The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
Goldberger and his colleagues, after a careful investigation of
pellagra epidemiology, decided that such facts as the complete
absence of the disease among the nurses and attendants of the
pellagrous insane, or among the prison guards of institutions where
pellagra prevailed extensively, as well as among those caring for
pellagrous orphans, indicated that a dietary factor rather than
an infectious one was operative in the disease. Even where it was
stated that attendants and inmates of institutions had the same
dietary investigation indicated that as a matter of fact the insane
and the prisoners were not as well fed as the other group. Then too
the insane frequently fail to avail themselves of the food provided.
A study of the records of the Army and Navy of the United States
failed to show that a single case of pellagra had ever developed
among the personnel, although large numbers of the men came from
pellagrous districts of the South. This exemption they thought due to
the generous service ration.
In an investigation of the diet of the workingman’s family in the
North and South it was found that the southern one consumed much
larger quantities of starches and fats than the northern one, but
less fresh meat. In the family of the cotton mill operative, a
class showing a great incidence of pellagra, corn bread, flour
biscuits, and fat pork were the chief articles of diet. There is
a great deal of ancylostomiasis among these cotton mill people
and the debilitating effect of this disease may predispose to
pellagra. The general rise in the cost of food and, in particular,
the disproportionate increase in price of meats over cereals, since
1907, may explain the greater incidence of the disease since that
time. The wages of southern mill operators have also suffered on
account of frequent periods of financial depression during the last
ten years, thus causing them to buy cereals rather than meats.
_Goldberger’s Experiment._—In February, 1915, Goldberger started
a “pellagra squad,” consisting of 11 prisoners on a diet of wheat
flour (patent), corn meal, corn grits, corn starch, polished rice,
granulated sugar, cane syrup, sweet potatoes, fat fried out of salt
pork, cabbage, collards, turnip greens and coffee. Baking powder was
used for making biscuits and corn bread. The food value of each man’s
diet averaged 2952 calories.
A control was carried out with prisoners on a normal diet. The
experiment was continued until Oct. 31, 1915. Of the 11 volunteers
on the excessive carbohydrate diet six developed symptoms. Loss
of weight and strength and mild neurasthenia were early symptoms.
Definite cutaneous manifestations appeared only after five months.
The skin lesions were first noted on the scrotum, later appearing
on backs of hands in two cases and back of neck in one case.
Public-domain text, read in full here on John Shaqi.
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