Episode Summary: "Pellagra, Part 2"

Podcast: Stuff You Missed in History Class
Hosts: Holly Fry & Tracy V. Wilson
Release Date: March 5, 2025
Duration: Approximately 56 minutes
Transcript Segment Covered: [02:44] to [48:59]

Introduction & Recap

[02:44] Holly Fry: Holly welcomes listeners to the second part of the episode on pellagra, expressing surprise at the depth of its historical impact in Italy and the United States.
[03:00] Tracy V. Wilson: Tracy recaps Part 1, which covered the basics of pellagra, its symptoms, and its initial resolution in Italy. She highlights the focus of Part 2 on the epidemic in the Southern United States and the subsequent public health efforts to identify and combat the disease.

Pellagra’s Emergence in the Southern United States

[04:42] Holly Fry: Holly discusses the first known report of pellagra in U.S. medical literature by Henry Fauntleroy Harris in 1902, describing a farmer with a debilitating illness characterized by a rash every spring for 15 years.
Notable Quote:
"When I started, I was totally unaware that there was a whole history of pellagra in Italy before it became a problem in the United States." — Tracy V. Wilson [03:00]

The Three M's: Meal, Molasses, and Meat

[05:29] Tracy V. Wilson: Tracy introduces the “three M’s” — meal (cornmeal), molasses, and meat — staples in the diets of the impoverished, including those in institutions like mental asylums and orphanages. She cites the Mount Vernon Asylum for the Colored Insane in Alabama as a case study where poor nutrition led to a severe pellagra outbreak.

Medical Investigations and Early Findings

[06:22] Holly Fry: Dr. George H. Searcy reported an outbreak of pellagra at the Mount Vernon Asylum in 1906, with 88 cases and a 64% mortality rate.
Notable Quote:
"The disease occurs among the poorer classes and in institutions where the diet is at times limited." — Dr. George H. Searcy [07:04]

[08:06] Holly Fry: Searcy attributed pellagra to damaged corn and poverty, sending cornmeal samples to labs that confirmed mold contamination. Treatment efforts included removing cornbread and grits from diets, replacing them with wheat bread and potatoes.

The Zists vs. Anti-Zists Debate

[11:10] Holly Fry: The episode delves into the intense debate between the "Zists" (those who believed corn was the direct cause of pellagra) and the "Anti-Zists" (those advocating for alternative causes such as microbial infection).
Notable Quote:
"The great struggle now centers around the question: Is pellagra a kind of food poisoning from maize, or is it due to some parasite infecting the human body?" — Tracy V. Wilson [26:24]

Influences and Motivations

[12:53] Holly Fry: Sociocultural factors played a significant role, with regional identities and economic interests clashing over the cause of pellagra. The Midwestern corn industry feared economic repercussions, while Southern pride made dietary explanations contentious.

Joseph Goldberger’s Pioneering Research

[27:29] Holly Fry: By 1914, without a definitive cause, Dr. Joseph Goldberger was appointed to lead pellagra research. Goldberger, renowned for combating infectious diseases, began investigating pellagra’s links to nutrition.
[28:20] Tracy V. Wilson: At the Milledgeville State Sanitarium in Georgia, Goldberger observed that pellagra affected only patients, not the staff, suggesting that diet played a crucial role since staff had access to better food.

Nutritional Deficiency Hypothesis

[35:29] Tracy V. Wilson: Goldberger proposed that a diet lacking in variety, particularly deficient in animal proteins and vitamins, was responsible for pellagra. His experiments in orphanages and later at Rankin State Prison Farm demonstrated that a corn-heavy diet induced pellagra symptoms, supporting the nutritional deficiency theory.

Controversial Experiments

[37:40] Tracy V. Wilson: Facing significant backlash from Anti-Zists, Goldberger conducted ethically questionable experiments in 1916 to disprove the infectious theory. Known as "filth parties," these involved participants (including his wife) being exposed to bodily fluids of pellagra patients.
[38:43] Tracy V. Wilson: Despite these extreme measures, none of the participants contracted pellagra, further supporting the nutritional hypothesis.

Societal Implications and Racism

[40:27] Holly Fry: The episode highlights how pellagra was intertwined with systemic racism and economic exploitation. Black populations and women were disproportionately affected, both due to their socioeconomic status and societal roles that limited their access to nutritious food.
Notable Statistic:
Between 1906 and 1940, approximately 3 million cases and 100,000 deaths occurred, with half of the deaths among Black individuals and two-thirds among women.

Resolution: Discovery of Niacin and Food Fortification

[44:06] Tracy V. Wilson: Biochemist Conrad Elvahem isolated niacin (vitamin B3) in 1937. By 1938, voluntary efforts to fortify bread with vitamins began, significantly reducing pellagra rates. Subsequent mandatory fortification laws in the 1940s further eradicated the disease in the U.S.
[46:59] Holly Fry: Major economic and social shifts, including the decline of sharecropping and improvements in the agricultural sector, also contributed to the resolution of the pellagra crisis.

Long-Term Impact and Legacy

[48:09] Tracy V. Wilson: Goldberger’s untimely death in 1929 left the final discovery of niacin’s role to others. The understanding of nixtamalization (a process that makes niacin more bioavailable in corn) emerged in the mid-to-late 20th century, underscoring the biochemical basis for pellagra prevention.
[48:59] Tracy & Holly: They discuss how modern food fortification practices, such as vitamin enrichment in cereals and bread, trace back to these early public health efforts.

Listener Engagement

[49:56] Tracy V. Wilson: The hosts share and respond to a heartfelt listener email from Kristen, who discovered her ancestry linked to Jon Arason, enhancing the community connection and personal touch of the podcast.

Conclusion

[44:58] Holly Fry: Holly summarizes the decline of pellagra in the U.S. by WWII, attributing it to dietary changes, food fortification, and socio-economic improvements. However, she notes that issues like poverty and food deserts persist, hinting at ongoing public health challenges.
[57:07] Tracy V. Wilson: Tracy reflects on the episode's comprehensive coverage of pellagra, emphasizing its historical significance and the intersection of science, society, and policy.

Notable Quotes with Timestamps

• "The disease occurs among the poorer classes and in institutions where the diet is at times limited." — Dr. George H. Searcy [07:04]
• "Is pellagra a kind of food poisoning from maize, or is it due to some parasite infecting the human body?" — Tracy V. Wilson [26:24]
• "The problem of pellagra is in the main, a problem of poverty." — Joseph Goldberger [44:06]

Final Thoughts

In "Pellagra, Part 2," Holly Fry and Tracy V. Wilson meticulously unravel the complex history of pellagra in the United States, highlighting the interplay between scientific discovery, socio-economic factors, and cultural resistance. Their exploration underscores the profound impact of public health research and the importance of addressing underlying socio-economic disparities to combat disease.