A GENERAL DISCUSSION OF PELLAGRA 1 WITH REPORT 

 OF A PROBABLE CASE IN THE PHILIPPINE ISLANDS. 2 



By David G. Willets. 

 [From the Biological Laboratory, Bureau of Science, Manila, P. I.) 



Pellagra is a chronic or acute, afebrile or febrile, endemic and at 

 times epidemic, probably noncontagious, systemic disease of unknown 

 etiology, occurring chiefly among the poorer classes of maize-eating 

 peoples. It is characterized clinically by a seasonal periodicity, a typical 

 skin eruption, digestive disorders and nervous and mental disturbances, 

 and pathologically by slight peculiar anatomical lesions. 



The disease first occurred in Spain in 1735, and now is found extensively in 

 Italy and Rournania, in Greece, France, Austria, northern .Portugal, Poland, 

 Turkey. Africa, upper and lower Egypt, the West Indies, various parts of South 

 America, Barbados. Mexico, and in the United States, especially in the South 

 Atlantic portion. Two cases have been reported from England, several from 

 India, one from Porto Rico, and two from the Panama Canal Zone. Although 

 the cultivation of Indian corn and its consumption as food occurs in parts of 

 the world from which pellagra is not reported, yet pellagra is unknown in 

 sections where maize is not used as an article of diet. 



The original home of Indian corn and the date of its introduction into Europe 

 are apparently debatable questions, but nearly all authors agree that pellagra 

 was not known in Europe until maize growing and eating had existed for some 

 time. King (6) claims North America as the original home of Indian corn and 

 also of pellagra and states that Baruino, in 1600, described meagerly a condition 

 among certain Indian tribes which doubtless was pellagra and that he thought it 

 arose from eating maize. 



Gaspar Casal, in 1762, reported pellagra under the name of mat de la rosa, 

 having seen his first case near Ovieda, Spain, in 1735, and subsequently other cases 

 in the Asturias (Asturiensis) . It was found in other parts of Spain within a 

 few years, and in 1893, 2 per cent of the Spanish peasantry were pellagrous. 

 (Tuczeh). 3 



The disease appeared in Italy, in the Lombardy district, in 1750, and grad- 

 ually spread to other provinces. It was clearly described by Frapoli, of Milan, 



1 Synonymy : Mai de la Rosa ; Mai de Padrone ; Lepra Scorbutica ; Asturiensis ; 

 Mai de Sole; Vernal insolation; Mai de Miseria; Maladie de la Teste; Buba tran- 

 jilar; Maidimus; Psychoneurosis Maidica. 



- Read at a meeting of the Manila Medical Society, October, 1910. 



3 Quoted by Lavinder. 



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