Scurvy: A Survey of 53 Cases

Abstract

Of the 53 cases, 48 were men. The incidence among medical admissions to the hospital rose from 0.16% in 1937-8 to 3.07% in 1941-2, falling the next yr. to 1.09%. The age of the patients ranged from 41-82 years, 43 being over 65 yrs. of age. 8 of those under 65 being admitted in 1941-2. Fifty-one of the patients lived alone (single 27, widowed 17, separated 7). Twenty-eight lived in working-men''s hostels, the rest in homes or rooms. Forty-eight cooked for themselves. The food-income was mainly adequate for 2/3 of the group. The incidence of the disease was highest in June, then came May, March, and April in that order. There were no cases in July and few in the other mos. The disease was mild in 2 cases, moderate in 51. Positive-pressure cuff tests before and after saturation with ascorbic acid showed that while neither the Hess nor Gothlin test is diagnostic, the former gave a higher % of the usually expected result. Neither method yielded results related to the plasma ascorbic acid level or the saturation requirements. There was no steady relationship between the saturation requirements and the plasma ascorbic acid content or clinical extent of the disease. The anemia present bore no constant relation to the extent of hemorrhage or to the plasma ascorbic acid content or saturation require-ments of the patients. It was varied in type, mainly normo-cytic, rarely hypochromic microcytic, and more rarely macrocytic. The anemias were nutritional in origin but were not due to ascorbic acid or Fe lack alone. Cause of the disease was ignorance, apathy or poverty; the so-called bachelor scurvy.