The following case of pellagra is of interest in that it was seen practically at the inception of the disease:
History.
—R. M., farmer, aged 65, first seen April 14, 1911, at the Asheville Free Dispensary, had been deaf for five years; otherwise his health had been good until within the last two weeks, during which time his appetite has been poor; he had suffered a little with eructations and sour stomach and had lost a little strength. He was given a "stomach mixture." Three days later he appeared with an erythema on the backs of both hands and lower part of forearms and complained of burning and itching in the inflamed area. The distribution of he erythema was symmetrical and "glove-like"; the skin was swollen, infiltrated and of a dull red color, pitting readily, and the redness disappearing temporarily on pressure. On the back of the right hand was