The information obtained from observations of human experience with inadequate war diet during the recent world conflict, together with extensive laboratory research, has clearly brought to view the existence of a third dietary essential, the “antiscorbutic,” meaning that which counteracts scurvy. It has served to emphasize the fact that scurvy in the guinea pig, that in the monkey, and that in man are alike occasioned by the lack of some specific substance in the diet which is not stable to heat.
Scurvy, often manifested in degenerative tooth changes, such as severe cases of looseness and finally falling out of the teeth, and soreness and bleeding of the gums (Osier), is one of the oldest of known diseases. It is usually associated in the mind with sailors’ on long voyages, living on salt meat and hard-tack. In years past, in times of war, not infrequently an army suffered a greater total of casualties from scurvy than from bullets.
When the situation in Europe during the recent war became such that in some localities both troops and civilians were compelled to subsist on unsuitable food, scurvy made its unwelcome appearance. This was not attributable to an insufficient supply of energizing substances, nor to a lack of foods containing a proper supply of protein constituents, but on the contrary, it was a forceful demonstration of the fact that in the midst of plenty, the nutrition of foods may be dangerously defective. It further demonstrated that while the caloric value of foods may rightly claim recognition, it avails nothing without the cooperation of accessory substances.
By the authorities of the American Medical Association,12 we are informed that definite symptoms, resembling in several details those found in infantile scorbutus, were induced in guinea pigs by dietary deficiencies. Perhaps the most striking fact brought forth is the predisposing effect of an exclusive cereal diet, and the curative and antiscorbutic potency of fresh fruits and vegetables. Another fact discussed is the loss of this valuable property through certain methods of cooking and preservation, notably heat and desiccation (drying). We are told that in campaigns in Mesopotamia, the British forces in some places were afflicted with scurvy as the result of a constant and exclusive use of dried foods.
In a memorandum on food and scurvy, issued by the “Food [war] Committee of the Royal Society, London, England, we are informed that through the investigations carried on, especially at the Lister Institute, as to the cause of scurvy, nothing new had been found, save evidence of the presence, in many foods, of a certain basic substance, the exact nature and composition of which remain obscure, but whose benign influence is indubitable.
This authority puts forth the assertion that scurvy, like beriberi, is a deficiency disease, and is traceable to a long continued consumption of foods lacking in accessory food substance, or vitamine. This antiscorbutic vitamine (water-soluble C) is contained in fresh foods in largest amounts in oranges, lemons, and fresh vegetables; in considerable amounts in roots and tubers (potato, etc.) ; also in small quantities in milk and fresh meat but is very deficient in dried and preserved foods. The further statement is made that water-soluble C vitamine is destroyed by prolonged boiling; also that soda rapidly destroys the antiscorbutic properties of food, hence should not be added to the water in which vegetables are either soaked or boiled.
It is shown that beans, peas, and lentils in their dried condition possess no antiscorbutic properties. If, however, the dried seeds are soaked in water at room temperature for twenty-four hours, then drained and kept moist in thin layers until they germinate (about forty eight hours more), they develop antiscorbutic vitamine, water soluble C. It states further that the antiscorbutic value of fresh meat is very low in comparison with that of fresh vegetables, and that tinned and preserved meat possesses no anti-scorbutic value.
Water-soluble C is very sensitive to heat or drying, although its keeping qualities seem to be much improved by the presence of an acid. Cabbage eaten in the raw state contains active antiscorbutic properties ; but when it is dried or boiled, its antiscorbutic properties are practically null. Most of the neutral vegetables, as peas, corn, etc., lose their antiscorbutic properties in the process of canning and drying.
On the other hand, in the case of tomato and orange, which are acid, the effect of boiling or drying is not nearly so pronounced, as a great deal of the antiscorbutic vitamine is preserved in canned tomato, also in dried tomato and orange. Canned tomato therefore constitutes one of the most useful accessories for the long winter months, when, in many places, canned goods are largely used, likewise for sailors on long voyages, and for armies in the field. An editorial in the Journal of the American Medical Association, under the heading, “Orange Juice Considered in a New Light,” says on this point :
“It is recognized by pediatricians that artificially fed infants thrive better if they receive some addition to cow’s milk, particularly when the latter is Pasteurized or sterilized. One reason for this, now understood, is that many of the artificial food mixtures are likely to be qualitatively incapable of averting scurvy in young children, so that some added antiscorbutic must be provided. For this purpose orange juice has attained a well deserved popularity.
“Owing to the price and occasional scarcity of oranges, notably during the war, special efforts were made, both here and abroad, to secure suitable substitute antiscorbutics for infant feeding. The use of tomato, first urged by A. F. Hess, of New York, has been particularly promising, owing to the fact that, in contrast with some other antiscorbutics, this readily available vegetable can be dried or canned without losing its potency in antiscorbutic vitamines, and it can be administered in various ways, including intravenous injection of the juice.” June 19, 1920.
As to the best ways of cooking fresh vegetables, with regard to preserving the water-soluble C properties, we quote from the Lancet, London, as follows:
“The destruction of the antiscorbutic properties depends rather upon the time than the température employed. All foods, especially vegetables, should be cooked for as short time as possible, at boiling point. Slow methods of cooking, such as stewing with meat or simmering below the boiling point, should be avoided. Potatoes should be plunged into boiling water, and the boiling continued for twenty to thirty minutes after the boiling point has again been reached.” November 3o, 1918.
As throwing further light on the destructive effects of soda on vitamines, we refer to the experiments of Miller,” who states that the cooking of navy beans in 0.5% sodium bicarbonate (soda) solution for one hour and ten minutes caused a loss of 37.4% of vitamine.
To the common use of “soda biscuit” and of corn bread raised with soda, throughout the Southern States, is largely attributed the prevalence of pellagra and other deficiency diseases, due largely to a lack of a proper supply of food accessories, the vitamines.
When fruits, salad plants, herbs, and fresh vegetables are described as antiscorbutic, the meaning is simply that they have the power of preventing those changes in the blood which produce scurvy. What they really do is to supply the blood with various salts and accessory substances which maintain the body fluids in their proper chemical condition, thus preventing tissue change and decay.