PELLAGBA 359 



Amentia (42 per cent typical first stage) 320 



Mania 115 



Melancholia 113 



Dementia 103 



The mortality was 32 per cent; aside from this, 47 per cent were 

 discharged, with unknown issue. 



In the brain, the following lesions were found : pia and arachnoid 

 were thickened, with a milky cloudiness and ecchymoses. In the 

 brain, mostly edema and hyperemia with hydrops of the ventricles 

 are noted. In chronic cases, the brain and the brain convolutions, 

 especially the frontal, frequently become atrophic, hard and anemic. 

 Miscrocopically, cortical nerve cells are degenerated, with swelling, 

 vacuole formation, displacement of the swollen nucleus to the side, 

 and later atrophy of the degenerated cells. 



In the spinal cord, in acute cases, dilatation of the blood vessels 

 and edema are found; in chronic cases, chiefly degeneration of the 

 dorsal fibers and the direct pyramidal tract. Scattered localities 

 with disappearance of the nerve fibers in the whole white substance 

 of the spinal cord were also noted. With this, the dorsal roots are 

 also degenerated with arterial thickening. In the gray substance, 

 and also in the cells of the ventral and dorsal horns, we find pigmen- 

 tation, swelling of the cell protoplasm, chromatolysis and displace- 

 ment of the nucles to one side. In the sympathetic nerve, especially 

 in the abdominal ganglia, degeneration was observed. It must be 

 explicitly stated that in the nerve centers, there was not a trace of 

 inflammatory lesions; all the changes, according to Mott (I.e. 890), 

 are exclusively of a degenerative nature. 



Microscopic hemorrhages were often noted in the nerve centers. 

 In one of Chalmer's (1321) cases in Roumania, the cause of death 

 was a marked hemorrhage in the lower cervical and dorsal part of 

 the spinal cord. In the sciatic nerve, Mott found scattered degener- 

 ation of nerve fibers. 



4- Circulatory system 



In the blood, according to Findlay (1318), an increase in lympho- 

 cytes is mostly found. Hemoglobin, about 80 per cent; pulse, usually 

 100 and in acute pellagra, up to 120; blood-pressure is mostly low. 

 Examination of the blood for microorganisms was negative. Bardin 

 (1322) found an increase in the number of small and large lympho- 



