Pellagra : first progress report of the Thompson-McFadden Pellagra Commission of the New York Post-Graduate Medical School and Hospital / by J.F. Siler [and others].

  • Siler, J. F. (Joseph Franklin), 1875-1960.
Date:
[1913]
Catalogue details

Licence: In copyright

Credit: Pellagra : first progress report of the Thompson-McFadden Pellagra Commission of the New York Post-Graduate Medical School and Hospital / by J.F. Siler [and others]. Source: Wellcome Collection.

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    19. Predisposing Diseases: General health conditions in childhood do not appear to warrant consideration as etiologic factors when the disease develops in adult life. In a num- ber of cases the development of pellagrous symptoms in children was preceded by one of the acute exanthematous dis- eases of childhood. About one-fourth of the cases gave a his- tory of a preceding chronic disease in adult life. In more than one-half of the cases (62' per cent.) the history was that of good health. Among adult females, those most affected were married women (86 per cent.) and 86 per cent, of the married women had borne children. A history of ill- ness immediately preceding the development of pellagra was elicited in 59 per cent, of the cases. 20. Hygiene and Sanitation of Houses and Premises: The most insanitary condition found in the county is the absence of properly constructed privies. Outside of a part of the city of Spartanburg, which is supplied by a water-carriage sewage system, there is no effective provision in the county for the proper disposal of human excreta. A second striking insani- tary condition is the almost complete absence of effective screening of dwellings. These two conditions present a situa- tion highly favorable to the transmission of disease organisms eliminated in the excreta, both by direct contamination of food and person and by insects. This situati i is naturally aggravated in the mill-villages and small towns by the greater congestion of houses. The absence of effective screening for dwellings gives rise to conditions conducive to the possible transfer of diseases transmitted by biting insects. 21. Dietary: Observations on the habitual use of the more common foodstuffs failed to discover any points of difference between pellagrins and non-pellagrins in the county or any facts which would seem to explain the strikingly greater prevalence of pellagra among certain classes of the population. The most striking defect in the general dietary of the working classes, appears to be the limited use of fresh meats, the animal protein being supplied largely in the form of cured meats, of which salt pork (especially bacon) is the most important. Unhygienic preparation of food appears to be a probable important factor in the general health of the population. Investigation of the kind, quantity and quality of corn and corn products used in the county, failed to bring to light any epidemiologic evidence pointing to the agency of corn as an etiologic factor in the disease. The presence of two cases in our series giving a definite history of no corn consumption within two years prior to the onset of symptoms, together with several other cases in which corn products were eaten, if at all, only in small quantity and at extremely rare inter- vals, would seem to argue strongly against any hypothesis