Red Madness: How a Medical Mystery Changed What We Eat

Congratulations to Kathleen Burkinshaw who won Miriam Franklin's ARC, Extraordinary. Random.org didn't know they are both Sky Pony debut authors--but I did! Look for a review and giveaway of Kathleen's book, The Last Cherry Blossom  next fall.

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How many of you have heard of pellagra? Before reading Red Madness, I was unfamiliar with the disease. But reading it resolved a personal mystery for my husband's 85-year-old uncle. He finished the book and said, "Now I know what I had as a child."

This disease which produces a horrible skin rash, leads to severe intestinal problems, causes neurological problems, and often leads to death, no longer afflicts wide portions of our population--the way it did during the first half of the twentieth century. Pellagra has been eradicated from most developed countries because of the tireless work of one physician: Joseph Goldberger. Red Madness by award winning author Gail Jarrow, describes how this medical mystery was solved.

Written with clear language accessible to readers from age ten through adult, Gail Jarrow chronicles the history, myths, and treatments associated with pellagra. Dr. Goldberger's tireless efforts to determine the primary cause of pellagra included hosting "filth parties." In gruesome detail, Gail describes how Goldberger tried infecting himself with pellagra in order to prove that it was not contagious or a result of infection. 

http://www.loc.gov/pictures/item/ncl2004004556/PP/
"This Oklahoma sharecropper and his family pick cotton in 1916.
The older two children--ages six and five--together picked twenty-five pounds of cotton a day.
Goldberger tried to communicate his message about diet to farmers and mill workers,
 two groups that suffered from pellagra." (p.100)

Since the disease appeared most often in poor households where diets were limited to 3-M's: meal (cornmeal baked into bread), meat (fatback, form the fatty layer on a pigs back) and molasses (syrup), Goldberger was convinced that pellagra was probably caused by a diet deficiency. But how could he prove that? Goldberger spent eleven years, traveling frequently in the South where the disease was most common, and performed experiment after experiment. 

In 1923 his efforts finally paid off. Experimenting with dogs who were experiencing pellagra symptoms, Goldberger fed them brewer's yeast (something missing from most pellagrins' diets). Quickly, the dogs recovered. In 1926 the Mississippi River flooded. 700,000 people lost their homes and 45-50,000 developed pellagra. The Red Cross took Goldberger's recommendation to add yeast to the impoverished people's diet. Within two months people were cured. 

After Goldberger died in 1928, other scientists continued searching for the vitamin that would prevent pellagra. Eventually, Conrad Elvehjem discovered that nicotinic acid (now known as niacin) was indeed, the pellagra-preventing vitamin. Ten years later bakers began adding niacin, along with other Vitamin B complex vitamins to bread. That was the beginning of the enriched bread we enjoy today. 

According to a recent Writer's Digest article, "Straight Up Nonfiction with a Twist," one way authors enhance text is by using sidebars for supplemental material. Gail and her team at Calkins Creek did an excellent job of interweaving newspaper headlines, facts, and photos such as this one into the body of the text.

"Some doctors referred to the butterfly-shaped rash on the
girls neck as the Collar of Casal, named after
the first doctor to write about pellagra." (p. 83)

In addition, dozens of case histories of individuals whose lives were torn apart by the disease, are sprinkled throughout the book. 

In a recent SCBWI, Bulletin article, "What Teachers Want from Nonfiction Authors," Alexis O'Neill said that teachers wanted authors to share about their research and writing process. Accordingly, I asked Gail a few questions about her process.

Carol: What was it like for you to see the images of people afflicted with pellagra and pulling them together for this book?

Gail: Part of me approached this topic in a clinical manner. I have a background in biology, and I was fascinated to learn how a vitamin deficiency could lead to such dramatic physical symptoms. But when I read the accounts of patients’ suffering written by their doctors, I felt upset knowing this disease was so easy to prevent. Even after  pellagra’s cause and cure were discovered—and publicized—people continued to fall ill and die. Many victims lacked the resources to eat properly or didn’t realize how diet affected their bodies. Tragically, other deaths occurred because some physicians refused to accept that pellagra was a diet deficiency disease.

Carol: Was any part of this writing/publishing journey more difficult than another? 

Gail: The hardest part—and this is always the case when I write a non-fiction book—is locating and obtaining the primary documents.  Those were key because  secondary sources were contradictory about the early-20th-century understanding of pellagra, Joseph Goldberger and his research, and other details included in my book. Whenever possible, I go back to the original sources and do not necessarily trust what I read elsewhere. Too many times, I’ve found errors in the secondary sources.

For more information on the nitty gritty behind writing this book, see the informative Author's Note at the end of the book and Gail's interview in the School Library Journal. Teachers, make sure you utilize the educational activities which Gail has assembled. With such a detailed analysis of the disease, what caused it, and the stigmas associated with the disease, Red Madness will be an excellent supplement to history, sociology, and science lesson plans. 

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I usually give away the books which I receive to review. This time I donated Red Madness to The Christian Academy, where my daughter teaches. In an upcoming blog I plan to review another new book by Gail, Fatal Fever: Tracking Down Typhoid Mary.  You'll have a chance to win that one; both books are outstanding additions to any home or school library. 

Read this book and maybe you'll discover answers to the mystery disease which left its mark on someone you know.