HUNGER EDEMA 373 



years among the prisoners, in fact, it was noted that the disease 

 broke out in less than three months after incarceration. 



In infants, on a carbohydrate-rich diet, there develops a condition 

 called "Mehlnahrschaden." of which we have already spoken. 

 Many of these cases, if not all, can be considered analogous to hunger 

 edema. Vacher (1433) reported such cases during the siege of Paris; 

 later, similar conditions were described by de Wolf (1434) and 

 Potter (1435) in children suffering from marasmus. Potter believed 

 that lack of protein was the cause of the disease. The disease was 

 also noted by Chapin (1436), Waterman (1437), Hume (1438), Ashby 

 (1439) and Klose (1440). Many of these investigators studied the 

 effect of a change in the diet, especially an addition of protein. 

 In the American literature, the disease is often designated as acro- 

 dynia and has been described by Weston (1440a) and by Cartin 

 (1440b). 



Of additional interest, is the relationship between hunger edema 

 and "epidemic dropsy" in India. This disease, described by 

 Greig (I.e. 880), was first regarded as wet beriberi. Although 

 scorbutic symptoms were also observed, the condition of the patients 

 could be markedly improved by an addition of meat. Most of these 

 cases developed on a rice diet, and yet they could be identified as 

 hunger edema. McCay (1441) believed that the cause of epidemic 

 dropsy lay in the lack of protein. In a compilation on this subject, 

 Maver (1442) believed that hunger edema, edema of children and 

 epidemic dropsy have the same etiology. 



SYMPTOMATOLOGY AND MODE OF DEVELOPMENT 



A splendid description of the symptomatology, pathology and 

 pathogenesis is given by Schittenhelm and Schlecht (1443) and by 

 Schiff (1444). The most prominent sign is the edema, localized 

 mostly on the legs and on the face, near the eyes. According to 

 Hiilse (1445) pains in the calves are very characteristic. Polyuria 

 is very pronounced, according to Rumpel and Knack (1446) and 

 Zondek (1447). Jansen (1448) found decreased blood pressure and 

 subnormal temperatures. Jess (1449) called attention to the eye 

 symptoms, hemeralopia and peripapillary edema of the retina. The 

 marked bradycardia is especially characteristic of hunger edema, 

 according to Rumpel and Knack (I.e. 1446). This is not to be at- 



