516 ANNUAL REPORT SMITHSONIAN INSTITUTION, 19 38 



and crippling bone lesions returned to him constantly with recur- 

 rences and metastatic disseminations, despite the most careful applica- 

 tion of modern medical and surgical measures, he developed the cour- 

 age of his convictions. Soliciting the aid of David Miller and other 

 zoologists with an intimate knowledge of the life cycle of the maggot, 

 methods for the reproduction of fly larvae under sterile precautions 

 were developed. In the beginning, some enzyme or chemically active 

 secretion was hypothesized as the active principle ; and now allantoin 

 has been identified by the chemists as the effective substance and is 

 replacing the original less esthetic maggot treatment of Mother Nature 

 and the observant surgeon. 



Whipple, while studying the comparative value of different foods 

 in the regeneration of hemoglobin in dogs following hemorrhage, dis- 

 covered that liver was invariably most effective. Minot and Murphy, 

 knowing of these experiments, then, observed that liver fed in sufficient 

 quantities to human patients with pernicious anemia resulted in a 

 prompt and sustained remission. Chemists promptly fractionated 

 liver, and many other tissues, with the eventual isolation of the active 

 erythrocyte maturation principle in a purified and simplified solution 

 suitable for parenteral administration, thus saving the lives of many 

 sufferers from this disease who would rather have died than eat a 

 pound of liver daily for the remainder of their lives. Only later came 

 the keen analysis of Castle, which firmly established pernicious anemia 

 as a deficiency disease dependent upon the exhaustion of an essential 

 hormone in the stomach, and demonstrated that the erythrocyte 

 maturation factor stored in the liver, normally, is the resultant of the 

 interaction of the gastric hormone known as the "intrinsic factor" 

 with an essential dietary or "extrinsic factor" contained in animal 

 protein. 



One of the great modern advances in the science of medicine has 

 been the realization that all disease is not necessarily the result of some 

 external circumstance or bacterial invasion, and that there is a dis- 

 tinction between "optimum" health and "apparent" health, i. e., 

 between good, better, and best. Vitamine and endocrine researches 

 in recent years have done most to exemplify the potential threat to 

 health and well-being of deficiency in these vital elements. The chemist 

 and the physician here combine their resources again in the funda- 

 mental problems which underlie the deficiency states. Night blindness, 

 ophthalmia, pyorrhea alveolaris, and urinary calculi suggest vitamin A 

 insufficiency. Polyneuritis follows a vitamin B-l deficiency, and 

 pellagra with dermatitis, pigmentation of the skin, glossitis, stomatitis, 

 and, at times, mental disturbances may be symptomatic of vitamin B-2 

 complex deficiency. Easy bruising, oozing of the gums, or unexplained 

 oedema may reflect a vitamin C inadequacy, and rickets and dental 

 caries have largely disappeared where adequate vitamin D is available 



