Joseph Goldberger: The Transmissibility of Pellagra: Experimental Attempts at Transmission to the Human Subject

McC-GW.—Medical officer, 40 years. Stationed at Washington, D. C. Participated in experiment No. 4.

M-MB.—Technical assistant, 33 years. Stationed at New Orleans, La. Participated in experiment No. C.

S-AM.—Medical officer, 39 years. Stationed at Washington, D. C. Participated in experiment No. 4.

S-E.—Statistician, 35 years. Stationed at Spartanburg, S. C. Participated in experiments No. 3 and No. 7.

S-EA.—Medical officers, 39 years. Stationed at Washington, D. O. Had an attack of renal colic August 14-22, 1916. Participated in experiment No. 5.

T-WF.—Medical officer, 28 years. Stationed at Columbia and Spartanburg, S. C. Participated in experiment No. 3.

W-CL.—Medical officer, 28 years. Stationed at New Orleans, La., up to September 12; at San Francisco after that date. Participated in experiment No. 6.

W-DG.—Assistant epidemiologist, 42 years. Stationed at Milledgeville, Ga. Participated in experiment No. 3,

W-GA. : —Medical officer, 31 years. Stationed at Spartanburg, S. 0. Participated in experiments No. 1, No. 3, and No. 7.

No. 1.

W-S.—White female admitted to United States Pellagra Hospital, Spartanburg, S. C, April 14, 1916. Hospital No. 191.

Salient clinical features . —Weakness, moderate skin lesions which first appeared April 7, 1916, moderate diarrhea.

Severity .—Rated by Dr. R. M. Grimm, the medical officer in charge, as a moderately acute first attack.

Experimental material . —Furnished blood and nasopharyngeal secretions on April 25 and epidermal scales and nasopharyngeal secretions on May 7.

No. 2.

M-FN—White male, Ward 4, Columbia State Hospital, Columbia, S. C. Service of Dr. J. T. Munnerlyn. Admitted February, 1916.

Salient clinical features .—History of illness of two years. Insane. Presents marked seborrhea of nose and lips. Dermatitis on both elbows, with encircling " areola " on left. Has about four soft movements a day.

Severity .—Rated by Dr. Munnerlyn as a " severe" case.

Experimental material .—Furnished feces on April 28, 1916.

No. 3.

L-JL.—White female, Ward A12, Columbia State Hospital, Columbia, S. C. Service of Dr. D. W. Register. Admitted February, 1916.

Salient clinical features .—Mental manifestations, eruption, red tongue.

Severity . —Rated by Dr. Register as a " severe " first attack.

Experimental material . —Furnished epidermal scales and urine April 28,1916.

No. 4.

M-MC—White female, Ward A12, Columbia State Hospital, Columbia, S. C. Service of Dr. D. W. Register.

Salient clinical features . —Mental manifestations, extensive eruption. History of an attack in 1914.

Severity . —Rated by Dr. Register as a " mild " second attack.

Experimental material . —Furnished epidermal scales and urine on April 28, 1916.

No. 5.

E-EA.—White male, admitted to United States Pellagra Hospital, Spartanburg, S. C, May 5, 1916. Hospital No. 24, 24a, 24b.

Salient clinical features . —History of first attack in 1908; present is ninth attack and is said to have begun about April 15, 1916. Presents mild skin and minor nervous manifestations, marked weakness, constipated.

Severity . —Rated by Dr. Grimm as a mild, acute ninth recurrence.

Experimental material . —Furnished nasopharyngeal secretion, urine, feces, and blood on May 7, 1916.

No. 6.

O-I.—White female, admitted to United States Pellagra Hospital, May 6, 1916. Hospital No. 195.

Salient clinical features . —Weakness, moderately severe skin manifestations, moderate " nervousness," vertigo, mild salivation. History of first attack April, 1915.

Severity . —Rated by Dr. Grimm as a moderately acute second attack.

Experimental material . —Furnished nasopharyngeal secretions, urine, feces, and blood on May 7, 1916.

No. 7.

S-H.—White male, 8 years old. Admitted to United States Pellagra Hospital April 26, 1916. Hospital No. 193.

Salient clinical features . —Severe extensive skin manifestations, some of moist type. Mentally dull and depressed. History of a first attack in spring of 1915.

Severity . —Bated by Dr. Grimm as a severe acute second attack.

Experimental material . —Furnished nasopharyngeal secretions, blood, urine, and feces on May 7, 1916.

No. 8.

S-M.—White female, 48 years old. Admitted to Washington Asylum Hospital, Washington, D. C, April 27, 1916. Service of Dr. W. M. Barton; resident physician, Dr. Reiss.

Salient clinical features . —Mild skin manifestations, beefy tongue, diarrhea, involuntary evacuations, disoriented, typhoidal.

Severity . —A typhoid-pellagra, fatal; died June 17, 1916.

Experimental material . —Furnished two specimens of feces for experiment on June 7, 1916. One, fairly liquid, was passed at 9 p. wj June 6; the second, more nearly solid, at 7 a. m. June 7. Also a specimen X>i urine drawn at 8.45 a. m. June 7.

For the experiment of June 8, besides the second of the preceding fecal specimens, which was preserved at air temperature, this patient furnished two additional stools, both fluid, one passed at 11.30 p. m. June 7 and the other at 7.15 p. m. June 8. Also a specimen of urine drawn at 8.45 a. m. June 8, 1916.

No. 9.

B-M.—Colored male, 74 years. Admitted to Charity Hospital, New Orleans, La., June 11, 1916, ward No. 31, bed 405. Service of Dr. I. I. Lemmon; resident physician, Dr. C. Dean.

Salient clinical features . —Minor nervous manifestations, mild dermatitis, history of loose bowels.

Severity . —A mild first attack.

Experimental material . —Furnished feces and urine. Stool, liquid, after saline purge, passed about 7.15 a. m.; urine drawn at 8 a. m., June 13, 1916.

No. 10.

K-L.—White male, 11 years. Admitted to Spartanburg County Farm June 16, 1916. Service of Dr. O. W. Leonard.

Salient clinical features . —Extensive marked skin manifestations; mild gastrointestinal symptoms.

Severity . —A well-marked first attack of moderate grade.

Experimental material . —Furnished urine and feces June 25, 1916.

No. 11.

K-OB.—White male, 43 years. Admitted to Spartanburg County Farm June 16, 1916. Service of Dr. O. W. Leonard.

Salient clinical features . —Extensive severe skin manifestations; mild buccal and gastric symptoms; constipated.

Severity . —A well-marked first atttack of medium grade.

Experimental material . —Furnished urine and feces June 25, 1916.

No. 12.

K-O.—White female, 9 years. Admitted to Spartanburg County Farm June 16, 1916. Service of Dr. O. W. Leonard.

Salient clinical features . —Extensive severe skin manifestations; marked diarrhea.

Severity . —A fatal first attack. Died August 25, 1916.

Experimental material . —Furnished urine and feces June 25, 1916.

No. 13.

S-JE.—White male, 37 years. Admitted to Spartanburg County Farm June 10. 1916. Service of Dr. O. W. Leonard.

Salient clinical features . —Has a history of pellagra extending over six to seven years; mental manifestations winter 1915-16.

Presents well-marked eruption; marked buccal and severe intestinal symptoms (watery diarrhea). Severity.—A chronic pellagra, fatal. Died August 1, 1916. Experimental material. —Furnished feces June 25, 1916.

No. 14.

J-M.—White female, 33 years. Out patient No. 43, United States Pellagra Hospital, Spartanburg, S. O. Came under observation June 19, 1916.