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.