V. SPECIFICITY OF ACTION 445 



B. HUMAN METABOLISM 



Early work on \i(ainin Hi- was prompted by a desire to liiid the anti- 

 pernicious anemia factor. Many fractions from liver were tested for activity 

 on addisonian pernicious anemia cases. The first successful use of crystalline 

 vitamin Bj2 in the treatment of this disease was reported by West in 1948." 

 Vitamin Bio seems to l)e effective for the relief of all symptoms of addisonian 

 pernicious anemia. Cases with pernicious anemia in relapse show a rapid 

 hematological response similar to that produced by liver extract with an 

 almost immediate increase in reticulocyte count and gradual rise in hemo- 

 globin and erythrocyte regeneration."'^^ Erythrocyte regeneration from 

 megaloblastic to noiTnoblastic types of cells may occur in 48 to 72 hours 

 when relatively large amounts of vitamin B12 are administered. ^^ Improve- 

 ment in strength, mental alertness, and appetite is characteristic, with 

 weight gams and disappearance of glossitis.^* Vitamin B12 appears to be 

 quite specific for relief of combined degeneration of the spinal cord and 

 involvement of the central nervous system which often accompany addi- 

 sonian pernicious anemia. ^^'^^ Lingual manifestations of pernicious anemia 

 appear to respond well to vitamin B12 therapy, ^^ 



Administration of \dtamin B12 to a series of twenty-five premature in- 

 fants did not effect l)etter growth as compared to a series of untreated 

 premature infants.-" In two cases of megaloblastic anemia of infancy, ad- 

 ministration of \'itamin B12 produced a hemopoietic response.^' 



Mtamin B12 is effective in a number of other hematological diseases 

 where anemia is a primary symptom. Nutritional macrocytic anemia,-- 

 tropicaP' and non-tropical sprue,-- and tropical macrocytic anemia'-* all 

 responded with prompt or striking clinical improvement when treatment 

 with vitamin B12 was initiated. 



A number of investigators have carried out clinical trials of the various 



" R. West, Science 107, 398 (1948). 



12 E. Jones, W. J. Darby, and J. R. Totter, Blood 4, 827 (1949). 



" B. E. Hall, and D. C. Campbell, Froc. Staff Meet. Mayo Clinic 23, 584 (1948). 



" B. E. Hall and D. C. Campbell, Pmc. Staff. Meet. Mayo Clinic 23, 591 (1948). 



1* B. E. Hall and D. C. Campbell, /. Lab. Clin. Med. 33, 1646 (1948). 



'* T. D. Spies, R. E. Stone, G. Garcia Lopez, F. Milanes, T. Aramburu, and R. Lopez 



Toca, Postgrad. Med. 4, 89 (1948). 

 " J. Kaufmann and A. Cooperberg, Can. Med. Assoc. J. 60, 552 (1949). 

 >« T. D. Spies, R. E. Stone, S. Kartus, and T. Aramburu, Southern Med. J. 41, 1030 



(1948). 



19 J. F. Schieve and R. W. Rundles, J. Lab. Clin. Med. 34, 439 (1949). 



20 D. F. Downing, Science 112, 181 (1950). 



21 A. Z. McPherson, U. Jonsson, and R. W. Rundles, ./. Pediut. 34, 529 (1949). 

 " T. D. Spies, R. E. Stone, and T. Aramburu, Southern Med. J. 41, 522 (1948). 



*' T. D. Spies, G. Garcia Lopez, F. Milanes, R. Lopez Toca, and B. Culver, Southern 



Med. J. 41, 523 (1948). 

 2^ J. C. Patel, Brit. Med. ./. 1948, 934. 



