November 22, 1941


Author Affiliations

Kansas City, Mo.

JAMA. 1941;117(21):1807. doi:10.1001/jama.1941.02820470055028

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To the Editor:—  Dr. Philip R. Trommer (The Journal, October 11, p. 1283) will do well to check some of his own premises before impugning the opinion of Dr. Logan Clendening with whose timely comment as to the factual dearth of clinical hypovitaminoses I heartily agree. In the dermatologic section of the outpatient clinic from which Dr. Clendening's patients also were drawn, I see extremely little evidence of pellagra, although a dermatologic eye at least intends to be acute to such symptoms. A diet of "6 to 8 cups of coffee a day together with 2 to 3 packs of cigarets" is, incidentally, quite a reliable symptom of hypothyroidism, which is more likely to be the basic cause of "anorexia and loss of weight" than the patient's selection of ingesta. Hypothyroidism is also a cause, frequently enough, of malmetabolism of vitamins, especially of vitamin A. Perhaps with a normal complement

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