The Vitamins in Medicine, Part 1 (Vitamin A and the B Complex)

By Franklin Bicknell, MD, and Frederick Prescott, MD

Summary: Nutrition and medicine have seldom seen eye to eye. Though the discovery of the vitamins in the early twentieth century did cause some physicians to grasp the profound connection between vitamin deficiencies and degenerative disease, medicine as an institution never truly embraced this idea. Ultimately, the American Medical Association declared—in concert with the industrial food industry and the U.S. Food and Drug Administration—that most Americans do not suffer vitamin deficiencies of any consequence. This position, however, contradicts decades of scientific study, as famed natural nutritionist Dr. Royal Lee argued throughout his career. One of the books Dr. Lee cited most often in making his case was the text here, The Vitamins in Medicine, by British physicians Drs. Franklin Bicknell and Frederick Prescott. Backed by over 4500 scientific references, the text sums the totality of scientific knowledge about the vitamins at the time of its publication in the mid-twentieth century. While the book does take some typically medical views of vitamins, e.g., that they are single chemical substances and not synergistic biochemical complexes, as Dr. Lee taught, it nevertheless supports strongly the notion that many, if not most, of our modern ailments stem from partial (or “subclinical”) vitamin deficiencies. “This book not only tells of the ravages caused by ignoring nature’s ways,” Dr. Lee said, “but it also shows us the way to prevent these bodily damages.” In the first part of the text (see link to PDF below), the authors discuss vitamin A as well as the various B vitamins. In Part 2, Bicknell and Franklin go on to address vitamins C, D, E, and K and a host of other vital nutrients. Though the information in this book is over seven decades old, it is still incredibly valuable today, when so few health practitioners actually know what the vitamins do—or what a lack of them can cause. Lee Foundation for Nutritional Research, 1953. Original publisher William Heinemann, London.

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[You can browse the table of contents for Part 1 below.]

Table of Contents: The Vitamins in Medicine, Part 1 (Vitamin A and the B Complex)

CHAPTER I: VITAMIN A

History  1
Chemistry of Vitamin A and Carotene  3
Estimation of Vitamin A and Carotene  7
—Biological Estimation  7
—Physical Estimation  8
—Chemical Estimation  9
Units of Vitamin A  9
Physiology of Carotene, or “Provitamin A” 10
—Function of Carotene  11
—Absorption of Carotene  11
—Storage and Excretion of Carotene  13
—Conversion of Carotene to Vitamin A  13
—Utilization of Carotene  16
Physiology of Vitamin A 16
—Sources  16
—Absorption  16
—Factors Influencing Absorption  17
—Storage  19
—Factors Apart from Intake Affecting Storage  22
—Blood Levels  24
—The Mobilization of Hepatic Stores  27
—Excretion and Destruction  30
—Factors Influencing Requirements of Vitamin A  31
—Action of Vitamin A in the Body  32
—The Effects of Lack of Vitamin A on the Epithelial Surfaces of the Body
  32
—The Secondary Result of Changes in the Epithelia Due to Lack of Vitamin A
—Decreased Local Resistance to Infection: The Secondary Result of Changes in the Epithelia Due to Lack of Vitamin A  36
—Fetal Development and Rubella  39
—Vision  40
—Vitamin A and the Nervous System  42
—Vitamin A and Growth of Bone  43
—Vitamin A and the Endocrine System  45
—Vitamin A and Renal Function  47
—Relation of Vitamin A to Other Vitamins  49
—Vitamin A, Fat and Protein Metabolism  50
The Provision of Vitamin A in Human Diets  50
—Effects of Cookery, Storage, Canning, Freezing, Drying, and Dehydration on Carotene and Vitamin A  54
Amounts of Vitamin A and Carotene in Foods [Table]  54–58
Human Requirements of Vitamin A and Carotene  58
—In Health  58
—In Disease  60
Methods Used for Recognizing Human Vitamin A Deficiencies  60
—Clinical Examination  60
—Slit-Lamp Microscopy  60
—Dark Adaptation  60
—Differential Diagnosis of Impaired Dark Adaptation  63
Human Diseases Due to A Deficiency of Vitamin A  64
—[Pages 64 to 72 omitted in original.] —The Effect of Lack of Vitamin A on the Eyes  72
—The Effect of Lack of Vitamin A on the Nervous System: Lathyrism  74
—Other Effects of Lack of Vitamin A  77
Carotinemia, Xanthosis Cutis and Hypervitaminosis A  78
—Carotinemia 78
—Xanthosis Cutis  78
—Hypervitaminosis A in Man  81
—Hypervitaminosis A in Animals  84
Vitamin A2  85

REFERENCES (Vitamin A)  86–99 [612 citations]

CHAPTER II: THE VITAMIN B COMPLEX
[Excluding Vitamins B1, B2, and B3]


[History and Naming of the B Vitamins]
100

VITAMIN B6  103
—Isolation and Chemistry of Vitamin B6  103
—Distribution of Vitamin B6 in Foods  104
—Vitamin B6 Content of Foodstuffs [Table]  104–105
Physiology and Functions of Vitamin B6  105
—Reactions Catalyzed by Pyridoxal Phosphate  106
—Vitamin B6 and Amino Acid and Protein Metabolism  107
—Fat Metabolism  108
—Adrenal Cortical Damage and Water Metabolism  108
—Analogues and Antagonists  108
—Absorption, Storage, and Excretion  109
—Requirements  110
—Vitamin B6 Deficiency Symptoms in Animals  110
—Human Vitamin B6 Deficiency  112
—Toxicology and Pharmacology  112
Therapeutic Use of Vitamin B6  112
—Deficiency States  112
—Blood Diseases  112
—Neuromuscular and Nervous Diseases  114
—Skin Diseases  115
—Vomiting  115
—Other Conditions  116

PANTOTHENIC ACID [VITAMIN B5]  116
—History, Isolation, and Chemistry  116
—Distribution [in Foods]  116
—Pantothenic Acid Content of Foodstuffs [Table]  117–118
—Biogenesis  118
—Functions and Physiology: Coenzyme A  119
—Pantothenic Acid Deficiency  120
—Pantothenic Acid Antagonists  120
—Absorption, Storage, Excretion of Pantothenic Acid  121
—Pharmacology  122
—Requirements of Pantothenic Acid  122
—Clinical Studies on Pantothenic Acid  122

BIOTIN  
123
—History, Isolation, and Chemistry  123
—Units and Distribution  124
—Biotin Content of Foodstuffs [Table]  125
—Avidin and Biotin Inhibitors  125
—Physiology and Functions of Biotin  126
—Metabolism, Absorption, and Excretion  127
—Pharmacology  129
—Effects of Biotin Deficiency in Animals  129
—Biotin and Infection  129
—Biotin Deficiency in Man  129
—Biotin and Cancer  130

INOSITOL  131

CHOLINE  132
—Choline in Foodstuffs [Table]  132–133
—Choline Deficiency  133
—Functions of Choline  134
—Clinical Uses of Choline  134

PARA-AMINOBENZOIC ACID [PABA]  135
—Absorption and Excretion of PABA  136
—PABA Deficiency in Animals  136
—Antibacterial Action of PABA  136
—Pharmacology and Toxicology  136
—Clinical Uses of PABA  137

FOLIC ACID GROUP  142
—History  142
—Estimation of Folic Acid  143
—Occurrence in Foods  143
—Distribution of Folic Acid in Foodstuffs [Table]  144
—Uracil and Thymine  145
—Folic Acid Antagonists  145
—Physiology and Functions  145
—Pharmacology  146
—Absorption, Storage, Excretion  146
—Requirements  147
—Folic Acid Deficiency  147
—The Significance of Folic Acid in Human Nutrition  148
—Therapeutic Uses of Folic Acid  148
—Granulocytopenia  151
—Irradiation Sickness  152
—Folic Antagonists in the Treatment of Leukemia and Malignant Disease  152
—Folic Antagonists in the Treatment of Arthritis and Psoriasis  153

THE VITAMIN B12 GROUP  153
—History  153
—Chemistry  153
—Assay of Vitamin B12  154
—Units  155
—Occurrence of Vitamin B12 [in Food and Other Sources]  155
—Functions of Vitamin B12  155
—Vitamin B12 in Foodstuffs [Table]  156
—Absorption, Storage, and Excretion of Vitamin B12  157
—Requirements  158
—Pernicious Anemia  159
—The Sprue Syndrome  159
—Tropical Nutritional Anemia  159
—Megaloblastic Ancemia of Pregnancy and the Puerperium  159
—Megaloblastic Anemia of Infancy  159
—Megaloblastic Amemia After Gastrectomy  159
—Leucopenia  159
—Neurological Conditions  159
— Growth of Children  159
—The Animal Protein Factor  159
The Citrovorum Factor (Folinic Acid, Leucovorin)  160
—Vitamin B12, Folic Acid, Thymidine, the Citrovorum Factor, and Nucleic Acid Synthesis  162
— Hemopoietic Activity of Citrovorum Factor  163
—Citrovorum Factor and Folic Acid Deficiency  163
Vitamin B13 and Vitamin B14  163

REFERENCES (The Vitamin B Complex) 163–182 [748 citations]

CHAPTER III: ANEURINE (VITAMIN B1, THIAMINE)

History 183
Chemistry of Aneurine 184
Units of Aneurine 186
Distribution of Aneurine in Foods 186
— Effect of Cooking, Canning, Freezing, and Drying on Aneurine 187
Vitamin B1 Content in Foods [Table]189–193
The Physiology of Aneurine 193
—Aneurine and Carbohydrate Metabolism 193
—The Tricarboxylic Acid Cycle [Diagram] 195
—Aneurine and Fat Metabolism 197
—Aneurine and Protein Metabolism 198
—Aneurine and the Endocrine System—Thyroid 198
—Aneurine and Acetylcholine 199
—[Anuerine and] Reproduction 199
—Aneurine and Phagocytic Function 200
—Aneurine and Mineral Metabolism 200
—Relationship to Other Vitamins 200
— Absorption of Aneurine 201
—Storage of Aneurine 201
—Excretion 202
Pharmacology and Toxicology 204
Human Requirements of Aneurine 205
—Human Requirements Based on Animal Data 205
—Aneurine Requirements Calculated from Dietary Studies 205
—Requirements Based on Aneurine Deficiency Studies 206
—Requirements based on Excretion Studies 207
—Human Requirements of the Adult 209
—Requirements of Infants and Children 209
—Requirements in Pregnancy and Lactation 210
— Aneurine Requirements under Special Conditions 210
Human Disease Associated with Aneurine Deficiency Beriberi 211
—Incidence 211
—Etiology 212
—Clinical Signs and Symptoms 212
—Diagnosis 220
—Differential Diagnosis 221
—Pathology and Morbid Anatomy of Beriberi 221
—Prognosis and Treatment of Beriberi 222
Other Manifestations of Aneurine Deficiency 222
Factors Conditioning Vitamin Deficiency 222
— I. Factors Interfering with Ingestion 224
— II. Factors Interfering with Absorption 225
— III. Factors Interfering with Utilization 226
— IV. Factors Increasing Requirement 227
— V. Factors Causing Destruction of Vitamins 227
— VI. Factors Increasing Excretion 228
—Biochemically Induced Aneurine Deficiency 228
—Nervous Lesions in Aneurine Deficiency 229
—Psychological Manifestations of Aneurine Deficiency 234
—Cardiac Lesions in Aneurine Deficiency 234
—Aneurine Deficiency and Gastrointestinal Symptoms 238
—Experimental Aneurine Deficiency in Man 238
— Diagnosis, Treatment and Prevention of Aneurine Deficiency 240
Methods Used for the Assay of Aneurine 240
—Biological Assay 240
—Microbiological Assay 240
—Thiochrome Method 241
—Colorimetric Methods 241
—Estimation of Cocarboxylase 241
Laboratory Methods Proposed for the Detection of Aneurine Deficiency 241
—Estimation of Pyruvic Acid and Bisulfite Binding Substances 242
—Estimation of Blood Aneurine 243
—Estimation of the Urinary Excretion of Aneurine 243
—Pyramin (Pyrimidine) Estimation 244
—Muscle Biopsy 244
Therapeutic Uses of Aneurine 244
—Neurology 245
—Affections of the Cranial Nerves 249
—Diseases of the Spinal Cord 250
—Relief of Pain 251
—Summary 251
—Neuropsychiatric Disorders 251
—Psychotic States Associated with Alcoholism 252
—Aneurine in Ophthalmology 253
—Aneurine in Vascular Disease 253
—Aneurine in Gastro-intestinal Conditions 253
—Aneurine in Pregnancy 254
—Aneurine in Metabolic Diseases (Diabetes, Hyperthyroidism, Gout) 256
—Dermatology 258
—Shock 258
—Irradiation Sickness 258
—Aneurine and the Sulfonamides 259
—Uterine Cancer 260
—Resistance to Fatigue 260
—Morphine Addiction 261
—Other Clinical Uses of Aneurine 261

REFERENCES (Vitamin B1) 261–284 [953 citations]

CHAPTER IV: RIBOFLAVIN [VITAMIN B2]

History 285
Chemistry of Riboflavin 285
Units of Riboflavin 287
Distribution of Riboflavin in Foods 287
—Effect of Cooking, Curing, Freezing, and Canning 287
Vitamin B2 Content in Foods [Table] 288—292
Physiology of Riboflavin 292
—Riboflavin and Flavoprotein Enzyme Systems 292
—Phosphorylation 295
—Biosynthesis of Riboflavin 295
—Riboflavin Deficiency in Animals 295
—Riboflavin and the Eye 296
—Riboflavin and Hematopoiesis 297
—Riboflavin and Tumor Formation 298
—Riboflavin and Nitrogen Metabolism 298
—Riboflavin Metabolism and Other Vitamins 298
—Chemically Induced Riboflavin Deficiency 298
—Pharmacology of Riboflavine 298
—Absorption, Storage, and Excretion of Riboflavin 299
Human Requirements of Riboflavin 302
Riboflavin Deficiency Syndrome, Ariboflavinosis, Diseases Associated with Riboflavin Deficiency 304
—Historical 304
—Incidence of Ariboflavinosis 305
—Lesions of Lips 306
—Validity of Angular Stomatitis as a Manifestation of Riboflavin Deficiency 307
—Dermal Lesions of Ariboflavinosis 309
—Tongue Lesions of Ariboflavinosis 312
—Ocular Manifestations of Ariboflavinosis 313
—Conjunctivitis 313
—Photophobia 314
—Diminished Visual Acuity and Eye Strain 314
—Cataract 315
—Iritis 315
—Rubeosis lridis 315
—Nutritional Amblyopia 315
—Snow Blindness 316
—Corneal Vascularization 316
—Validity of Circumcorneal Injection and Corneal Vascularization as Manifestations of Riboflavin Deficiency 317
—Neurological Manifestations of Riboflavin Deficiency 320
—Kwashiorkor 320
—Pathogenesis of Ariboflavinosis 321
—Diagnosis of Ariboflavinosis 321
—Treatment of Ariboflavinosis 322
—Plummer-Vinson’s Syndrome 323
Clinical Uses of Riboflavin 323

REFERENCES (Vitamin B2) 325–332 [337 citations]

CHAPTER V: NICOTINIC ACID [NIACIN, VITAMIN B3]

History 333
Chemistry of Nicotinic Acid 333
Distribution of Riboflavin in Foods 334
—Effect of Cooking, Curing, Freezing, and Canning 287
Vitamin B3 Content in Foods [Table] 335—339
Physiology of Nicotinic Acid 339
—Nicotinic Acid and Enzyme Systems 339
—Nicotinic Acid and Porphyrin Metabolism 342
—Nicotinic Acid and Carbohydrate Metabolism 342
—Nicotinic Acid and Hematopoiesis 343
—Nicotinic Acid Requirements of Microorganisms 343
—Biosynthesis of Nicotinic Acid 343
—Nicotinic Acid and Tryptophan 344
—Nicotinic Acid Antagonists  345
—Pharmacology of Nicotinic Acid 346
—Absorption, Storage, and Excretion of Nicotinic Acid 347
Human Requirement of Nicotinic Acid 349
Diseases Associated with Deficiency of Nicotinic Acid—Pellagra 351
—History 351
—Distribution of Pellagra 351
—Etiology 352
—Critical Signs and Symptoms of Pellagra 354
—Infantile Pellagra 363
—Diagnosis of Pellagra 364
—Laboratory Tests for Diagnosis of Nicotinic Acid Deficiency 364
—Pathology of Pellagra 366
—Prognosis and Treatment 367
—Nicotinic Acid Psychoses 368
—Lingual Manifestations of Nicotinic Acid Deficiency 372
—Induced Nicotinic Acid Deficiency 373
Nicotinic Acid Therapy 373
—Oral Conditions:“Trench Mouth”373
—Cardiovascular Diseases 375
—Skin Diseases 375
—Diabetes 378
—Asthma 378
—Neurology 378
—Other Uses 380

REFERENCES (Vitamin B3) 381–389 [361 citations]

 

 

 

 

Patrick Earvolino, CN

Patrick Earvolino is a Certified Nutritionist and Special Projects Editor for Selene River Press, Inc.

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