One of the most influential public health
figures of the period is Joseph Goldberger
In 1914 he was summoned by the surgeon
general to investigate
an especily baffling disease, ravaging the
American south.
It's called Pellegra.
The victims develop redish, rough skin
that often appears as a butterfly shaped
rash.
As the disease progresses, patients become
confused, hallucinate, and finally go
insane.
There have been tens of thousands of
deaths in the rural south
by the time Joseph Golderberger is
assigned the case.
"At the time it was a mystery disease
and people had many theories about
what caused it.
The most prominent theory was that it was
caused by eating corn.
and there were other people who
thought that it must be carried by
an insect.
This was fairly early on in the
bacteriological revolution, and so some
people thought that it was carried
by a bacteria.
But, no one knew."
Goldberger journey's through the south
to observe first hand the conditions
where Pellagra is most severe.
Everywhere he travels, the picture
is strikingly similar.
Desperately poor people,
working in cotton fields and textile mills
suffering from the disease.
Goldberger visits insane asylums,
and other state instituitions,
where alarming numbers of new cases
are being reported.
He knows the disease causes insanity.
Which might account for victims in asylums
but why is it so prevolent in orphanages,
and prisons?
And if it is an infectious disease
why isn't the staff getting sick as well?
"One would think that if this were a germ
disease, the germs certainly wouldn't
be aware of status boundaries.
Why would only the inmates get
Pellagra, and why never a nurse,
a physician, or a teacher?"
"And he began to look at what people ate,
and he was horrified at what he saw
because the diet was so miserable.
Not like anything he had ever seen before.
It was the diet of the southern frontier.
Consisting primarily of cornbread
fat back or pork, and syrup."
Goldberger is well aware of the recent
discoveries of chemical elements in food
called vitamins.
He also knows that diseases like scurvy,
and berry berry have been linked to vitamin
defficiencies, and he suspects Pellagra
may be the same kind of disease.
Goldberger decides to test his theory
at two orphanages full of Pellagra victims
in Jackson, Mississippi.
He starts by improving the childrens
meager diet,
with fresh vegatables, meat, and milk.
Foods rich in vitamins and proteins.
"And low and behold, much to his own
delight, the children who had Pellagra
got well, when their diets were changed,
and those who didnt have Pellagra, didnt
contract Pellagra after their diets
were changed. Well that was all well
and good, but it certainly wasn't
scientific evidence, and Golderberger
was very much aware of that."
Goldberger decides to show southerners
that he can actually give people pellagra
by simply changing their diet.
He persuades the governer of Mississippi
to pardon any convicts who volunteer
for a controlled diet experiement.
He chooses the Randkin prison farm,
because there are no cases of Pellagra
and plenty of room to isolate the convicts
from germs.
"They were moved to a special building,
that had special screens on the windows,
so that no insects could come in.
It was scrubbed once a week very carefully
they wore clean clothes every day.
The only thing that was different
about their lives, other than that,
was the food that they ate."
Six months later, seven of the eleven
prisoners break out with the
characteristic Pellagra rash.
Goldberger tells the pardoned men
which food they should eat to cure
their Pellagra. And then waits for public
acknowledgement of his breakthrough.
But acceptance doesnt come.
Some southerners even accuse him of
perpetrating a hoax.
When he links Pellagra to jobs that dont
pay enough for people to eat well
southerns only hear his social criticism,
not his medical reasoning.
Goldberger the scientist is stunned,
by what he sees as total irrationality.
Goldberger returns to the lab
and dedicates the rest of his life
to finding the specific cause of a disease
he already knows how to prevent and cure.
Eight years after Goldberger's death
scientists finally discovers that Niacin
a B complex vitamin can prevent the
disease. It's soon added to common foods.
Today there are no more cases
of Pellagra in the United States.
And hardly anyone knows this terrible
disease, ever existed.