“4. A diet of the composition used by the pellagrins prior to their attack by the disease leads to malnutrition and certain pathological changes in animals, resembling those found in pellagra. A typical pellagrous dermatitis has not been observed in animals. Pellagrous symptoms have been produced in man by the continued consumption of a restricted vegetable diet.
“5. The nature of the dietary effect has not been discovered, although certain observations point to a combined deficiency in some of the recognized dietary factors as the cause of the pellagrous syndrome.”
Dietetic Treatment.—The diet in pellagra is one which is well balanced in all its particulars, and one in which the proteins are carefully adjusted as to type. The best results have been observed on diets in which the complete proteins (milk, meat and eggs) have a prominent place. As a rule, in the diet of an adult suffering from pellagra, at least forty grams (about 60 per cent) of the necessary proteins should be in this form. The diet for pellagra must necessarily be such as to overcome as far as possible the progressive emaciation which is an important symptom. However, it must be kept in mind that gastro-intestinal disturbances are likewise prominent and that diarrhea is often most difficult to overcome. For these reasons it is essential to formulate a diet which will not interfere with the treatment for the disease, and which will be at the same time one on which the patient can gradually be built up, and in this way benefit, as far as possible, under the circumstances. The diet used in the treatment of anemia seems to be the one best suited to meet the requirements of the patient suffering with pellagra; changes may be made in this diet, however, by the physician, who will be able to judge the need of the individual under his care. Whether pellagra can be cured by dietetic treatment is very uncertain, but the condition of the patient can undoubtedly be materially improved, provided the treatment is begun sufficiently early; that is, before the disease has progressed to such an extent that neither diet nor anything else can bring about a cure.
The above dietetic treatment is not claimed to be infallible. It is merely given as a suggestion to be used at the discretion of the physician.
In all probability the treatment of pellagra will undergo a definite change in the near future, but at present our best results accrue from the giving of an adequate, well-balanced diet. The extent of the relief of such dietetic measures depends, as has already been stated, upon taking the disease in its early stage.
SUMMARY
Food Poisoning is more or less common, being induced by polluted water, milk, or other foods, bad sanitation, and imperfect canning, as well as by certain obscure substances known as ptomaines.
Shellfish have often been found to cause poisoning in certain individuals. Stale fish may cause the most violent type of poisoning in any individual.
Chicken Salad which has been kept overnight in tin receptacles has been known to cause violent attacks of poisoning.
Ice Cream which is melted and re-frozen is likewise a source of a number of the cases reported.