Early 20th century saw the outbreak of a deadly mysterious disease,
pellagra that could cause anything from fever to dementia to death. The
disease that had killed over 100,000 people by the end of 1914 was shrouded
in deep mystery because of the fact that the epidemic was largely limited
to the South and was exclusively affecting the peasant class. It was indeed
a poor man's disease and conventional wisdom suggested it had something to
"Pellagra, a classic dietary deficiency disease caused by insufficient
niacin, was noted in the South after the Civil War. Then considered
infectious, it was known as the disease of the four Ds: diarrhea,
dermatitis, dementia, and death. The first outbreak was reported in
1907. In 1909, more than 1000 cases were estimated based on reports from
13 states. One year later, approximately 3000 cases were suspected
nationwide based on estimates from 30 states and the District of
Columbia. By the end of 1911, pellagra had been reported in all but nine
states, and prevalence estimates had increased nearly ninefold. During
1906- 1940, approximately 3 million cases and approximately 100,000
deaths were attributed to pellagra." (5)
At that time, physicians attributed massive impact of the disease on its
contagious and infectious nature, something that had hitherto been
unexamined by the medical circles or research groups. The worst hit area
was Mississippi where it appeared that the incidence of pellagra increased
every time cotton prices went down and every time flood hit the Mississippi
"In 1915, the Mississippi State Board of Health captured the nature
of the medical crisis by reporting that during the previous year,
pellagra had "caused more deaths than typhoid fever, smallpox,
measles, scarlet fever, influenza, epidemic cerebrospinal
meningitis, and acute poliomyelitis combined."...