A. Winnifred Golley, R.N., superintendent of the Central Michigan Children's Clinic

Patient, age eight months, was admitted to the Central Michigan Children's Clinic on 3 4 39, with the chief complaint of sweating and coughing for past week. The mother states that the patient has been perspiring markedly since December and was irritable when handled. The patient had not been taking formula well, had been getting some cod liver oil of a preparation of bulk cod liver oil. Had not taken any orange juice the past month. On admission the patient appeared to be an average nourished, acutely ill, white child. Physical examination found that the mouth hygiene was poor, lips scaled and cracked. Chest revealed scorbutic notching, heart was rapid, the buttocks were excoriated [peeling]. Examination of the extremities were painful on motion of legs.

Treatment was commenced and the baby seemed content as long as permitted to lie quietly, and when handled cried a great deal. The patient expired ten hours after admission. Post mortem examination was performed and it was found that there were numerous petechiae in the serous surfaces of the body [i.e., broken capillaries beneath the membranes sheathing the internal organs], the ribs definitely hemorrhagic and typically scorbutic in character [i.e., affected by scurvy] from gross examination.

Final Diagnosis: Scurvy
Secondary: Anemia
Malnutrition
Impetigo

. . . From the final diagnosis we feel had it had care just a few days earlier, its life need not have been lost.

Source: A. Winnifred Golley, R.N., superintendent of the Central Michigan Children's Clinic, reporting on Case 1892, March 1939, in Joseph M. Hawes, Children Between the Wars, 108, 109