Scurvy is a disease caused by vitamin C deficiency (ascorbic acid). Early symptoms include weakness, fatigue, and sore arms and legs. Without treatment, decreased red blood cells, gum disease, hair changes, and skin bleeding can occur. Because scab disease worsens there can be poor wound healing, personality changes, and eventually death from infection or bleeding.
Typically, scabies is caused by a deficiency of vitamin C in the diet. It takes at least a little month until there is no vitamin C before symptoms appear. In modern times, it occurs most often in people with mental disorders, unusual eating habits, alcoholism, and self-centered parents. Other risk factors include intestinal malabsorption and dialysis. Humans and certain other animals need vitamin C in their diet to create building blocks for collagen. Diagnosis is usually based on physical signs, X-rays, and repair after treatment.
Treatment with vitamin C supplements is taken. Improvements often begin within a few days with complete recovery in a few weeks. Sources of vitamin C in foods include citrus fruits and some vegetables such as tomatoes and potatoes. Cooking often lowers vitamin C in the diet.
Scurvy is currently rare. It happens more often in developing countries in relation to malnutrition. Rates among refugees are reported at 5% to 45%. Scurvy is depicted as early as ancient Egypt. That is the limiting factor in long distance sea travel, which often kills many people. During the Sail Century, it is assumed that 50% of seafarers will die from scabies on the given journey. A Scottish surgeon at the Royal Navy, James Lind, is generally credited with proving that the scabies can be successfully treated with citrus fruits in 1753. Nonetheless, it will become 1795 before health reformers like Gilbert Blane convince the Royal Navy to routinely provide lemon juice for the sailors.
Video Scurvy
Signs and symptoms
The initial symptoms are malaise and lethargy. Even earlier it may be pain in the gums that interfere with digestion. After 1-3 months, the patient experiences shortness of breath and bone pain. Mialgia may occur due to reduced carnitine production. Other symptoms include skin changes with roughness, easy bruising and petechiae, gum disease, loosening of teeth, poor wound healing, and emotional changes (which may appear before physical changes). Dry mouth and dry eyes similar to SjÃÆ'¶gren syndrome may occur. In the final stages, jaundice, generalized edema, oliguria, neuropathy, fever, seizures, and eventually death are often seen.
Maps Scurvy
Cause
Scurvy, including subclinical mange disease, is caused by vitamin C deficiency because humans are not able to metabolically make this chemical. The diet provided contains enough vitamin C, the lack of work of the GULO enzyme has no meaning, and in modern Western society, scurvy is rarely present in adults, although babies and older people are affected. Almost all commercially available infant formulas contain vitamin C supplements, preventing childhood scurvy. Human breast milk contains enough vitamin C, if the mother has enough intake. Commercial milk is pasteurized, a heating process that destroys the natural vitamin C content of milk.
Scurvy is one of the diseases that accompany malnutrition (other micronutrient deficiencies such as berries or pellagra) and is thus still widespread in many parts of the world dependent on external food aid. Although rare, there are also documented cases of scabies due to poor dietary choices by people living in industrialized countries.
Pathogenesis
Vitamins are essential for the production and use of enzymes involved in the ongoing processes throughout the human body. Ascorbic acid is required for various biosynthetic pathways, by accelerating the hydroxylation reaction and the middle reaction. In collagen synthesis, ascorbic acid is required as a cofactor for prolyl hydroxylase and lysyl hydroxylase. Both of these enzymes are responsible for the hydroxylation of proline and lysine amino acids in collagen. Hydroxyproline and hydroxylysine are important for stabilizing collagen by cross linking propeptides in collagen.
Collagen is the main structural protein in the human body, which is necessary for healthy blood vessels, muscles, skin, bones, cartilage, and other connective tissues. The damaged connective tissue causes fragile capillaries, causing abnormal bleeding, bruising, and internal bleeding. Collagen is an important part of the bone, so bone formation is also affected. Teeth loosen, bone broken more easily, and rest once recovered can recur. Damaged fibrochemia collagen damages wound healing. Untreated mange disease is always fatal.
Diagnosis
Diagnosis is usually based on physical signs, X-rays, and repair after treatment.
Prevention
Scurvy can be prevented by a diet that includes foods rich in vitamin C such as peppers (sweet peppers), blackcurrant, broccoli, chili, guava, kiwi fruit, and parsley. Other sources rich in vitamin C are fruits such as lemons, oranges, papaya, and strawberries. It is also found in vegetables, such as brussels sprouts, cabbage, potatoes, and spinach. Some fruits and vegetables that are not high in vitamin C can be acidified in lemon juice, which is high in vitamin C. Although excessive with a balanced diet, various nutritional supplements are available that provide more ascorbic acid than is needed to prevent cheating.
Some animal products, including liver, Muktuk (whale skin), oysters, and parts of the central nervous system, including the adrenal medulla, brain, and spinal cord, contain lots of vitamin C, and can even be used to treat scabies. Fresh meat from animals that make vitamin C itself (which most animals do) contain enough vitamin C to prevent scurvy, and even some treat it. In some cases (especially French soldiers who eat fresh horse meat), it is found that only meat, even partially cooked meat, can alleviate scurvy. Conversely, in other cases, a meat-only diet can cause scurvy.
Antarctic expeditions of 1902 by Scott used a lightly fried seal and liver seal, where complete recovery of the newly-made scurvy was reported to have taken less than two weeks.
History
Hippocrates documented scabies as a disease, and the Egyptians had recorded symptoms as early as 1550 BC. The knowledge that consuming foods containing vitamin C is a cure for scurvy has been repeatedly discovered and forgotten in the early 20th century.
The early modern era
In the 13th century, Crusaders often suffered from scurvy. In 1497 the Vasco de Gama expedition, the curative effect of citrus fruit was known and confirmed by Pedro ÃÆ' lvares Cabral and his crew in 1507.
The Portuguese planted fruit and vegetable trees in Saint Helena, a stop for shipping from Asia, and left the sick, scurvy and other diseases, to take home, if they were recovered, by the next ship.
In 1500, one of Cabral's fleet pilots to India noted that in Malindi, its king offered fresh supplies of expeditions such as sheep, chickens and ducks, along with lemons and oranges, for which "some of our diseases are cured of scurvy."
Unfortunately, these travel accounts do not stop further marine tragedies caused by scurvy, firstly due to lack of communication between travelers and those responsible for their health, and because fruits and vegetables can not be stored long aboard.
In 1536, the French explorer Jacques Cartier, exploring the St. Lawrence, uses the knowledge of the locals to rescue his dying people from scurvy. He boiled the needle of the arbor vitae tree (Eastern White Cedar) to make a tea which later proved to contain 50 mg of vitamin C per 100 grams. Such treatment is not available on ships, where the disease is most common. In February 1601, Captain James Lancaster, while sailing to Sumatra, landed on the north coast to specifically get lemons and oranges for his crew to stop scabies. Captain Lancaster conducted an experiment using four ships under his command. One ship crew received a regular dose of lemon juice while three other ships did not receive such treatment. As a result, unattended ship members began to become sick, contracting scurvy with many deaths as a result.
During the Age of Exploration (between 1500 and 1800), it was estimated that scabies killed at least two million sailors. Jonathan Lamb writes: "In 1499, Vasco da Gama lost 116 of his 170 crew, In 1520, Magellan lost 208 from 230;... mainly because of scabies."
In 1579, Spanish monk and Medicinal Doctor Agustin FarfÃÆ'¡n published a book on medicines in which he recommended oranges and lemons for scabies, a drug already known in the Spanish Navy.
In 1593, Admiral Sir Richard Hawkins advocated drinking orange and lemon juice as a means of preventing scabies.
In 1614, John Woodall, the Surgeon General of the East India Company, published "The Surgion's Mate" as a handbook for an apprentice surgeon aboard a company ship. He repeated the sailor's experience that the medicine for scabies is fresh food or, if not available, oranges, lemons, limes, and acids. She, however, can not explain the reason why, and her statement has no impact on the opinions of influential doctors running medical institutions that scurvy is a gastrointestinal complaint.
18th century
A 1707 handwritten book by Ny. Ebot Mitchell, found in a house in Hasfield, Gloucestershire, contains "Recp.t for the Scurvy" which consists of extracts from various plants mixed with a plentiful supply of orange juice, white wine or beer.
In 1734, Johann Bachstrom-based Leiden doctor published a book on scurvy in which he declared, "scabies solely because of the total taboo of fresh plant foods, and green vegetables, which are the main cause of disease", and urges the use of fruit and fresh vegetables as a medicine.
However, it was not until 1747 that James Lind formally indicated that scabies could be treated by supplementing the diet with citrus fruits, in one of the first controlled clinical trials reported in medical history. As a naval surgeon at HMS Salisbury, Lind has compared some of the recommended scabies: hard cider, vitriol, vinegar, sea water, orange, lemon, and a mixture of Peruvian balsam, garlic, myrrh, mustard seeds and radish roots. In A Treatise on Scurvy (1753) Lind explains the details of his clinical trials and concludes "the result of all my experiments is that oranges and lemons are the most effective solution for this distemper at sea. "
Unfortunately, the experiments and results only occupy several paragraphs in a long and complex piece of work and have little impact. Lind herself has never been actively promoting lemon juice as a single 'cure'. He shared his medical opinion at the time that scurvy had many causes - especially hard work, bad water, and salt meat consumption in a damp atmosphere that inhibits healthy sweat and normal excretion - and hence many solutions are needed. Lind is also sidetracked by the possibility of producing 'robbery' lemon juice by boiling it. Unfortunately this process destroys vitamin C and therefore does not work.
During the 18th century, the disease killed more British sailors than the enemy's actions. Especially by scabies that George Anson, in his voyage celebrated in 1740-1744, lost nearly two-thirds of his crew (1300 from 2000) in the first 10 months of the voyage. Royal Navy enrolled 184,899 seafarers during the Seven Years' War; 133,708 of them "disappeared" or died of disease, and scurvy was the main cause.
Although during this period mariners and naval surgeons are increasingly convinced that citrus fruits can cure scurvy, a classically trained doctor who runs a medical standpoint dismisses this evidence as anecdotes that are inconsistent with the current disease theory. Literature championing the cause of orange juice, therefore, has no practical impact. The medical theory is based on the assumption that scurvy is an internal decay disease caused by the wrong digestion caused by the difficulty of living in the ocean and the naval diet. Although this basic idea is given a different emphasis by consecutive theorists, the medications they advocate (and which the navy receives) amount to less than the consumption of 'soft drinks' to activate the digestive system, the most extreme of which is the consumption of the' elixir of vitriol '- sulfuric acid taken with alcohol and barley water, and mixed with spices.
In 1764, a new variant appeared. Encouraged by Dr. David MacBride and Sir John Pringle, Army Surgeon General and later President of the Royal Society, the idea is that scurvy is a result of a lack of 'fixed air' in tissues that can be prevented by drinking infusions of malt and wort that ferment in his body will stimulate digestion and restore the lost gas. These ideas received widespread and influential support, when James Cook set out to circumnavigate the world (1768-1771) in HM Bark Endeavor , malt and wort was the top list of solutions that were instructed to be investigated. others are beer, sour sour, and 'rob' Lind. The list does not include lemons.
Cook does not lose a single person for scurvy, and his report goes down in favor of malt and wort, although it is now clear that the reason for his crew's health on this and other trips is Cook's regime of ship cleanliness, enforced by strict discipline, and frequent replenishment of fresh food and green goods. Another rule imposed by Cook is his ban on consuming salt fat taken from boiling copper pans on boats, then common practice in the Navy. In contact with air, copper forms compounds that prevent the absorption of vitamins by the intestine.
The first large long-distance expedition that experienced almost no scabies was the Spanish naval officer Alessandro Malaspina, 1789-1794. Malaspina medical officer Pedro GonzÃÆ'¡lez believes that fresh oranges and lemons are essential to prevent scurvy. Only one epidemic occurred, during the 56 day journey across the open sea. Five sailors come with symptoms, one serious. After three days in Guam, everything is healthy again. The huge Spanish empire and numerous harbor calls make it easier to get fresh fruit.
Although near the end of the century, MacBride theories are challenged, medical institutions in the UK stick to the notion that scurvy is an internal 'spoilage' disease and Pain and Illness, run by administrators, feels obliged to follow his advice.. However, inside the Navy The kingdom, opinion - reinforced by first hand experience of using lemon juice at the siege of Gibraltar and during Admiral Rodney's expedition into the Caribbean - has become increasingly convinced of its efficacy. This is reinforced by the writings of experts such as Gilbert Blane and Thomas Trotter and by reports of naval commanders who came.
With the coming of war in 1793, the need to eliminate scurvy gained a new urgency. But the first initiative did not come from medical institutions but from the admirals. Ordered to lead an expedition against Mauritius, Admiral Gardner was not interested in the wort, malt and elixir of vitriol still issued to the Royal Navy ship, and demanded that he be supplied with lemons, to fight scurvy on the journey. Members of the Sick and Pain Board, recently added by two practical naval surgeons, supported the request, and Admiralty ordered that it be done. However, there was a change of plan at the last minute. The expedition against Mauritius was canceled. On May 2, 1794, only HMS
The effect immediately felt. The commander of the fleet was shouting also for lemon juice, and in June the Navy acknowledged that demand in the navy had approved a proposal from the Sick and Pain Board that the lemon and sugar juice should be in future issued as daily rations for the crew of all warships.
It took several years before the method of distribution to all ships in the fleet had been perfected and the supply of large amounts of lemon juice should be guaranteed, but by 1800, the system was already there and functioning. This has led to a tremendous increase in health among seafarers and consequently plays an important role in gaining advantage in sea battles against enemies who have not yet introduced the steps.
19th century
Napoleon's chief army surgeon in the Siege of Alexandria (1801), Baron Dominique-Jean Larrey, wrote in his memoir that horse meat consumption helped France to curb the epidemic of scurvy. The meat is cooked but only obtained from the young horses bought from the Arabs, and remain effective. It helped start the tradition of horse meat consumption of the 19th century in France.
The last Slaveship to travel from West Africa to America in 1860, Clotilda, may have added vinegar to water given to the captives. The last of the survivors of the trip, Oluale Kossola (Cudjo Lewis), remembered in 1927: "Dey give us a little water twice a day Oh Lor ', Lor', we're very thirsty! De water taste sour."
Lauchlin Rose patented the method used to preserve non-alcoholic orange juice in 1867, creating a concentrated drink known as Rose Rose's juice. The Merchant Shipping Act of 1867 required all Royal Navy ships and Navy Merchants to provide daily rations to sailors to prevent scurvy. The product became almost ubiquitous, the term "limey", first for British sailors, then for British immigrants in former British colonies (especially America, New Zealand and South Africa), and finally, in the American slang, everyone English.
The Cochlearia officinalis plant, also known as "Common Scurvygrass", derives its common name from observations that it cures scurvy, and it is taken aboard with a dry bundle or a flute extract. The bitter taste is usually disguised with herbs and spices; However, this did not prevent scurvygrass and sandwich drinks from becoming popular in the UK until the mid-nineteenth century, when citrus fruits became more readily available.
Limes of West India began to complement the lemons, when the Spanish alliance with France against the British in Napoleonic Wars made the supply of Mediterranean lemons problematic, and because they were more readily obtained from the British Caribbean colonies and believed to be more effective because they were more acidic. It was sour, not Vitamin C (unknown) that is believed to treat scurvy. In fact, the content of West Indians is significantly lower in Vitamin C than in previous lemons and is further not served fresh but as lime juice, which has been exposed to light and air, and is channeled through copper pipes, all of which significantly reduce Vitamin C. Indeed, 1918 animal experiments using representative samples of lime juice of the Navy and Merchant Marine indicate that it has almost no antiscorbutic strength at all.
The belief that scurvy is essentially a nutritional deficiency, best handled by the consumption of fresh foods, especially fresh grapefruit or fresh meat, was not universal in the 19th and early 19th centuries, and thus sailors and explorers continued to suffer from scabies in the century 20. For example, the Belgian Antarctic Expedition of 1897-1899 became severely affected by scurvy when its leader, Adrien de Gerlache, initially did not advise people to eat penguins and seal meat.
In the Royal Navy's Arctic expedition in the 19th century it was widely believed that scurvy was prevented by good hygiene on board, exercising regularly, and maintaining the morale of the crew, rather than with a fresh food diet. Navy expeditions continue to be plagued by scurvy diseases even while fresh meat (not jerked or tinned) is known as a practical antiscorbutic among whalers and civil explorers in the Arctic. Even cooking fresh meat does not completely destroy its antiscorbutic properties, especially since many cooking methods fail to bring all meat to high temperatures.
This confusion is associated with a number of factors:
- while fresh oranges (especially lemons) cure scurvy, lime juice exposed to light, air and no copper pipe - thereby destroying the orange theory treat scurvy;
- fresh meat (especially organ meats and raw meat, consumed in arctic exploration) also cures scurvy, damaging the theory that fresh vegetables are essential to prevent and cure scabies;
- increased sea velocity through steam delivery, and better nutrition on land, reducing the incidence of scurvy - and thus the effectiveness of lime-copper juice compared to fresh lemon is not immediately revealed.
In the confusion that arises, a new hypothesis is proposed, following a new germ disease theory - that the disease is caused by ptomaine, a bacterial waste product, especially in contaminated canned meat.
Young scabies appeared in the late nineteenth century because children were fed cow pasteurized milk, especially in urban upper classes. While pasteurization kills bacteria, it also destroys vitamin C. This is ultimately solved by supplementation with onion juice or cooked potatoes.
20th century
At the beginning of the 20th century, when Robert Falcon Scott made his first expedition to Antarctica (1901-1904), the prevailing theory was that scurvy was caused by "ptomaine poisoning", especially in canned meat. However, Scott found that a fresh meat diet from the Antarctic seal cured scurvy before death.
In 1907, animal models that ultimately helped isolate and identify "antiscorbutic factors" were found. Axel Holst and Theodor FrÃÆ'¸lich, two Norwegian doctors who studied the vessel beriberi contracted by the crew of the Norwegian Fishing Fleet, wanted a small test mammal to replace the pigeon which was then used in the research of beriberi. They feed their guinea pig test diet grains and flour, which previously produce beriberi in their pigeons, and are surprised when the classic scurvy produces instead. This is a selection of animals that are serendipit. Until then, scurvy has not been observed in organisms separate from humans and has been regarded as exclusively human disease. Some birds, mammals, and certain fish are susceptible to scurvy, but pigeons are not affected, because they can synthesize ascorbic acid internally. Holst and FrÃÆ'¸lich found that they can cure scabies in guinea pigs by the addition of various foods and fresh extracts. The discovery of an animal experimental model for this scurvy, made even before the essential idea of ​​"vitamins" in food has been suggested, has been described as the single most important vitamin C study.
In 1915, New Zealand troops at the Gallipoli Campaign had a deficiency of vitamin C in their diet that caused many Soldiers to contract Scurvy. It is considered that Scurvy is one of the many reasons that the Allied attack on Gallipoli fails and if the army has the proper diet, the outcomes of World War I and the future of the middle east may look very different.
Vilhjalmur Stefansson, a polar explorer who lived among the Inuit tribe, proved that the meat diet they consume did not cause vitamin deficiency. She participated in a study at Bellevue Hospital in New York in February 1928, where she and her colleagues only ate meat for a year while under medical supervision, but remained healthy.
In 1927, the Hungarian biochemist Szent-GyÃÆ'¶rgyi isolated the compound he called "hexuronic acid". Szent-GyÃÆ'¶rgyi suspected hexuronic acid, which he had isolated from the adrenal gland, became an antiscorbutic agent, but he could not prove it without a model of animal shortage. In 1932, the relationship between hexuronic acid and scabies was finally proven by American researcher Charles Glen King of the University of Pittsburgh. King's laboratory was given some hexuronic acid by Szent-GyÃÆ'¶rgyi and immediately determined that it was the wanted anti-scorbutic agent. Due to this, the hexuronic acid was subsequently renamed ascorbic acid.
21st century
The level of scurvy in most of the world is low. The most frequently affected are malnourished people in developing and homeless countries. There is an outbreak of conditions in refugee camps. Reports of cases in developing countries from people with severe healing wounds have occurred.
Human trials
An important human dietary study of experimental-induced scurvy was performed on the opponents of conscience during World War II in Britain and in Iowa country detainee volunteers in the late 1960s. These studies both found that all the obvious symptoms of scurvy previously induced by an experimental scorbutic diet with very low vitamin C content could be completely reversed with supplemental vitamin C supplements of only 10 mg per day. In this experiment, no clinical differences were noted between men who were given 70 mg of vitamin C per day (which produced a blood vitamin C level of about 0.55 mg/dl, about 1/3 of tissue saturation), and those given 10 mg per day (which results in lower blood levels). The men in the prison study developed the first signs of scurvy about 4 weeks after starting a vitamin C-free diet, while in the UK study, six to eight months were needed, probably because the subject was pre-filled with 70 mg/day. supplements for six weeks before a scorbutic diet is fed.
Men in both studies, on a hollow diet or almost without vitamin C, had too low levels of vitamin C in the blood to be accurately measured when they developed signs of scurvy, and in the Iowa study, currently estimated (with labeled vitamins ) C dilution) has a body pool of less than 300 mg, with a daily turnover of only 2.5 mg/day.
Evolution
Most animals and plants are able to synthesize vitamin C, by sequence of enzyme-driven steps, which convert monosaccharides to vitamin C. However, some mammals have lost the ability to synthesize vitamin C, especially simian and tarsius. It forms one of the two major primordial subordos, Haplorrhini and this group including humans. The Strepsirrhini (non-tarsier prosimians) can make their own vitamin C, and these include lemurs, lemurs, pottos, and galagos. Ascorbic acid is also not synthesized by at least two species of Caviidae, capybara and marmot. There are known bird and fish species that do not synthesize themselves Vitamin C. All species that do not synthesize ascorbic need it in food. Deficiency causes scurvy in humans, and symptoms are somewhat similar in other animals.
Animals that have scabies all lack the enzyme L -gulonolactone oxidase (GULO), which is needed in the last stage of vitamin C synthesis. The genome of this species contains GULO as a pseudogen, which serves as an insight into the evolution of the past species.
Name
In infants, scurvy is sometimes referred to as Barlow's disease, named after Thomas Barlow, a British physician who described it in 1883. However, Barlow's disease or Barlow's syndrome may also refer to a mitral valve prolapse, first described by John Brereton Barlow in the year 1966.
References
Further reading
- Brown, Stephen R. Scurvy: How a Surgeon, a Mariner, and a Gentleman Complete the Largest Medical Mystery of the Sail Age .
- Carpenter, K.J. (1986). History of Scurvy and Vitamin C . Cambridge. Ã,
- Ceg? owski, Maciej (March 7, 2010). "Scott and Scurvy". IdleWords.com .
- Vale, B. & amp; Edwards, G. (2011). Doctor to Fleet: Life and Time from Thomas Trotter 1760-1832 . Boydell. CS1 maint: Using the author parameters (links)
External links
- Media related to Scurvy on Wikimedia Commons
Source of the article : Wikipedia
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