Pellagra no longer stalks the nation as it once did. But during the early part of the 20th-century, pellagra, a disease that results from a diet deficient in niacin, killed many poor Southerners. Dr. Joseph Goldberger, a physician in the U.S. government's Hygienic Laboratory, the predecessor of the National Institutes of Health, discovered the cause of pellagra and stepped on a number of medical toes when his research experiments showed that diet and not germs (the currently held medical theory) caused the disease. He also stepped on Southern pride when he linked the poverty of Southern sharecroppers, tenant farmers, and mill workers to the deficient diet that caused pellagra.

Dr. Joseph Goldberger discovered the of pellagra, a disease resulting from a diet deficient in vitamin B. Pellagra killed many poor Southerners in the early part of the 20th century.

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.

Small Boy with Pellagra

Man with Pellagra

Joseph Goldberger was born on July 16, 1874 in Giralt, Hungary, then a part of the Austro-Hungarian Empire. His parents were sheep herders, whose flock was decimated by sickness. The Goldbergers withtheir six children, including Joseph, the youngest, emigrated to the United States in 1883. Here the Goldbergers ran a small grocery store on Pitt Street on New York City's Lower East Side and had three more children.

A product of New York's public schools, Joseph Goldberger entered The City College of New York with hopes of a career in engineering. However, in 1892 Goldberger heard a lecture at Bellevue by physiologist Dr. Austin Flint, Jr. that changed his plans. Perhaps entranced by the intricacies of the human body's structure, Goldberger transferred to medical school and earned an M.D. from Bellevue in 1895.

Bellvue Hospital Staff

In 1892 Goldberger heard a lecture at Bellevue by physiologist Dr. Austin Flint, Jr. that changed his plans. Goldberger transferred to medical school and earned an M.D. from Bellevue in 1895. Photos: Dr. Joseph Goldberger and Bellevue Hospital Staff, reproduced with permission of the Southern Historical Collection, Library of the University of North Carolina at Chapel Hill. 

Dr. Joseph Goldberger

Dr. Joseph Goldberger was a product of New York's public school. He entered The City College of New York with hopes of a career in engineering. However, in 1892 Goldberger attended a lecture at Bellevue by physiologist Dr. Austin Flint, Jr. that changed his plans. Perhaps intrigued by the intricacies of the human body's structure, Goldberger transferred to medical school and earned an M.D. from Bellevue in 1895.

Dr. Joseph Goldberger never discovered precisely what was missing from the diets of pellagrins. The year following the Great Flood, Dr. Joseph Goldberger fell gravely ill of hypernephroma, a rare form of cancer. He died on January 17, 1929. His ashes were sprinkled over the Potomac River as a rabbi chanted Kaddish.

During the next decade, Conrad A.Elevjhem learned that a deficiency of nicotinic acid, better known as B vitamin niacin, resulted in canine black tongue disease. In studies conducted in Alabama and Cincinnati, Dr. Tom Spies found that nicotinic acid cured human pellagrins as well. Tulane University scientists discovered that the amino acid tryptophan was a precursor to niacin. When tryptophan was added to commercial foods such as bread to "fortify" them, it prevented the scourge of the South. Today, pellagra has been all but banished, except for infrequent occurrences during times of famine and displacement.

Heroes are few in science as in every field. However, the selfless devotion of Dr. Joseph Goldberger to relieving the suffering of those whose plague was born of poverty might well qualify him for the garland. His portrait hangs in the Director's Building at the National Institutes of Health as an inspiration to young investigators and a reminder that medical science is not isolated from the social dimensions of the human condition.

Dr. Goldberger & Sons

Dr. Joseph Goldberger with three of his four children at his in-law's summer home in Biloxi, Mississippi, ca,1910. From left to right: Joseph Herman Goldberger, Dr. Joseph Goldberger, Edgar Farrar Goldberger, and Benjamin Humphreys Goldberger is seated on his father's lap.

Dr. Goldbeger Honored

During World War II, the Merchant Marine named ships after notable Americans. One ship was named after Dr. Joseph Goldberger.