864 EXPERIMENT STATION RECORD. [Vol.43 



In this paper the author discusses the epidemic of pellagra occurring in the 

 winter of 1916-17 among the Ottoman prisoners of war in Egypt, the epidemic 

 being coincident with and following the outbreak of edema previously noted 

 (E. S. R., 43, p. 66). The symptoms, post-mortem findings, treatment, and 

 experimental study of the disease are described, and the theories concerning 

 the causation of the disease are discussed in detail. 



The author is of the opinion that pellagra is a syndrome of three grades with 

 l)ossibly a different etiology. The first grade is a condition which can promptly 

 be remedied by a slight improvement in the diet, the second a condition which 

 can be cured only by extreme overfeeding, and the third a state in which the 

 balance is lost completely and nothing can reestablish it. It is thought that 

 the majority of pellagra outbreaks, including the present one, can be accounted 

 for on the ground of food deficiency, probably in the sense of low biological 

 value of the protein as brought out in the report of the Egyptian Pellagra 

 Commission. In eases of pellagra involving no food deficiency, such as the one 

 described by Enright, as noted below^, the explanation suggested is the presence 

 of some toxic substance which prevents proper assimilation of the protein. 

 This hypothetical toxic substance is assumed to be of the nature of a virus, 

 which enters the body from without and possibly produces its effect by attack- 

 ing the endocrine organs, especially the suprarenals. 



The pellagra outbreak in Egypt. — II, Pellagra amongst German prison- 

 ers of war: Observations upon the food factor in the disease, J. I. Enbight 

 (Lancet [London], 1920, I, No. 19, pp. 998-1001,, figs. 4).— The outbreak de- 

 scribed in this paper occurred in the fall of 1918 among the German prisoners 

 in Egypt to the extent of 65 cases, details of 32 of which are presented. 



The striking feature of this outbreak was the fact that the prisoners had 

 been living on a varied diet ample both in quantity and quality for normal 

 requirements, hence something more than a dietetic factor must have been 

 involved. It is pointed out that an originally good diet may be vitiated by 

 loss through abnormal expenditure of energy, defective assimilation consequent 

 on impaired digestive function, and the absence of some internal secretion 

 necessary for protein metabolism. In the present case the first factor is thought 

 to be ruled out, but considerable evidence is presented that the pellagrins 

 suffered from defective digestive assimilation. In support of the third factor 

 attention is called to the relatively common occurrence among the patients 

 of a peculiar afebrile parotitis or enlargement of the parotid glands. The 

 suggestion is made that this gland " may possess an internal secretion, the 

 function of which is concerned in the economy of protein, just in the same 

 manner as the pancreatic secretion is essential for normal carbohydrate me- 

 tabolism." 



Report of a committee of inquiry regarding the prevalence of pellagra 

 among Turkish prisoners of war (Jour. Roy. Army Med. Corps, S3 (1919). 

 Nos. 5, pp. 426-W; 6, pp. 508-527; 34 (1920), Nos. 1, pp. 70-79, pi. 1; 2, pp. 

 173-184; 3, pp. 272-292, figs. 10). — This is the detailed report of the committee 

 appointed on October 6, 1918, by D. M. S., Egyptian Expeditionary Force, to 

 study the pellagra situation among the Turkish prisoners of war in Egypt. 

 The report consists of a brief statement of the terms of reference to the com- 

 mittee and the committee's conclusions, a summary of the course and scope of 

 the inquiry, final conclusions, recommendations, acknowledgments, appendixes 

 containing the detailed reports of the various sections, and a series of maps, 

 charts, and graphs covering the statistical data. 



The general conclusions of the committee were that the disease from which 

 the Turkish prisoners were suffering was true pellagi'a, that the cases were 



