It is my purpose to record four cases of pellagra in San Francisco. (Three of the case reports were prepared by Dr. W. P. Goddard and one by Dr. H. H. Anderson, house officers in Mary's Help Hospital.) California is in the area of sporadic occurrence but many cases in this state are imported. The four cases reported here all developed in San Francisco.
Hein and Merrill (California and Western Medicine, May, 1919) give the following table showing the incidence of pellagra in the San Francisco County Hospital and in California as a whole from 1918 through 1927. Recurrences are excluded.
Hein and Merrill from 1924 to the spring of 1928 saw 29 cases of pellagra in the medical service of the University of California, covering one-half of the San Francisco County Hospital. They call attention to an increasing case incidence a definite predisposing influence of alcohol and gastro-intestinal disease, a predominant spring onset, and a majority of the Irish race.