- Person
- Joseph Goldberger
- Lived
- 1874–1929
- Field
- Epidemiology, public health
- From
- Hungarian-born American
The story
In the early 1900s pellagra was an epidemic in the American South. Its victims developed a burning rash, diarrhoea and dementia, and many died; asylums filled with patients whose minds the disease had destroyed. Between about 1906 and 1940 some three million Americans developed pellagra and roughly 100,000 died. Most experts believed it was an infection, spread by insects or poor sanitation.
In 1914 the Surgeon General gave the problem to Joseph Goldberger, a Hungarian-born Jewish doctor who had grown up on New York’s Lower East Side and had spent fifteen years fighting epidemics. Goldberger noticed that in institutions where pellagra raged, the inmates fell ill but the staff did not. A germ would not make that distinction; diet would. The patients lived on the cheap staples of Southern poverty: cornmeal, fatback and molasses.
He tested the idea. When he added fresh meat, milk, eggs and vegetables to the meals at two orphanages in Jackson, Mississippi, new cases stopped and almost all the sick children recovered. In 1915 volunteers at a Mississippi prison farm, offered pardons, ate a corn-based diet for about six months, and six of the eleven developed pellagra. To answer critics who still insisted on infection, Goldberger, his wife and other volunteers swallowed and injected material from pellagra patients; none fell ill. Surveys of South Carolina mill villages showed that pellagra tracked family income.
Southern leaders resented his message that their region’s disease came from poverty, and his methods, especially the prison experiment, fall short of modern ethical standards. But he kept going, found that cheap brewer’s yeast prevented and cured the disease, and in 1927 oversaw its distribution by the Red Cross to survivors of the great Mississippi flood. He died in 1929. In 1937 the missing factor was identified as the vitamin niacin. With better diets, economic recovery and the enrichment of flour with niacin, pellagra was nearly eliminated in the United States by the end of the 1940s.
Why it matters
Goldberger’s proof that pellagra is a disease of poor diet led to its prevention, and the enrichment of flour with niacin that followed protects people from it to this day.
About Joseph Goldberger
Immigrant public health doctor who proved that pellagra, which killed about 100,000 Americans, came from poverty and poor diet, not germs, pointing the way to its cure and prevention.
Sources
- The unwavering doctor who unraveled a medical mystery International Journal of Women’s Dermatology (PMC)
- The American South’s Deadly Diet Discover Magazine
- Achievements in Public Health, 1900–1999: Safer and Healthier Foods CDC MMWR
- Joseph Goldberger Wikipedia
Another act of tikkun olam. This is part of tikkun olam, the Jewish idea of repairing the world, and every one of us can add to it.