How long has pellagra existed in South Carolina? : a study of local medical history / by J.W. Babcock.

  • James Woods Babcock
Date:
1912
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Licence: In copyright

Credit: How long has pellagra existed in South Carolina? : a study of local medical history / by J.W. Babcock. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    well, for it puzzled me greatly, and I made a strong appeal to the authorities, both of general practice and dermatology, for help. When the time came to sign the death certificate, the diagnosis recorded above was the best I was able to render. Of course, I know now that the poor woman, whose epidermis peeled off and whose hands and feet became gangrenous, died of pellagra of the so-called “ wet ” type. In passing, I recall another case now known to be pellagra, in a colored woman at about the same time, which I diagnosed and treated as “ scurvy.” She is still living and has had only one relapse—last year—in the seven or eight subsequent years. During my temi of service since 1891, the most common diag- noses that I find as applied to fatal cases of probable pellagra, are: ‘‘ intestinal tuberculosis,” when the diarrhea was most pronounced ; general paralysis ” and “ meningo-encephalitis ” for the cerebral and spinal cases; “ syphilis,” when the skin lesions were marked ; and “ acute delirium ” for the fulminating mental type. In the mortality tables of the earlier annual reports, I find from 1890 to 1878, “ consumption ” and “ exhaustion ” are the most commonly assigned causes of death, but besides these, “ inanition,” “ marasmus,” “ anasarca,” “ dysenteryq” “ ascites,” and “ gan- grene ” are frequent. Chronic dysentery and chronic diarrhea, which play so large a part in the earlier mortality lists, are com- paratively rarely mentioned. To cite a case of this period, we may take that of : Miss E. L. White woman. Admitted from Charles- ton County, May 30, 1887. Died May ii, 1891, from “ inanition.” Previous history: “For about three years, this lady has been having hemorrhages from the uterus. For the last three months, these have been checked and the periods normal. She is restless by day, but sleeps well at night. Her mental derangement is in- creasing and she believes that she has a number of suitors, but her sister prevents her seeing them. Dr. X. [a famous specialist of New York], whose patient she has been, considers her a case of ‘ cerebral anemia ’ with prognosis bad.” The patient is described as a decided blonde, cross and irritable, with a mania for eating corn starch. She would quarrel with her nurse until she went to the laundry and got starch for her. She became emaciated and died from obstinate diarrhea. As pellagra is now understood, she no doubt had that disease, associated with