B VITAMIN DEFICIENCY STATES 



417 



the preparations used 128 (p. 295) . In this regard, however, there is good 

 evidence to indicate that folic acid increases cholinesterase formation in 

 the body, and folic acid is apparently quite effective in counteracting the 

 hyperchromic anemia produced by choline injection. It therefore seems 

 well to reserve judgment in this regard until the functions of folic acid 

 in neural physiology are more clearly elucidated. 129, 13 ° Recent indications 

 are that vitamin B i2 does improve the neurological status of at least most 

 patients with subacute combined degeneration of the spinal cord. 131 * 132 



THYMINE 



10,000,000 M9 .*& % 

 bm mouth 



. 1 1 1 1 1 1 1 1 1 1 1 1 



FOUCACIO 



10,000 a* doily 



by mouth 



ZS*. 



""■"■""" 



1 1 1 1 1 1 1 1 ii i ii 1 1 



I" 



3 io 



S 8 



6 

 5 



Figure 19. Hematological response in a case of tropical sprue. 



* 



The achlorhydria of pernicious anemia does not respond to treatment by 



any known means. 



Sprue is a clinical condition that has been well recognized for some two 

 centuries and is characterized by a macrocytic anemia with moderate 

 leucopenia and bone marrow hyperplasia, steatorrhea 133 (high fat in the 

 feces), glossitis, diarrhea, skin pigmentation, loss of body weight, and 

 impaired absorption from the gastrointestinal tract. It differs from para- 

 sprue, which is more basically a niacin deficiency and in which the 

 diarrhea is of the nonfatty type. 88 It is generally felt to be a deficiency 

 disease resulting from impaired absorption of the antipernicious anemia 



VITAMIN B n 

 ,23/ia.l.M. 



