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Goldberger's War chronicles one of the U.S. Public Health Service's most renowned heroes--an immigrant Jew who trained as a doctor at Bellevue, became a young recruit to the federal government's health service, and ended an American plague. He did so by defying conventional wisdom, experimenting on humans, and telling the South precisely what it didn't want to hear.
- Sales Rank: #642517 in Books
- Brand: Brand: Hill and Wang
- Published on: 2004-09-01
- Released on: 2004-08-26
- Original language: English
- Number of items: 1
- Dimensions: 9.00" h x .78" w x 6.00" l, 1.00 pounds
- Binding: Paperback
- 336 pages
- Used Book in Good Condition
From Publishers Weekly
The title in this fascinating history refers not to any military battle, but to a doctor's successful fight against the disease known as pellagra. Until Joseph Goldberger proved otherwise in the early 20th century, the illness, a scourge of the South, was believed to be an infectious disease. Goldberger's diligent research and tireless campaigning demonstrated that it was, in fact, due to dietary deficiencies. (Later researchers showed that pellagra resulted from a lack of niacin.) Using both primary and secondary documents, Kraut, a professor of history at American University, traces Goldberger's life from his late-19th-century childhood on the Lower East Side of New York City to his rise through the U.S. Public Health Service. This story follows an immigrant's rise in America, but in Kraut's hands, it is more than just a biography; it is also a history of science. Kraut shows how Goldberger worked to push for the eradication of the disease-even using radical methods, such as injecting forms of the disease into himself, his wife and other subjects. Kraut also subtly demonstrates how such factors as religion, class and regionalism played themselves out in Goldberger's life. The son of Orthodox Jews, Goldberger married the grandniece of Confederate leader Jefferson Davis, but not before both families struggled with the intermarriage. And as Kraut shows in this engaging and multilayered American history, much of the fight against Goldberger's findings came from Southerners who were concerned that his work would reinforce the region's image as backward.
Copyright 2003 Reed Business Information, Inc.
From The New England Journal of Medicine
Goldberger's War opens in 1916, as Joseph Goldberger injects his wife with blood taken from patients with advanced pellagra. As the vignette suggests, historian Alan Kraut's engaging biography is about a bold medical investigator, an inexplicable disease, human experimentation, and an unusual marriage. (Figure) In 1874 Joseph Goldberger and his family left Hungary for New York City. His father ran a grocery store on the Lower East Side, and the son studied medicine at Bellevue Hospital's Medical College, graduating in 1895. Goldberger's limited means and his identity as a Jewish immigrant led to his rejection by the U.S. Navy Medical Corps, which he tried to join at the start of the Spanish-American War. In 1899 Goldberger entered the Public Health Service, in which he spent the rest of his professional life, attracted by both the regular government salary and the opportunities for scientific investigation in the laboratory and in the field. While holding his first position, as a quarantine officer, he was introduced by a fellow physician to Mary Humphreys Farrar of New Orleans. Her father, a wealthy Episcopalian lawyer, conducted an investigation of the Goldberger family before reluctantly agreeing to the marriage of Joseph and Mary in 1906. The young couple struggled to create a happy, mixed-faith family. For Joseph, Kraut argues, the Public Health Service's Hygienic Laboratory "would become his temple," but for Mary, his constant traveling left her too often as the sole parent of four rambunctious children. And his work could be dangerous: Goldberger contracted yellow fever in 1902, dengue fever in 1907, and typhus in 1910. To Mary he admitted "a certain pride in my `battle' scars . . . received in the line of duty for my country." In the early 20th century, the Public Health Service offered its officers an exciting new job as physician-investigators on "search and destroy" missions, calming a hysterical public, confronting the skeptical with technological expertise, and saving the day with scientifically sound solutions. The work was not always so simple, however, as Goldberger discovered when he began to argue that pellagra -- a major health problem in the South with an associated mortality rate of around one in three -- was caused not by a germ but by a nutritional deficiency. Drawing on histories by Elizabeth W. Etheridge and Daphne A. Roe, as well as on letters between Goldberger and his wife, Goldberger's published work, and an interview with Goldberger's son, Joseph Herman Goldberger, Kraut traces Goldberger's efforts to convince the medical profession and the public of his theory. At that time, the germ theory had made environmental explanations sound old-fashioned and unscientific. White Southerners, angry at this attack on their region and on the "three-m" diet of the rural poor (meat, meal, and molasses), retorted that pellagra was a "germ" disease, thus one that could easily be fixed by some kind of sanitary measure. Black physicians, conscious that deficiency diseases were frequently blamed on ignorant, lazy, and thriftless black persons, also argued that pellagra was "communicable," that perhaps, like yellow fever, it was spread by insects. Impressed by suspicious evidence that pellagra appeared in state institutions among inmates but never among their keepers, Goldberger tried to undermine theories of bacterial infection by organizing "filth parties," during which he, his wife, and 14 volunteers took pellagra "pills" and were injected with pellagra-contaminated blood. I wish Kraut had speculated further and explored Goldberger's attraction to an explanation for pellagra based on nutrition. Certainly his sharp eyes, trained to detect diseases caused by germs and insects, could "sweep away" other explanations. Or perhaps Goldberger's assumption that milk and other "animal proteins" were the solution may have reflected the effect of the powerful advertising campaigns conducted by the dairy industry in the popular and medical press (to counter the many times milk was blamed for outbreaks of typhoid fever and tuberculosis) -- a kind of early 20th-century version of "Got Milk?" A more troubling side of Goldberger's efforts to prove that pellagra could be explained by diet, not germs, was his experimentation for over a decade on human subjects who were in orphanages, prisons, and asylums. Kraut admits that the mentally ill black women at the Georgia state asylum who were Goldberger's subjects from 1915 to 1926 "had little choice about whether they would participate," but he has restricted what should have been an extensive bioethical discussion of these experiments to a brief footnote. For Goldberger, the solution to pellagra was a political morass that defeated him. The detailed epidemiologic study of seven mill towns in South Carolina that he conducted with statistician Edgar Sydenstricker, also in the Public Health Service, showed the complex social and economic factors that underlay the Southern agricultural economy and shaped what people ate and why they got sick. By the mid-1920s, although Goldberger acknowledged that "the problem of pellagra is in the main a problem of poverty," he concluded that bold structural solutions such as food cooperatives and community dairies would not "conform to local conditions" and retreated to the relative serenity of the laboratory to try to find a specific "pellagra-preventive." Mary Goldberger lobbied Congress to establish the National Institute of Health. In 1927, when a massive pellagra outbreak threatened after floods on the Mississippi River, the Red Cross, advised by Goldberger, developed a "moderate" solution -- education about nutrition and handouts of canned vegetables, brewer's yeast, and even some cows. Nominated five times for the Nobel Prize, Goldberger died in 1929 amid odd rumors that the cause of his death was not kidney cancer but pellagra. His wife received a $125-a-month pension thanks to a special congressional bill that recognized the value of Goldberger's work. In the 1930s niacin deficiency was identified as the specific cause of pellagra, although the Southern Medical Association continued to honor researchers who demonstrated the pellagra "virus." The disease ceased to be an important American health problem as a result of the expanded use of home refrigerators, made possible by the New Deal's electrification programs, and the government-mandated vitamin enrichment of bread and flour that was introduced during World War II. In this century, however, pellagra continues to threaten communities in the Third World whose food supply is disrupted by civil war. "Goldberger's war never really ends," Kraut concludes. "We just send in fresh troops." In this engrossing story of an American medical hero whose work and life illustrate the intertwining of medical, social, and political history, Kraut shows us that the research and practice of physicians can help to explain how people become sick, but that especially for diseases for which there are no vaccines, prevention and treatment must involve a conscious reorganization of the ways people live and of the social and economic factors that shape their choices. Naomi Rogers, Ph.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
From Booklist
At the turn of the twentieth century, the American South was plagued by pellagra, a disease characterized by dermatitis, diarrhea, dementia, and death. In 1912, South Carolina alone reported some 30,000 cases, with a 40 percent fatality rate. Of unknown etiology, pellagra had public-health officials stymied. Enter Joseph Goldberger. In 1914, this public-health physician was assigned the task of finding the cause and cure for what had come to be called "the scourge of the South." In this biography, substantially documented from Goldberger's personal and professional correspondence, Kraut recounts how the idealistic physician faced down several dread diseases while tackling the politics of public health. Often becoming a willing subject of his experiments, he put his life at risk as bravely as any infantryman, contracting three of the sometimes-fatal ailments he sought to cure, including typhus and yellow fever. His is the inspiring story of a man who confronted the grim reality of infectious disease in pursuit of a healthier future for America. Donna Chavez
Copyright © American Library Association. All rights reserved
Most helpful customer reviews
3 of 5 people found the following review helpful.
Very quick service
By H. Ohde
The quality of the book is excellent. I received my order within 2-3 days. Thank you!
7 of 7 people found the following review helpful.
A Fine Bio of a True American Hero
By A Southern Reader
Joseph Goldberger is a true American hero. He was a US PHS officer who devoted his life to combating various infectious and communicable diseases. However, his biggest triumph was in determining that pellagra, a disease you never hear of any more but in the 19th and early 20th century took the lives of thousands, was caused by a dietic deficiency not a germ or virus. Pellagra was especially prevalent in the US southeast where poor sharecroppers and mill workers often were the victims. The book is very well written and addresses the medical mysteries and the social barriers to implementing Goldberger's suggestions. Alan Kraut has done a real service in preserivng Godlberg's life and work in the book. I think the book will be enjoyed
by those who like biographies and medical mysteries.
4 of 4 people found the following review helpful.
A very good read.
By A. Wozniak
The book is well written, very interesting, and easy for a lay person to understand. If you like to read medical history books and don't remember or know about the achievements of Joseph Goldberger, then you should read this book. The book would be a good Christmas or birthday present.
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