[Neurological changes related to malnutrition during the spanish civil war (1936-1939)]

In this lecture, given at the International Conferences on Neuroscience, in Quito, May 31st-June 1st of 2013, the topic of famine situations during the Spanish Civil War, 1936-1939, was approached. Madrid, the capital of Spain, was under food, water and milk rationing during that period. This situation led to conditions that showed the relationships between the nervous system and nutrition. The Madrilenian population was submitted to a real experiment of hyponutrition, similar to the one that may be reproduced at the laboratory. At the end of the war, the National Direction on Health and the Institute of Medical Investigations, with the collaboration of the Rockefeller Foundation, carried out a series of clinical and food consumption surveys among the Madrilenian population. There were three medical situations that were of particular relevance during the Civil War and after it: the pellagra epidemics, the onset of lathyrism, and the socalled Vallecas syndrome. The occurrence of pellagra cases was paramount because it allowed reconsidering all the unspecific symptoms observed from an already known vitamin deficiency. Pellagra became the most prevalent deficitrelated disease, and most clearly related to nutrition. Lathyrism is a chronic intoxication produced by the accumulation of neurotoxins. It is due to common intake of chickling peas (Lathyrus sativus). Chickling peas are toxic only if they represent more than 30% of the daily calories consumed for a prolonged period greater than two to three months. Lathyrism would reoccur in the Spanish population after the war, in 1941 and 1942, the so called "famine years", when due to the scarcity of foods chickling pea flour was again consumed in high amounts. Deficiency-related neuropathies observed in Madrid during the Civil War led to new and original clinical descriptions. In children from schools of the Vallecas neighborhood, a deficiency syndrome, likely related to vitamin B complex deficiency, was described, which manifested by muscle cramps and weakness, and was termed the Vallecas syndrome. Poor fat content in the diet and a light decrease in calcium levels, which were already very low, were observed in the group with cramps. Both the administration of tablets containing an adequate amount of calcium and phosphorus and the daily intake of 4-6 milligrams of thiamine, achieved a considerable reduction in the frequency and severity of the cramps, or their complete resolution.