The gynecological, obstetrical and surgical aspects of pellagra : a preliminary study / by Eleanora B. Saunders.

  • Saunders, Eleanora Bennette, 1883-1933.
Date:
1911
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Licence: In copyright

Credit: The gynecological, obstetrical and surgical aspects of pellagra : a preliminary study / by Eleanora B. Saunders. 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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    Case 6.-.—Married ten years, 28 years old, first pregnancy ending about twelve months ago. Three weeks after child-birth, she suffered with sore mouth, but had nervous symptoms before confinement. Stomatitis, diarrhea excitement, later eruption on hands which grew worse. Patient lost ground physically and mentally, became suicidal and consequently was admitted to asylum. Has run a typical course and has been very suicidal, and at present all symptoms are better except the mental. Still under observation. [Since this paper was read this patient, in spite of all precautions, succeeded in committing suicide by hanging herself with her own hair and a few strands of thread.] Prolonged lactation by enervating influence may cause a de- pression amounting to resistive melancholia. Such cases becom- ing pellagrous usually complain of “ getting run down,” and are thin and nervous. Diarrhea sets in and the eruption completes the picture. In time it is to be hoped that we shall learn to diag- nose or at least to suspect the presence of pellagra in debilitated and nervous women without waiting for the appearance of the eruption. Case 7.—A decided blonde, age 32 years, second child three years of age. Prolonged lactation during the summer of 1908, was much debilitated and “ run down.” Eruption appeared later, but she continued to nurse the child until admitted to asylum in April, 1909. Since admission she has shown great mental instability, is moody, emotional and at times very noisy, has had diarrhea and eruption which is exceptional in that it extended far above the elbows. (Is still under treatment.) Frequent child-bearing by sapping the strength of these nervous patients seems to play its part as a predisposing cause in the de- velopment of the pellagra syndrome. Already Strambio about 1790 as noted by Babes and Sion had observed that gestation gave occasion to the breaking out of pellagra. He also observed cases in which pellagra appeared only during gestation and lactation, and then receded. Case 8.—Married, age 49, history of many and very rapid pregnancies, always “ run down,” had eruption several years. Very depressed, upon admission to asylum had dermatitis and diarrhea. Abject depression marked this case. She suffered from menorrhagia. Finally she made a complete recovery. Discharged. Surgical operations acting as trauma develop latent pellag^ and lowering the resistance aggravate or hasten its course. In the early cases, we have all the train of symptoms: back-ache, pelvic distress, headache, bearing down pains, weakness, lassitude,