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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.