The Stratford Evening Post WITH WHICH IS INCORPORATED THE EGMONT SETTLER. MONDAY, AUGUST 25, 1913. THE NEW DISEASE.

Stratford Evening Post, Volume XXXVI, Issue 94, 25 August 1913, Page 4

The Stratford Evening Post WITH WHICH IS INCORPORATED THE EGMONT SETTLER. MONDAY, AUGUST 25, 1913. THE NEW DISEASE.

The fatalities which, came under the notice of the medical profession of the United Kingdom during the past year, and which were diagnosed as due to pellagra—a new disease, so far as the ordinary individual is concerned—have excited considerable attention in the medical world. Only a day or eo ago we were informed by Press message that a death from this complaint had occurred at Westport, the lady victim having been a sufferer for the past ten years. Until quite recently most practitioners are' understood to have considered pella-! gra to be foreign to Great Britain and Australasia, and regarded it as an' obscure malady which affected the her-| 'vous system and skin, and occurred. mainly in Italy, Spain, and other parte' of Southern Europe. This belief, how- 1 over, Ims been entirely dispelled by Dr. ' Louis W. Sambou, lecturer to the Lon-| don School of Tropical Medicine, and parasitologist to the Wellcome Re-j search Laboratories, who draws attention to the records of an undoubtedi case of pellagra which occurred in, Scotland in the year 1863. Several; more or less doubtful cases were reported up till 1912, when a renewed interest was awakened in professional circles by Dr. Sambon and Dr. A. S. Chalmers, who reported that the (lis-! ease was endemic in certain parts of > Scotland, and in the Shetland Islands. Several fatal English cases occurred at the London Hospital in the same year. As in Croat, Britain, so in the United States of America, the disease was, until a few years ago, considered to be unknown. Sir" William Osier, in the 1900 edition of his "Practice of Medicine," slates that the disease {"lias not been observed in the United States."' However, in 1907, an e'piIdemic of pellagra at the Mount Vor-

non Asylum for Negroes, Alabama, ivas reported, and in the ■same year thei ilitsoa.se was recognised at the S,tate hospital for the Insane at Columbia, South Carolina. These tacts led to] an investigation, with the result that| pellagra is now known to prevail in no, J" fewer than 33 American States; and that since its recognition in 1903, 30,000 cases have been "discovered. It was then shown that the disease could; " he traced hack as Far as 1834 in South ' Carolina. Although the disease has J only lately attracted the attention of medical men in Great Britain and the j' United States of America, it has for many years been well known in Italy, Spain, and Southern France, not only . to the profession, but also to the publie. In certain Italian districts practically the whole of the poplation are sufferers from this disease. An authority states that pellagra may be g defined as an endemic disease of toxic origin, affecting the nervous, digestive, . and cutaneous systems. The disease ( 1 appears under many forms and runs , either a rapid or slow course. In the | early stages there is, in the spring, ( a feeling of weakness, dizziness, headache, and a burning sensation. There is a loss of appetite and diarrhoea ; a skin eruption appears on those portions most exposed to the heat of the sun—as the hacks of the hands, face, , and neck—in the form of patches of , a dark brown or livid red. The skin swells, hums, and itches, small blisters form, and staining develops. Towards winter there is easting off of skin in flakes, and the redness and swelling disappears. It recurs again in the spring, and may follow this course for. several years. The patient gets weak and emaciated, and headaches become verv severe. The nervous symptoms increase, even to. insanity, delirium, stupor, melancholia, etc'and paralysis of the legs may occur. Intestinal symptoms may be accentuated, with profuse diarrhoea, and patients may die from malnutrition. The disease lasts from five to fifteen years before its supposedly always fatal ending. The'cause of the disease has been put down to toxine, formed by decomposing and fermented maize, and it was thought to occur only amongst the poor, ill-nourished portion of the population. The investigations of Dr. Louis Cambon, both in Italy and Great Britain, however, go to prove that neither of these factors can be regarded as established facts in the causation of the complaint. He has advanced the theory that pellagra is an insect-borne injection, and ' that the. insects concerned in the transmission of the disease were probably a certain class of blood-sucking flies, known as the simuliidae, called in America "Buffalo gnats." Dr. Cam- 1 bon's researches proved that in the English and in many of his Italian j cases which he had investigated, maize as a causative agent was out of the question, as none of the snfferi Wi' liM%sersOTeri this of. diet. They then go on to prove that the disease is distributed in certain United districts, or stations, and that in all of these there are rapidly running streams, in which the larvae and pupae of the simuliidae can be found. He states that pellagra seems to be linked to briskly-running streams, just af malaria is linked to stagnant water, and that it is interesting to note that I "in countries such as Roumania and Italy, where both malaria and pellagra prevail extensively, the two diseases, though overlapping in places, exhibit a decidedly inverse distribution. Pellagra prevails chiefly in the Piedmont section of the highlands, trenched by lively steams, and malaria prevails in the swampy lowlands. He further states that in the pellagra dv tricts the disease is rampant, and af fects newcomers. Outside of these j stations, however, it cannot be eon- : tracted, notwithstanding close and I continued association with immigrant. ■ | pellagrins. The discovery of a cas< "fin New Zealand will doubtless cause thorough investigation into the local ! conditions. ,