Abstract Chronic diarrhea occurs as a symptom in a great variety of diseases (table 1). In the management of the majority of these conditions, one of the problems of prime importance is the assurance of an adequate supply of dietary essentials. Without intending to minimize the importance of mineral constituents or of the other substances known to be necessary in the diet, we present this study concerned with one particular aspect of the problem, namely, the amount of vitamin B1 which may be required by patients suffering from diarrhea. The literature contains abundant clinical evidence that disorders due to dietary deficiencies, usually multiple but particularly of the vitamins of the B complex, occur as complications of chronic diseases of the alimentary tract. Signs and symptoms of pellagra and beriberi have been observed in carcinoma of the gastrointestinal tract (Rolph,1 1916; Eusterman and O'Leary,2 1931), in ulcerative colitis (Barnes, References 1. Rolph, F. W.: Cancer of the Stomach and Pellagra in the Same Patient , Canad. M. A. J. 6:323-324 ( (April) ) 1916. 2. Eusterman, G. B., and O'Leary, P. A.: Pellagra Secondary to Benign and Carcinomatous Lesions and Dysfunction of the Gastrointestinal Tract , Arch. Int. Med. 47:633-649 ( (April) ) 1931.Crossref 3. Barnes, J. M.: Typical Pellagra Syndrome Developing in Patient with Chronic Ulcerative Colitis While Under Hospital Treatment , Ann. Clin. Med. 4:552-564 ( (Jan.) ) 1926. 4. Mackie, T. T.: Ulcerative Colitis: II. The Factor of Deficiency States , J. A. M. A. 104:175-178 ( (Jan. 19) ) 1935.Crossref 5. Jones, C. M.: Peripheral Complications of Ulcerative Colitis , M. Clin. North America 16:919-928 ( (Jan.) ) 1933. 6. Urmy, T. V.; Ragle, B. H.; Allen, A. W., and Jones, C. M.: Beriberi Secondary to Short-Circuited Small Intestine , New England J. Med. 210:251-254 ( (Feb. 1) ) 1934.Crossref 7. Larimore, J. W.: Chronic Ulcerative Colitis: Observations of Treatment by Diet , Tr. Am. Gastro-Enterol. A. 30:298-318, 1928. 8. Bargen, J. A., and Victor, M.: Diet in Intestinal Disorders , J. A. M. A. 97:151-154 ( (July 18) ) 1931.Crossref 9. Corner, H. W.: Bacillary Dysentery: A Summary of Treatment , Brit. M. J. 1:1162-1165 ( (June 8) ) 1935.Crossref 10. Grünfelder, B.; Rabinovici, E.; Geiger, A., and Rosenberg, A.: Ueber die therapeutische Wirkung von intravenös verabreichtem B1-Vitamin in der Behandlung der Ernährungsstörungen mit toxischen Erscheinungen bei Säuglingen , Klin. Wchnschr. 12:983-985 ( (June 24) ) 1933.Crossref 11. McConkey, M.: The Treatment of Intestinal Tuberculosis with Cod Liver Oil and Tomato Juice , Am. Rev. Tuberc. 21:627-635 ( (May) ) 1930. 12. Steinbach, M. M., and Rosenblatt, M. B.: Vitamin Therapy in Intestinal Tuberculosis , Am. Rev. Tuberc. 31:35-43 ( (Jan.) ) 1935. 13. Cowgill, G. R.; Deuel, H. J., Jr., and Smith, A. H.: Studies in the Physiology of Vitamins: III. Quantitative Aspects of the Relation Between Vitamin B and Appetite in the Dog , Am. J. Physiol. 73:106-126 ( (June) ) 1925. 14. Cowgill, G. R.; Rosenberg, H. A., and Rogoff, J.: Studies in the Physiology of Vitamins: XVI. The Effect of Exercise on the Time Required for the Development of the Anorexia Characteristic of Lack of Undifferentiated Vitamin B , Am. J. Physiol. 98:589-594 ( (Nov.) ) 1931. 15. Himwich, H. E.; Goldfarb, W., and Cowgill, G. R.: Studies in the Physiology of Vitamins: XVII. The Effect of Thyroid Administration upon the Anorexia Characteristic of Lack of Undifferentiated Vitamin B , Am. J. Physiol. 99:689-695 ( (Feb.) ) 1932. 16. Cowgill, G. R., and Dann, M.: The Failure of Dinitrophenol to Influence the Vitamin B Requirement , Yale J. Biol. & Med. 8:501-509 ( (May) ) 1936. 17. Cowgill, G. R.; Rosenberg, H. A., and Rogoff, J.: Studies in the Physiology of Vitamins: XIV. The Effect of Administration of Large Amounts cf Water on the Time Required for Development of the Anorexia Characteristic of a Deficiency of the Vitamin B Complex , Am. J. Physiol. 95:537-541 ( (Dec.) ) 1930. 18. Cowgill, G. R.: The Vitamin B Requirement of Man , New Haven, Conn., Yale University Press, 1934. 19. Baker, A. Z., and Wright, M. D.: Vitamin Bi in Human Diets , Proc. Roy. Soc. Med. 29:1145-1154 ( (July) ) 1936. 20. Jolliffe, N., and Colbert, C. N.: Etiology of Polyneuritis in the Alcohol Addict , J. A. M. A. 107:642-647 ( (Aug. 29) ) 1936. 21. Goodhart, R., and Jolliffe, N.: Effects of Vitamin B (B1) Therapy on the Polyneuritis of Alcohol Addicts , J. A. M. A. 110:414-419 ( (Feb. 5) ) 1938. 22. Muckenfuss, A. M.: The Presence of Food Accessories in Urine, Bile and Saliva , J. Am. Chem. Soc. 40:1606-1611, 1918.Crossref 23. Van der Walle, N.: The Presence of the Antineuritic and Antiscorbutic Vitamins in Urine , Biochem. J. 16:713-726, 1922. 24. Harris, L. J., and Leong, P. C.: Vitamins in Human Nutrition: The Excretion of Vitamin B1 in Human Urine and Its Dependence on the Dietary Intake , Lancet 1:886-894 ( (April 18) ) 1936.Crossref 25. Steenbock, H.; Sell, M. T., and Nelson, E. M.: Vitamin B: I. A Modified Technique in the Use of the Rat for Determinations of Vitamin B , J. Biol. Chem. 55:399-410 ( (March) ) 1923. 26. Salmon, W. D.: Vitamin B in the Excreta of Rats on a Diet Low in This Factor , J. Biol. Chem. 65:457-462 ( (Sept.) ) 1925. 27. Damon, S. R.: Some Observations in Regard to Growth-Promoting Substances of Bacterial Origin , J. Biol. Chem. 56:895-902 ( (July) ) 1923 28. Acid-Fast Bacteria as a Source of Vitamin B , J. Path. & Bact. 27:163-169 ( (April) ) 1924. 29. Heller, V. G.; McElroy, C. H., and Garlock, B.: The Effect of the Bacterial Flora on the Biological Test for Vitamin B , J. Biol. Chem. 65:255-264 ( (Aug.) ) 1925. 30. Sunderlin, G., and Werkman, C. H.: Synthesis of Vitamin B by Microorganisms , J. Bact. 16:17-33 ( (July) ) 1928. 31. Cowgill, G. R., and Weinstein, L.: Unpublished data. 32. Cowgill, G. R.; Rosenberg, H. A., and Rogoff, J.: Studies in the Physiology of Vitamins: XV. Some Observations of the Effect of Administration of the Antineuritic and Heat Stable Factors on the Anorexia Characteristic of Lack of the Vitamin B Complex , Am. J. Physiol. 96:372-376 ( (Feb.) ) 1931. 33. Burack, E., and Cowgill, G. R.: Anorexia Characteristic of Lack of the Vitamin B Complex: The Roles of the Individual Components , Proc. Soc. Exper. Biol. & Med. 28:750-752 ( (April) ) 1931. 34. Sherman, H. C., and Sandels, M. R.: Further Experimental Differentiation of Vitamins B and G , J. Nutrition 3:395-409 ( (Jan.) ) 1931. 35. Cowgill, G. R.: Studies in Physiology of Vitamins: II. Parenteral Administration of Vitamin-B—Mammalian Experiments , Am. J. Physiol. 66: 164-175 ( (Sept.) ) 1923. 36. Block, R. J.; Cowgill, G. R., and Klotz, B. H.: The Antineuritic Vitamin: I. The Method of Assay, Concentration of the Vitamin with Silver Under Various Conditions, and Its Solubility in Certain Organic Solvents , J. Biol. Chem. 94: 765-782 ( (Jan.) ) 1932. 37. Liebig's extract of beef, lemco, was used. 38. Stuart, E. H.; Block, R. J., and Cowgill, G. R.: The Antineuritic Vitamin: V. The Preparation of a Vitamin Concentrate Suitable for Parenteral Use , J. Biol. Chem. 105:463-466 ( (June) ) 1934. 39. Sherman, H. C.: Chemistry of Food and Nutrition , New York, The Macmillan Company, 1924, p. 391. 40. Cowgill,18 p. 186. 41. Cowgill,18 pp. 87-93. 42. Cowgill,18 p. 110.
Archives of Internal Medicine – American Medical Association
Published: Jul 1, 1938
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