Although scurvy is more a deficiency disease than one of the haemopoietic system, it has two points of resemblance: marked capillary bleeding and progressive anemia. Scurvy is due to a prolonged deficiency of vitamin C in the diet and takes about 4 to 8 months to develop clinical signs. Habitation in an unhealthy surrounding predisposes.

Vitamin C is required for the activity of prolyl hydroxylase, which is responsible for the extensive hydroxylation of prolines in collagens. Deficiencies in proline hydroxylation interfere with the assembly of the procollagen triple-helix, resulting in degradation of the collagen. an understanding of the cause and remedy for scurvy grew out of the experience of British sailors in the 18th century. It occupies an interesting place in the history of the world when English sailors became progressively ill after long voyages at sea. It was only with the observation that the consumption of fruit helped to ward off the devastating effects of scurvy did the sailors begin to transport limes with them.

Scurvy has been known since ancient times, but the discovery of the link between the dietary deficiency of ascorbic acid and scurvy has dramatically reduced its incidence over the past half-century. Sporadic reports of scurvy still occur, primarily in elderly, isolated individuals with alcoholism. the incidence of scurvy in the pediatric population is very uncommon, and it is usually seen in children with severely restricted diets attributable to psychiatric or developmental problems. the condition is characterized by perifollicular petechiae and bruising, gingival inflammation and bleeding, and, in children, bone disease.

Scurvy was in some ways a more serious, certainly a more widespread problem. Relatively few men actually died of scurvy except on very long ocean passages, but it effectively limited the time a squadron could stay at sea, and thus directly affected the efficiency of the Service. No strategy of blockade, or any other which depended on keeping squadrons at sea for long periods, was possible in the face of endemic scurvy. the difficulty was to find a cure.

Causes of Scurvy:

Fortunately, there was a general understanding among sea officers that scurvy was a dietary disease, caused either by the presence of something harmful in the sailor’s diet, or by the absence of something essential, and in either case curable by fresh victuals.

Scurvy is due to a prolonged deficiency of vitamin C in the diet and takes about 4 to 8 months to develop clinical signs.

Habitation in an unhealthy surrounding predisposes.

Symptoms of Scurvy:

The chief deficiency sign is an inability of producing and maintaining the intercellular ground substance as collagen of all fibrous tissues: the matrix of bones, cartilages and dentine and all non-epithelial cement substances especially of vascular endothelium. as a result there is an increased permeability of the capillaries to the red blood corpuscles causing hemorrhages, new bone formation stops but as bone absorption still goes on, the bones become friable at the growing ends, interference with timely collagen formation causes delay in healing of wounds.

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Some other important symptoms of scurvy are gradual weakening, pale skin, sunken eyes, tender gums, muscle pain, loss of teeth, internal bleeding, and the opening of wounds such as sword cuts that had healed many years before.

Exhaustion, fainting, diarrhea, and lung and kidney trouble followed.

There is massive periosteal reaction with increase in the distance between tibia and fibula.

This deficiency disease usually shows epidermal pallor in the upper part of the epidermis.

Psoraisiform hyperplasia with pallor of the lower half of the epidermis.

Numerous extravasated rbcs with lymphocytic infiltrate in the upper dermis are also present.

Dear Dr. Donohue: in 1970, when in college, I had a friend whobruised so badly that she looked like a battered woman. The doctorat the health care center told her to take vitamin C because itstrengthens cell walls. She did, and the bruising stopped.

My father died of ischemic stroke and had suffered from heartdisease. my mother has had several hemorrhagic strokes. I am 60 andstarted taking baby aspirin. I am bruising more. I am thinkingabout adding vitamin C to my program. Will it interfere with thebaby aspirin’s blood-thinning effect? 

A: ever hear of scurvy? It’s not seen much these days, but inthe 15th through 18th centuries, it was a common disorder and wasrampant among sailors. Dr. James Lind, a British naval surgeon,experimented with groups of sailors, giving them a variety oftreatments. The group given a daily lemon and two oranges recoveredquickly from all the signs and symptoms of scurvy. those signs aresmall and large bruises, bleeding from the gums, coiled hairs,joint pains and impaired wound healing. perhaps this was behind thecollege doctor’s prescription of vitamin C for your friend.

Vitamin C is involved with the synthesis of collagen, one of themajor support tissues in the body. It’s a powerful antioxidant,neutralizing oxidants, which are byproducts of cell metabolism thatwreak havoc in the body. it aids in the absorption of iron. Itkeeps the immune system healthy. it stops the bleeding and bruisingof scurvy by strengthening capillaries, the smallest of bloodvessels. I find no information that it interferes with aspirin’santi-platelet effect. Platelets form clots that sometimes occur inarteries and obstruct blood flow. The result can be a heart attackor a stroke.

With your mother’s history of hemorrhagic (bleeding) strokes,you should consult your doctor before launching into dailyaspirin.

Dear Dr. Donohue: my 51-year-old son has been diagnosed with aZenker’s diverticulum. he has seen many specialists, but none hasspoken of a cure. he has difficulty swallowing. is there anyrelief? 

A: The loss of tissue elasticity, along with weakening of theswallowing muscles, sets the scene for the bulging of the throatlining through the throat muscles to create a pouch. That’s aZenker’s diverticulum. Food gets caught in the pouch, and no efforton a person’s part can dislodge it. Difficulty swallowing and anincreased production of saliva result. Food decomposes in thepouch. Eventually it’s regurgitated into the mouth and creates afoul odor.

Surgery corrects the situation. A newer technique is the use ofa flexible scope, introduced through the mouth, that permits repairwithout an incision.

Dear Dr. Donohue: I am a 63-year-old male. I work out three orfour times a week, doing aerobic exercise as well as weighttraining. from November to April, I officiate basketball at thecollege level. Last year, during a routine physical, I wasdiagnosed with low testosterone. my doctor scheduled me forbimonthly injections in his office.

Recently a friend told me her husband was diagnosed with lowtestosterone and his doctor prescribed a pill. is testosteroneavailable as a pill? 

A: Testosterone is available as a pill. however, oraltestosterone isn’t the best way to correct a deficiency. it doesn’treliably provide sustained blood levels of the hormone. To overcomethis obstacle, doctors choose other methods of delivering it orprescribe a testosterone that has been chemically altered.

Testosterone does provide good blood levels through injection, askin patch or a tablet placed between the gum and the cheek.

If injections are not your cup of tea, ask your doctor aboutthese other methods of delivery or the substitution of an alteredtestosterone molecule.

Dr. Paul Donohue writes for North America Syndicate. Sendletters to Box 536475, Orlando, FL 32853-6475.

Dear Dr. Donohue — In 1970, when in college, I had a friend whobruised so badly that she looked like a battered woman. the doctorat the health care center told her to take vitamin C because itstrengthens cell walls. she did, and the bruising stopped.

My father died of ischemic stroke and had suffered from heartdisease. my mother has had several hemorrhagic strokes. I am 60 andstarted taking baby aspirin. I am bruising more. I am thinkingabout adding vitamin C to my program. will it interfere with thebaby aspirin’s blood-thinning effect? — N.L.

Answer — Ever hear of scurvy? It’s not seen much these days, butin the 15th through 18th centuries, it was a common disorder andwas rampant among sailors. Dr. James Lind, a British naval surgeon,experimented with groups of sailors, giving them a variety oftreatments. the group given a daily lemon and two oranges recoveredquickly from all the signs and symptoms of scurvy. those signs aresmall and large bruises, bleeding from the gums, coiled hairs,joint pains and impaired wound healing. Perhaps this was behind thecollege doctor’s prescription of vitamin C for your friend.

Vitamin C is involved with the synthesis of collagen, one of themajor support tissues in the body. It’s a powerful antioxidant,neutralizing oxidants, which are byproducts of cell metabolism thatwreak havoc in the body. It aids in the absorption of iron. Itkeeps the immune system healthy. It stops the bleeding and bruisingof scurvy by strengthening capillaries, the smallest of bloodvessels. I find no information that it interferes with aspirin’santi-platelet effect. Platelets form clots that sometimes occur inarteries and obstruct blood flow. the result can be a heart attackor a stroke.

With your mother’s history of hemorrhagic (bleeding) strokes,you should consult your doctor before launching into dailyaspirin.

Dear Dr. Donohue — my 51-year-old son has been diagnosed with aZenker’s diverticulum. He has seen many specialists, but none hasspoken of a cure. He has difficulty swallowing. is there anyrelief? — M.F.

Answer — the loss of tissue elasticity, along with weakening ofthe swallowing muscles, sets the scene for the bulging of thethroat lining through the throat muscles to create a pouch. That’sa Zenker’s diverticulum. Food gets caught in the pouch, and noeffort on a person’s part can dislodge it. Difficulty swallowingand an increased production of saliva result. Food decomposes inthe pouch. Eventually it’s regurgitated into the mouth and createsa foul odor.

Surgery corrects the situation. a newer technique is the use ofa flexible scope, introduced through the mouth, that permits repairwithout an incision.

Write Dr. Donohue at P.O. Box 536475, Orlando, Fla.32853-6475.