Dr. Goldberger and the Great Pellagra Epidemic,Pellagra was a disease common in North American and E

Dr. Goldberger and the Great Pellagra Epidemic,Pellagra was a disease common in North American and Europe around the late 19th and early 20th century. Common symptoms included painful sores on the mouth and skin, diarrhea, and in severe cases dementia. Between 1900 and 1940 it is estimated that around 3 million people suffered from the disease causing 100,000 deaths in the United States alone. In 1914 a physician with the US Public Health Service named Dr. Joseph Goldberger was tasked with discovering the cause of the disease and coming up with a treatment or cure.  By the turn of the century pellagra cases were skyrocketing in the United States, with the vast bulk of cases occurring in the south. Originally born in Hungary, Dr. Goldberger was a veteran epidemiologist who had worked on cases all over North America, Central America, and the Caribbean, and had been infected with serious diseases such as typhus and yellow fever no less than five times. Just a hazard of the job.At the time pellagra was believed to be a communicable disease caused by bacteria or a virus.  However many doctors disagreed and after examining patients Dr. Goldberger likewise questioned it’s cause. Dr. Goldberg noted that almost all patients who had pellagra tended to have two things in common; first they were very impoverished or lived in a facilities such as asylums or orphanages. Second, they had a very inadequate diet. For most poor Southerners and those who were institutionalized, the common diet was cornbread and grits, with some meat, and if you were lucky canned vegetables. Since before the American Civil War southern agriculture was becoming more and more of a monocrop system dominated by cotton.  By the turn of the century cotton had almost drowned out all other crop production, and as a result fresh fruit, vegetables, and meat were no longer on the menu for poor sharecroppers. The resulting diet was severely deficient in protein, vitamins, and minerals. Dr. Goldberger hypothesized that pellagra was not a communicable disease, but caused by a dietary deficiency. To treat pellagra Dr. Goldberger began feeding patients a healthy diet full of fruit, vegetables, eggs, milk, and meat.  In no time the vast majority of patients quickly recovered.  Dr. Goldberger published his results but met harsh skepticism, particularly among southern politicians.  For them it seemed impossible that pellagra was a dietary efficiency. In essence Dr. Goldberger’s diagnosis was that pellagra was a socio-economic disease and it would be much more convenient if it was a communicable disease. Dr. Goldberger was challenging southern economics and the southern way of life.To further prove his theory Dr. Goldberger gathered a sample of 11 prison convicts who volunteered in exchange for forgiveness of their sentences. Dr. Goldberger sequestered the men and fed them a diet lacking nutrition for 6 months. As expected, six men showed symptoms of pellagra. Dr. Goldberger then fed them a healthy diet, the symptoms went away.Regardless, Dr. Goldberger’s results were ridiculed and ignored. Finally Dr. Goldberger decided to stage an experiment/publicity stunt to remove all doubt. Gathering together his friends, family, and colleagues he hosted a “pellagra party”.  The party consisted of activities including swabbing themselves in the noses with q-tips that had previously swabbed the noses and mouths of pellagra patients, injecting themselves with “pellagra infected” blood, then swallowing tablets filled with the urine, feces, and sore scabs of pellagra patients. None who attended were infected with pellagra. Based on Dr. Goldberger’s discovery President Warren G. Harding moved to set up a food program for southern states in order to combat pellagra. A lobby of southern governors and congressman responded by blocking the action, even going as far as to refuse government aid from food programs. Frustrated Dr. Goldberger continued his studies with the goal of finding a cheap cure, this time using dogs for medical experiments. Dr. Goldberger tried to feed the dogs a high cereal diet but the dogs wouldn’t eat the slop. So he flavored their food with brewers yeast.  Incredibly the dogs didn’t suffer from black tongue, the doggie version of pellagra. Dr. Goldberger changed the flavoring in the food, and suddenly the dogs developed black tongue. Dr. Goldberger had his cure but couldn’t isolate what exactly was in brewers yeast that prevented pellagra. He died in 1929 without ever finding the connection between brewers yeast and pellagra.  It wasn’t until 1937 that chemists discovered that it was niacin (vitamin B3) that was the cure and that pellagra is a result of a niacin deficiency.In 1941, as the United States entered World War II, the US Government feared that pellagra rates would increase as a result of wartime food rationing. A program was started to fortify foods such as flour and cereal with niacin to prevent pellagra. Many other countries would follow, and thus pellagra is a very rare condition in first world countries.  In poor, less developed countries however it still continues to be a menace.  -- source link

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