Nutritional Deficiencies: Diagnosis and Treatment

The isolation in recent years of many vitamins in pure form and clinical tests of them have resulted in notable advances in our knowledge of their usefulness in clinical medicine. Dr. Youmans has been one of the pioneers in the study of this particular subject, and therefore is well qualified to write on it. As is evident from the title, as well as the preface, the body of information here gathered has been treated quite definitely from the standpoint of the needs of the clinician rather than the further promotion of popular interest in vitamins. The title finally selected made it possible for the author to deal not only with the avitaminoses, but also with such deficiencies as lack of calcium , iron, iodine, and protein. Each deficiency is discussed with respect to history, nature and function of the dietary factor in question, pathology and pathogenesis, incidence and epidemiology, symptoms, diagnosis, and treatment. In the last 52 pages one finds a "tabular summary of the vitamins," a table giving "the principal dietary sources of the essential food factors," and "laboratory methods for diagnosing deficiency diseases." Our knowledge of this last topic is still far from satisfactory, and the author therefore has not made this section a compendium of everything suggested in the literature but as yet insufficiently tested in clinical work. He is to be commended for his restraint in this matter. Any writer dealing with the subject of nutritional deficiencies must necessarily discuss the question of the relative values of properly selected foods as sources of the needed dietary factors as contrasted with vitamin preparations , particular mixtures of various vitamins, and essential mineral nutrients. An excellent but brief discussion of this topic is presented in the first chapter. The author points out the necessity for proper study of the patient in an endeavor to determine as exactly as possible the nature of the deficiency, all to the end that the therapy may be as specific and scientific as possible. The appropriate pure vitamins should then be used in liberal amounts in treating the condition that has been diagnosed. A well-selected dietary should be used as a supportive treatment. The practice of indiscriminate administration of vitamin mixtures, which is too much like the old "shotgun" drug therapy, is properly condemned. Students of the vitamins will probably be disappointed not to find more elaborate discussions of many pet topics. Some …