Vitamin A as an anti-infective agent : its use in the treatment of puerperal septicaemia / by E. Mellanby and H.N. Green.

  • Mellanby, Edward, Sir, 1884-1955.
Date:
[1929?]
Catalogue details

Licence: In copyright

Credit: Vitamin A as an anti-infective agent : its use in the treatment of puerperal septicaemia / by E. Mellanby and H.N. Green. Source: Wellcome Collection.

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    vitamin A in infective conditions if the hypothesis of its anti-infective function were sound. The choice of puerperal septicaemia, where the blood infection is usually due to a haemolytic streptococcus, had the advantage that the mor¬ tality rate is so high that the series of cases in which com¬ plete cure is brought about need not be large in order to allow a decision as to whether the remedy tested is having a beneficial effect. In the present communication, which is of a preliminary nature, the number of cases treated only allows the claim that the administration of preparations rich in vitamin A has had some beneficial result. Whether this form of treatment is specific for septicaemia, and pos¬ sibly bacterial infections in general, can only be decided after the subject has been investigated on a much larger scale. The Method Adopted. The treatment consisted, so far as we are concerned, of the administration of preparations containing vitamin A. Two preparations were used, X and Y. In order to give some idea of their content of vitamin A, it may be said that, using the colorimetric method of Carr and Price,3 preparation X gave a dilution test of 1 in 20,000 to 1 in 30,000, and preparation Y of 1 in 300,000. An average specimen of cod-liver oil will give a corresponding figure of 1 in 2,000, so that X, on the average, was about 10 times and preparation Y about 150 times as rich in vitamin A as cod-liver oil. (It has not yet been definitely proved that the antimony colour reaction is specific for vitamin A, but all evidence tends to show that this is the case.) When the condition of the patient was such that X could be administered it was usual to give 2 drachms (about 7 c.cm.) twice daily. On the basis of the above colour test figures this is equivalent to about 5 ounces of cod-liver oil. In some cases (vide Cases iv and v later) it was im¬ possible to give X by mouth owing to vomiting, and it was necessary to give preparation Y in doses of 2 minims hourly in a teaspoonful of orange juice for twelve doses daily. When Y was thus given, about 1| c.cm. was the total daily dose. This is equivalent, on the above reckoning, to 225 c.cm. of cod-liver oil—namely, 8 ounces. In another case, treated before Y was obtainable, the preparation X, since it could not be taken by mouth, was injected sub¬ cutaneous^ in 1-drachm doses for two days. This pro¬ cedure was not continued, however, for although the in¬ jected doses were apparently absorbed fairly rapidly, and gave rise to no local sepsis, we did not think this mode of administration desirable. It may be well to add that, since the patients were not under our direct charge, the treatment in some cases was not confined to the administration of vitamin A prepara¬ tions. In one case (Case ii) the patient received quinine; another case (Case v) received a course of intramuscular