Georgia. Some 200 or more physicians were interviewed and data obtained relating to a total of 1,426 cases. Two hundred and ninetysix pellagrous homes were personally visited and 323 pellagrins personally interviewed.1 The facts that apply to the total number of cases will be taken up. first; next, the additional facts that pertain to the cases personally seen will be given; finally, there will be presented a brief description of the districts visited, with a more or less full account of the pellagra situation in communities found in three of these districts. CONSIDERATION OF THE TOTAL NUMBER OF CASES. Distribution of cases. The total number of cases, including cases and deaths reported and cases personally seen, were distributed among the three States as follows: These figures can not be considered as indicating comparative prevalence of the disease in the three States, as they are in proportion to the lengths of time spent in each State, and are not in proportion to the number of counties visited nor to the territory covered. Race and sex. -The number of cases and deaths in the series is shown in the following table according to race and sex: The accompanying chart (Chart 1), which is constructed from the column of percentages in the above table, shows in a graphic way the The cases which are considered in this report are made up of the cases of three series, designated for the sake of reference "WKB," "SCY," and "SCG." When reference is made to individual cases the name of the series and the number of the case in its series are both given. difference in the numbers of cases in each race-sex group of the cases SHOWING THE RELATIVE NUMBERS OF WHITE FEMALES, WHITE In considering these results it must be remembered that this series of cases was collected in States where a large proportion of the population is colored and that in some of the communities visited. the negroes equal or probably outnumber the whites. The possibility that the negroes do not become ill enough from the disease to consult a physician does not seem sufficiently strong to explain this difference. In the districts which I visited pellagra seemed to spare the negro to a remarkable extent, and it was not unusual to find a physician who, although he had seen many cases of pellagra among the whites, had never seen one among the blacks. Once attacked, however, as will be seen below where insanity incidence and mortality rates are considered, negroes seem to be treated less kindly by pellagra than are the whites. The great preponderance in both races of affected females over males is another fact which so far is wanting a satisfactory explanation. Case mortality rate and insanity incidence.-In the table given below there is grouped with reference to race and sex the total number of cases, the number of deaths, and the number of insane cases in the whole series. Only the deaths and cases of insanity in pellagra which were reported to me by the physicians in the districts visited have been included here, since to have included the many cases seen at the State asylums of South Carolina and Georgia would have given erroneous results with reference to insanity incidence. The rates of case mortality and of insanity incidence for each race-sex group have been calculated and appear in the two columns so designated. The aggregates appear at the foot of each column. The case mortality rate and the rate of insanity incidence for the whole series of 1,426 cases and for each race-sex group is expressed graphically by charts (Charts 2, 3, and 4). In Chart 2 the total of 1,426 cases is taken as 100 per cent, and in Chart 3 the total number of cases in each race-sex group is taken as 100 per cent. The portions indicating the deaths and insane cases have been measured off in accordance with the percentages in the columns of mortality rate and insanity incidence. Chart 4 shows the proportional parts formed by the death and insane cases in each race-sex group compared absolutely with the same proportional parts in the other race-sex groups. SHOWING THE PERCENTAGES OF THE TOTAL NUMBER OF CASES INSANE CASES AND DEATHS BY RACE SEX. SHOWING THE PERCENTAGES IN EACH RACE-SEX GROUP FORMED BY THE SHOWING THE ABSOLUTE COMPARISON OF THE NUMBER OF DEATHS AND INSANE CASES IN EACH RACE-SEX GROUP WITH THOSE IN THE OTHERS. Age. In considering the subject of age, the white females, the white males, the colored females, and the colored males are taken up separately. The cases in each race-sex group are collected into 5-year age groups according to age. In the tables which follow there are shown in the various columns the total number of cases, the number of reported deaths, and the number of insane pellagrins in each age group for each race-sex group. The case fatality rates and the rates of insanity incidence for the age groups have not been calculated on account of the small number of cases in some of them. In the charts which accompany these tables (Charts 5, 6, 7, 8, and 9), there are shown for each race-sex group age, curves for the total number, for the deaths, and for the insane cases. In each curve the ordinate measures the number of cases and the abscissa the years of age. The charts are merely graphic representations of the results shown in the tables. All of the white female cases in the series are grouped in the following table according to age: 1 This age group includes those up to the end of the fifth year of life. 2 This age group includes those from the beginning of the sixth to the end of the tenth year of life |