vii. effects of deficiency 421 



2. Induction of Vitamin K Deficiency 

 a. Dietary Lack of Vitamin K 



It was first noted that on certain inadequate diets superficial and internal 

 bleeding developed in chicks.* The ability of dietary means alone to induce 

 a deficiency of vitamin K is almost exclusively an avian characteristic;^ but 

 in the rat/° rabbit," mouse/- and perhaps man'^ moderate hypoprothrombin- 

 emia may occasionally develop. The newborn of man/^' ^^ sheep, goat,^^ 

 and guinea pig"' are critically lacking in vitamin K, as shown by the fact 

 that small doses of this vitamin will correct the blood-clotting abnormality. 



The infant luidergoes a potentially serious blood-clotting change during 

 its first week of life; this can be corrected or prevented by administration 

 of vitamin K either to the baby or, shortly before the baby's birth, to the 

 mother. The cause of the vitamin K deficiency is not clear, but apparently 

 negligible amounts of the naphthociuinone have been stored by the infant 

 at the time of birth. Salomonsen'* suggested that there is probably some 

 storage during the summer months, since the incidence of actual bleeding is 

 less during the summer and fall than at other seasons. Waddell and Lawson^* 

 are in agreement, adding that the peak month for hypoprothrombinemia is 

 March, at which time there is the greatest incidence of deaths from birth 

 injuries. On the basis of a very limited observation Thordarson^^ was un- 

 able to find a seasonal trend in the prothrombin levels of infants. 



Just as the cause of the hypoprothrombinemia, or rather the neonatal 

 lack of stored vitamin K, is unexplained, there is little agreement on the 

 spontaneous recovery which most infants undergo by about the seventh 



8H. Dam, Biochem. Z. 215, 475 (1929); 220, 158 (1930); W. D. McFarlane, W. R. 



Graham, Jr., and G. E. Hall, /. Nutrition 4, 331 (1931); W. D. McFarlane, W. R. 



Graham, Jr., and F. Richardson, Biocfiem. J. 25, Part 1, 358 (1931); W. F. Hoist 



and E. R. Halbrook, Science [N. S.] 77, 354 (1933). An analysis of the distribution 



of hemorrhages in the chick has been made by S. Ansbacher, /. Nutrition 17, 303 



(1939). 

 ^ H. Dam, F. Sch0nheyder, and L. Lewis, Biochem. J. 31, Part 1, 22 (1937). 

 '0 H. Dam and J. Glavind, Z. Vitaminforscti. 9, 71 (1939). 

 " H. Dam and J. Glavind, Acta Med. Scand. 96, 108 (1938). 

 '2 R. Murphy, Science [N. S.] 89, 203 (1939). 

 13 R. Kark and E. L. Lozner, Lancet II, 1162 (1939); C. M. Thompson and D. J. 



Hilferty, Med. Clin. N. A7ner. 33, 1685, (1949). 

 '' K. M. Brinkhous, H. P. Smith, and E. D. Warner, Am. J. Med. Sci. 193, 475 (1937). 

 i»W. W. Waddell, Jr., D. Guerry, III, W. E. Bray, and O. R. Kelley, Proc. Soc. 



Exptl. Biol. Med. 40, 432 (1939). 

 1® A van Vyve, Ada Brcvia Neerl. Physiol. Pfianiiacol. Microbiol. 11, 101 (1941). 

 " F. Widenbauer and U. Krebs, Monatsschr. Kinderheilk-. 91, 223 (1942). 

 •8 W. W. Waddell, Jr., and G. McL. Lawson, J. Am. Med. Assoc. 115, 1416 (1940). 

 '9 0. Thordarson, Klin. Wochschr. 20, 645 (1941). 



