   #copyright

Scurvy

2007 Schools Wikipedia Selection. Related subjects: Health and medicine

   CAPTION: Scurvy
   Classifications and external resources

     ICD- 10   E54
     ICD- 9    267
      OMIM     240400
   DiseasesDB  13930
   MedlinePlus 000355
    eMedicine  med/2086  derm/521 ped/2073 radio/628

   Scurvy (N.Lat. scorbutus) is a deficiency disease that results from
   lack of vitamin C, which is required for correct collagen synthesis in
   humans. The scientific name of vitamin C, ascorbic acid, is derived
   from the latin name of scurvy, scorbutus. Scurvy leads to the formation
   of liver spots on the skin, spongy gums, and bleeding from all mucous
   membranes. The spots are most abundant on the thighs and legs, and a
   person with the ailment looks pale, feels depressed, and is partially
   immobilized.

   Scurvy was at one time common among sailors and others who were on
   ships, whose ships were out to sea longer than perishable fruits and
   vegetables could be stored and by soldiers who were similarly separated
   from these foods for extended periods. It was described by Hippocrates
   (c. 460 BC–c. 380 BC). Its cause and cure has been known in many native
   cultures since prehistory. For example, in 1536, the French explorer
   Jacques Cartier, exploring the St. Lawrence River, used the local
   natives' knowledge to save his men who were dying of scurvy. He boiled
   the needles of the arbor vitae tree (Eastern White Cedar) to make a tea
   that was later shown to contain 50 mg of vitamin C per 100 grams.

   However it was a Scottish captain in the British Royal Navy, James Lind
   ( 1716 – 1794) who first proved it could be treated with citrus fruit
   in experiments he described in his 1753 book, A Treatise of the Scurvy.

   In infants, scurvy is sometimes referred to as Barlow's Disease, named
   after Sir Thomas Barlow ( 1845- 1945), a British physician who
   described it. Barlow's disease is different from Barlow's syndrome.

   Scurvy is also known as Moeller's disease and Cheadle's disease.

Prognosis

   Untreated scurvy is always fatal. However, since all that is required
   for a full recovery is the resumption of normal vitamin C intake, death
   from scurvy is rare in modern times.

Pathophysiology

   Normal collagen synthesis depends upon the hydroxylation of proline and
   lysine residues in the endoplasmic reticulum, to form hydroxyproline
   and hydroxylysine, respectively. Prolyl and lysyl hydroxylase, the
   enzymes that catalyze the hydroxylation reactions, require vitamin C as
   a cofactor. In cases of chronic deficiency, hydroxyproline and
   hydroxylysine are not formed in appreciable amounts and the resulting
   collagen fibrils are considerably weaker. This is due in part to the
   loss of hydrogen bonding between hydroxyprolines and constituent
   heteroatoms within the collagen α-helical trimer, which otherwise
   confer mechanical stability.

History

   Scurvy was probably first observed as a disease by Hippocrates. In the
   13th century the Crusaders suffered from scurvy frequently, and it has
   inflicted terrible losses on both besieged and besieger in times of
   war. Scurvy was one of the limiting factors of marine travel, often
   killing large numbers of the passengers and crew on long-distance
   voyages. It even played a significant role in World War I.

   The British civilian medical profession of 1614 knew that it was the
   acidic principle of citrus fruit which was lacking, although they
   considered any acid as acceptable when ascorbic acid (Vitamin C) was
   unavailable. In 1614 John Woodall (Surgeon General of the East India
   Company) published his book "The Surgion's Mate" as a handbook for
   apprentice surgeons aboard the company's ships. In it he described
   scurvy as resulting from a dietary deficiency. His recommendation for
   its cure was fresh food or, if not available, oranges, lemons, limes
   and tamarinds, or as a last resort, Oil of Vitriol (sulfuric acid).

   However, it was not until 1747 that the treatment and prevention of
   scurvy by supplementation of the diet with citrus fruit such as lemons
   and limes was introduced into the British Navy by James Lind. It was in
   conforming to this policy that Captain James Cook persuaded his men to
   eat foods such as citrus fruits and sauerkraut during their voyages of
   discovery in HM Bark Endeavour. This major innovation ensured that not
   a single man was lost to scurvy during Cook's first voyage, although
   two did suffer from the disease for a time. This was a remarkable and
   practically unheard-of achievement in 18th century long-distance
   sea-faring.

   The plant known as " scurvy grass" acquired its name from the
   observation that it cured scurvy, but this was of no great help to
   those who spent months at sea. During sea voyages, it was discovered
   that sauerkraut was of use in preventing scurvy. In the Royal Navy's
   Arctic expeditions in the 19th century it was widely believed that
   scurvy was prevented by good hygiene on board ship, regular exercise,
   and maintaining the morale of the crew, rather than by a diet of fresh
   food, so that Navy expeditions continued to be plagued by scurvy even
   while fresh meat was well-known as a practical antiscorbutic among
   civilian whalers and explorers in the Arctic. At the time Robert Falcon
   Scott made his two expeditions to the Antarctic in the early 20th
   century, the prevailing medical theory was that scurvy was caused by
   "tainted" canned food. It was not until 1932 that the connection
   between vitamin C and scurvy was established.

   The use of limes by the Royal Navy to prevent scurvy gave rise to the
   name "limey" for a British sailor, which has been since extended to all
   British in American slang. The name " kraut" for a German soldier in
   World War II may similarly be based on the fact that the German Navy
   kept sauerkraut as scurvy prevention after the Royal Navy changed to
   limes.

Modern incidence

   Scurvy is mostly caused by the lack of Vitamin C. In modern western
   society, scurvy is rarely present in adults. However, vitamin C is
   destroyed by the process of pasteurization, so babies fed with ordinary
   bottled milk sometimes suffer from scurvy if they are not provided with
   adequate vitamin supplements. Virtually all commercially available baby
   formulas contain added vitamin C for this reason, however heat destroys
   vitamin C. Human breast milk contains sufficient vitamin C to prevent
   scurvy on its own.

   Scurvy is one of the accompanying diseases of malnutrition (other such
   micronutrient deficiencies are beriberi or pellagra) and thus is still
   widespread in areas of the world depending on external food aid. (See
   also the report from the WHO referenced below.)

Prevention

   Scurvy can be prevented by a diet that includes limes, oranges, and
   lemons, or the juices of these fruits. Other good sources of Vitamin C
   are fruits such as guava, papaya, or strawberries. It can also be found
   in some vegetables, such as bell peppers, tomatoes, broccoli, potatoes,
   cabbage, and spinach.

   Retrieved from " http://en.wikipedia.org/wiki/Scurvy"
   This reference article is mainly selected from the English Wikipedia
   with only minor checks and changes (see www.wikipedia.org for details
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