Pellagra: This illness results from a shortage of niacin, a B-complex vitamin. Known as the "disease of the four D's," it manifests through: - **Diarrhea** - **Dermatitis**: Characterized by a scaly rash on skin exposed to sunlight. - **Dementia**: Involves mental confusion, delusions, and depression. - **Death** Additional symptoms include mouth ulcerations, nausea, vomiting, seizures, and balance issues. Though now uncommon in developed nations with varied diets and enriched foods, pellagra once posed a significant health threat in the United States. Between 1906 and 1940, three million Americans suffered from pellagra, resulting in 100,000 deaths. The disease was particularly prevalent among the impoverished in the South, whose diets typically consisted of "the three M's": meat (often pork fatback), molasses, and cornmeal. Today, pellagra remains a concern in developing regions where diets lack niacin-rich foods and heavily rely on staples like corn and rice.The mystery of pellagra was unraveled by Dr. Joseph Goldberger. In 1914, the US Public Health Service tasked him with addressing pellagra in the South. During his investigations in orphanages, mental health facilities, and prisons, he noticed that malnourished inmates frequently developed pellagra, whereas the well-fed staff remained unaffected. Dr. Goldberger concluded that pellagra stemmed from a lack of nutrition, contrary to the prevailing belief that it was caused by germs. To validate his theory, Dr. Goldberger, his team, and his wife conducted "filth parties," where they injected themselves with blood or consumed the scabs, feces, and bodily fluids of those afflicted. None of them contracted pellagra. He also carried out critical experiments with Mississippi prisoners, who volunteered in exchange for a pardon. By feeding them a deficient diet, he induced pellagra in many of them. Once he supplemented their meals with meat, fresh vegetables, and milk, the symptoms disappeared. Although Dr. Goldberger never pinpointed the specific dietary component responsible, he passed away in 1929 from kidney cancer. It wasn't until eight years later, in 1937, at the University of Wisconsin, that niacin was identified as the crucial factor. Niacin, found abundantly in red meat, fish, poultry, and green leafy vegetables, can both prevent and treat pellagra.The term "pellagra" is derived from the Italian words "pelle" (skin) and "agra" (rough), referring to the skin issues associated with the disease.
