The Etiologic Controversy Regarding Pellagra

Abstract

pellagre des Landes dans le pass\l=e'\ et dans le pr\l=e'\sent,Th\l=e`\se,Bordeaux, 1907.4. Creighton, Charles: The Encyclop\l=ae\dia Brittanica, Ed. 9, xviii, 476.

Progress in Dermatology: Pellagra

“…Between that time and 1907 the disease could have occurred only sporadically as, except for 2 cases reported in 1863, 1 by Dr. Tyler, of Somerville, Mass., and 1 by Dr. Gray, of Utica, N. Y., and later 1 case by Dr. Harris, of Georgia, and 1 case by Dr. Sherwell, of Chicago, there is no reference to pellagra in our medical literature. (14) Therefore, granting that the disease may have existed for thirty or forty or even more years, as Lavinder (13) says, the accepted date of 1907 of the first appearance of pellagra in the United States is probably correct, at least as concerns its appearance in any considerable number of cases.…”

“…(7)(8)(9)(10)(11)(12)(13)(14) (1) that " the manifestations of the disease have been found to vary even in adjoining provinces." Nevertheless, the variations are usually those of intensity and evolution rather than of kind.…”

“…In Italy the symptoms usually recur only in the springtime, but in America many cases have a second recurrence in the autumn, generally in October. (11,13,27) The parts involved by the erythema are generally those which are exposed to the light, i. e., the face, neck and backs of the hands, (12,13,28) although in many American cases the covered parts also may be extensively involved. (1,12,28) The border of the erythema is often very sharply defined at the point where the uncovered parts meet the covered.…”

“…(14) Occasionally dilatation or other disturbances are noted in the eyes, but nothing especially characteristic. (12,13,28) The triad of symptoms is completed by the gastro-intestinal symptoms. The diarrhea which was noted during the stage of invasion still continues, improving perhaps with the onset of eaoh erythematous attack, but on the whole in a more aggravated form.…”

“…Lavinder says of the duration and course of pellagra: (13) "The manifestations are periodic and usually appear in the spring. If the winter is warm, they may appear earlier.…”