In the late 1800s a disfiguring and often fatal disease became epidemic in the South. Called pellagra (Italian for “rough skin”), it caused diarrhea, mental confusion, and severe scaling and flaking of the skin. By 1911, pellagra had become the leading cause of death in asylums. Eventually, the Public Health Service dispatched the physician Joseph Goldberger to determine its cause.
At the time, a “pellagra germ” was the leading suspect, but Goldberger dismissed this hypothesis after observing that the cases didn’t fit an infectious disease pattern. Pellagra was prevalent among people who depended on corn as a staple, and he proposed a dietary cause.