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XXVII] they assign to the beginning of the eighteenth century, hold that the incriminated corn was not extensively cultivated until after the middle of the seventeenth century, ignoring all evidence of its cultivation, sale, and consumption between the middle of the sixteenth and the beginning of the seventeenth centuries. Although not recognized prior to the middle of the eighteenth century, there is every reason to believe that pellagra is as old as any other disease. Owing to the complex, protean, and frequently obscure nature of its syndrome, we lack definite information that might enable us securely to trace the history of pellagra in the medical records of the past; but wherever it occurs— in Italy, Spain, France, Roumania, Hungary, Egypt, the United States of America, the West India Islands those who first discovered it never claimed that it was a new disease, but invariably affirmed that it had long existed in the respective locality although confounded ' with other maladies. The wide range of pellagra throughout Europe at the time of its first recognition is irrefutable evidence of the antiquity of the disease, because pellagra is essentially a place-disease, and has never shown any disposition to spread after the manner of cholera and plague. It has been objected that if pellagra existed long before it was recognized, and if maize was introduced earlier than supposed, the possibility that they appeared together still remains, and the dates would merely be moved back. That is not so, because whilst maize was certainly not imported prior to the discovery of America by Columbus in 1439, there is strong scientific evidence to prove the great antiquity of pellagra, and, in any case, ample historical evidence to prove that the disease was widely distributed throughout both Spain and Italy at a time when maize could not have become a staple in the alimentation of either country.

Against the maize theory stand two decisive facts: (1) The occurrence of pellagra in people who have never eaten maize, as, for instance, in the British