Page:Tropical Diseases.djvu/479



Synonyms.— Pellarina, mal de la rosa, mal rosso, flema salada, Alpine scurvy, Asturian leprosy, Asturian rose, disease of the Landes, dermotagra, psilosis pigmentosa.

Definition.— An endemic disease of slow evolution, characterized by a complexity of nervous, alimentary, and cutaneous symptoms, which make their first appearance during the spring months (sometimes the autumn months), and recur year after year at the same season, remitting more or less during the winter months. It is for the most part confined to field-labourers. The more distinctive features are— (a) a remitting dermatitis of the ex- posed parts of the body; (b) marked emaciation; (c) profound depression alternating with mania.

Geographical distribution.— Europe: Pellagra has a wide distribution in Southern Europe. It is found in northern Portugal, in Spain, in Italy, in the south-west of France, in the Austrian Tyrol, in Hungary, Croatia, Dalmatia, Bosnia, Servia, Bulgaria, Turkey, Greece, Corfu, Roumania, Bessarabia, Kherson, and Poland. Sambon has shown that, though hitherto practically unrecognized, it prevails endemically throughout the British Isles.* Africa: