Pellagra : a précis / by C.H. Lavinder ; prepared by direction of the Surgeon-General.

  • Lavinder, C. H. (Claude Hervey), 1872-1950
Date:
1908
Catalogue details

Licence: In copyright

Credit: Pellagra : a précis / by C.H. Lavinder ; prepared by direction of the Surgeon-General. 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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    mental dullness, even stupor, and frequent delirium, rapid emacia- tion, with a low grade of fever, and too often comparatively early death. The chronic types are, however, seen too with their slow, though steady, advance, but even these do not seem to possess the great chronicity described in the pellagra of the Old World. One other variation is the divergence in many cases from the strict seasonal recurrence of the manifestations of the disease. It observes more or less generally a seasonal recurrence, but not with the strict regularity described for Old World pellagra. It may be added that among the cases seen at Wilmington, N. C., nephritis has not been infrequent, and that indican has been often found abundant]}' in the urine. Of the parasitic diseases, malaria has been observed occasionally, round worms once, but not uncinariasis, so far as I can learn. It might also be said that variations of this character are not suf- ficient to discredit the diagnosis of pellagra. It is a disease of varied symptomatology. For example, Kaposi (15) says: The symptoms of pellagra have been described in various ways. I believe this is owing to the fact that the disease does really occur in various forms, may run a more acute or an extremely slow course, and may exhibit very few or very many symptoms. Whether this disease be true pellagra or not, it has so far proven itself a factor to be reckoned with in some of the Southern States, and it should receive now the most earnest attention and careful study of those medical men under whose observation and care such cases may chance to fall. This will in all likelihood be the especial province of the southern physician. In conclusion I desire to express my thanks to certain local practi- tioners at Wilmington, N. C. To Dr. Thomas M. Green I am indebted for the privilege of seeing a case of the disease; to Dr. R. FI. Bellamy I am indebted for many favors; and to Dr. E. J. Wood I am especially indebted. I have had the privilege of seeing and studying several of his cases, and with him have reviewed much literature and done a good deal of other work. For most of this precis I am under obligations to some of the well- known literature of pellagra, of which, as is very evident, I have made extensive use. I have, as far as possible, purposely refrained from verbatim quotation in order not to interrupt the continuity of a paper of this kind. I have tried in the appended brief bibliography to make some acknowledgment of my indebtedness. I am also under obligation to the librarian of the Surgeon-General's Office at Washing- ton for information and many courtesies.