VII. EFFECTS OF DEFICIENCY 501 



bilual, aiul lliat al)out 10% ol all prc^iiaiicics tcnniiiatc in ahorlioii, 

 amounting to 24(),()()() yearly in the United States.'-" Bacluiruch,'-" in u 

 statistical analysis of reported cases of hal)it.ual uhoition treated with 

 vitamin E up to 1940, felt that the chance of a successful piegnancy was 

 definitely increased by this therapeutic measure. Ilertij? and Livingstone-''^ 

 later state: "Vitamin E, judging from the literature, has an important effect 

 on the favorable outcome of pregnancy in cases of habitual abortion — this 

 in spite of the fact that the average human dietary cannot be shown to be 

 deficient in vitamin E." Only about 16% of habitual aborters show plasma 

 tocopherol levels below the average normal range, and these are effectively 

 raised to normal by as little as 25 mg. of a-tocopherol, daily.^*^ An 80% 

 salvage in 211 patients with from three to eleven previous abortions, by 

 correction of contributory conditions of varied type, has been reported by 

 Javert et alP'' The present status of the problem is well summarized in 

 their statement: "There is such a maze of literature that proper cognizance 

 cannot be taken of all the pertinent articles. As the reader reviews them 

 in order to develop his own philosophy, let him be reminded of three im- 

 portant matters : the high percentage of success irrespective of which vita- 

 min, hormone or method is employed; the lack of specific information as to 

 the pathogenesis of human spontaneous abortion ..." 



(2) Threatened Abortion and Miscarriage. Evan Shute, although dubious 

 about the merits of vitamin E in habitual abortion, has reported its thera- 

 peutic usefulness in threatened abortion and threatened miscarriage,-^^' -^^ 

 premature labor,^^'' abruptio placentae,-*^ and non-eclamptic late-tox- 

 emias of pregnancy,-'- and is of the opinion that tocopherol may in some 

 way counteract the effects of high blood estrogen rather than compensate 

 for a true avitaminosis E. Other clinicians have reported similar success 

 with tocopherol, frequently combined with progesterone therapy; the rea- 

 son that so much doubt still exists concerning these claims is due not so 

 much to other reports in the negative as it is to failure to, or inability to, 

 satisfactorily validate these clinical experiences by control data or by basic 

 information regarding the tocopherol status of the patients. The most 



2" C. Mazer and S. L. Israel, Diagnosis and Treatment of Menstrual Disorders and 

 Sterility, 3rd edition. Hoeber, New York, 1951. 



2" A. L. Bacharach, Brit. Med. J. I, 890 (1940); I, 567 (1948). 



"5 A. Hertig and R. A. Livingstone, New Engl. J. Med. 230, 707 (1944). 



"« E. Delfs and G. K. S. Jones, Obstet. Gynecol. Survci/ 3, OSO (1948). 



2" C. T. Javert, W. F. Finn, and H. J. Stander, Am. J. Oh.slct. Gynecol. 57, 878 (1949). 



238 E. Shute, Urol, and Cutaneous Rev. 47, 239 (1943). 



233 E. Shute and W. E. Shute, ./. Oljstet. Gynaecol. Brit. Empire 49, 534 (1942). 



2^0 E. Shute, Am. J. Obstet. Gynecol. 44, 271 (1942); ./. Obstet. Gynaecol. Brit. Em- 

 pire 52, 571 (1945). 



2" E. Shute, Surg. Gynecol. Obstet. 75, 515 (1942). 



2« E. Shute, Am. J. Surg. 71, 470 (1946). 



