The involvement of the blood and blood vessels in infantile scurvy

Abstract

Infantile scurvy is a disease characterized by malnutrition, and a tendency to bleeding, especially in the gums, and under the periosteum of the long bones. It is very often classed under the hemorrhagic diatheses. There has been no comprehensive study of the blood made in this condition. I have had an opportunity to examine the blood in eight cases, more specially from the point of view of coagulation. As is well known there is more or less secondary anemia, a deficiency of hemoglobin and of red blood cells. In addition to this there has been in all the cases examined an increase of leucocytes. The platelets which have been examined several times in each case have been found to be normal in number.

Special attention was paid to the coagulability of the blood. For this purpose the blood was removed directly from the veins into sodium oxalate, was centrifuged, and the plasma was titrated with varying amounts of 1/2 per cent. calcium chloride solution. At least two tests of this nature were made in each case. The prothrombin was found to be about normal. In a few cases it was somewhat less than that of the normal control, which was always tested at the same time and in the same way as the case of scurvy. The antithrombin was not found to be in excess. The calcium, which by some has been blamed for the bleedings, was found to be quite sufficient for coagulation. That is to say, in the prothrombin test no more calcium had to be added to produce a clot in the cases of scurvy than in the normal cases.

Having found that the blood was normal in these respects, a test of the blood vessels was carried out.