Comments re my Medical History
The history of medicine is fascinating and we often lose sight of how little we knew before the last 50 or 100 years. I've written a few short articles and I'm web-publishing a few more that I've collected. I hope these are of interest. Obviously they're not to be taken as current medical practice, though it's also interesting how little the basics have changed.
Sincerely, Mark R. Anderson, M.D.
Pathophysiology and Symptoms of Scurvy
© Mark R. Anderson, M.D. 2000
The biochemistry and action of Ascorbic acid, (Vit. C) is not fully understood. The end result is primarily that the "ground substance", (the glue that holds together the collagen fibers, (the basic structural members of connective tissue)), and the collagen fibers themselves, deteriorate. There are also concentrations of Vit. C in the adrenal glands and in parts of the brain, but how that connects with the mental effects of scurvy I don't know. Basically imagine all the fibers, (e.g. tendons and ligaments) and bones, of your body becoming unglued, (imagine what a cold molded boat would do if the epoxy became liquid during a storm and the wood all became rotten). In addition, the walls of your capillaries and other vessels become weak and burst. (Now that boat is full of a slurry of water, sewage and diesel as your hoses and tanks burst, not to mention sloshing in all the canned tomato juice, vinegar, beer, pop, etc., etc.). Finally the electronic navigation equipment fails to give reliable information.
Back to people.
Your body stores a fair amount of vitamin C. Therefore, symptoms of scurvy don't generally develop until 2 or more months of deprivation. Thus, it wasn't a big problem with sailors until long exploratory voyages.
The primary lesions of scurvy relate to bleeding and swelling and inflamation of soft tissues and bone. Wounds don't heal because you can't make collagen. Bleeding occurs into the skin around the roots of all your hairs, which later fall out. Swollen gums bleed, the jaw bone softens, and eventually your teeth fall out. Hemorrhaghic spots develop in your eyelid linings. There's painful bleeding into your joints, and into the surface membrane of bones, causing crippling pain, and eventually spontaneous breakage of bones. Eventually you're coughing up blood and possibly asphyxiating. Bleeding develops in the intestines, leading to black, and then bloody, horrifically foul smelling stools. Anemia, weakness. Emotional lability. Bleeding into the sack around your heart so your heart can't fill with blood and pump. Bleeding around the brain, compressing it, causing headache, vomiting, eventually coma and death as your brainstem is crushed as your swollen brain pushes itself down into the spinal canal. Perhaps your spirit hovers overhead to watch your body committed to the deep.
Mark Anderson, M.D.