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BL'LLETIX X. C. BOARD OF HEALTH. 89 Involvement of the anterior horns of the cord will show muscular weakness with atrophy and symptoms identical with amyotrophic lateral sclerosis when the lateral tracts are conjointly affected. Transverse myelitis is seen at times. Only a month ago a patient was seen with this condition, resulting in death. We have also seen this summer a patient with bulbar palsy. Acute cases have either normal or lowered reflexes. After a case has existed for years, usually toward the end the reflexes become much lowered and may disappear. The pupils are , involved at times and generally show a tardy reaction to both light and accommodation. Mental symptoms are extremely common and are seen in almost all cases that have had a recurrence. Even during the first attack invariably the patients become neurasthenic and are moody and apathetic. After a recurrence they become much depressed, often weep and may have delusions. It is seldom that we see any real mental condition until after the second recurrence, when melancholia is the most common. Mania is not common, but we have had one patient with this condition and another with an apparent circular insanity. All of these conditions invariably end in dementia. Dementia may occur without melancholia or any preceding condition, but the rule is melancholia followed by dementia. Other Symptovis.—Emaciation to some degree is seen in all cases. Those cases with severe diarrhea and stomatitis invariably lose flesh rapidly. After the subsidence of symptoms a patient generally gains flesh rapidly, but in the old chronic cases with mental symptoms patients always remain emaciated. There is a peculiar cry or whine which seems to occur only in this disease. It is hard to describe, but is usually heard on answering questions. Nephritis is seen at times and is usually due to a complication or precedes the disease. Indicanuria is common. The blood shows secondary an^s^mia of a mild to a severe degree. In our cases there was no leucocytosis. Diagnosis.—In making a diagnosis of pellagra, always remember the triad of symptoms: stomatitis, diarrhea and erythema. Erythema is always present at some time. If it is not, or has not been present, do not make a diagnosis. Diarrhea is constant and by close questioning a history of it can usually be brought out, although it may have been very slight. Stomatitis is the rule, but in our experience is the least constant of all symptoms. Trmtment,—Our first experience in the treatment of pellagra was most disappointing. This was largely due to the fact that the greater
Object Description
Rating | |
Fixed Title * | NCHH-03: Bulletin of the North Carolina Board of Health [1886-1913] |
Document Title | Bulletin of the North Carolina Board of Health [1886-1913] |
Subject Topical | Public health -- North Carolina -- Periodicals. |
Subject Topical Other | Public Health -- North Carolina -- Periodicals. |
Description | Published: 1886-1913. |
Contributor | North Carolina. State Board of Health. |
Publisher | Wilmington, N.C. : Secretary of the Board, 1886-1913. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1909-1910 |
Identifier | NCHH-03-024 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 24 |
Health Discipline | Public Health |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-03/nchh-03-024.pdf |
Document Sort | all; group-b; nchh-03 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-03-024 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-03 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1324480 |
Description
Fixed Title * | Page 89 |
Document Title | Bulletin of the North Carolina Board of Health [1886-1913] |
Subject Topical | Public health -- North Carolina -- Periodicals. |
Subject Topical Other | Public Health -- North Carolina -- Periodicals. |
Description | Published: 1886-1913. |
Contributor | North Carolina. State Board of Health. |
Publisher | Wilmington, N.C. : Secretary of the Board, 1886-1913. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1909-1910 |
Identifier | NCHH-03-024-0097 |
Form General | Periodicals |
Page Type | all; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | bulletinofnorthc24nort_0097.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 24 |
Issue Number | 7 |
Page Number | 89 |
Health Discipline | Public Health |
Full Text | BL'LLETIX X. C. BOARD OF HEALTH. 89 Involvement of the anterior horns of the cord will show muscular weakness with atrophy and symptoms identical with amyotrophic lateral sclerosis when the lateral tracts are conjointly affected. Transverse myelitis is seen at times. Only a month ago a patient was seen with this condition, resulting in death. We have also seen this summer a patient with bulbar palsy. Acute cases have either normal or lowered reflexes. After a case has existed for years, usually toward the end the reflexes become much lowered and may disappear. The pupils are , involved at times and generally show a tardy reaction to both light and accommodation. Mental symptoms are extremely common and are seen in almost all cases that have had a recurrence. Even during the first attack invariably the patients become neurasthenic and are moody and apathetic. After a recurrence they become much depressed, often weep and may have delusions. It is seldom that we see any real mental condition until after the second recurrence, when melancholia is the most common. Mania is not common, but we have had one patient with this condition and another with an apparent circular insanity. All of these conditions invariably end in dementia. Dementia may occur without melancholia or any preceding condition, but the rule is melancholia followed by dementia. Other Symptovis.—Emaciation to some degree is seen in all cases. Those cases with severe diarrhea and stomatitis invariably lose flesh rapidly. After the subsidence of symptoms a patient generally gains flesh rapidly, but in the old chronic cases with mental symptoms patients always remain emaciated. There is a peculiar cry or whine which seems to occur only in this disease. It is hard to describe, but is usually heard on answering questions. Nephritis is seen at times and is usually due to a complication or precedes the disease. Indicanuria is common. The blood shows secondary an^s^mia of a mild to a severe degree. In our cases there was no leucocytosis. Diagnosis.—In making a diagnosis of pellagra, always remember the triad of symptoms: stomatitis, diarrhea and erythema. Erythema is always present at some time. If it is not, or has not been present, do not make a diagnosis. Diarrhea is constant and by close questioning a history of it can usually be brought out, although it may have been very slight. Stomatitis is the rule, but in our experience is the least constant of all symptoms. Trmtment,—Our first experience in the treatment of pellagra was most disappointing. This was largely due to the fact that the greater |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-03/nchh-03-024.pdf |
Document Sort | all; group-b; nchh-03 |
Article Title | Pellagra |
Article Author | Wood, Edward J. |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-03-024 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-03 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1324480 |
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