Joseph Goldberger & Pellagra: Proving a Nutritional Deficiency

In 1914–1915, Joseph Goldberger (USPHS) investigated pellagra (dermatitis, diarrhea, dementia, death) in the American South.

Key Experiments

• Orphanage/asylum studies: Improved diet (milk, eggs, meat, veg) prevented pellagra; institution diets (cornmeal, fatback, molasses) caused it.
• Volunteer experiments: Goldberger + colleagues ingested patient secretions/excreta → no disease. Volunteers fed pellagra diet → developed pellagra.
• Conclusion: Not infectious; caused by dietary deficiency (later identified as niacin/tryptophan).

Impact

• Niacin enrichment of flour (1940s) → pellagra eliminated in US.
• Paradigm shift: nutrition as disease prevention.
• Goldberger nominated for Nobel 5×; died 1929 before award.

Goldberger's rigorous epidemiology and self-experimentation exemplify evidence-based public health.