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VITAMIN C DEFICIENCY: SYMPTOMS OF SCURVY

The symptoms of scurvy are so well described in the textbook Modern Nutrition in Health and Disease by Goodhart and Shils, that I cannot do better than quote from their description.

‘The onset of adult scurvy can be detected between 60 and 90 days after the beginning of Vitamin C deficiency in the diet. The earliest signs which can easily be missed are the appearance of a few small spots of bleeding beneath the skin. These fade within a few days, but other spots continue to appear.

‘A little later larger patches of blood beneath the skin appear and may appear round the hair roots. At the same time the skin becomes rough and like a nutmeg grater, and heaps up around the hair follicles especially on the but­tocks, thighs and calves of the legs. Many of these little lumps contain broken or coiled up hairs.

‘In fact, this heaped up hair follicle in the centre of a red inflammed circle is considered the classic sign of early scurvy.

‘A little later still the gums become swollen and bleed easily. This is most noticeable where the teeth are neglected, as in some elderly people, but does not occur when the teeth have been extracted.

‘Haemorrhages may now appear in the conjuctiva of the eyes — red eye.

‘Most characteristic is a dryness of the mouth, eye and scalp with loss of hair and a dry itchy skin. The teeth become loose in their sockets and fillings fall out. Near the third month of deficiency profound fatigue, weakness and lethargy develop; the legs ache and soon develop painful swollen joints and swelling of feet and ankles.

‘The urine often becomes scanty and high coloured.

‘Psychological changes are common, marked by undue concern about the health, depression and hysteria. Haemorrhages and bruising appear in many places, even into the nerve sheaths causing neuritic pains in legs and arms.

‘In babies, scurvy is most apt to occur a short time after they are weaned from the breast, unless Vitamin C is given them in supplements or in plenty of orange juice or other fresh fruit juices. The few teaspoons of orange juice, spe­cially when fruit is out of season, do not supply enough Vitamin C to keep the baby in good health. Even breast fed babies have developed scurvy when the mother’s diet is deficient in Vitamin C

This deficiency has occurred among Australian aborig­inal babies living in reserves or on fringe of civilisation — not in their native state.

In infants the signs of scurvy are different from those of adults. The onset is usually insidious. ‘Failure to thrive’ may be the only clue at first. The baby is irritable, the limbs are tender to touch and he will not move them — almost as if paralysed. In fact, the baby fears to be touched or handled and cries instead of being soothed, when he is picked up.

If he is teething there is often bleeding of the gums. Tiny blood spots may first appear in the skin, then there is bleeding in many areas — into the joints, next to bones, blood-stained urine and motions and even behind the eyes.

These babies are most susceptible to infections of all kinds. Indeed, the first signs of Vitamin C deficiency in children may be ear infection, tonsillitis, bronchitis, constant colds and ‘running nose’. The later is constantly seen in malnourished native children of all races, and common among our own aboriginal babies and children.

Anaemia occurs in adults, babies and children.

An example of how important Vitamin C is in control­ling these infections occurred in one of our larger Queens­land country towns where a number of aboriginal families lived — some in good houses, some in humpies on the reserve. Practically all the babies and young children suf­fered some infection of the nose, throat or ears.

The white women of the town organized a van manned by volunteers and a Health Department Sister to visit these families each day and check the health of the children, talk to the mothers and distribute vitamin and iron pills and the milk enriched biscuits which the government was distribut­ing to children in lieu of milk. ¹ They found that 250 mg and 500 mg orange flavored

Vitamin C tablets were liked by the children and that many of the infections cleared up on this regime. There were not nearly so many runny noses, coughs and school sores, and their general health improved.

However, ‘Not necessary and too expensive’, declared the Government Medical officer, who did not believe in the value of Vitamin C. So he cut down the dose to one 50 milligram tablet a day (the Recommended Daily Allow­ance) — as has recently been done to the dose of ascorbic acid as a pensioners’ pharmaceutical benefit. The sister in < charge of the van told me that since cutting down the

Vitamin C all the old infections were back again in full force. I could see this for myself — every child over 6 months had a runny nose and a cough.

Dr Archie Kalokerinos — working among aboriginal children in the town of Collarenabri in Western New South Wales — reduced the high death rate among aboriginal ‘ babies and children from almost ‘Every Second Child’ to

practically zero by the use of Vitamin C, not only to prevent j scurvy but to cure the pneumonia and diarrhoea and sudden deaths from which so many had succumbed.

His Book Every Second Child describes the life-saving properties of ascorbic acid — and its salt sodium ascorbate by mouth and by injection.

Dr Kalokerinos’ results repeat and confirm the results of Dr Frederick Klenner of Reidsville, North Carolina, in his use of massive doses of Vitamin C in curing many infections and poisonings and promoting healing of in­juries and burns.

The history of Vitamin C is by no means complete, as research in laboratories and in fields of general practice still goes on. It is found to play an ever greater and more significant role in human metabolism, and in the preven­tion and cure of human disabilities and disease.

More research, begun in the 1930s and 1940s, is ur­gently needed to establish its value in such conditions as poisoning, drug addiction and shock, and such intractable diseases as arthritis, encephalitis and cancer on what is effective therapeutic dosage.

Present clinical experience has so far shown that as­corbic acid is not merely a vitamin to be used in minute doses to prevent scurvy but, used as a so called megavitamin — in gram rather than milligram doses, it has tremendous potential in saving human life and promoting human health and well being.
The history of Vitamin C is still in the making.
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VITAMIN C: HISTORY OF VITAMIN C

Vitamin C — ascorbic acid — is a wonderful substance, as it takes part in so many vital processes in the body and is essential to health and life itself. In fact, ascorbic acid might well be called a ‘food’, not merely a vitamin.

A complete deficiency — less than 10 milligrams a day — results in scurvy, a disease that has plagued mankind ever since history has been recorded.

A condition that was almost certainly scurvy was described in an ancient Egyptian papyrus 1550 B.C. and ancient Ro­mans and Greeks evidently suffered from scurvy, especially on military campaigns.

Indeed, a lack of Vitamin C has shaped the very course of history, limiting military conquests and exploration .by land and sea.

Explorers in the 16th, 17th and 18th centuries gave vivid accounts of scurvy and many and varied cures were devised. Some were effective, others useless. The successful remedies seem to have been forgotten from one generation of sufferers to the next, as their findings were not recorded, and the same methods with trial and error were repeated again and again — just as we do nowadays with other vitamins. The catch cry of ‘not proven’ was as limiting then as it is today.

In fact, sea captains, merchant or navy, whether exploring for new lands or breaking into unchartered seas, expected to lose a proportion of their men from scurvy every voyage; and peasant folk in the northern hemisphere were inured to some of their children and old folk succumb­ing to the disease by the end of winter, before the spring brought fresh foods again to their larder.

In 1536, The French Naval Commander, Jacques Car-tier, exploring in Newfoundland, was gravely concerned because most of his crew were ill with scurvy. Twenty-five of them died. The survivors, however, were promptly cured by a remedy used by the Indians — the juice and sap from the leaves of the Amedia tree — probably the American spruce. Cartier was so delighted with the result that he wrote in his diary —

‘It wrought so well, that if all the physicians of Montpelier and Louraine had been there, with all the drugs of Alexandria, they would not have done as much in one year as that tree did in 6 days; for it did so prevail, that for as many as used it, by the Grace of God, recovered their health’.

A beer, or decoction, of the American black spruce was well known among Greenlanders and the never failing remedy of Greenland scurvy grass was used by sailors on the Arctic Seas.

If the English Admiral, Sir Richard Hawkins, had known about spruce beer some 50 years later, he would not have lost 10,000 seamen from scurvy in the British Navy. He it was who first advocated oranges and lemons as a cure and so saved the Navy — 150 years before Dr James Lind made his famous discovery.

When Sir Richard died his ideas died with him. No one took them seriously, and scurvy returned with equal menace to the British Navy and merchant ships.

Hundreds of remedies were used with more or less — rather less — success for the prevention and cure of scurvy. They are listed in the 1771 edition of the British Encyclopaedia. Although Lind’s treatise on scurvy is recog­nised and oranges and lemons were listed, the article claims that cyder was next best, also ‘plenty of fresh greens and vegetables — particularly salads arid garden cresses’.

It gives detailed directions for preservatising and re­ducing orange juice to a syrup ‘and the virtues of this extract, thus made, will serve one man at sea for several years’. The Encyclopaedia goes on to advise bottled gooseberries, small onions pickled in vinegar, cabbage, French beans and other vegetables preserved in layers of salt in clean stone jars, also the ‘never failing remedy

Greenland scurvy grass’.

Patients with scurvy were treated with raisins and cur­rants or pickled cabbage, small onions boiled — well acid­ulated with orange and lemon juice — and with salads more particularly ‘dandelion, sorrel, endive, lettuce, sumitary and purslave to which may be added scurvy grass, cresses and the like’.

In winter they used not only spruce beer but an anti­scorbutic ale made of an infusion of heads of red cabbage cut small, horse radish and mustard seed and other spices.

There was a great deal of valuable information about remedies for prevention and cure of scurvy, yet in 1740 Admiral George Anson set off on a voyage round the world with six ships and 1955 men without availing himself of any of it. Only the flagship Centurion returned. One thousand and fifty-one seamen died, chiefly from scurvy.

This disaster inspired Dr James Lind, Surgeon of the British Fleet (or perhaps he was ordered) to seek a definite cure for scurvy. Lind had all the current ‘remedies’, and he compared their value, as he used some of the most popular in his classical experiment on the naval ship Salisbury. He had compared the diets of sailors on various ships and sea routes and discovered that those which visited Southern ports and took cargoes of citrus fruits and added lots of oranges or lemons to their monotonous diet survived best.

‘Lind’s experiment was a landmark in the search for Vitamins, and to this day it remains a model for scientific investigation’, writes Herbert Bailey in his book The Vitamin Pioneers — (well worth reading).

‘It was carefully planned. The conditions were con­trolled. There were comparable groups, quantative data and carefully recorded findings’.

Let Dr Lind tell of it in his own words from his treatise on scurvy.

‘On 20th May, 1747, I took twelve patients in the scurvy …. Their cases were as similar as I could have them …. They lay together in one place, and had one diet common to all…. Two of these were ordered each a quart of cider a day. Two others took twenty-five drops of elixir vitriol three times a day .Two others took two spoonfuls of vinegar three times a day upon an empty stomach. Two of the worst patients …. were put on a course of sea water …. Two others had each two oranges and one lemon given them every day …. The two remaining patients took the bigness of a nutmeg three times a day of an electary in the amount as recom­mended by a hospital surgeon …. The consequence was that the most sudden and visible good effects were perceived from the use of the oranges and lemons; of those who had taken them being at the end of the six days fit for duty.’

Instead of proving his point, the results of Lind’s ex­periments were ignored by the Navy and ridiculed by his colleagues. They labelled him a ‘crank’!

It was not until 1794 — year of Lind’s death — that his work received any official recognition and his proposal to supply a British Squadron with an adequate amount of lemon juice for an extended voyage of 23 weeks was accepted and tried — with dramatic results. Only one member of the crew developed scurvy.

There was one man, however, on whom Lind’s studies and recommendations did have a prompt and profound effect — his close friend Captain (then Lieutenant) James Cook. Cook not only followed Dr Lind’s advice in providing lemons for his crew but took on fresh fruits, greens and vegetables whenever his ships made a land-fall, and insisted on his officers setting an example to the men by eating them themselves. He also insisted on good hygiene and cleanli­ness on his ships. The result was that not one seaman died of scurvy on his long 3 year voyages (1768-1771 and 1772 to 1775). It was for this achievement he was honoured by the award of Copley Medal, rather than for his discovery of Australia.

Finally, in 1795, lemon juice was actually added to the diet of British Sailors — hence the nickname ‘limey’ — although it was not until 1884 — eighteen years later — that the order was made official. In the forty-eight years that elapsed between Lind’s proof of the lifesaving properties of oranges and lemons and the actual adoption of these anti-scurvy measures thousands of sailors must have died un­necessarily from scurvy.

Lind, in his bitterness, wrote ‘There are certain persons who just will not let themselves be convinced that a terrible disease can be cured easily, yes that it can be even pre­vented’.

The same attitude of mind prevailed for many years as regards Vitamin C and still persists today in orthodox med­ical circles as other vitamins of proven value have been discovered.

Only in the last 50 years has scurvy become an uncom­mon disease. Until the turn of the century scurvy was ram­pant among babies and children in the cities of England, Europe and America. At that time everyone was so keen on hygiene, purity and prevention of germs that mothers were learning to boil and sterilise everything — even the baby’s milk, thus destroying the little Vitamin C it contained.

Bottle feeding was also coming into vogue in place of breast feeding — which usually supplies ample Vitamin C. With boiled and pastuerised milk, babies did not succumb so frequently to gastroenteritis — but they did get scurvy. Now mothers are thoroughly aware that every artificially fed baby needs Vitamin C in the form of orange juice or rose hip syrup or ascorbic acid drops every day.

Scurvy is rarely seen nowadays in Australia or New Zealand, but a relative Vitamin C deficiency is prevalent. Actual scurvy is sometimes found among fringe-dwelling or even city-dwelling aboriginal babies — even in one or two breast fed babies — owing to a diet of dried milk or con­densed milk with no supplement, or a diet of white bread, jam and tea in the mothers, unfortified by any Vitamin C supplement.

Cases of scurvy have also been discovered among newly arrived migrant children whose parents have not yet adapted to our Australian diet, and can easily feed their children and themselves on restaurant foods, supermar­ket foods, snacks, soft drinks, lollies, ‘take-away’ foods and what have come to be known as ‘junk’ foods, but no fresh fruits or salads. They do not realise that there is practically no Vitamin C left in these attractive ‘convenience’ foods.

Although actual cases of scurvy are seldom seen, there is a great deal of relative deficiency of Vitamin C among Australian people particularly among pensioners and ado­lescents living away from home.

This is not always realised even yet, but way back in 1939 the U.S. Department of Agriculture printed in its Food and Life Yearbook :—

‘In fact, even when there is not a single outward symptom of trouble, a person may be in a state of Vitamin C deficiency more dangerous than scurvy itself.

‘When such a condition is not detected, and continues uncorrected, the teeth and bones will be damaged; and, what may be even more serious, the blood stream is weakened to a point where it can no longer resist or fight infections not so easily cured as scurvy. It is true that with­out adequate Vitamin C myriads of body processes would deteriorate or even come to a fatal halt’.
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NUTRITION FOR PREADOLESCENT AND ADOLESCENT YOUTH FOOD SELECTION AND HABITS

THE AIROLA DIET: COMPLEMENTING YOUR BASIC HEALTH-BUILDING FOODS WITH MILK

CHILD’S HEALTH/SKIN DISORDERS: ABRASIONS

Abrasion is a general term given to an injury such as a graze, scratch or cut. These are a common occurrence in childhood, and if not severe can usually be treated at home.

Treatment

Clean all sores immediately with running water to remove dirt. Clean the surrounding skin with clean gauze or a handtowel soaked in water. Do not use cotton wool as this can leave fibres in the wound. Always wipe away from the wound — never wipe from the surrounding skin towards the wound. Use a diluted antiseptic solution to clean the sore — this will sting, but you need to persist with its use in order to prevent infection. Then cover the sore with a sterile, non-stick dressing. If the wound is bleeding, apply firm pressure for 10 minutes.

When to see your doctor

• if the abrasion is deep and does not stop bleeding despite firm pressure;

• if there is a lot of dirt, gravel, or pieces of wood, metal or glass in the abrasion;

• if it is a large abrasion with rough or jagged edges;

• if you are unsure whether your child is up to date with his tetanus immunisation.

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SENIOR CITIZEN SEX EDUCATION: THE MOST OFTEN ASKED SENIOR SEX QUESTIONS

    ”I notice that I don’t have as much of an erection as I used

to. Isn’t that just aging?”

The quality of erections changes throughout the life. Usually, good health, good exercise, good diet, low stress, no drugs or alcohol, and an interested and interesting partner are the best guarantee that you will have whatever genital reflex the body can have. Remember, though, the erection of the penis or clitoris is not necessary for a fulfilling sex life. It is not the measure of enjoyment, only blood flow. That changes through life, so erections change.

    ”Same thing for men? Can we keep it going?”

Absolutely. There may be less ejaculate, less pressure at ejaculation, different contraction sensations, less frequent and less firm erections, but psychasms and orgasms continue. All health habits should continue through life, and that includes sex. Not only does aging not stop sex or sex interest and arousal, but some of the changes that come with aging can be slowed by remaining sexually active, either alone or with a partner.

    ”Doesn’t a woman lose her ability, though? She gets old

down there.”

We get old everywhere. A woman might notice less lubrication in her vagina and some pain when stimulated genitally, so adding lubrication can help. The ability to have orgasm and certainly psychasm is not affected. Some of the genital reflexes and the contraction of the muscles in the pelvic area might feel differently than years ago, but different doesn’t mean less. It is just plain myth and ageist attitudes that view sex as decreasing with the aging process.

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YOUR MARITAL HEALTH/WIVES’ SEXUALITY: TYPES OF “SEXUAL” WIFE

I offered twelve types of husbands derived from the interviews. These were provided for discussion and for the fun of reviewing stereotypes that can emerge from a limited view of sex. Compare these twelve wife categories with the twelve husband categories. As I suggested in super marital sex opportunity number six, try to “match them up,” try to see those times when you and your spouse might have been acting out roles assigned by “sexpec-tations” rather than enjoying the opportunity for “sharegasms.”

1. The Helpee

I know that if I’m happy, he’s happy. God knows, I try to be happy. I try to respond in the way he wants, but I have to work on my groans a little more.

WIFE

This is the wife who feels that her role is to be the responder, to react in the sex-manual-predicted ways to the husband’s sexual ministrations. It seems from my work with couples that ministration is far more dangerous to sexual fulfillment than masturbation. She feels that her sexual response is a measure of her husband’s effectiveness rather than her own self-representation.

V

2.    The Hounded

I love to hug and hug him hard, but when I do, he always gets harder than my hug. If I don’t want sex, I just don’t hug.

WIFE

This is the wife who feels that any sign of tenderness may be the overture to sex rather than an expression of love. Some wives felt that they had to monitor their expressions of feelings and touching for fear they would set off a chain reaction.

3.    The Faker

I’ve never had an orgasm, but I’ll bet I fake it better than it actually is. It could never be as good as I make it look.

WIFE

-This is the wife who has learned to pretend. Feeling that her husband will not be fulfilled until she is fulfilled, she has learned to act rather than experience, to try rather than be. While there is nothing wrong with a little drama and acting in sexual encounters, faking it to “get it done” ultimately destroys any hope of intimate sexual communication.

4.    The Hurrier

Someday, someday, I hope we can really take some time with this. I can get off quick, but it seems that I am trying to get off more than trying to enjoy us making love.

WIFE

This wife who is capable of extensive and fulfilling sexual response but rushes herself for the sake of time. She may feel that her husband is tiring, is struggling to control his ejaculation, which he has defined as his orgasm, or is becoming bored or anxious to get on with it. As a result she pushes herself to early and abbreviated sexual response.

5.    The Piece

I feel like a piece of ass, just a piece. It’s funny how men are hunks, large hunks, and we are pieces, small pieces. We are diminished even in size.

WIFE

This wife feels that her husband is making love to someone, but not necessarily her. She feels that she represents “a woman” more than her “self.” She does not feel valued as a person but needed as a sexual outlet.

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THE DESEXUALIZATION OF THE AMERICAN MARRIAGE/WAY TO LEAVE YOUR LOVING: “IF THIS IS SATURDAY, WE’LL PROBABLY DO IT” – DOCTOR’S PRACTISE

One of the husbands in my sample complained in a therapy session, “She just got heavy. Same old person, only a heavier version. How can I get turned on by her?”

When I responded that he was responsible for his own arousal, not merely reactive to a body image, he became angry. “Why do I need a partner, then? I can just get myself turned on.”

“It’s a system,” I responded. “You affect her, she affects you, and so it goes. You broke the chain when you declared her the sole source of your sexual feelings. Instead of asking why she is heavier, you might ask yourself about the qualities that lead to your arousal. Are you still able to see the whole, the total person? Do you want her thinner for you, for her, or for the two of you? Are you with her in this struggle of weight, or just an appraiser of final outcome? Are you aware of her or just her body?”

“You mean like my feelings that she is the mother of my children, the person who helped me through my heart attack, the person who tolerates my immaturity, and stuff like that? Okay … but that’s not sex,” he responded, “I mean it is not really sexual or a turn-on or anything.”

This husband is mistaken. Change and adaptation in marriage hinge on broadening our reactions to one another, not depending on predetermined, culturally determined standards. The stimulation comes from within the system, not from skin and bones and their respective arrangement. The question is, Does your relationship turn you on, not does someone or something turn you on. This emphasis equalizes responsibility for arousal.

If we cling to a search for newness, uniqueness, compliance by our partner to ever-changing external cultural standards of “sexiness,” we miss one of the greatest opportunities that marriage provides: the familiarity of communication on levels beyond the see-and-touch world.

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OSTEOPOROSIS – HORMONES

With the onset of the menopause, there is a reduction in the amount of circulating oestrogen, the main female hormone. It is this lack of oestrogen which is responsible for the symptoms associated with the menopause, such as hot flushes and drying up of the normal vaginal secretions.

Giving oestrogen supplements to women at the menopause may reduce these symptoms and may prevent the development of osteoporosis.

Osteoporosis may occur as a secondary problem due to some other disorder. There are four parathyroid glands and they lie half-buried in and behind the thyroid gland in the neck. They are concerned with the calcium metabolism of the body.

Over-activity of these glands, particularly due to the development of a tumor in them, can lead to an excess loss of calcium from the body through the kidneys.

This can result in the development of kidney stones and to osteoporosis. Other endocrine gland disturbances involving the thyroid or the adrenal glands may also lead to osteoporosis.

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COLLAGEN DISEASES – PROGRESSIVE SYSTEMIC SCLEROSIS

Scleroderma or Progressive Systemic Sclerosis is another of the collagen diseases. It is characterised by an increase in the collagen fibres of connective tissue which leads to obliteration of small arteries.

It usually starts in the skin but may later spread to other organs. The digestive tract, the lungs, the kidneys and the heart may all be involved.

The cause of this disorder, like SLE, is thought to be an auto-immune disease. Occasionally it may have an acute onset with rapid progression to an early death, but, more commonly, it is a slowly progressive disorder.

Involvement of the peripheral arteries may lead to the condition known as Raynaud’s Phenomenon, where the hands and feet become cold and blue and over-sensitive to cold.

When the gullet or oesophagus is involved, the scarring causes obstruction and difficulty in swallowing.

Treatment is unsatisfactory and cortisone is of little benefit.

Polyarteritis Nodosa differs from the other collagen diseases in that it is rare and affects males three times as commonly as females. It may occur at any age.

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