The diseases of infants and children / by Edmund Cautley.

  • Cautley, Edmund, 1864-1944.
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of infants and children / by Edmund Cautley. Source: Wellcome Collection.

    188/1070 (page 166)
    and of the crystalline and less soluble calcium citrate from the more soluble amorphous salt (Citric Acid Theory). Nevertheless, the addition of citrates to the food, or of alkaline phosphates to keep the citrate in solution, has apparently no remedial action. Nor is it due to the absence of potash salts in organic form, for these salts are not curative. Cooking does not affect the antiscorbutic property of potatoes and greens. The theory that it it is due to tainted food or ptomaines (Tainted Food Theory) is certainly not supported by evidence derived from cases in infancy ; for it arises occasionally in the breast-fed and on diets in which neither animal food nor microbes are present; and there is no evidence of ptomaine poisoning. Sir Almroth Wright ascribes it to an Acid Intoxication, very similar to that produced experimentally in herbivora by the ingestion of a surplus of mineral acids over bases. Thus, a diet of meat and cereals with the exclusion of green vegetables and fruits will produce it. Meat and cereals contain a large excess of minerals acids, especially phosphoric acid, while vegetables and fruits contain an excess of bases. Wright divides foods into : (1) Acid or scorbutic, viz., eggs, fresh and salt meat, and many cereals; (2) Neutral or non-scorbutic, viz., sugar, vegetable oils, and animal fats ; (3) Alkaline or antiscorbutic, viz., milk, blood, lime-juice, orange juice, potatoes, green vegetables, etc. In adults he found the alkalinity of the blood was decreased, and he advises the administration of the salts of the oxidizable organic acids, e.g., sodium lactate, to restore the normal blood alkalinity. But the reduced alkalinity, if present, is due to anaemia. Moreover, scurvy does not occur in Acidosis, and lime-juice raises the acidity of the urine, yet cures the disease. According to Hut¬ chison, Wright’s division of food-stuffs is based on inaccurate chemistry, and only eggs and meat, deprived of all blood, leave an acid ash. Recent experiments by Axel Holst of Christiania (1908) upset Wright’s theory. Scurvy was produced in guinea pigs by a diet of bread and dry cereals, but not if fresh raw carrot was added ; on a diet of compressed dried potato and water, but not if cabbage juice was added ; on a diet of dried carrot, even if soaked in a solution of bicarbonate of soda ; and on a diet of dried barley and water, but not if the barley was allowed to sprout first. Yet in the sprouted and unsprouted barley the same amounts of acid and salts were present. Nor did the addition of sodium citrate and calcium carbonate to these diets prevent the disease. It may, therefore, be accepted that scurvy is not due to acid intoxication or reduced alkalinitv of the blood. 4/ All that we can say at present is that it is the result of the lack of some property in fresh food, which is destroyed by heat, or an inadequate supply of fresh food, and that it may be accentuated by unsuitable diet con¬ taining an excess of starch. Symptoms and Course.—The onset is gradual, with fretfulness, impaired appetite, malaise, anaemia and loss of weight. Sometimes immobility of a limb is the first sign to attract attention, or some general tenderness, the