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10 The Health Bulletin ease, othex than the eruption, are slight and frequently difficult or impossible to make out. It has happened more than once in the experience of the writer that the liveliest of a group of children was found with a well-developed eruption. Notwithstanding this, however, careful questioning of the mother, if she be observant, not infrequently develops the fact that the child seems to her less active than common; in some cases it is evidently listless and fretful and the mother may also recognize that it has fallen off in weight. In older individuals 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 are very frequently met with. The patient will complain of being ^'worked out," of having '^blind staggers" (dizziness, vertigo), of discomfort or pain in the pit of the stomach, frequently of headache, somptimes of wakefulness, frequently also of sluggishness of the bowels, requiring the habitual use of medicine to move them. Although, as has already been said, these symptoms alone, or even with the addition of such symptoms as a burning or scalding feeling of the mouth, reddened tongue, burning of the hands or feet and loose bowels, are not enough to distinguish pellagra from other conditions, they are 'anvAe to justify a suspicion of the disease, especially if such iiulividuai is known to be finicky or a nibbler about food, or has been li^'ing on a diet made up largely of biscuits, corn bread, grits, gravy, and sirup, with little or no milk or lean meat; in other words, on a diet mainly of cereals, starches, and fat, with but little, if any, of the animal flesh (protein) foods. The suspicion of pellagra may with confidence be dismissed in one who is known to be, and to have been, a habitual milk drinker and meat eater. It is well to be warned, however, that it is very easy to be mislead about what and how much the individual actually eats. Insanity,—lu a small proportion of cases, fortunately much smaller than is commonly believed, the mind is affected to a degree requiring asylum care. Many of these cases get well under treatment. Recovery of the mind is not to be expected, however, where the pellagra occurs in a person whose insanity is due to some other (incurable) cause. importance and distribution Under proper treatment and with careful nursing only a small percentage of cases die; nevertheless, the actual number of deaths is deplorably large. Indeed, in nearly all the Southern States pellagra is one of the foremost causes of death. Thus, in 1916, it ranked fourth in Mississippi, third in Alabama, and second in South Carolina. In that year, probably an average one so far as pellagra is concerned, this disease was charged with having caused 677 deaths in Alabama, 810 in Mississippi, 467 in North Carolina, 627 in South Carolina, 607 in Tennessee, and 452 in Texas, or an aggregate of some 3,700 deaths for these six states alone. As the fatality rate, counting all types of cases, was probably not in excess of 5 per cent, it can readily be seen that not only is this disease among the most important as a cause of death, but it probably ranks with the first in importance as a cause of sickness and lowered physical efficiency of the people in the area affected. In the six states named there probably occurred some 70,000 definite cases of pellagra. As it is quite safe to assume that there were in the remaining 7 of the 13 states south of the Potomac and Ohio rivers— the section most seriously affected— at least balf as many more, there probably occurred in this region in 1916 upward of 100,000 cases. The incomplete figures at hand indicate a considerable increase of the disease in 1917. It seems safe to assume that this increase averaged about 25 per cent, so that it may be estimated that in 1917, in the part of the country mentioned, fully 125,000 people were attacked. In other parts of the country the disease is very much less common. The explanation for this has not been fully worked out. It depends in part, at least, on a difference in dietary habit. The people of the South are known to eat much less of the animal
Object Description
Rating | |
Fixed Title * | NCHH-04: The Health Bulletin [1914-1973] |
Document Title | The Health Bulletin [1914-1973] |
Subject Topical | Public health -- North Carolina -- Periodicals. |
Subject Topical Other | Public Health -- North Carolina -- Periodicals. |
Contributor | North Carolina. State Board of Health. |
Publisher | Raleigh, North Carolina State Board of Health. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1921 |
Identifier | NCHH-04-036 |
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 | 36 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-04/nchh-04-036.pdf |
Document Sort | all; group-b; nchh-04 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-04-036 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-04 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1296443 |
Description
Fixed Title * | Page 12 |
Document Title | The Health Bulletin [1914-1973] |
Subject Topical | Public health -- North Carolina -- Periodicals. |
Subject Topical Other | Public Health -- North Carolina -- Periodicals. |
Contributor | North Carolina. State Board of Health. |
Publisher | Raleigh, North Carolina State Board of Health. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1921 |
Identifier | NCHH-04-036-0138 |
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 | healthbulletinse36nort_0138.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 | 36 |
Issue Number | 8 |
Page Number | 12 |
Health Discipline | Medicine |
Full Text | 10 The Health Bulletin ease, othex than the eruption, are slight and frequently difficult or impossible to make out. It has happened more than once in the experience of the writer that the liveliest of a group of children was found with a well-developed eruption. Notwithstanding this, however, careful questioning of the mother, if she be observant, not infrequently develops the fact that the child seems to her less active than common; in some cases it is evidently listless and fretful and the mother may also recognize that it has fallen off in weight. In older individuals 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 are very frequently met with. The patient will complain of being ^'worked out" of having '^blind staggers" (dizziness, vertigo), of discomfort or pain in the pit of the stomach, frequently of headache, somptimes of wakefulness, frequently also of sluggishness of the bowels, requiring the habitual use of medicine to move them. Although, as has already been said, these symptoms alone, or even with the addition of such symptoms as a burning or scalding feeling of the mouth, reddened tongue, burning of the hands or feet and loose bowels, are not enough to distinguish pellagra from other conditions, they are 'anvAe to justify a suspicion of the disease, especially if such iiulividuai is known to be finicky or a nibbler about food, or has been li^'ing on a diet made up largely of biscuits, corn bread, grits, gravy, and sirup, with little or no milk or lean meat; in other words, on a diet mainly of cereals, starches, and fat, with but little, if any, of the animal flesh (protein) foods. The suspicion of pellagra may with confidence be dismissed in one who is known to be, and to have been, a habitual milk drinker and meat eater. It is well to be warned, however, that it is very easy to be mislead about what and how much the individual actually eats. Insanity,—lu a small proportion of cases, fortunately much smaller than is commonly believed, the mind is affected to a degree requiring asylum care. Many of these cases get well under treatment. Recovery of the mind is not to be expected, however, where the pellagra occurs in a person whose insanity is due to some other (incurable) cause. importance and distribution Under proper treatment and with careful nursing only a small percentage of cases die; nevertheless, the actual number of deaths is deplorably large. Indeed, in nearly all the Southern States pellagra is one of the foremost causes of death. Thus, in 1916, it ranked fourth in Mississippi, third in Alabama, and second in South Carolina. In that year, probably an average one so far as pellagra is concerned, this disease was charged with having caused 677 deaths in Alabama, 810 in Mississippi, 467 in North Carolina, 627 in South Carolina, 607 in Tennessee, and 452 in Texas, or an aggregate of some 3,700 deaths for these six states alone. As the fatality rate, counting all types of cases, was probably not in excess of 5 per cent, it can readily be seen that not only is this disease among the most important as a cause of death, but it probably ranks with the first in importance as a cause of sickness and lowered physical efficiency of the people in the area affected. In the six states named there probably occurred some 70,000 definite cases of pellagra. As it is quite safe to assume that there were in the remaining 7 of the 13 states south of the Potomac and Ohio rivers— the section most seriously affected— at least balf as many more, there probably occurred in this region in 1916 upward of 100,000 cases. The incomplete figures at hand indicate a considerable increase of the disease in 1917. It seems safe to assume that this increase averaged about 25 per cent, so that it may be estimated that in 1917, in the part of the country mentioned, fully 125,000 people were attacked. In other parts of the country the disease is very much less common. The explanation for this has not been fully worked out. It depends in part, at least, on a difference in dietary habit. The people of the South are known to eat much less of the animal |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-04/nchh-04-036.pdf |
Document Sort | all; group-b; nchh-04 |
Article Title | Pelagra -- Its Nature, Prevention and Treatment |
Article Author | Goldberger, Joseph |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-04-036 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-04 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1296443 |
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