Avitaminoses or the Diseases that Result from Vitamin Deficiencies : Part 1

The Vitamine Manual
by Walter H. Eddy

(Page 7 of 8)

A survey of the vitamins would be incomplete without a discussion of the vitamin deficiency diseases in particular, though many of the facts already cited obviously bear on the treatment and prevention of such diseases.

The idea of "avitaminoses" or vitamin deficiency as the cause of a disease of a specific nature was set forth in detail by Funk in his book Die Vitamin. In his discussion of this view he suggests several types that would, he felt, on examination prove to be due to the absence of a vitamin in the diet. Of these predicted types beri-beri was the only one to be established in 1913. Scurvy has now been added to the fold and rickets or rachitis seems well on the way to acceptance though the specific vitamin absent in this case is not yet positively identified. Pellagra still resists the efforts of the vitamin hypothesis to bend it to that theory and its etiology is still obscure.

I. Beri-Beri

This disease while specifically confined to the oriental in the mind of the student can be justly considered of much wider distribution for the mild forms of malnutrition associated with a deficiency in the "B" vitamin are less acute manifestations of this disease. The disease is not likely to become marked in well nourished districts in its acute form, but in famine districts its incidence is always possible. It would be more than possible were it not for the fact that famine tends to eliminate the highly milled cereals and throw the people back on to the whole grain, peas and beans, which are rich in the preventive factor. But when for any reason diets become limited extra attention is demanded in regard to their selection and preparation. The main characteristics of this disease have already been fully covered in what precedes and need not be repeated here.

II. Scurvy

This disease, like beri-beri has already been fully discussed in what precedes. One of the striking discoveries of this subject has been the retreat from favor of the time-honored lime juice which is now found to be much less potent than oranges, lemons, or even canned tomato juice and which on preservation loses practically all its potency. In the modern hospital, cases of scurvy rarely appear outside of occasional infant cases and it might appear that the problem of scurvy prevention is peculiarly that of the sailor, the explorer and the army rationer. Nevertheless an insufficient supply of the "C" vitamin may retard growth and well being in the individual without manifesting itself in its more acute form of scurvy. In a recent review Hess states: "It is hardly an exaggeration to state that in the temperate zones the development or non-development of scurvy depends largely on the potato crop." "This is attributed in part to the fact that the potato is an excellent antiscorbutic, but to a greater extent because it is consumed during the winter in amounts that exceed the combined total of all other vegetables."

To the public and to the food purveyor there is a definite problem in how to best supply the preventive and how best to concentrate and preserve the sources of this vitamin without injury to its potency. The following observation is therefore appended as bearing on this point. In the absence of fruits or other high potency sources it is possible to develop this factor in cereal grains by the simple expediency of sprouting. If seeds are soaked in water for twenty-four hours and then kept moist for from one to three days with the free access of air, sprouts will develop whose content of the antiscorbutic vitamin is comparable to that of many fresh vegetables, even though the dry seeds themselves have little of this factor. In other words the germination process is a synthesiser of the vitamin.

This observation may be of value where fruits and vegetables are scarce or expensive. On account of cooking effects, it cannot be too often reiterated that raw fruits, vegetables and salads, are of more value than cooked forms of these same sources and that drying processes are extremely destructive where heat enters into the drying process. Vacuum drying seems to be much less destructive and it may be possible to develop the drying of vegetables to a point where retention of this vitamin factor is practical. At present all dried vegetables should be regarded with suspicion as a source of vitamin "C." Expressed juices may often be used where the whole vegetable is scarce or incompatible and this fact is one to be borne in mind by the worker in famine districts.

III. Rachitis (Rickets)

This disease is engaging the attention of many workers on both sides of the Atlantic at the present time. In England the principal contributor is Dr. Mellanby, who has accumulated evidence which he believes indicates that the preventive factor is the A vitamin. This view is not yet accepted as conclusive by the American workers. McCollum, Howland, Park, and others at Johns Hopkins University have experimented with various rickets-producing diets and while the principal deficiency in these diets seems to be Ca salts and the A vitamin they do not consider that the disease can as yet be traced to deficiency in any one factor. Hess has called attention to several new features and the significance of some older measures. He has shown on the one hand that cod-liver oil is almost a specific remedy for the disease but that this remedy is not replaceable by other rich sources of the A vitamin.