The disease may be prevented or cured only by including in the diet such food as milk, eggs, fresh fruit and vegetables.
Xerophthalmia is a deficiency disease characterized by eye lesions and due to a lack of, or deficiency in the diet of the protective substance which has been designated as fat-soluble A. This substance is absent in polished rice, and present in but small amounts in barley and other cereals; in muscle cuts of meat; in peas, beans and other vegetables excepting those described as “leafy.” It is contained in cod-liver oil, butter, cream, egg yolk, liver, kidneys and the leafy vegetables.
In the early stages of the disease the eyes are inflamed and the lids badly swollen. If the diet is wholly lacking in fat-soluble A, the disease progresses rapidly, the eye balls frequently rupture and the lens and vitreous humor are expelled, with total and permanent blindness as the tragic result. On the other hand, the malady clears up in a very spectacular manner if, in the early stages, the patient is fed those foods which contain the mysterious, but indispensable fat-soluble A.
Fig. 140.—This baby is totally blind in the left eye as a result of ulcers, due to a long continued diet of cereals with a little skimmed milk; in other words, a diet poor in fat-soluble A. The right eye became involved but administration of cod-liver oil was followed by speedy recovery and partial vision was saved. There is little doubt but that the baby would have been totally blind had the faulty diet been continued. (From the Newer Knowledge of Nutrition, by E. V. McCollum.)
Well developed xerophthalmia is not common in this country but one sees inflamed eyes and corneal ulcers in young children which clear up with little local treatment after a mother has been persuaded to give the patient more fresh milk, butter and green vegetables.
Mori reports upon about 1500 cases occurring in Japan, in 1905, among children between the ages of two and five years. He states that the disease does not occur among the fisher folk but among people whose diet is largely composed of rice, barley, cereals, beans and “other vegetables,” but he does not state what the other vegetables are. Prompt relief of the eye symptoms was observed when cod-liver oil, chicken livers and eel fat were administered.
Bloch describes cases of xerophthalmia among infants under one year of age, in the vicinity of Copenhagen, during the years of 1912 and 1916. (Fig. [140].) The babies were also suffering from malnutrition and the skin was dry, shrivelled and scaly. Their diet consisted largely of separator skimmed milk, which was, therefore, practically fat-free, oatmeal gruel and barley soup. The milk was pasteurized and then cooked in the home before being fed to the babies. Such a diet was so faulty that the infants in question may well have been border-line cases of scurvy and beri-beri, as well as developed cases of xerophthalmia. It is also evident that the children were unquestionably suffering from rickets.
It is believed that the condition known as night-blindness is related to, or a mild or early form of xerophthalmia. It occurs in Newfoundland and Labrador, among men in lumber camps and elsewhere, whose diet consists chiefly of wheat flour, beans, meat, fish, molasses, raisins and coffee. Such a diet is made up of those parts of the plant or animal which have good keeping qualities, but these qualities do not compensate for the poverty of the protective substance.
Dr. Anna Strong, who has had experience as a medical missionary in India, observes that night-blindness is common in the vicinity of Calcutta, and it is said to occur frequently in Russia during the Lenten fasts. The popular treatment for this condition consists of poulticing the eyes with fresh goat’s liver and giving the liver as a food as well; while in Japan the efficacy of eating liver to cure night-blindness has been recognized from early times.