February, '13] PELLAGRA DISCUSSION 99 



1. The number of sand-flies has been directly proportional to the 

 number of cases of Pellagra. 



2. The first appearance of the cases of Pellagra is coincident with 

 the principal broods. 



3. Just succeeding the time of the principal broods the flies appear 

 to bite more vigorously. 



4. Sand-flies which have fed on human blood live several days longer 

 than those which have not been so nourished, thus favoring an in- 

 cubation period for a parasite if such there be. 



5. Pellagra, thus far in Kansas, has appeared almost entirely in 

 one restricted locality. Of the nine cases recorded last year five 

 were traced back to ^one town. In this region flies are widely dis- 

 tributed and unusually abundant. 



Upon the other hand, 



1. Pellagra has never been produced in any other animal experi- 

 mentally either through inoculation or through transference by 

 means of sand-flies. 



As far as our history of this subject goes the appearance of Pellagra 

 in Kansas is a recent occurrence. Nearly all of the cases are those 

 of natives that have never been out of the state. 



From this it would seem that the etiology of Pellagra exists in Kansas. 



The situation here is not complicated through long standing con- 

 ditions. It is the purpose, therefore, to continue this phase of the 

 work and with it the correlation of the chnical and pathological phases 

 by the medical school of the University of Kansas. 



Mr. S. J. Hunter: To illustrate one point: we took this problem 

 up two years ago and reported Douglas County, the county in which 

 the University of Kansas is located, as being absolutely free from Sand- 

 fly, and last June I stepped across a stream in the grass which ran 

 about five gallons an hour as an overflow of one of the campus drinking 

 fountains, and found the larvae there on the blades of the grass in 

 great numbers. That is, it requires an unusual scrutiny of conditions 

 in any given locality before a conclusion can be safely drawn regarding 

 the presence or absence of the Sand-fly. 



President W. D. Hunter: The reader spoke advisedly when he 

 referred to the Sambon theory. It is surprising that Doctor Sambon 

 has performed no experiments whatever. He has merely drawn con- 

 clusions. The work of Mr. Hunter is much more suggestive as regards 

 the demonstration of the possible transmission of pellagra by Sand- 

 flies than anything that has been done and allows the suggestion that 

 if the Sambon theory is ever proven it is likely that some other investi- 

 gator will accomphsh it. The investigation in South Carolina, which. 



