That pellagra is going to be one of the most serious problems with which we will have to deal in the next few years nobody can deny. It is certainly assuming alarming proportions and is slowly but surely pressing its way into the middle and northern states. It looks as if it were going to become endemic all over the United States, and at present it is almost epidemic in the south.
One who has followed the history of etiology of pellagra cannot help being conservative in adapting a certain theory. So many theories have been brought forward, adapted, rejected and then again adapted, that one cannot blame the "doubting Thomases" among the medical profession. Some of the theories were very attractive, but lacked scientific corroborations. Some thought this disease to be a phase of syphilis and leprosy, while others attributed it to incomplete metabolism, causing a symptom-complex known as
RAVITCH ML. A PLEA FOR AN EARLIER DIAGNOSIS OF PELLAGRA. JAMA. 1912;LIX(1):33–36. doi:10.1001/jama.1912.04270070035013
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