WEBVTT 00:00:05.585 --> 00:00:07.656 One of the most influential public health 00:00:07.656 --> 00:00:10.256 figures of the period is Joseph Goldberger 00:00:12.301 --> 00:00:14.491 In 1914 he was summoned by the surgeon 00:00:14.491 --> 00:00:15.818 general to investigate 00:00:15.830 --> 00:00:18.533 an especily baffling disease, ravaging the 00:00:18.533 --> 00:00:19.783 American south. 00:00:22.176 --> 00:00:23.582 It's called Pellegra. 00:00:25.452 --> 00:00:27.826 The victims develop redish, rough skin 00:00:27.826 --> 00:00:29.756 that often appears as a butterfly shaped 00:00:29.756 --> 00:00:30.536 rash. 00:00:34.887 --> 00:00:37.386 As the disease progresses, patients become 00:00:37.386 --> 00:00:39.963 confused, hallucinate, and finally go 00:00:39.963 --> 00:00:41.273 insane. 00:00:43.883 --> 00:00:45.611 There have been tens of thousands of 00:00:45.611 --> 00:00:47.291 deaths in the rural south 00:00:47.291 --> 00:00:49.321 by the time Joseph Golderberger is 00:00:49.321 --> 00:00:50.581 assigned the case. 00:00:52.581 --> 00:00:54.802 "At the time it was a mystery disease 00:00:54.802 --> 00:00:57.142 and people had many theories about 00:00:57.142 --> 00:00:58.162 what caused it. 00:00:58.162 --> 00:01:01.762 The most prominent theory was that it was 00:01:01.762 --> 00:01:03.963 caused by eating corn. 00:01:03.963 --> 00:01:05.592 and there were other people who 00:01:05.592 --> 00:01:07.332 thought that it must be carried by 00:01:07.332 --> 00:01:08.182 an insect. 00:01:08.750 --> 00:01:10.460 This was fairly early on in the 00:01:10.460 --> 00:01:12.660 bacteriological revolution, and so some 00:01:12.688 --> 00:01:15.008 people thought that it was carried 00:01:15.008 --> 00:01:16.088 by a bacteria. 00:01:16.427 --> 00:01:18.047 But, no one knew." 00:01:18.532 --> 00:01:20.528 Goldberger journey's through the south 00:01:20.528 --> 00:01:23.040 to observe first hand the conditions 00:01:23.050 --> 00:01:24.950 where Pellagra is most severe. 00:01:27.646 --> 00:01:29.315 Everywhere he travels, the picture 00:01:29.315 --> 00:01:30.458 is strikingly similar. 00:01:31.523 --> 00:01:33.183 Desperately poor people, 00:01:33.525 --> 00:01:35.885 working in cotton fields and textile mills 00:01:36.327 --> 00:01:38.137 suffering from the disease. 00:01:42.422 --> 00:01:44.552 Goldberger visits insane asylums, 00:01:44.552 --> 00:01:46.452 and other state instituitions, 00:01:46.485 --> 00:01:48.415 where alarming numbers of new cases 00:01:48.415 --> 00:01:49.455 are being reported. 00:01:49.602 --> 00:01:51.512 He knows the disease causes insanity. 00:01:51.715 --> 00:01:54.415 Which might account for victims in asylums 00:01:55.313 --> 00:01:57.603 but why is it so prevolent in orphanages, 00:01:57.603 --> 00:01:58.753 and prisons? 00:01:59.462 --> 00:02:01.377 And if it is an infectious disease 00:02:01.377 --> 00:02:03.857 why isn't the staff getting sick as well? 00:02:03.973 --> 00:02:06.593 "One would think that if this were a germ 00:02:06.593 --> 00:02:08.807 disease, the germs certainly wouldn't 00:02:08.807 --> 00:02:10.607 be aware of status boundaries. 00:02:12.417 --> 00:02:14.347 Why would only the inmates get 00:02:14.347 --> 00:02:16.467 Pellagra, and why never a nurse, 00:02:16.468 --> 00:02:17.818 a physician, or a teacher?" 00:02:18.277 --> 00:02:21.017 "And he began to look at what people ate, 00:02:21.017 --> 00:02:23.967 and he was horrified at what he saw 00:02:23.967 --> 00:02:26.137 because the diet was so miserable. 00:02:26.137 --> 00:02:28.500 Not like anything he had ever seen before. 00:02:28.667 --> 00:02:32.667 It was the diet of the southern frontier. 00:02:32.714 --> 00:02:36.344 Consisting primarily of cornbread 00:02:36.379 --> 00:02:40.379 fat back or pork, and syrup." 00:02:41.431 --> 00:02:43.586 Goldberger is well aware of the recent 00:02:43.586 --> 00:02:45.634 discoveries of chemical elements in food 00:02:45.634 --> 00:02:47.814 called vitamins. 00:02:47.959 --> 00:02:50.339 He also knows that diseases like scurvy, 00:02:50.344 --> 00:02:52.944 and berry berry have been linked to vitamin 00:02:52.944 --> 00:02:55.524 defficiencies, and he suspects Pellagra 00:02:55.534 --> 00:02:57.901 may be the same kind of disease. 00:03:00.003 --> 00:03:02.066 Goldberger decides to test his theory 00:03:02.066 --> 00:03:04.476 at two orphanages full of Pellagra victims 00:03:04.476 --> 00:03:05.810 in Jackson, Mississippi. 00:03:09.032 --> 00:03:10.756 He starts by improving the childrens 00:03:10.756 --> 00:03:11.826 meager diet, 00:03:11.826 --> 00:03:14.686 with fresh vegatables, meat, and milk. 00:03:14.686 --> 00:03:18.016 Foods rich in vitamins and proteins. 00:03:18.016 --> 00:03:20.286 "And low and behold, much to his own 00:03:20.286 --> 00:03:22.646 delight, the children who had Pellagra 00:03:22.862 --> 00:03:26.088 got well, when their diets were changed, 00:03:26.088 --> 00:03:29.065 and those who didnt have Pellagra, didnt 00:03:29.065 --> 00:03:31.922 contract Pellagra after their diets 00:03:31.922 --> 00:03:34.162 were changed. Well that was all well 00:03:34.162 --> 00:03:35.892 and good, but it certainly wasn't 00:03:35.892 --> 00:03:37.867 scientific evidence, and Golderberger 00:03:37.867 --> 00:03:39.937 was very much aware of that." 00:03:40.260 --> 00:03:42.188 Goldberger decides to show southerners 00:03:42.188 --> 00:03:44.437 that he can actually give people pellagra 00:03:44.437 --> 00:03:46.409 by simply changing their diet. 00:03:47.719 --> 00:03:49.581 He persuades the governer of Mississippi 00:03:49.581 --> 00:03:51.838 to pardon any convicts who volunteer 00:03:51.838 --> 00:03:55.179 for a controlled diet experiement. 00:03:56.393 --> 00:03:58.833 He chooses the Randkin prison farm, 00:03:58.833 --> 00:04:00.726 because there are no cases of Pellagra 00:04:00.726 --> 00:04:03.125 and plenty of room to isolate the convicts 00:04:03.125 --> 00:04:04.365 from germs. 00:04:06.182 --> 00:04:09.524 "They were moved to a special building, 00:04:09.524 --> 00:04:11.664 that had special screens on the windows, 00:04:11.664 --> 00:04:14.229 so that no insects could come in. 00:04:14.229 --> 00:04:17.037 It was scrubbed once a week very carefully 00:04:17.037 --> 00:04:20.286 they wore clean clothes every day. 00:04:20.286 --> 00:04:22.886 The only thing that was different 00:04:22.886 --> 00:04:24.932 about their lives, other than that, 00:04:24.932 --> 00:04:27.113 was the food that they ate." 00:04:28.596 --> 00:04:31.206 Six months later, seven of the eleven 00:04:31.206 --> 00:04:33.166 prisoners break out with the 00:04:33.166 --> 00:04:36.062 characteristic Pellagra rash. 00:04:36.926 --> 00:04:38.815 Goldberger tells the pardoned men 00:04:38.815 --> 00:04:40.527 which food they should eat to cure 00:04:40.527 --> 00:04:43.107 their Pellagra. And then waits for public 00:04:43.107 --> 00:04:46.722 acknowledgement of his breakthrough. 00:04:47.512 --> 00:04:50.372 But acceptance doesnt come. 00:04:50.372 --> 00:04:52.562 Some southerners even accuse him of 00:04:52.562 --> 00:04:53.943 perpetrating a hoax. 00:04:54.325 --> 00:04:56.432 When he links Pellagra to jobs that dont 00:04:56.432 --> 00:04:59.392 pay enough for people to eat well 00:04:59.392 --> 00:05:02.073 southerns only hear his social criticism, 00:05:02.073 --> 00:05:05.533 not his medical reasoning. 00:05:05.533 --> 00:05:08.993 Goldberger the scientist is stunned, 00:05:08.993 --> 00:05:12.993 by what he sees as total irrationality. 00:05:13.504 --> 00:05:15.976 Goldberger returns to the lab 00:05:15.976 --> 00:05:17.647 and dedicates the rest of his life 00:05:17.647 --> 00:05:20.237 to finding the specific cause of a disease 00:05:20.237 --> 00:05:23.470 he already knows how to prevent and cure. 00:05:24.081 --> 00:05:26.552 Eight years after Goldberger's death 00:05:26.552 --> 00:05:28.738 scientists finally discovers that Niacin 00:05:28.738 --> 00:05:31.030 a B complex vitamin can prevent the 00:05:31.030 --> 00:05:35.030 disease. It's soon added to common foods. 00:05:38.387 --> 00:05:40.261 Today there are no more cases 00:05:40.261 --> 00:05:42.708 of Pellagra in the United States. 00:05:43.828 --> 00:05:45.679 And hardly anyone knows this terrible 00:05:45.679 --> 00:05:48.319 disease, ever existed.