Clinical experience with crystalline vitamin D: The influence of the menstruum on the effectiveness of the antirachitic factor

Abstract

Summary In order to determine whether crystalline vitamin D in milk was more effective unit for unit than crystalline vitamin D in oil, nine rachitic infants were given 90 units of crystalline vitamin D in milk, and nine were given 90 units of crystalline vitamin D in oil and a comparison of healing in both groups was noted. The scope of the investigation was enlarged to include a study of the effect on the course of rickets of 45 units of crystalline vitamin D in milk, and 900 units in oil. Accordingly eight rachitic infants were given daily 45 units of crystalline vitamin D in milk, and ten infants, 900 units in oil. The results of the administration of 90 units of crystalline vitamin D in milk were definitely superior to those obtained with a similar number of units in oil. Of nine infants receiving 90 units of crystalline vitamin D in milk, healing was observed in all at the end of one month, whereas only three of nine infants receiving 90 units of crystalline vitamin D in oil showed healing during the same period of observation. Roentgenograms were also taken after crystalline vitamin D had been given for six, eight, and ten weeks, and the results revealed that the group of infants receiving the antirachitic vitamin in milk reacted more favorably. These results indicate that the medium of milk allows for better utilization of the antirachitic vitamin than does the medium of corn oil and thus offer an explanation for the greater effectiveness, from the standpoint of rat units, of antirachitic milks as compared with viosterol. The therapeutic results with 45 units of crystalline vitamin D in milk were superior to those obtained with 90 units of crystalline vitamin D in oil. However, two failures were noted among eight infants receiving the 45-unit milk, so that this dosage of units in milk must be regarded as below the therapeutic level. With 900 units of crystalline vitamin D in oil, satisfactory healing resulted in nine of ten rachitic infants. We would recommend that from 10 to 15 drops (800 to 1,200 Steenbock units) of a 250-D preparation of crystalline vitamin D in oil should be used as a curative dose for mild and moderate cases of rickets and that from 20 to 60 drops be given for marked cases. However, if a solution of crystalline vitamin D in propylene glycol 250-D is employed by incorporation in 24 ounces of milk, only one drop (83 Steenbock units) is necessary to cure infantile rickets.