VITAMIN A AS AN ANTI-INFECTIVE AGENT
Authors: H. N. Green, E. Mellanby
Journal: BMJ (1928)

Xm J;oU UNA2 looked suspicious, but were not swollen; no suggestion of atrophy.Vision (with glasses) 6/9 each eye; no contractioln of visual fields.In other respects there were no signs of organic disease.August 31st, 1928.Patient attended for examination by request.She was able to continue to work, and examination showed her geieral condition and the ophthalmoscopic facts to be the same as in 1921.In a word, a patient regarded in 1908, and by an expe- rieniced physician, as unidoubtedly the subject of an intra- cranial tumllour, is in 1928 in fair general health, aind the former optic neuritis has disappeared without leaving optic atrophy as its sequel.CASE 8.A boy (J.L.), aged 9 years, seen with Dr. Meikle in February, 1924, gave a history of attacks of severe headache, sometimes attended with vomniting, extending over three nmonths; recently diplopia and -dimness -of vision and " weakness " of the left upper limb.Exaimiination showed mnuch exudation at each optic disc; visioni (each eye) 6/9 part; paresis of the right externial rectus and of the left louwer face.He was admitted to hospital with a view to _operation, but gradually the headache and vomiting ceased, double vision disappeared, and there was obvious recession of the swelling of the optic discs.In the end, the boy left the liospital apparently quitc well.Seen in November, 1925, his weight had increased from 5 st. 1 lb, to 7 st.7 lb.; .hismother described him ae " in perfect health."Examination was niegative except that the optic discs were unduly white; vision (each eye) 6/6.In August, 1928, Dr. Meikle reports him to be " perfectly welL."In the early stage of this case there seemed no possible escape from a diagniosis of intracranial tumour.Does the completeniess of the recovery and the, persistence of good health quialifv this conclusion?If iot, then thie case illus- tr ates the l)prolosition advanced in this (ommlunication- namiely, that recover'y fiolnl symilptomlis of intracranial tumilour', whlen it occurs, may proceed to such a level as to includkle resolution of an optic neuritis anid reten-tion of a ftull standai-d of vision.CASE 9.A boy, aged 6, was seen in May, 1894, by Mr. Charles Higgens9 oni accouint of failure of sight; vision was found to be much depreciated; there was exudation at eacih optic disc.He was later seen by Dr. (afterwards Sir David) Ferrier, who recognized double optic nieuritis and symptoms of cerebellat disease, aind regarded the case as one of turmour.After this the boy was reportedi to have " gone blind," but when re-6xamined in 1907 by Mr. Higgeiis the visual acuity in each eye was 6/6 anid the obtic discs, though pale, were atherwise normlial.When these case records are subject to examiniation as a whiole it would appear that in Cases 1, 2, anid 3 symiptoms of initracraniial tumour disap)pear except for blindness due to optic nierve atroph, whlile in Cases 6, 7, 8, and 9 similar-symptoms are followed by complete recovery, anld the reliai)ility of the recoverv is certified bv freeidomi from01 symptomns for a, term of years.Except in the degriee of recovery attained, there 'does not appeal to be any reason to draw a distinction betwieen the two groups, an;id Cases 4 and 5 mnay be quoted as emphasizing the identity of the pathological basis on which the several cases r'est.Hence it would appear that the facts as here collected and quioted justify the following co-chlisionis:1.That