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Introduction
Eighty
years ago, long before Dr. C. Everett Koop and a new generation of public
health professionals suffered social criticism in their public health
pronouncements on AIDS, Dr. Joseph Goldberger, Surgeon in the United
States Public Health Service, was doing much the same thing. Even as
Koop has been critical of personal behavior and social policies that
could put populations at risk of acquiring the AIDS virus, Goldberger
warned Americans about the crucial link between poor nutrition as the
result of poverty and the onset of a scourge known as pellagra.
Pellagra was first identified among Spanish peasants by Don Gaspar Casal
in 1735. A loathsome skin disease, it was called mal de la rosa and often
mistaken for leprosy. Although it was not conclusively identified in
the United States until 1907, there are reports of illness that could
be pellagra as far back as the 1820s. In the United States, pellagra
has often been called the disease of the four D's -- dermatitis, diarrhea,
dementia, and death. National data is sketchy, but by 1912, the state
of South Carolina alone reported 30,000 cases and a mortality rate of
40 percent. While hardly confined to Southern states, the disease seemed
especially rampant there.
Between 1907 and 1940, aprroximately three million Americans contracted pellagra and 100,000 of them died. A worried Congress asked the Surgeon General
to investigate the disease. In 1914, Joseph Goldberger was asked to head
that investigation.
Back To Top | Photography Credits
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| Small Boy with Pellagra |
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| Man with Pellagra |
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