330 Vitamines and Deficiency Diseases [June-September 



1. A chronic intoxication by soluble aluminium Compounds; 



2. Lack o£ vitamines (Casimir Funk) ; 



3. Lack of certain amino-acids. 



Treatment. In some parts of Italy the government initiated 

 very energetic measures against Pellagra. Alpago-Novello (75) has 

 summarized the work undertaken in the province of Belluno, where 

 Pellagra diminished very rapidly when the cultivation of beet-root 

 and potatoes was substituted for that of maize. The pellagra com- 

 mission of the district of Mariano, near Triest, has distributed, 

 among the population, seeds of sweet potato {76). In Southern 

 Tyrol Kleiminger (yy) cured 13 cases of lunacy, on the basis of 

 Pellagra, by a change of diet even without addition of fresh vege- 

 tables and meat, Allison (78), Sylvester (79), and Elebash (80) 

 recommend fruit or fruit-juices, milk, eggs, and vegetables. Lorenz 



(81) treated 27 cases of pellagra with what he calls an excessive 

 diet for eight weeks, with the following result: 7 cases died, 3 re- 

 mained stationary, 13 cases improved, and 4 recovered completely, 

 even in respect to the mental Symptoms. Quite recently Blosser 



(82) observed 133 cases of pellagra, all of which, except 3, ate cane 

 products freely. Exclusion of all partially refined sugars and 

 sirups was followed by a eure in 121 cases and improvement in 

 8 cases; 4 died. It would be interesting to know the percentage of 

 cane products in the original food of these patients. If they repre- 

 sented the bulk of the nutritive substances, the results of this ex- 

 periment would bear striking analogy to those of my experiments 

 on pigeons, in which beriberi was produced by a diet of sugar alone. 



As a practical conclusion to this section on pellagra, I wish to 

 draw attention to the following point. Pellagra is, beyond doubt, a 

 disease peculiar to districts inhabited by poor people, i. e., in dis- 

 tricts where the population lacks the financial means to Supplement 

 the routine diet with imported foods. We know of many examples 

 that illustrate the limitation of pellagra to areas devoted to maize- 

 culture. The peasants of Poland and Russia live exclusively on 

 soup consisting of potato and cabbage, and whole-rye bread. One 

 could not imagine a cheaper and less varying food. We can safely 

 State, however, that deficiency diseases are practically unknown in 

 these countries, with the sole exception that during periods of bad 

 harvests, scurvy epidemics sometimes appear. As, however, we 



