Red Madness: How a Medical Mystery Changed What We Eat

Since I didn’t have my TBR list handy and needed a new read, I noticed this book staring at me from my desk. I had put it on display because alot of my preteens enjoy reading narrative non-fiction. Red Madness: How a Medical Mystery Changed What We Eat by Gail Jarrow is fits that genre to the T.

This book is nothing less than FASCINATING. I cannot find a better adjective to describe this book. Non-fiction is stranger than fiction. If you don’t believe me, then read this medical mystery. Tell me how many times you get baffled that such a disease was present in the Twentieth Century America and are amazed at how the doctors and scientists figured out what it was and how to cure it.

In the early 1900s, many people in the South developed a gross skin condition. It would pop up in the Spring and Summer as a strange rash that was accompanied by intestinal issues. Some folks, from little kids to young mothers, would not have the strange aliment for long before dying; others would have the symptoms pop up year after year, getting stronger with each bout. Eventually, people would die from the disease after facing depression. Doctors soon came to realize this 4-D (dermatitis, diarrhea, depression, and death) disease was pellagra.

A young girl with pellagra.

Most assumed it was due to the moldy corn the Southerners ate. But after thorough researching and compiling data, scientists, doctors and researchers came to the conclusion that it was not corn’s fault alone. Pellagra happened because a person’s entire diet was deficient in niacin. It took decades of research to figure this deadly mystery out.

To make sure pellagra was not contagious, Dr. Goldberger, a key figure in the discovery of what caused and prevented pellagra, would throw “filth parties.” He and a few others would intentionally swallow pills that had a mixture of pellagra victims’ fecal matter, urine, and skin scales. They would get injected with pellagra victims’ blood and rub mucus in their noses. And…then nothing happened. It was confirmed: pellagra was not a contagious disease.

Dr. Goldberger went on to test which foods healed pellagra. Conrad Elvehjem continued Goldberger and his assistants’ research. He discovered that niacin healed pellagra victims after testing different foods out on dogs with “black tongue,” a form of pellagra.

What stood out the most to me in this medical history was the exchange between economics, politics, and health. It is wild to know that businesses, even today, profit off diseases with quack remedies. So-called medicines were created merely due to the population’s fear of catching pellagra. They had no sound evidence to uphold them. Even though the research confirmed time and time again that pellagra was not a contagious disease, businesses and even politicians did not want to agree.

The South did not like how the medical field was giving it a bad rap for its people’s diet and way of life. The one-crop system of cotton not only was bad for the Southern economy, but it turned out to be bad for the health of its people. Because the majority of people could not plant their own vegetables (all land was used for cotton, not planting or grazing!) and had to rely on the food only available at their employers’ stores, most could not eat a varied diet that would give them all the necessary nutrients they needed. Thus, pellagra has been called a poor man’s disease.

The pellagra crisis in the South would dwindle after its people changed its eating habits and food became enriched.

Politics also played a big a part in hindering the spread of the truth surrounding the causes of pellagra and how to not get it. Southern politicians did not want this disease to be known as a poor man’s disease because it made the South look bad. Instead, they preferred to say it was a contagion spread from immigrants, which was a lie. After discovering that niacin healed the disease, government officials and medical organizations decided that the best way to ensure everyone in the country would not be deficient was to add this and other complex B vitamins to wheat products. Now no one had to change their diet or be offended.

The following may be a controversial statement, but after finishing the book I can’t help thinking it: pellagra is no longer the poor man’s disease, obesity it. Since wheat products are enriched with all the necessary vitamins one doesn’t have to eat a variety of foods. Wheat products are also cheap. But they are high in carbohydrates and we all know that eating too many carhobydrates will make you gain weight. However, because wheat products are so cheap poor people rely heavily on them.

Yes, the plight of pellagra was fraught with cultural misunderstanding: the medical field wasn’t attacking the South’s eating habits to belittle it, even if it appeared that way. The people of the South needed access to a better variety of foods to be healthy. But because this idea stepped on the toes of businesses and politicians alike, the idea of enriching foods already being eaten was the route to take. It, to me, seemed like a compromise. But this enrichment of cheap wheat products has now created another problem: obesity.

It is truly sad that good food is so expensive. Health issues mostly stem from what we eat. Instead of educating ourselves about what to eat and having those food products cheaper, we end up taking medication for diseases that come from poor eating choices. It’s a horrible cycle.

What do you think?

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