pill. All recovered in short time, and of course none contracted pellagra.
Some doctors criticized the experiment: the volunteers were too few; the
trial was mere grandstanding. But the germ theory was discredited.
Goldberger labored on in the South through most of the s, and his
medical comrades continued through the Depression and beyond. These
decades were fruitful in humanitarian fieldwork but also in laboratories.
Nutrition was a new science when that first-known pellagra sufferer ap-
peared in Atlanta in . Thereafter scientists separated and named one
vitamin after another. Among these were brilliant and persistent biochem-
ists and epidemiologists in Germany and at the University of Wisconsin,
who during the s confirmed that nicotinic acid, among the B group
of vitamins, was the missing element in pellagrins’ diets. Renamed niacin
and added to virtually all store-bought bread since , the mighty amino
conquered pellagra, at long last, in relatively short time.
Perhaps as many as , Americans actually died from the disorder.
They were overwhelmingly southerners, more were women, and black
southerners suffered disproportionately to whites. Conquest of pellagra
was spotty and interrupted, too. In —three years after distribution of
nicotinic acid pills—, pellagra deaths were recorded. In —three
years after the introduction of niacin-enriched bread—there were . Few
cases and hardly any deaths were reported after the s. This triumph-
apparent exceeds that of the nineteenth-century French version of Joseph
Goldberger, the great Dr. Théophile Roussel, who defeated pellagra by per-
suading the national government to distribute wheat to corn-plagued
peasants.^9 (Distributing beans, one must think, would have been yet more
successful.) Normally, or canonically in medical history, scientific under-
standing of cause and practical application of a cure trumps experimental
and humanitarian fixes, such as Roussel’s and Goldberger’s. But perhaps
not. The ancient triad—or merely corn and beans without squashes—had
prevented pellagra for millennia, and Roussel, Sandwith, Goldberger, and
many others demonstrated that it could cure pellagra quickly and relatively
inexpensively. Important as beans and information were and remain, how-
ever, the real causes of pellagra were and remain poverty, dependency, and
alienation from garden- and animal-sustaining land. Goldberger and his
cohort understood this well enough. They were humanitarians and publi-
cists, at best saving a few lives here and there, giving temporary reprieves,
and knowing all along that only structural changes would ultimately end
the epidemic. Sure enough, post–World War II migration and prosperity
eliminated pellagra. Niacin-laced store-bought bread seems more like in-