Immediately after the appearance of the paper of McCollum and Pitz, Hess (17) presented a study of infantile scurvy which seemed to support strongly the view that scurvy is not simply a deficiency disease. He observed that infants fed milk which had been pasteurized at 145 degrees for thirty minutes did not develop scurvy, whereas others fed the same milk but which had been allowed to age for twenty-four hours on ice did so. Milk which had been pasteurized at 165 degrees was found to be more likely to induce scurvy than milk which had been pasteurized at the lower temperature. Hess also found that aging of raw milk also increased its liability to induce scurvy in infants. The degree of heat to which the milk had been subjected seemed not to be the most important factor, for according to his experience boiled milk did not produce the disease. The most plausible deduction from these observations appeared to be that boiling tended to render the milk sterile, whereas heating to 165 degrees killed for the most part the lactic acid forming bacteria, leaving the more resistant spore-forming organisms in the milk, where they could develop rapidly because with aging the lactic acid content would not rise and hold them in check as is the case in milk which is soured in the normal manner. Milk which was pasteurized at 145 degrees, and milk which was aged, both developed flora which might with reason be supposed to be detrimental to an infant. Hess drew the conclusion that it was the staleness, and therefore the bacteriological condition, rather than the temperature to which the product had been heated, which determined whether or not milk would tend to cause scurvy in the infant.

As the result of later studies, however (18), Hess was led to abandon this theory and to accept the view that scurvy is a deficiency disease, and that it is prevented or cured by the administration of an anti-scorbutic substance.

The appearance of these papers aroused a number of investigators to renew the study of the etiology of scurvy, and the various theories concerning the etiology of the disease soon were subjected to the test of new experiments. Two papers among these deserve special consideration since they completely explained the errors into which several workers had fallen, and fully established the correctness of the view of Hoist that scurvy is indeed a deficiency disease of a specific nature.