36 - Filth Parties

The southern United States was hit by a dramatic epidemic of a mysterious disease called pellagra in the early twentieth century. This episode discusses the cultural and scientific sources of the outbreak -- from the cotton fields of the south, to the cow pastures of rural Germany, to the river basins of Uganda -- and the incredible lengths a young doctor named Joseph Goldberger went through to try and put an end to this plague. Plus, a new #AdamAnswers about the source of the name “internal medicine.” All this and more on episode 36 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!

• Bean WB,  “Origin of the Term Internal Medicine,” N Engl J Med 1982; 306:182-183
• Blevins SM and Bronze MS, Robert Koch and the ‘golden age’ of bacteriology, Int J of Inf Dis, Vol 14, #9, Sep 2010.
• Bloomfield AL, “The origin of the term ‘internal medicine,” JAMA, April 4, 1959.
• Bressani R et al, Corn Nutrient Losses, Chemical Changes in Corn during Preparation of Tortillas, J Agr and Food Chem, 6, 10, 770-774.
• Brim CJ. Job's Illness: Pellagra. Archives of Dermatology and Syphilology. 1942;45:371-6.
• Carpenter KJ, The relationship of pellagra to corn and the low availability of niacin in cereals, Experientia Suppl. 1983;44:197-222.
• Clay K et al, Rise and Fall of Pellagra in the American South.
• Elmore JG and Feinstein AR, Joseph Goldberger: An Unsung Hero of American Clinical Epidemiology, Ann Intern Med. 1994;121:372-375.
• Goldberger J. The transmissibility of pellagra: Experimental attempts at transmission to human subjects. Public Health Rep. 1916;31:3159–73
• Goldberger J. Public Health Reports, June 26, 1914. The etiology of pellagra. The significance of certain epidemiological observations with respect thereto. Public Health Rep. 1914;29(26):1683–1686.
• Goldberger J, Wheeler GA, Sydenstricker E. A study of the relation of diet to pellagra incidence in seven textile-mill communities of South Carolina in 1916. Public Health Rep. 1920;35(12):648–713.
• Goldberger J, Waring CH, Willets DG, et al. The Treatment and Prevention of Pellagra. Washington, DC: Government Printing Office; 1914.
• Goldberger J, Wheeler GA. Experimental pellagra in the human subject brought about by a restricted diet. Public Health Rep. 1915;30(46):3336–3339.
• Harris HF: Ankylostomiasis in an individual presenting all of the typical symptoms of pellagra. Am Med 1902; 4:99-100, retrieved from:
• https://babel.hathitrust.org/cgi/pt?id=uc1.c3312358;view=1up;seq=107;size=125
• Lavinder CH, Pellagra, The American Journal of Nursing, Vol. 13, No. 10 (Jul., 1913), pp. 746-754.
• MacNeal WJ, The Alleged Production of Pellagra by an Unbalanced Diet, JAMA. 1916;LXVI(13):975-977.
• Middleton J, Pellagra and the blues song ‘Cornbread, meat and black molasses’. J R Soc Med. 2008 Nov 1; 101(11): 569–570.
• Mooney et al, The Thompson-McFadden Commission and Joseph Goldberger: Contrasting 2 Historical Investigations of Pellagra in Cotton Mill Villages in South Carolina. Am J Epidemiol. 2014 Aug 1; 180(3): 235–244.
• Morabia A (2006). Joseph Goldberger’s research on the prevention of pellagra. JLL Bulletin: Commentaries on the history of treatment evaluation.
• Niles GM. Pellagraphobia: A word of caution. JAMA. 1912;58:1341.
• Roberts CS, Goldberger and the Mal de la Rosa, Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.
• Roberts SR, SAMBON'S NEW THEORY OF PELLAGRA AND ITS APPLICATION TO CONDITIONS IN GEORGIA, JAMA. 1911;LVI(23):1713-1715.
• Searcy GH: An epidemic of acute pellagra. Transactions of the Medical Association of Alabama, 1907, pp 387-393
• Wacher, C. (2003). Nixtamalization, a Mesoamerican technology to process maize at small-scale with great potential for improving the nutritional quality of maize based foods.