ABSTRACT
Bleeding gums, swollen discolored interdental papillae, bruises, large ecchymoses, subperiosteal hematomata, and painful swollen joints are the classical signs of naturally occurring human scurvy. Scurvy involves weakness of the basement membrane beneath the endothelial cells and also weakness of the perivascular sheath due to absence of mature collagen, and these changes are not produced by histamine intoxication. The histaminemia of scurvy causes widening of the gaps between the endothelial cells of the capillaries and venules, which is responsible for the increased "capillary permeability" which occurs both in inflammation and in scurvy. Depolymerization of the mucopolysaccharides of the basement membrane and weakening of the perivascular collagen seem to be the additional changes that lead to increased microvascular fragility and petechial hemorrhages in scurvy. It may be the ability of healthy persons to utilize reduced glutathione, corticosteroids, and other systems to keep ascorbic acid in the reduced form that protects them from scurvy even when their ascorbic acid levels are low.
