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One of the most influential public health

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figures of the period is Joseph Goldberger

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In 1914 he was summoned by the surgeon

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general to investigate

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an especily baffling disease, ravaging the

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American south.

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It's called Pellegra.

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The victims develop redish, rough skin

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that often appears as a butterfly shaped

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rash.

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As the disease progresses, patients become

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confused, hallucinate, and finally go

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insane.

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There have been tens of thousands of

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deaths in the rural south

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by the time Joseph Golderberger is

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assigned the case.

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"At the time it was a mystery disease

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and people had many theories about

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what caused it.

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The most prominent theory was that it was

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caused by eating corn.

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and there were other people who

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thought that it must be carried by

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an insect.

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This was fairly early on in the

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bacteriological revolution, and so some

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people thought that it was carried

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by a bacteria.

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But, no one knew."

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Goldberger journey's through the south

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to observe first hand the conditions

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where Pellagra is most severe.

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Everywhere he travels, the picture

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is strikingly similar.

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Desperately poor people,

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working in cotton fields and textile mills

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suffering from the disease.

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Goldberger visits insane asylums,

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and other state instituitions,

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where alarming numbers of new cases

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are being reported.

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He knows the disease causes insanity.

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Which might account for victims in asylums

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but why is it so prevolent in orphanages,

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and prisons?

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And if it is an infectious disease

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why isn't the staff getting sick as well?

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"One would think that if this were a germ

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disease, the germs certainly wouldn't

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be aware of status boundaries.

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Why would only the inmates get

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Pellagra, and why never a nurse,

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a physician, or a teacher?"

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"And he began to look at what people ate,

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and he was horrified at what he saw

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because the diet was so miserable.

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Not like anything he had ever seen before.

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It was the diet of the southern frontier.

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Consisting primarily of cornbread

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fat back or pork, and syrup."

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Goldberger is well aware of the recent

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discoveries of chemical elements in food

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called vitamins.

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He also knows that diseases like scurvy,

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and berry berry have been linked to vitamin

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defficiencies, and he suspects Pellagra

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may be the same kind of disease.

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Goldberger decides to test his theory

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at two orphanages full of Pellagra victims

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in Jackson, Mississippi.

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He starts by improving the childrens

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meager diet,

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with fresh vegatables, meat, and milk.

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Foods rich in vitamins and proteins.

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"And low and behold, much to his own

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delight, the children who had Pellagra

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got well, when their diets were changed,

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and those who didnt have Pellagra, didnt

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contract Pellagra after their diets

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were changed. Well that was all well

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and good, but it certainly wasn't

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scientific evidence, and Golderberger

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was very much aware of that."

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Goldberger decides to show southerners

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that he can actually give people pellagra

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by simply changing their diet.

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He persuades the governer of Mississippi

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to pardon any convicts who volunteer

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for a controlled diet experiement.

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He chooses the Randkin prison farm,

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because there are no cases of Pellagra

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and plenty of room to isolate the convicts

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from germs.

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"They were moved to a special building,

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that had special screens on the windows,

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so that no insects could come in.

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It was scrubbed once a week very carefully

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they wore clean clothes every day.

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The only thing that was different

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about their lives, other than that,

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was the food that they ate."

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Six months later, seven of the eleven

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prisoners break out with the

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characteristic Pellagra rash.

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Goldberger tells the pardoned men

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which food they should eat to cure

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their Pellagra. And then waits for public

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acknowledgement of his breakthrough.

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But acceptance doesnt come.

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Some southerners even accuse him of

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perpetrating a hoax.

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When he links Pellagra to jobs that dont

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pay enough for people to eat well

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southerns only hear his social criticism,

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not his medical reasoning.

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Goldberger the scientist is stunned,

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by what he sees as total irrationality.

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Goldberger returns to the lab

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and dedicates the rest of his life

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to finding the specific cause of a disease

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he already knows how to prevent and cure.

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Eight years after Goldberger's death

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scientists finally discovers that Niacin

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a B complex vitamin can prevent the

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disease. It's soon added to common foods.

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Today there are no more cases

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of Pellagra in the United States.

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And hardly anyone knows this terrible

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disease, ever existed.