Conference on Pellagra : held under the auspices of the State Board of Health of South Carolina at the State Hospital for the Insane, October 29th, 1908.

Date:
1909
Catalogue details

Licence: In copyright

Credit: Conference on Pellagra : held under the auspices of the State Board of Health of South Carolina at the State Hospital for the Insane, October 29th, 1908. 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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    Health in December, I907- This identification of the two diseases was made the subject of an Associated Press dispatch from Milan, July 15th, at the instance of Mr. W. Bayard Cutting, Jr,, deputy consul general of the United States, who had become especially interested in the subject. It is hardly necessary to give full partic- ulars of the visits leading up to this identification at the present time, but the brief notes taken on several of the more interesting cases may be worthy of record. Case I: Female, 54 years old; has had signs of pellagra two years; has improved lately, but still has dermatitis on shoulders and chest. The skin on the backs of hands and forearms is dry, thick- ened and pigmented. She still has diarrhoea, but no stomatitis. Case II: Female, admitted one year ago; said to be in stage of remission, but the skin on hands, forearms and forehead is dry and discolored. She has slight diarrhoea and is demented. She has also a trilobed goitre. Case III: Female; skin on hands and face now dry and thickened; has had diarrhoea. Case IV: Female; age about 30 years; confined to bed; a case of “pellagra sine pellagra.” She does not show any eruption, but the mental symptoms are those of marked delirium of exhaustion. She has some diarrhoea. The diagnosis in these cases must be made from the especial type of mental symptoms, the diarrhoea, and the in- creased knee-jerks, as well as from the fact that she comes from a family of peasants whose food is largely maize and who live in a region known to be especially pellagrous. The prognosis as to life in such cases is very unfavorable. Case V: Male, 60 years old; skin on backs of hands and feet dry and brown; has intestinal form of pellagra, which is not now well marked. Mentally, a case of melancholy with stupor. Case VI: Male of 50 years ; a typical case; erythematous eczema on backs of hands and feet; feet also swollen and scaly; tongue red, rough, cracked and slightly slimy; has diarrhoea, and is melancholy. Case VII: Man, 30 years old; hands red; feet very black, en- crusted and swollen. Skin over upper part of chest red and scaly; face erythematous; has stomatitis; all reflexes increased, especially knee-jerks. Case VIII: Male, hands and feet show usual results of pellagrous inflammation, the feet in particular being swollen, black and scaly; all reflexes exaggerated; ankle clonus formerly present also (a rare symptom). Has some nystagmus now, but formerly it was marked. He has also had Romberg’s symptom. Case IX: Male; very hypochondriacal; has erythema of hands and feet; nails of hands and feet thickened and black; tongue red and rough; neck pigmented from previous inflammation. This is a case of the “crossed form” of pellagra, that is, the left hand and right foot are considerably involved with pellagrous inflammation, while the right hand and left foot are only slightly affected.