Forgotten Diseases and Fred Elgin Rutledge

We have come so far in our understanding of disease that we forget how well-off we are until we run smack into something that reminds us. I hit something yesterday, the death certificate of Fred Elgin Rutledge.

He died 29 March 1933 in Shelby County, Tennessee, of "pelagra." I vaguely remembered it was some kind of disease like rickets, that was related to some vitamin deficiency. So off to Google, and the discovery of a forgotten hero, Joseph Goldberger, a member of the US public health service.

Pellagra, to spell it correctly, was a common disease in the South, but in the 1910's it became an epidemic. It causes mouth sores, skin rashes, loose bowels and even mental deterioration, if untreated. Mr. Goldberger's extensive observations led him to conclude that the typical diet of the Southern poor, cornbread, molasses and a little pork fat, led to the disease. He experimented by proving it by changing the diets of some volunteer prisoners. He never found what was missing in the typical diet that led to the disease (niacin), and had great difficulty convincing people of the link.

Now due to the inclusion of vitamins in flour and practically everything we eat, pellagra is a forgotten disease. I wonder if the average US doctor would even be able to diagnose it.