Nerve and Cord Degeneration Referable to Vitamin-A Deficiency

In 1933 I inspected a large number of prisoners in the jails of Ceylon for signs and symptoms of nutritional deficiencies. The results were reported in this journal (Nicholls, 1933). The conditions which were attributed to vitamin-A deficiency were :?a papular dry skin eruption (phrynoderma), night blindness, dimness of sight, xerophthalmia, keratomalacia, a lowered resistance to dysentery, and neuritis. The last was so common that a diagnosis of neuritis had been made during 1932 in the case of 41 patients admitted to the Colombo Prison Hospital, and 2,397 treated at the dispensary. At that time the diagnosis was accepted, but at a later date more careful clinical investigations made this doubtful. There was considerable uniformity in the symptoms in the early stages, the patients complained of a burning sensation of the hands and sometimes of the feet, and numbness, tingling and weakness of the limbs. Many patients had pain when the muscles of the calves were squeezed. The reflex responses varied and were increased, normal or diminished.