(Page 8 of 8)

He has also recently shown that hygienic measures may have an influence. Schmorl showed that the disease was seasonal, a high rate maintaining in the winter months and a lower rate in the summer months. Hess has recently reported beneficial results from use of the ultra-violet rays which he uses as a substitute for sunlight. The results seem to confirm Schmorl's view that the sunlight of the summer months is a preventive factor. He has also suggested that the specific effect of the cod-liver oil might be due to a new vitamin, Vitamin D? On the other hand Zilva and Miura in England have recently shown that crude cod-liver oil is something like two hundred and fifty times as rich in vitamin A as butter fat, which tends to support the British view that the A vitamin is the antirachitic factor.

Sherman and Pappenheimer have recently shown that the phosphates exert a marked preventive effect on rickets and suggest that the utilization of the calcium by the individual may be determined in part by this factor.

The views in brief are now in an extremely chaotic state and it is impossible at present to determine whether rickets is a true avitaminose or a consequence of deficiency in a series of factors. It is however certain that the disease in its subacute forms is extremely wide-spread among infants and that its prevention can be most easily secured by the addition of cod-liver oil to the diet. In this procedure warning is necessary that the cod-liver oil be as pure a product of oil as possible, since the market preparations are often almost devoid of the true oil and hence of the curative agent.

IV. Pellagra

This disease has been the subject of exhaustive inquiry and study on this side of the Atlantic and the findings of the various investigating boards have added much to the prevention and cure of the scourge, but have failed as yet to agree on any one etiological factor. The best recent review of the current findings is to be found in an article by Voegtlin published as Reprint 597 of the Public Health Reports of the United States Public Health Service. His conclusions may be quoted in full as representing the latest summary of evidence now extant:

1. The hypothesis that there is a causal relation between pellagra and a restricted vegetable diet has been substantiated by direct proof to this effect and has led to results of considerable practical and scientific value.

2. The metabolism in pellagra shows certain definite changes from the normal, which point to decreased gastric secretion and increased intestinal putrefaction.

3. In the treatment and prevention of pellagra, diet is the essential factor. The disease can be prevented by an appropriate change in diet without changing other sanitary conditions.

4. A diet of the composition used by pellagrins prior to their attack by the disease leads to malnutrition and certain pathological changes in animals, resembling those found in pellagra. A typical pellagrous dermatitis has not been observed in animals. Pellagrous symptoms have been produced in man by the continued consumption of a restricted vegetable diet.

5. The nature of the dietary effect has not been discovered, although certain observations point to a combined deficiency in some of the recognized dietary factors as the cause of the pellagrous syndrome.

In elaborating on conclusion 5 Voegtlin states that:

The conception that pellagra is due to a dietary deficiency is, therefore, not contradicted by the available evidence. This does not imply that the disease is necessarily due to a deficiency of diet in a specific substance such as the hypothetical pellagra vitamin of Funk (1913). It is much more likely that the pellagrous syndrome is caused by a combination of the deficiencies in some of the well recognized food factors.

V. Other Avitaminoses

The role of the vitamin in the nutrition and growth of organisms other than the man is becoming a matter of interest in various ways. The construction of culture media for various strains of bacteria and the conditions favorable or unfavorable to their growth, are features of study in which the new hypothesis has demanded attention. It has already been claimed that vitamins are essential to the growth of the meningococcus, the influenza bacillus, the typhoid bacillus, the gonococcus, the pneumococcus Type I, Streptococcus hemolyticus, the diptheria bacillus, the Bacillus pertussis and certain soil organisms.

If these views are confirmed it becomes evident that the means for prevention of the development of these forms may lie in the control of the vitamin content of the materials on which these forms thrive and that in the study of these types it may be possible to speed up the incubation of strains and thus hasten diagnostic measures by introducing the necessary vitamins into the culture media. These observations merely suggest the possible widening of the scope of the vitamin study in the service of man and give added reason for our keeping pace with the strides made in this particular field.

Tags: Vitamins