XIV. 



MAIZE GRAIN AS, FOOD 68 1 



pellagra is very permanent, but its prevalence varies consider- CHAP, 

 ably from year to year, not always in direct ratio to the amount 

 of rainfall, or the hygrometric state of the air, as has been 

 erroneously asserted, but in connection with other cecological 

 conditions not yet determined" (Sambon, i). 



Hunter (i) informs us that for 200 years pellagra has been 

 a subject of serious inquiry, but that up to the present 

 its cause is purely a matter of conjecture. " The solution 

 of this problem," he adds, "has at various times been pro- 

 claimed, but subsequent investigations have failed to furnish 

 corroborative material." Generally speaking, medical men 

 are divided into two schools of thought over the etiology of 

 pellagra : (1) those who hold the zei-toxic theory, based on the 

 work of Balardini in 1 844, and who have therefore been called 

 "sez'sts"; and (2) the " anti-zeists," including those who hold 

 that pellagra is a protozoal disease, or due to some other 

 cause than the consumption of maize. 



The Illinois (U.S.A.) State Pellagra Commission, appointed 

 in 1909, issued a report in November, 191 I, which was pub- 

 lished in 1 91 2. This report covers 250 pages, and furnishes an 

 interesting summary dealing with the clinical manifestations, 

 pathology, and theories as to etiology of the disease. From 

 this summary the following information as to the possible con- 

 nection between maize and pellagra has been extracted ; 

 the italics are supplied by the present writer : — 



"1. Pellagra in Relation to Maize. — . . . All work directed 

 to this question has uniformly yielded negative results. . . . 

 The evidence collected in this report all tends to discredit any 

 such assumption. ... It seems to us that the burden of proof 

 must rest with the zeists. The following facts may be es- 

 pecially emphasized as tending to discredit any catisal relations 

 between maize a?id pellagra : ( 1 ) Sound Maize ; (a) excessive 

 corn-feeding was not accompanied by more pellagra than was 

 observed in individuals kept upon a strictly corn-free diet, 

 other conditions being, as far as possible, identical as regards 

 the age, sex, mental and bodily condition, habits, and occupation 

 of the patients and the size, location, and general arrangement of 

 the buildings, although cases developed under both conditions ; 

 (b) maize products constituted only a moderate proportion of 



