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[坏血病——一种如今已被遗忘的曾经广泛传播的疾病]

[Scurvy-A now forgotten previously widespread disease].

作者信息

Flamm Heinz

机构信息

Medizinische Universität Wien, Martinstraße 7, 3400, Klosterneuburg, Österreich.

出版信息

Wien Med Wochenschr. 2025 Mar;175(3-4):75-97. doi: 10.1007/s10354-024-01054-8. Epub 2024 Oct 16.

Abstract

From the sea voyages of the fifteenth century often lasting for years with provisions only of fish, salted meat and biscuits reports came of fatal health alterations of the seamen which were characterized by prostration, loss of teeth and bad breath.Reports on comparable endemic illnesses soon came from the Netherlands, North Germany, the Baltic area, France, Lorraine, Geneva, Bohemia, Moravia, Silesia, Swabia and Russia: the so-called land scurvy. The first medical specification was found in a letter from 1541 by Johann Echt to colleges in the area of Lower Germany, which was published four times. One of the first comprehensive considerations was prepared by the English physician James Lind. Scurvy was also mostly published under many local names, such as Skorbut, Scharbock or Scheurbuik.The pathology of scurvy is dominated by gingival necrosis with loss of teeth, hemorrhages with destruction of the cartilage-bone border especially of the ribs and by subperiosteal hemorrhages of the ribs and long bones.For treatment and prevention of scurvy eating green plants as originally Ficaria verna (lesser celandine, pilewort), Chelidonium majus (great celandine, nipplewort, tetterwort) and Cochlearia officinalis (scurvy grass) proved to be effective. Where green plants were missing decoctions of conifer needles and fresh animal innards were used. When the infantile disease originally named "acute rachitis" in England was diagnosed as scurvy (later Möller-Barlow disease) the treatment of cow's milk for baby food became of great interest.Finally, hexuronic acid, later called ascorbic acid or vitamin C, was found to be a drug that could easily dosed for curing and prevention of scurvy.

摘要

从15世纪那些往往持续数年、仅以鱼、腌肉和饼干为给养的海上航行中,传来了海员健康出现致命变化的报告,其特征为身体虚弱、牙齿脱落和口臭。不久之后,荷兰、北德、波罗的海地区、法国、洛林、日内瓦、波希米亚、摩拉维亚、西里西亚、施瓦本和俄罗斯也传来了类似地方病的报告:即所谓的陆地坏血病。1541年约翰·埃希特写给下德意志地区各学院的一封信中首次出现了医学上对坏血病的描述,该信被发表了四次。英国医生詹姆斯·林德撰写了最早的全面论述之一。坏血病也大多以许多当地名称发表,如Skorbut、Scharbock或Scheurbuik。坏血病的病理学特征主要是牙龈坏死伴牙齿脱落、出血伴软骨-骨边界尤其是肋骨处的破坏,以及肋骨和长骨的骨膜下出血。事实证明,食用绿色植物,如最初的小毛茛(小毛茛、碎米荠)、白屈菜(白屈菜、乳草、疥疮草)和药用辣根菜(辣根菜),对治疗和预防坏血病很有效。在没有绿色植物的地方,使用针叶树针剂和新鲜动物内脏熬的汤。当英国最初称为“急性佝偻病”的婴儿疾病被诊断为坏血病(后来的莫勒-巴洛病)时,用牛奶作为婴儿食品的治疗方法就变得备受关注。最后,发现己糖醛酸,后来称为抗坏血酸或维生素C,是一种易于给药以治疗和预防坏血病的药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff3f/11903575/ab57d7d15b3e/10354_2024_1054_Fig1_HTML.jpg

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