The Bamberg herald. [volume] (Bamberg, S.C.) 1891-1972, 1914-10-01
HOOKWORM AND PELLAGRA.
Some of the. Characteristic Features
That Attend the Diseases.

AS part of the effort which We
think the press should make to dis
seminate the results of all competent
investigations into pellagra We take
notice of some reports laid before the
second annual Kentucky Pellagra
conference, at Pineville. in the noun
tain region of the State. There
abouts the disease has become extra
ordinarily prevalent. Perhaps the
most suggestive observation made
relates to a frequent, if not invari-
able, association noted between pei
lagra and hookworm. One physician
stated that he had examined over
400 cases of pellagra and had found
hookworm present in every case.
During the worst stages OF the dis
ease, he said, hookworm eggs were
not in evidence, but after the pa
tient had become better with or with
out treatment they would always ap-
pear. There was universal agree
ment upon these statements. So,
too, in the more familiar opinion
that pellagra is infectious, and is
due to living mero-organism car
ried by some insect. The insects un-
der strong suspicion among these OBJ
servers are the hookworm and the
bedbug Roll call by counties show
ed over 1900 known cases in east
ern and southeastern Kentucky, a
large increase in recent years. This,
however, was recognized as due not
only to spread of the disease but al
so to more thorough detections be-
cause physicians had acquaintance
with it which they lacked before.
And we might remind our readers
that the same must be true regarding
the impressions which they get Of in
creased pellagra prevalence. While
the disease has unquestionably in
creased in marked degree, a good
part OF the apparent increase is pure
ly apparent and nothing more. Pei
lagra had been present long before
it Was recognized at all.
An instructive feature of the Ken
lucky discussion was a report by
Doctor Martin, of Harlan, as one who
had himself experienced an unmis-
taxable case of pellagra. The char
acteristic sign of the disease, he
said, is an eruption resembling sun
burn upon the back of the hands and
forearms. This eruption next ap-
pears as a dark-brown color around
the neck, ankles and sometimes
shoulders and face. Marked mental
and digestive disturbances attend the
disease. Doctor Martin himself rec
ognized the infection at once. In
consequence of prompt measures he
had quick and apparently complete
recovery. He and others stressed the
extreme importance of recognizing
pellagra in the first stage.
Investigations at Spartanburg and
elsewhere have shown close relation
ship, with very rare exceptions, be-
tween pellagra and bad sanitation.
Absence of sewerage connections
where they are needed accounts for
the great majority of all cases in
towns and villages. Whatever the
specific agent fostered by bad condi-
tions, pellagra appears to resemble
tuberculosis and typhoid. whose eau
sative agents are definitely known, in
proceeding essentially from condi-
tions which weigh upon health even
when they cause no. particular dis
ease. In this case, for instance, poor
sanitation, hookworms and bedbugs
should be abhorrent if they were no
such disease as pellagra. And dis
ease having a recognized or suspect
ed cause which leads US as matter
of precaution to more healthful liv-
ing does not exist without compensa-
tionc of the most valuable kind.