The Health bulletin [serial] - University of North Carolina at Chapel Hill

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Vol. XliH APRIL, 1937 No. 4
PELLAGRA
In 1926 Pellagra Caused the Death of Four Hundred and Fifty-Eight
People in North Carolina
Pellagra is a disease of people who
eat too much bread, grits, rice, gravy
and sj^rup, and too little milk, lean
meat, green vegetables and fresh fruits.
It is caused by eating a diet which is
not balanced by the proper amount of
each of these two kinds of foods, and
which needs more of the latter to balance
it. The disease is prevented, and
is also cured, by drinking enough milk
and eating enough lean meat, green
vegetables and fresh fruits.
Four years ago we published the foregoing
paragraph together with quite a
lot of other information on the subject
of pellagra. We called attention to the
fact that in that year and the preceding
years the mortality fi-om pellagra in
North Carolina was high enough to be
of grave concern to health officers and
physicians as well as all other people
in North Carolina at the time. That
was in 1923. During that year there
were two hundred and twenty-four
deaths, which meant a death rate, according
to our population then, of eight
and three-tenths per one liundred thousand.
During the year 1926 there has
been reported to date four hundred and
fifty-eight deaths in North Carolina, or
a death rate, according to our present
population, of sixteen per one hundred
thousand. It will be seen that the number
of deaths have more than doubled
during the last four years, and the rate
is now almost twice as high as from
typhoid fever.
Pellagra is a disease to be greatly
feared, and certainly a disease to be
prevented. In a strict sense of the
word it is a preventable disease, regarded
for the past several years as
one of the "deficiency" diseases. That
means a disease caused by a deficiency
in diet necessary for human balance
and continued over a period of a sufficient
number of years to produce vital
tissue changes. Physicians and health
officers, as well as domestic science
teachers and all of us qualified to discuss
the matters of diet, should repeatedly
and constantly emphasize to
sick and well the importance of a
varied, common sense diet all the time.
Food may be provided, as so often is
the case, for children ; but unless the
children are forced to partake of a
variety of food which their system
needs, the very fact that the food is
there is, of course, useless and means
nothing.
History
According to Garrison, the first written
description of pellagra was by
Gasper Casal, a Spanish physician, in
1735. His book, however, was not published
until 1762. The disease was
called by him "rose sickness." In 1771,
FrapoUi, an Italian physician, published
a carefully written description
of the disease, in which he designated
it by the name "pellagra," by which it
has ever since been known. Although
first noted in Italy in 1771, within a
period of thirteen years the disease had
become so widespread and serious in
that country that a hospital under
royal authority was founded for the
study of its nature. Medical opinion
then, as since, was divided concerning
many phases of the malady. A new
era in the study of the disease followed
the publication of an exhaustive paper