682 MAIZE 



CHAP, the general diet of those affected ; (c) cutaneous tests in 

 pellagrins, with extracts of corn, gave rise to no anaphylactic 

 symptoms. (2) Damaged Maize ; (a) the corn used in the 

 State Institutions (where the cases investigated occurred) has 

 been of high grade ; (b) all experimental work has necessarily 

 been performed upon animals. In none have there been any 

 pellagra-like manifestations, and in fact with few exceptions 

 the toxicity has been low ; (c) cutaneous anaphylaxis tests with 

 extracts from damaged corn were negative. 



" If one adds to these direct observations the keen critical 

 analysis by Sambon of the foundations upon which the maize 

 hypothesis rests, one cannot but feel that the arguments in its 

 favour are extremely slender. 



"2. Antizeist Theories. — . . . All investigations carried 

 out by us with the object of demonstrating the presence of a 

 blood parasite have so far failed. Nevertheless, it is quite pos- 

 sible that a parasite may live and propagate in the blood but 

 require special methods for its demonstration, not yet discovered. 

 . . . The relation of Simulia to pellagra, hypothecated by 

 Sambon, finds but little support from the researches we have 

 been able to make. . . . 



" This discussion would not be complete without considera- 

 tion of the problems of prevention. The evidence seems con- 

 clusive that poor nutrition is an important factor in predisposing 

 to the disease, although we fully admit and can confirm the 

 occurrence of pellagra in persons well nourished and apparently 

 robust. The investigation of the dietaries of the State Institu- 

 tions reveals no defect in quality or quantity, but only a low 

 animal protein content. The Italian peasantry have suffered 

 more from pellagra than any other people, and their diet con- 

 sists almost exclusively of maize in the form of polenta. They 

 eat practically no meat, fish, milk, or eggs. In fact it may be 

 said that meat becomes a luxury in all conditions of poverty. 

 Maize has a large protein value, but this apparently cannot 

 satisfactorily take the place of animal protein altogether. It 

 may be, then, that conditions in which the animal protein con- 

 stituent of the diet is low, constitute a predisposing factor to 

 infection with pellagra. . . . We do not consider that pellagra 

 is due to lack of food or even to deficiency in any particular 

 constituent of the food. Our impression is rather that pellagra 

 is due to infection of the body with some micro-organism. It 

 does seem possible, however, that a diet deficient in animal 



