Pellagra: My Tale Of Events

Pellagra has been around for more than just its better known stint in the USA in more recent times of the 20th century. It was first identified among Spanish peasants by Don Gaspar Casal in 1735. Pellagra is a nutritional deficiency disease, caused by a lack of niacin (vitamin B3) absorption in the body[1].

Pellagra is called the ‘Sour Skin Disease’ or the ‘Three Ds’, As it results in: Diarrhoea, Dermatitis and Dementia, as well as anxiety, aggression and insomnia[2], in some cases it is known as the ‘Four Ds’, Diarrhoea, Dermatitis, Dementia and Death over a period of four or five years.
The literature articles I have used to base my research on are, Joseph Goldberger’s research text, ‘Goldberger On Pellagra’, Louisiana State University Press, 1964 containing 395 pages, Digitized on the 8th of August 2008. And the Identification on Pellagra in 1763, by Don Gaspar Casal, who was a Spanish court doctor.

Don Gaspar Casal described and documented all of the features of Pellagra in 1763, a time where travel in the world was huge as countries were busy trading and exploring. As the planting of maize through countries occurred,  as it was a much more bountiful grain than wheat, pellagra spread with it.
This is because the original users of maize would soak it in lime water before consumption, allowing the Vitamin B to be absorbed on ingestion. This habit was not taken with the spread of maize. At this time Casal, the court doctor in Spain described its cause as an unbalanced diet and pointed out that the poor diet consisted of maize, as he saw some of  the poorer class of the population in Spain slowly become ill with Pellagra.

In its outbreak in the USA in the 1900s, it was commonly thought Pellagra was a germ, or that maize, itself carried the disease. After Doctor Joseph Goldberger research on pellagra, between 1913-1930, he put the cause down to something ‘lacking’ in nutrition. He ran tests in Orphanages and prisons, testing cleanliness and diet as these were places well known for their mostly lack of cleanliness and funding to provide a healthy diet. His treatment for it was that a varied diet consisting of a good dose of milk and meat were required. Persons who usually suffered from Pellagra may have consumed little meat, milk or animal products[3]. This is because grains were cheaper than animal products.

The limitations faced  is that Don Gaspar Casal’s documentation are in Spanish and from the 1700s, this made tracking it down very difficult not to mention the translation. Out of some the records I found via online books I have found many quotes and abbreviations of his work, but who knows if it was word for word his documentation.

Tracking down Goldberger’s research was not nearly as hard as finding Casal’s, it still took me a few days to find his work on pellagra, but I was able to use his letters to the Public Health Office from 1913 as a helping hand[4] . After Goldbergers death it was up to  Conrad Elvehjem, a biochemist to do more research into the treatment, Elvehjem also studied nutrients in food.

The two Doctors, Casal and Goldberger both had the right idea, while people around them assumed it was a germ or the grain itself, both doctors make reference to nutrition in their theories in the cause of Pellagra (meaning ‘Rough Skin’). Casimir Funk and Conrad Elvehjem are two major players in relation to Pellagra. Elvehjem used Funk’s research in his pursuit to cure Beriberi, in which he found Vitamin B acid in rice husks which Elvehjem later tested on Blacktongue (cainine form of pellagra) which had amazing affects, and then on the human form. The treatment methods have changed over time but always revolve around a balanced and varied diet, Moving away from the common three staples, Meat, Molasses and Maize.




Burris, R,H,  Baumann, C, A , Van Potter, R, ‘Conrad Elvehjem’  National Academy of Sciences, Washington DC.

Goldberger, J, Lorenz, W, F, 1914,‘The Cause and Prevention of Pellagra: A Letter’, Public health report, Volume 218

Goldberger, J, published 1964, ‘Goldberger On Pellagra’, Louisiana State University Press, containing 395 pages, Digitized on the 8th of August 2008.

Klasco, R, updated 2/5/2011

Latham, M. C. (1973) A historical perspective. In Nutrition, National Development and Planning. Edited by Berg, A., Scrimshaw, N. S. and Call, D. A. The MIT Press, Cambridge, Massachusetts, pp. 313-328

‘Pellagra – prevention and control in major emergencies’, 2008 , World Health Organisation, 48 pages in total.

Turrent, A, Antonio Serratos, J, Maize and Biodiversity: The Effects of Transgenic Maize in Mexico,

Zieve, D,  Eltz, D.R, 2011, University of Washington Medical Center Diabetes Care Center, Seattle, Washington updated the 31/8/2011

[3] ‘Pellagra – prevention and control in major emergencies’, 2008 , World Health Organisation, 48 pages in total.

[4] Goldberger, J, Lorenz, W, F, 1914,‘The Cause and Prevention of Pellagra: A Letter’, Volume 218 of Public health reports. Public health reports.


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