Pellagra : first [and second] report of the Thompson-McFadden Pellagra Commission / by J.F. Siler, P.E. Garrison and W.J. Macneal et al.
- New York Post-Graduate Medical School and Hospital
- Date:
- 1913-1914
Licence: In copyright
Credit: Pellagra : first [and second] report of the Thompson-McFadden Pellagra Commission / by J.F. Siler, P.E. Garrison and W.J. Macneal et al. Source: Wellcome Collection.
Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.
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![Ormsby in Chicago. But this is not what is impHed by this description. The cases here grouped have all been rapidly fatal and the picture presented is that of the final stage of dementia paralytica. It is not claimed that they run the whole course of that disease. To quote from the report by Green of Milledgeville, Ga., the features which lead to such a grouping are: Exaggeration or loss of knee-jerk, speech dis- turbance [possibly a dysarthria due to stomatitis, K. D. S.], tremors, muscular incoordination, pupillary inequality or irregularity, convul- sions and sensory disturbance. The case records of examples which I was able to study at the Milledgeville hospital speak of extreme dis- orientation with confusion and a muttering incoherence, so that but little information can be obtained from the patient who leads a more or less vegetative existence, does nothing for himself and voids urine and feces in the bed. The picture thus described suggests an extreme degree of general intoxication with central and possibly at times peripheral neuritis. It resembles in many respects the severe toxic forms of infective fevers, such as typhoid, and there seems but little justification for regarding it as especially comparable to dementia paralytica. It is not the extreme nervous disorganization which is characteristic of general paralysis, and it is unfortunate that a name with a specific significance should be used to describe a condition which may result from many dififerent causes. For purposes of description the types of mental disorder associated with pellagra may be grouped as follows: Group I. Disorders directly due to the pellagra toxin (or toxins). 1. Symptomatic depressions. 2. Delirious pictures. Group 11. Disorders based on peculiarities in personal make-up, the attack of insanity being precipitated by pellagra. 1. Manic-depressive disorders. 2. Hysteria. 3. Psychasthenia. 4. Dementia praecox. 5. Paranoic developments. Group III. Disorders due to definite brain changes with pellagra merely as a complication. 1. Arteriosclerotic dementia. 2. Senile dementia. 3. Presenile psychoses. 4. General paralysis of the insane. The disorders in Group I may be considered in some detail, whereas the others will be passed over more briefly.](https://iiif.wellcomecollection.org/image/b21353128_0302.jp2/full/800%2C/0/default.jpg)
