The star. (Reynoldsville, Pa.) 1892-1946, 1909-04-28

this country until recently, but which
has prevailed for a long time in Italy,
Roumania, France, Spain, Corfu and
Upper Egypt. 1t has often been re-
ported in other European countries
besides those mentioned, and is oc-
casionally heard of in India, Africa,
Mexico and South America. At least
one case has been discovered in New
York, according to Passed Assistant
Surgeon G. II. Lavinder, of the Public
Health and Marine Hospital Service.
The spread of this disease in the
Southern States has been rapid and
alarming, and has been the subject
of several conferencesand conventions
of physicians in the last few months.
In spite of the generally accepted the
ory that the dreaded ailment comes
from eating, spoiled maize, 1t is the
opinion of great many physicians
that its origin Is still mystery. All
are agreed that determined efforts
must be made to stamp 1t out In the
South.
DR.. Lavinder, in an official report
made to the Government after an ex-
haustive study of the disease abroad,
says that the literature on the subject
in English is very meagre and unsat-
isfactory.
More or less recently" he says,
"there has appeared In the Southern
States disease which Is possibly true
pellagra, and there is reason for be-
lieving that perhaps this disease may
be quite prevalent, but unrecognized.
Since 1T is of serious nature, and
epidemic in character, knowledge con-
cerning it is becoming of much i'm
portance to the American physician,
and more especially to the practition-
er in the Southern States"
DR.. Lavinder summarizes the symp-
toms of the disease as follows:
"Pellagra is both an endemic and
epidemic disease, which occurs in
those who feed on spoiled maize, and
is characterized by an erythema of
the skin, digestive disturbances and
nervous disturbances. 1t may ter
inmate in such serious conditions as
grave cachexia or insanity; 1t Is
periodic in its manifestations, and
usually appears with the beginning
of spring, ameliorates during sum-
mer, and ordinarily in winter the
symptoms disappear to such an ex-
tent as often to give the false idea of
recovery. So long as the cause per-
sists, however, it reappears each year.
"The disease usually begins with
gastro-intestinal disturbances, fol-
lowed shortly by the erythema of the
skin, and in a brief while there Is
more or less involvement of the ner-
vous system. 1t is slowly advancing
toxemia, the brunt of which, in the
end, is borne by the nervous system,
and each annual recurrence leaves a
deeper and more indelible mark on
the mental and nervous condition Of
the sufferer.
"The symptoms are divided by
most authors into three periods or
stages. Many other divisions have
been suggested. None seem entirely
satisfactory. The division into three
stages, while artificial, is convenient
and is generally adopted. Such d.
vision has no reference to the length
of time the malady has existed, but
is based largely on the intensity Of
existing symptoms. A patient may
have suffered from pellagra for many
years and still remain in the first
~ Of ha
In much briefer period, may ad-
vance to the third stage.
"The disease is essentially chronic,
although an acute (or florid) type is
usually mentioned by writers on pei
lagra. Small space seems to be de-
voted to any description of acute
types, however, and one is left to in
fer that the acute disease does not
differ in symtomatology from the
chronic, but that it is simply far more
rapid in its evolution"
The most important conference on
pellagra in this country was that
held some months ago under the
auspices of the State Board of Health
of South Carolina at the State Hos
pital for the Insane. The transac-
tions of the conference, including all
the papers read, have just been issued
by the State Company, printers, Col
umbia, S. G. Many of the addresses
had been reprinted previously in the
Journal of the South Carolina Med
ical Association.
At this conference the disease was
discussed in all it's aspects, and every
effort was made to dispel the mystery
surrounding its origin.
The contribution of DR.. John Nc
Campbell, Superintendent of the State
Hospital at Morganton, N. c., is i'm
portant. He says:
II suppose that no one any longer
seriously doubts the existence of pei
lagra in the South. Sufficient and in
disputable evidence has been brought
forward to establish this fact beyond
peradventure. 1t will be noticed
further that practically all reports Of
cases have been made within the last
eighteen months, Indicating that it
l. Nc In