Chapter XVII: Appendix

Extract from "Treatise on Scurvy," by James Lind, London, 1772.

(a) _Recipe for preparing a stable orange or lemon juice._ Let the squeezed juice of these fruits be well cleared from the pulp and purified by standing for some time; then poured off from the gross sediment; or, to have it still purer, it may be filtrated. Let it then be put into any clean open vessel of china or stone-ware, which should be wider at the top than bottom, so that there may be the largest surface above to favor the evaporation. For this purpose a china basin or punch-bowl is proper, and generally made in the form required; all earthen glazed vessels are unfit, as their glazing will be dissolved by the acid. Into this pour the purified juice, and put it into a pan of water, upon a clear fire. Let the water come almost to a boil, and continue nearly in that state (with the basin containing the juice in the middle of it) until the juice is found to be of the consistence of a thick syrup when cold. The slower the evaporation of the juice the better; and it will require at least twelve or fourteen hours continuance in the bath heat before it is reduced to a proper consistence.

It is then, when cold, to be corked up in a bottle for use. Two dozen good oranges, weighing five pounds four ounces, will yield one pound nine ounces and a half of pure juice; and when evaporated, there will remain about five ounces of rob, or extract; which in bulk will be equal to less than three ounces of water. So that thus the acid, and the virtues of twelve dozen lemons or oranges, may be put into a quart bottle, and preserved for several years.

I have now some extract of lemons which was made four years ago.

Those who intend this extract for making punch may infuse some of the fresh peel of the oranges or lemons into the spirit before it is used.

But for this purpose I find it is sufficient to add a very small quantity of the outer peel to the extract a little before it is taken off the fire, and there will be all that is requisite to make it entirely equal to the freshest fruit.

(b) _How to preserve berries and other fruits for long periods._ And it may be proper to acquaint them that most berries, and several fruits, when gathered two-thirds ripe on a dry day, while the sun shines, if put into earthen pots, or rather in dry bottles, well corked, and sealed up, so that no air or moisture can enter, will keep a long time, and at the end of a year, be as fresh as when new pulled.

(c) _Method of preparing an antiscorbutic decoction from fir-tops, leaves, bark, etc._ When the Swedes carried on a war against the Muscovites, almost all the soldiers of their army were destroyed by the scurvy, having putrid gums, rigid tendons, etc. But a stop was put to the progress of this disease by the advice of Erbenius, the King's physician, with a simple decoction of fir-tops, by which the most deplorable cases were perfectly recovered, and the rest of the soldiers prevented from falling into it.

I am inclined to believe by the description given by Cartier of the ameda tree, with a decoction of the bark and leaves of which his men were so speedily recovered, that it was the large swampy American spruce tree.

A simple decoction of the tops, cones, leaves or even green bark and wood of these trees is an excellent antiscorbutic medicine; but it will, I am apt to think, become much more so when fermented, as in making spruce beer. By carrying a few bags of spruce or its extract to sea, this wholesome drink may be prepared at any time. But where it cannot be had the common fir-tops used for fuel in the ship should be first boiled in water, and the decoction afterwards fermented with molasses in the common method of making spruce beer; to which a small quantity of wormwood and horse-radish root (which it is easy to preserve fresh at sea) may be added. The juice of the cocoanut tree was experienced to be of very great benefit to several persons afflicted with the scurvy.

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INDEX

A

Acid, effect on keeping qualities of antiscorbutics, 66, 161

Acidosis, 244 theory, 24

Adrenals, 102
in guinea-pig scurvy, 122

Adult, scurvy in, history of, 1

Age incidence, 51

Aging, effect on antiscorbutics of, 67

Agglutinins, effect of scurvy on, 68

Alimentary tract, gross pathology, 89
microscopic pathology, 100

Alkalization, effect on milk of, 50
on orange juice of, 66, 154

Amboceptor, effect of scurvy on, 68

Anasarca, 86, 196

Animals, scurvy in, 114

Anorexia, 206

Antiscorbutics, and antiscorbutic foods, 143, =149=, 157
history of use of, 9, 143

Antitoxin, effect of scurvy on, 68

Appendicitis, confused diagnosis, 183

Appetite, 206

Apple, antiscorbutic value of, 158

Armies, scurvy in, 3, 15

Army, use of canned tomatoes in ration of U. S., 231

B

Bacteria, fecal, in scurvy, 28
as etiological factor in scurvy, 134
in tissues, 133

Bacterial theory of scurvy, 30

Banana, antiscorbutic value of, 158

Beading of ribs, 197
in guinea-pig, 129, 137
pathology of, 94

Beans, germinated, 167, 231

Beef juice, 236

Beer, antiscorbutic value of, 20, =169=

Beriberi, differential diagnosis, 221
relation to scurvy, =249=

Berries, antiscorbutic value of, 156

Blindness, 182

Blood cells, changes in, 209-211

Blood cells, chemistry of, 244, 245
coagulability of, 211

Blood vessels, changes in, 68, =98=, 209
in guinea-pigs, 133

Blood, vitamine content of, 76

Bones, gross pathology, 93
microscopic pathology, 105

Brain, pathology, 93

Breast fed, scurvy in, 35

C

Cabbage, antiscorbutic value of, 159
dehydrated, 165
effect of heat on, 159

Calcium, deposits of, 98, 102, 103
metabolism, 241-247

"Capillary resistance test," =212=, 257

Carbohydrates, 34, 59

"Cardiorespiratory syndrome," 200

Cardiovascular system, 199

Carrots, antiscorbutic value of, 159, 160

Central nervous system, gross pathology, 93
microscopic pathology, =104=

Cereals, antiscorbutic value of, 170
germinated, 167

Cerebrospinal fluid, 203

Chlorides, 242-247

Citric acid theory, 23

Climate, 55

Complement, effect of scurvy on, 69

Complexion, characteristic change in, 176, 184

Complications of scurvy, 182, 202, 205, 217

Constipation, 27, =118-122=, 207

Cord, spinal, pathology, 93, 104

Creatinine, 244

Cure, 236

D

Death, causes of, 179, 227

Deficiency diseases, general discussion, 63, 248

Diagnosis, 176, 219

Diastase, blood content of, 244

Diet, general, 59

Digestive disturbances, 78

Diphtheria, antitoxin in blood, 68
as complication of scurvy, 217

Drying, effect on vitamines of, 66

Duodenum, pathology, 89

Dysentery, 59, 182

E

Economic status, 55

Eczema, 195

Edema, 178, 184, =196=
hunger, 256
war, 256

Eggs, antiscorbutic value of, 168

Endocrine organs, gross pathology, 92
microscopic pathology, 104
extracts of, as preventive, 172
theory of vitamine action, 72

Epidemics, 2, 217

Epiphyses, separation of, 96, 181, =198=

Etiology, =35=
exciting factors in, 60

Excretion of vitamine, 77

Expeditions, scurvy in Arctic, 10

Experimental scurvy, 111
pathogenesis, 116
pathology, 122
symptoms, 135

Exudative diathesis, 59, 256

Eyeball, proptosis, 193

F

Familial tendency, 58

Fats, in diet, effect on scurvy, 59

Fever, 181, =216=

Foetus, effect of scorbutic diet on, 125

Food, excess of, 257

Foods, antiscorbutic, 143, =149=
proprietary, 49

Fractures, 95

Frost-bite, 180

Fruit juices, 153

Fruits, fresh, 144

G

Generative organs, pathology, 104

Glands, endocrine, 72
changes in, 73, 92, 104

Glucose, blood content of, 244

Grapes, antiscorbutic value of, 158

Growth in scurvy, 213

Guinea-pig scurvy, 112, 114

Guinea-pig pathogenesis, 116
pathology, 122
relation to human, 115
symptoms, 135

Gums, 177, 181, 184
in infantile scurvy, =189=
pathology of, 89, 100

H

Hair, changes in, 194

Heart, =200=
gross pathology, 87
microscopic pathology, 99

Heat, effect on vitamine of, 65

Hemorrhages, 180, 189
as early symptoms, 178
distribution of, 84
gastric, 208
orbital, 193
subperiosteal, 95, =191=
urinary, 204

History of scurvy, 1

Hog, effect of scorbutic diet on, 115

Hypophysis, 104

I

Infantile scurvy, history, 10
in artificially fed, 40
in breast-fed, 35
increase during World War, 21-22
relation to epidemic scurvy of adults, 15, 37
relation to rickets, 11, =110=, =252=
symptomatology, =183=

Infection, as exciting factor, 60, 218
increased liability to, 68
effect on prognosis, 227

Intestines, gross pathology, 90
microscopic pathology, 100

Intravenous use of orange juice, 238

Irregularities in course of deficiency diseases, 78

J

Jaundice, 208

Joints, lesions of, 199

K

Kidneys, gross pathology, 91
microscopic pathology, 102

L

Latent scurvy, 179, 183, =187=

Laxatives, failure to cure with, 28, =207=

Lemon juice, antiscorbutic value of, 153, 234
dried, 155, 232
ration in British Navy, 9, 144

Lentils, value as antiscorbutic, 167, 231

Lice, theory of transmission of scurvy by, 30

Lime juice, antiscorbutic value of, 156
fallacy in regard to, 149
use in British Navy, 144

Liver, gross pathology, 91
microscopic pathology, 101

Lungs, gross pathology, 88
microscopic pathology, 99

Lymph-nodes, gross pathology, 92
microscopic pathology, 101

M

Malnutrition, general, 58

Malt soup, 50

Marrow, changes in, 107

Meat, fresh, 147, =168=
salt, 146

"Mehlnaerschaden" of Czerny, 256

Metabolism in scurvy, 241-247

Milk, alkalized, 50
amount necessary to prevent scurvy, 49, 117, =150=
boiled, 44, 65
condensed, 48
dried, 46, 66, =152=
effect of industrial methods on, 43
evaporated, 45
pasteurized, 40, 65
home vs. commercial, 42
sterilized, 44
breast, amount necessary to prevent scurvy, 36, 39, 153
as cause of beriberi, 39
cows, antiscorbutic value of, 40, 152
goats, antiscorbutic value of, 153

Mineral metabolism in scurvy, 241-247

Monkey, scurvy in, 114, =127=
pathology, 128

Muscles, pathology, 97

N

Nails, changes in, 194

Necropsy reports, 82

Nephritis, 205

Nerves, peripheral, in guinea-pig
scurvy, 132
pathology, 105

Nervous system, effect of scurvy on, 202

Nutrition, general, in scurvy, 58, 59, 213

Nyctalopia, 182

O

Orange juice, antiscorbutic value of, =153=, 234
"artificial," 33
dried, 155
effect of alkalization of, 154
intravenous use of, 238
subcutaneous use of, 155
peel, antiscorbutic value of, 234

Osteogenesis imperfecta, 255

Osteomalacia, differentiation of, from scurvy, 255

Osteomyelitis, differentiation of, from scurvy, 222

Osteoporosis, differentiation of, from scurvy, 255

Osteotabes infantum, 109

P

Pains, as early symptom, 176

Pancreas, gross pathology, 91
microscopic pathology, 104

Pasteurized milk, 40

Pathogenesis of scurvy, theories of, 23

Pathology of scurvy in guinea-pig, 122
in man, gross, 83
microscopic, 96
in monkey, 128

Peas, antiscorbutic value of, 167, 231

Pellagra, 251

Phenols, excretion of, 245

Phosphate metabolism, 241-247

Pigeon, effect of scorbutic diet on, 114

Pneumonia, 202

Posture, characteristic, in guinea-pig, 136

Posture, characteristic, infant, 183

Potassium deficiency theory, 23
metabolism, =241-247=

Potatoes, antiscorbutic value of, 6, 7, 146, =161=, 235

Prevention of scurvy, 230

Prognosis, 225

Protein in diet, effect on scurvy, 59

Psychic element in scurvy, 57

Pulse, 181, =201=

Pulses, germinated, 167, 231

Purpura, differential diagnosis, 221

Pyorrhoea, relation to lesion of gums, 181

R

Racial immunity, 56

Rats, effect of scorbutic diet on, 114, 115

Recurrent scurvy, 228

Respirations, 201

Retina, hemorrhages in, 105

Rheumatism, confusion with scurvy, 176, 220

Ribs, beading of, 197
pathology, 94
in guinea-pig, 129, 137

Rickets, relation of, to scurvy, =11=, =110=, =252=

Rosary, 94, 197

S

Sauerkraut, antiscorbutic value of, 145

Season, effect on incidence, 54

Sex, effect on incidence, 56

Shaking, effect on antiscorbutic factor, 68

Ship beriberi, 250

Skin, pathology, 96

Spleen, gross pathology, 91
microscopic pathology, 102

Sprue, 256

Starvation, pathology of, 125

Stomach, gross pathology, 89
microscopic pathology, 100

Storage of vitamine in body, 74

Streptococcus in blood in scurvy, 134

Subacute form of scurvy, 184

Subcutaneous use of antiscorbutics, 155

Swede, antiscorbutic value of, =162=, 235

Symptomatology, in adult, 176
in infant, 183

Syphilis, congenital, differential diagnosis, 222, 223

T

Teeth, in guinea-pig scurvy, 130, 137
in human scurvy, 177

Temperature, in guinea-pig scurvy, 141
in human scurvy, 181, =216=

Thymus, pathology of, 104
use of gland in treatment, 172

Thyroid, pathology of, 104
use of gland in treatment, 172

Tomatoes, canned, antiscorbutic value of, =166=, 231, 234
in U. S. Army ration, 231

Toxic theory of pathogenesis of scurvy, 25

Treatment of scurvy, 230
duration of, 237
non-dietetic, 239

U

Ultra-violet rays, effect on antiscorbutics, 67

Urea content of blood, 244
of tissues, 245

Urine in scurvy, =204-206=

V

Vegetable juices, keeping qualities of, 161

Vegetables, antiscorbutic value of 144, =158=
canned, 166
dehydrated, 163
effect of heat on, 159
fresh, 144, =158=
ripeness of, effect on antiscorbutic value, 160

Vitamine, antiscorbutic, general discussion of, 62
action of, 68, 69
as antitoxin, 69
as catalytic agent, 70
as nutriment, 69
blood content of, 76
effect of heat on, 65
of ultra-violet ray on, 67
excretion of, 77

Vitamine, experimental evidence for, 62
fate in body, 74, 77
relation to water-soluble factor, 65, 67
relation to antineuritic vitamine, 67
resistance to chemical and physical processes, 64
storage in body of, =74=
theory of scurvy, 32

W

Weight, loss of, 138, 213

"White line" of Fraenkel, =128=, =198=

World War, scurvy in, 15

X

X-ray in diagnosis of scurvy, 128, 192, 198

Y

Yeast, antiscorbutic value of, 171

End of Project Gutenberg's Scurvy Past and Present, by Alfred Fabian Hess