560 THE TOCOPHEROLS 



a type of myopathy occurring predominantly in women, but occasionally 

 in men, at the age of about 40 years or thereafter, and thought to be a 

 close counterpart of the dystrophy in vitamin E-deficient animals; others 

 classify this condition as myositis.^^* Both diseases are said to respond also 

 to cortisone therapy.-^ The observations-^ regarding dermatomyositis are 

 in accord with the favorable response to wheat germ oil reported previously 

 by Milhorat et al}^^ There is still a question whether wheat germ products 

 possess effective substances apart from tocopherols. It has been suggested^'^'' 

 that one such substance, inositol, can interact with tocopherol in the gastro- 

 intestinal tract to form a condensation product which diminishes the 

 creatinuria of progressive muscular dystrophy; conceivably, a metabolic 

 mechanism of this type could be defective or absent in patients with dys- 

 trophy. 



On the basis of different patterns of inheritance, Tyler and Stevens^^^ • -^^ 

 are of the opinion that most cases of progressive muscular dystrophy can 

 be grouped under two major headings: the childhood type, occurring only 

 in males and inherited as a sex-linked recessive, and the fascioscapulo- 

 humeral type, occurring in both sexes and inherited as a Mendelian domi- 

 nant. It is as yet impossible to say whether the same or different metabolic 

 defects of metabolism are involved, or the extent to which the metabolic 

 defect in each case may eventually be related to oxidation or other conver- 

 sion products of tocopherol. 



d. Disorders of Reproduction 



The discovery of vitamxin E and the long-established method for its bio- 

 assay are based upon the phenomenon of fetal resorption in the rat. It is 

 not surprising that over the past twenty-five years there have appeared 

 numerous clinical reports on the therapeutic use of vitamin E in habitual 

 abortion, threatened abortion, threatened miscarriage, premature labor, 

 and eclamptic states. The results are conflicting and confused by differ- 

 ences in definition, vitamin E dosage, and extent to which other therapeutic 

 measures are employed and often not recorded. As is so often the case with 

 unestablished therapeutic agents, favorable reports considerably exceed 

 those which relay negative findings. 



(1) Habitual Abortion. An habitual aborter is usually defined as one who 

 has spontaneously aborted before the 16th week during three successive 

 pregnancies. It is estimated that 4 % of all spontaneous abortions are ha- 



228 D. Denny-Brown, Can. Med. Assoc. J. 67, 1 (1952). 



"9 A. T. Milhorat, F. C. Weber, and V. Toscani, Proc. Soc. Exptl. Biol. Med. 43, 470 



(1940). 

 "» A, T. Milhorat and W. E. Bartels, Science 101, 93 (1945). 



2" F. H. Tyler and F. E. Stevens, Ann. Internal Med. 32, 640 (1950); 35, 169 (1951). 

 "2 F. E. Stevens and F. H. Tyler, Am. J. Human Genetics 3, HI (1951). 



