806 W. McKIM MARRIOTT 



Disturbances of Metabolism Due to a Deficiency of 

 the Accessory Food Factors (Vitamines) 



When the accessory food factors, or vitamines, are lacking in the diet, 

 definite alterations in metabolism and growth result. Some of the ef- 

 fects of a deficiency of "fat soluble A" in the diet have already been 

 mentioned. There is some evidence that a deficiency in the "fat soluble 

 A" or some related fat soluble substance is a causative factor in rickets. 

 The relationship of diet to this disease and the metabolic changes oc- 

 curring are discussed elsewhere. (See article on Rickets.) 



It is not positively known whether infants fed on milk modifica- 

 tions ever suffer from a deficiency of "water soluble B", but the results 

 obtained by Eddy and Roper and by Daniels and Byfield following 

 the administration of substances rich in this vitamine to infants, sug- 

 gest that a milk diet may be insufficient to supply the demands of some 

 infants for this particular accessory food factor. 



Infants fed exclusively on milk which has been boiled, or those being 

 nursed by mothers whose diet is deficient in antiscorbutic substances, may 

 develop scurvy. (For full consideration of this disease see section on 

 Scurvy. ) 



Disturbances Due to a Diminished Capacity of 

 Certain Organ Systems 



In the group of nutritional diseases due to diminished functional 

 capacity of organ systems, one would certainly include diabetes. The 

 metabolism in diabetes in children is not essentially different from that in 

 adults, and does not call for special consideration in this section. It is 

 important to realize that temporary glycosuria is not an unusual occur- 

 rence during infancy. In the great majority of instances it is of no sig- 

 nificance. 



Cretinism is an excellent example of a disturbance due to functional 

 deficiency of an organ. This condition is considered in a special article. 



Tetany or Spasmophilia 1 



There is some justification for considering infantile tetany as a dis- 

 ease due to a failure in function of some organ system although with 

 our present knowledge it is not possible to state with certainty that this 



1 The term tetany is here used to include all the manifestations of the so-called 

 spasmophilic diathesis, namely, carpopedal spasm, laryngismus stridulus, convulsions, 

 characteristic hyperexcitability of nerves to mechanical and electrical stimuli, etc. 



