Nutrition Classics. American Journal of Diseases of Children 8(6):399-405, 1914. Infantile scurvy: the blood, the blood vessels and the diet.

During the past three years we have had a considerable number of cases of scurvy develop in infants being fed on pasteurized milk. In 1912, when the first cases were noted, we were pasteurizing the milk in our own diet kitchen, heating it to a temperature of 165 F. for twenty minutes. At this time several cases of scurvy developed, owing to the fact that through an oversight orange-juice was not given. During the past year we have been supplied by one of the large dealers with a pasteurized milk that has been heated only to 145 F. for thirty minutes. Nevertheless, we had several cases of scurvy develop on this diet. In most of the cases the infant was receiving two-thirds milk and one-third barley-water, with the addition of sugar. In two instances, whole milk was being given without the addition of barley water. There were other patients in the same ward on the identical diet who did not develop scurvy. In other words, the pasteurized milk was not the sole factor in the production of the disease. That the pasteurization did play an important role, however, was shown by substituting raw, unheated milk for the pasteurized milk, the formula and the amount of food remaining unchanged. In this case the scorbutic symptoms began to disappear within a week of giving raw milk and had altogether vanished in two weeks. Whatever the predisposing factor of scurvy (this infant had exudative diathesis), a case with this clinical course can be interpreted only as being, in a large measure, the result of pasteurized milk. Raw cow's milk must not, on the other hand, be considered as having potent antiscorbutic properties. Its effect cannot be compared to the miraculous change which is brought about by giving orange-juice. This is especially striking when we take into consideration the small amount of orange-juice necessary to bring about a cure and compare it with the large amount of raw milk which is given. Raw milk, however, contains sufficient of the essential substances to prevent the development of scurvy.