Page:Encyclopædia Britannica, Ninth Edition, v. 18.djvu/499

P E L P E L 477 and a strong suicidal tendency are common accompani ments. A large number of pellagrous peasants end their days in lunatic asylums in a state of drivelling wretched ness or raving madness ; many more drag out a miserable existence in the communes where their working years had been spent, sometimes receiving the communal relief to which the law entitles them ; while the cases that are reckoned curable are in Italy received into the various endowed hospitals, of which there are a large number. Cases that are rapidly fatal end in delirium or a state of typhoid stupor ; the more protracted cases are cut off at last by rapid wasting, colliquative and ill-smelling sweats, profuse diarrhoea, and dropsy. After death a variety of textural changes are found, which may be referred in general to trophic disorders, or disorders of tissue-nutrition ; in a considerable number the kidneys are in the contracted state corresponding to the clinical condition of Bright s disease without albuminuria ; another condition often remarked is thinning of the muscular coats of the intes tine ; deposits of pigment in the internal organs are also characteristic, just as the discoloration of the skin is during life. Treatment. There is hardly any doubt as to the remedy for pellagra, just as there is hardly any doubt as to its cause. The question is mainly one of the social condition of the peasantry, of their food and wages ; it is partly, also, a question of growing Indian corn on a soil or in a climate where it will not mature unless with high farming. There is nothing in the resources of medicine proper to cure this disease ; as the cause is, so must the remedy be. Affinities of Pellagra. The disease has the general characters of a tropho-neurosis. The early involvement of certain areas of the skin, especially in exposed places such as the hands and feet, suggests leprosy ; as in that disease, there is first hypenesthesia and then loss of sensibility, sometimes a thickening of the surface and discolora- tions ; and, although in pellagra the onset each successive spring and the subsidence towards autumn are distinctive, yet in leprosy also the cutaneous disorder is apt to come and go at first, reappearing at the same spots and gradually becoming fixed. The grand difference in leprosy, at least in the nodular variety of it, is that a new growth of a granulomatous kind arises at these spots in the skin and around the nerves. The occasional deep discoloration of the pellagrous skin in certain spots has suggested a resemblance to Addison s disease of the suprarenals, and has even made the diagnosis difficult. But after the cutaneous disorders the course of pellagra is something sui generis ; the melancholy, imbecility, or mania, as well as the mummified state of the body, are peculiar to it. With ergotism the points of resemblance are more perhaps in the causation than in the nosological characters ; both diseases are specifically due to damaged grain, ergotism being caused by the presence of an actual bulky parasitic mould on rye, whereas pellagra is more probably caused by fermentation and decomposition within the proper sub stance of the maize -corn. As regards heredity, it is much less marked in pellagra than in leprosy, but there are good grounds for believing that the disease is in fact inherited sometimes by the offspring ; infants at the breast may show the symptoms of it, but that fact is not in itself conclusive for heredity, for the reason that infants at the breast are partly fed on the household polenta. As regards contagiousness, there is no more proof of it in pellagra than there is in leprosy. _ Geographical Distribution and History. Pellagra is peculiarly a disease of the peasantry, being hardly ever seen in residents of the towns. In Italy the number of peasants affected by it was estimated in 1879 at 100,000, the distribution being as follows : Lombardy, 40,838 ; Venetia, 29,386 ; Piedmont, 1692 ; Lignria, 148 ; ^Emilia, 18,728 ; Tuscany, 4382 ; the Marches and Umbria, 2155 ; Rome, 76. In Lombardy the worst centres are in the provinces of Brescia, Pavia, Piacenza, and Ferrara. In Italy the disease has increased very considerably within the last thirty years ; thus, in the pro vince of Vicenza the number of persons known to be pellagrous in 1853-55 was 1380, in 1860 it was 2974, and in 1879 it had risen to 3400. There are no accurate returns from the Asturias and other affected provinces of Spain, but the malady there is said to have declined very materially of late. In Gascony, where it did not begin until about fifty years ago, it is somewhat common, more in the Landes than in the Gironde ; in one district of the latter Petit estimates that there are 200 cases in a population of 6000. In Roumania the total number is given at 4500, Moldavia having a larger share than Wallachia. In Corfu it exists in 27 out of the 117 communes, the proportion of cases for the whole island being 3 2 per 1000 inhabitants. Maize was grown in Europe for many years before pellagra showed itself (see MAIZE) ; but the outbreak of the disease corresponds on the whole closely in time (particularly in Gascony and Roumania) with the introduction of an inferior kind of maize as the staple food of the peasantry. The first accounts of pellagra come from Spain. Casal in 1762 described the disease in the Asturias under the name of mal de la rosa ; it is said to have been noticed first in 1735 around Oviedo, being then confined within very narrow limits. The Asturias are still its headquarters in Spain, but it is prevalent also in Burgos, Navarra, Zaragoza, Lower Aragon, Guadalajara, and Cuenca, and it is met with in other provinces as well. In Italy it was first reported from the vicinity of Lago Maggiore, and a few years later (in 1750) it broke out simultaneously in the districts of Milan, Brescia, Bergamo, and Lodi, extending afterwards to Como, Cremona, Mantua, and Pavia, and to the whole of Lombardy before the end of the century. It became endemic also in Venetia on the one side and in Piedmont on the other, almost contemporaneously with this. Within the present century it has extended its area southwards into ^Emilia and into Tuscany, while it has become more prevalent in its earlier seats at the same time. There is very little of it in central Italy, while southern Italy with Sicily, is absolutely exempt, notwithstanding the common use of Indian corn in the form of bread and macaroni. The first authentic in formation of its existence in Gascony came from near Arcachon in 1818, after which it spread along the coast of the Gironde and the Landes. It has extended subsequently along the left bank of the Garonne and towards the Pyrenees ; but around Dax it is said to have decreased considerably of late. In Roumania, where the medical profession is unanimous in tracing it to the use of damaged maize, it dates from about 1833-46. It is only since 1856 that it has become endemic in Corfu, under the circumstances already mentioned. Literature. La Pellagra in Italia, Rome, 1880 (official report, with appendices relating to France, Spain, and Roumania, and a copious bibliography extending to fifteen pages). An article on "The Pellagra in Italy," in the Edin. EKV. for April 1881, is based on this report. The authority for Corfu isTypaldos. The best inquiries on the toxic properties of damaged maize are those of Lombroso. See also Hirsch, Historisch-geographiiche Pathologie, vol. ii., 2d eel., Stuttgart, 1883 (Engl. trans.). (C. C.) PELLICANUS, CONRAD (1478-1556), one of the most interesting minor figures in German theology and scholar ship in the great age of the Reformation, was born at Ruffach in Alsace in the winter of 1478. His paternal name was Kiirsner, his father s father having been a currier of Wyl in the Black Forest. The Latin name of Pellicanus was chosen for him by his mother s brother Jodocus Gallus, an ecclesiastic connected with the univer sity of Heidelberg, who gave his nephew sixteen months at the university at the cost of some fourteen florins in 1491-92. Pellican s parents were worthy people, but very poor ; the boy was eager for learning, but had no books ; at school at Ruffach, where he had learned well, "with much fear and many a scourging," it was only the richer boys who had a copy of the Ulm Donatus of 1485. So when his uncle tired of him and he came back to Ruffach, with some knowledge of the great Latin classics as well as of the usual bachelor s course, he was glad to teach gratis in the Minorite convent school that he might borrow books from the library, and in his sixteenth year he resolved to become a friar. This step helped his studies, for he was sent to Tiibingen in 1496 and became a favourite pupil of the guardian of the Minorite convent there, Paulus Scriptoris, a man of considerable general learning and of much boldness and honesty, who anticipated Luther in his open preaching on such topics as vows, indulgences, and the sacraments. There seems to have been at that time in south-west Germany a considerable amount of sturdy independent thought among the Franciscans, and more genuine conformity to the original ideas of the order than is often supposed ; Pellicanus himself became a Protestant very gradually, and without any such revulsion of feeling as marked Luther s conversion; at the moment when he went to Zurich and threw off the cowl he was pleased to think that the good St Francis would not abhor him for his change of dress, and for learning for the first time at the age of forty-eight the difference between crowns, florins, and batzen. At Tubingen the future "apostate in three