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Notes
a. Note:   Pellagra was first reported in the United States in 1902. Soon, pellagra and its accompanying dementia occurred in epidemic proportions in the American South. Poverty and dietary consumption of corn were the most frequently observed risk factors. Individuals with pellagra were felt to be infectious and were placed in facilities to protect the remainder of society. Dr. Joseph Goldberger of the US Public Health Service was assigned to perform research in a pellagra hospital and hypothesized that the clinical syndrome was the consequence of an inadequate diet. He then demonstrated that pellagra could be induced and prevented by dietary modification. Pellagra: a disease caused by deficiency of niacin or tryptophan (or by a defect in the metabolic conversion of tryptophan to niacin); characterized by gastrointestinal disturbances and erythema and nervous or mental disorders; may be caused by malnutrition or alcoholism or other nutritional impairments. Read more at http://www.wrongdiagnosis.com/p/pellagra/basics.htm?ktrack=kcplink


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