758 XTI. VITAMINS K 



whifh was effective in curing vitamin K deficiency in bile-fistiila rats. Dam 

 ct al.^^ confirmed these results l)y demonstrating that a crude vitamin K 

 solution in desoxycholate cured vitamin K deficiency in chicks when given 

 subcutaneously; a water emulsion was also found to be effective when 

 administered })y the intramuscular route, but not when injected subcu- 

 taneously. 



Several observers^^-^''^'' have demonstrated that the administration of 

 bile to animals with ligated bile ducts results in an increased prothrombin 

 level in the blood, in spite of the fact that bile contains practically none of 

 this vitamin.^®'" The interpretation of the beneficial effect of bile under 

 these conditions has been that it assists in the absorption of the vitamin K 

 which has been newly-syiithesized hi the hitesthie, as well as of any vitamin 

 K in the food. 



The results of a deficiency of vitamin K in animals are mirrored by those 

 of lack of vitamin K in man. However, vitamin K deficiency does not 

 occur in man only when the vitamin is lacking in the diet, inasmuch as 

 adequate quantities are synthesized in the gut. On the other hand, when 

 the absorption of vitamin K is prevented by the absence of bile in the gas- 

 trointestinal tract, characteristic deficiency symptoms rapidly develop. 

 Thus Quick and co-workers^^ noted that subnormal prothrombin values 

 obtained in jaundice, while a immber of workers '^''^'^^ reported that the 

 hemorrhagic tendency in obstructive jaundice could be overcome when 

 vitamin K was administered with bile or with bile salts. Water-soluble 

 preparations of vitamin K can be absorbed in the absence of bile."'' 



Several factors other than bile may influence the absorption of vitamin 

 K. Thus, when mineral oil is fed, the appearance of vitamin K deficiency 

 is accelerated, in mice"' and in rats.'^-"-^ According to Javert and Macri,^* 



^* H. Dam, J. Glavind, L. Lewis, and E. Tage-Hansen, Skand. Arch. Physiol., 79, 

 121-133(1938). 



«* J. D. Greaves, Am.J. Phi/sioL, 12-5, 423-428 (1939). 



"« J. D. Greaves, Am. J. Phi/sioL, 125, 429-436 (1939). 



" H. J. Almquist, Science, 87, 538 (1938). 



«8 A. J. Quick, M. Stanlev-Brown, and F. W. Bancroft,, Am. J. Med. Sci., 190, 501-511 

 (1935). 



89 K. M. Brinkhous, H. P. Smith, and E. D. Warner, Am. J. Med. Sci., 196, 50-57 

 (1938). 



70 E. D. Warner and J. E. FIvnn, Proc. Soc. Exptl. Biol. Med., 44, 607-608 (19401 



" W. A. Barnes, Proc. Soc. Exptl. Biol. Med., 49, 15-19 (1942). 



" M. C. Elliott, B. Isaacs, and A. C. Ivy, Proc. Soc. Exptl. Biol. Med., 43, 240-245 

 (1940). 



" E. K. Bacon, S. Lassen, S. M. Greenberg, J. W. Mehl, and H. J. Deuel, Jr., /. 

 Nutrition, 47, 383-398 (1952). 



'* C. T. Javert and C. Macri, Am,. J. Ohstet. Gijn.ecol., 42, 409-414 (1941). 



