CHAPTER LXXIII 



PELLAGRA 



Synonyms — Etymology — Definition — History — Climatology — i^^tiology — 

 Pathology — Morbid anatomy — Histopathology — ■ Symptomatology — - 

 Diagnosis — Prognosis — Treatment — Prophylaxis — References. 



Synonyms, — Italian : Umor Salso, Scottatura di Sole, Malattia della Miseria, 

 Mai del Sole, Malattia della Insolazione di Primavera, Risipola Lombarda, Mai 

 della Spienza, Mai del Padrone, Jettatura di Sole, Cattivo Male, Mai della 

 Vipera, Calore del Fegato, Salso, Pelandria, Pellarella, Pellarina, Psychoneuro- 

 sis Maidica, Mai Rosso, Maidismus, Lepra Italica Maidica, Scorbuto Montano, 

 Scorbuto Alpino, Elephantiasis Italica. Spanish : Mai de la Rosa, Mai 

 d'Asturias, Mai del Higado, Calor del Higado, Escamadura del Higado, Flema 

 Salada. French Maladie de la Teste, La Gale de Sainte Ignace, Mai de Saint 

 Amans, Mai des Saintes Mains, Mai de Sainte Rose, Mauvais Dartre. German : 

 Der Lombardische Aussatz. Roumanian : Buba Tranjilor, Rana Tranjilor, 

 Parleala, Jupuiala. Greek : Graeci Elephantiasim. Egyptian : Inshup, 

 Qushuf, Gofar, Lahooh. South America : Chichismo. 



Etymology. — The name ' pellagra ' is an Italian word, possibly 

 coined by the peasants from two words — pelle, meaning ' skin,' 

 and agra, meaning ' rough ' — though other possible origins are also 

 given. It was introduced into medical literature by Frapolli in 

 1771 in his work, ' Animadversiones in Morbum Vulgo Pelagram/ 

 when he spelt it with only one / instead of with two. 



Definition. — Pellagra is an endemic disease, usually of long 

 duration and of unknown causation, which is characterized by 

 cutaneous, gastro-intestinal, and nervous symptoms, which under- 

 go exacerbations at recurrent intervals, usually in the spring or 

 autumn. 



History. — When it is considered that pellagra has been over- 

 looked in quite recent years in America, Scotland, and England, 

 and probably in many other parts of the world, it will not be thought 

 to be astonishing that ancient literature is silent as to its existence 

 in Europe, but the absence of these references by no means proves 

 that the disease itself was not present. Strambio finds that some 

 of the symptoms mentioned in Hippocrates may be those of pellagra, 

 and says that his description of ' Sollicitudo ' indicates a disease 

 resembling the mental condition found in pellagra during an acute 

 exacerbation. We have searched through Hippocrates, and have 

 been unable to find anything which to our mind bears any resem- 

 blance to pellagra. The peculiar symptoms from which St. Francis 

 of Assisi, who lived in a district which to this day is pellagrous, 



1700 



