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Journal 1941 [Levine] Value of Meat as Antiscorbutic

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meat as a preventative of scurvy
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454

AMERICAN

JOURNAL

OF D I G E S T I V E

DISEASES

VOLUM~ 8 NUigBF,a 12

significance with respect to the mechanism of hydrochloric acid secretion. SUMMARY During the rapid secretion of hydrochloric acid by the gastric mucosa, appreciable differences in the chloride concentration in the arterial and gastric venous blood were observed only occasionally; these differences were mainly in the cell chloride. REFERENCES1. Hanke, M. E., Johannesen, R, E. and Hanke, Maude M.: Alkalinity of Gastric Venous Blood D u r i n g Gastric Secretion. Proc. Soc. Exper. Biol, and Med., 28:698-700, March, 1931.

2.

3. 4. 5. 6. 7.

Bulger, H. A., Allen, Duff r H a r r i s o n , L. B.: Studies of the Chemical Mechanism of Hydrochloric Acid Secretion. II. Observations on the Blood P a s s i n g Through the Stomach of Dogs. J. Clin. Invest., 5:561-571, June, 1928, Peters, J. P. and Van Slyke, D. D . : Quantitative Clinical Chemistry. Baltimore, Williams & Wilkins Company, Vol. 2, p. 835, 1932. Mann, F. D. and Mann, F, C.: An E x p e r i m e n t a l Study of Some Chemical Inhibitors of Gastric Acidity. A m . J. Dig. Dis., 6:322325, July, 1939. Bandes, J., Hollander, F. and Glickstein, J . : Effect of Fluid Absorption on Dilution Indicator Technique of Gastric Analysis. A m . J. Physiol., 131:470-482, Dec, 1940. Dodds, E. C. and Smith, K. Shirley: Variations in the Blood Chlorides in Relation to Meals. P a r t 1. J. Physiol., 58:157-162, Dec. 28, 1923. Lira, R. K. S. and Ni, T. G.: Changes in the Blood Constituents Accompanying Gastric Secretion. I. Chlorides. A m . J. Physiol., 75:475-486, Jan., 1926.

The Value of Meat as an AntiscorbuticByVICTOR E. LEVINE, M.D.OMAHA, N E B R A S K A

INTRODUCTION R. V I L H J A L M U R S T E F A N S S O N in a communication to SCIENCE, entitled "The Dilemma in Vitamins," calls attention to a difference of opinion between the field observer and the experimental nutritionist on the subject of scurvy with reference to meat as a preventive or curative. Upholding the stand of the explorer, Dr. Stefansson asserts that the records of travelers, field anthropologists and frontiersmen, such as the managers of trading posts in the employ of the Hudson's Bay Company throughout the north of Canada, abound in case histories, which offer indisputable proof of the fact that exclusive meat e a t e r s never develop the symptoms characteristic of scurvy. It must be noted, however, that in countries and climates where fruits and vegetables are available, animal food does not enter into the problem of the prevention of scurvy. Stefansson's views harmonize with his own experiences in curing and in preventing scurvy among his own Arctic companions by the consumption of fresh meat (2, 3). In his very interesting volume, THE F R I E N D L Y ARCTIC, he recounts how in 1917 he induced in his companions, Lorne Knight and Harold Noice, rapid recovery from scurvy by the consumption of fresh meat. Stefansson makes the illuminating, significant and judicious suggestion that Arctic and Antarctic explorers should not provide themselves with antiscorbutics in the form of fruits and vegetables. These may prove a burden on the trail because of excessive weight; they may be lost through accident; they may in time undergo rapid diminution in antiscorbutic potency. Fresh meat secured by "living off the land" has all advantages and no disadvantages (4, 5). However, it must be admitted that living off the land with reference to the prevention of scurvy is no longer an important problem for explorers, since they now can supply themselves amply with synthetic Vitamin C or ascorbic acid without any addition to the weight of supplies and without much danger of deterioration.

D

* F r o m the D e p a r t m e n t of Biological C h e m i s t r y and Creighton University, School of Medicine, Omaha, Neb. Submitted March 29, 1941.

Nutrition,

The experimental nutritionist is responsible for the belief that meat is inefficacious as an antiscorbutic. This viewpoint had its origin in the results obtained in the biologic assay of its antiscorbutic value, utilizing the guinea pig as the test animal. The findings of the nutritionist indicate that muscle meat has a negligible quantity of Vitamin C, and that it possesses therefore dubious value as a food to be utilized in the prevention and cure of scurvy. The internal organs, on the other hand, especially liver, are comparatively rich in Vitamin C and do possess efficiency as antiscorbutics (6). Moreover, muscle meat of all soft animal tissues the poorest in Vitamin C content, may undergo considerable loss or even complete loss in antiscorbutic potency as a result of oxidation, aided by aging, by cooking, by the natural process of drying or by the mechanical process of dehydrating. Dr. Stefansson is not in accord with the findings of the experimental nutritionists. He cites the case of such meat eaters as the northern Athapascans who punctiliously cook their food to an extent to which nutritionists imply would practically destroy Vitamin C potency. These northern Athapascans as well as the northern Canadian Eskimos feed to dogs or throw away most of the internal organs rich in Vitamin C. Yet, according to Stefansson, neither these Eskimos nor these Athapascans ever develop symptoms of scurvy. In attempting to solve the apparent dilemma between the animal experimenters and the observers of diets among primitive peoples, Stefansson offers four pertinent suggestions : (1) "The experimenters reach unsound conclusions with regard to human needs when they analogize for Vitamin C from guinea pigs to human beings." (2) "Those who measure the Vitamin C content of animal tissues through the current methods have probably overestimated from two to ten times the amount necessary to prevent scurvy symptoms in man - - o r perhaps they have underestimated the superiority of the human over the guinea pig mechanism for extracting and utilizing Vitamin C." (3) "The experimenters have overestimated the destructive effect of ordinary cooking upon the Vita-

JOUR. D. D. D~CEMBER, 1941

L E V I N E - - T H E VALUE OF MEAT AS AN ANTISCORBUTIC

455

rain C efficiency of animal tissues--in all probability the Vitamin C is greatly weakened or destroyed only in the outermost layer of a piece of meat. Most carnivorous people boil or roast their meat in large pieces and cook to where the outside only is well done while the inside of either boiled or roast is about like the inside of our roasts. In such cooking the Vitamin C efficiency may remain nearly or quite undiminished through 90 per cent of the diameter of each chunk." (4) "Or possibly t h e r e is some component of animal tissue other than Vitamin C which is able to prevent scurvy." In discussing these suggestions we shall endeavor to remove the dilemma. V I T A M I N P AND ITS P O S S I B L E R E L A T I O N TO SCURVY With reference to the suggestion relating to the probability of the presence of a component of animal tissue other than Vitamin C which is capable of preventing scurvy, it may be stated that Szent-Gyiirgi and his coworkers reported in extracts of Hungarian red pepper (paprika) and in lemon, grapefruit or orange, or in the peelings from these citrus fruits, a substance other than ascorbic acid which decreases capillary fragility and capillary permeability (7, 8). This substance, St. Ruzny~k and Szent-Gy5rgi (9) claimed to be a flavonone in chemical nature, and Bruckner and Szent-Gyhrgi (10) identified it as a mixture of hesperidin (a glucoside of 4-methoxyeriodyctyol) and eriodyctyol glucoside (a glucoside of 5 : 7 : 3 : 4 : tetrahydroxyflavanone). Clinically this vitamin, named Vitamin P (permeability factor), returned fragile and permeable capillaries to their normal state. Vitamin P deficiency may be part of the picture of clinical scurvy. Szent-Gyhrgi and his workers were able to control the number of hemorrhages in the course of certain clinical conditions, in three cases of vascular purpura, in four cases of thrombocytopenic purpura, in seven cases of infectious disease, and in two cases of diabetes me]litus. Experiments with scorbutic guinea pigs indicated a prolongation of life for 28.5 to 44 days as a result of the administration of Vitamin P and a decreased number of hemorrhages. Zilva (11) and also Moll (12) working with guinea pigs were unable to confirm these results. McHenry and P e r r y (13) maintain that a deficiency of Vitamin P is not a factor in producing hemorrhages in scorbutic guinea pigs and that a deficiency of ascorbic acid is alone responsible for scurvy in these animals. Results of other investigators on the other hand point to another factor implicated with Vitamin C. Jacobson (14) reported a lower concentration of ascorbic acid in the adrenals of guinea pigs receiving daily 20 milligrams of crystalline ascorbic acid than in the same organs receiving an equal amount of Vitamin C from cabbage. Fox and Levy (15) kept four guinea pigs for two months on a basal diet plus five milliliters of orange juice equivalent to 2.5 to 3.0 milligrams of ascorbic acid and found a retention of 0.5 gram of ascorbic acid per gram of adrenal tissue. Five animals fed for three months a basal diet plus lucerne leaves equivalent to 3.2 milligrams of ascorbic acid per day showed an average storage of only 0.32 milligram per gram of adrenal tissue. The difference may be in the fact that orange juice is rich in

Vitamin P. Hawley, Daggs and Stephens (16) also observed better retention of ascorbic acid in the tissue of guinea pigs when the vitamin was ingested in the natural form as cabbage, alfalfa and orange juice than when administered in the form of crystalline Vitamin C. Very recently Todhunter, Robbins, Ivey and Brewer (17) made a comparison of the utilization b y guinea pigs of equivalent amounts of asco

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