442 THE INDIAN MEDICAL GAZETTE [Sept., 1943

A Mirror of Hospital Practice

THE USE AND ABUSE OF LIQUID PARAFFIN

By L. K. UPAMANYU, m.b., b.s. (Bom.) (Mcdical Department, Narsinghgarh State, C. I.)

Liquid paraffin is not absorbed by the alimen- tary tract, and is very soothing to the mucous membrane. Hence it is* frequently prescribed for chronic constipation. When given with

food, it dissolves some of the important fat

soluble factors, especially the vitamins which are passed unutilized with the faecal matter. If

this goes on for a considerable period, avita- minosis or hypovitaminosis may follow.

I would here like to report three illustrative cases which happened to come under my obser- vation in private practice :? Case 1.?A Bohra male child, aged 10 months, was

brought *to mc with stomatitis, rhinitis and conjunc- tivitis of about three months' duration. He had a ' rickety rosaryHarrison's sulcus, enlarged epiphyses and curved shins. When his history was investigated, it was found that he had been given one of the

proprietary emulsions of liquid paraffin with hypo- phosphites for the last eight or nine months. .This was immediately stopped, and the patient was put on an emulsified preparation of fish-liver oil re-inforced with calciferol tablets (crushed and added to the emulsion). He was also given local treatment?acriflavine-glycerine paint for the mouth, acriflavine lotion vapour spray for the nose and mercurochrome drops for the eyes. The patient rapidly improved with this treatment. Case 2.?A Hindu male, aged 32 years, came to me

for the treatment of night blindness of six months' duration. After a careful study of the history it was found that he suffered from chronic constipation, and was advised to take liquid paraffin regularly. His

constipation was no doubt relieved to some extent but he developed night blindness. He used to have his food in a boarding house. It consisted mainly of polished cereals and pulses, with occasional fruity vegetables and rarely leafy ones. The food was kept, on the fire for hours together to keep it hot for all the boarders. He seldom took fruits. He was advised to stop liquid paraffin at once and was prescribed a concentrated solution of vitamin A in a vegetable oil, a preparation of cascara sagrada and aneurin (thiamine chloride) tablets with the result that the original trouble (consti- pation) and the acquired trouble (night blindness) gradually disappeared. Case 3.?A Hindu female, aged 23 years, was brought

to me for repeated abortions. She had previously given birth to a live child. But as.she suffered from chronic constipation she was given liquid paraffin. Her diet consisted mainly of cereals and pulses. Liquid paraffin was stopped. She was given remedies for

constipation alone, and she gave birth to a healthy infant in due course.

Conclusion

Liquid paraffin appears to be harmful when taken for a long period, by dissolving the fat soluble food factors and passing them with the faeces. The cases observed were already having a food with a low vitamin content. [Note.?That prolonged use of liquid paraffin as an

aperient prevents the proper absorption of fat soluble vitamins is an important fact, but it is not a new

discovery. Reports have been published on this matter in other countries, particularly America, and the

administration of liquid paraffin for long periods is therefore to be avoided, particularly in persons whose diet is' already deficient. The shortage of liquid paraffin may thus be a boon.?Editor, I. M. G.I