, an apple or orange, taken half-hour before breakfast Tea.
Bacon and eggs, or fish.
11 a.m. - Drink of lemonade and a biscuit.
Soup made from good vegetable stock.
Red or white meat, green vegetables, and potatoes.
Stewed fruit, or milk pudding.
Drink of fresh lime or lemon juice in water.
Fish or chicken.
Bread and cheese, and salad.