Bisulphite Binding Substances in the Blood in Health and in Disease,Particularly Vitamin B 1 Deficiency

Bisulphite binding substances (B.B.S.) in the blood have been reported increased in vitamin B₁ deficiencies both in experimental animals 1 and in clinical “wet beriberi”. 2 The present study of the B.B.S. in the blood was undertaken to determine its value in distinguishing vitamin B₁ deficiencies from other disease states.

Oxalated blood samples were taken fasting and at rest from 30 healthy controls, and from 110 patients. The method of Clift and Cook 3 was modified to adapt its use to trichloracetic acid filtrates of whole blood. Five milliliters of oxalated blood were precipitated with 20 ml. of 10% trichloracetic acid, allowed to stand 30 minutes and centrifuged. Five milliliter aliquots of the supernatant liquid were adjusted to pH 2 by the addition of 1.5 ml. of normal sodium hydroxide and allowed to react with 0.2 ml. of saturated sodium bisulphite solution for 15 minutes. Twenty-five milliliters of distilled water and 2 ml. of fresh starch solution were added and the excess of bisulphite titrated out with normal and N/10 iodine solutions adjusting the end point with N/200 iodine solution and N/100 sodium thiosulphate solution. The bound bisulphite was released by the addition of 2 gm. of solid disodium phosphate (Na₂HPO₄· 12 H₂O) and titrated within 5 minutes with N/200 iodine solution. The values were expressed in milligrams of pyruvic acid per 100 ml. of blood, using the expression: 1 ml. N/200 iodine = 0.22 mg. pyruvic acid. In most cases the non-protein nitrogen, the plasma carbon dioxide capacity and blood sugar were measured on the same samples. In a smaller group the urine was tested for sugar, acetone, acetoacetic acid and pyruvic acid.

Results. Thirty normal subjects had values for B.B.S. in the blood ranging between 3.66 and 5.75 mg. with an average of 4.74 mg. per 100 ml. Values for B.B.S. above 6.0 mg. are accepted as elevated. Normal values were found in the following conditions: arteriosclerosis, compensated heart disease, carcinomatosis, glomerulonephritis, hepatitis with jaundice, severe anemia, toxemia of pregnancy, acute alcoholism, chronic alcoholism without vitamin deficiency, chronic alcoholism with vitamin (B₁) deficiency after treatment.