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COD LIVER OIL CONCENTRATE (CONCENTRATED VITAMINS A AND D): Title and subTitle BreakINEFFECTIVENESS OF LARGE DOSES IN THE PROPHYLAXIS OF OTITIS MEDIA COMPLICATING SCARLET FEVER FREE

W. D. SUTLIFF, M.D.; EDWIN H. PLACE, M.D.; SAMUEL H. SEGOOL, M.D.
JAMA. 1933;100(10):725-728. doi:10.1001/jama.1933.02740100019008
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The frequency with which localized purulent infections appear on the mucous membranes of animals and of men deprived of vitamin A has led to the view that an adequate supply of this vitamin may be essential for the maintenance of resistance to infection. It is logical to inquire whether certain purulent complications of the acute infectious diseases of childhood may not be prevented by supplying large amounts of vitamin A. An approach to an answer for this question has been made in the work to be reported. The otitis media following scarlet fever was chosen as the most suitable purulent infection for observation because of the following reasons: It develops at a site commonly infected in vitamin A deficient animals; it is relatively simple to diagnose; it occurs with considerable frequency and regularity; and it usually appears in the second, third and even fourth week of the disease, thus giving

REFERENCES

Daniels, Amy L., and Armstrong, Margaret E.:  Nasal Sinusitis Produced by Diets Deficient in Fat-Soluble A Vitamin , J. A. M. A. 81: 828 ( (Sept. 8) ) 1923;.
Green, H. N., and Mellanby, Edward:  Vitamin A as an Anti-Infective Agent , Brit. M. J. 2: 691 ( (Oct. 20) ) 1928;.
Turner, R. G., and Loew, E. R.:  Infection of the Accessory Sinuses and Upper Respiratory Tract in Avitaminosis of Rats , J. Infect. Dis. 49:244 ( (Sept.) ) 1931;.
Sherman, H. C., and Burtis, M. P.:  Vitamin A in Relation to Growth and to Subsequent Susceptibility to Infection , Proc. Soc. Exper. Biol. & Med. 25: 649 ( (May) ) 1928;.
Turner, R. G.; Anderson Dorothy E., and Loew, E. R.:  Bacteria of the Upper Respiratory Tract and Middle Ear of Albino Rats Deprived of Vitamin A , J. Infect. Dis. 46: 328 ( (April) ) 1930;.
Wolbach, S. B., and Howe, P. R.:  Vitamin A Deficiency in the Guinea-Pig , Arch. Path. & Lab. Med. 5: 239 ( (Feb.) ) 1928;.
Tilden, Evelyn B., and Miller, E. G., Jr.:  The Response of the Monkey (Macacus Rhesus) to Withdrawal of Vitamin A from the Diet , J. Nutrition 3: 121 ( (Sept.) ) 1930;.
Mori, Shinnosuke:  The Changes in the Para-Ocular Glands Which Follow the Administration of Diets Low in Fat-Soluble A, with Notes on the Effect of the Same Diets on the Salivary Glands and the Mucosa of the Larynx and Trachea , Bull. Johns Hopkins Hosp. 33: 357 ( (Oct.) ) 1922;.
Wolbach, S. B., and Howe, P. R.:  Tissue Changes Following Deprivation of Fat-Soluble A Vitamin , J. Exper. Med. 42: 753 ( (Dec.) ) 1925;.
Seifried, Oskar:  Studies on A Avitaminosis in Chickens: I. Lesions of the Respiratory Tract and Their Relation to Some Infectious Diseases , J. Exper. Med. 52: 519 ( (Oct.) ) 1930;
 II. Lesions of the Upper Alimentary Tract and Their Relation to Some Infectious Diseases , SeifriedJ. Exper. Med. 52: 533 ( (Oct.) ) 1930;.
Bloch, C. E.:  Klinische Untersuchungen über Dystrophie und Xerophthalmie bei jungen Kindern , Arch. f. Kinderh. 89: 404, 1919;.
Frazier, C. N., and Hu, Ch'uan-K'uei:  Cutaneous Lesions Associated with Deficiency in Vitamin A in Man , Arch. Int. Med. 48: 507 ( (Sept.) ) 1931;.
Wilson, J. R., and DuBois, R. O.:  Report of a Fatal Case of Keratomalacia in an Infant, with Postmortem Examination , Am. J. Dis. Child. 26:431 ( (Nov.) ) 1923;.
Macy, Icie G.; Outhouse, Julia; Graham, Alice, and Long, M. Louise:  Human Milk Studies: II. The Quantitative Estimation of Vitamin A , J. Biol. Chem. 73:175 ( (May) ) 1927;.
Mori, Shinnosuke:  Ueber den sogennten Hikan (Xerosis conjunctival infantum ev. Keratomalacie) , Jahrb. f. Kinderh. 59: 175, 1904;.
Bloch, C. E.:  Further Clinical Investigations into the Diseases Arising in Consequence of a Deficiency in the Fat-Soluble A Factor , Am. J. Dis. Child. 28: 659 ( (Dec.) ) 1924;.
Pillat, Arnold:  Does Keratomalacia Exist in Adults? Arch. Ophth. 2: 256 ( (Sept.) ), 399 (Oct.) 1929;.
Dean, L. W.:  Nasal Sinus Infections in Children , J. A. M. A. 93: 838 ( (Sept. 14) ) 1929;.
Wright, H. P.; Frosst, J. B.; Puchel, F., and Lawrence, Margaret R.:  Vitamin A and the Common Cold , Canad. M. A. J. 25: 412 ( (Oct.) ) 1931;.
Barenberg, L. H., and Lewis, J. M.:  The Relationship of Vitamin A to Respiratory Infections in Infants , J. A. M. A. 98: 199 ( (Jan. 16) ) 1932;.
Hess, A. F.:  Diet, Nutrition and Infection , New England J. Med. 207: 637 ( (Oct. 13) ) 1932;.
Green, H. M.; Pindar, D.; Davis, G., and Mellanby, Edward:  Diet as a Prophylactic Agent Against Puerperal Sepsis , Brit. M. J. 2: 595 ( (Oct. 3) ) 1931;.
Thatcher, H. S., and Sure, Barnett:  Avitaminosis: III. Pathologic Changes in Tissues of the Albino Rat During Early Stages of Vitamin A Deficiency , Arch. Path. 13: 756 ( (May) ) 1932;.
Dahlberg, Gunnar, and von Sydow, Gertrude:  Komplikationsstatistische Methoden an Scharlach und Diphtheriemateriel dargestell , Acta med. Scandinav. 72: 124, 1929;.
Furnished by the White Laboratories, Inc., Gloucester, Mass.
Carr, F. H., and Price, E. A.:  Color Reactions Attributed to Vitamin A , Biochem. J. 20: 497, 1926;.
Rosenheim, Otto, and Schuster, Edgar:  A New Colorimeter Based on the Lovibond Color System and Its Application to the Testing of Cod Liver Oil and Other Purposes , Biochem. J. 21: 1329, 1927;.
Moore, Thomas:  The Colorimetric Estimation of Vitamin A , Lancet 2: 219 ( (Aug. 3) ) 1929;.
Gunn, William, and Griffith, Fred:  Bacteriological and Clinical Study of One Hundred Cases of Scarlet Fever , J. Hyg. 28: 250 ( (Dec.) ) 1928;.
Woody, S. S.:  Scarlet Fever , in Tice's Practice of Medicine 3: 247.
Ludy, J. B.; Hunt, E. L., and Cogswell, L. H.:  Observations on 500 Cases of Scarlet Fever , Mil. Surgeon 45: 414 ( (Oct.) ) 1919;.
Gardiner, W. T.:  Scarlet Fever Otitis , J. Laryng. & Otol. 37: 497 ( (Oct.) ) 1922;.
Harries, E. H. R., andd Gilhespy, F. B.:  Scarlet Fever Otitis , Lancet 1: 843 ( (April 26) ) 1924;.

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Daniels, Amy L., and Armstrong, Margaret E.:  Nasal Sinusitis Produced by Diets Deficient in Fat-Soluble A Vitamin , J. A. M. A. 81: 828 ( (Sept. 8) ) 1923;.
Green, H. N., and Mellanby, Edward:  Vitamin A as an Anti-Infective Agent , Brit. M. J. 2: 691 ( (Oct. 20) ) 1928;.
Turner, R. G., and Loew, E. R.:  Infection of the Accessory Sinuses and Upper Respiratory Tract in Avitaminosis of Rats , J. Infect. Dis. 49:244 ( (Sept.) ) 1931;.
Sherman, H. C., and Burtis, M. P.:  Vitamin A in Relation to Growth and to Subsequent Susceptibility to Infection , Proc. Soc. Exper. Biol. & Med. 25: 649 ( (May) ) 1928;.
Turner, R. G.; Anderson Dorothy E., and Loew, E. R.:  Bacteria of the Upper Respiratory Tract and Middle Ear of Albino Rats Deprived of Vitamin A , J. Infect. Dis. 46: 328 ( (April) ) 1930;.
Wolbach, S. B., and Howe, P. R.:  Vitamin A Deficiency in the Guinea-Pig , Arch. Path. & Lab. Med. 5: 239 ( (Feb.) ) 1928;.
Tilden, Evelyn B., and Miller, E. G., Jr.:  The Response of the Monkey (Macacus Rhesus) to Withdrawal of Vitamin A from the Diet , J. Nutrition 3: 121 ( (Sept.) ) 1930;.
Mori, Shinnosuke:  The Changes in the Para-Ocular Glands Which Follow the Administration of Diets Low in Fat-Soluble A, with Notes on the Effect of the Same Diets on the Salivary Glands and the Mucosa of the Larynx and Trachea , Bull. Johns Hopkins Hosp. 33: 357 ( (Oct.) ) 1922;.
Wolbach, S. B., and Howe, P. R.:  Tissue Changes Following Deprivation of Fat-Soluble A Vitamin , J. Exper. Med. 42: 753 ( (Dec.) ) 1925;.
Seifried, Oskar:  Studies on A Avitaminosis in Chickens: I. Lesions of the Respiratory Tract and Their Relation to Some Infectious Diseases , J. Exper. Med. 52: 519 ( (Oct.) ) 1930;
 II. Lesions of the Upper Alimentary Tract and Their Relation to Some Infectious Diseases , SeifriedJ. Exper. Med. 52: 533 ( (Oct.) ) 1930;.
Bloch, C. E.:  Klinische Untersuchungen über Dystrophie und Xerophthalmie bei jungen Kindern , Arch. f. Kinderh. 89: 404, 1919;.
Frazier, C. N., and Hu, Ch'uan-K'uei:  Cutaneous Lesions Associated with Deficiency in Vitamin A in Man , Arch. Int. Med. 48: 507 ( (Sept.) ) 1931;.
Wilson, J. R., and DuBois, R. O.:  Report of a Fatal Case of Keratomalacia in an Infant, with Postmortem Examination , Am. J. Dis. Child. 26:431 ( (Nov.) ) 1923;.
Macy, Icie G.; Outhouse, Julia; Graham, Alice, and Long, M. Louise:  Human Milk Studies: II. The Quantitative Estimation of Vitamin A , J. Biol. Chem. 73:175 ( (May) ) 1927;.
Mori, Shinnosuke:  Ueber den sogennten Hikan (Xerosis conjunctival infantum ev. Keratomalacie) , Jahrb. f. Kinderh. 59: 175, 1904;.
Bloch, C. E.:  Further Clinical Investigations into the Diseases Arising in Consequence of a Deficiency in the Fat-Soluble A Factor , Am. J. Dis. Child. 28: 659 ( (Dec.) ) 1924;.
Pillat, Arnold:  Does Keratomalacia Exist in Adults? Arch. Ophth. 2: 256 ( (Sept.) ), 399 (Oct.) 1929;.
Dean, L. W.:  Nasal Sinus Infections in Children , J. A. M. A. 93: 838 ( (Sept. 14) ) 1929;.
Wright, H. P.; Frosst, J. B.; Puchel, F., and Lawrence, Margaret R.:  Vitamin A and the Common Cold , Canad. M. A. J. 25: 412 ( (Oct.) ) 1931;.
Barenberg, L. H., and Lewis, J. M.:  The Relationship of Vitamin A to Respiratory Infections in Infants , J. A. M. A. 98: 199 ( (Jan. 16) ) 1932;.
Hess, A. F.:  Diet, Nutrition and Infection , New England J. Med. 207: 637 ( (Oct. 13) ) 1932;.
Green, H. M.; Pindar, D.; Davis, G., and Mellanby, Edward:  Diet as a Prophylactic Agent Against Puerperal Sepsis , Brit. M. J. 2: 595 ( (Oct. 3) ) 1931;.
Thatcher, H. S., and Sure, Barnett:  Avitaminosis: III. Pathologic Changes in Tissues of the Albino Rat During Early Stages of Vitamin A Deficiency , Arch. Path. 13: 756 ( (May) ) 1932;.
Dahlberg, Gunnar, and von Sydow, Gertrude:  Komplikationsstatistische Methoden an Scharlach und Diphtheriemateriel dargestell , Acta med. Scandinav. 72: 124, 1929;.
Furnished by the White Laboratories, Inc., Gloucester, Mass.
Carr, F. H., and Price, E. A.:  Color Reactions Attributed to Vitamin A , Biochem. J. 20: 497, 1926;.
Rosenheim, Otto, and Schuster, Edgar:  A New Colorimeter Based on the Lovibond Color System and Its Application to the Testing of Cod Liver Oil and Other Purposes , Biochem. J. 21: 1329, 1927;.
Moore, Thomas:  The Colorimetric Estimation of Vitamin A , Lancet 2: 219 ( (Aug. 3) ) 1929;.
Gunn, William, and Griffith, Fred:  Bacteriological and Clinical Study of One Hundred Cases of Scarlet Fever , J. Hyg. 28: 250 ( (Dec.) ) 1928;.
Woody, S. S.:  Scarlet Fever , in Tice's Practice of Medicine 3: 247.
Ludy, J. B.; Hunt, E. L., and Cogswell, L. H.:  Observations on 500 Cases of Scarlet Fever , Mil. Surgeon 45: 414 ( (Oct.) ) 1919;.
Gardiner, W. T.:  Scarlet Fever Otitis , J. Laryng. & Otol. 37: 497 ( (Oct.) ) 1922;.
Harries, E. H. R., andd Gilhespy, F. B.:  Scarlet Fever Otitis , Lancet 1: 843 ( (April 26) ) 1924;.
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