Experimental cataracts have been produced in every type of animal studied, including fish and geese, by diets low in vitamin B2; and these cataracts disappear when the vitamin is added to the diet. Cataracts in horses, a common cause of equine blindness, have been corrected by giving vitamin B2. Excessive amounts of milk sugar or galactose from the digestion of milk sugar, which increases the need for vitamin B2, also cause cataracts in animals. Infants who cannot utilize galactose normally become blind from cataracts unless milk sugar is quickly withdrawn from their diets.

This disease, a major cause of blindness in the United States, results from prolonged stress and is a typical reaction of adrenal exhaustion. When the adrenals cannot produce aldosterone, so much salt is lost from the body that fluids pass into the tissues at a focal point of stress. Because the eyeball is no longer elastic, the intraocular pressure increases. This fluid not only pushes the optic nerve back toward the brain, often damaging it, but also forces the lens forward, distorting vision and perhaps closing off the tiny drainage canal in the lower part of the eye. Scar tissue and adhesions can also prevent this canal from draining.

The cause of detached retina is not known. When vitamin E is deficient or when iron salts, which destroy this vitamin, are given to pregnant women, however, infants are often born prematurely and their retinas frequently become detached if they are exposed to an oxygen concentration greater than ordinary air. A few years ago, putting such babies in oxygen tents caused thousands to become permanently blind. This abnormality could be prevented by giving 150 milligrams of vitamin E daily starting immediately after birth or by breast milk, which supplies this vitamin. If vitamin E is inadequate, the essential fatty acids in the cells forming the walls of the capillaries in the retina--only one cell thick--are so harmed by oxygen that these cells disintegrate.

Visual problems associated with a mild lack of vitamin A include quick tiring of the eyes, sensitivity to bright lights and glare, dimness of vision at night (a common cause of car accidents), less acute day vision, and susceptibility to such infections as sties, conjunctivitis, iritis, and corneal ulcers. Persons taking fewer than 5,000 units of vitamin A daily have an abnormal thickening of the conjunctiva and sometimes degeneration of the optic nerve. In America, severe vitamin-A deficiencies are common among persons whose bile flow is inadequate.

An eye abnormality known as Bitot's spots appears to be caused by a combined lack of vitamin A and protein; when 50,000 units of the vitamin have been given daily with milk protein, improvement has been "surprisingly quick."

When an adequate high-protein diet has been given patients both before and after surgery, the destruction of body protein has been almost completely prevented in spite of extreme stress; and such a diet often makes the expense and discomfort of intravenous and/or tube feedings unnecessary. A month or more of preparation before surgery is important for all persons, especially those who are already ill. Malnourished and ill individuals are poor surgical risks, have adverse reactions to anesthetics, are susceptible to shock and infections, and heal slowly. Animals deficient in protein for only five days prior to surgery require twice as long to heal as their well-fed litter mates even though given adequate protein afterward.8 Because the blood protein may remain normal, a patient's protein intake can be far too low without the physician recognizing it.

All vitamins that dissolve in water, especially those needed by the adrenals, should be increased immediately after any injury and kept unusually high during the entire convalescence; and "heavy vitamin supplementation" has been found to add tremendously to the comfort of the patient. For the first few days, the anti-stress formula might be taken every two hours, and supplements of minerals and all other vitamins obtained with each meal. To save the time of busy physicians and nurses, these supplements can be brought from home and given by some visiting member of the family.

When food cannot be held on the stomach, physicians give intravenous feedings, which usually supply sugar, salt, digested proteins, and perhaps vitamin Bl. These nutrients are valuable but cannot meet the needs of stress. All vitamins and essential fatty acids, however, absorb well through the skin. If vomiting persists, oils, vitamins A, D, E, and massive quantities of powdered vitamin C and the B vitamins (stirred into salve or cold cream) can be applied directly to the skin several times daily.