The syndrome which we accept provisionally as pellagra in infants is prevalent among the non-European children in Johannesburg. An analysis of the hospital records during the last four years has revealed that the death rate among children suffering from this disease fluctuates between 40 and 60 per cent irrespective of the nature of the treatment administered. Even vitamin concentrates given parenterally did not in any way diminish this high mortality rate.
The views generally held concerning the causes of pellagra1 seem to suggest that this disease is in some way caused by a lack of vitamin B complex, especially of nicotinic acid. However, the failure of vitamins in approximately 50 per cent of cases added support to our hypothesis that after a variable latent period a disease initiated by a dietary deficiency fails to respond when the factor whose deficiency is suspected to cause the disease is supplied liberally.