Scurvy Past And Present

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His color becomes sallow or muddy, an aspect difficult to describe, but one which is characteristic, and constitutes an im- portant danger signal to the eye of the experienced phy- sician. About the same time the patient loses his accus- tomed vigor, seemingly becomes indolent and complains of tiring quickly, and of breathlessness. He may ex- perience fleeting pains in the joints and limbs, especially in the legs, symptoms which are frequently attributed to rheumatism. At this early stage the a...ppetite may still 176 SYMPTOMATOLOGY AND DIAGNOSIS 177 be normal, there is usually no loss in weight, but merely a general malaise which is significant, although in no way distinctive. Very soon the gums become sore, bleed read- ily, and are found to be congested, spongy, and somewhat hemorrhagic at their edges. Absolute reliance must not, however, be placed on this sign for early diagnosis, as at times it does not appear until later. Careful examina- tion at this stage will disclose petechial spots on the body, more especially on the legs, at the site of the hair-follicles, or even larger ecchymoses, depending upon the hemor- rhagic tendency of the individual, his exposure to bruis- ing, the adequacy of his diet, and secondary infection.

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