During the winter and spring of 1928 and 1929 many cases of keratomalacia were seen in the hospital of the Peiping Union Medical College. Most of these occurred among Chinese soldiers, garrisoned in villages in the vicinity of Peiping, who had subsisted for various periods of time on inadequate diets, deficient particularly in animal proteins and fats.
In addition to the classic signs of keratomalacia, the majority of these patients manifested certain cutaneous lesions of such uniform character as to suggest their being of more than coincidental significance. This assumption was given further support by the fact that they were analogous histologically to the pathologic changes in the eye and in other tissues of animals and man following deprivation of fat-soluble vitamin A. As a rule the lesions of the skin preceded the appearance of keratomalacia and responded to dietary therapy simultaneously with the ocular lesions, although much more slowly.