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AuoG r3, 19211 THE PHARMACOLOGICAL VALUE OF COD-LIVER OIL. r Tax Dam - 245' and from those wljich lhad remained neutral. She Yolung animals die fairly rapidly on a diet deprived-of looked to chlild welfare. work to raise a bulwark of vitamins, and tlie addition of vitamins in small quantities goocl feeling wlhich slhould be sufficient to resist national to suclh a diet enables the animals to grow normally, and animosities. MIle. FERRIERE, of tile Union Internationale in this way the existence of vitamins can be demonstrated de Secours aux Eufants, whvlichl is the central organiza- as certainly as can the existence of an antitoxin. 'tion in Geneva of all the " Save the clhildren" funds The demonstration of a vitamin involves, hlowever, pro- in 'tle different counitries, said tlhat this body was longed feeding experiments with very careful controls. now sliaping for its6lf a more permanent structure, Such experiments are very difficult to perform; it is withi the object of maintaining interest in child welfare difficult to obtain a diet which is free from vitamins and in every country. Mme. DUCHtNE, of the French Com- is non-toxic and adequate in all other respects. Moreover, mittee of tllis organization, spoke on similar lines, and tlle experiments are always liable to be upset by epidemics. nobly said tlhat if there was (langer of pauperism in the Finally, the reaction of different animals to vitamin-lack countries which received assistance, tllis was more tllan varies enormously; animals of different species react in counterbalanced bv the gain in education to the countries very different manners; young animals are far more whichi gave it. Fraulein HEYMANN, of Germany, saidl that affected by vitamin-lack than adults; and, finally, animals relief work in lher country also had assisted the inter- of the same species and age fed upon the same diet often national ideal, and slhe thought that the clhildren who had show considerable individual differences. Work upon benefited from tlhis real Samaritanism would later on vitamins is therefore bound to be extremely slow and become apostles of humanity and peace. Frau HERZFELDER, laborious; the number of possible errors is extremely large, of Austria., said that the children's protection societies in and it is therefore not surprising that many questions that country lhad always had an international standpoint, concerning vitamins are still matters of controversy. wllich the war lhad not entirely effaced. Miss JANE Three vitamins are known, namely: (1) the fat-soluble ADDAMS, President of the Women's Inteinational League vitamin A, (2) the antineuritic water-soluble vitamin B, of Peace and Freed6m, urged tlle setting up of an inter- and (3) the antiscorbutic vitamin C. These three vitamins national standard of cllild welfare wlichl should ma.ke it have different distributions, different chemical properties, impossible for childreni to starve on one side of a frontier and different plhysiological actions. It is possible, and wlhen there was bread to spare on the other. Other even probable, that other similar factors exist, which also speakers to the same, effect were Danish and Swedish have the two important characteristics of being necessary ladies. Miss ALICE FITZGERALD, head of the department in minutc amounts for animal nutrition, and of being of nursing of the Leaaue of Red Cross Societies, made the easily destroyed. interesting statement that under the auspices of the None of the vitamins have been isolated, and tlherefore League eighlteen nurses from as miiany different countries it is not possible to say for certain that any two deficiency had been sent to London for post-graduate public health diseases are produced by the lack of the same substance; training. Tlhe lhonorary president of this successful con- all that it is possible to prove is tllat two diseases are ference was Frau Marianne Hainisch, a famous Austrian caused by the lack of factors wlhich have an identical social worker, and mother of the President of the Austrian distribution. The statement that any disease is caused republic. by the lack of any particular vitamin only means, there- fore, that it is caused by the lack of a factor whic'h has the THE PHARMACOLOGICAL VALUE OF same distribution as that vitamin. Animals are unable to synthesize the vitamin A con- COD-LIVER OIL. tained in their fats; they obtain supplies from vegetable CLINNICAL observers have always been positive of the foods and store tlle vitamin in their fat. Adult animals tlherapeutic value of cod-liver oil, but have been unable to contain a large reserve of the vitamin in their fat, and can give any explanation of its superiority to other oils. live on these supplies for prolonged periods; and therefore It was believed formerly that the special value of cod- it is not easy to produce any very obvious effects upon liver oil depended upon its high content of unsaturated fatty adult animals by deprivation of vitamin A. Young growing acids, and on this assuLiption substitutes for cod-liver oil animals require much larger amounts of this vitamin and have-been prepared from vegetable oils, such as.poppy seed have smaller reserves, and in these deficiency of vitamin A oil or soya oil, wlhich contained a large amount of un- produces effects in a few weeks or months. saturated fatty acids.- Substitutes for cod-liver oil have Vitamin A is contained in the green leaves and tlhe even been prepared from olive oil. growing parts of plants, and it is from tlhese that the Cod-liver oil suffers from the disadvantages of lhaving animal world ultimately obtains its supply of vitamins. an unpleasant taste, and of readily becoming rancid, and Vitamin A is stored by animals in their fats, and occurs manufacturers have devoted their energies to producing in large quantities in milk fat and in egg yolk. The fats highly refined preparations of the oil so as to eliminate aind 'oils of fisshes and of whales also contain an exception- these unpleasant qualities. Doubt has frequently been ex- ally' large amount of this vitamin. pressed, however, whether the purified forms of the oil All of the vitamin A present in milk is contained in the were as efficacious in therapeutics as the older and cruder milk fat; there is therefore very little in skimmed milk; preparations. the vitamin A content of milk depends entirely upon the Recent research upon vitamins has thrown an entirely diet of the animal, and vitamin A may be almost com- new light upon the action of cod-liver oil, for it has been pletely absent from the milk of stall-fed cows. Similarly, shown tllat crude cod-liver oil is peculiar in containing a it may be absent from the milk of women fed on a diet free far larger amount of the fat-soluble vitamin A than any from vitamins. Vitamin A is a more stable substance than otlher foodstuff. At the present time it is difficult to form- the antiscorbutic vitamin C, but it is fairly readily destroyed a correct estimate of tlle importance of vitamin deficiency by heating in the presence of oxygen. Hopkins' and in the production of disease; there' is fairlv conclusive others have shiown tlhat butter can be rendered vitamin- evidence that such deficiency causes scurvy, infantile free by heating to 1200 C. for four hours, provided that a scurvy and beri-beri, and there is a very strong probability current of air is passed through it. that it is tlle cllief cause of rickets; and, finally, thoere The vitamin content of milk is reduced by pasteurization is the possibility that vitamiin deficiency may produce a- or by boiling, and both condensed and dried milk contain host of otber chronic disorders ranging from dental caries smaller amounts of the vitamin than does fresh milk. to amer4orrhoea anmd reduced resistance to infections. Lard as. ordinarily manufactured contains no vitamin, and ThJ degree to which vitamin deficiency affects the all of the vitamins of wlhale oil are destroyed by hydro- health of the community is at present uncertain, and it is genation; vegetable oils and fats contain little or none of very necessary to steer a course between the two extremes the vitamin. of an uncritikal enthusiasm which attributes every dis- The absence of vitamin A from' the diet can be slhown to order to lack of vitamins, and an equally irrational pioduce in animals the following effects:2 scepticism -which denies any importance to vitamins 1. Lack of growth in young rats (Hopkins, Drummond, and because they are a new discovery, and because their others). importance is exaggerated by others. Vitamins are not 2. Rickets in puppies (Mellanby). exceptionally mysterious substances; it is true that they '3; Disorders of de'ntitio'n. in pnuppies (MI. Mellanby). have not been isolated, and that are readily destroyed 4. Diminished resistance to infections. they 5. Failure of the nutrition of the cornea resultingin xeroph- by chemical treatment, but these properties they share .thalmia"..-.' with bicterial toxins and' a titoxin'. 6. Tenldencyo to ocdema. 246 AUG. T3, 192I TIHE PHARMACOLOGICAL VALUE OF COD-LIVER OIL. McCarrison, has carried out extensive observations on Vitamin A is widely distributed in nature and can be the effects of lack of vitamins in pigeons and in monkevys; easily preserved in fats, but various causes have led to its most of tl]ese experiments were conducted witlh diets gradual elimination from the food of the people. deficient in more tllan one vitanmin; tlhev provcd that Tllis vitamin is contained in wlhole-meal bread and in vitamin lack induces a wlhole series of gastro-intestinal buitter, btut is absent from wlhite bread and margarine.

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