440 PELLAGRA 



Goundou. Symmetrical bony tumors of nasal processes of superior 

 maxillary bones. 



Oroya Fever. A disease with a fever characterized by a profound 

 involvement of the bone marrow producing very rapidly an anaemia 

 resembling that of pernicious anaemia. Pains of bones and joints 

 marked. See Verruga. 



The disease is chiefly found in towns situated in narrow, wind-protected valleys 

 of the West side of the Andes, at elevations of from 3000 to 9000 feet. Townsend 

 has suggested that a species of Phlebotomus, which is very prevalent, may be the 

 transmitting agent. 



Barton isolated a paratyphoid bacillus from the blood of a patient, besides which 

 other bacteria have also been isolated. In 1909, Barton noted certain rod-like 

 organisms in the red cells of Oroya fever patients which he considered protozoal in 

 nature. 



Strong and his colleagues found in the blood of Oroya fever cases 

 rod-shaped forms in the red cells, varying from i to 2 microns in length, 

 the red cells containing from i to 30 of these elements. 



Intravenous inoculation of blood containing these elements into monkeys and 

 rabbits was negative in result. These organisms were considered as intermediate 

 between bacteria and protozoa. They are closely related to Grahamella and the 

 Harvard commission has proposed the name Bartondla bacilliformis. 



Pellagra This disease is characterized by (i) a sprue-like stomatitis 

 and disorders of alimentary canal, (2) an erythema usually limited to 

 parts exposed to the sun and characterized by marked symmetry and 

 striking delimitation from the sound skin and (3) various neurological 

 manifestations and a toxic psychosis which may go on to confusional 

 insanity. The disease is characterized by annual recurrences in the 

 spring with improvement in the winter. The views as to etiology 

 which consider the causative agent as a protozoon, possibly transmitted 

 by a Simulium or by Stomoxys are now historical. 



The maize ideas of etiology are now considered as having a bearing only in con- 

 nection with the larger question of vitamine deficiency in cereals in general. Aless- 

 andrini has recently brought forward the colloidal silica etiology. 



These views are that colloidal silica in water is responsible for the disease. Voegt- 

 lin noted the great amount of aluminium in certain vegetables and suggested this 

 as the toxic causative substance. A mixture of colloidal alumina and silica in water 

 is supposed to be operative as well as silica alone. Against the colloidal silica 

 hypothesis is the statement of Sandwith that the water of the Nile, the drinking 

 water of Egypt, is low in colloidal silica content. 



