Notes on the prognosis and treatment of pellagra / by C.H. Lavinder.

  • Lavinder, C. H. (Claude Hervey), 1872-1950.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Notes on the prognosis and treatment of pellagra / by C.H. Lavinder. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    overwhelming close of toxic material. Then, of course, if a patient is carried through his summer manifestations safely one year, a reappearance of acute manifestations the next year must be watched for, more especially if anything should intervene to lower the general resistance, such as acute illness, childbirth, etc. PROPHYLAXIS. In any discussion of treatment we must first of course recognize the paramount importance of prophylaxis. Whatever views one may entertain as to the cause of the disease there seems to be an almost universal belief that there is some definite etiological rela- tion between Indian corn and pellagra. In dealing with a disease of such gravity, a belief so universal as this can not be discarded except in the face of conclusive proof to the contrary. There are also the best of reasons for thinking that poverty, especially abject poverty, and all that is implied in that term—poor and insuf- ficient food, bad housing, unhygienic surroundings, mental depres- sion, lowered physical resistance, and often alcoholism—have a greater effect than usual in predisposing to pellagra; and predisposi- tion in this disease is generally admitted to be a factor of the greatest importance. What shall be done then in the way of prophylactic measures? It is evident of course that as far as possible distress, poverty, and unbygienic surroundings should be relieved, alcohol interdicted, and the individual, as well as the community, placed under the best pos- sible circumstances. This is nothing new of course and will receive the assent of all, but in Italy such unique attempts at general pre- ventive measures have been adopted along this line as to give this statement a new meaning. Various establishments for the prophylaxis of the disease have been originated and are said to have been of aid in the production of hopeful results, such as the pella- grosari, forni economici, forni rurali, cucine economice, locande sani- tarie, all of which are devoted to feeding, treating, and educating the unfortunate sufferers. So far as a dietary containing corn is concerned, there is abundant evidence that good corn is not only a wholesome but a harmless food, and not a few writers have pointed out the folly of those who counsel the total rejection of so valuable a cereal. At the same time, entirely wholesome corn is not always easily differentiated from harmful corn. In the light of our present knowledge, therefore, maize should be admitted, it seems to me, into the dietary of certain institutions, like insane asylums, with the utmost caution. As for the use of corn or its products elsewhere or in one’s individual diet,' that is a matter which is as yet, to some extent, sub judice, and must for the time perhaps be left to individual judgment.