Evening star. [volume] (Washington, D.C.) 1854-1972, 1912-05-26
PELLAGRA.
Contributed by the Medical Society of the District

Until three years ago it was thought
that pellagra did not exist in the United
States; since that time. however, case
after case has been discovered. until the
disease is now known to exist in over
two-thirds of the states. At the present
time it is unsettled whether we suf-
fering from an epidemic of the disease or
whether we are merely recognizing an
ailment that has existed for perhaps
many years. Judging from experiences
in other countries it would seem prob
able that we have had the trouble with
us for decades.
On the continent pellasra is not a new
disease. 1t was first accurately described
by Spanish physician, DR.. Gaspar Casal,
in 1875, as occurring among the peasants
of the Asturias. Italy has suffered more
than any other country. ii being esti-
mated that in 1880 there were in Lom-
hardy alone over 10000 cases. and that
nearly per cent of the inhabitants of
northern Italy were afflicted. The Italian
government by strict hygienic and dietary
measures has greatly reduced the prev
alence of the disorder throughout the
entire country.
Cause Still Unknown.
| The cause of pelagra is still unknown.
| OF the many theories as to its origin two
now predominant, firstly that the
eating of bad corn is responsible. and
secondly that the disease is transmitted
| by biting-fiy and is due to an animal
! parasite just as is malaria. Certain IL is
that most. but not all of the victims,
have eaten considerably of corn, but on
IL a,.I l.or fxxF<
cases in nursing babes. The malady
does not originate in the city. but seems
| to occur among the poorer class OF coun
| try people, and among the inmates OF
various asylums Many of the insane
asylums have a very high percentage or
cases. In other words. the disease usual
| ly occurs among those who live in cramp-
| ed quarters and have a rather poor food
supply.
The disease affects three portions of the
body with the greatest intensity. namely,
the skin. the intestinal tract and the
nervous system.
| The skin LESSONS appear first and are
more characteristic than are the others.
| Usually in April the first attack comes
on. The patient first feels rather under
| the weather. and usually attributes it to
| either malaria or spring fever. Then
| the face and neck ard the hands and
wrists where they are exposed TO the
| sun become red. as from sunburn; in a
! couple of weeks the skin begins to peel
off, this peeling sometimes being so Sc
| we're that the hands look as though they
| had been dipped in boiling water. After
| this desauamat ton is complete the skin
| is very dry and tense and looks like the
| skin of an d man who has done much
| work in the sun.
Insanity One Feature.
| The patients tongue is usually red and
| the gums may bleed. Very many of the
victims become violently insane as the
disease progresses. 4, first. however.
there are no mental symptoms.
! The first attack usually clears up and
leaves the sufferer in apparently good
health. but in the fall or in the spring
of the next year another attack comes
in just the way that the first one did.
except that each new attack is more Sc
| we're.
AT least 'one-third and probably more
of those attacked with pellagra ultimate
/ Is die as the direct result of the disease
Ii is impossible to say what percentage
/ become hopelessly insane. Very few pa
tients die in the first attack. There is
no specific treatment for pellagra; no
known drug will act as cure The
diagnosis must be made early-shortly
after the first cutaneous symptoms and
long before the patients mentality is af-
| fected. The diagnosis may be made from
the appearance of the hands and race
by any one who has seen number OF
| cases Treatment consists of rest. fresh
| air and the best of food, with the with
| drawal of corn. If blood can be obtained
4 from the veins of a patient who has had
i pellaera and permanently recovered from
i il and directly injected into the veins OF
1 the sufferer the latter will have a much
| better chance of recovery This Is the
best treatment, outside of general n.y.
giene.
Prevention Serious Problem.
| How to prevent the spread of the dis