No abstract

No abstract

No abstract

This case, which forms the basis of this paper, came under the observation of one of us during an investigation, by balance experiments, of the metabolism of atrophic infants. During life, the condition was diagnosed as one of congenital obliteration of the bile ducts, and it was thought that a study of the absorption and retention might prove useful in observing the effect of a low fat absorption on the absorption of calcium, phosphorus, carbohydrate and protein.The importance of disorders of fat digestion in producing infantile atrophy has been largely stressed by the German school, particularly by

The widespread prevalence in infancy of hypochromic anaemia, the result of a deficiency of iron in the diet, has been stressed within recent The question whether iron alone can produce a cure of experimental nutritional anaemia or if other metals can replace copper as a supplement has been referred to in a preceding paper (Part II). 'Absence of certain metals from the diet is not the only dietetic deficiency associated with the development of hypochromic anaemia; for instance, the anaemia of scurvy cannot be cured unless adequate amounts of vitamin C are consumed, and the anaemia occasionally found with hypothyroidism or cretinism is said to react specifically to thyroxin. According to Witts' iron, copper, vitamin C and thyroxin are necessary for the maturation of normoblast to erythrocyte, and in adults the failure of this change results in the development of a microcytic anaemia. We have been able to demonstrate by means of the heematocrit and by PriceJones curves (Fig. 1) that the nutritional anaemia of infants is also of the microcytic type.From the recent work of Strauss and Castle2 the interaction of two factors would appear to be essential for the maturation of megaloblast into normoblast and the consequent prevention of megalocytic anvemia. These factors are: -(a) an intrinsic factor present in normal gastric juice, and (b) an extrinsic factor which they believe to be vitamin B., Megalocytic anaemia may also result if there is a failure of absorption or of utilizt-tionl of the product of the interaction of these two factors.