190 General Discussion 



Gillman: This has been one of our main pleas. Those of us in 

 South Africa, who have been attempting to get to grips with this 

 problem, have tried to impress upon people the need for gathering 

 the material before it is gone. This is something for which we have 

 hitherto received very little assistance. One wants not only financial 

 assistance, but help in terms of people to come and exploit the unique 

 material in our country. Available evidence indicates that the reverse 

 is happening in South Africa compared with that described by Dr. 

 Lorge in Puerto Rico. There seems to have been a gross deterioration 

 in the nutritional status of the African people during the last 50 

 years. The first cases of pellagra were reported during the Zulu 

 rebellion at the end of the last century, and the first epidemic of 

 pellagra occurred in the 1920's; so this deterioration seems to have 

 supervened rather suddenly. The adoption by the African, in South 

 Africa, of European customs and dietary habits is a relatively new 

 thing. When I was a medical student, not so long ago, three- 

 quarters of the Africans attending an Outpatient Department were 

 blanketed. With the coming of World War II, relatively few 

 Africans wore European clothes; but there has been such rapid 

 industrialization in South Africa during the last 15 years that by the 

 end of World War II it was rare to see an African attending an 

 Outpatient Department in a blanket. This gives some indication of 

 the speed with which this change is occurring among the Union 

 Africans. Associated with this is a rapid deterioration in the agri- 

 cultural value of the land available to these people in various parts 

 of the Union. This is another basic, socio-economic aspect of the 

 overall problem in my country. 



Olbrich: If you compare your agricultural population, still blan- 

 keted, to the industrial population, you already have the answer. 



Gillman: We are trying to get something organized along these 

 lines. So far, we have carried out only a relatively limited survey 

 in a completely different rural population of African fishing folk, 

 near Lourenco Marques in Portuguese East Africa. We have taken 

 liver biopsies from some 50 or 60 adult volunteers. But this group 

 were eating a particular kind of diet, different from that consumed 

 by either the rural or urban populations in the Union. It was a 

 fishing community whose main article of diet was fish. Thus their 

 diet contained quite large quantities of proteins, vitamins A, D and 

 B complex. All the information thus far available from nutritional 

 surveys among urban and rural Union Africans indicates that 

 malnutrition and pellagra are common throughout our country. 

 We hope in the near future to acquire precise data concerning the 

 incidence of liver disease in rural and urban Africans in the Union. 



Zilli: I would like to comment on what Dr. Landowne and Prof. 



