The chief symptoms of pellagra, which is associated with a deficiency of niacin or nicotinic acid, include a red inflammation of the skin, a burning red tongue and mouth, diarrhea, and, in late stages, some mental disturbance. Many people in backward areas of the United States live on diets consisting largely of corn meal, fat meat and molasses. The meat is usually salt pork or side meat. The chief deficiency in such diets is the lack of animal protein such as milk, cheese, lean meat, and eggs, and the failure of the diet in leafy green vegetables. Apparently exposure to sunlight of a person who is deficient in niacin brings out the symptoms.
Almost 7000 people died of pellagra in the United States in 1928. By 1946 the educational campaign on proper nutrition had been so effective that only 804 deaths were reported.
While few cases of the complete development of pellagra are seen nowadays, there may be many instances of beginning symptoms or what doctors call a “subacute condition.” First come such symptoms as fatigue and loss of appetite. Then, following exposure to the sun, the burning and stinging of the skin appears and next the soreness of the mouth and tongue. With these symptoms the patient is nervous, irritable, and finds difficulty in sleeping.
Since the condition is a deficiency disease, the treatment is primarily the taking of adequate amounts of niacin, which is now available in several forms. If the condition is severe the doctor will inject the niacin rather than give it by mouth. The diet can be provided with the important niacin-containing foods. The doctor will look after the patient’s skin condition and make sure that he gets proper nursing care during the severe symptoms of the disease. Some physicians give large doses of liver extract. With proper treatment patients improve rapidly.