IX. EFFECTS OF DEFICIENCY 183 



lesions of tlic oral nuicous membriiiies often become infected with Slrcp- 

 (ococci, A'^hiplii/lococci, or the flora of Vincent's anjj;ina. Tn monkeys on normal 

 diets these l(>sions do not occur spontaneously, and where accidental trauma 

 of the gum or buccal mucosa docs occur no secondary infection appears. 

 This illustrates the increased susceptibility of the monkey to bacterial in- 

 fection during a deficiency of PGA. 



c. Diarrhea and Susceptibility to Bacillarij Dysentery 



Diarrhea is one of the most frequent and striking characteristics of the 

 vitamin M deficiency syndrome. The stools become watery in a short time, 

 and in some cases blood and mucus appear. Administration of PGA has a 

 rapid and dramatic effect. In a few days formed stools appear which almost 

 suggest that this vitamin has an effect on water balance in the intestine. 

 The diarrhea in the monkey and the marked effect of PGA are very similar 

 to that observed in sprue in clinical patients. When blood and mucus ap- 

 pear, the monkey becomes ill with the clinical symptoms of bacillary dysen- 

 tery. Stool cultures usually reveal the presence of Shigella type of organism. 



Janota and Dack^^ demonstrated convincingly the relation between vita- 

 min AI deficiency and dysentery in the monkey. They found that monkeys 

 which have been kept in the laboratory on a stock diet do not develop bacil- 

 lary dysentery, even though animals are received \Wth the disease from the 

 dealers. If the resistance of the animal is lowered by vitamin M deficiency, 

 some of the animals develop bacillary dysentery. This suggests that Bad. 

 dysenteriae (Flexner) may live in a saprophytic existence in the intestine. 

 ''The fact that control monkeys do not develop dysentery when kept in 

 the same room with animals on a vitamin M-deficient diet indicates that 

 the disease occurs as a result of lowered resistance due to vitamin deficiency 

 and not to contact infection." These workers also found "that monkeys 

 deficient in vitamins C, A and D in addition to vitamin ]\I did not show 

 any increased incidence of lesions of the mouth or bowel over those monkeys 

 deficient in vitamin M alone." 



Day,^- in his excellent review of this subject, reported that the feeding 

 of large numbers of living dysentery bacilli to a monkey receiving a normal 

 diet (a vitamin M-deficient diet supplemented with liver extract) did not 

 produce diarrhea, clinical dysentery, or any changes in the blood picture. 

 A year later this monkey was made deficient in vitamin ]\I and spontane- 

 ously developed an acute clinical dysentery and died. 



Saslaw et al.^'^ found that monkeys on a vitamin M-deficient diet mani- 

 fested a "markedly lowered clinical resistance to spontaneous infections 

 with high mortality. The susceptibihty to experimental infections with 



" M. Janota and G. M. Dack, ./. Infectious Diseases 65, 219 (1939). 



