604 IX. CAROTENOIDS AND VITAMINS A 



spond to vitamin A therapy. Papular lesions resembling those found in 

 follicular hy]3erkeratosis were also demonstrated in the case of twenty-four 

 out of thirty-one subjects who voluntarily partook of a partial starvation 

 diet containing 1810 I.U. of carotene. ^''^- 



There has sometimes been a lack of definite correlation between the inci- 

 dence of skin lesions and of other evidence of vitamin A deficiency in chil- 

 dren and adults. ^°^^~*°''^ However, Nicholls^"^^'^"^* attributed bhndness in 

 children in Ceylon to corneal xerophthalmia and keratomalacia due to 

 vitamin A deficiency, and LoewenthaP''^* suggested a causal connection 

 between phrynoderma and this deficiency. Pal^*^" and Ramahngas- 

 wami^"^^ reported a high incidence of Bitot's spots, keratomalacia, and 

 severe diarrhea, associated with a dry, inelastic skin, in children in Coon- 

 oor. South India. Marmelzat^"^^ also recorded the case of a ten-year-old 

 white girl in Gah'eston, Texas, in whose case Bitot's spots, typical follicu- 

 lar hyperkeratotic lesions, and metabolic calcinosis in both kidneys Avere 

 observed simultaneously. Medication with 25,000 I.U. of vitamin A daily 

 cleared up the Bitot's spots in twenty-four days, while most of the hyper- 

 keratosis had disappeared within two months. For a further discussion of 

 this subject, the reader is referred to the review of Mason. ^"^^ 



11. Hypervitaminosis A 



(1) Introduction 



Within the last few years it has been recognized that the ingestion of ex- 

 cessive amounts of vitamin A results in the appearance of toxic symptoms. 

 If the abnormal doses of vitamin A are continued, the animals subjected 

 to them may die. It has long been known that the ingestion of polar bear 

 liver by Eskimos and by Arctic travelers will bring on severe illness in 

 man as well as in dogs. It is also claimed that the hver of the bearded seal 

 {Phoca harhata) is poisonous, although opinions on this point are not 

 unanimous. According to Richardson,"^ as early as 1596 members of an 



1092 A. Keys, J. Brozek, A. Henschel, O. IMickelsen, and H. L. Taylor, The Biology of 

 Human Starvation, Vols. I and II, Univ. Minnesota Press, Minneapolis, 1950. 



'093 L. Nieholls, Indian Med. Gaz., 69, 241-251 (1934); 70, 14-16, 550-552 (1935). 



1094 L. J. A. Loewenthal, Ann. Trop. Med. Parasitol., 29, 349-360, 407-413 (1935). 



1095 w. R. Aykroyd and K. Rajagopal, Indian J. Med. Research, 24, 419-437 (1936). 



1096 w. R. Aykroyd and B. G. Krishnan, Indian J. Med. Research, 24, 707-725 (1937). 

 >o9v D. Pal, Indian J. Pediat., 16, 1-5 (1949). 



1098 V. Ramalingaswami, Indian J. Med. Sci., 2, 665-674 (1948). 

 '099 W. L. Marmelzat, Arch. Dermatol, and Sijphilol, 63, 759-763 (1951). 

 1100 J. Richardson, Polar Regions, A. and B. Black, Edinburgh, 1861, p. 71; cited 

 by K. Rodahl and T. Moore, Biochem. J., 37, 166-168 (1943), p. 166. 



