• DOI:10.2307/3347750
• Corpus ID: 55658526

Nutritional Failures: Their Causes and Prevention

@article{Jolliffe1942NutritionalFT,
  title={Nutritional Failures: Their Causes and Prevention},
  author={Norman. Jolliffe},
  journal={Milbank Quarterly},
  year={1942},
  volume={20},
  pages={103-125}
}

• N. Jolliffe
• Published 14 June 1942
• Medicine
• Milbank Quarterly

N utritional failure* begin s w h e n ad equ ate am ou n ts o f essential nutrients are n ot p ro vid ed to the “ m ilieu in ­ terne.” F r o m this p o in t the successive stages are repre­ sented b y tissue depletion, b ioch em ical “ lesions,” im p aired fu n c ­ tion, and fin ally b y an atom ical lesions. T h e anatom ical lesions w h ic h occu r in such clin ical states as hunger edem a, rickets, osteom alacia, scu rvy, beriberi, an d p ellag ra have lon g been re co g n ized . T h e r e are a n u m b e r o f an atom ical les­ ions, h ow ever, w h ic h are o n ly b e g in n in g to be re co g n ized as d u e to nutritional failure. A m o n g these are cheilosis, fissures in the angles of the m outh, filifo rm derm atosis in the nasolabial fo ld s, an d in ­ vasion o f the cornea b y cap illa ry b lo o d vessels, all co m m o n ly at­ tributed to nutritional fa ilu re related to d eficien cy o f riboflavin. Quite re cen d y KLruse ( i ) pointed out th at xerosis conjunctivae is probably the earliest an ato m ical lesion o f n u tritio n al fa ilu re related to deficiency o f vitam in A . E vid ence has accu m u lated d u rin g the past five years w h ic h in d i­ cates that the diagnosis o f n u tritio n al fa ilu re cann ot be lim ited to clinically m anifest an atom ical lesions. T h e preclin ical states, as rep­ resented b y tissue depletion, b ioch em ical “ lesions,” an d altered physiology, h o ld greater im p o rt because th ey precede an d are m ore com m on th an the anato m ical lesions. T h e se prean ato m ic lesions cause inefficiency, im p a ir w e ll-b e in g , an d constitute potent sources of poor health.