ONYALAI was first described by Wellman,1 in 1904. He and, shortly afterward, Massey2 reported cases observed in Angola. Since then, various investigators have reported cases in many parts of Africa. A number of theories as to the cause of the disease have been advanced, but as recently as November 1946 Retief3 stated that its etiology was unknown. There is general agreement that onyalai is a form of thrombopenic purpura, with prolonged bleeding time and normal blood coagulation time. The disease is characterized by the formation of distinctive hemorrhagic bullae on the mucous membranes, most frequently in the mouth. Nasal hemorrhages are often seen. Postmortem examination shows extensive areas of hemorrhage, and death appears to result from severe loss of blood.
During the past twenty years 150 patients with onyalai have been admitted to our hospital; until 1940 no effective treatment was available. Like other workers, we found
STRANGWAY WE, STRANGWAY AK. ASCORBIC ACID DEFICIENCY IN THE AFRICAN DISEASE ONYALAI. Arch Intern Med (Chic). 1949;83(4):372–376. doi:10.1001/archinte.1949.00220330012002
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