Localities in which Pellagra is Prevalent. 77 



ington. I find that Dr. Sambon has weighed the evidence 

 for and against his idea with a good deal of care. He went 

 over the territory in Italy where pellagra is most prevalent, 

 studying the disease, and found Simulium larvae or pupse, in 

 the streams wherever he found pellagra. He states his 

 views in concise form as follows : (Vol. XHI. Sep. 15, 

 1910, p. 271.) 



' 'So far I have been able to establish : 



(1) That pellagra is not due to the eating of maize, 

 either sound or deteriorated, as hitherto almost universally 



believed. 



(2) That it has a striking, pecuhar and well defined 



topographical distribution. 



(3) That its endemic foci or 'stations' have remained 

 exactly the same in many places for at least a century. 



(4) That its stations are closely associated with streams 

 of running water. 



(5) That a minute blood-sucking fly of the genus 

 Simulium is, in all probability, the agent by which pellagra 

 is conveyed. ' ' 



Dr. Sambon admits that he has made no experiments 

 testing his theory, but thinks the facts he has brought 

 together are sufficiently powerful as evidence to render it 

 almost a certainty. 



After enumerating fully the various theories held m 

 Italy as to the origin of pellagra. Dr. Sambon declares that 

 there is no foundation for the belief that pellagra broke out 

 on the introduction of maize into Europe, and that the topo- 

 graphical distribution of pellagra does not coincide either 

 with the distribution of maize, its cultivation, or its con- 

 sumption; and, further, that all preventive means based on 

 the maize theory have failed. 



Maize appears to have been used in Italy as early as 

 1554, by the records, and was certainly used in this country 

 much earlier, in fact the early explorers make frequent 

 mention of maize used as food by Indians, and often so 

 badly prepared as to be inedible to the white man. Samuel 

 de Champlain in his narrative of exploration written in 1613, 



