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Arch Intern Med (Chic). 1909;II(6):553-568. doi:10.1001/archinte.1909.00050110050004.
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DEFINITIONS AND SYNONYMS.  Until the recent work of Searcy, in Alabama, and the epoch-making studies of Babcock, in South Carolina, pellagra had been practically unrecognized in this country, while it has been known and studied for nearly two centuries in the countries of southern Europe and the east, under the various names of mal de la rose, mal de misère, mal de sole, risipola estiva, erythema endemicum, Lombardian leprosy, mal de la spienza, mal del padrone, Balordone, elephantiasis italica, dermatagra, maidismus, psychoneurosis maidica.The word, "pellagra," compounded originally from the Italian pelle agra (rough skin), was first used by Frappoli, of Milan, as descriptive of the most characteristic skin lesion in the course of the disease. Pellagra may be defined as a systemic intoxication, associated always with the ingestion of maize or maize products and characterized by a triad of symptoms (gastrointestinal, cutaneous and neuropsychic), with marked tendency to seasonal


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