68G CHARLES W. HOOPER 



I 



also found that phosphorus given with the cod liver oil materially enhances 

 the latter in this respect. In tetany there is a gradual reduction of electrical 

 irritability with a simultaneous increase in calcium retention. Brown, Mac- 

 Lachlan and Simpson (1920) confirm the findings of Schabad in tetany, 

 and are convinced that the two diseases are intimately associated, in that 

 all of their cases of tetany showed varying degrees of rickets. Howland 

 and Park (1020) have conclusively demonstrated the effectiveness of cod 

 liver oil as a therapeutic agent in rickets. They have shown that a defi- 

 nite correlation exists between the Roentgen-ray signs and the actual path- 

 ological condition. Calcium deposits in the cartilage cast well defined 

 shadows. In animal experiments an increased calcium deposit can be 

 demonstrated two days after the administration of cod liver oil. In human 

 beings the calcium deposit in the cartilage is definitely demonstrable at the 

 end of three weeks after beginning the administration of cod liver oil. 



The above experiments are in harmony with the long accepted conclu- 

 sion of many clinicians that this oil is more than a food and contains some- 

 thing which exercises a stimulating and alterative influence on the proc- 

 esses of assimilation and nutrition, thereby promoting normal metabolism 

 and the production of healthy tissue. What is it in cod liver oil that causes 

 the increased calcium retention in rickets and tetany? The question is 

 open. Hess and linger (1920) emphasize that rickets frequently develops 

 in infants receiving too much milk, rich in fat, protein, and salts. They 

 state that the fat soluble vitamin is not the controlling influence; that 

 infants develop rickets while receiving a full amount of this principle, and 

 that they do not manifest signs, although deprived of this vitamin for many 

 months, at the most vulnerable period of their life. 



Cod liver oil undoubtedly contains other substances which may account 

 for its special properties. Iscovesco (1914) described a lecithid which 

 he isolated from cod liver oil" and later from beef heart, which apparently 

 promotes the growth of rabbits and stimulates the development of the 

 lungs. It is possible that a chemical substance closely associated with a 

 phosphatid contained in cod liver oil, such as Tscovesco describes, may 

 account for the increased calcium retention in rickets and tetany. 



Liver Extracts. In general, saline extracts of liver given intraven- 

 ously, not unlike extracts of other parenchymatous organs, stimulate plain 

 muscle tissue, depress the circulation, and may cause a fatal shock-like 

 reaction. Voegtlin and Bernheim (b) (11)10-11) state that 5 c.c. of a saline 

 extract of dogs liver cause a considerable fall in blood pressure and other 

 symptoms found in anaphylactic shock, such as muscular weakness, nerv- 

 ous depression, defecation and urination. Parker (1918) found that the 

 saline extracts of the livers from rabbits, previously inoculated with cul- 

 tures of bacillus typhosus and bacillus prodigiosus, are more toxic than 

 the extracts of normal livers when injected intravenously into normal rab- 

 bits. Rogers and his co-workers (1915-16) are convinced that only the 



