This episode is about pellagra — a disease that killed an estimated 100,000 Americans and devastated the post-Civil War South. The medical establishment blamed a stable fly. Families were quarantined, shunned, turned away from hospitals. The real cause was sitting on every dinner table in every sharecropper's home across the region.

Joseph Goldberger figured it out. It took the medical establishment twenty more years to admit he was right.

This isn't just a story about 1916. It's about what happens when the science is inconvenient for the people in power — and who pays the price while they stall.

Read the Full Essay

The long-form piece this episode is based on is available on the For History's Sake newsletter. It includes sources, additional context on the Confederate veteran angle, and the modern parallel to Covid-19 and DOGE's dismantling of public health infrastructure.

👉 https://forhistoryssake.beehiiv.com/p/poverty-as-a-plague-sharecropping-pellagra-and-institutional-neglect

Further Reading & Resources

Books

Goldberger's War: The Life and Work of a Public Health Crusader Alan M. Kraut (Hill and Wang, 2003) The definitive biography. Goes deep on Goldberger's background as a Hungarian Jewish immigrant, his field work, and the cultural collision between a Northern scientist and a defensive Southern establishment.

The Butterfly Caste: A Social History of Pellagra in the South Elizabeth W. Etheridge (Greenwood Publishing, 1972) Connects the pellagra epidemic directly to the post-Civil War cotton monoculture and sharecropping system. Essential if you want to understand the systemic side of this story.

A History of the World in Seven Cheap Things Raj Patel & Jason Moore (University of California Press, 2017) Referenced in this episode. A broader argument about how capitalist agricultural systems are built to extract, not to feed.

Becoming Abolitionists Derecka Purnell (Astra House, 2021) Also referenced in this episode. Traces the machinery of extraction across generations of Black American life — from the fields to the factories to the prisons.

Academic Papers

An Epidemic of Pride: Pellagra and the Culture of the American South M. K. Crabb (Anthropologica, 2022) Focuses on the science denial angle — why the Southern medical and political establishment fought Goldberger's correct findings for over two decades.

The Rise and Fall of Pellagra in the American South Karen Clay, Ethan Schmick & Werner Troesken (Journal of Economic History, 2019) Hard data linking high cotton acreage to high pellagra death rates county by county. Includes the unexpected role of the boll weevil in forcing crop diversification and inadvertently reducing the disease.

Primary Sources

The U.S. National Library of Medicine holds Goldberger's original field photographs, letters to his wife Mary, and public health reports from his time at the Mississippi prison farms — available through the NIH Digital Collection.

Music

Original music by Xaphr

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In January 1968, a sports writer named Stanley Frank published an article in True magazine questioning whether cigarettes were really that dangerous. Readers had no idea Frank was on the tobacco industry's payroll — or that Brown and Williamson had editorial control over the piece before it went to print.

That article was one move inside a decades-long strategy to manufacture scientific doubt, purchase editorial silence, and keep the American public in the dark about what cigarettes were doing to them.

This episode traces the architecture of that campaign — from the 1953 Plaza Hotel meeting to the internal memos that were never supposed to see daylight.

Sources & Further Reading

1. "Smoking and the New Health Education in Britain 1950s–1970s | AJPH | Vol. 95 Issue 6" (Webpage)

2. "The Cigarette Papers" (Webpage)

3. "The Dark History Of The Tobacco Industry" (YouTube Video)

4. "The Evolution of Cigarette Advertising: Shifting Narratives and Brand Perception" (Webpage)

5. "The Ghost of Cigarette Advertising Past | AEI" (Webpage)

6. "The Way Things Were: Cigarette ads on television" (Webpage)

7. "When Cigarette Companies Used Doctors to Push Smoking | HISTORY" (Webpage)

8. "https://cancercontrol.cancer.gov/sites/default/files/2020-06/m19_9.pdf" (PDF)

9. "https://pmc.ncbi.nlm.nih.gov/articles/PMC3490543/" (Webpage)

10. "https://www.nbcnews.com/now/video/how-cigarette-advertising-has-changed-with-over-the-years-78701637765" (Webpage)

11. "https://www.publichealthlawcenter.org/sites/default/files/resources/Tobacco-Industry-Targeting.pdf" (PDF)

12. "https://www.tobaccopreventioncessation.com/pdf-176336-98000?filename=Big-tobaccos-dirty-tricks.pdf" (PDF)

Music by Xaphr