| Riboflavin Deficiency | | | | irritable and the muscles, particularly those of the calf |
| The vitamin B complex includes not only niacin and | | | | of the leg, become painful. Later serious |
| thiamin but also riboflavin and other substances. | | | | inflammations of the nerves appear, and these may |
| When riboflavin is deficient the symptoms noted | | | | go on to the point of loss of sensation and paralysis. |
| include principally fissures and soreness at the corners | | | | When neuritis becomes so prominent, the doctor |
| of the mouth, redness of the white portion, or | | | | must make sure that it does not result from some |
| cornea, of the eye with pain on seeing strong light, | | | | other cause, since lead or arsenic poisoning or various |
| and also some changes in the tongue and skin. | | | | infections may also cause neuritis. |
| | | | As soon as a sufficient intake of thiamin is assured |
| Dr. William Darby has described the appearances | | | | the patient begins to improve. Thiamin is now |
| around the comers of the mouth which are typical. | | | | available in the form of tablets or capsules that can |
| First the lips get pale at the corners, then they seem | | | | be taken internally, and also in forms that can be |
| chewed or softened, after which the fissures appear. | | | | injected into the body when prompt action is desired. |
| As these heal, pink scars appear. The sore spots | | | | If treatment is begun sufficiently early most patients |
| may become covered with crusts. The surface of | | | | recover rapidly and completely. If treatment is |
| the tongue gets a mushroom-like appearance and the | | | | delayed until actual destruction of nerve tissue has |
| color has been described as magenta. | | | | occurred, results are doubtful. |
| Patients with ariboflavinosis complain of a sandy | | | | Vitamin B12 Deficiency |
| feeling of the eyelids, with blurring of vision and | | | | A disease quite recently included among the |
| burning on exposure to strong light. As in pellagra | | | | deficiency diseases is sprue, observed chiefly in the |
| these patients have a record of failure to include in | | | | tropics but seen occasionally also in the United States. |
| their diets such substances as lean meat, green leafy | | | | Most authorities now classify sprue among the |
| vegetables, milk, eggs or liver. | | | | conditions associated with the absence of sufficient |
| Once the diet of the patient is supplemented with | | | | vitamin B12 or the animal protein factor in the diet. |
| adequate amounts of the food mentioned, the | | | | Similar conditions to those prevailing in sprue are also |
| symptoms disappear. In difficult cases doctors | | | | seen, however, in a rather unusual condition called |
| prescribe a normal dosage of riboflavin itself. Since, | | | | celiac disease, which occurs in infants, and in idiopathic |
| however, few patients have an uncomplicated | | | | steatorrhea. In these latter conditions the patient has |
| shortage of riboflavin, but rather a shortage of all of | | | | difficulty in handling fats in the digestive tract. The |
| the vitamin B complex and since B complex is so | | | | primary symptom in sprue is difficulty in the |
| easy to secure and administer, the whole B complex | | | | formation of the blood, and with it inflammation of |
| is given. | | | | the mouth and tongue and difficulty in absorbing fat. |
| Thiamin Deficiency | | | | Most frequent among the symptoms of sprue are |
| The chief symptoms of a disease called "beriberi" are | | | | diarrhea, indigestion, distention of the abdomen, |
| due to a lack of one of the portions of the vitamin B | | | | soreness of the mouth and tongue, loss of weight |
| complex called thiamin. Thiamin is soluble in water, | | | | and, with all this, weakness. The condition is likely to |
| damaged by heat and found chiefly in whole cereals, | | | | come on gradually in people who have been long on |
| peas, beans, lean meats, nuts and yeast. Refined | | | | a monotonous low-protein diet. The patients are pale, |
| sugar, milled rice and low-extraction flour have lost | | | | thin, and sometimes have eruptions of the neck, face |
| most of their thiamin. | | | | and hands and extreme redness of the tongue and |
| People whose diets are low in protein and high in | | | | mouth. Doctors make certain of the diagnosis by |
| carbohydrates are likely to show symptoms of | | | | using the X-ray and by making studies of the blood |
| thiamin deficiency. In the United States the condition | | | | and the bone marrow, where the red blood cells are |
| is seen often among chronic alcoholics who get | | | | formed. |
| insufficient amounts of the right foods because of | | | | Fortunately such preparations as liver extract, folic |
| their displacement by alcohol. | | | | acid, vitamin B12, vitamin K, and a good diet high in |
| The chief damages to tissues of the body seen in | | | | protein bring prompt relief to patients with sprue. The |
| thiamin deficiency are found in the nerves and in the | | | | symptoms begin to disappear in a few days and in a |
| heart and blood vessels. Often these tissues become | | | | few weeks, unless there has been too much damage |
| swollen with water. After about three months on a | | | | to the tissues, the patient is well on the way to |
| diet really deficient in thiamin the symptoms begin to | | | | complete recovery. |
| appear. Gradually the person becomes tired and | | | | |