Clinical Nutritional Deficiency Disease
It is increasingly evident to clinicians that a lack of necessary specific nutritional elements often leads to definite symptoms and syndromes. Certain deficiency diseases such as scurvy and beriberi resulting from a total lack of such elements have long been recognized but are seldom seen in this country. Mild symptoms, however, due to an inadequate supply of nutritional factors occur frequently. We should think of a nutritional deficiency state as a combination of different symptoms and signs resulting from the disturbed nutrition of tissue rather than as a definite “disease.” Often, more than one specific element is lacking, thus further complicating the picture. A nutritional deficiency results from a deficient supply or use of a specific nutritional element at the point of normal utilization. The element may be brought by the blood stream to the point of normal utilization and still be unused. Thus, in certain conditions such as lead poisoning, iron may be supplied in adequate amounts without influencing an iron deficiency anemia because the tissues are unable to utilize the iron offered in the building of hemoglobin. Similarly, absorption may be interfered with so the nutritional element is of no more value so far as the tissue needing it is concerned than if it had not been taken into the gastro-intestinal tract. It is apparent also that vomiting and diarrhea cause a mechanical loss of elements before absorption can take place.
All the specific nutritional elements must be ingested as such or formed in the gastro-intestinal tract from. . .