Voegtlin (40) selected the following diet (Diet A) for one hundred patients in the Pellagra Hospital at Spartanburg, S. C, who were suffering from mild and uncomplicated pellagra. He regards this as typical of the food supply of numerous homes where cases of pellagra are observed.

Diet A

Wheat bread ..... 300 grams.

Butter ......... 30

Cabbage ........ 100

Corn meal ...... 50

Ham ......... 25

Hominy ........ 75

Corn syrup .:..... 30

Pork ......... 50

Potatoes ....... 150

Prunes ........ 30

Turnip tops ...... 100

Sugar ......... 40

Milk ......... 40

Diet B

Wheat bread ..... 300 grams.

Butter ......... 45

Corn meal ...... 50

Eggs ......... 100

Meat ......... 100

Orange juice ..... 100

Potatoes ....... 150

Prunes ........ 30

Sugar ......... 40

Milk ......... 1000

Patients restricted to Diet A failed to improve or grew noticeably worse. They were later changed to Diet B, which differed essentially in containing much more milk, meat and eggs. Most cases showed definite improvement within two weeks, and within two months or more they were pronounced cured, except in a few more severe and advanced cases. The therapeutic value of the dietetic treatment was very spectacular.

Goldberger and Wheeler (41) undertook to determine whether adherence to a diet composed in great measure of milled cereal products, sugar, syrup, potatoes and fat meat would cause pellagra to develop in man. This was tested out on eleven healthy adult men in the Mississippi state prison in 1915. The men volunteered to submit to the test for the reward of pardon after six months' adherence to the experimental diet.

The following list of foods with their amounts, representing the diet per man per day for the week ending September 13,1915, is typical of the diets employed with a view to the experimental production of pellagra in man:

Corn meal ...... 253.0 grams.

Grits ........ 38.7

Corn starch ..... 34.0

Wheat flour ..... 150.3

Rice, polished.... 19.8

Cane syrup ..... 27.3

Cane sugar ..... 57.8

Sweet potatoes ... 100.0 grams.

Turnip greens .... 7.3

Cabbage ....... 10.7

Collards ....... 24.6

Pork fat ....... 1122

This was regarded as comparable in its constitution and quantitative relations with diets taken by pellagrins. With this diet Goldberger secured results which leave little room for doubt that men confined to it for a period of six months developed incipient signs of pellagra (41).

It is impossible to say, from a study of these diets why the two first mentioned should produce scurvy rather than pellagra. This is especially true of the diet of the miners of Rhodesia. It seems equally remarkable that the diet reported by Chamberlain caused beri-beri rather than pellagra, for so far as one can judge from the results of feeding experiments with animals, there are no special qualities in beef which could differentiate it from other foods in respect to any dietary essential which we should have reason to believe would induce a specific syndrome. The possibility is not excluded, of course, that pellagra is a disease which cannot be produced in those species of experimental animals which have been employed, because of the presence of synthetic powers of a specific type not possessed by man. The proof that the rat and prairie dog on certain diets can synthesize the antiscorbutic substance, affords an illustration of a case where this is true.