PELLAGBA 361 



pcllagrous pregnant women; hemorrhages following birth are not 

 uncommon. In latent cases, following pregnancy, an acute condition 

 is not infrequently brought on; . similar observations have been 

 made in beriberi. 



7. Other organs 



Regarding eye symptoms, Marie (I.e. 1280) described conjuncti- 

 vitis with pterygium and hemeralopia, and sometimes pigmentary 

 retinitis. Calhoun (1327) found that certain visual disturbances, 

 especially certain forms of color blindness, precede other symptoms 

 of pellagra, so that they may be used in the diagnosis. 



As regards the endocrine glands, Beeson (1328) observed, out of 

 316 cases, 25 cases of thyroid complications. Modinos (1329) noted 

 cases in Egypt with enlarged adrenals, about twice the usual size. 

 In cases observed by Wilson (1330),, also in Egypt, these glands were 

 much lighter in weight. Morse (1331) found severe atrophic degen- 

 erative changes in the thyroid and the adrenal medulla. In the 

 latest reports, especially from Egypt, special attention was paid to 



the insufficiency of the adrenals (Wilson, I.e. 1330). 



I 



CHEMICAL PATHOLOGY 



Koch and Voegtlin (1332) analyzed the spinal cord and brain of 

 pellagrins and found that the figures agreed, in general, with those 

 obtained in pigeon beriberi. One of the most important findings 

 was the loss of lipoids, particularly in the spinal cord. 



Indicanuria was found by Ridlon (1333) in 90 per cent of his 

 cases. Murlin (1334) found high amino nitrogen and hippuric acid 

 values (two to three times greater than normal), indicating a poorer 

 nitrogen utilization. If the carbohydrate diet is replaced by a protein 

 diet, then the values found are smaller. The effect of both of these 

 diets on the composition of the blood was investigated by Lewis 

 (1335). The carbohydrate diet gave smaller urea and non-protein 

 nitrogen figures, but otherwise the findings were normal. Jobling 

 and Maxwell (1336), as well as Sullivan and Stanton (1337), deter- 

 mined the alkali reserve of the blood; the figures varied only slightly 

 from the normal; no acidosis was noted. Sullivan and Jones (1338) 

 found indican in the saliva in one case; in addition, there was a 

 thiocyanide reaction, indicating a retardation of protein metabolism. 



