674 PANTOTHENIC ACID 



rarely encountered among the prisoners. Among prisoners of war it was 

 noted by physicians, who themselves were in prison camps and were able 

 to make observations at first hand, and among investigators, who had an 

 opportunity of studying the prisoners when they were released from the 

 camps, that many of the pathological lesions present did not respond to 

 specific fractions of the B complex, such as thiamine, riboflavin, or nico- 

 tinic acid, but did respond to dried brewers' yeast or to liver extract. The 

 lesions that did not respond to specific fractions of the B complex were in 

 some instances suggestive of pantothenic acid deficiency in experimental 

 animals, and it is these findings that will be discussed. 



(1) Ocular Changes. Among prisoners of war visual disturbances ranging 

 from complete blindness to just blurring of vision were reported by many 

 investigators. Pallor of the optic discs and central scotoma were also ob- 

 served. ^^^ Improvement did not occur on high vitamin diets. The fact that 

 there was no improvement with therapy may well have been due to the 

 fact that the visual symptoms had developed two to three years prior to 

 any therapy. Scott^" reported that in some of the British West Indies islands 

 the eye changes were associated with itching and burning of the eyes and 

 inflammatory lesions in the mouth and fissures. Pallor of the optic disc 

 was noted in children in Kingston, and treatment with brewers' yeast and 

 cod liver oil improved the visual disturbances, but not if the disease had 

 existed for some time.^^^- ^^^ Bell and O'Neill^'*'^ observed 95 cases of partial 

 optic atrophy from malnutrition occurring in liberated prisoners of war from 

 Hong Kong, which was an incidence of 20 %. The main findings were scoto- 

 mata and contraction of the peripheral visual fields. In discussing the oph- 

 thalmology, they felt that the lack of vitamin B and the hypoproteinemia 

 were factors and that, in addition, there was possibly a toxic factor. In- 

 vasion of the cornea was also noted by Kark.^"*^ Some observers felt that this 

 was due to riboflavin deficiency. 



The fact that many of the prisoners of war had had symptoms of beriberi 

 and pellagra, the fact that the response to these fractions of the B complex 

 were not uniformly satisfactory, and the fairly high incidence of eye lesions 

 obviously suggest that other factors were involved in the production of 

 these lesions. In view of the corneal vascularization that occurs in panto- 

 thenic acid deficiency in animals, and in view of the other eye lesions occur- 

 ring in animals, it seems reasonable to suggest that pantothenic acid may 



236 W. L. Roberts and T. H. Willcockson, Ajn. J. Ophthalmol. 30, 165 (1947). 

 2" H. H. Scott, Ann. Trop. Med. Parasitol. 12, 109 (1918). 



238 D. Whitebourne, Am. J. Ophthalmol. 30, 169 (1947). 



239 F. D. Carroll, Am. J. Ophthalmol. 30, 172 (1947). 



240 P. G. Bell and J. C. O'Neill, Can. Med. Assoc. J. 56, 475 (1947). 



2" R. Kark, H. F. Aiton, and E. D. Pease, Ann. Internal Med. 25, 266 (1946). 



