What is Scurvy?

Scurvy is caused by vitamin C deficiency, so scurvy is also called vitamin C deficiency. But vitamin C deficiency can not only cause scurvy, but also be related to inflammation, arteriosclerosis, tumors and other diseases. Scurvy has historically been a serious threat to human health. It has been popular among seafarers, explorers, and the military in the past few hundred years, especially among seafarers, and it is known as "sailor's fear" and "sea fierce god". Clear records of scurvy began in the 13th century Crusades. Some scholars date back to the Hippocrates BC. It is also said that scurvy was also found on the human remains in primitive society. Remains of disease. Regarding the prevention and treatment of scurvy, it has been discovered as early as the 17th to 18th centuries that fresh vegetables, oranges, and lemons can be used for prevention and treatment. In 1753 Lind's masterpiece of scurvy questionnaire, hexuronic acid was extracted from cabbage and adrenal glands. At the same time, the chemical structure of Reichstein was successfully synthesized in 1933, so that humans finally conquered scurvy. But the research on the theory and application of vitamin C is far from over.

Scurvy is a disease caused by a lack of vitamin C in the body. Insufficient long-term intake or diarrhea, vomiting, etc. can cause lack of vitamin C, prevent collagen from normal synthesis, cause cell connection disorders, increase capillary fragility, and cause bleeding in the skin and submucosa. Medically known as scurvy disease. Scurvy can also be seen in infants and young children who are poorly fed.

Introduction to Scurvy Disease

History of scurvy

The more ancient description of scurvy in ancient books is in the records of the medieval Crusades. At the end of the fifteenth century, scurvy was also the reason many seafarers stayed in bed for a long time. In 1753, Scottish Navy medic James Linde discovered that the disease was related to diet and was further cited by English explorer James Cook. Found that drinking orange juice and lemon juice can treat and prevent scurvy.

James Lind (1716-June 13, 1794), Royal Navy Surgeon (1739-1748), Royal Navy Haslar Hospital Physician (1758-1783), was the founder of English Hygiene People, initiated the use of citrus fruits and fresh vegetables to treat and prevent scurvy. Affecting the development of preventive medicine and nutrition among warriors and sailors, he is also the author of A Treatise of the Scurvy.

Scurvy pathology

Vitamin C is involved in the synthesis of intercellular substances. Insufficient vitamin C can cause bleeding in the digestive tract, subcutaneous tissues and bones. The bleeding site is in the capillaries, which are often parts that grow rapidly, such as the metaphysis and the periosteum. This indicates that vitamin C is involved in the nutrition of the capillaries and the synthesis of intercellular substances.

Scurvy-X-ray examination The pathological changes were irregular patchy bleeding spots in the metaphyseal capillaries growing into the ossification area, preventing new bone formation. The epiphysis was separated due to bleeding, which severely affected the development of the growth layer. Subperiosteal hemorrhage can be quite extensive, causing long segments of periosteum to protrude from the backbone.

In addition to the above changes, scurvy rickets also have hyperplasia of cartilage columns.

Scurvy symptoms

A few months after vitamin C deficiency, the patient feels burnout, general weakness, mental depression, weakness, anorexia, malnutrition, pale face, swollen gums, bleeding, and can cause tooth looseness and loss due to gum and alveolar necrosis, bone and joint muscles Pain, skin stasis, ecchymosis, hyperkeratosis of the hair follicles, peripheral bleeding, children may be paralyzed in the lower limbs due to subperiosteal bleeding, swelling, tenderness, obvious hip joint extension, knee flexion, foot rotation, frog Kind of pose.

Scurvy prevention

(1) Choose foods rich in vitamin C, improve cooking methods, and reduce the loss of vitamin C during cooking. Artificial feeding infants and young children should add vitamin C-containing foods or vitamin C. Diseases, post-surgery, smokers, oral contraceptives, and workers in the Arctic and Arctic regions should increase vitamin C intake appropriately.

(2) Symptomatic treatments such as keeping the mouth clean, preventing or treating secondary infections, analgesics, and those with severe anemia can be transfused and given iron. In severe cases, if there is a huge subperiosteal hematoma or a fracture, surgery is not required. After treatment with vitamin C, the hematoma can gradually disappear and the fracture can heal automatically.

Diagnosis of scurvy

Typical scurvy has obvious symptoms and is easier to diagnose. Recessive and early scurvy is difficult to diagnose due to the lack of specific symptoms. It should be combined with a history of feeding and other tests for a comprehensive analysis.

History of scurvy feeding and clinical symptoms

Artificially fed infants without supplementation with vitamin C or breastfeeding

Scurvy-Periosteum X-rays Lack of fresh vegetables or fruits, or nursing mothers only eat pickles. The age of onset of scurvy (3-18 months), combined with some of the aforementioned non-specific symptoms and feeding history, can provide clues to the diagnosis of early scurvy. If the disease has reached a certain stage or advanced stage, it can be diagnosed according to symptoms such as limb swelling and pain, frog-shaped legs, gums and submucosal bleeding.

Scurvy limb swelling and pain

Should be distinguished from septic arthritis, osteomyelitis, cellulitis and deep abscess. These diseases are more common in

x-ray inspection Unilateral limbs, with local swelling and burning, marked systemic symptoms, high fever, poisoning, and increased white blood cells, all were significantly different from scurvy. Rheumatoid arthritis is rare in infants under 2-3 years of age, and is migratory. Other rheumatic fever-specific symptoms and signs can be identified. Subperiosteal hemorrhage of scurvy sometimes needs to be distinguished from tumors, but other symptoms of scurvy are easy to identify with tumors. If necessary, the diagnosis can be confirmed by X-ray examination and treatment tests.

The perinatal symptoms and skeletal tenderness of infantile cortical hyperplasia are sometimes similar to scurvy, but the lesions are more common in flat stomachs, such as the jaws, scapula, skullcap, and clavicle. The face is often affected, and sometimes also the limbs. Increased erythrocyte sedimentation and increased serum alkaline phosphatase help identification. The age of onset is mostly 6 months after birth, and scurvy is mostly after 6 months. The course of osteocortical hyperplasia is very irregular, short for several weeks, elderly for several months, sometimes recurrent, and usually heal naturally. X-ray examination showed bone hyperplasia and thickening of the cortex, which gradually disappeared over several months, and had nothing in common with scurvy.

The age of onset of limb pain is different from scurvy. It has characteristic hand, foot and skin redness, itching, and severe pain, high blood pressure, sweating, and shame. In severe cases, the fingers and toes become black or even fall off. Easy to identify with scurvy.

Scurvy limb paralysis

It must be distinguished from polio, rickets, trauma, congenital syphilis, etc .: Poliomyelitis shows flaccid paralysis, no swelling and pain, and other body-wide symptoms, which is very different from scurvy; Rickets has special signs and X Seen on the line; Trauma cases should have a history of injury, and few symmetrical injuries were bilateral. X-ray examination showed a significant difference; Congenital syphilis mostly occurs in infants younger than 4 months. The mother suffers from phenotypic or recessive syphilis. The child has specific signs of congenital syphilis. Serological examination and X-ray long bone photography can dentification.

Scurvy bleeding symptoms

Should be distinguished from other bleeding disorders:

Thrombocytopenic purpura, allergic purpura, hemophilia, etc. can be identified based on platelet, bleeding and clotting time, and other clotting tests and family history;

Leukemia bleeding, with characteristic changes in blood and bone marrow at the same time;

Septic epidemic meningococcal meningitis has signs of the nervous system and cerebrospinal fluid, and it is easy to find pathogenic bacteria in the skin purpura and cerebrospinal fluid, which is easy to identify;

Orbital hemorrhage and exophthalmos should be distinguished from neuroblastoma and chronic xanthomas, the latter two have no other characteristics of scurvy;

When bleeding gums, when distinguished from gingivitis, the latter is rare in infants, their gums are mostly flushed, and without other symptoms of scurvy.

Points for prevention and treatment of scurvy

(1) The main source of vitamin C is fresh vegetables and fruits, and there should be sufficient vegetable intake every day;

Vitamin C in fruits (2) It should be cooked properly and not over boiled, so as not to cause a lot of damage; Vitamin C is water-soluble, and it is necessary to develop the habit of drinking soup;

(3) The supply of vitamin C for adults is about 30 milligrams per day. Pregnant women, breastfeeding, surgery and trauma should be appropriately increased according to doctor's orders;

(4) If necessary, vitamin C tablets can be added daily, 0.1 grams each time, 3 times a day. Long-term high-dose supplementation should be cautious, and information indicates that this is not a wise move.

Scurvy Food Therapy

1. wolfberry leaves fried pork liver

Formula: 200 grams of fresh wolfberry leaves, 250 grams of pork liver, soy sauce, sugar, refined salt, wet starch, rice wine, cooking oil, lard, monosodium glutamate, balsamic vinegar.

Method: First, heat the pot, use cooking oil to smooth the pan, add lard, add pork liver, stir fry until the color is white, then add wolfberry leaves. Then add lard, sugar, refined salt, monosodium glutamate, rice wine, etc. into the pot and season, continue to stir fry, then use wet starch to thicken, add a little balsamic vinegar and stir fry until cooked.

Effect: nourishing liver and blood. For scurvy caused by vitamin C deficiency .

2. Tomatoes with sugar

Recipe: 200 grams of tomatoes, moderate sugar.

Method: first wash the tomatoes and cut into pieces, mix with sugar.

Efficacy: beauty and color, vitamin C supplementation. Simple and economical. ^[1]

- Biological mechanism of scurvy -Shanghai Medical College

Scurvy is due to the lack of vitamin C, a cofactor of proline hydroxylase and lysine hydroxylase, which impairs this hydroxylation, affects the structural stability of the triple helix, and further affects normal collagen. The formation of microfibers can cause related symptoms such as increased embrittlement of blood vessel walls and decreased muscle bonds and skin toughness. There is a kind of peas called peas in peas, which can specifically inhibit the activity of lysine oxidase. Ingestion of large amounts can cause shandein poisoning, affect the side-to-side cross-linking of collagen fibers, and cause severe bone and joint And abnormalities in the walls of large blood vessels.