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

:
April 1927
The Health Bulletin
are specialists now working upon the
disease, searching for a germ as its
cause.
But the one fact that all who have
studied the disease agree upon is that
it occurs in people who live mainly upon
a carbohydrate diet that is unbalanced
because it does not have the proper
proteins in it. The disease has been
produced in prisoners by feeding them
upon a diet of only biscuits, corn bread,
grits, rice, gravy and coffee. And it
has been cured by adding milk, lean
meat, green vegetables and fruits.
Whether the disease is caused by a
germ or not, our present knowledge
of it makes the diet the most powerful
thing that we have for controlling it.
By manipulating the diet we can produce
the disease or cure it, although
future knowledge may show that we
are doing it by growing or killing the
germs that cause it.
People who drink plenty of milk and
eat lean meat, green vegetables and
fruits do not have pellagra. And those
who have it are benefited by adding
these foods to their diet more than by
anything else.
Probable
Sjinptoms
Pellagra has three main symptoms
a skin eruption ; a bowel disorder ; and
an affection of the mind.
The skin eruption is the most
characteristic symptom of the disease.
It tells the tale when the looseness of
the bowels and the weakness and nervousness,
which may have come before
it, have failed to do so. It begins like
a sunburn and may afterwards peel
off. It sometimes turns to a dirty brown
color and becomes thickened, rough and
scaly, and cracks or peels. An important
thing about the eruption is that it
comes out at certain places on the body
and usually at the same places on both
sides of the body. The backs of the
hands in grown people and the tops
of the feet in children are common
places for it to begin. Other places
where it often appears are the neck,
face, elbows and knees.
In grown people a complaint of loss
of strength, with indigestion or nervousness,
or both, coming on or made
worse in the spring or summer and
improving in the fall and winter, with
or without the skin eruption, is often
met with. A burning or scalding feeling
of the mouth, reddened tongue,
burning of the hands or feet, and loose
bowels, are also often met with, and
are enough to justify a suspicion of the
disease if the patient is known to be
living on a diet of biscuits, corn bread,
grits, gravy, and syrup, with little or
no milk or lean meat. There is no use
to look for pellagra in a person who is
in the habit of drinking a lot of milk
and of eating meat.
Diet Suggested by Goldberger
The following is an outline of a bill
of fare as an example of a diet which
will prevent pellagra. To make it suitable
for the treatment of a case that
has already developed, substitute more
milk, lean meat, meat juice, and eggs.
This diet is advised by Dr. Joseph Goldberger,
surgeon, U. S. P. H. S., whose
study of pellagra has done much to
make it a disease that can be controlled
:
Breakfast—Sweet milk, daily. Boiled
oatmeal with butter or with milk, every
other day. Boiled hominy, grits, or
mush, with a meat gravy or with milk,
every other day. Light bread or biscuit
with butter, daily.
Dinner—A meat dish (beef stew,
hash, or pot roast, ham or shoulder
of pork, boiled or roast fowl, broiled
or fried fish, or creamed salmon or codfish
cakes, etc.), at least every other
day. Macaroni with cheese, once a
week. Dried beans (boiled cowpeas
with or without a little meat), two or
three times a week. Potatoes (Irish or
sweet )
, four or five times a week. Rice,
two or three times a week, on days with
the meat stew or the beans. Green vegetables
(cabbage, collards, turnip greens,
spinach, snap-beans or okra), three or
four times a week. Corn bread daily.
Buttermilk, daily.
Supper—Light bread or biscuit, daily.
Butter, daily. Milk (sweet or buttermilk),
daily. Stewed fruit (apples,
peaches, prunes, apricots), three or
four times a week, on days when there
is no green vegetable for dinner. Peanut
butter, once or twice a week. Syrup,
once or twice a week.