Goldberger Shows Pellagra Comes from Diet

In 1914, United States Surgeon General Rupert Blue assigned physician Joseph Goldberger to investigate pellagra, a debilitating disease that had become widespread across the American South. The condition caused painful skin eruptions and severe systemic deterioration. By 1912, South Carolina alone recorded 30,000 cases, with estimated mortality rates reaching 40 percent. Mainstream medical opinion largely attributed pellagra to an unknown infectious agent, reflecting the dominance of germ theory at the time. Other contemporaries speculated that poor sanitary conditions or genetic factors caused the affliction.

Goldberger began his inquiry by visiting institutions heavily affected by the disorder, including asylums and orphanages. He observed a crucial pattern: although inmates and patients regularly developed the disease, doctors, nurses, and attendants in the exact same environments never fell ill. This discrepancy persuaded Goldberger that pellagra was not contagious. Instead, he observed that sufferers were predominantly impoverished Southerners, particularly African Americans and sharecroppers, whose customary subsistence relied on nutrient-poor, corn-based foods without sufficient milk, fresh meat, or vegetables.