“Frauds,” “Filth Parties,” “Yeast Fads,” and “Black Boxes”: Pellagra and Southern Pride, 1906-2003*

The American pellagra epidemic began with the discovery of this nutritional deficiency in epidemic proportions by Alabama physician George H. Searcy (1877-1935) near Mobile in the late summer of 1906 (“Alabama Physicians Debate”). This multifaceted medical drama and the role of US Public Health Service (PHS) officer Joseph Goldberger (1874-1929) and his research team (particularly aided by the brilliant statistician Edgar Sydenstricker [1881-1936]) demonstrated that pellagra was result of specific economic conditions in the South. As Alan Kraut describes in his masterful biography, Goldberger’s War, Goldberger (Figure 1) had already distinguished himself in Cuba and Mexico where he made gains in understanding the causes of typhus, yellow and dengue fevers. Described as “an ingenious epidemiologist,” he and his PHS team performed transformative research studies on the nature of nutrition, economics, and the social dynamics that impacted and mediated health or illness within discrete populations in the South (Kraut 73).

The monotonous 3-M diet—meat, meal, molasses—that many poor Southerners (black and white) subsisted on led to the 4-D’s of pellagra—dermatitis, diarrhea, dementia and sometimes death. In short, pellagra was a dietary deficiency disease intrinsic to socio-economic conditions in the South (Kraut 101-02). This disease raises issues of postbellum poverty, class disparity emanating from and accentuated by regional defeat and submission to Northern industrial interests, and the counterproductive efforts of so-called “New South” boosters to ignore the facts such as few economic opportunities, poor wages, and worker dependence upon company-run stores that would form the sociological implications of an ailing South. In other words, pellagra brought science into conflict with Southern pride, hampering efforts to ameliorate the socio-economic conditions that lay behind a disease rooted in class and race-based privation, a struggle that curiously persisted long after the disease had been conquered.

Figure 1.

Joseph Goldberger, US Public Health Officer, headed the investigation of the pellagra epidemic. His innovative studies first uncovered the nutritional basis of the disease.

Image courtesy of the Centers for Disease Control and Prevention (CDC), Public Health Image Library (ID# 8464)

Goldberger and Sydenstricker knew that for poor whites and blacks the life of the old agrarian South transformed slavery into of a color-blind bondage of economic dependence upon tenant farming of an equally merciless white master—cotton. But if the old agrarian ways of Dixie offered only the prospect of a dismal life under new arrangements, the so-called “New South” of business and industry was showing itself to be equally incapable of yielding worthwhile returns. Indeed the New South was built upon a bitter contradiction. Touting the benefits of modern diversified agriculture and industrial expansion, the New South stood upon the foundations of a low wage base supporting textile manufacturers and mining magnates quick to take advantage of the post-bellum opportunities offered by the vanquished South. For example, the Macon, Georgia, Chamber of Commerce’s typical booster ad declared, “Abundant supply of labor, thrifty, industrious, and one hundred percent American,” belied an income only sixty to seventy percent that of other Americans (Tindall 319). Tenant farmers were bound to their local stores and sundry shops through lines of credit that dropped them deeper and deeper into debt. Factory and mine workers similarly were frequently paid in company script redeemable only at the company store or a store that accepted the company vouchers by pre-arrangement. This tied both workers to the store inventory, which could be ample or limited, and even in the face of the most abundant store inventories, low wages and mounting debt forced even the most frugal workers away from choice meats and fresh fruits and vegetables and toward corn bread, molasses, syrup, fatback, and coffee, a menu made for pellagra (Kraut 98). A similar scenario played out among sharecroppers and tenant farmers tied to the credit lines imposed by landowners. As Kraut puts it, farmers’ “diets declined as their debts rose” (98). When diet declined enough, pellagra appeared.

Goldberger never did discover the...