The doctor who ate feces and found the cause of the epidemic – 02/01/2023 – Health

Nutrition, which is all the rage these days, has long been a neglected area of ​​medicine.

Strange as it may seem, research investigating the relationship between food and health was remarkably slow, and a significant part of the knowledge was gained thanks to doctors who experimented on themselves, putting their own lives at risk.

Doctors like Joseph Goldberger, a Jew from New York who in 1914 arrived in the extreme south of the United States.

There, he took an intellectual leap that led him to unravel a mystery, save tens of thousands of lives and force governments, for the first time, to intervene in what the population ate.

He had been sent by the Surgeon General of the United States (the government’s chief spokesman for public health affairs) to investigate an epidemic sweeping the southern states of the country.

Pellagra was a horrible disease. It started with what looked like a mild sunburn on the backs of her hands, and turned into a butterfly-shaped rash on her face.

Then came depression, confusion, and dementia. In 40% of cases, it ended with the death of patients.

It was killing thousands of Americans every year—and making tens of thousands sick.

Goldberger’s mission was to find the cause.

A CRUCIAL DETAIL

The disease had appeared out of nowhere, and in homes where there was an “infected” person, there was an 80% chance that the other residents would acquire the condition.

Not surprisingly, it was considered highly infectious, and those who suffered from it were shunned like lepers.

Goldberger had the support of the Surgeon General, but as the son of immigrants, he always saw himself as an outsider, a nonconformist.

“Throughout his life, Joseph Goldberger was fascinated by the American West and the Wild West. And much of his medical detective work and his fight against the epidemic was an extension of that desire to be an adventurer who achieved something valuable”, says Alan Kraut, author of Goldberger’s War (“Goldberger’s War”, in free translation) to the BBC.

“He saw himself in part as a lone cowboy swimming upstream, firing scientific bullets,” confirms physician Don Sharp, Goldberger’s grandson.

Goldberger traveled the southern United States, tracking the disease in prisons, orphanages, and nursing homes.

And noticed something surprising. Pellagra affected inmates but not staff.

He realized then that it could not be an infectious disease, as most of his medical colleagues insisted. It had to be something else.

He soon became convinced that there was something in the diet causing the pellagra. But Goldberger knew that criticizing Southern food as someone from the North would not make him popular.

“To get scientists to support his conviction that pellagra was a dietary deficiency and not a germ disease, he needed evidence,” says Kraut.

It was then that he devised a controversial experiment.

He decided that he would take 12 perfectly healthy men and have them get pellagra.

The “volunteers” would come from a Mississippi prison.

At that time, many people, especially the poor, ate what was considered a typical southern delicacy, and nothing else.

They ate bacon—a layer of fat under the skin on the pig’s back—crunchy, cornmeal, and molasses.

“All the inmates had to do was eat normal food, without fresh meat, eggs, vegetables or greens,” explains Goldberger’s grandson.

“Initially, the participants thought it was fantastic.”

But after six months, all the prisoners developed pellagra—and Goldberger stopped the experiment.

He was now fully convinced that a dietary deficiency was the cause of pellagra.

But the scientific community disagreed.

“They criticized the methodology and the results and insisted that, whatever Goldberger had shown, it was a germ disease, and he hadn’t found the germ,” says Kraut.

Goldberger was furious. “Those stupid, selfish, envious, prejudiced neighing their supposed criticisms.”

By this time, he was so desperate that he was willing to do just about anything.

To silence the critics and prove beyond a shadow of a doubt that pellagra was not an infectious disease, he decided to do something even more controversial: test it on himself.

“I have not imposed any restrictions of any kind… No attempt has been made to prevent ‘natural infection’,” he wrote.

The first thing he did was go to the local pellagra hospital and, using a cotton swab, collected mucus from the patients’ noses and introduced it into his own nostril.

“The time elapsed between collection and inoculation was less than two hours.”

“By the way, perhaps it should be taken into account that some of the secretions applied to the nasopharynx must have been swallowed”, he detailed.

Afterwards, he collected urine, skin and stool samples.

“The patient providing the stool was suffering from a severe case and had four soft bowel movements a day.”

He mixed these ingredients with wheat flour to make a pill… and swallowed it.

PARTY OF FILTH

“There’s certainly a sickening quality to the idea of ​​ingesting other people’s feces and skin scabs,” Kraut points out, likely echoing what you’re thinking.

“We as a family have always found it unbelievable that he would put himself at risk in this way. Often when we talk about it among family members or groups of friends, we cringe,” says Sharp.

Goldberger even convinced his colleagues to participate in the experiments, which he called the “filth party”.

As if the feces and urine weren’t enough, Goldberger had one last surprise for them: blood.

He collected some blood from a patient to inject into each of the volunteers, including his wife, Mary.

“I think my grandmother wanted to do everything she could to help silence the critics,” says Sharp.

“The men would not allow me to swallow the pills, but they gave me an injection in the abdomen with the blood of a woman who was dying of pellagra,” wrote Mary.

Any kind of disease could have been transferred on that needle.

“It was a leap of faith. I didn’t need courage.”

Mary’s faith was rewarded.

None of the volunteers got sick.

“My grandfather was very touched and very happy that none of the people who attended the filth party suffered from anything serious other than a little diarrhea.”

“And certainly none of them had pellagra.”

Goldberger thought he finally had it—he had all the evidence he needed to prove that pellagra was not contagious.

The condition had to be caused by some element lacking in the Southern diet.

His case was absolutely irrefutable. It was time to make it public and accept the applause.

But what he received was a barrage of violent and bitter criticism from the southern population.

“Whether (the fact that) he was Jewish, a New Yorker and a Federalist played a role in how he was treated and reprimanded or if it was just because of what he was saying, of course we’ll never know,” notes Sharp.

Goldberger realized that he would never convince doctors that pellagra was caused by a dietary deficiency unless he found a simple, inexpensive cure.

SOME YEARS LATER…

In 1923, Goldberger finally found what he was looking for – and the discovery happened in a curious way.

He had been experimenting with dogs, trying to get them pellagra by making them eat a Southern diet.

The problem was that the dogs didn’t want to eat that food.

Then he added what he described as an appetite stimulant.

Months passed, and the dogs were still healthy.

Goldberger finally realized that the stimulant was what was protecting the animals—it was the answer he had been looking for all these years.

And here it is.

It is not animal, it is not vegetable, it is not mineral. It’s yeast.

In 1927, Goldberger’s time had finally come.

Floods had triggered another outbreak of pellagra. And Goldberger took yeast to the refugees.

It was amazing. Just a few teaspoons a day was enough to cure them.

Goldberger was finally proclaimed a hero.

A few years later, a chemist finally isolated the pellagra-preventing factor in yeast. It’s a vitamin called niacin.

The United States government ordered factories to fortify flour with niacin. Other countries followed suit, and pellagra soon became a rare disease.

We now know that niacin is essential for healthy skin and the proper functioning of the digestive and nervous systems.

But what Goldberger really showed was the strong link between food and health. There is a direct relationship between what we eat and how we live and what will make us sick, and that’s exactly what Joseph Goldberger wanted the world to understand.

This article is based in part on the BBC series “Medical Mavericks”.