Evening star., 1911-01-19
HISTORIC SC0URGES
VIII-PELLAGRA.
Bv FREDERIC J. HASKIN.

Pellagra is at one and the same time
new and an old disease 1t was recos-
nized as epidemic in certain countries VI
Europe and in North Africa for nearly
200 years. while only comparatively 1e"
cases have been located in the southern
United States This is perhaps the more
strange, since pellagra is strictly con-
| fined to those races where maize or IN
dian corn is a staple article of diet. Yet
America is one of the original indigenous
homes of that valuable food staple. The
explanation consists mainly in the fact
that the original homes Of the maize
| culture, Asia and America, have escaped
by reason of superior climatic condi-
tions.
Pellagra is pronounced disease due
to using as food Indian corn which, under
the influence Of parasitic growths, has
undergone certain chemical changes. with
the consequent production of one or more
| toxic substances. This relation between
| cause and effect was suspected early in
the nineteenth century. The disease gen.
| orally occurs among the poorer classes
Of rural populations who subsist largely
or exclusively on maize, most usually pre-
pared by boiling cornmeal in salt water.
a dish which in Italy is called polenta.
most severely the corn is often of
poor quality. gathered before proper rip
ening or not properly cured and stored.
SO that in this diseased corn parasites
easily develop.
The pellagra pest has been known in
Spain since 1885. 1t appeared in Italy
about 17JO and
| Pest Known in by 1874 there
Spain Since 1885. cases aeas in ~ the lat lat
ter country that a hospital and clinic
treatment and study AS result, two
Italian physicians. Marzari and Belar-
dini, suggested the theory that the dis
ease might be due to spoiled maize This
precis has also recently been defended
and developed by Lombroso. In France
the disease appeared about 1890. also in
Roumania, Austria and Bulgaria 1t is
known to have fourished in Egypt. and
sporadic cases are met with in various
and widely separated parts of the world.
But in France, Italy and Roumania, since
other cereals have replaced maize in re-
cent years, pellagra has much decreased.
In the United States there was an cpl
demic Of pellasra in Alabama in 1907,
number of states. In Texas. during six
months of 1910, there were fifty-seven
deaths from pellagra. OF these forty
eight wore women and nine were men
fifty whites, six negroes and one Mexican.
i
There is always a high mortality among
those afflicted. In Roumania there are
3O.CcO pellagrins.
Mortality HIGH There are 1OO,OGJ
From the Disease. and inward ar o. Of
50,O0o in Bulgaria. The duration of the
disease may last from one to twenty
years. but there is a steady physical de-
terioration. while development seems to
be more rapid and severe in children. Re-
covery may take place. yet many cases
OF long :tanding ultimately degenerate
into pellasrous insanity and paranoia.
The outward symptoms of pellagra are
nmistaKabie. The characteristic erup-
ton and roughening of the skin caused
the disease at one time to be regarded as
a spccies, of feprosy-'Italan leprosy.
This skin eruption usually first attacks
the arms and the backs of the hands.
There is a subsequent wasting of the tis-
sues. atrophy of the heart, anenlia. nerv-
Gus and digestive troubles, intestinal dis
turbances. insanity, typhoid pellagra, and
finally death. The disease is essentially
chronic.
The rash or skin eruption is the char
actcristic and invariable symptom of the
disease. 1t attacks the victim almost in
variably in the spring. develops during
the summer and fades, with the appear
ance of winter. 1t appears first on the
backs of the hands, the forearms, face,
back of neck upper chest and the feet.
Cases have been described when the erup-
ton involved the whole body. Its rela
tion of the suns rays has been subject
of much discussion. but the most general
ly accepted idea is that the actinic rays
of the sun simply act as exciting
cause in persons, already victims of the
disease.