CHAPTER XXVII
PELLAGRA
Synonyms.— Pellarina, mal de la rosa, mal rosso, flema salada, Alpine scurvy, Asturian leprosy, Asturian rose, disease of the Landes, dermotagra, psilosis pigmentosa.
Definition.— An endemic disease of slow evolution, characterized by a complexity of nervous, alimentary, and cutaneous symptoms, which make their first appearance during the spring months (sometimes the autumn months), and recur year after year at the same season, remitting more or less during the winter months. It is for the most part confined to field-labourers. The more distinctive features are— (a) a remitting dermatitis of the ex- posed parts of the body; (b) marked emaciation; (c) profound depression alternating with mania.
Geographical distribution.— Europe: Pellagra has a wide distribution in Southern Europe. It is found in northern Portugal, in Spain, in Italy, in the south-west of France, in the Austrian Tyrol, in Hungary, Croatia, Dalmatia, Bosnia, Servia, Bulgaria, Turkey, Greece, Corfu, Roumania, Bessarabia, Kherson, and Poland. Sambon has shown that, though hitherto practically unrecognized, it prevails endemically throughout the British Isles.*[1] Africa:
- ↑ * Until 1912 pellagra was not known to be endemic in the British Islands. It is true that three or four cases had been described and correctly diagnosed between 1863 and 1909, but they had not attracted any attention. Indeed, Sand with, who had had the opportunity of studying pellagra in Egypt, stated that the published accounts did not tally with the disease as he knew it, though the symptoms were somewhat similar to those of pellagra. Since 1912 Sambon has had the opportunity of examining over a hundred cases of indigenous pellagra in England, Scotland, and Wales, and he has established that pellagra is widely distributed throughout the British Isles, having endemic stations as far north as the Shetlands. He also believes that the disease is of long standing in these isles, as evidenced by the
