Southern History Series: Pellagra

Editor’s Note: This is a work in progress.

I’m a harsh critic of free-market capitalism.

As I have said in multiple articles on this website, the fundamental reason why I am so skeptical of free-market capitalism is our experience with that economic system during the New South from 1865 until 1933 and how it ended during the New Deal when FDR was president.

In my opinion, there is probably no better symbol of the total failure of free-market capitalism than the pellagra epidemic which once afflicted 3 million people in the South and West between 1900 and 1940. 100,000 Americans died from the disease. The vast majority of them were White Southerners who were so poor they couldn’t afford to grow vegetables to supplement their diets of niacin deficient cornpone and fatback on their tiny miserable plots of land they worked on for landlords.

Here’s a link to a great article about the pellagra epidemic in the early 20th century South, Joseph Goldberger’s role in identifying the cause of the disease and how pellagra was wiped out in the South by a combination of a public awareness campaign and a change of food habits during World War II:

“The first case of pellagra in the United States was reported in 1902.[5] Soon pellagra began to occur in epidemic proportions in states south of the Potomac and Ohio rivers.[6] The pellagra epidemic lasted for nearly four decades. It was estimated that there were 3 million cases and 100,000 deaths due to pellagra during the epidemic.[4] The exact cause of pellagra was not known. The patients felt ostracized and were shunned. The social stigmatization was similar to that of the present day epidemic of acquired immunodeficiency syndrome.[4] Joseph Goldberger of the US Public Health Service solved the secret of the malady of pellagra. Goldberger’s epic work and the social history of the pellagra epidemic in the United States are reviewed. …

Pellagra was a rural disease among the sharecroppers, tenant farmers, and cotton mill workers of the South. Its occurrence in epidemic proportions was linked to the economic depression of the times and the monoculture of cotton cultivation. Depression meant less money for food and subsistence on an inadequate diet. The cotton monoculture and nonexistent animal husbandry resulted in a lack of locally produced food. Along with poverty, corn was the common denominator among pellagrins in the United States and Europe. Corn had been the staple diet among the natives of Mexico and Central America for several centuries without causing pellagra. Why had corn suddenly become pellagragenic in United States and Europe? The answer to the problem lay in the methodology of corn processing, cooking, and milling.[36] The natives of Mexico and Central America had always soaked the corn in alkali before cooking. The alkali treatment liberates the bound niacin in corn, thereby enhancing the niacin content of the diet to the point of being protective against pellagra. The process of degerming in the preparation of cornmeal became feasible with the development of the Beall degerminator in 1905.[36] The process of degermination reduces the niacin content of corn and could have precipitated the development of pellagra among a vulnerable population.

Public awareness campaigns, agriculture diversification, change of food habits, and food fortification with nicotinic acid were all responsible for the eradication of pellagra in the South.[8] The recommendation of the Food and Nutrition Board regarding the enrichment of bread and flour with thiamine, niacin, and iron was endorsed by the members of the baking and milling industries in 1941.[37] Soon the food fortification program played a crucial role in eliminating pellagra. The consumption of enriched flour and bread ensured that the dietary intake of niacin and thiamine was adequate, thus ensuring the prevention of pellagra and beriberi. Pellagra was truly conquered in the American South during the Second World War.[38] Paradoxically, there was relative prosperity during the war. The economy improved, there were more jobs, and almost everyone had an income. The wartime rationing also made the people conscious of eating high quality food. By 1945, pellagra had become extinct in the South, and the pellagra producing 3-M diet of southerners had become a relic of the past.”

A victim of pellagra

The pellagra epidemic, which was caused by extreme poverty and malnutrition, was one of the lowest points in our history. It reached its climax around the nadir of the Southern economy when the boll weevil was marching across the Cotton Kingdom from Mexico to the Atlantic.

In the colonial and antebellum era, the Southern population was much smaller and there was abundant game to supplement a corn and pork-based diet, but much of that had been wiped out in the early 20th century South. As we have already seen, it got so bad that even the whitetail deer and the wild turkey were nearly hunted to extinction in the New South.

Joseph Goldberger, a Jewish physician from New York, played a key role in establishing that pellagra was caused by poverty and malnutrition.