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
Many of the peculiarities of sex and place distribution could be
explained by the stable fly, _Stomoxys calcitrans_, a fly which
bites viciously in the district in which they worked. This fly
bites only by day and is intimately associated with human dwellings
so that the greater incidence of the disease in the women, who stay
at home, as against an incidence five times less in the men who
work in the mill during the day might be explained by _Stomoxys_
bites.
At the same time their failure to transmit pellagra to monkeys by
injections of defibrinated pellagra blood would militate against any
infectious agent existing in the blood. It may be stated that Harris
has claimed to have produced a disease resembling pellagra in two
monkeys by injecting filtrates from emulsions of brain, skin and
intestinal tract of cases dying of pellagra.
Lavinder and Francis injected 79 monkeys and 3 baboons with varying
material from pellagra autopsies. Some of the animals were injected
with emulsions or Berkefeld filtrates of such emulsions made from
brain and cord. Other monkeys were inoculated with material from
skin similarly prepared, others with stomach and mouth mucosal
emulsions, and still others with intestine and faeces emulsions.
Blood, urine and cerebro-spinal fluid were also injected. Feeding
experiments were also carried out. With one exception, and that one
only suggestive of pellagra, the experiments were negative.
Sixteen volunteers, working under Goldberger, tried to infect
themselves with blood, nasopharyngeal secretions, epidermal scales,
feces and urine from pellagrins. Various atria of infection were
tried according to material; blood by intramuscular injection,
excreta by mouth. After a period of six months all the subjects of
the experiments remained well. _This evidence is certainly against
the infectious nature of the disease._
_Greater Prevalence in Women_.—Now that we attach no weight to
insect transmission of pellagra we have only the debilitating effects
of menstruation, pregnancy and lactation to explain the marked
susceptibility shown by women of from seventeen to forty years of
age. Before and beyond these ages the incidence in males and females
is about the same.
Before Goldberger began his experiments he was struck by the
relation poverty had to pellagra epidemiology, and as diet is the
chief element differentiating poverty and affluence, he chose this
line of research with the results recorded under etiology. His
explanation of the greater incidence in adult females, especially
wives and mothers, was their act of denying themselves the more
desirable parts of the food.
Sandwith has noted the great frequency of pellagra in hookworm
patients, thus of 300 such cases in Egypt, 46% had pellagra.
Public-domain text, read in full here on John Shaqi.
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