1887

Chapter 16 : Plagues without Germs

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Abstract:

The red plague, pellagra, is a disease almost unheard of today but, in its time, it was a killer. The flaming of the skin was the signature of the disease, but a loss of balance, a staggering gait, and senseless mutterings also characterized the disease. An epidemiological study conducted by Goldberger and his associates from 1917 to 1921 showed that the lower the income, the greater the incidence of pellagra. In 1916, Joseph Goldberger organized "filth parties", where gelatin capsules were filled with the skin scrapings, urine and feces from pellagra patients, and each volunteer swallowed a capsule. None became ill with pellagra. The red plague of pellagra was a plague of corn: hominy grits, corn mush, and corn bread all lack the P-P factor. Once the dietary cause was appreciated, the key to understanding the disease of pellagra had been found. The P-P factor was heat-resistant and was contained in dried brewer’s yeast. Yeast would both prevent and cure pellagra. Nicotinic acid and its amide were renamed niacin. Niacin, a water-soluble B vitamin, was the specific preventative of black tongue and pellagra, and it was Goldberger’s P-P factor. Pellagra clearly shows that the proposal that microbes cause all diseases is misleading. Some diseases are related to the food eaten and to economic conditions. The many-feathered story of identification of the cause of beriberi once again demonstrates how, on occasion, even the best prepared scientific sleuth can be handicapped by adherence to prevailing dogma—germs as the cause of disease.

Citation: Sherman I. 2006. Plagues without Germs, p 354-381. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch16
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Figures

Image of Figure 16.1
Figure 16.1

The sign of the butterfly (pellagra) in a young girl (Courtesy CDC).

Citation: Sherman I. 2006. Plagues without Germs, p 354-381. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch16
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Image of Figure 16.2
Figure 16.2

Enzyme activity depends on the shape of molecules. The enzyme must fit the substrate (a) in order for there to be enzyme activity. Vitamins (b and c) act as adaptor molecules and are necessary for some enzymes to be active, i.e., to bind to the substrate. Since vitamin analogs are structurally similar to the natural vitamin, they can bind to the enzyme, but once bound the enzyme cannot bind to its natural substrate.

Citation: Sherman I. 2006. Plagues without Germs, p 354-381. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch16
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Image of Figure 16.3
Figure 16.3

This young woman is unable to stand on her own feet because she suffers from beriberi. (Courtesy of the Armed Forces Institute of Pathology.)

Citation: Sherman I. 2006. Plagues without Germs, p 354-381. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch16
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Image of Figure 16.4
Figure 16.4

An urban slum in London circa 1903. (From the Getty Hulton Collection.)

Citation: Sherman I. 2006. Plagues without Germs, p 354-381. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch16
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Image of Figure 16.5
Figure 16.5

(A) A young girl with rickets standing with her young brother and (B) the skeleton of a person with rickets. (Panel A courtesy of Corbis. Panel B courtesy of the Wellcome Library of Medicine.)

Citation: Sherman I. 2006. Plagues without Germs, p 354-381. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch16
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