1712 



PELLAGRA 



of an older view, that normal maize in certain individuals may 

 produce pellagra, or, in other words, that there is an individual 

 susceptibility to maize. This subject has been recently carefully 

 investigated by Rondoni in human beings. He procured his maize 

 from the domestic store of certain pellagrins, and having tested 

 his cases for tuberculosis by von Pirquet's test, administered ex- 

 tracts of the maize by intramuscular injections to thirty-three 

 pellagrins and thirty non-pellagrins. He did not find any violent 

 reaction, as described by other writers, but he found that recent 

 cases of pellagra and convalescents reacted more definitely than 

 non-pellagrins, showing slight fever, headache, malaise, excitability, 

 and sleeplessness, and considered that this increased sensibility 

 might be regarded as an anaphylactic reaction to some undefined 

 factor in the maize extract. If this anaphylactic theory held, then 

 any person who for a few weeks ate a quantity of maize at any time 

 of the year should develop acute pellagra. The Illinois Commission 

 attempted anaphylactic tests by von Pirquet's method, substituting 

 maize extracts for tuberculin, and the result was negative. 



A second theory states that pellagra is due to toxins produced 

 during the spring by the germination of the maize. The objection 

 to this is that some cases start in the autumn. 



The third theory asserts that poisons are generated in the bowel 

 from the grain (Neusser) by the aid of the Bacillus coli communis 

 (De Giaxa). This latter theory of De Giaxa is supported by experi- 

 ments, for he produced the symptoms in animals inoculated by the 

 toxin produced by growing the B. coli communis in maize media. 



Numerous observers have reported poisons in fermenting maize. 

 Thus, Lombroso in 1871 obtained two alkaloids, one like conium 

 and the other like strychnine, but the symptoms produced by these 

 on men and animals were not like those of pellagra. Others have 

 reported tetanic or narcotic poisons, etc., but, on the other hand, 

 Monselice failed to obtain any such poisons in damaged grain from 

 pellagrous districts. 



4. Infectivity. — At the present time the popular belief is that the 

 disease is caused by maize damaged by being cultivated and har- 

 vested under unfavourable circumstances, and stored in such a damp 

 condition that it becomes mouldy. This has been supported by 

 Hirsch, who points out that a bad maize harvest is followed by an 

 increase in the cases of the disease. The theories as to the sub- 

 stance in the damaged maize which causes the disease are manifold, 

 and may be classed into {a) fungi, {b) bacteria, (c) chemical sub- 

 stances. 



{a) Fungi. — Monti and Tirelli showed that fungi were commonly 

 found in maize, those most usually met with being Penicillium 

 glaucum, Rhyzopus nigricans, Mucor racemosus, and species of 

 Aspergillus and Saccharomyces. The special fungus, Sporisovium 

 maidis, described by Ballardini in 1845 as the cause of the disease, 

 is probably only Penicillium glaucum or Mucor racemosus, the former 

 being held by some writers to be the causative agent, but its effects 



