365: Chemistry for Life
DAY 35

Dr. Joseph Goldberger & the War on Pellagra

In 1915, Joseph Goldberger begins the experiment that demonstrates that pellagra is a dietary disease. Pellegra is caused by having too little niacin or VitaminB3 in the diet.

The molecular structure of vitamin B3

Credit: iStock

Eighty years ago, long before Dr. C. Everett Koop and a new generation of public health professionals suffered social criticism in their public health pronouncements on AIDS, Dr. Joseph Goldberger, Surgeon in the United States Public Health Service, was doing much the same thing. Even as Koop has been critical of personal behavior and social policies that could put populations at risk of acquiring the AIDS virus, Goldberger warned Americans about the crucial link between poor nutrition as the result of poverty and the onset of a scourge known as pellagra.

Pellagra was first identified among Spanish peasants by Don Gaspar Casal in 1735. A loathsome skin disease, it was called mal de la rosa and often mistaken for leprosy. Although it was not conclusively identified in the United States until 1907, there are reports of illness that could be pellagra as far back as the 1820s. In the United States, pellagra has often been called the disease of the four D’s — dermatitis, diarrhea, dementia, and death. National data is sketchy, but by 1912, the state of South Carolina alone reported 30,000 cases and a mortality rate of 40 percent. While hardly confined to Southern states, the disease seemed especially rampant there. Between 1907 and 1940, aprroximately three million Americans contracted pellagra and 100,000 of them died. A worried Congress asked the Surgeon General to investigate the disease. In 1914, Joseph Goldberger was asked to head that investigation.
Goldberger found no evidence for that hypothesis, but diet certainly seemed the crucial factor. Shipments of food which Goldberger had requested from Washington were provided to children in two Mississippi orphanages and to inmates at the Georgia State Asylum. Results were dramatic; those fed a diet of fresh meat, milk and vegetables instead of a com-based diet recovered from pellagra. Those without the disease who ate the new diet did not contract pellagra.

Visit the National Institutes of Health website to continue reading about Dr. Joseph Goldberger and the War on Pellagra.

Excerpted from the NIH Office of History, www.history.nih.gov