Vol. 60, 1909 - University of North Carolina at Chapel Hill

Charlotte of t^^e Medical problem Journal than European sanitarians
were a quarter of a century ago.
Published Montbly. Not for one moment would we seem to
EDWARD C. REGISTER, M. D., EDITOR express our disbelief in the existence of
CHARLOTTE, N. Cpellagrra
in the Southern States. We know
_ it is here and we believe likewise that it
PEULAGR^ A^D PEUbAGRAPHOBifl ^^^ ^^^" prevalent for a number of years.
I' "rthermore, '
Ti,o T^ c, . o we are
. r rr
satisfied that , ,
the dis-
The Tennessee State Board of Health, at ease is uniformly fatal, and that great sufa
recent meeting n. Nashvdle. I deeded to fering results to the victim in many cases
,order the isolation of all cases of pellagra before death comes. Let it be said here and
inow existing or that may be discovered in now, however, that the diagnosis is by no
the future. I 1 he cities or counties in which means always quite easily made, since there
;such cases are found inust meet the expense are other diseases which i>ear a more or less
.of such isolation. 1 his Board ,s reported close similarity. In our desire to discover
to have expressed the opinion that the dis- cases there is doubtless too oTeat a tendency
lease is communicable In the above re- to jump at conclusions without due con
port we have yet another evidence of the sideration. In other words, our enthusiasm
length to which man is swayed by that is apt to obscure our judgment. It is not
which IS novel and bizarre We do not with any intention of questioning the abiliwish
to be misunderstood in this matter, but ties of our brother doctors that these things
It IS not difficult to see that in the case of are written, but merely to sound a note of
pellagra there is manifest the world-old warning: it isn't that we would attempt to
tendency of humanity to fly to extremes, throw an obstacle in the way of progress.
Doubtless It IS to the credit of the medical but we would plead for a somewhat saner
protess.on--perhaps It is not—that so wide- attitude. Xo one would attempt to dispute
spread and profouna a sensation has been the proposition that other diseases like tvstirred
up throughout the length and breadth phoid fever and tuberculosis have produced
ot this land of ours. Perhaps, also, he who are producing and potentially will produce
tias the temerity to raise a protesting voice infinitely more suffering and loss, both
•vill be branded as iconoclastic and cynical, financial and vital, than pellagra does. In
lutit IS a fact, and we believe that success- any one community there are probably
ul contradiction is improbable, that the scores of cases of tuberculosis whose outmpression
made upon the minds of the laity look is quite as hopeless as that of any
lasreally created, and added to the already pellagrin, notwithstanding the fact that
ong list, a new phobia. The writer has science seems to have found a remedy for
ecentlv observed with considerable curios- the former. And in the case of typhoid fever
ty the frequency with which pellagra be- —a disease that is always with us, poten-
•omes a subject of conversation whenever tially if not in fact—the people who suffer
wo or more people come together and talk and die outnumber many times the victims
s possible. Invariably the discussion turns of pellagra. In the case of both typhoid
this disease and one hears expressions fever and tuberculosis, lhecau.se and pathovbici.
111 some cases, amount to evidences genesis of the diseases are— one might alt
absolute terror. It is a fear having its most say— well understood. Preventive
rigin in ignorance, and while no one can treatment, at least, is entirely possible in
e blamed because of the ignorance, still it both and a fair amount of success is promoes
seem so unnecessary, so fruitless, and ised, so far as curative measures are conne
might even venture to si^y. so pernic- cerned. Yet practically no space is devoted
3US that such sensationalism has been per- by the lay papers to jopular or sensational
iitted to develop m regard to a disease discussions concerning these diseases. They
'hich, at worst, is comparatively rare, even are far too common, we have made our bed
1 the South. As we have said above, it is with them for too many years for us longer
ery probably our ignorance concerning the to feel any fear. Our souls are not thrilled
ause and nature of the disease, and our with horror at the bare mention of the dispparent
entire helplessness so far as cura- ease" one does not hear them discussed in
ve measures are concerned, that have every social gathering—from bridge whist
roused the emotional side of the people, parties to public receptions. On the other
omplete knowledge of the pathogenesis of hand one rarely looks through the columns
|»e malady and a consequent knowledge of of a daily or weekly paper published anvliat
to do for the patient would lead to a where in the counlrv that something isn't
ilm and sane attitude of mind, and breed found about pellagra. Apparently every
teeling of security which ignorance makes doctor who thinks himself the discoverer of
ipossible. However, we do not at present a pellagrin, or who signs the death certifipear
to have drawn any nearer a solution cat? of a pellagra patient finds himself