It is of little value to look ahead and try to foresee what the next
decade will bring forth in regard to the nature of the vitamines.
Investigation has broadened remarkably during the past few years and now
embraces the chemical field--chemical and adsorption methods, the large
realm of biology, including studies in physiology and pharmacology; and
recently pathology has once more been called upon to aid in the solution
of the problem. Probably additional vitamines will be discovered. From
time to time it has been suggested that a specific growth vitamine
exists quite distinct from the three which are recognized, and recently
Mellanby has suggested still another food factor--a specific "rachitic
vitamine." When we reflect that the characteristic functions of the
various organs--the kidneys, liver, etc.--must depend on essential
differences in chemical structure, the complexity of the entire problem
of unidentified factors becomes evident.[28]
[28] For recent and comprehensive reviews of the vitamines the reader is
referred to papers by A. B. Macallum (Trans. Royal Canadian Institute,
Toronto, 1919) and by W. H. Eddy (Abstracts of Bacteriol. 1919, Vol.
iii, 313.)
CHAPTER IV
PATHOLOGY
Physicians have had a general knowledge of the pathology of scurvy for a
great many years. Lind, in his "Treatise on the Scurvy," published in
1772, included a chapter on "dissections" and a postscript on
"Appearances on Dissections of Scorbutic Bodies," based on a large,
although indefinite, number of postmortem examinations. In the century
which followed, there are to be found many reports of scurvy, especially
in connection with the frequent wars, but it is surprising how little
detailed pathologic information they furnish. Barlow's publication in
1883, establishing the identity of the scurvy of adults and of infants,
must be regarded as the modern milestone in the study of the pathology
of this disorder. This work did not contribute richly to the data of the
subject, or suggest novel interpretations, but directed attention to a
new source of material--the increasing number of cases of infantile
scurvy--at a critical moment when the opportunity for the study of
scurvy in the adult was rapidly becoming less. At the time of Barlow's
exposition of the true nature of "acute rickets," scientific medicine
was concentrating its interest on pathology. Tissues were being
carefully studied by means of the microscope, and scurvy was subjected
to this new method of investigation. As a result of intensive
application of this technic, a lesion of the bones was identified and
established as characteristic of scurvy. Study was focussed so
exclusively on the bones, that for many years, indeed until very
recently, the other organs of the body were neglected. This is true of
the gross as well as of the microscopic anatomy. Protocol after protocol
gives a hasty account of the appearance of the various organs, merely as
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