Speaker 1: Welcome to Stuff You Missed in History Class, a production
Speaker 1: of iHeartRadio.
Speaker 2: Hello, and welcome to the podcast. I'm Tracy V. Wilson
Speaker 2: and I'm Holly Frye. Here is part two of our
Speaker 2: episode on pelagra, something I did not realize was going
Speaker 2: to need two parts when I started, I was totally
Speaker 2: unaware that there was a whole history of pelagor in
Speaker 2: Italy that took place before it really became a problem
Speaker 2: in the United States, and I was only aware of
Speaker 2: the US stuff before working on this. Last time, we
Speaker 2: talked about what pelagor is, its appearance and eventual maybe
Speaker 2: not disappearance, but like resolution in Italy, and some of
Speaker 2: the social and economic factors that led to a rise
Speaker 2: in pellagra in the Southern United States in the early
Speaker 2: twentieth century. Today, we're going to talk more about how
Speaker 2: pelagora became a huge public health problem in the United
Speaker 2: States and the efforts to find its cause and a
Speaker 2: solution for it. To be clear, we are mostly focused
Speaker 2: on the Southern United States here because that's where pelagora
Speaker 2: reached really epidemic levels, but pelagra could and did happen
Speaker 2: anywhere in the country that was facing poverty, and a
Speaker 2: lack of access to a range of foods. This episode
Speaker 2: includes some human and animal experimentation, and if you have
Speaker 2: listened to our episode on epotymous diseases from not that
Speaker 2: long ago, some of the human experimentation I would rank
Speaker 2: as about equivalent to how gross the experimentation was with neurovirus.
Speaker 2: There are also some experiments will be talking about that
Speaker 2: we're not so viscerally disgusting in that way, but they
Speaker 2: would not pass ethics review boards today.
Speaker 1: So as we said at the end of last episode,
Speaker 1: the first known report of pelagra in medical literature in
Speaker 1: the US was published in nineteen oh two, but investigations
Speaker 1: over the following decades revealed that there had been outbreaks
Speaker 1: going back to at least the first decades of the
Speaker 1: nineteenth century. Most of those nineteenth century outbreaks had taken
Speaker 1: place before medical textbooks in the US mentioned pelagra at all,
Speaker 1: so most American practitioners didn't know anything about it, and
Speaker 1: those patients had consequently been misdiagnosed. But after Henry Fauntleroy
Speaker 1: Harris's nineteen oh two description of a farmer who had
Speaker 1: been developing a debilitating illness with a rash, every spring
Speaker 1: for about fifteen years. Other reports soon followed.
Speaker 2: We also talked last time about the three ms of meal, molasses,
Speaker 2: and meat, which made up the bulk of the diets
Speaker 2: of a lot of the poorest people in the United
Speaker 2: States in the late nineteenth and early twentieth centuries. This
Speaker 2: included the diets of people who were living in institutions
Speaker 2: like mental asylums and orphanages, because they were generally being
Speaker 2: fed the cheapest food possible. One example was Mount Vernon
Speaker 2: Asylum for the Colored Insane in Mount Vernon, Alabama. This
Speaker 2: hospital had been established as a state run segregated mental
Speaker 2: hospital for black patients in nineteen hundred. Prior to that,
Speaker 2: it had been an arsenal and military barracks, and in
Speaker 2: that earlier time that's where physician Walter Reid had confirmed
Speaker 2: that yellow fever was transmitted by mosquitoes.
Speaker 1: Doctor George H. Searcy reported an outbreak of disease in
Speaker 1: eighty eight patients at the hospital in the early fall
Speaker 1: of nineteen oh six, publishing a paper on it in
Speaker 1: the Journal of the American Medical Association the following year.
Speaker 1: He said that these were not the first cases of
Speaker 1: pelagra at the hospital, that there had been a few
Speaker 1: cases every summer since patients were first transferred to the
Speaker 1: hospital in nineteen oh one, but that they had not
Speaker 1: been recognized as pelagra. When a much bigger outbreak started,
Speaker 1: doctors at the hospital had gone to Circe for help,
Speaker 1: and he reported that of those eighty eight cases, fifty
Speaker 1: seven had died, for a mortality rate of about sixty
Speaker 1: four percent.
Speaker 2: In his paper, sirirc described the disease as endemic and systemic,
Speaker 2: involving skin lesions and disturbance of the digestive tract and
Speaker 2: nervous system. He said it should be classed as food poisoning,
Speaker 2: similar to ergotism, which comes from eating food that's contaminated
Speaker 2: with ergate fungus, or latherism, which comes from eating large
Speaker 2: amounts of certain legumes that contain a neurotoxin. And he
Speaker 2: made an observation that would hold true in other outbreaks
Speaker 2: in the United States. Quote the disease occurs among the
Speaker 2: poorer classes and in institutions where the diet is at
Speaker 2: times limited. It develops most frequently among adults and in
Speaker 2: females more frequently than in males. Of the eighty eight
Speaker 2: patients at Mount Auburn eighty of them had been women,
Speaker 2: and two thirds had been at the hospital for more
Speaker 2: than a year. Eighty percent of them had experienced fair
Speaker 2: or good health before developing pelagra. Circi described pelagra as
Speaker 2: being caused by quote continuous eating of damaged corn and poverty.
Speaker 2: Poor hygienic surroundings, and exposure to the sun's rays have
Speaker 2: been given as predisposing factors. He specifically referenced the work
Speaker 2: of Cesar Lombroso, who we talked about in Part one,
Speaker 2: and the idea that pelagor was caused by eating spoiled
Speaker 2: or contaminated corn. He said he had sent a sample
Speaker 2: of the corn meal served at the hospital, which was
Speaker 2: supposedly the best meal that was being made in the West,
Speaker 2: to a plant pathology lab which had described it as
Speaker 2: quote whole unfit for human use, that it was made
Speaker 2: of moldy grain and contained quantities of bacteria and fungi
Speaker 2: of various sorts, some of which were identified. He went
Speaker 2: on to say, quote As for the treatment, there are
Speaker 2: no specific remedies. The essential management consists in placing the
Speaker 2: patient in good hygienic surroundings and trying to improve the
Speaker 2: general health by good nourishing foods, and such tonics as
Speaker 2: may seem indicated. Arsenic iron and pepsin preparations were the
Speaker 2: remedies on which most support was placed and which sometimes
Speaker 2: seemed to influence the disease favorably. The affected patients at
Speaker 2: the hospital were taken off of cornbread and grits and
Speaker 2: they were given wheat bread and potatoes instead, with no
Speaker 2: other changes to their diet. A set of eight unaffected
Speaker 2: patients were also placed on a diet of cornbread and
Speaker 2: grits as an experiment. One developed pelagra and another showed
Speaker 2: signs of the disease. All of them started to show
Speaker 2: signs of poor health, so their diets were changed. Also,
Speaker 2: sears ended his nineteen oh seven article by saying that
Speaker 2: he had heard the western corn crop of nineteen oh
Speaker 2: five had been damaged by wet weather, so that was
Speaker 2: what the hospital would have been using in nineteen oh
Speaker 2: six when the outbreak happened, so he had sent a
Speaker 2: sample of the corn they'd gotten in nineteen oh seven
Speaker 2: to the same lab to be tested. The lab said
Speaker 2: that this newer batch of corn was up to standards,
Speaker 2: so Searcy added it back into the patient's diets. Searce
Speaker 2: wrote that after his nineteen oh six report, other cases
Speaker 2: of pelagra had been identified at the Hospital for the
Speaker 2: Insane at Tuscaloosa, and that as there was more awareness
Speaker 2: of the disease, he expected more reports to follow. In
Speaker 2: nineteen oh eight, James Babcock, superintendent of the South Carolina
Speaker 2: Hospital for the Insane, traveled to Italy to see patients
Speaker 2: their first hand so that he could compare their conditions
Speaker 2: to what he was witnessing in South Carolina. This basically
Speaker 2: allowed him to confirm that he was also seeing pelagra.
Speaker 2: Bobcock also organized the first US Conference on pelagra, which
Speaker 2: took place on November third and fourth of nineteen oh nine.
Speaker 2: Almost four hundred physicians attended. In Italy, for the most part,
Speaker 2: there had been agreement that pelagora was caused by corn,
Speaker 2: but the medical community had been at odds over whether
Speaker 2: the issue was about nutrition or about some kind of
Speaker 2: toxin contaminating the corn. In the US, a different disagreement
Speaker 2: developed whether pelagora was caused by corn or whether it wasn't.
Speaker 2: This disagreement can be framed as the Zeus versus the
Speaker 2: anti Ziists, with Zeist coming from Zma's the scientific name
Speaker 2: for corn. Of the forty one speakers at this nineteen
Speaker 2: oh nine conference were Zeists, although many of them had
Speaker 2: very different explanations for the exact role that corn played
Speaker 2: in pelagra, and the anti ziists similarly had a lot
Speaker 2: of different reasons for thinking that the corn was not
Speaker 2: the cause. Some of them were motivated by the germ
Speaker 2: theory of disease and the fact that researchers had started
Speaker 2: identifying specific microorganisms that caused a range of diseases, including
Speaker 2: tuberculosis and cholera.
Speaker 1: These were things.
Speaker 2: People had previously attributed to things like environmental causes. Some
Speaker 2: were working off the idea that not only did microorganisms
Speaker 2: cause disease, but that every disease had one specific cause,
Speaker 2: said that that cause for all diseases was a microorganism.
Speaker 2: This was also happening during the eugenics movement in the
Speaker 2: United States dates, so there were people who thought pelagra,
Speaker 2: or at least a predisposition for pelagra, was the result
Speaker 2: of bad breeding.
Speaker 1: And some of the anti ziist response was more emotional.
Speaker 1: Much of the corn in the US was being grown
Speaker 1: in the Midwest, and a Midwestern sense of identity had
Speaker 1: started to coalesce. One that was centered on agriculture. The
Speaker 1: idea that Midwestern corn was causing illness was damaging to
Speaker 1: that sense of regional identity, and there were also obvious
Speaker 1: worries that connecting pelagra to corn would damage the corn
Speaker 1: industry and the Midwestern economy. This ran parallel to a
Speaker 1: sense of Southern pride and identity. Those three ms that
Speaker 1: we talked about in Part one of meal, meat, and
Speaker 1: molasses had formed the foundation of a lot of Southern cuisine.
Speaker 1: People wanted to find an explanation for pelagra that did
Speaker 1: not land on Southerner's own foods, which were close to
Speaker 1: their hearts making them sick. Also, pelagra, hookworm, and malaria
Speaker 1: were all prevalent in the South at this point. All
Speaker 1: of these could cause symptoms like diarrhea, abdominal pain, fatigue,
Speaker 1: and malaise. These diseases themselves all carried a lot of stigma,
Speaker 1: and all this had fed into negative stereotypes of Southerners
Speaker 1: as lazy. So the idea that people were to blame
Speaker 1: because of what they were eating was like adding insult
Speaker 1: to injury. The attendees at the first conference on pelagra
Speaker 1: resolved to start a national Association for the study of Pelagra,
Speaker 1: and Babcock was elected as its president. Also in nineteen
Speaker 1: oh nine, the US Public Health Service, at the time
Speaker 1: part of the Marine Hospital Service, appointed doctor Claude Lavender
Speaker 1: to head up the service's study of pelagra. Lavender worked
Speaker 1: with Babcock to translate Cesar Limbroso's Italian were on pellagra
Speaker 1: into English. A wave of research into pelagor followed this,
Speaker 1: but it was not initially productive, and we will talk
Speaker 1: about why after a sponsor break. A lot of the
Speaker 1: writing on pelagra in the United States in the first
Speaker 1: decade of the nineteen hundreds had drawn on Italian work
Speaker 1: that had connected the disease to corn consumption in some way.
Speaker 1: But then in nineteen ten, the London School of Tropical
Speaker 1: Medicine published a report saying that pelagor was caused by
Speaker 1: a microbe that was being spread by insects. A Pelagra
Speaker 1: Investigation Committee had been established in the UK that year,
Speaker 1: and it had funded a research trip to Italy that
Speaker 1: was carried out by physician Lewis Sambon. Sambon had been
Speaker 1: born in Italy and had moved to the UK to
Speaker 1: head up the School of Tropical Medicine. His earlier work
Speaker 1: included the study of sleeping sickness in Uganda. He had
Speaker 1: correctly concluded that sleeping sickness was caused by a parasite
Speaker 1: that was transmitted by the Sizi fly. In his pelagra study,
Speaker 1: he noted some commonalities between pelagra and insect born diseases
Speaker 1: like sleeping sickness, and concluded that it was not about
Speaker 1: the corn, that it was a disease carried by some
Speaker 1: kind of biting insect, probably gnats, that were also common
Speaker 1: in the same rural areas where corn was a big
Speaker 1: part of people's diets. In Italy, pelagra had become much
Speaker 1: less common, and the general consensus for decades had been
Speaker 1: that it was corn related, So this report really did
Speaker 1: not get a lot of traction there. Many Italian doctors
Speaker 1: dismissed it entirely, even calling it absurd. But in the US,
Speaker 1: Sambon's conclusion really appealed to all the researchers who were
Speaker 1: looking for some kind of explanation for pelagra that did
Speaker 1: not trace back to Midwestern corn or southern diets. This
Speaker 1: included the state of Illinois, whose Investigatory Commission on Pelagra
Speaker 1: was established in nineteen ten and largely focused on Sambon's work.
Speaker 2: My read on this is that Simbon's conclusions on pelagra
Speaker 2: were really influenced by his own preconceptions based on his
Speaker 2: earlier successful work on insect born diseases, and this may
Speaker 2: have also been true for one of the commissions that
Speaker 2: started studying pelagra in the nineteen teens. That was the
Speaker 2: Thompson McFadden Commission, named for its two primary funders, Robert M. Thompson,
Speaker 2: who was in mining, and Henry McFadden, who was a
Speaker 2: cotton merchant. Both of these men had a vested interest
Speaker 2: in determining a cause and treatment for pellagra, since it
Speaker 2: was prevalent in the mining camps and mill towns where
Speaker 2: the workers in their industries lived.
Speaker 1: The researchers who were part of this commission carried out
Speaker 1: their work in and around Spartanburg, South Carolina, where local
Speaker 1: officials agreed to cooperate and where the situation was critical.
Speaker 1: There were about thirty thousand reported cases of pelagra, with
Speaker 1: a fatality rate of about forty percent. Investigators went house
Speaker 1: to house asking about who lived there, their ages and sexes,
Speaker 1: whether any of them had pelagra, and what they ate.
Speaker 1: Doctors also diagnosed cases of pelagra during these visits.
Speaker 2: The primary investigators for this commission were all microbiologists, and
Speaker 2: they discounted links to things like economic conditions and the
Speaker 2: maize and the gnats that Sambon had cited before, focusing
Speaker 2: on trying to pinpoint a specific microbial cause. In their
Speaker 2: second progress report, they didn't name a specific cause for pelagra,
Speaker 2: but they reported that pelagora rates were the highest in
Speaker 2: the places that did not have an enclosed sewer system
Speaker 2: and people were using unscreened privies. Also, if one person
Speaker 2: in a household had pelagra, usually at least one other
Speaker 2: person had it as well. They wrote, quote, we are
Speaker 2: inclined to regard intimate association in the household and the
Speaker 2: contamination of food with the excretion of pelagrons as possible
Speaker 2: moods of distribution of the disease. Pelagrins was the term
Speaker 2: being used to describe people with pelagra, so these researchers
Speaker 2: were saying that pelagra spread from person to person when
Speaker 2: the waste of someone with pelagra contaminated the food other
Speaker 2: people were eating. That contamination was spreading in neighborhoods where
Speaker 2: there was no sanitary system for dealing with human waste.
Speaker 2: They also noted some of the same demographic patterns as
Speaker 2: Henry Fauntleroy Harris had in his nineteen oh two paper
Speaker 2: that we talked about earlier. Polagor was far more common
Speaker 2: in women. They reported five hundred twenty eight cases in
Speaker 2: women and two hundred twelve in men. They also found
Speaker 2: far more cases among white people than among black people,
Speaker 2: but noted that the cotton mill villages that they were
Speaker 2: researching were almost exclusively white. Yeah, when you looked at
Speaker 2: a broader sample of the population, it was the opposite.
Speaker 2: It was a lot more common among black people. They
Speaker 2: just were looking at a sample that was mostly white.
Speaker 2: A sewer system was built in Spartan Mills, after which
Speaker 2: pelagora rates there did start to decline, and so this
Speaker 2: wound up reinforcing the idea that the sanitary conditions had
Speaker 2: been involved in the polagrasp. One possible explanation for why
Speaker 2: this sewer system quote worked is that the building of
Speaker 2: the sewer brought some more money into the town, which
Speaker 2: allowed people to buy a richer variety of food. But
Speaker 2: we don't really know. The connection to the sewers wasn't
Speaker 2: about some kind of waste contamination that was contaminating the food.
Speaker 2: It was that the people that were living in places
Speaker 2: that were so poor that they had no sewer system
Speaker 2: couldn't afford to buy a richer variety of food. Just
Speaker 2: to make that clear, the Thompson McFadden Commissions reports deepened
Speaker 2: the division between the Zeists and the anti Ziists. Claude Lavender,
Speaker 2: who had been heading up the government's response to the disease,
Speaker 2: wrote in a nineteen thirteen report quote, it is not
Speaker 2: to be understood from them that there are only two
Speaker 2: theories of the cause of pelagra. On the contrary, there
Speaker 2: are scores of theories. The Zeists agree in one thing only,
Speaker 2: and that is that, either directly or indirectly, pelagra is
Speaker 2: ideologically related to MAZE, while the Antiziists agree in one
Speaker 2: thing only, and that is that the disease bears no
Speaker 2: such relation to MAZE. The Zeists, however, do not agree
Speaker 2: among themselves, nor do the Antisiasts show any more harmony
Speaker 2: in their views. Without going into the details of the
Speaker 2: various theories and shades of opinion, it may be said
Speaker 2: that the great struggle now centers around the question is
Speaker 2: pelagra a kind of food poisoning from maze? Or is
Speaker 2: it due to some parasite infecting the human body. In
Speaker 2: nineteen twelve, which was the same year that the Thompson
Speaker 2: McFadden Commission started its investigation, Polish biochemist Casimir Funk coined
Speaker 2: the word vitamin as vital amines, and he connected deficiencies
Speaker 2: in these vital amines to diseases. He noted similarities among
Speaker 2: them pelagra, berry berry, ricketts, and scurvy, all of which
Speaker 2: are understood as vitamin deficiency diseases today. He observed that
Speaker 2: these diseases tended to erupt in countries where quote a
Speaker 2: certain unvarying diet is partaken for long periods. People had
Speaker 2: already figured out that barry berry, which is a thiamin deficiency,
Speaker 2: could be treated and prevented with rice brand and that scurvy,
Speaker 2: which was a vitamin sea deficiency, could be treated with
Speaker 2: a variety of fresh fruits and vegetables. We have a
Speaker 2: whole episode on scurvy. Funk argued that there was probably
Speaker 2: a dietary treatment for pelagra as well. By nineteen fourteen,
Speaker 2: Claude Lavender had not been successful in finding a definite
Speaker 2: cause for pelagra, and he asked to be assigned to
Speaker 2: other work. US Surgeon General Rupert Blue appointed doctor Joseph
Speaker 2: Goldberger as his replacement. Goldberger was from a Jewish family
Speaker 2: from the Austro Hungarian Empire who had moved to the
Speaker 2: United States when he was about nine. After becoming a doctor,
Speaker 2: he had worked in private practice for a while before
Speaker 2: joining the United States Marine Hospital Service. He had worked
Speaker 2: as an immigration inspector in the Port of New York
Speaker 2: before moving on to studying and fighting infectious diseases. He
Speaker 2: had fought outbreaks of yellow fever, dengey fever, and typhoid,
Speaker 2: among others.
Speaker 1: When he was appointed to study pelagra, he was in
Speaker 1: Detroit helping to fight a diphtheria outbreak. Yeah.
Speaker 2: His public health and infectious disease work has been described
Speaker 2: as like monumental and heroic. He did a ton and
Speaker 2: a lot of it. He was doing at risk to
Speaker 2: his own health. That same year, the State Sanitarium in Millageville, Georgia,
Speaker 2: was in the middle of a pelagora crisis. Almost two
Speaker 2: hundred people had died and pelaga had passed tuberculosis as
Speaker 2: the leading cause of death at the hospital. The federal
Speaker 2: government had started to see the situation as really urgent
Speaker 2: and Goldberger was given a budget of eighty thousand dollars
Speaker 2: for his investigation that was out of the entire US
Speaker 2: public health budget of two hundred thousand dollars.
Speaker 1: Goldberger studied conditions at the hospital and noticed something that
Speaker 1: George H. Searcy had also described in his reports on
Speaker 1: the pelagra outbreak at Mount vernonn Asylum, almost a decade before.
Speaker 1: Pelagor was affecting only the patients, not staff. Staff were
Speaker 1: in close contact with the patients all day, and some
Speaker 1: of them lived at the facility. If the disease had
Speaker 1: been communicable, whether it was being spread through insects or
Speaker 1: some other vector, it would have affected staff as well. Theoretically,
Speaker 1: staff and patients were eating the same food, but Goldberger
Speaker 1: learned that the staff were served first, so they usually
Speaker 1: took the best food for themselves, and the staff also
Speaker 1: had options to supplement their diets beyond what the hospital served.
Speaker 1: Although most of Goldberger's background was in infectious diseases, he
Speaker 1: started researching pelagra as a possible nutritional deficiency. This is
Speaker 1: where we will get to the human experimentation that we
Speaker 1: talked about at the beginning of the show and some
Speaker 1: of its fairy growths. We'll have more on that after
Speaker 1: a sponsor break.
Speaker 2: In nineteen fourteen, Joseph Goldberger started polagor research at two
Speaker 2: orphanages in Jackson, Mississippi, where more than two hundred total
Speaker 2: children had developed the disease during the spring and summer.
Speaker 2: He found that pelagra only seemed to affect children between
Speaker 2: the ages of six and twelve, and they were all
Speaker 2: mostly eating biscuits, grits, corn meal, and syrup. I'm not
Speaker 2: sure if the syrup was his word for molasses, but
Speaker 2: something sugary and syrupy. Even though the general conditions at
Speaker 2: the orphanages were not good in terms of things like
Speaker 2: sanitation and overcrowding and overall health, he left those conditions
Speaker 2: as they were for the sake of this experiment.
Speaker 1: At both orphanages. In his words quote, a very decided
Speaker 1: increase was made in the proportion of the fresh animal
Speaker 1: and of the leguminous protein foods. This included milk, eggs, beans,
Speaker 1: and peas, and at breakfast the children were served oatmeal
Speaker 1: rather than corn grits. Other foods were added as well.
Speaker 1: After the implementation of this diet, the children were observed
Speaker 1: for a year. One of the orphanages had no recurrences
Speaker 1: of pelagra the following spring and summer. The other had
Speaker 1: just one. A similar experiment with similar results was carried
Speaker 1: out at the Georgia State Sanitarium in nineteen fifteen. Goldberger
Speaker 1: began reporting his results in the Southern Medical Journal and
Speaker 1: in public health reports. This research strongly suggested that a
Speaker 1: diet containing a variety of foods could prevent pelagra, and
Speaker 1: he wanted to confirm whether pelagra could also be induced
Speaker 1: through diet.
Speaker 2: He worked with Earl Brewer, Governor of Mississippi, to arrange
Speaker 2: an experiment at Rankin State Prison Farm, which did not
Speaker 2: have a history of pelagra among the people incarcerated there.
Speaker 2: Twelve healthy men were recruited from this study, although one
Speaker 2: of them was found to have a previously undetected medical
Speaker 2: condition and he was dismissed. These men were offered pardons
Speaker 2: for their participation that would be seen as unethical and
Speaker 2: coercive today. They were placed on a largely corn based diet,
Speaker 2: and after about five five months, six of them had
Speaker 2: developed the rash that is characteristic of pelagra. So this
Speaker 2: supported the idea that a primarily corn based diet could
Speaker 2: cause pelagra. Goldberger's conclusions really inflamed a lot of the
Speaker 2: cultural responses that we talked about earlier. While there were
Speaker 2: some Southern leaders and advocates who called for food aid
Speaker 2: to the South to combat any dietary deficiencies, many many
Speaker 2: others were outraged. This was fueled by attitudes dating back
Speaker 2: to before the Civil War and reinforced during reconstruction, and
Speaker 2: perceptions that a Jewish New Yorker seen as a paternalistic,
Speaker 2: moralizing outsider, had come to pass judgment on the South,
Speaker 2: its people, and its food. Anti ziasts doubled down on
Speaker 2: the insistence that this wasn't about food, and it specifically
Speaker 2: wasn't about corn, and that there must be an infectious
Speaker 2: agent at work. Yeah. Some of the tone of this
Speaker 2: conversation at the time was basically Goldberger saying, there is
Speaker 2: famine in the South and we need to take action
Speaker 2: to save people's lives, and his most vocal critics were like,
Speaker 2: that is an insult.
Speaker 1: How dare you? Defensiveness will make people do really foolish things.
Speaker 1: Uh huh.
Speaker 2: So, based on these criticisms, on April twenty sixth of
Speaker 2: nineteen sixteen, Goldberger started a series of experiments to try
Speaker 2: to prove that no, there was not an infectious agent
Speaker 2: at work. Most of the seventeen participants in these experiments
Speaker 2: were doctors, but one of them was also his wife.
Speaker 2: They intentionally exposed themselves to the bodily fluids of pelagora patients,
Speaker 2: including their blood and swabs from their noses and throats.
Speaker 2: They also exposed themselves to skin from the patient's This
Speaker 2: happened through things like injections and compounded pills that they swallowed. Basically,
Speaker 2: if you can imagine a way to get material from
Speaker 2: one person's body into another, they tried.
Speaker 1: That.
Speaker 2: These were nicknamed filth parties. No one got pelagor from them.
Speaker 2: Did they get other things though? Did they get hepatitis?
Speaker 1: I don't know. Uh. Even so, in November of that year,
Speaker 1: there were doctors at the Southern Medical Association annual meeting
Speaker 1: who still maintained that Goldberger was wrong. In particular, South
Speaker 1: Carolina State health officer James A. Hayn insisted that pelagra
Speaker 1: was infectious. He continued to publicly criticize Goldberger and his
Speaker 1: findings for years, no matter how much evidence was presented
Speaker 1: or how that evidence was framed. He later compared Goldberger
Speaker 1: to fascist dictator Benito Mussolini and described his ideas as
Speaker 1: having been quote rammed down their throats.
Speaker 2: Good thing. We've been talking about stuff rammed down our
Speaker 2: throats for more than a century.
Speaker 1: My least favorite phrase on the planet.
Speaker 2: Perhaps. Also in nineteen sixteen, Goldberger started working with a
Speaker 2: team to study the relationship between pelagra and the Southern economy.
Speaker 2: His collaborators included Edgar Seidenstricker, who had a background in
Speaker 2: labor economics and was a statistician. Their work was deeply
Speaker 2: critical of the exploitive systems that were at work in
Speaker 2: the South, including sharecropping and the cotton monoculture. Another researcher,
Speaker 2: carl A. Grot, also studied the mining camps in Walker County, Alabama,
Speaker 2: and confirmed that pelagor was not affected by a person's
Speaker 2: heredity or their race, but that rates of the disease
Speaker 2: were directly correlated with income, making the food that people
Speaker 2: could afford the most likely explanation. One of the criticisms
Speaker 2: of Goldberger's work was that it had been carried out
Speaker 2: in the controlled settings of orphanages and asylums, so in
Speaker 2: nineteen eighteen he did his own mill studies as the
Speaker 2: Thompson McFadden Commission had done. He selected seven cotton mill
Speaker 2: villages in South Carolina and screened every person in every
Speaker 2: household for pelagra. Everyone was very poor, but the households
Speaker 2: in which at least one person had pelagra were the
Speaker 2: ones were there was little to no animal protein in
Speaker 2: their diets, although what they were eating wasn't necessarily limited
Speaker 2: to just corn. Through all of this, pelagor rates had
Speaker 2: continued to rise and fall in conjunction with changes in
Speaker 2: economic factors and food availability. So, for example, a bull
Speaker 2: weavil infac station in Alabama in nineteen fifteen led to
Speaker 2: them spiking. Although the disease was most prevalent in the South,
Speaker 2: it could be found all over the US, really anywhere
Speaker 2: that people could not afford a variety of food and
Speaker 2: were just subsisting on one specific staple.
Speaker 1: But then, over the late nineteen teens and early nineteen twenties,
Speaker 1: researchers including Goldberger, Russell, Henry Chittenden, and Frank pell Underhill
Speaker 1: found one particular thing that seemed to prevent pelagra. Brewers yeast,
Speaker 1: which we know today is high in protein, B vitamins,
Speaker 1: and other nutrients. This discovery came from experiments on pelagra
Speaker 1: in dogs. It was difficult to induce pelagra in dogs
Speaker 1: because most dogs don't want to eat nothing but corn meal,
Speaker 1: so researchers were using brewers yeast to try to stimulate
Speaker 1: their appetites. It turned out the brewers yeast protected them
Speaker 1: from developing pelagon.
Speaker 2: Yeah. Goldberger had also at the same time been systematically
Speaker 2: trying to find something that would work as a protective
Speaker 2: and then this happened with the dogs. Brewers yeast was
Speaker 2: also inexpensive, and Goldberger started advocating for the use of
Speaker 2: brewers yeast to treat and prevent pelagra. When the Mississippi
Speaker 2: River flooded in nineteen twenty seven, causing immense destruction and
Speaker 2: widespread crop devastation, Goldberger warned that there would probably be
Speaker 2: an increase in pelagor rates to follow. He called for
Speaker 2: education about the use of brewers yeast and distribution of
Speaker 2: brewers yeast to affected communities. The Red Cross delivered twelve
Speaker 2: thousand pounds of brewers yeast to flood affected areas. There
Speaker 2: was still widespread malnutrition in the wake of this flood,
Speaker 2: and there were also racial disparities as black people were
Speaker 2: kept out of a lot of the relief camps, but
Speaker 2: Goldberger is credited with helping to mitigate some of the
Speaker 2: worst outcomes of this catastrophe. While some of the South
Speaker 2: had been reluctant to accept a dietary explanation of pelagra
Speaker 2: or to ask for or accept food relief, this flood
Speaker 2: was truly a massive disaster. It was so huge in
Speaker 2: scale and devastation that it removed some of the stigma
Speaker 2: around asking for help, especially asking for food help. Afterward,
Speaker 2: many of the doctors who had kept looking for an
Speaker 2: infectious cause of pelagra were more willing to accept that
Speaker 2: it was caused by a nutritional deficiency. The Red Cross
Speaker 2: also continued to deliver Brewers yeast, distributing five hundred thousand
Speaker 2: pounds of it over the next decade. On October thirty first,
Speaker 2: nineteen twenty eight, Goldberger gave a speech before the American
Speaker 2: Dietetic Association in which he said, quote, the problem of
Speaker 2: pelagra is, in the main a prime problem of poverty.
Speaker 2: Education of the people will help, but improvement in basic
Speaker 2: economic conditions alone can be expected to heal this festering
Speaker 2: ulcer in the body of our people. But much of
Speaker 2: the effort to cure pelagra prevent it societally did not
Speaker 2: involve trying to reduce poverty. There definitely were efforts to
Speaker 2: provide food aid and other assistants during the Great Depression
Speaker 2: and other times of crisis, and there were various anti
Speaker 2: poverty programs, But the bigger and more long term focused
Speaker 2: involving pelagra was on fortifying food. Biochemist Conrad Elvihim isolated
Speaker 2: niacin also called vitamin B three in nineteen thirty seven.
Speaker 2: By nineteen thirty eight, bakers had started voluntarily producing bread
Speaker 2: using a high vitamin yeast, which helped reduce pelagra rates.
Speaker 2: As synthesized vitamins became less expensive of bread products and
Speaker 2: other foods were fortified with vitamins directly. A lot of
Speaker 2: this was like what we discussed in our episode on
Speaker 2: the iodization of salt, voluntary efforts by food producers and
Speaker 2: state laws requiring fortification. This continued into the nineteen forties,
Speaker 2: with twenty eight states passing some kind of mandatory law
Speaker 2: for fortifying bread or flour between nineteen forty two and
Speaker 2: nineteen forty nine. I was telling my spouse about what
Speaker 2: this episode was about, and he said, is that why
Speaker 2: they spray vitamins on breakfast cereal. Yes, I mean other
Speaker 2: deficiencies too, But yes, economic systems also changed during those decades. Obviously,
Speaker 2: poverty still exists. There are still food deserts where people
Speaker 2: cannot get access to the foods that they need to
Speaker 2: eat to live. But the sharecropping system started to fade
Speaker 2: in the wake of the mechanization and industrialisation of the
Speaker 2: farm industry in the nineteen thirties and forties. That of
Speaker 2: course caused its own disruption to people's lives and circumstances,
Speaker 2: but it did mean that people were not in a
Speaker 2: situation where they were sharecropping and they could only get
Speaker 2: food at a commissary. Following cotton prices in the nineteen
Speaker 2: thirties also led to some diversification in the crops that
Speaker 2: were being planted. The payment of wages in scrip, which
Speaker 2: had been common in mill towns and mining towns and
Speaker 2: locked people into buying their food only from a company
Speaker 2: store and nowhere else. That was outlawed under the Fair
Speaker 2: Labor Standards Act of nineteen thirty eight. With food fortification
Speaker 2: and social and economic shifts, the pelagri crisis in the
Speaker 2: US was largely over by the start of World War II,
Speaker 2: but between nineteen oh six and nineteen forty there had
Speaker 2: been approximately three million cases and one hundred thousand deaths
Speaker 2: from the disease. About half of those deaths were among
Speaker 2: black people, and about two thirds of them were women.
Speaker 2: This was something that some of the researchers, including Goldberger,
Speaker 2: commented on at the time. Because of ongoing patterns of
Speaker 2: racism and bigotry, black people in any given community tended
Speaker 2: to be in the poorest class, with the fewest resources,
Speaker 2: and were sometimes excluded from receiving food, aid or other support.
Speaker 2: The gender disparity is a little more complicated. It's possible
Speaker 2: that there were some physiological factors involved in the absorption
Speaker 2: and use of niosin in women's bodies, but some of
Speaker 2: this was probably connected to gender roles and family dynamics.
Speaker 2: In most families, women were the ones procuring and preparing food,
Speaker 2: and mothers and wives often deprived themselves so the rest
Speaker 2: of the family could eat. Joseph Goldberger did not live
Speaker 2: to see the isolation of niosin or the end of
Speaker 2: the polagra epidemic. He died of cancer on January seventeenth,
Speaker 2: nineteen twenty nine. His critics spread rumors that he had
Speaker 2: really died of pelagra. The exact mechanisms of niosin in
Speaker 2: the body and how it relates to pelagra continued to
Speaker 2: be studied for decades after the nineteen forties, and the
Speaker 2: discovery of nichemalization's role in making nutrients in corn more
Speaker 2: bioavailable is comparatively recent. Researchers started publishing work analyzing the
Speaker 2: available nutrients and niche temalized corn in the nineteen fifties,
Speaker 2: with research confirming that nichemalization increases the availability of triptafan
Speaker 2: and niasin by the late nineteen eighties. During our lifetimes, yeah, yeah,
Speaker 2: I had trouble pinning down exactly when that research happened,
Speaker 2: because that's a that's a thing, that's a series of terms.
Speaker 2: To try to do sort of a literature review on
Speaker 2: UH And I found various papers over the course of
Speaker 2: those decades that were related to it in one way
Speaker 2: or another. And then also I would find other papers
Speaker 2: that were about pellagorate in some other way, written from
Speaker 2: like the seventies that just seemed unaware that niche stivialization
Speaker 2: was even a factor in anything. So even if it
Speaker 2: was more understood like that had not spread through all
Speaker 2: of the research community. Anyway, we'll talk about some things
Speaker 2: on Friday.
Speaker 1: I'm sure.
Speaker 2: In our behind the scenes, I have some listener mail.
Speaker 1: Fabulous.
Speaker 2: This listener mail is from Kristen who wrote in after
Speaker 2: our episode on jan Arson. This says, Hi, Holly and Tracy.
Speaker 2: I'm a longtime listener and repeat fan mail writer. I
Speaker 2: love your episodes, and I'm particularly interested when I find
Speaker 2: a personal connection to the story you are telling, as
Speaker 2: is the case in your recent episode on Yan Arson.
Speaker 2: I am half Icelandic by descent, and so am tickled
Speaker 2: by your interest in the land of my forefathers. During
Speaker 2: the podcast, Tracy toss in a comment that it's quite
Speaker 2: likely that all Icelanders are descended from Yon Arson in
Speaker 2: one way or another.
Speaker 1: I thought to.
Speaker 2: Myself, challenge accepted, and went to the Icelandic genealogy database
Speaker 2: that is at icelandicgroots dot com to see if I
Speaker 2: could establish a personal connection to Yon Arson lo and behold,
Speaker 2: Tracy was right. I am related to Yon Rason, who
Speaker 2: is my twelve times great grandfather or Lancofe. I'm sorry
Speaker 2: if I did not do a great job of pronouncing
Speaker 2: that term. Not only that, but I am related to
Speaker 2: him through fifteen different lines of descents the attached family tree.
Speaker 2: This is due to the fact that Iceland's population has
Speaker 2: always been relatively small, so most people are related. In fact,
Speaker 2: when I was in Reykievic on a business trip some
Speaker 2: years back, I was invited to a small get together
Speaker 2: after work where I met a recently retired Bishop of Iceland,
Speaker 2: Peter Stegerson. I feel like I left a syllable out
Speaker 2: of that, but I don't think I could do it again.
Speaker 2: I mentioned that my mother's family was from Iceland, and
Speaker 2: he responded that we must be related. After I tossed
Speaker 2: a few ancestral names out, he said, of course we
Speaker 2: are distant cousins. I was able to confirm his statement
Speaker 2: recently on the s Icelandic Roots genealogical database. What funds
Speaker 2: you have an automatic conversation starter like this? I'm including
Speaker 2: a photo of four generations of my family, me, my mother,
Speaker 2: my Ama, and my Lagama. I am not saying their
Speaker 2: names for the sake of privacy, but they are in
Speaker 2: the email. This photo was actually taken in Canada, which
Speaker 2: is in Gimli in Manitoba, which is the largest Icelandic
Speaker 2: settlement outside of Iceland for pat tax I run out
Speaker 2: of current pets to introduce you to you, So I'm
Speaker 2: going back in time to our family's first kitty. Early
Speaker 2: one Saturday morning, the wife of my father's boss showed
Speaker 2: up at our door. When my mother opened the door,
Speaker 2: the woman said here and shoved a kitten and a
Speaker 2: can of cat food into my mother's hands, and then
Speaker 2: strode quickly away. We children, of course, were thrilled at
Speaker 2: the idea of a kitten. My parents bowed to the inevitable.
Speaker 2: They both had a quirky sense of humor, and decided
Speaker 2: to name our cat Fido. Fido quickly grew from a
Speaker 2: small kitten to an extremely large cat. The attached photo
Speaker 2: shows Fido being held by then three year old brother
Speaker 2: for Scale Fighter, who lived the ripe old age of
Speaker 2: twenty two despite receiving the excessive love from all four
Speaker 2: of us kids. Lastly, this made me cry when I
Speaker 2: first read it, and so I'm going to try to
Speaker 2: read it without crying. Fingers crossed. I don't know if
Speaker 2: I can, but I'm gonna try. Lastly, I want to
Speaker 2: thank you for your gentle benedictions. At the end of
Speaker 2: each Friday behind the scenes podcasts. Kristen just going on
Speaker 2: to talk about how dealing with some things and this
Speaker 2: positive message at the end of your show gives me
Speaker 2: a little lift going into the weekend. This did made
Speaker 2: me cry when I first read it. I'm crying a
Speaker 2: little bit right now. Thanks for everything, Kristin. Thank you
Speaker 2: so much. Kristin.
Speaker 1: I love the.
Speaker 2: Confirmation of the interrelatedness of folks in Iceland. It is
Speaker 2: a small islands and the population is small. What a
Speaker 2: great family picture also, and then we have a picture
Speaker 2: of a small child holding a large, very fluffy, white
Speaker 2: and gray kitty cat. And this the cat is almost
Speaker 2: as big as this child whole or so. I love
Speaker 2: all of this. Thank you so much for this email
Speaker 2: and for all this about your family, and for your
Speaker 2: very gentle thank you at the end.
Speaker 1: I loved this. It made me.
Speaker 2: Tear up and gave me a little bit of a
Speaker 2: lift for the rest of the day. If you would
Speaker 2: like to send us a note about this or any
Speaker 2: other podcast or at history podcasts at iHeartRadio dot com,
Speaker 2: and you can subscribe to our show on the iHeartRadio
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Speaker 2: You Missed in History Class is a production of iHeartRadio.
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