Conference on Pellagra : held under the auspices of the State Board of Health of South Carolina at the State Hospital for the Insane, October 29th, 1908.

Date:
1909
Catalogue details

Licence: In copyright

Credit: Conference on Pellagra : held under the auspices of the State Board of Health of South Carolina at the State Hospital for the Insane, October 29th, 1908. 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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    fore undertake to present briefly some of his opinions as to causa- tion. The history and distribution of the disease show that pellagra is associated with nourishment from maize. As this appears indisput- able there remain two possibilities, first that in sound maize sub- stances can be present which under certain conditions can affect an organism injuriously, or second, that the disease is produced by spoiled maize. It is true that careful investigations in all lands afflicted with pellagra have proven that pellagra appears where maize is harvested in an unripe state, or is spoiled through dampness. Still, there are pellagrous regions where, apparently, sound maize is eaten. It seems not to be doubted that these last two assumptions are of impor- tance in the etiology of pellagra only with the limitation that often apparently sound maize is affected with a fungus and bacteria, and it remains undecided whether in entirely sound maize poisonous substances are found. This much is certain, that the more notice- able the spoiled conditions of maize, the more poisonous substances it contains. In regard to the apparently sound maize the investigations of pellagra are interesting. Barbes reports particularly the fact that even in sound maize there are numerous organisms of minute size, often more than in that which has the appearance of being spoiled; But when the maize remains several days exposed to a dry heat of 70 degrees, it contains very few bacteria. These, produced by pure culture were-not injurious to animals. Only those produced by the special culture of the bacteria of putrefaction were poisonous. More important are the results which were obtained with extracts taken from polenta and corn bread, according to which 10 grams of watery extract introduced intravenously to every kilogram of the animal experimented on, produced appearances similar to pellagra, for instance, gastro-intestinal disturbances, sometimes with mental derangement. It is doubtless a question of ferments which are pro- duced by various micro-organisms in a certain phase of their devel- opment. Although these investigations cannot be regarded as final, still they agree with the statistical data of Lombroso and our own, according to which scarcely 25 per cent, of pellagrous sufferers can be shown to be in the habit of eating spoiled maize. Also, Lombroso emphasized the fact that cured pellagrous patients, when they go back to a maize diet, even though it be apparently sound, always 2—rvi.