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Article
April 11, 1914

THE TONGUE AND UPPER ALIMENTARY TRACT IN PELLAGRA

Author Affiliations

ASHEVILLE, N. C.

JAMA. 1914;LXII(15):1151-1153. doi:10.1001/jama.1914.02560400019006
Abstract

The diagnosis of pellagra is not infrequently fraught with difficulty for two reasons: In the first place, the disease is remarkable for its behavior with reference to seasonal variations, and the remission or decrease of symptoms during the colder months of the year is very apt to lead one astray. In the second place, pellagra is very irregular in its manifestations; it is a long-drawn-out disease, as a rule, requiring months or even years for the development of such symptoms as we have been wont to consider characteristic. When the pellagrous triad of dermatitis, nervousness and diarrhea is present, the diagnosis is of course readily made; but if the skin changes are slight, with an indefinite history of an eruption, if the nervous symptoms are not prominent, and if there has been but moderate diarrhea or perhaps none, the diagnosis may be attended with considerable difficulty. For the symptoms on

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