In view of the increasing prevalence of pellagra, I wish to make a brief report of two cases.
—The patient, a married woman, white, aged 30, had had no serious illness previous to the spring of 1907, when she had an eruption on the side of the neck and backs of her hands. This improved during the summer but recurred in the spring of 1908 and did not disappear as before. In November, 1908, the patient consulted me, complaining of weakness and dyspnea after exertion and of loss of memory. On Dec. 24, 1908, I saw the patient again and found a dermatitis resembling sunburn on the back of both hands and sides of the neck. In the center of this eruption was a reddish, shiny appearance of the skin, the edges having a brownish, dirty look. No other symptoms were noted except increasing loss of strength. A gastritis and enterocolitis soon followed with diarrhea and vomiting. There was lack of feeling in the stomach and. bowels. The bowel movements contained blood and mucus. The bladder was completely paralyzed and there was vaginitis. These symptoms grew steadily worse until the patient's death, Jan. 5, 1909.