Hi Colleen' Pellagra is a niacin deficiency disorder, that is characterized by the three "D"s...Diarrhea, Dermatitis, and Dementia. That's what they told us in nursing school twenty plus years ago. Early in the last century, pellagra was common in the Southern US among the poor who subsisted on corn-based diets. It seems that the niacin in corn is in a bound form, that cannot be absorbed by the body. Since the discovery of the cause of Pellagra, flours have been enriched with niacin, and the incidence of Pellagra has decreased dramatically. However in Asia and Africa Pellagra still occurs among the general population. It was common pratice to commit victims of Pellagra to mental institutions, for the confusion, anxiety, and paranoia that developed as a result of niacin deficiency. If I can be of any more help, let me know. Janice