PERVASIVE INDIFFERENCE AND DENIAL
Because of Southern indifference, outsiders from the North eventually set up research facilities to find a cure for pellagra. In 1912, the New York Post-Graduate Medical School and Hospital established the Thompson-McFadden Pellagra Commission based in the South. The school chose Joseph F. Siler, a physician with the Army Medical Corps, and Philip E. Garrison, a Navy surgeon, to head the commission. The following year, Dr. Charles Davenport (1866–1944), a Harvard-trained biologist from the Eugenics Record Office in Cold Spring Harbor, New York, joined the commission to study pellagra from the viewpoint of heredity.
Eugenics has been called a form of scientific racism because eugenicists encouraged selective breeding to improve the human race. Davenport was a eugenicist who opposed the idea that poor nutrition or disease could affect brain function. He did not join the commission out of a concern for the poor. Instead, the existence of a disease like pellagra threatened the very foundations of eugenics; that is, the idea that violence could be caused by a bad diet would reduce the idea of being superior to simply being better fed.
The Pellagra Commission surveyed more than five thousand people and found no relationship between diet and the occurrence of the disease.26 In 1914, the U.S. Public Health Service Hygienic Laboratory, which would become the NIH, started a competing commission on pellagra to find a cure. The U.S. surgeon general appointed Dr. C. H. Lavinder to lead the government commission.
By 1914, the Thompson-McFadden Commission concluded that pellagra was likely an infectious, insect-borne illness. In the same year, Lavinder was replaced by Joseph Goldberger, a trained researcher and medical pioneer from New York City.
Goldberger advocated for the poor and tested solutions. He visited places where the disease was most prevalent: orphanages, asylums, and prisons. In these institutional settings, only the orphans, patients, or inmates got sick with pellagra; workers were rarely affected. The disease was not contagious; he noted that the only difference between the two groups was what the workers ate—their diet was not as restricted as that of the orphans and inmates. Goldberger suspected that some essential missing factor in corn caused the disease. In the fall of 1914, Goldberger supplemented the diets at three institutions: two Mississippi orphanages and a Georgia state sanitarium.
By the following spring, of the 172 cases in the orphanages, only one recurred; no new cases developed. In the sanitarium, all 72 cases in the test group were cured. Pellagra recurred in half of the control group. This was proof enough for Goldberger, who concluded that a balanced diet cured pellagra. In his 1915 annual report, Goldberger wrote that a change in diet cured all of the children and made them healthier than ever before: “There can be no doubt that the cause of pellagra is dietary.”27 After Goldberger published his results, Siler and Garrison both resigned from the Pellagra Commission, leaving Davenport in charge.
For the next six years, Goldberger continued to conduct experiments and tried to persuade the authorities to take action. In 1921, he wrote the U.S. surgeon general describing how poverty and a poor diet led to pellagra. President Warren G. Harding responded by urging the Red Cross to provide aid and suggested that Congress make a special appropriation to address the problem. But this offended politicians throughout the South.28 One remarked that news reports of “famine and plague” were “utter absurdity.”29 Southern leaders were not interested in curing pellagra.
The United Daughters of the Confederacy, who voted at first to thank the president, ended up sending him a letter of protest a month later. Southern leaders not only rejected the president’s offer, but also rejected the idea that people in the South were suffering from the effects of poverty or malnutrition. For his part, James Babcock, the one doctor who had described the connection between pellagra and crime, was fired in 1914 by the South Carolina legislature for, among other things, having “caused injury to the reputation and progress of South Carolina by calling attention to the prevalence of pellagra in that state.”30
Most people today have no knowledge of pellagra or Goldberger’s efforts to combat this disease. The entire episode was swept under the rug. Goldberger spent the rest of his life trying in vain to persuade the medical community of his findings. He died unheralded in 1929. Eight years later, in 1937, Conrad Elvehjem discovered nicotinic acid, or niacin, a B vitamin—the missing factor in corn. By then, the pellagra epidemic had largely subsided because of the Depression and public feeding programs.
THE BIRTH OF A LIE: EUGENICS
The indifference of Southern politicians to this horrible ailment was in part due to the efforts of Charles Davenport, who rejected the idea that human differences were linked to nutritional differences. He advocated an alternative ideology that continues to dominate our thinking to this day. Davenport was one of the leaders of eugenics in the United States. This ideology was first conceived in 1863 by British mathematician Sir Francis Galton, the half-cousin of Charles Darwin. Galton assumed that observed differences in humans were the result of heredity. He believed that healthy offspring could be produced only if healthy and talented people married other healthy and talented people. Eugenics, from the Greek meaning “well-born,” was based on the premise that humanity could be perfected through better breeding; it was part religion and part science. Nutrition did not enter into the eugenics equation.
Violence in the South did not go unnoticed; it in fact inspired the American eugenics movement. The deteriorated physical and mental condition of nutrient-deficient Southerners was well-known. Many nineteenth-century travelers and writers observed the high prevalence of nutritional illness in the South, describing white skin, rashes, a sunken chest, and a sinister countenance; many people lived in squalor, with a high incidence of insanity, epilepsy, and tuberculosis as well as pellagra.31
In 1916, one year after Goldberger reported that pellagra was a nutritional disease, Davenport perpetrated his greatest crime: He published an article in the Archives of Internal Medicine on the hereditary causes of pellagra.32 Davenport presented detailed tables and pedigree trees to establish his view that pellagra was a hereditary disease.
Davenport’s paper was readily embraced because of its length, scientific complexity, and “authoritative” tone. But the different standards of medical education in those days did not require that physicians question the report’s veracity. Davenport persuaded the medical community that pellagra and all of the social problems it caused were not the result of bad diet, but of bad genes. It confirmed that people who didn’t have this disease were superior. It was precisely the lie that most people wanted to hear.
Not everyone was swayed by Davenport. Some of his methods were so flawed that even his fellow eugenicists criticized him. His methods had been questioned before: In 1913 and 1914, members of the Galton Eugenics Laboratory in England, including Karl Pearson and David Heron, published a response to an earlier paper critical of Davenport’s methods and of his organization, the Eugenics Record Office.33 Heron noted that Davenport had essentially falsified data in order to support his claims. Pearson believed that Davenport’s deception would cause eugenics to be discredited. But it had precisely the opposite effect, at least in the short term.
Pellagra was an unpopular disease shunned by doctors, politicians, and eugenicists. Eugenics shifted scientific focus away from the study of nutrition, instead advocating remedies of violence, sterilization, and segregation. Even the idea of extermination was floated as an acceptable means of “keeping up the standard of the race.”34 Eugenics, which was the alternative hypothesis for diseases like pellagra, took the place of nutritional wisdom.
A NEAT, PLAUSIBLE, AND WRONG SOLUTION
H. L. Mencken said “There is always a well-known solution to every human problem—neat, plausible, and wrong.” The assumption that all human problems resulted from heredity led to the belief that all human problems could be solved by eliminating the people with the problems. This is flawed logic of the so-called eugenics solution. The popularity
of eugenics in the early twentieth century was a direct consequence of a failure to learn from the medical examples of pellagra, hookworm, and iodine deficiencies. In a real sense, we are all victims of Charles Davenport’s deception, which would have global consequences. By promising racial superiority, eugenics lured many prominent Americans, such as Madison Grant, a lawyer, conservationist, and religious postmillennialist. Grant helped preserve the California redwoods and the American bison; he founded the Bronx Zoo, fought for strict gun control, built the Bronx River Parkway, helped to create Glacier and Denali National Parks, and worked tirelessly to protect whales, bald eagles, and pronghorn antelopes—all while advocating for the sterilization of humans.
In 1916, Grant published The Passing of the Great Race, an international best seller that influenced a generation of scientists, academicians, and businesspeople. In it, Grant presents the eugenic solution to all the world’s problems:
Those who read these pages will feel that there is little hope for humanity, but the remedy has been found, and can be quickly and mercifully applied. A rigid system of selection through the elimination of those who are weak and unfit—in other words, social failures—would solve the whole question in a century, as well as enable us to get rid of the undesirables who crowd our jails, hospitals, and insane asylums. The individual himself can be nourished, educated and protected by the community during his lifetime, but the state through sterilization must see to it that his line stops with him or else future generations will be cursed with an ever-increasing load of victims of misguided sentimentalism. This is a practical, merciful and inevitable solution of the whole problem and can be applied to an ever-widening circle of social discards, beginning always with the criminal, the diseased and the insane and extending gradually to types which may be called weaklings rather than defectives and perhaps ultimately to worthless race types.35
Grant was referring to poor whites from the American South and Eastern Europe who filled U.S. prisons and insane asylums—80 percent of whom were later found to have pellagra. Around this same time, Davenport’s assistant at the Eugenics Record Office, Harry H. Laughlin, began lobbying for eugenics laws. He developed model legislation for compulsory sterilization and immigration restrictions based on eugenics “science.” A group of Virginians devised a plan to enact Laughlin’s law, launching a preemptive “friendly suit” that would ultimately end up in the U.S. Supreme Court. This lawsuit sought to preempt future challenges by deliberately compromising the rights of Carrie Buck, a young mother who gave birth to a daughter after being raped by a relative of her foster family. To avoid prosecution, the family placed her in the Virginia Colony for Epileptics and the Feebleminded, whose superintendent, Albert Priddy, advocated for the sterilization of the “feebleminded.” Priddy previously had been sued for forcibly sterilizing patients against their will.
Priddy eventually persuaded the Virginia legislature to pass the 1924 Sterilization Act, which empowered the state to legally sterilize its citizens on the basis of a finding of feeblemindedness. A confederate of Priddy immediately filed suit on Buck’s behalf contesting the state’s right to perform involuntary sterilizations. In the course of the litigation, Priddy died. His successor, John Hendren Bell, was named in the suit. Buck’s lawyer, who was also her guardian, was in cahoots with the state. He deliberately lost and appealed the case in order to get a higher court to affirm the lower court ruling. His goal was to preempt someone else from effectively challenging the law. The case finally reached the U.S. Supreme Court in 1927.
Laughlin wrote a scientific analysis of Carrie Buck for the court, concluding that Buck and her mother “belong to the shiftless, ignorant and worthless class of anti-social whites of the South. . . . The evidence points strongly toward the feeblemindedness and moral delinquency of Carrie Buck being due, primarily, to inheritance and not to environment.”36 Justice Oliver Wendell Holmes Jr., in writing for the court, opined that “it is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind.”37
The 1927 Supreme Court decision in Buck v. Bell made eugenics the law of the land. Thirty-three states ultimately adopted eugenics laws. California applied the law most vigorously, conducting the most prodigious number of involuntary sterilizations. Sixty thousand Americans would be forcibly sterilized; the vast majority were white. About one-third of the sterilizations were carried out in California. It was the beginning of what would soon become a global catastrophe.
Three years earlier, in 1924, a young Adolf Hitler was inspired by the German translation of Madison Grant’s manifesto—a book he would later call his “Bible.” Hitler’s Nazi Party seized power in 1933 and modeled its Nuremberg Laws after California’s eugenics code. The California sterilization efforts further inspired the Nazis and their Final Solution. In 1934 E. S. Gosney, founder of the Human Betterment Foundation to support compulsory sterilization, received a letter from C. M. Goethe, a prominent California eugenicist visiting Germany, that said:
You will be interested to know that your work has played a powerful part in shaping the opinions of the intellectuals behind Hitler in this epoch-making program. Everywhere I sensed that their opinions have been tremendously stimulated by American thought, and particularly by the work of the Human Betterment Foundation. I want you, my dear friend, to carry this thought with you for the rest of your life that you have really jolted into action a great government of 60 million people.38
The Nazis sterilized an estimated four hundred thousand people. A Virginian eugenicist complained that “they are beating us at our own game.”39 Nazis would ultimately exterminate five and a half million people under the guise of eugenic science and launch a world war whose impact continues to haunt us to this day.
At the military tribunals at Nuremberg after the war, Major General Karl Brandt, who was Hitler’s personal physician, was charged with heinous crimes relating to the slaughter of the Jews during the Holocaust. In his defense, Brandt’s lawyers introduced into evidence a copy of Madison Grant’s book. During the trial, Nazis also quoted Oliver Wendell Holmes’s opinion in Buck v. Bell in which he had stated, “Three generations of imbeciles are enough.”
The scope of Hitler’s crimes cannot be overstated. Yet the Nazi Party also seemed to be aware of things that were actively hidden from the American public. They understood that nutrition matters. The Nazis didn’t just profess to be the master race; they sought to actively achieve it by implementing the most progressive public feeding programs the world has ever seen. The Nazis collaborated closely with U.S. scientists, including Davenport, who held editorial positions at two influential German journals. They banned everything that was unhealthy, including carcinogens such as asbestos and food dyes. They established policies that promoted healthful food while opposing excessive fat, sugar, and alcohol in the diet and a sedentary lifestyle. Otto Flössner, a nutritional physiologist at the Reich Health Office, believed that a whole food diet complemented racial hygiene.40
Nazi researchers suggested that improper dietary habits led to an increased risk of cancer decades before scientists in the United States reached the same conclusion. They encouraged consumption of fresh fruit, vegetables, and whole grain bread as well as the avoidance of meat-derived fat.41 A 1930s Hitler Youth manual titled Health Through Proper Eating discussed the dangers of empty calories and championed legumes such as soybeans as a healthier alternative to meat. In 1939, Hitler invaded Poland, launched the Holocaust, and started a world war.
This is a surprising and mostly untold story of the role of nutrition in the lead-up to this tragic historical moment. It is also a warning about allowing “facts” to remain unquestioned. The contradictory arguments made by the Nazis were not the first or the last time that science and fake science have been used to promote evil.
As we move closer to the present day, we will see the ways in which technology
seemed to displace some of the gains made in nutritional science. The war came home to U.S. soil in many ways.
THE MILITARY LAUNCH THE FAST FOOD INDUSTRY
A generation after World War II, in the 1960s, crime rates exploded in the United States. Nowhere was this catastrophe felt more than in African American communities. The war had transformed the country economically, socially, and physically. It created the longest economic boom in U.S. history, which turned the country into a global superpower. The G.I. Bill enabled millions of vets to get a college education; in 1947 G.I.s made up 47 percent of college enrollments. G.I. benefits also helped returning vets to buy new homes, farms, and businesses. The war elevated the entire nation. In 1949, the desegregation of the military had launched the civil rights movement. However, what was perhaps the most significant change was also the least recognized: World War II fundamentally altered how Americans ate.
While the Nazis were advancing nutritional science, American scientists were operating under the faulty premise that nutritional adequacy could be achieved by chemical means. Medical experts at the turn of the twentieth century had failed to learn from the pellagra outbreak. The general presumption that all calories are created equal perpetuated the flawed conclusion that people are not created equal. By simply recognizing how poor nutrition leads to chronic illness and impairs human brain function, we could have avoided many tragic and lasting consequences.
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