MIND, BRAIN AND BIOCHEMISTRY 399 



iodine. A few weeks after birth the characteristic physical 

 stigmata appear, accompanied by signs of involvement of the 

 central nervous system."" Decreased acuity of the special senses 

 is evident; speech and socialization are retarded; muscular 

 coordination is impeded, and unless the condition is treated 

 the mental status of the individual is no more than that of an 

 idiot. 



The second large class of biochemical disturbances giving rise 

 to abnormal behavior consists of acquired metabolic malfunc- 

 tions. This class can be broken down into diseases arising from 

 some nutritional deficiency and those arising from a toxic 

 substance either exogenous or presumptively endogenous. The 

 latter type, indeed, may be due in whole or part to a congenital 

 defect, but in the present state of our knowledge it remains an 

 open question. Diseases arising from nutritional deficiency are 

 of many types, but only one need be mentioned because of its 

 striking mental involvement: pellagra. 



Pellagra has a variety of symptoms which, in the more 

 advanced stages, include a considerable mental dysfunction 

 characterized by a clouding of consciousness, hallucinations 

 and confusion, frequently terminating in a psychosis if adequate 

 treatment is not instituted.^" It has been determined that this 

 condition is due to the absence of one of the B vitamins, nico- 

 tinic acid (or its amide) , or its precursor, tryptophan. ^^. In 

 1937 it was discovered that pellagra could be relieved by 

 administering nicotinic acid (not to be confused with the 

 alkaloid nicotine) .^- The importance of this vitamin is that 

 it is an integi-al part of one of the coenzymes, known as diphos- 



-® H. P. Rome and D. B. Robinson, " Psychiatric Conditions Associated with 

 Metabolic, Endocrine and Nutritional Disorders," in American Handbook of Psy- 

 chiatry, ed. cit., II, p. 1274. 



'°R. L. Cecil and R. F. Loeb, ed., A Textbook of Medicine (Philadelphia: 

 Saunders, 1959) , p. 547. 



'^ J. Gregory, " The Role of Nicotinic Acid (Niacin) in Mental Health and Dis- 

 ease," Journal of Mental Science, CI (1955), 85. 



''''D. T. Smith, J. M. Ruffin and S. G. Smith, "Pellagra Successfully Treated 

 with Nicotinic Acid: A Case Report," Journal of the American Medical Association, 

 CIX (1937), 2054. 



