Pellagra in the United States: A historical perspective

Pellagra was in existence for nearly two centuries in Europe before being r ecognized in the United States, where it was first reported in 1902. Over t he next two decades, pellagra occurred in epidemic proportions in the Ameri can South. Poverty and consumption of corn were the most frequently observe d risk factors. Since the exact cause and cure of pellagra was not known, a culture of "pellagraphobia" formed among the public. Patients were shunned and ostracized. The medical community implicated spoiled corn as the cause of pellagra, which had economic repercussions for agriculturists. Joseph G oldberger, MD, of the United States Public Health Service eventually solved the secret of the malady: faulty diet. Goldberger was able to prevent and induce pellagra by dietary modification, a landmark event in the annals of medicine, nutrition, and epidemiology. His work and the social history of t hat period are reviewed.