- Dermatitis: A scaly rash on skin exposed to light or trauma;
- Dementia: Mental disorientation, delusions and depression; and
Pellagra is now rare in developed countries which enjoy balanced diets and fortified foods, but it was once a huge public health problem in the US. Three million Americans contracted pellagra and 100,000 died of it from 1906-40. Pellagra was especially a problem for the poor in the South whose meals usually consisted of the "three M's": meat (pork fatback); molasses; and meal (cornmeal). Today pellagra continues to be a problem in developing countries where there is significant malnutrition or where niacin-deficient foods such as corn and rice are the primary sources of nutrition.
The puzzle of pellagra was solved by Dr. Joseph Goldberger. Dr. Goldberger was assigned in 1914 by the US Public Health Service to the South to deal with pellagra. After inspecting Southern orphanages, mental hospitals and prisons, Goldberger made the pivotal observation that the malnourished inmates of those institutions often developed pellagra while the better-fed staff did not. Pellagra, he deduced, did not arise from germs, as was commonly believed, but rather from a nutritional deficiency. To prove this, Dr. Goldberger, his assistants and even his wife engaged in experiments called "filth parties." They injected themselves with blood or ingested the scabs, feces and body fluids of patients. None developed pellagra. He also did decisive experiments with Mississippi prison inmates (who "volunteered" in return for a full pardon). Dr. Goldberger fed them a poor diet that he believed caused pellagra and within months, many developed the disease. He then added meat, fresh vegetables and milk to their diet and reversed all of the signs and symptoms of pellagra. Dr. Goldberger never identified the dietary principle that had this extraordinary effect. He died in 1929 (of kidney cancer). Eight years later, the factor was found to be niacin. This discovery was made in 1937 at the University of Wisconsin. Niacin is abundant in red meat, fish, poultry, and green leafy vegetables. Niacin can prevent pellagra (and can cure it).
The name "pellagra" comes from the Italian "pelle", skin + "agra", rough = rough skin, referring to the skin problems in pellagra.