Time Factor in Multiple Injuries

Under certain conditions the small trauma will adapt the organism, and temporarily increase the resistance, by means of unspecific stimulation. In the case of 2 and 3 the combined effect will be additive or strongly synergistic depending on timing (S3). 

The ratio of methylcobalamin to total vitamin derivatives of extractable B12 has been determined in liver from mice who were subjected to different types of injury (mechanical trauma, bums, and ionizing radiation) inflicted separately or in various combinations. A decrease in methylcobalamin was observed paralleling the severity of the damage. There may thus be a decreased synthesis of methycobalamin or an increased catabolism or leakage from the liver—or combination of these causes. The method used did not determine the nonextractable cobalamin, so that a disappearance into a nonextractable form could have been the cause (L9). 

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