What are pellagra and pellagrous insanity? : Does such a disease exist in South Carolina, and what are its causes? : an inquiry and a preliminary report to the South Carolina State Board of Health.

  • South Carolina State Hospital for Insane
Date:
[1908]
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Licence: In copyright

Credit: What are pellagra and pellagrous insanity? : Does such a disease exist in South Carolina, and what are its causes? : an inquiry and a preliminary report to the South Carolina State Board of Health. 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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    better in cold weather, but never entirely healed. Family produced all the com they used. None of family or neighbors have had “ eczema,” but family physician said he had had a similar case. Patient developed symp- toms of mental depression about two years ago, which subsequently have been continuous. Bowels have been constipated with occasional diarrhoea, the latter having been constant and severe for three months before admis- sion. (See Plate I.) On Admission.—Extreme adynamia, stupid appearance, reluctance to exertion. Sat with bowed head and spoke in monosyllables and only when spoken to. Muscular system fairly preserved. Axillary and suprapubic hair present. Poor appetite but intense thirst. Temperature 97 degrees; pulse 80, regular and full. Respiration 20. Urine normal, as shown by repeated examinations. Blood examination showed a relative increase of lymphocytes and a moderate degree of anaemia. Gastro-intestinal.—Abdomen flat. Exhausting diarrhoea, sometimes as many as twenty stools a day, light yellow to copper color. Hook-worms and eggs found by several observers. Skin.—Slightly jaundiced; eczematous condition covered forehead, also alae nasi, malar bones and chin, as well as dorsal surfaces of hands and feet; very scaly and rough on exterior surface of elbows and knees. No sores or scars. Most of these regions were chapped and fissued. Anaemic and puffy about eyes. Mouth.—Foul breath; tongue deep red and clean, straight and not tremulous. Lungs.—Normal. Heart, accentuated aortic second sound. Nervous and Mental.—Tendon reflexes exaggerated; tabetic gait; stiff- ness of muscles; dull and melancholy; suspicious about food; occasionally mildly excited. Pupils react to accommodation and slightly to light. Has slightly lost ground physically and mentally since admission. Has become more and more paretic, so that she had to be put to bed. Tem- perature varies from 96 degrees to 99 degrees. January i, 1908, she was given thymol grains 15. Thymol repeated January 12. Has made an assault upon an old woman sleeping in room with her. After studying this case Dr. Stiles’s comment was: “ If this is hook-worm disease, its symptoms are entirely different from those I am familiar with, and without microscopic examination I should place her in the doubtful class as regards uncinariasis.” Case II.—R. P., admitted to State Hospital, December 2, 1907, colored, male, age 30 years. History meager. Mother is said to have died of old age. Mental symptoms developed slowly. History of apoplectiform seiz- ures. At times was incoherent and profane. Mind ran much on religion. Diarrhoea for three months, and eruption appeared on hands three months before admission. (See Plate II.) Physical Examination.—Patient very emaciated and anaemic. Deep re- flexes somewhat exaggerated. Heart, at times soft, blowing systolic mur-
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