Study of Vitamin-A Deficiency in Ceylon

To the Editor, The Indian Medical Gazette Sir,?We have read with great interest the ' Study of Yitamin-A Deficiency in Ceylon' by Dr. L. Nicholls, published in the May number of the Indian Medical Gazette. May we, however, suggest that the syndrome he describes is a wider deficiency than merely that of vitamin A. The sore mouth and 'neuritis' symptoms have been described as pellagrous by Stannus {sec, for example, his review of the subject in Trans. Roy. Soc. Trop. Med. and Hyg., Vol. XXIII, p. 627). Our own observations upon a disease found in Malayan prisons in which the chief symptoms are sore mouth and eczema of the scrotum lead us to believe that this syndrome is due to vitamin-B deficiency. Our conclusions are largely based upon therapeutic tests. We have not found phrynoderma common but there is no doubt that deficiency diseases vary from country to country. Dr. Nicholls himself says of the incidence of phrynoderma and sore mouth, ' the conditions do not follow one another in uniform curves'. This point suggests that two separate deficiencies may be present. Therapeutic tests would be of great interest in the conditions that Dr. Nicholls has described.