Ignorance and denial of the early 20th century pellagra epidemic in the South
Four decades of “the four Ds” for the working poor (1900–1940)
“[W]e know practically nothing of its cause, nor mode of transmission, or whether it is transmitted by man at all…” — Rupert Blue, M.D., Surgeon General of the U.S. (1912)
Outbreak and investigation of the epidemic
A mysterious epidemic broke out in the early 1900s, primarily in the Southern United States. The classic symptoms included diarrhea, dermatitis, dementia, and death (“the four Ds”). The Greensboro News in North Carolina reported 1,000 cases in the state in 1908, with only one county free from the disease. It made its appearance in Gaston county in October of 1908 and Newton in November of 1909. A physician in Charlotte was warning people to avoid Midwestern milled corn, which many believed to be the cause of this “newly diagnosed disease, about which the medical fraternity of the United States is now so deeply concerned” (Newton Enterprise, 1909).
In September of 1909, the city of Durham had started investigating a herbivorous remedy, brought by “a native African, graduate of…
