McCOLLUM— RELATION OF DIET TO PELLAGRA. 49 



Goldberger attempted to solve the problem of whether pellagra 

 is due to lack of something essential in the typical " pellagrous " diet 

 by a direct experiment on man. He restricted men to a diet pre- 

 pared from bolted wheat flour, degerminated corn-meal, polished 

 rice, starch, sugar, syrup, pork fat, sweet potatoes, cabbage, collards, 

 turnip greens and coftee, and at the end of five and a half months 

 five of the eleven men who took this diet were diagnosed as exhib- 

 iting incipient signs of pellagra. That the disease was actually pro- 

 duced has been emphatically denied by McNeal. 



In another experiment Goldberger and fifteen of his associates 

 made heroic attempts to infect themselves with material from the 

 lesions of pellagra, and with excreta from pellagrins, but without 

 success. The experimenters were, however, taking a diet of good 

 quality while these attempts were being made. 



Still more convincing evidence that the diet is at least an impor- 

 tant predisposing factor in the etiology of pellagra is furnished by 

 the experience of Goldberger in improving the diets in institutions 

 in which the disease was common. These diets were observed to 

 consist largely of degerminated seed products, tubers or roots, and 

 fat pork, together with minimal amounts of leafy vegetables, fruits, 

 eggs, meats, and milk, and the legume seeds. On modifying the 

 diets of orphanages and of an insane asylum by the addition of lean 

 meat, milk, eggs, and peas or beans, the condition with respect to 

 pellagra steadily improved, and the disease promptly disappeared. 

 New cases were admitted from without and the sick were mingled 

 with the well, but after the improvement of the diet no new cases 

 developed. 



Those who have had extensive experience with pellagra are in 

 agreement in the matter of the fundamental importance of dietary 

 treatment together with any other method of management of pella- 

 grins, and the assertion has been made by Roussel that without 

 dietary measures all remedies fail. The results obtained by Gold- 

 berger point clearly to the belief that the disease develops because 

 of some one or more faults in the diet. They afiford no basis, how- 

 ever, for judging as to the nature of these faults, whether they are 

 in the nature of a lack of a sufficient amount of one or more chem- 

 ically unidentified dietary essentials of a specific character, as is 



PROC. AMER. PHIL. SOC, VOL. LVIII, D, JUNE 25, I9I9. 



