334 



DISEASES OF UNCERTAIN ETIOLOGY 



seeking to drown himself. He lias abdominal pains, and thinking 

 that the cook has been poisoning him, he seeks to kill the cook and 

 finds himself in an asylum. There is reason in his madness. 



Winter comes and with it relief, but the skin does not become 

 normal. With repeated attacks the skin changes are marked, the mind 



Pellagra in Egypt. Photograph by F. M. Sandwith, M.D., M. R.C.I'. 



becomes permanently affected, melancholic or maniacal symptoms set 

 in. Pain about the back at either side of the dorsal spine, over spinal 



nerves in dorsal and lumbar regions. 



K. J.'s plus later. Patient ^alks with his legs apart, may fall 

 backwards or forwards 



Facies of anxiety and mental worry, sleeplessness, discontent, and 

 mental depression or excitement, and irritabilit}' or stupidity. 



