DEFICIENCY DISEASES 287 



amounts in fresh fruits and grcrn vegetables, to a less extent in root 

 vegetables and tubers. It is present in small amount in fresh moat 

 and milk, and has not 3'et been detected in yeast, fats, cereals, pulses. 

 The explorer, Stefansson,^^ has reported observations indicating the 

 presence of antiscorbutic substances in raw meat, and their absence 

 or deficiency in well-cooked meat and tinned foods. Evidently this 

 antiscorbutic element is very unstable, since even drying vegetables 

 at moderate temperatures, 6.5-70°, and cooking or salting meats, or 

 heating with weak alkalies, destroys or greatly reduces their antiscor- 

 butic value. ^^ Pasteurization of milk also reduces the preventive 

 value of this food" which, in its raw state, contains in abundance 

 all necessary factors for nutrition, but apparently little more of the 

 antiscorbutic substance than is barely sufficient to maintain health. 



Pellagra^^ probablj- belongs among the deficiency diseases, despite 

 numerous attempts to account for it as an infectious disease. The 

 work of Goldberger^^ is especially valuable in affirmative evidence 

 of the relation of dietary deficiency to pellagra. Here again we are 

 entirely uninformed as to the nature of the deficiencj'. Goldberger®'' 

 sums up his conclusions as follows: "The pellagra-producing dietary 

 fault is the result of some one, or, more probably, of a combination of 

 two or more of the following factors: (1) a physiologically defective 

 protein supply; (2) a low or inadequate supply of fat-soluble vitamine; 

 (3) a low or inadequate supply of water-soluble vitamine, and (4) a 

 defective mineral supply. The somewhat lower plane of supply, both 

 of energy and of protein, of the pellagrous households, though appa- 

 rently not an essential factor, ma}', nevertheless, be contributory by 

 favoring the occurrence of a deficiency in intake of some one or more 

 of the essential dietary factors, particularlj^ with diets having only a 

 narrow margin of safety. The pellagra-producing dietary fault may 

 be corrected and the disease prevented by including in the diet an 

 adequate supply of the animal protein foods, particularly milk, in- 

 cluding butter and lean meat. " 



McCollum calls attention to the fact that a diet is not adequate 

 unless it contains active metabolizing protoplasm, as found in green 

 leaves, eggs, meat and milk; and pellagra-producing diets are largely 

 composed of seed foods and pork fat. To make cereal grains diete- 

 tically satisfactory there must be added inorganic elements, a protein, 

 and substances containing "fat soluble A."^' 



" Jour. Amer. Med. Assoc, 1918 (71), 1715. 



" Givens and Cohen, Jour. Biol. Chem., 1918 (36), 127; Amer. Jour. Dis. Chil., 

 1919 (18), .30. 



*' See Hess, Amer. Jour. Dis. Chil., 1919 (17), 221. 



'* Concerning metabolism in pellagra see ]\Iyers and Fine, Amer. Jour. Med. 

 Sci., 1913 (145) 705. Chemical changes in the central nervous system described 

 by Koch and Voegtlin, Hygienic Lab. Bull. 103, 1916. 



"Public Health Rep.,' 1914 (29), 1683; 1915 (30), 3117, 3336. 



«» Jour. Amer. Med. Assoc, 1918 (71), 944. 



«> Jour. Biol. Chem., 1919 (38), 113. 



