Report of the Pellagra Commission of the State of Illinois, November, 1911.
- Illinois. Pellagra Commission.
- Date:
- 1912
Licence: In copyright
Credit: Report of the Pellagra Commission of the State of Illinois, November, 1911. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![had attacks of morning diarrhoea for several summers and \vas subject to attacks of acute indigestion. The first known attack of dermatitis oc- curred in October, 1910, but was very mild and without severe constitutional symptoms. The second attack in 1911 was much more severe and led her to come to Chicago for assistance. When seen she presented an entirely char- acteristic skin eruption of pellagra involving the hands, arms, forearms, and across the sternum with sore mouth and diarrhoea. In spite of this she ap- peared to be in a good state of nutrition. With such facts before us it is certainly difficult to understand the freedom of hospital employes. Attention should be directed to the coexistence of intestinal pai-asitism with the larger outbreaks of pellagra at the Peoria State Hospital; 1909 also saw an epidemic of amoebic dysentery and we find that since that year pellagra has subsided very rapidly. It is of course passible that the enor- mous fatality during 1909 may have removed most of the more susceptible individuals. The question of the relation of protozoal infection to pellagra is more fully discussed in later sections of this report (See report by Capts. Siler and Nichols and also by J. T. Rooks) and need not further detain us The Question of the dietary of the State Hospitals is also the subject ot detailed study later (See report by Grindley and Wussow). It may however be mentioned here that the chief point of deficiency in the dietaries has been in regard to animal protein, and yet the institution feeding the smallest amount of meat, which forms the main source of this material, has shown ^Vfew^words are advisable in regard to the habits of the patients which would expose them to biting by insects, etc. In all institutions patients are out of doors as much as possible. At Peoria probably the ma]ority of the patients who have contracted pellagra have spent the time, while out ot doors sitting upon the porches of the buildings which they leave only foi a sho'rt time if at all. So many have been more or less helpless dements that any more active outdoor life has been out of the Question. Others it is true have had the free run of the grounds. It should be noted that this out- door period of the day does not include the early morning and late evening at which time blood-sLking insects would be most prevalent Furthermore many attacks of pellagra have arisen in patients confined to the bospitai wards and not out of doors at all. In this connection ^-effi-ence may be made to the striking example quoted by Dr. Hyde^ from the Elgin State HospitaL '■The patient, a woman. , had been bedridden for years and occupied a room in common with another insane woman, also pellagrous. The first patient occupied a bed at the farther extreme corner of an apartment lighted by a single window. The only light accessible for a long period pnor to the advent of the pellagrous disorder was furnished by this one window It is but fair to state that inquiries at the Elgin State Hospital failed to elicit the name of this patient but the medical staff has changed since this observation was made (1909). The facts are substantiated however b> Dr Ormsby who was with Dr. Hyde upon the occasion of the visit. With regard to other insects, such as fleas, bedbugs and body lice it can- not be said that any institution is entirely free from them but they cei- tainly are not numerous in any of the hospitals where constant warfare is maintained against them. , , , •it„„„ +i-,o The distribution of the cases in the different wards and build ngs at the Peoria State Hospital, built strictly upon the cottage P^^n revealed no spe^ cial foci. Cases apparently originated in all of them and w^r^ o* m°^^ common even in those cottages in which a large number were segiegated tor observation. Furthermore, there were no differences m the f^^^ary of the different wards, with the exception of the hospital wards, all being suppuea from the same kitchen. „„foi/i« tiio As regards the distribution of pellagra throughout the State outside the hospitals for the insane, we feel that the data are still too few to justify 1 Pellagra and Some of its Problems Amer. Joiini. of the UcA. Sci., ,Ian. 7, lom, p. 10.](https://iiif.wellcomecollection.org/image/b2398322x_0020.jp2/full/800%2C/0/default.jpg)
