PATHOLOGICAL CONDITIONS DUE TO LACK OF VITAMINES 381 



A further field in which the vitamines may be of significance, is 

 the diet in various acute, and especially chronic infections. During 

 convalescence, after acute infections, the diet is of greatest impor- 

 tance. It happens occasionally that in all these conditions, quite 

 a one-sided diet is given for weeks at a time, for example, flour 

 preparations, because of which recovery is impeded, and the resis- 

 tance of the patients is further decreased. These conditions occur 

 especially after typhoid fever, as Morrison (1496) showed. The 

 question of the diet in typhoid was studied by Barker (1497), while 

 Coleman (1498) Walton (1499), Carter, Howe and Mason (1500) 

 laid emphasis on the caloric value of the diet in convalescence. 

 Coleman spoke of the necessity of a well-balanced diet, with which 

 he treated 222 patients, with the result that the mortality was 50 

 per cent less. Combe (1501) described the influence of the war 

 diet on the course and convalescence of typhoid in Germany. 



Isenschmid (I.e. 1447) believed that some edemas, which occur 

 after dysentery or other protracted diseases, are of dietary origin and 

 belong to the type of hunger edema. In all these cases, it is important 

 that the diet, even though small in quantity, in accord with the 

 appetite of the patient, must be complete in its composition. It is 

 not without reason that milk is so often used for the above purpose. 

 If the disease or convalescence is too long drawn out simultaneously 

 with an unsuitable diet, then it is possible for a real avitaminosis 

 to develop. 



OPHTHALMIA 



The disease, likewise called "xerophthalmia," seems to occur also 

 endemicalry. Thus, Hirdlika (1502) described a similar disease 

 among the Indians in the southwestern part of the United States, 

 while McCarrison (1503) stated that the disease occurs not infre- 

 quently in India, on a diet of rice and vegetable oils, and is curable 

 by cod liver oil. The disease consists in an infection of the con- 

 junctiva, which, under certain conditions, may lead to a destruction 

 of the cornea, falling of the lens and the iris, and total blindness. 

 Mori (1504) was one of the first to describe the condition somewhat 

 more in detail. An outbreak of this disease, called "hikan," which 

 developed at a time of partial famine, was mentioned by Mori, who 

 investigated 1400 cases in detail. It rarely occurred among fisher- 

 men, and could be cured with chicken liver. Czerny and Keller 



