1704 



PELLAGRA 



disease, and came to the conclusion that ' Mai del Higado,' ' Malde 

 la Rosa/ and pellagra were one and the same disease. In 1835 

 Mendez Alvaro recognized pellagra in the malady called ' Flema 

 Salada,' and in 1847 Henriquez showed that ' Mai de Monte ' was the 

 same disease. In 1849 Roussel visited Spain, and recognized that the 

 disease in France and that in Spain were the same clinical entity. 

 Since that date many excellent works have been published in Spain 

 on pellagra, notably by Calmarza and Roel, while of late the disease 

 has been carefully studied by Huiteras, Pittaluga, and the physicians 

 of Oviedo. 



The maize theory of the aetiology of pellagra has never gained 

 credence in Spain, and hence the term 'Spanish pellagra,' or a 

 pellagra not due to maize, has been used by some Zeists as a medical 

 synonym for a hoax. 



Portugal. — Pellagra is known to exist in Portugal, but we are in 

 the same condition as older writers, in that we can give no history 

 of its recognition or spread. 



France. — We have already noted Thiery's publication in 1755, 

 and the fact that in 1787 a young Frenchman, Levacher de la 

 Feutrie, proceeded to Italy to study the disease, concerning which 

 he subsequently pubhshed accounts in 1802 and i8c6; but it was 

 Hameau in 18 18 who first recognized the disease in France as 

 occurring around Teste-de-Buch, in the Plain of iVrcachon. Hameau 

 was not acquainted with the literature which had sprung up con- 

 cerning pellagra, and his observations were in reality a rediscovery 

 of the disease. In 1829 he read an excellent dissertation on the 

 subject before the Society of Medicine of Bordeaux, under the title 

 'Description d'une Maladie Nouvelle.' It would appear that he 

 considered it to be an infection in some way acquired from sheep. 

 In all he observed no less than seventy-six cases. 



There is, however, evidence in favour of the suggestion that 

 pellagra had long existed in France, and this is to be found in the 

 fact that the peasants used to call the disease ' Mai de Saint Amans,' 

 because there was a statue to St. Amans in Bascons which was 

 always moist, and this moisture was used by the pellagrins as an 

 application to their eruption. According to Roussel, there was 

 another curious custom followed by the peasants of the Landes, 

 which was to visit a certain statue in which the Christus was repre- 

 sented with red hands. The priest was- wont to apply an ointment 

 to these hands, from which the sufferers removed a little of the 

 ointment and applied it to their own inflamed hands, feet, face, etc. 

 From this interesting ceremony the disease was called the ' Mai des 

 Saintes-Mains. ' Other popular names, such as ' Mai d' Arouse ' 

 and ' Mai de Saint e-Rosa,' tend to show that the common people 

 were well acquainted with the disorder. Sambon has also informed 

 us that some of Napoleon's soldiers became affected by pellagra 

 during the campaigns in Italy, and certainly cases are recorded in 

 the Hotel Dieu and in the Hopital Saint-Louis, while Jourdan 

 published a paper on the disease in 1819. 



