EFFECT OF DEFICIENCY IN MAN 



oedema generally respond dramatically to vitamin B^, these being 

 assisted by the diuretic effect of the vitamin, which helps to remove 

 accimiiilated fluid from the tissues. 



Experimental Vitamin Bi Deficiency 



Perhaps the simplest picture of uncomplicated vitamin B^ de- 

 ficiency is obtained in experiments with human volunteers, though it 

 must be confessed that the results are not always as consistent or clear- 

 cut as might be desired, perhaps for reasons that will be referred to 

 later (see page 76). 



Jolliffe et al}'^ produced aneurine deficiency artificially in four out 

 of five subjects by maintenance on a diet low in vitamin Bj. Subjec- 

 tive symptoms were observed on the fourth day and objective signs 

 on the fifth. One subject, however, developed no symptoms or signs 

 after thirty days on a diet containing 60 % of his calculated aneurine 

 requirement. Addition of aneurine cured all the symptoms within 

 three days and the objective signs within five days. Between 7 and 

 25 % of the ingested aneurine was excreted in the urine. Urinary 

 excretion appeared to be well correlated with the aneurine intake 

 (see page 63), though the amount excreted varied from one individual 

 to another with the same intake. 



Oedema was reported by Elsom et al.'^^ to be an early symptom of 

 experimental human aneurine deficiency. The changes in carbo- 

 hydrate metabolism included failure of the blood-sugar to return to 

 normal within three to four hours of ingestion of glucose, and main- 

 tenance of a high pyruvic acid content in the blood. The blood lactic 

 acid also increased, the R.Q. was unaltered and the response to insulin 

 decreased as the deficiency progressed. The abnormalities disappeared 

 on administration of aneurine. 



A considerable number of experiments of this kind were carried 

 out over a number of years by R. D. Williams and his colleagues. ^^ 

 Anorexia, fatigue, loss of weight, absence of or low free gastric acidity, 

 constipation, tenderness of the muscles of the calves and abnormalities 

 in the electrocardiogram were more or less constant findings, but no 

 oedema, cardiac dilatation or peripheral pain, such as are encountered 

 in classical beriberi, were observed. Subjective symptoms were 

 usually experienced by the patients before objective signs became 

 manifest. The first of these signs, which appeared about the thirtieth 

 day with subjects maintained on a daily intake of 0-2 mg. (i.e. about 

 10 % of the normal intake) was a diminished aneurine excretion, and by 

 the fiftieth day the urinary excretion following administration of the 

 test dose was also reduced (see page 63). After this stage was reached 

 administration of glucose raised the blood-pyruvic and lactic acid 



59 



