MTIOLOGY 



1709 



to its fatal termination. A study of merely Hameau's writings, excluding all 

 the modern Italian, Roumanian, and American literature on the subject, 

 would, we think, satisfy any unbiassed person that this view is untenable. 



3. That it is not a disease per se, but merely symptoms of some other 

 well-known disorder. The disease which it is most commonly said to belong 

 to is ankylostomiasis, but most of our readers will themselves have treated 

 many cases of ankylostomiasis without meeting with the symptoms of 

 pellagra, and many will be acquainted with pellagrins who show no signs of 

 ankylostomiasis . 



The above can be easily dismissed, and would not have been men- 

 tioned if we had not personally met with believers in all of them. 

 With regard to the more likely theories, we must discuss the 

 following : — ■ 



I. The deficiency theory. 

 II. The maize theory. 



III. The parasite theory. _ ^ 



I. The Deficiency Theory.— In Chapter IV., p. 94, we have 

 briefly traced the evolution of foods and the effects of a low protein 

 dietary, as well as the effects of certain nitrogenous complexes on 

 man, and therefore need not recapitulate what we have written on 

 those pages. Arguing upon the theory of the causation of beri-beri 

 by the absence of a nitrogenous complex, some people have asked 

 whether pellagra may not be due to the lack of some nitrogenous 

 complex in the food; and, further, it has been suggested, or rather 

 hinted, that this might explain, not merely the maize theory of 

 pellagra, but those cases in which no maize has been eaten, but in 

 which the diet has been largely oatmeal or rice. Thus, Nightingale 

 in his paper on Zeism, which appears to us to be pellagra, finds that 

 when steam-milled mealie bread alone was supplied to the prisoners 

 in the Victoria Gaol in Rhodesia the disease broke out, and when this 

 was stopped, and meat, vegetables, and rice were substituted, the 

 epidemic ceased ; and when hand-milled rapoko (maize) was obtained, 

 the effect, in Nightingale's words, was ' immediate and almost 

 magical,' as the patients began quickly to recover. In this rapoko 

 the husk was not eliminated by the hand-milUng. The parallel 

 between this and beri-beri is obvious. In our opinion there is one 

 great flaw in this theory, and this is that pellagra may occur in 

 people provided with an excellent dietary. To this it might be 

 replied that some peculiarity of the individual's body destroyed 

 the necessary vitamine, but this argument is, to our minds, rather 

 strained. Modern work tends at the moment to support this theory 

 as being the true course of the disease, but there are man}^ difficulties, 

 and it cannot be said to be proven. 



II. The Maize Theory. — Much of a most convincing nature, if left 

 unanalyzed, can be written in support of the maize theory in general. 

 It can be pointed out that maize [Zea mats Linnaeus) was originally a 

 native of America, where it has been found in its ancient form of 

 small grains in the graves of the Incas, and that it was introduced 

 by Columbus or his followers into Europe, where it did not grow 



