PELLAGRA 



well in certain countries, like the British Islands, which, therefore, 

 remained free from the disease until the nineteenth century, when 

 importation of maize took place in greater quantities than hereto- 

 fore, but where now there is plenty of maize sold as pop-corn for 

 children, and it may possibly be made into bread, cakes, scones, 

 porridge, etc., while whisky is often partially made from the same 

 grain. On the other hand, it grew well in Spain, Itaty, and France, 

 and that its introduction into a country has always been followed 

 by the appearance of pellagra in that country, and quotations 

 supporting maize can be drawn even from the writings of its most 

 vigorous opponent, Sambon, who states: — ' From authentic docu- 

 ments of the time we learn that " mehca," or *' from ent one " ' 

 — i.e., maize — 'was grown in Cremona in the sixteenth century, 

 and ... in 1556 a Cremona nobleman offered the Duke of 

 Florence ten staia of the new cereal.' When this statement that 

 there is plenty of maize in Cremona in 1556 is compared with the 

 statement that pellagra was well known in Cremona about 1700 to 

 peasants and medical men alike, a Zeist would maintain that, 

 allowing for the disease being so liable to be overlooked, this was 

 a remarkable coincidence. Another epidemiological fact which, 

 taken by itself, would strongly support the maize theory is the well- 

 known fact that in the delta of the Nile there is plenty of pellagra 

 and plenty of maize, but as the Nile is ascended the maize diminishes, 

 millet being used instead, and the incidence of pellagra also di- 

 minishes, and at present it is said to be unknown south of Assouan, 

 which statement must be received with caution, as pellagra has so 

 often been reported absent from places where it is now known; and, 

 moreover, pellagra is known to exist in Central Africa. In Columbia 

 pellagra is said to be found only in people who regularly take a 

 drink made from fermented maize. This drink is called ' chicha ' 

 and the malady 'chichismo.' The Zeist states that pellagra is 

 found wherever maize is used, at all events, as an important article 

 of food. As a matter of fact, maize, either growing or imported, 

 is found all over the world, and pellagra would appear also to be 

 found all over the world. 



Against the maize theory there are the facts that tend to demon- 

 strate that persons who are alleged never to have tasted maize have 

 suffered from pellagra ; moreover, relapses have occurred after three, 

 five, and even fifteen years' residence in gaols or asylums iii which 

 maize is not merely not allowed to be used as an article of diet, but 

 care is taken, by inspection and by jperiodical chemical and micro- 

 scopical examination, to exclude it. A Zeist would answ^er to these 

 objections that there was some fallacy, and that nothing short of 

 being the victim yourself would make it reasonably certain that 

 maize was not consumed, and even then it might have been eaten 

 unwittingly; and, further, that all safeguards designed to prevent 

 food sophistications in institutions break down. 



Notwithstanding this, some of the Scotch cases appear to exclude 

 the possibility of maize being an setiological factor, and prophylactic 



