The Morbid Anatomy of Infantile Malnutrition in Cape Town

In recent years several detailed descriptions have been published of the morbid anatomical findings in malnourished children. Waterlow (1948) reported fatty liver disease from the West Indies and suggested that the children died from hepatic failure, while Davies in discussing kwashiorkor in Uganda (Trowell, Davies and Dean, 1954) felt that atrophy of the pancreas and other enzyme-secreting glands was the most important aspect of the condition, while the type of malnutrition seen in Johannesburg is still regarded as infantile pellagra by Gillman (Gillman and Gillman, 1951; Gillman and Gilbert, 1954). As a result of these papers one has an impression of several somewhat distinct pathological forms of malnutrition occurring in different parts of the world. These apparent distinctions, however, largely reflect differences of terminology and inter- pretation rather than of pathological findings, which, with the exception of those described in serous hepatosis, present a fairly constant pattern of retarded growth, fatty liver, pancreatic atrophy and skin lesions. The findings to be presented in this paper deviate only in their detail from this general pattern.