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Scurvy in pregnant and lactating women and infantsPregnant women with low vitamin C intakes are not known to give birth to a scorbutic infants.Studies of breast-feeding women also indicate not only the freedom from scurvy in their infants, but also a larger amount of vitamin C in their milk than the women themselves consume daily.Secretion into milk seems to have high priority in maternal vitamin C economy; concentrations up to 48 times higher than in maternal plasma have been found in breast milk (Salmenpera, 1984).Infants had plasma concentrations 6Ė12 times higher than corresponding maternal concentrations.There is an obvious adaptive preventive effect against vitamin C deficiency even among infants whose mothersí nutrition is marginal (Salmenpera, 1984). No symptoms of scurvy have been known to appear in infants breast-fed by malnourished mothers with very low concentrations of vitamin C in their milk (Deodhar et al., 1964).One study showed that the mean infant/maternal plasma concentration ratio was 2 during deliveryand appeared to be similar or higher during lactation (Salmenpera, 1984). Surprisingly, infantsí plasma concentration continued to rise despite the decreasing concentration of vitamin C in milk.This maintenance of high plasma concentration in infancy suggests that a high concentration is necessary during infant growth. The fetal brain is reported to contain a concentration of vitamin C several times higher than the adult brain (Adlard et al., 1974). A study undertaken by Rajalakshmi et al. (1965) showed that pregnant women in India who were ingesting less than 10 mg of vitamin C per day were in fact secreting 15Ė30 mg of the vitamin in their milk while showing no clinicalsigns of scurvy. These findings suggest that the human breast and placenta might be able to synthesize some vitamin C (Hodges, 1980).© World Health Organization, 1999http://whqlibdoc.who.int/hq/1999/WHO_NHD_99.11.pdf
The crucial experiment Lind performed in 1747 at sea on the Salisbury, was to take twelve seamen suffering from the same degree of scurvy and divide them into six groups of two each. In addition to their regular diet, he gave each group a different, commonly used treatment for scurvy and observed its action. One group received a quart of cider daily, the second group received twenty-five drops of dilute sulfuric acid three times a day, the third group was given two spoonfuls of vinegar three times a day, the fourth team drank half a pint of seawater three times a day, the fifth received a concoction of garlic, mustard seed, horseradish, gum myrrh, and balsam of Peru. The last group received two oranges and one lemon daily for six days. These last two men improved with such astonishing rapidity that they were used as nurses to care for the others. There was slight improvement in the cider group but no benefit was observed in the others. http://www.vitamincfoundation.org/stone/chap1-11.htm
One group received a quart (two pints) of cider daily
the second group received twenty-five drops of dilute sulfuric acid three times a day
the third group was given two spoonfuls of vinegar three times a day
"the fourth team drank half a pint of seawater three times a day
the fifth received a concoction of garlic, mustard seed, horseradish, gum myrrh, and balsam of Peru
The last group received two oranges and one lemon daily for six days.
Salisbury was still in that area on 20 May when Linds experiment began, eight weeks after leaving port. He picked twelve men for a six-way comparison of cider, elixir of vitriol, vinegar, sea water, oranges and lemons, and a purgative mixture. A tenth of the crew by now had scurvy, so he had 30 or 40 individuals to choose from. Yet the roll call shows at most one or two as sick during this entire voyage on which six men departed this life.http://www.jameslindlibrary.org/trial_records/17th_18th_Century/lind_biog/salisbury_commentary.html
To understand clinical trials, it may be helpful to review the very first one in medical history. The year was 1746, the investigator, Dr. James Lind, a British navy surgeon. In those days, scurvy was a common and serious problem for sailors on long sea voyages. Dr. Lind believed he could cure the disease with citrus fruits. To test his theory, he divided his sailors into six groups; one got a normal ships diet while the others received supplements of cider, sea water, vinegar, elixir of vitriol, or lemons and oranges.After several months at sea, Dr. Linds theory proved correct. The sailors who ate citrus fruit recovered; all the others remained ill with the abnormal bleeding and diseased gums, hair, and skin characteristic of scurvy. http://hmiworld.org/hmi/issues/May_June_2002/around_prostate.html
"Now we know that 50 percent of all deaths of young children in the world are due to malnutrition," Habicht says. "It's also because of illness, but if they were nourished, they would have survived. Looking at it that way makes a big difference in how you allocate resources."click here for the complete article: http://www.nutrition.cornell.edu/news/s00/habicht0500.html
One of the earliest outbreaks of scurvy at sea was sustained by the crew of Vasco da Gama during his 1497 expedition to India. Da Gama began his expedition from Lisbon on July 9, 1497, with a fleet of 4 ships and a crew of 140 men. It took them 6 months to round the Cape of Good Hope. By the time da Gama's crew landed on the southeast coast of Africa, most of them were afflicted with scurvy. Da Gama recorded: "Many of our men fell ill here, their feet and hands swelling, and their gums growing over their teeth so that they could not eat." As they sailed farther up the east coast of Africa, they met local traders, who traded them fresh oranges. Within 6 days of eating the oranges, da Gama's crew recovered fully and he noted, "It pleased God in his mercy that ... all our sick recovered their health for the air of the place is very good." http://pediatrics.aappublications.org/cgi/content/full/108/4/e76
From India, da Gama returned across the Arabian Sea. Within 12 weeks of sailing, his crew was again afflicted and weakened by scurvy. Da Gama commented: "We addressed vows and petitions to the Saints ... it pleased God in his mercy to send us a wind which in the course of six days, carried us within sight of land ... at this we rejoiced as ... we hoped to recover our health there as we had done before ... the Captain-Major sent a man on shore to bring off a supply of oranges which were much desired by our sick." Da Gama lost more than half of his crew by the end of his journey. His crew sustained scurvy when they had been at sea for 10 weeks or more. They recognized oranges to be an effective antiscorbutic by the second outbreak. The experience of da Gama in dealing with scurvy did not become common knowledge, and over the next several centuries, scurvy remained as the scourge of the sea explorers. http://pediatrics.aappublications.org/cgi/content/full/108/4/e76