In 1902, a new disease appeared in South America. During spring, red scabby rashes would flare up on people's faces, arms and legs. They'd become depressed and lose weight, suffering terrible diarrhea. In the worst case scenario the patients went mad, and started speaking to the dead or snatching up kitchen knives to hunt invisible intruders. When the weather cooled, the rashes faded until next spring. In the decade to come, the plague whipped through orphanages and mental asylums, mill towns and villages.
Between 1907-1912 doctors confirmed over 25,000 cases. And almost 40% of the victims died.
This disease had a name: Pellagra, and no one knew what caused it. In the February of 1914, Dr Joseph Goldberger of the Public Health Service was battling a diphtheria outbreak in Detroit where he got a letter, it was from his boss, the Surgeon General, and ordered him to report for a new position as the service's new pellagra investigator. Now, Goldberger was a good choice because he was intelligent, vigorous, and tenacious and had spent 15 years fighting epidemics. During that time, he battled yellow fever in Puerto Rico, studied typhoid in Washington's hygienic laboratory, pushed back dengue fever in Texas, and fought typhus in Mexico, catching nearly every disease he studied.
The remaining food comprised the staple diet of the southern poor: cornbread molasses and fatback bacon, canned vegetables if they were lucky.
If pellagra was linked to diet, Goldberger reasoned, he should be able to prevent it with dietary changes. In September 1914, he conducted an experiment at three institutions with endemic pellagra. He picked two orphanages in Mississippi and a sanatorium in Georgia. For six months, he provided the subjects with a diet of eggs, fresh milk, legumes and lean protein. The results were dramatic. Come spring, only a single victim had a recurrence, with no new cases. The diet had not only prevented pellagra, it had cured it. But that wasn't enough FOR SCIENCE! After all, if pellagra was a deficiency disease, then Goldberger should be able to induce it with diet. And his resulting experiment was...uhhh... Let's just say it was probably unethical even back then. He got 12 prisoners to volunteer as test subjects in exchange for pardons from the governor of Georgia. For six months, he isolated them in an outbuilding, and restricted their diet to low-calorie, low-nutrition foods. Of the 11 that completed the study, 6 developed pellagra. Bingo. After all, how could the south attract businesses, if they thought the workers were sick and starving? How could they attract tourists? So, when Goldberger convinced President Harding to champion food aid a coalition of southern congressmen and governors pushed back, turning down the aid and challenging Goldberger's science. Pellagra had become politicized. But messaging wasn't Goldberger's only problem. His cure wasn't scalable. Even if the government got involved, no one could afford to feed everyone in the South meat and eggs.
However, if he could discover what elements in that diet cured pellagra, he might be able to wipe out the disease once and for all. So, he decided to try out different possible cures using dogs who got a variation of pellagra called black tongue. First, he tried to induce black tongue with a poor diet of cereals, but the dogs refused to eat it until he added brewers' yeast to give it flavor. But the dogs didn't develop black tongue. They switched the flavoring and all of the sudden, black tongue. Hey, wait a minute. Why didn't the first diet work? He added the brewers' yeast back in, and sure enough, the black tongue disappeared. He had his cure: a simple cheap cure that wouldn't spoil and was easy to distribute. And none too soon, because in 1927, the Mississippi River flooded, displacing millions.
Instead of South America, you should have written "The Southern United States", otherwise, this article was good and interesting, to say the least.