These unfortunates, forgotten by civilisation, are destined to roam the fields, bearing with them, till the day of their death, a deceptive appearance of youth, and an infantile incapacity for work, an object-lesson of misery and barbarity! Among the means of fighting malaria, the spread of civilisation and the school ought to find a place. Even the quinine given freely by the government is distributed with difficulty among these unhappy people, brutalised by hunger and fever; and some message from civilisation ought to precede the remedy for the material ill. A far-sighted institution is that of Sunday classes founded by Signor Celli and his wife in the abandoned malarial districts. In these classes, the teachers from elementary schools give lessons every Sunday, spreading the principles of civic life, at the same time that they distribute quinine to the children.
If we stop to think that wherever malaria is beaten back, it means a direct conquest of fertile lands and of robust men, and hence of wealth, we must realise at once the immense importance of this sort of school and this sort of struggle, which may be compared to the ancient wars of conquest, when new territories and strong men constituted the prize of battles won, and the grandeur of the victorious nations.
Pellagra.—Pellagra is still another scourge diffused over many regions of Italy. It is well known that this disease, whose pathological etiology is still obscure, has some connection with a diet of mouldy grain. Pellagra runs a slow course, beginning almost unnoticed in the first year, with a simple cutaneous eruption, which the peasants sometimes attribute to the sun. The second year disturbances of the stomach and intestines begin, aggravated by a diet of spoiled corn; but it is usually not until the third year that pellagra reveals itself through its symptoms of great nervous derangements, with depression of muscular, psychic and sexual powers, together with melancholia, amounting to a true and special form of psychosis (insanity) leading to homicide, even of those nearest and dearest (mothers murdering their children) and to suicide.
This established cycle of the disease is not invariable. Instead of representing successive stages, these symptoms may often be regarded merely as representing the prevailing phenomena in various forms of pellagra; in any case, it constitutes a malady that runs a slow course during which the same patient is liable to many relapses. While the malady is running its course, the patients may continue their usual physiological and social life, and even reproduce themselves. So that it is not an infrequent case when we find mothers, suffering from pellagra, nursing an offspring generated in sickness and condemned to manifold forms of arrested development, both physical and mental.
Against a disease so terrible that it strikes the individual and the species, it is now a matter of common knowledge that there is an exceedingly simple remedy: it consists in a strongly nitrogenous diet (i.e. meat) and that, too, only temporarily. In fact, in the districts where the pellagra rages, various charitable organisations have been established, among others the economic kitchens for mothers, which by distributing big rations of meat effect a cure, within a few months, not only of the sick mothers but of their children as well.
The real battle against pellagra must be won through agrarian reforms: but in the meantime the local authorities could in no small degree aid the unhappy population with their counsel, by enlightening the peasants regarding the risks they run, as well as by informing them of the various forms of organised aid actually established in the neighbourhood and often unknown to the public or feared by them, because of the ignorance and prejudice with which they are profoundly imbued!
Pauperism, Denutrition, Hypertrophy.—We may define all the causes hitherto considered that are deleterious to growth, as toxical dystrophies, since not only alcohol, but the several diseases above discussed—syphilis, tuberculosis, malaria, pellagra—produce forms of chronic intoxication. But besides all these various forms of dystrophies, we may also cite cases of infantilism due purely to defective nutrition, and family poverty. Physiological misery may produce an arrest of growth in children.
But just as denutrition associated with pauperism (social misery, economic poverty, lack of nourishment) may cause an organism in course of development to arrest its processes of evolution through lack of material, the same result is equally apt to be produced by any one of a great variety of causes liable to produce organic denutrition, physiological poverty.
For example, too frequent pregnancies of the child's mother, which have resulted in impoverishing the maternal organism, causing deficiency of milk, etc.
Infant Illnesses.—In the same way, organic impoverishment is caused by certain maladies of the digestive system which impede the normal assimilation of nutritive matter: dysentery, for instance; and the effects may be still more disastrous if symptoms of this kind are accompanied by feverish conditions, as in typhus.