Localities in which Pellagra is Prevalent. 5 



er was very unfavorable for my work, rain keeping the water 

 of streams roiled and making a search for insects in them 

 difficult. The cases of pellagra were located, as I had been 

 led to expect, near streams, some of them only a few hundred 

 feet away from the water, though as a matter of fact most 

 of those living in the country in these mountain counties are 

 near springs and streams for obvious reasons. When ques- 

 tioned it was found in some instances that the patients had 

 not contracted the ailment where they were then living. 

 One had not had good health where she formerly resided and 

 had moved "up here" where she thought her condition was 

 improved. In several cases observed the disease had in all 

 probability been contracted where the patients then lived. 

 This seemed true of three individuals, a mother and two 

 boys, living on the banks of Laurel River north of Corbin. 

 The mother had been very severely affected early last spring 

 about garden making time at which time she was confined to 

 her bed. Her face, hands and feet still showed the effect of 

 the disease, though she was about the house when I saw her. 

 One of the boys was affected on the calves of the legs quite 

 extensively, the dusky cuticle being visible as he walked 

 beside the buggy. The second boy showed only a small area 

 on one of his legs, and was said to have contracted the ailment 

 a week or so later than the others. All seemed to have become 

 affected in the spring of 1911 at the place where they were 

 seen. Excepting for the diseased skin neither boy seemed 

 to be in bad health. None of them showed signs of mental 

 derangement. The house in which the family lived was a 

 mere shed that had been abandoned by sawmill men on the 

 bank of Laurel River. The water of the river where near- 

 est the house was at a much lower level, having cut its bed 

 so as to leave rather steep banks, but is only a few hundred 

 feet away. Several hundred yards below the dwelling is a 

 ford where the stream is more rapid and shallow, running 

 over and among large rocks consisting of a red sandstone 

 which blackens on exposure to the weather and gives the 

 river a rather forbidding appearance. I was able to cross 

 here on the rocks, and spent some minutes looking for in- 



