A Doctor Cured Pellagra With Eggs and a Prison Bargain

By 1912, South Carolina alone had 30,000 cases of pellagra, and the disease was killing roughly four out of every ten people who got it. The textbook progression was a mnemonic: dermatitis, diarrhea, dementia, death. Doctors thought it was infectious. Public health officials were looking for a germ.

Joseph Goldberger, a Hungarian-born US Public Health Service officer, was assigned to the problem in 1914 and noticed something that bothered him. In Mississippi orphanages and asylums, the inmates got pellagra and the staff did not. If it were contagious, the nurses should have been dropping at the same rate as the children. The thing that actually separated the two groups was what showed up on their plates — corn mush and molasses for one, meat and milk for the other.

He ran the experiment. At two Jackson orphanages, he added fresh meat, eggs, milk, and vegetables to the children's diets. Pellagra essentially stopped. To prove the inverse, he needed people he could feed the bad diet to on purpose, which is where Mississippi Governor Earl Brewer came in. Brewer offered pardons to eleven Rankin Prison Farm inmates who agreed to live for nine months on the corn-heavy ration eaten by the rural poor. Five of them developed full pellagra. They got their pardons.

The medical establishment still resisted. So in 1916 Goldberger and his wife held what they called "filth parties" — they injected themselves and volunteers with blood, mucus, and scrapings from pellagra patients to demonstrate the disease was not transmissible. Nobody got pellagra.

Goldberger died in 1929 without identifying the missing nutrient. Conrad Elvehjem named it in 1937: niacin. By then the cornbread South had buried about 100,000 people from a deficiency a few eggs a week could have prevented.