Abstract Details

Title Nutritional Night Blindness during the Crimean War and the U.S. Civil War

Topic History of Neurology

Presentation(s) S57 - (-)

Poster/Presentation
Number 004

Objective

Background VAD can result in nutritional night blindness (from impaired phototransduction in retinal rod cells) and corneal epithelial disorders.

Design/Methods Review of reports of night blindness and corneal epithelial disorders identified through compilations of the U.S. Surgeon General, electronic databases and search engines, bibliographic compilations, diaries, memoirs, medical journals, and monographs. Quantitative morbidity data were obtained from extensive tabulations of the U.S. Surgeon General from July 1861 through June 1866. Incident cases of night blindness, scurvy, and diarrheal diseases, and mean troop strength among Union troops, were abstracted by month, year, and race.

Results In both wars, medical officers commonly attributed night blindness to malingering among soldiers. However, a dietary deficiency basis is supported in both wars by: (1) the severely inadequate vitamin A content of military rations; (2) close correspondence of clinical descriptions with the full spectrum of VAD eye disease; (3) occurrence of night blindness in conjunction with other disorders that cannot be readily feigned, and that are now known to result from nutritional deficiencies (keratomalacia and scurvy); and (4) resolution of night blindness with appropriate dietary modification. Also, during the U.S. Civil War marked seasonal variation in night blindness incidence among Union soldiers corresponded closely to seasonal variations in both the availability of foodstuffs and the incidence of scurvy and diarrhea.

Conclusions Nutritional night blindness occurred among soldiers forced to subsist on nutritionally inadequate diets during both the Crimean War and the U.S. Civil War. The seasonal pattern during the U.S. Civil War is consistent with seasonal variations in the availability of foodstuffs with high vitamin A content (or provitamin A carotenoid content) superimposed on marginal vitamin A reserves.

Authors/Disclosures
Douglas J. Lanska, MD, FAAN PRESENTER	Dr. Lanska has received personal compensation for serving as an employee of Ministry of Health of the Russian Federation. Dr. Lanska has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MedScape ��ɫ��. Dr. Lanska has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink Neurology. Dr. Lanska has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Ebix/Oakstone Publishing. Dr. Lanska has received publishing royalties from a publication relating to health care. Dr. Lanska has received personal compensation in the range of $500-$4,999 for serving as a Invited speaker with Mayo Clinic.
	No disclosure on file

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