Shepherdstown Register

This is a disease which has long been known among the peasants of northern Italy, northern Spain, and parts of southern France, but has only recently been discovered in this country.
It is variously regarded as a skin disease and as a form of insanity, for it is in reality both; that is to say, there are skin eruptions and a disturbance of the mental faculties, both due to the same cause.
The disease is at first remittent in character, that is to say, it has periods of remission in the winter, when the patient is apparently in his ordinary health; but each spring it returns worse than before, and so it goes on, with three steps forward and one backward, to a fatal termination at the end of from three to five or six years.
The eruption begins as a diffused redness or discolored patches, itching most distressingly, and is followed by a peeling of the epidermis in the form of branny scales. It is most marked on the backs of the hands and feet, but may come on the body or legs as well. It begins in the spring and gets worse during the summer, but may nearly or quite disappear with the advent of cold weather.
The next spring it returns, and now there are digestive troubles added—pain and distress in the stomach after eating, diarrhoea, and often vertigo, headache, and persistent ringing in the ears.
In the winter these troubles again become less, but return in aggravated form the next summer, and with them appear mental symptoms—delirium and profound melancholia. And so the disease goes on until death puts an end to the patient's sufferings.
This description is that of the disease as it occurs in chronic form in Italy. In this country it is apt to be more acute and rapidly progressive, without the winter remissions observed in the European cases.
Pellagra occurs generally only among the very poor and those living under the most unhygienic conditions; but although poverty may predispose to the disease, its sole cause so far as known is the eating of diseased maize. This grain trouble is a corn-smut, a form of mold which attacks the grain stored in damp places.
The prevention is simple—the use of flour and meal made from good grain only; but in the conditions under which many of the Italian peasants live, this is not so easy as it sounds.