I NUTRITION NOTES I

Paul Gyorgy - An Appreciation April 7, 1893 - March I , 1976

The basic scientific importance and the diver- sity of the discoveries which Paul Gyorgy’s imaginative mind and keen powers of observa- tion contributed are matched only by the bene- fits to children throughout the world that re- sulted from his leadership in multifaceted pedi- atric nutrition developments and programs. His science, whether of most basic chemical or medical in nature, always was directed to “something useful in private life,” and he saw his science applied to fulfilling needs of man- kind, usually of children.

His earliest research, shortly after obtaining his M.D. in Budapest in 1915, pertained to the then ill-understood nutritional disorder, rickets, and to the metabolism of calcium and phos- phorus. Subsequently in Heidelberg, he and his associates, Professor Richard Kuhn and Dr. Th. Wagner-Jauregg, began to unravel the vitamin B2 complex that had been defined by the British Committee on Accessory Food Fac- tors in 1927 as “the more heat stable, water soluble dietary factor recently described and named P-P (pellagra preventive) factor by Goldberger, Wheeler, Lillie and Rogers and found necessary for maintenance of growth and health and prevention of characteristic lesions in rats and considered by the latter workers to be concerned in the prevention of human pellagra.”

In Paul Gyorgy’s own words (see Nutrition Classics, pp. 141-144):

In 1929 we proceeded with a chemical isola- tion of so-called vitamin 6 2 . . . during the course of the isolation of ‘vitamin 62’ it was our collaborator, Dr. Wagner-Jauregg, who first noted that all concentrates which proved to be active when used as supplement to a vitamin 61 concentrate were colored and showed an intensive green-yellow fluorescence in direct proportion to their biological effect. Exposure to visible light destroyed the growth promoting

activity of these concentrates. . . the con- centrates became biologically inactive in the rat growth test as they were further purified and became more highly colored.

. . . first, the green-yellow fluorescent sub- stance had to be isolated. This was readily achieved as a result of a cooperative study undertaken with Richard Kuhn and Th. Wagner-Jauregg. This new substance is now called riboflavin. . .

With both crystalline vitamin B1 and pure ribo- flavin available, Dr. Gyorgy in 1934-35 demon- strated that these did not prevent a dermatitis in the rat which was first called pellagra-like “without prejudice as t o . . . identity or non- identity with human pellagra. . .” Subse- quently, he described the syndrome as “rat acrodynia” and again without prejudice as to identity with the human disease, but ever re- minding us of the need to see the discovery applied in medicine. He identified this nutrient which cured the skin lesions as that now known as vitamin BS or pyridoxine.

His subsequent experimental studies on pantothenic acid, adrenal necrosis in panto- thenic acid deficiency and on nutritionally in- duced fatty livers and cirrhosis and on biotin were related to his interest in human liver dis- ease and his responsibilities on an important national advisory committee on liver disease to the Surgeon General. This led him to se- cure support for two highly significant Macy conferences to consider protein malnutrition in infants and the preschool age group. The first of these was in Jamaica in 1953, the second at Princeton in 1955. At the second of these, the Princeton Conference, the organization and initial goals of what was to become the World Health Organization’s Protein Advisory Group were set. Paul Gyorgy served as a member of the evolving PAG from its constitution as a WHO advisory group through 1966. He was

NUTRITION REVIEWSIVOL. 34, N O . SIMAY 1976 159

Chairman from 1960 to 1964. The subsequent broad influence of the PAG were outgrowths of those efforts that he spearheaded.

When through retirement he was relieved of his day to day responsibilities in the hospital and university, Dr. Gyorgy directed his enor- mous energies toward extending nutritional measures for the benefit of the infant or pre- school child in Southeast Asia-Indonesia and Thailand, especially-with particular emphasis

upon prevention and treatment of protein- calorie malnutrition and vitamin A deficiency.

On the personal side, Paul Gyorgy was warm, energetic, inquiring, compassionate, sensitive and modest. He was a man of impec- cable integrity. He expected no less of others. Straight-forward and objective in his construc- tive criticism, his critiques were neither de- structive nor mean whether they applied to work, to concepts or to people. 0

Letter to the Editor

Mottled Enamel in Teeth

Sir: Included in the February, 1976, Nutrition Reviews was an article from the Journal of Den- tal Research, volume 12, 1932 (Nutrition Re- views 34:47-49, 1976), which dealt with the cause of mottled enamel in human teeth. Al- though the article was interesting and infor- mative, it has the potential of being somewhat misleading. It was not until 1938 that the first findings were published that showed a bene- ficial relationship between the presence of flu- oride in the drinking water and a decreased caries incidence. Not having access to this knowledge, Dr. Smith and her associates stated that fluoride in the drinking water was responsible for fluorosis, without qualifying that statement with the word “excessive” (ex- cept to note that water with less than 0.3 mg per liter did not seem to cause fluorosis). Later, the studies of Dean and others showed that a fluoride concentration of up to 1.4 mg per liter could reduce caries experience by

approximately 60 percent, while even very mild dental fluorosis is not observed until that con- centration exceeds 2 mg per liter. Therefore one should keep in mind that fluoride per se does not cause destruction of enamel, but like many dietary components which are beneficial in small amounts, it can be harmful if excess- ively large concentrations are consumed.

Trudy L. Schlumberger, R.D.H. Fremont, Nebraska

Editor’s Note: In publishing Nutrition Classics we cannot interpret them in light of current knowledge and assume that our readers can or will be stimulated to do so. The definition of dental fluorosis was important in its own right and a forerunner of the relationship between fluoride and dental caries. See the Nutrition Classic in Nutrition Reviews 34: 116-1 18, 1976.

160 NUTRITION REVIEWSIVOL. 34, NO. SIMAY 1976