New Light on The Control of Dental Caries and the Degenerative Diseases

In man’s universal struggle for life, the emphasis has been rapidly passing from the role of the invading organism to the factors which determine the capacity of the host to maintain defense against the invader. With this is coming a new view of the fundamental contributing factors to the degenerative processes, including dental caries, which, while usually associated with evidence of bacterial invasion, are coming rapidly to be viewed as being, in large part, nutritional in origin. The emphasis of various workers in different fields has been placed on different ones of the few already identified vitamins. I have interpreted the available data as indicating the presence of a group of activators not limited to the known vitamins. For the past eight years, I have been presenting research reports indicating consistent and regular progress in the control of dental caries in which various of the contributing factors have been discussed in connection with mineral utilization and defense against disease.¹

These studies have provided a large mass of data indicating that dental caries is primarily a nutritional disturbance, though influenced by local environmental conditions, and that it is directly related in its etiology to some other degenerative processes. The materials that I have briefly utilized for treatment and recommended have included cod-liver oil, raw and activated, and activator concentrates from dairy products, together with adaptations of the diet.

The studies that I shall report in this paper include a review of the clinical results obtained through the administration of special activators taken in capsule form by an experimental group of more than 200 individuals, with a comparison with other individuals living under the same general conditions and in the same age periods who did not receive special vitamins. I have divided these individuals according to age into ten-year period groups for six decades. While it is clearly very difficult to control conditions in groups that are not under hospitalization, the differences in the groups are so great as to absorb all possible errors and leave a wide margin. The data are shown in graphic form in Figure 1, in which the dotted line shows by the elevation of the columns the number of cavities per person in the group not receiving the vitamin capsules, and the solid line shows the number of cavities per person in the individuals receiving capsules. In the entire group of all ages for the period covered, which was, in most cases, from September and October, 1929, to May and June, 1930, there were ten times as many cavities in the individuals not receiving capsules as in those receiving them, and, for the individual groups, the figures were as follows: for those from 1 to 10 years of age, inclusive, the ratio was 0:3; from 11 to 20 years of age, 1:40; in other words, in twenty individuals who received the capsules, there were only three cavities that developed in that period, whereas, in twenty similar individuals not receiving the capsules, there were disclosed 141 cavities. In the age groups from 21 to 30, the ratio was 1:6; for those from 31 to 40, 1:2.4; from 41 to 50, 0:1.0; from 51 to 60, 0:2.0. It is of interest to note that, with the continued research on and testing of activators, the percentage of ratios has progressively increased. For example, in two groups that were carried through the year 1928-1929, one with treatment and the other without, the former had 4.85 cavities per person and, in 1929, 4.73 per person. This group contained forty-nine patients. In another group which was selected from the available cases and consisted of those who had an exceedingly large number of cavities, namely, an average of 8.02 cavities per person for 1928 when not receiving treatment, the cavities dropped to 1.40 per individual when the patients received special activators in capsule form. In a previous report, I presented data on fifteen individuals between the ages of 12 and 18, inclusive, in which nine individuals not receiving treatment had 5.50 cavities per person and those individuals receiving treatment did not have a single cavity. In the group attending boarding schools, four without treatment had an average of 8.50 cavities per person, and those receiving treatment, but living under the same conditions, had no cavities in four individuals. In one case, there were two brothers, the one taking capsules and the other not taking them. The one taking the capsules had no cavities and the one not taking them had five. These individuals were all examined during the same ten-day period of the Easter vacation. In a group of pregnancy cases, one patient without treatment had nine cavities, and one with treatment, one cavity.

 

Fig. 1. Effect of vitamin capsules on dental caries by ten-year age groups. Progress in the control of dental caries is shown by the difference in the number of cavities which have developed per individual in the group receiving special activators as compared with those in the group not receiving them. For all ages, this difference is 1 to 10 and the “teen” ages, 1 to 40. Broken line, capsules; solid line, no capsules.

 

While the improvement in dental conditions has been marked, it is of great importance that the practically universal report of all the patients under special treatment has been improvement in physical well-being, reduction of colds and increased energy capacity. A large number of clinical conditions which were considered as diseases greatly improved or disappeared, which suggested that, in part, and probably in large part, they also were symptoms of nutritional imbalances. The association of these various phenomena has strongly indicated that we are dealing with related factors and has emphasized the need for the continuation of studies on the fundamental factors in these various phenomena.

During the past year my effort has been continued on the analyses of both the mineral and the activator content of the various products, including the foods of both human beings and domestic animals. My researches on the seasonal tides and local levels of the activators in dairy products produced in different places at different periods of the year and for comparison of different places at the same time have been extended so that samples of cream, butter and cheese are now being received at the rate of about 700 per month from many countries throughout the world. It is of great importance that, in general, curves that are now produced for the first six months of 1930 show a remarkable similarity to those of the same months for the years 1928 and 1929. These are shown as general averages for a five-state area in Figure 2. It will be noted that the general levels were a little higher in 1929 than in 1928, and that for the first six months of 1930, they are higher than for either 1928 or 1929. This is doubtless due to the earlier spring growth caused by rains and warmer weather. They seem to have predicted not only an early summer but also an unusually hot one for 1930. Vitamin A is shown in the dotted line and vitamin D in the solid line. These data are for a five state area in Zone IV between latitudes 35 to 45 north. In other recent reports, I have shown vitamin D in four factors or levels.

 

Fig. 2. Comparison of vitamins A and D in butter by months for three years (1928, 1929, 1930). The levels of vitamins A and D as determined by chemical tests of the samples for the same five-state area for two whole years and six months of this year show, in general, the same rise in the early summer and autumn, with a depression in midsummer and a severe depression for winter and spring.

 

The area being covered by these intensive studies has been progressively enlarged until it now includes many nations throughout the world in both hemispheres, and it is exceedingly significant that now that data are available for comparing the northern and southern hemispheres with regard to vitamins in dairy products, the curves are in reverse with regard to their high and low periods just as should be expected on the basis of seasons and their effect on plant growth for providing food for dairy cattle. These data are shown in Figure 3. It is also of interest to note, when comparing the southern hemisphere with the northern, that the summer peaks in some of the countries in the southern hemisphere are higher than the summer peaks in the northern hemisphere. The causative factors are being intensively studied. It will be noted that, in the northern hemisphere, Zone III, which constitutes the southern tier of states, latitudes 25 to 35, north, and Zone IV, the next 10-degree period, including the center tier of states, are exceedingly similar in that they each carry a sharp rise in April, a fall in May, a rise in June, a fall in July and a rise in August, with a rapid decline in November. This is probably a direct indication of the influence of climate factors, chiefly temperature and rainfall. The smoothness of the curves will be greatly increased when larger numbers of determinations are available, it being a physical impossibility as yet to obtain an adequate number of samples to represent these various districts properly.

 

Fig. 3. Comparison of northern and southern hemispheres by latitude zones for vitamin D in butters. An important similarity in the northern and southern hemispheres is shown to exist with regard to butter samples tested, except that the seasons are reversed. The remarkably good showing of some countries in the southern hemisphere is significant.

 

Owing to the need for brevity, I cannot present data here in as complete detail as I would wish to demonstrate the great difference in the levels of the vitamins in different places in the same latitudes at the same time. have, accordingly, consolidated three types of data dealing with three entirely different phases of vital phenomena and I am presenting the information in a form that makes comparison possible. I have divided the United States and Canada into sixteen different districts, each containing many thousand square miles, and so related that they are comparable on the chart in their normal geographic relation to other districts. This presentation of these various phases is done in order that the coordinated problems may be studied under four headings, as follows:

1. To show the evidence of cycles in health and disease as illustrated by two of the typical and major affections of mankind; namely, pneumonia, an acute infectious process, and organic heart disease, a chronic degenerative process with contributing factors due to chronic and to recurring infection
2. To present data dealing with variations in the total level of vitamins A and D in butter fats as determined in my studies from month to month throughout an annual cycle. These are determined from samples of butter and cream which I have obtained from individual creameries in various districts.
3. To study the possible relationship of cause and effect or common effects of the two factors, morbid conditions on the one hand and vitalizing forces on the other, in order to throw light on the etiology of diseases, both acute and degenerative.
4. To study the larger problem of the cause of the progressive development of disease, including dental caries, at a more rapid rate in some districts than in others.

It will immediately be seen from a study of the charts in Figure 4 that these diseases show a distinct cycle in their severity and that the cycle varies in different districts, though, in general, it tends to follow the same course and periodicity of increase in the fall, winter and spring and decrease in the later spring and summer. The general characteristics of this curve, which is shown in the solid line, is expressed as an increase in susceptibility or rate of deaths for these two affections, beginning in August and September and progressively increasing in most places until late winter or March, then progressively declining to mid-summer. A critical analysis of the various vitamin curves which show the sum of vitamin A plus vitamin D as determined by colorimetric methods reveals not only a general higher level of the vitamins for the summer than the winter, but also evidence of a sharp rise according to latitude, beginning probably at a time when the cattle are receiving rapidly growing young grass. In the southern latitudes, this rise comes in January and February, and, in many districts, it is followed by a later depression, which probably is related to precipitation affecting the vegetation. In general, the morbidity curve is the reverse of the vitamin curve, and if it be true that plant life vitamins follow those of the cattle feeds as expressed in milk, there is strong evidence of a relationship of cause and effect through the development of acute infections and progressive tissue degeneration, with a reduction of the activators, some of which are known vitamins, and a marked decrease in these morbidity processes with a rise of plant vitamins. It is a striking fact that just as the vitamin rise comes later in the more northerly latitudes, the most rapid fall in the morbidities also appears later in the spring than in the more southern latitudes. There is also evidence of a summer depression in vitamins in several districts with the effect that the summer levels of these morbid conditions remain higher than in those districts with a high summer vitamin level. The conclusion seems logical, if not inevitable, that the life-giving factors as vitamins influence, if they do not determine, the level of the morbid conditions, and it seems most imperative to study the factors which determine the level of the activators in the food to ascertain why the available levels exist and also, if possible, to determine how they may be modified in order that the incidence of morbid conditions may be lessened.

Fig. 4. Combined mortality curve for pneumonia and organic heart disease, shown to be, in general, the opposite of the vitamin level A plus D when the United States and Canada are divided into sixteen general districts.

 

The relationship that I have shown to exist between the degenerative diseases and the vitamin levels by months in the product of plant food, namely, milk, the only known complete food for life and growth, has strongly emphasized the need for research on the factors controlling the development of the activators or vitamins and also the levels of the minerals and other chemicals in the food products. It is of particular interest that many of the plant-eating animals of the world, if not most of them, are subject to periodic and often exceedingly severe disturbances which have been considered in the past to be mysterious diseases of unknown cause, but which have now come to be recognized as deficiency diseases, due chiefly to an inadequate supply of minerals and activators. This has resulted in the death of large numbers of domestic animals in various countries of the world at certain seasons and under certain climatic conditions.

My studies the last two years have included very extensive chemical analyses of soils and of plants growing upon them in relation to the health of animals and individuals living on those products. A typical and striking illustration is shown in Figure 5, which represents an affection of cattle which appears in some of the coastal gulf counties of Texas and some other states. The cattle frequently go down with a disturbance locally known as loin disease. Through the kindness of Dr. H. Schmidt, veterinarian, acting for the chief at the Texas Agricultural Experiment Station (College Station), I have received samples of blood of affected animals for chemical analysis and also samples of the soils and two of the grasses. I will present here in detail results of six different types of determinations that have been made in a study of the causative factors or organ and tissue degeneration, due primarily to nutritional disturbance. In a more extended communication, I am discussing the evidence of breakdown in one or more organs or tissues in domestic and wild animals in many countries throughout the world. While some of these, including loin disease, have an associated infection factor, the fundamental lesion or disturbance is brought about by chemical deficiencies, chiefly mineral. Such disturbances in domestic animals are usually associated with an abnormal craving, particularly for bones, and treatment in many countries has as one, and usually the chief, factor, the feeding of ground sterile bone. Animals may be so afflicted with a craving for the minerals that they will eat even putrid bones and, by so doing, may obtain toxic material and bacterial infection from organisms such as Bacillus botulinus, and death may ensue. In many countries, members of this group of organisms are not present in the soil, and although the animals do not get this organism, large numbers die or are greatly reduced in efficiency. I have made these studies to throw light on human nutritional disturbance as well as that of the dairy cow. In Figure 5 I have presented the five following phases for study: (1) soils, the total and available plant food of calcium, phosphorus and potassium; (2) a comparison of two of the grasses (A1 and A2) growing in the loin disease district with an average lawn grass taken from my front lawn (B); (3) the average calcium, phosphorus and potassium levels of the blood of three cows in the loin disease area and the average for fifteen normal cows; (4) the milk-fat vitamins for cows in the loin disease district and, in comparison, my data for that entire latitude zone; (5) the daily requirements of a 1,000 pound cow, shown for, each, metabolism and milk.

Fig. 5. Study of a Texas cattle disease area on mineral and vitamin basis, considering grasses, cow’s blood, milk-fat vitamins and cow’s mineral requirements. In Groups I and II, A1 and A2, the composition of soils and grasses is associated with a loin disease area in Texas. B represents a knoll grass and its soil from Pennsylvania for comparison for calcium, phosphorus and potassium. In Group III, comparison is made of the calcium and the phosphorus of the blood of cows of the loin disease area. Group IV shows a comparison of milk-fat vitamins. Group V shows a cow’s requirements for these three minerals for metabolism and for milk.

 

The chemical analysis of the soils from beneath the grasses analyzed gives information bearing directly on factors controlling the quality of the grass. This is shown in Figure 5, Group I. The chemicals are shown in one form only, i.e., that available for each of three minerals. Most of the minerals are in a chemical form not available for plants. The calcium, phosphorus and potassium are all low in both Texas soils, the phosphorus and potassium being exceedingly low. In fact, with no other information, in the light of our present knowledge, we would expect that these two soils could not continue to maintain stock on the pasture they could grow. The levels shown here for available plant food phosphorus at 0.0007 and 0.0008 are only a fraction of that provided by a typically good soil, and the available potassium at 0.0004 and 0.0003 is likewise far below the minimum requirements for a good soil.

In Group II will be seen the chemical content of the grasses. The calcium of the grass marked A1 is about one-third that found in my lawn grass B, which itself is low in calcium. Grass A2 is about one-quarter that of my lawn grass. As we shall see later, even this low level of calcium is not the great embarrassment. The phosphorus contents of these two grasses are, respectively, 0.04 and 0.07 per cent of the dry grass, or one-twenty eighth and one-sixteenth, respectively, the quantity in my lawn grass. The potassium fares still worse. The quantity in grass A1 is 0.07 per cent of the dry grass, and in A2, 0.05 per cent of the dry grass. That in my lawn grass is 0.49, seven times that in grass A1, and approximately ten times that in grass A2. We will see shortly the results that must be produced from the use of such fodder.

Since the blood of cows as well as the efficiency of the body will, of necessity, be dependent on the food elements available, we obtain important information from analysis of the blood for the level of various chemical elements, only three of which are presented in this chart. In all of these studies, including soils, grasses, blood, milk, etc., a large number of chemical elements were determined which space does not permit of presenting here. It is of importance that the controlling mechanisms of the body are able to maintain relatively constant levels for most of the chemical constituents, owing to a remarkable system of temporary borrowing from depots of storage within the body. When disturbances appear in the mineral content of the blood or body tissues, they usually indicate a marked stress in which the body is not able to compensate by processes of readjustment and borrowing. The tissues, therefore, must suffer and function be impaired. Notwithstanding this remarkable compensatory capacity, blood sent to me for analysis of cows living on the pasturage of the loin disease area shows definite evidence of embarrassment. In Group IV, Figure 5, I have presented the levels of calcium, phosphorus and potassium in the blood of fifteen normal cows as controls and the average levels for three cows from the loin disease district. It is of importance that all of these three cows whose blood chemical content is shown here have had blood so seriously deficient in spite of the fact that each was receiving three ounces of bone meal per day, which, if it were all available, would go far to compensate for an ordinarily deficient pasture grass. The average calcium level in the serum of normal cows in my series has been 11.5. The average for these three cows in the loin disease area is 9.7. The inorganic phosphorus of the blood of my series of normal cows has an average of 5.5 and in these three is 3.3. It has been known by the cattlemen of the affected districts that simply moving the affected cattle to another district for a few weeks or months would not only cure the disease, but also permit them to return to the same pasturage and frequently not break again for months. This demonstrates Nature’s remarkable ability to replace depleted minerals in the normal storage depots of the body.

An additional group of data are available from a study of the requirements of the body for metabolism and for milk production. This is shown in Group V, Figure 5. The daily requirements of a normal cow weighing 1,000 pounds for metabolism will be 42 gm. of phosphorus, 63 gm. of calcium and 114 gm. of potassium, estimated as their oxids. It has been estimated that a normal cow weighing 1,000 pounds can eat 56 pounds of fresh grass. The water content of the green grass making the difference between green and dry grass is usually estimated at 70 per cent. From the analysis of the grass shown in Group II, marked A1, which expresses the minerals in the percentage of dry grass, we see that that quantity of this grass would only furnish a total of 19 gm., which would be the limit of available phosphorus from that source for one day. We see by this that each day this cow would have to borrow from her storage depots, the tissues of her body, chiefly the skeleton, 23 gm. of phosphorus. Her requirements for calcium would be 63 gm. and the amount available in grass A1 would be 199 gm. There would, therefore, be 136 gm. more than she would need for the daily requirements for metabolism. The needs of the body for potassium are great. This 1,000 pound cow would require 114 gm. every day. Grass A1 could only furnish her 11 gm, and her need would, of necessity, become very great. Were this cow being milked and producing 5 gallons of milk per day, which would not be a large amount for a good producer, she would require 40 gm. of phosphorus for that purpose in addition to that required for metabolism. Of calcium, she would require 34 gm. and of potassium 58 gm. for the milk alone. In other words, there would be a combined demand for both metabolism and milk production of 82 gm. for phosphorus, 97 for calcium and 172 for potassium. These are all computed as their oxids. On a ration of grass A1 alone, the daily overdraft for phosphorus would be 63 gm., and for potassium, 161 gm. The calcium demand would be satisfied with 102 gm. unused. About one-fifth of normal bone structure is phosphorus, one-third, calcium, and the remainder chiefly organic material. The 3 ounces of bone meal would provide only about 18 gm. of phosphorus even if all were utilized, which is probably never possible.

In Figure 6 is shown graphically this daily mineral shortage for phosphorus and potassium if only grass A1 were used. In this chart, there are also shown graphically the mineral requirements of a 1,000 pound cow for, each, metabolism and milk production. There is no doubt that these cows found other grasses, though perhaps in limited quantity, to augment their potassium and phosphorus.

Fig. 6. Mineral deficiency for 1,000-pound cow on No. 1 grass (loin disease area). This shows the metabolism and milk demands of a cow for minerals and the amount of these minerals available in a 56-pound daily ration of the Texas A1 grass. There is more than enough calcium, but a marked deficiency of both phosphorus and potassium.

 

In Figure 7 will be seen two views of cows that are down with loin disease. Through the kindness of Dr. Schmidt, I am permitted to use these typical illustrations of this disturbance. Cows with loin disease at times go insane and attack those who are trying to help them. They often linger for days, dragging about their paralyzed parts in an effort to maintain nutrition. Somewhat similar deficiency diseases have created great havoc in many countries of the world. Expressions of deficiency diseases are generally a little different in one country from those in another, owing primarily to differences in the mineral deficiencies of the soil. In some countries, these conditions become so severe that when cattle and lambs are allowed to run together the cattle will kill and completely eat the lambs. Workers on biologic problems involving deficiency diets frequently find that if animals are placed together, one after another, members of the group in the cage will be missing, having been eaten by their associates. This, of course, requires that, in such tests, animals must be in separate cages.

 

Fig. 7. Above, animal making effort to rise after it had been down with loin disease for ten hours; below, animal suffering from loin disease, just found on prairie; some typical expressions of loin disease, which is primarily a mineral deficiency disturbance, with toxic poisoning from the eating of infected bones.

 

The emphasis of recent years has been almost entirely on the role of infecting organisms without due consideration for either the mineral content of the food ingested and the mineral needs of the body or the role that these deficiencies play in establishing a condition of susceptibility to attack from infecting organisms. When we recognize that human beings are chemical machines like the cows and are dependent on the food intake for the maintenance of the structural units of the body, we realize at once that there is great possibility that imbalances will develop from inadequate diets. It is easy for us to place practically all the stress on the mineral intake together with the energy-producing food factors, with too little attention on the activators. While the activators include the known vitamins, they also include many substances not already identified or classified.

A most interesting incident occurred in connection with the cows whose blood we have just been studying with regard to loin disease in the coastal counties of Texas. According to Dr. Schmidt, within about a week, nearly all of the cows affected “went off bone meal.” In other words, they suddenly lost their bone craving. This occurred with the rapid growth of the young grass and lasted for about six weeks, when a remarkable incident occurred. Within about four or five days, practically all of the animals again acquired the craving for bones. The usual method for testing for this condition (though often it will be immediately observable by the fact that the cows will eat pieces of wood, cloth or even dirt when bones are not available) is to place two grades of bones before the cattle to be tested and to note the percentage that try to eat them. Usually, two kinds of bone are used: some that are clean and white, free from all objectionable odors, and some putrid bones.

A very marked craving is shown by the fact that they will eat not only the clean bones, but also the putrid bones. Why did the cattle acquire the craving so suddenly? Dr. Theiler, working in South Africa, where there has been a great deal of trouble with this affection, has presented data from which I have made the graph shown in Figure 8. By following the results outlined by Dr. Theiler as shown in the graph, which I have developed from his data to more easily visualize them, it will be seen at once that the intensity of the hunger is not related directly to either sunshine or rain alone, or even the two together. A note of caution is probably justified, in that individuals living in a particular latitude in either the northern or southern hemisphere will be in danger of thinking of seasons in terms of their expression in their geographic and physical location, whereas quite different factors will obtain with regard to the period of growth as related to sunshine, maximum heat and cold periods, seasonal rainfall, etc. The latitude in which Dr. Theiler’s work was done was approximately 40 south. During the period commencing with the beginning of the winter season, which is not a cold season in that latitude, and progressing through May to August (our November to February), there was a continual increase in bone chewing. Note that, at this point, 80 per cent of all the cattle ate rotten bones. From August 5 to October 27, there was a continual diminution of the curve, at which time it had fallen to 40 per cent. Note that during this period Dr. Theiler states: “The weather had been continuously dry, but as it grew warmer, the spring vegetation began to appear, and this is regarded as responsible for the diminution in pica (bone chewing).” At this time, rains began, lasting for a fortnight, with the result that “the young vegetation became almost luxuriant, and by the middle of November, the craving had rapidly fallen to 6 per cent.” We see, then, an association so far with the rapidly growing grass. A number of important factors are recorded after a fortnight of rainless weather: the young grass wilted, and although the craving remained at the low level of 6 per cent for two weeks, in the next three weeks it increased to the high level of 82 per cent, the highest recorded, around which figure it oscillated for the next two months of summer drought. Clearly, something had happened to the grass so that, in its current state, it could not supply to the animals that which they needed so acutely to prevent the abnormal craving. As Dr. Theiler has emphasized, we have the record that the craving increased while the cattle were eating the old dry grass of the preceding year, prior to the beginning of the growth of new grass in August (their midwinter, equivalent to our February), and that again, during the period of dry weather when the grass was wilted in their summer, December and January (our June and July), the craving was acute. In the middle of January, “The drought broke, the pasture recovered, and it was naturally thought that the craving would again disappear. The unexpected happened, however, and notwithstanding the ample supply of good green grass and the absence of wilting, the craving did not fall to the previous 6 per cent, but only to 50 per cent.” He states further that “by the end of March (our September, the end of their summer), the craving again stood at 80 per cent.” It is of particular interest that Dr. Theiler relates these phenomena to the phosphorus content of the growing vegetation.

 

Fig. 8. Seasonal tide in bone craving produced by mineral deficiency, which is a common and serious disturbance in some grazing animals in many countries.

 

It is very evident, from many sources of information, that the utilization of minerals in foods is often directly dependent not only on a sufficient quantity of the particular minerals in available form, but also an adequate quantity of certain activators, some of which are the known vitamins. For the cow, these must be available in the grass which she eats. If she can obtain sufficient of both the minerals and the activators for the needs of her own body, she will, without depletion of her skeleton, provide them for either lactation or gestation. Nature has provided that, in case of shortage, the mother’s body will be depleted. This depletion may be offset and, under normal condition, the restoration is completely accomplished during the period of rest after stress. The nature of the activators, whether the known vitamins, including both the water-soluble and fat-soluble, or those regarding which little is known, would seem to be almost dependent on several factors; namely, the character of the plant, the soil on which it grows, the available moisture and temperature and the radiant energy, with regard to both the kind and quantity which nourishes and develops it.

We have naturally thought of grass such as cows eat as being a similar thing wherever found. It looks green and has many physical factors in common. In Figure 9 I have shown in groups for comparison grasses that I have studied from the chemical standpoint and for their vitamin content. These grasses selected are from eight different sources and have been studied for four of their minerals, namely, calcium, potassium, phosphorus and magnesium. They are numbered from 1 to 8 successively for each of the four chemicals. No. 1 is a Pennsylvania knoll grass which I obtained while searching for the reasons that high vitamins were being produced by a particular herd feeding on this farm. No 2 is an Ohio lawn grass growing on the front lawn at my office. Nos. 3 and 4, called Johnson and crowfoot grass, respectively, were from an Arizona district that showed evidence of nutritional disturbances. Nos. 5 and 6 are the two Texas loin district grasses, the first of which we have just been studying. No. 7 is a plant that the cows were eating with great avidity on a farm in Pennsylvania. This plant is locally called iron weed. No. 8 is a pasturage shrub eaten liberally by the stock in British Columbia and called land kale. A glance at this chart reveals a remarkable difference in the quantity of the minerals in the grasses grown in different places. For example, the variation in calcium is from 0.17 per cent of the dry grass in the Arizona crow foot grass, to 1.9 per cent in the Pennsylvania iron weed and to 2.0 per cent in the British Columbia land kale, the last two having ten times as much available calcium as the most deficient grass. The variation in potassium is seen to be very great, that in No. 8 being over fifty times as great as that in No. 6. The variations in phosphorus are also very great, that in the Texas loin district grass (No. 1) that we have just been studying being only one-forty-sixth that in the Pennsylvania iron weed. Similarly, the variations in magnesium is about sixty (?) times as great in the Pennsylvania iron weed, which was being eaten ravenously by the cows, as that in the grass No. 2 from Texas. From this chart, we see at once where we might go for some grass or fodder to re-enforce that which is found to be so deficient both from clinical experience and from chemical analyses. Similarly, I will present data illustrating the great difference in the chemical content of the same plant foods which we human beings eat when grown on different soils.

 

Fig. 9. Comparison of mineral content of pasture grasses 1, Pennsylvania knoll grass. 2, Ohio lawn grass. 3, Arizona Johnson grass. 4, Arizona crowfoot grass. 5, Texas loin district grass No. 1. 6, Texas loin district grass No. 2. 7, Pennsylvania iron weed. 8, British Columbia land kale plant. The difference in the chemical content of different pasturages from different places indicates an almost unbelievable difference in the mineral content that is possible and demonstrates readily the tragic stress that deficient grasses must produce in animals.

 

In the extensive studies that I have been conducting for several years on the vitamin content of dairy products as produced in different places at the same time and the same places at different times, studies which now include about 700 samples per month of cream, butter and cheese, we are finding that there is not only a yearly cycle that tends to present in each individual district, but that the time of high vitamins corresponds with the period of rapid growth in young grass and that it is not readily produced by dry feeds and rations such as grain concentrates. I have studied a large number of grasses and cattle feeds in order to relate their chemical content, both mineral and organic, including vitamins, to their ability to produce a high vitamin milk product, and evidence is rapidly accumulating in large quantity indicating that the mineral and vitamin content of the foods constitute controlling factors for those of health with which we are directly concerned. Butter samples coming from districts that are characteristically high or low provide, by comparison, means for studying the controlling factors for vitamin levels.

The butter samples that have been received from a particular district in northwestern Pennsylvania were conspicuous, as I have indicated, by their high vitamin content, and I, accordingly, made trips to the district personally to study the water supply and other contributing factors and to obtain samples of the soil and glasses. I have already discussed only two of the grasses from this area; namely, knoll grass and iron weed. The physical characteristics of this district include a river valley about a mile in width, with sloping country on each side, the river being about 200 feet below the level of the surrounding country. The lowland is about from 6 to 12 feet above the summer level of the river, and the river bed is from 100 to 300 feet wide with a gravel bottom and only an occasional coarse boulder. This is shown in Figure 9 under river bottom land, the soil of which is loam and silt over gravel. The country opposite the river basin has a sandstone base and this is shown at the left in Figure 10. The hillside land is chiefly gravel and loam and this is at the right in this chart. The upland grass growing over the sandstone base of which specimens were taken is called poverty grass. From the river bottom land, I selected two grasses that the grazing cattle were not eating and a group of grasses and a plant that they were eating. On the hillside land samples of red clover were taken. The soil immediately under each type of grass was also taken for analysis, and the minerals available as plant food in the soil are shown in this chart in the broken lines, and the mineral content of the grasses growing upon these soils, in the solid lines. It is of interest that the cattle were wandering over the area apparently in search of the iron weed, which is shown by the graph to have a calcium level many times that of the first three grasses. The calcium was very high in the soil beneath the knoll grass, which had very short roots. It was also high under the iron weed. I am advised that the iron weed got its name from the size and strength of its roots, which penetrated very deeply into the gravel and therefore reached food sources at much greater depth than the surface grasses, which probably accounted for its high calcium level. I obtained additional samples of this plant in the early part of this season for comparison with. the product of last season. The chemical analysis of this younger growth shows the calcium to be even higher than that tested last season. The calcium of the dried leaves of the plants which the cows were eating as obtained last year constituted 1.55 per cent of the total plant dry weight. That obtained this year from younger plants constituted 1.89 per cent, which is very high. The phosphorus in the mature leaves of last year was 0.3 per cent, and in the more rapidly growing younger leaves of this year, 1.8 per cent, or six times as great. We see at once one of the characteristics of the rapidly growing young plant life, which is able to produce not only minerals for the cow, but the activators, including the vitamins, with which she will provide life-giving qualities for her offspring or her adopted wards. It is of interest to note that the phosphorus of this iron weed is 450 times that of the No. A1 grass in the Texas loin disease district. It is said that the roots of the iron weed have been known to penetrate four feet into the gravel, which would enable it to bring up from that depth minerals that would be completely out of reach of ordinary plants. It is also of interest to note that the potassium of this plant is nine times the quantity of that found in the Texas grass. We see at once the need to test the possibility of growing this iron weed plant on the Texas soil in order that it may, by the great penetrating power of its roots, bring up from the subsoil supplies of, each, calcium, phosphorus and potassium, so badly needed for the grazing stock of that district.

 

Fig. 10. Curves showing mineral content of grasses and total plant food from soils from dairy district in northwestern Pennsylvania. The relation of soil poverty to grass poverty is directly revealed in the study of six grasses and the soils beneath them.

 

In this connection, it should be instructive to observe the marked difference in total mineral in the soils in question and that which is available as plant food. These determinations are shown graphically in Figure 11, from which it will be seen that only a small percentage of many of the minerals present in the soil are really available for plant food. The light lines indicate the total and the heavy lines total available chemicals. Plants are largely limited to water-soluble binary compounds.

Fig. 11. Comparison of total chemicals and those available as plant foods from soils from a dairy district in northwestern Pennsylvania. Since the minerals available as plant food must determine the limit of growth of plant life, it can readily be seen how depletion may rapidly destroy the fertility of the soil. Light line, total chemicals; heavy line, available chemicals.

 

In order to further visualize the route of the minerals from soil to human beings, and other animal needs, I have shown, in graphic form, in Figure 12 the relation of each to the other of soils, grasses, animals and animal products, namely, milk and eggs. The soils plus water and sunshine and germinating seeds will provide the needed minerals. Only three of the chemicals are shown in this chart: calcium, phosphorus and potassium. The grass plus the activators and vitamins which it carries, together with the action of radiant energy, as sunshine, nourishes the growing animal and stores these chemicals at much higher concentration. The grass is shown as dry weight and the animal as live and therefore, wet, weight. These data, since they were not found available in the literature, are obtained by analyzing an entire adult chicken, and they show the average chemical content of all tissues of the body. The animal, plus hormones and sunshine and utilization of the grass and its activators, is able to produce a highly concentrated animal food in the form of milk in the mammalia and as eggs in the egg laying species.

Fig. 12. Comparison of mineral content of soil, plant, animal and food, x, extra good pasture; square, poor pasture; circle, wet weight. The route of the minerals from soils through grass to animal and to products, milk or eggs, indicates a stepping-up concentration from soil to animal.

 

It has long been known that farm stock tends rapidly to deteriorate in size and efficiency as well as for milk production and reproduction on certain soils. It is common practice to grade up stock, whether dairy cattle, sheep, horses or pigs, by importing particularly favorable sires or dams and in this way improve the cross of the group or herd. It is also common knowledge that these efforts often result in a very temporary benefit. Too little emphasis has been placed on the importance of the plant food used as pasturage, which not only must provide the physical structures of the animal, but also must control its fundamental efficiency. As an approach to this problem, I am presenting, in Figure 13, a comparison of two pastures: A, Lord Ashton’s race horse paddock, on which superior stock develops, each generation being a little better than the one preceding, and B, Falkland Island pastures, on which horses such as those imported from Lord Ashton’s race horse paddock are progressively reduced in size not only in their own generation, but rapidly in succeeding generations so that, in a few generations, they are reduced in size to that of ponies. The solid black line marked A shows the amount of the various chemicals in Lord Ashton’s pastures, and the open work column, B, the amount in the Falkland Island pastures. The latter has less than half as much silica free ash as the former, less than one-half as much nitrogen, about one-tenth as much calcium, five-sixths as much potassium, about one-half as much phosphorus and about three-fifths as much sodium, but has a higher concentration of chlorin or acid factor and a much higher factor of fiber. I shall presently speak of this reduction in size of the body with deficient mineral and other chemical intake as it applies to human beings. In Figure 3, I presented data indicating the levels of vitamin A plus D, shown in the broken line, and the levels of the death rate from the two diseases, pneumonia and organic heart disease, in the solid line, and I have shown that, in general, one is the reverse of the other. It is of particular interest that this condition obtains not only for the entire territory of the United States and Canada, when considered as a unit, but also when that large area is divided up into sixteen smaller districts. It will also be seen, by referring to that chart again, that there is a marked difference in the average levels of these vitamin factors as determined from dairy products for different divisions of the larger territory. In Figure 14, it will be seen that, when we add together the monthly totals representing the vitamin units for each of these sixteen districts and then divide them into two groups of eight on the basis of these units, one of these groups contains 1,482 vitamin units as compared with 1,038 in the other, the former being approximately one-half greater than the latter. Similarly, I have determined from available statistical data the total number of deaths from pneumonia and organic heart disease in each of these two groups and find them to have two quite different levels. In the territory with the high vitamin content, the total deaths are represented here by the figure 1,115, and in the group with the low vitamin level, this increases to 1,287. We see at once evidence of a difference in the capacity of a district to furnish vitamin substance which appears to have a relationship to mortality that may readily be that of cause and effect.

 

Fig. 13. Comparison of pastures. A, Lord Ashton’s race horse paddock in which superior stocks develop. B, Falkland Island pasture, where horses are reduced in size to ponies. The inevitable deterioration of animal life on deficient plant foods due to soil deterioration has been plainly demonstrated in horses transferred from English paddocks to countries with deficient soils.

 

Fig. 14. Relation of vitamins to deaths from pneumonia and organic heart disease: Sixteen districts of the United States and Canada are divided into two groups on the basis of vitamin levels. There is strong evidence that mortality levels are directly related to vitamin and activator levels.

 

In order to study this problem further, I have expressed in graphic form in Figure 15 these same factors for each of the sixteen districts. It will readily be seen that, when the vitamin content is high, the mortality is low, and when the mortality is low, the vitamin content is high. It will also be discernible on study that certain large districts are characterized by certain phases of this factor. For example, there is a tendency for the vitamin levels to be low in the Atlantic seaboard states and for the mortality rate to be high.

 

Fig. 15. Relationship of vitamins to mortality, shown to obtain in individual districts of the United States and Canada and suggesting a contributing factor through the progressive increase or mortality.

 

When we study these data in connection with those provided by the American Heart Association, we have what appears to be important new light on the progressive increase in mortality in certain sections of this country, particularly from organic heart disease. This is illustrated in Figure 16, which is taken from the report of the American Heart Association. From this, it will be seen that the annual death rate from heart disease is very much higher in those states that are colored black, the figures reading 273 per hundred thousand of population in Vermont; 240 in Maine; 249 in Massachusetts; 252 in New Hampshire; 262 in New York; 82 in North Dakota; 100 in Wyoming, and 124 in Nebraska. In general, it will be seen to be lower throughout the middle western states. California and Oregon both show high rates, particularly the former, probably owing largely to a movement of people suffering from heart involvements from the highlands to the western lowlands. Since animal life is entirely dependent on plant food for its maintenance, it might readily be assumed that the minerals of the soils and the plants they produce constitute the chief or only controlling factors, if, of course, the energy-producing chemical factors, such as carbohydrates, fats and proteins, together with the atmospheric oxygen, constitute the requirements for life and body building. It has long been known by those studying intensively in the biologic field that the purer the synthetic food, the shorter the duration of life that could be maintained on it. From this has developed the great advance in the knowledge of life from an increased understanding of the activators, some of which are the vitamins.

 

Fig. 16. Heart disease death rates, all forms, by states, United States registration area, 1925. The high mortality rate of certain areas of the United States are seen to have an important relationship to the vitamin levels and suggest a soil depletion by comparison with Figure 15.

 

Many illustrations might be used at this point, but I have used one immediately at hand, the studies on which are still in progress at this time. A flock of young turkeys belonging to a friend were in danger of serious loss through the development of weak legs. This occurred notwithstanding the fact that they were on a widely advertised baby chick ration which was supposed to contain not only all the mineral content needed, but also an adequate supply of cod-liver oil, presumably to provide vitamins. These turkeys had excellent care and were out in the sunshine and pasture all day, but notwithstanding this, they were going down. A half dozen of them were brought to me, and these are shown in Figure 17. Two were kept for controls, one of which died within a few days. The controls were continued on the same diet; namely, elaborately compounded chick food, and were given a grain mixture furnished by the same company. The other four received, in addition, the following treatment: No. 3 was given one 0 size capsule (0.6 gm.) of the preparation that I am now providing for patients in my experimental group. This mixture consists of a concentrate of the vitamins from an exceptionally high vitamin butter mixed with an exceptionally high vitamin cod-liver oil. Both are selected on the basis of chemical analysis. No. 4 had cod-liver oil activated five minutes in the sun rubbed on both legs, which required it to be kept separate from the others. No. 5 had one capsule of an activated cod-liver oil, and No. 6, 5 per cent of a high A and high D butter concentrate mixed with its regular food. Turkey No. 6 got its foot injured and observation of it was discontinued. Roentgenograms were made of one leg of each turkey. Space does not permit of presenting here as much detail as is desirable. The results are very clearly illustrated in Figure 17, which shows No. 3, the turkey on the activators obtained from a high vitamin butter and high vitamin cod-liver oil, to be in much better physical condition than any of the others. While one of its legs which was badly twisted and deformed when the treatment was started developed in an abnormal position, making it walk with a distinct limp, it is nearly normal and has outdistanced all of the others. I have recently discussed in different communications the inability of vitamin D alone as activated ergosterol in any of its forms to completely correct this condition of weak legs in chickens. The percentage gain for this turkey (No. 3) was 37.5 per cent in twelve days, while the control on the standard chick foods gained 8.3 per cent. The turkey on the cod-liver oil plus standard diet gained 16.7 per cent. Blood chemical studies made on the thirteenth day are shown in Figure 17. The whole blood calcium for No. 1 is at 5 mg. per hundred cubic centimeters and in 2 and 3, both of those treated, over 7. The phosphorus is highest in No. 3. These changes are due to activators.

 

Fig. 17. Treatment of turkeys with weak legs. Six turkeys were down with weak legs. The effect of treatment is shown to be greatly in favor of a mixture of the activators as concentrated from a high vitamin butter with a high vitamin in cod-liver oil, over cod-liver oil alone. The turkey standing gained over four times that of the control and over twice that of the one on cod-liver oil.

 

In several of my research reports, I have discussed the matter of physical deterioration with regard to the utilization of the stored minerals of the skeleton for meeting the daily needs of metabolism. I have referred to this as burning the furniture. One of its frequent expressions is the easy fracturing of bones, particularly of elderly people, though quite often of young people, and the difficulty of obtaining union. I have also presented data indicating the marked improvement in this regard through the use of the preparations built up to provide the activators in accordance with my views. In Figure 12, I have shown how horses that continued to grow larger and larger in succeeding generations on an exceptionally fine pasturage were reduced in size to ponies in a few generations on a very poor pasturage. This strongly suggests that nature adapts the size of the body, in large part, to the available food. No doubt, this has had much to do with the development of animals to enormous size in favorable periods of growth and similarly has controlled the size of the skeleton for many forms. It probably will be a surprise to many, as it was to me, to find that many of the patients who have come to me for study and guidance had already been reduced in stature. Cases of shortening of the body have been reported from time to time, some being quite extreme. One was reduced 12 inches in stature. One of my patients was found to have lost 4 inches in stature in five years, during which time she had been on a diet that had been prescribed to keep her weight down, literally one of starvation as to both minerals and vitamins. In less than four weeks, I have measured nine people who have shrunken in height an average of 1.6 inches within the last three to six years. One had shortened 2⅜ inches in height. All were breaking physically, with distinct evidence of degenerative breakdown which had been the reason for their having come in for study. A critical study of their diets indicated that these had been very incomplete both in minerals and in activators. In the last few years, I have had some cases of extreme shortening. I had warned the members of one family of the impending danger to their elderly mother who, according to her daughter’s records, had lost about 6 inches in height. One day, in walking across the floor, her hip collapsed. She, of course, became bedridden, later developed pneumonia and died from it in two weeks’ time. I have a roentgenogram taken of her broken hip. The femur in size is that of a small child. Nature had endeavored to rebuild her body to adapt it to the limited material available, so much of it having been borrowed for the needs of metabolism. It is amazing how many people are burning their furniture at and before middle life. This has come about through two great stresses; namely, an inadequate supply of the building blocks needed for the repair and maintenance of the body and the activators needed for enervating the tissues and for making the minerals available even when present in the food and also entering into tissue building. When we study the cause for breakdown in the tissues of the cows with loin disease, due primarily to a deficiency of the soil in certain minerals and the consequent deficiency of the pasturage thereon, we see at once means for reenforcing the ration of the cows to provide these emergency needs. An effort to do this was made and the cattle were fed bone meal, but it was only partially adequate. Incidentally, it would not furnish the potassium, which was shown to be so excessively low. From the table of grasses shown in Figure 9, it is easy to select additions for the ration of these cows that would reenforce at the point of weakening, it being assumed, of course, that the cows were dependent on grasses either A1 or A2. This we would also do by improving the quality of the grasses available for pasturage, by improving the quality of the soil through mineral treatment, as part of a fertilization process. This is often not justified on account of the expense involved.

If space permitted, I would present here detailed data that I have obtained by analyzing for their mineral and other content samples of Marquis wheat grown from the same seed in twenty-one different places in Canada. The same seed developed marked differences when grown in different places. For example, there was over fifteen times as much iron in the wheat grown on the experimental plot of one section as on the experimental plot of one of the other sections. There are also wide variations in the calcium, phosphorus, potassium, sodium and other minerals.

The levels of the minerals in white bread as compared with those of whole wheat will vary considerably according to the wheat mineral content and the fineness of the bolting of the flour, and also as to whether milk has been added. The calcium content of white flour is less than one-half that of whole wheat flour. The phosphorus and iron content are each about one-fifth that of whole wheat flour.

Since animals are dependent on plants to put the minerals into a chemical form that makes them readily available for utilization, and since, as we have seen from my data and the work of others, there may be a wide variation in the amount of minerals in a given plant, depending on the soil, we see at once a new approach to the problem of disease, particularly the degenerative diseases, including dental caries. Since the body is dependent on activators for efficient utilization of minerals in the food, even in the best plant food, and because the minerals are necessary for the maintenance as well as the growth of the body, both hard and soft tissues, we come at once to be limited by the amount of these minerals in given foods that may be available for utilization. When we study human morbidity problems as well as those of growth and health in the light of the intake of minerals and activators, we see ample reason for physical breakdown in one case, or, at one period, and normal health and function under other circumstances. We have at once the problem of making up the deficiencies by supplying foods from plant and animal origin that are capable of making good the shortages. Almost daily, I am studying people with regard to dental degeneration associated with degeneration of other parts of the body. We see by a study of their diet that Nature could not possibly maintain body efficiency and that they could add to their dietary those supplies that would make a great improvement in their well-being. Probably no single group has impressed me more of late than that of boys and girls who have returned from higher educational institutions where they lived chiefly a dormitory life through the fall, winter and spring, and who showed an incidence of dental caries much above that of the general average of boys and girls of the same age period living under home conditions. One of my efforts is being conducted for the general betterment of this class. Some plant foods are particularly suited for providing high levels of certain minerals when grown on favorable soils. Lettuce, for example, has the capacity for carrying large quantities of iron. At the same time, it may contain little iron because of deficiencies in the soil. Tomatoes are probably our best food for providing copper, which is needed with the iron for blood building. Spinach is also a good carrier of iron, though not so good as lettuce. The quantity of available iron in the soil has an important influence in determining the amount of other metals that a given plant may take up. This is true of several minerals which, by the presence or absence of even a minute quantity to act as a catalyst, will greatly change plant growth. The influence of iron as a catalyst is well illustrated in Figure 18, in which will be seen two beets planted about the middle of May. About a month later, in accordance with my directions, there was placed in the surface of the ground and worked into the surface only a small quantity, about 1 ounce per square foot, of ferric ammonium citrate, one part of the row only being treated and the other part left without treatment. The difference in the growth of the two beets on the two different soils will be seen at once in this figure. When I photographed it, one would get the impression that there had been two different plantings, one later than the other. The gardener pulled some of both kinds to make a fair sample, and the largest beet in each group was selected for photographing and for making chemical analysis. The control, which is the smaller one, weighed 125 gm., beet and top, and the one from the treated soil 454 gm., an increase of 360 per cent. It is exceedingly interesting and significant that this enormous increase occurred without increasing the percentage concentration of calcium, phosphorus and potassium in the dry beet structure. The iron acting as a catalyst made it possible for this beet plant to build more vital structure without any increase in the amount of the other minerals in the soil. The amount of ferric ammonium citrate added was directed to be a tablespoonful for each square foot of surface without putting it close to the plant. This amount is about 1 part to 1,000 parts of the soil. This was done twice; first, at about five weeks after planting and again, ten days later, the same small quantity was added. There was, therefore, only three weeks’ influence to produce the difference that obtained in the two parts of the row.

Fig. 18. Remarkable difference in growth of beets produced by the addition of iron in small quantities to the soil.

 

Another result that is obtainable from the use of special chemicals as plant food is changing of the amount of minerals in plants. Some lettuce that was treated in the same way shows 16 per cent more phosphorus in the lettuce growing in the soil that received the ferric ammonium citrate than that growing on the untreated soil. We have here means for greatly modifying the amount of minerals that may be available in a given article of food. It is very probable that this newer knowledge of the variations in mineral content of given plants when grown on different soils will be utilized for the betterment of humanity. Various vegetable products will be sold on the basis of their chemical content. This may only require that we know the district in which a certain vegetable was grown for, in the light of my studies on wheat, there may be a wide variation of from 100 per cent to 1,500 per cent, depending on where it was grown and the mineral in question.

Unfortunately, space does not permit the presentation of as many clinical data as would be desirable for demonstrating the application of the new principles that have been suggested and emphasized in these studies. I will, accordingly, be able to present only one case as illustrating both clinical improvement and improvement in the chemical content of the blood as the result of carrying out the general procedures. The case is that of a very stubborn type of mineral utilization disturbance; namely, multiple proliferative arthritis in the hand. In Figure 19 will be seen one view of the left hand and two views of the right, the last two approximately one year apart, during which time this man had been taking additional activators in the form of a concentrate of the vitamins from a high vitamin butter mixed with an exceptionally high vitamin cod-liver oil, the dosage being two 0 size capsules (0.6 gm.) three times a day. It will be seen at once that whereas the carpal bones of the hand are fused together at the beginning of the treatment, they are distinctly separate and have an appearance quite near to that of the normal left hand after treatment. The stiffness of the hand completely disappeared, and the pain and swelling almost disappeared. Many other joints of the body had undergone a similar change. This patient had walked with difficulty and much pain, and he now stands erect and moves every joint with apparent ease and freedom. This man had been a painter and had previously had all of his teeth extracted. There was indication in the history of symptoms of lead poisoning. The relative and actual amounts of the minerals in human blood of twenty-five consecutive cases are shown in Figure 20 in three columns for each chemical: (1) the maximum, (2) the average and (3) the minimum. The averages are low normals.

Fig. 19. Changes in deforming arthritis with use of activators. The change in the right hand in a year in this case of multiple deforming arthritis has been produced by the use of the activators for assisting in the mineral metabolism.

Fig. 20. Mineral content of human blood (twenty-five cases) (maximum average and minimum levels). Notwithstanding the remarkable capacity of the blood building mechanisms to maintain standard levels for minerals, there are seen here quite wide variations, chiefly as depressions, though not so great as in plants.

 

The change in the blood chemical constituents in this case following treatment are shown in Figure 21. The solid dark portion shows the level at the beginning of treatment and the open column at T, the level following treatment. It will be seen at once that the serum calcium, the whole blood calcium and the cell calcium have all increased. The phosphorus of the whole blood and cells increased. The cholesterol of the cells increased and decreased in the serum. With the taking of the activators, the patient was given direction relative to the emphasis to be made in the selection of his foods. Unfortunately, space does not permit of including a copy of the spectrographic studies of the blood serum, urine and saliva before and after treatment.

 

Fig. 21. Improvement in levels of chemicals of blood associated with clinical improvement of last reported case of arthritis.

 

Summary and Conclusions

1. Further data have been presented indicating that dental caries can be largely controlled by means of a program which provides an increase in activators and mineral intake.
2. Comparison has been made of the levels of vitamins A and D, as found in dairy products throughout various subdivisions of large areas, with the death rates from pneumonia and heart disease for the same areas. This indicates that, in general, these two factors are in opposite phase; namely, when the recorded vitamin level is low, the recorded mortality rate for these diseases is high, and when the vitamin level is high, the mortality rate is low.
3. Evidence has been presented indicating that these forces do not have simply the relationship of being common effects of a common cause, but have evidently a relationship directly associated with those of cause and effect.
4. A detailed study has been presented on the relation of mineral and vitamin contents of foods to animal reactions in connection with cattle in a loin disease arca and of the important influence of the vitamins alone in a study of turkeys. The data again indicate that not all of the needed factors are to be found in cod-liver oil.
5. Direct application of these new principles has been discussed and illustrated in a practical case showing the change in the levels of certain chemicals of the blood following treatment and associated with marked improvement in even so stubborn a disease as multiple proliferative arthritis.
6. Mineral deficiency in the soil from any cause may make it impossible for that soil to produce a plant life that is competent to maintain human needs, and this condition may be progressive with the continuous cropping and shipping away of the plant mineral concentrates. Data have been presented indicating that this is already an important contributing factor in the progressive degeneration of our civilization in those districts of the world, particularly demonstrated in the United States, which have been cropped most intensively for the longest period. This indicates that we are facing a problem of so great importance that it constitutes an actual challenge or threat to the endurance of the levels of human fitness. Fortunately, it also suggests important means for meeting the emergencies, which will include the prevention of dental caries rather than the repair of its ravages, and, similarly, the prevention of many degenerative processes of the tissues about the teeth and the long and serious group of sequelae following in the wake of the growth of bacteria in inviting mediums of the body competent to produce increased virulence and, therefore, ability to break down organs and tissues of the body.

Discussion

G. K. Dice, Tipton, Iowa: Will the removal of the calcifying teeth hasten the death of the individual?

Dr. Price: Do you mean will caries hasten the death of the individual? Carious teeth will become devitalized and furnish a focus of infection, and focal infection may attack that person at the time when the vitamins are low. You watch the funerals that go by your office. You will be surprised to see how many of those are heart cases. Just think of that in connection with this vitamin curve. By using additional vitamins, you will prevent not only infections that follow caries, but also the degenerative processes in other parts of the body which are likely to be going on at the same time as the caries. I might mention that reindeer milk is so rich in butterfat that it can be churned directly as it comes from the reindeer, and it has so much vitamin content that it constitutes practically a hundred times as high a level of vitamin per unit volume as the average cow’s milk. For cows, the soil will determine the grass and the grass will determine the vitamin content of the milk.

R. M. Smith, Iowa Falls, Iowa: You spoke of cod-liver oil that one gets at drugstores as being very low in vitamin content?

Dr. Price: It is high enough in vitamin D to pass government requirements, but it is not nearly so high as I require for my use. If I had time to use the slides, I could show what serious injurious effects are experienced from giving large doses of cod-liver oil.

 

References Cited:

1. Price, W. A.: “Fundamentals Suggested by Recent Researches for Diagnosis, Prognosis and Treatment of Dental Focal Infections,” J. A. D. A., 12:1468 (June) 1925;
   “Newer Knowledge of Calcium Metabolism in Health and Disease, with Special Consideration of Calcification and Decalcification Processes, Including Focal Infection Phenomena,” ibid., 13:1765 (Dec.) 1926;
   “Relation of Light to Life and Health,” Indus. & Eng. Chem., July, 1926;
   “Calcium Metabolism Studies, A. Raising of Serum Calcium by Topical Applications of Raw and Activated Cod Liver Oil, B. Disturbances Associated with Active Dental Caries of Childhood and Pregnancy,” Am. J. Dis. Child., 33:78 (Jan.) 1927;
   “Calcium, Its Activation, Utilization and Metabolism,” J. A. D. A., 15:729 (April) 1928.
   “Some New Fundamentals for the Prevention of Dental Disease, with Special Consideration of Calcification and Decalcification Processes,” Dent. Cosmos, 71:145 (Feb.) 1929.
   “Calcium Metabolism Studies on Nature and Role of Activators; Researches on Fundamentals for Prevention of Dental Disease,” J. A. D. A. 16:265 (Feb.) 1929;
   “New Fundamentals for Treatment and Prevention of Dental Disease Based on Calcium Utilization and Disturbance, with Special Consideration of Factors Determining When Infected Tooth Becomes Liability,” ibid., 16:456 (March) 1929;
   “Calcium and Phosphorus Utilization in Health and Disease. I. Role of the Activators for Calcium and Phosphorus Metabolism. II. Nature and Source of Calcium and Phosphorus Activators. III. Seasonal Variations in Butter-Fat Vitamins and Relation to Seasonal Morbidity,” Cert. Milk, October, November, December, 1929; Dominion Dent. J., 41:315 (Oct.), 351 (Nov.) 1929;
   “Why the Annual Pilgrimages to the Hospitals?” Your Health, March, 1930.