Nutritional disorders among workers in North China during national turmoil.

Previously undescribed disorders of nutrition of thiamin, niacin and pyridoxin were observed among the poor people of North China during periods of prolonged deprivation. These disorders were often elicited or exacerbated by physical exertion. Thiamin deficiency syndromes included great toe pain, heel pain, temporomandibular joint click, and painful click of the knee. Syndromes of niacin deficiency included pellagral scrotal dermatitis, hypersecretion of ear wax, and night terrors. Episodic nocturnal motor hyperfunction was caused by pyridoxin deficiency. Several cases with cardiovascular diseases were observed in which nutritional debt appeared to occur simultaneously with oxygen debt following severe physical labor. Intramuscular thiamin HCl ameliorated symptoms of impending stroke. Persons with the same symptoms who did not receive thiamin progressed to fatal stroke.