Goldberger, Joseph

(b. Girált, Hungary, 16 July 1874; d. Washington, D.C., 17 January 1929)

epidemiology.

The son of poor Jewish immigrants, Goldberger was brought to the United States at the age of six by his parents, Samuel and Sarah Gutman Goldberger, who settled on New York’s Lower East Side. He attended the city’s public schools and entered the College of the City of New York in 1890 as an engineering student. In 1892 his career plans changed, and Goldberger became a student at the Bellevue Hospital Medical School, graduating second in his class three years later. After placing first on the highly competitive Bellevue internship examination, he spent eighteen months at the hospital as intern and house physician. Following two unhappy years of private practice in Wilkes-Barre, Pennsylvania (1897-1899), he took and passed the examination for an assistant surgeon’s post in the U.S. Public Health Service. Appointed in 1899, he remained in the Public Health Service until his death.

Public health was then dominated by the infectious diseases; and during the next fifteen years Goldberger received intensive on-the-job training in classic epidemiology, beginning with a traditional apprenticeship as quarantine physician. When not on field assignments, he accumulated valuable experience in parasitology and bacteriology at the Public Health Service’s Hygienic Laboratory. By 1910 Goldberger played an increasingly responsible role in field investigations of yellow fever, typhus, and dengue—as well as other, less dramatic, ills. During these journeyman years he became successively a victim of yellow fever, dengue, and typhus. In the course of his investigations he acquired a reputation in the Public Health Service as one of its most gifted epidemiologists. Goldberger also developed a familiarity with conditions in the southern United States and—in his typhus work—with Mexico as well.

During these years Goldberger made several important epidemiological contributions. Perhaps most significant was his demonstration, with J. F. Anderson, that measles is transmissible to monkeys by a filter-passing virus and that the virus is present in buccal and nasal secretions. In his typhus studies, also in collaboration with Anderson, Goldberger was able to show that head as well as body lice could act as vectors and that “Brill’s disease,” described in New York City, was actually typhus. In another, less significant but impressively elegant, field investigation, he demonstrated the role of a straw mite in causing a dermatological ailment.

While in the midst of directing a detailed study of diphtheria in Detroit in the winter of 1913-1914, Goldberger was requested by Surgeon-General Rupert Blue to undertake the direction of an expanded antipellagra program. Work on this disease was, with one or two brief diversions, to fill the rest of Goldberger’s life.

Essentially unknown to American clinicians before 1900, pellagra had seemingly spread rapidly during the century’s first decade. Its unpleasant symptoms, its novelty, and its rapid increase in an era proud of its public health accomplishments tended to focus both lay and medical attention on this new and terrifying disease. As early as 1909 the Public Health Service established a special committee on pellagra. Although its most dramatic incidence was in certain southern orphanages, insane asylums, and cotton-mill villages, few areas in the South were completely free of the disease. Southern senators and representatives were instrumental in passing a special appropriation to underwrite the extended pellagra study which Goldberger was chosen to direct.

Traditional explanations of the disease, long familiar to physicians in Italy and other Mediterranean countries, centered on the role of a diet based largely upon corn. This theory—in the form that spoiled corn somehow provided an appropriate substrate for the growth of a toxin-producing microorganism—dominated the conjectures of physicians in the generation before 1910. But by 1914 medical opinion had shifted toward a belief that the disease was infectious—that pellagra was caused by some as yet undiscovered microorganism (possibly a protozoon spread by an insect vector).

A few writers, most notably the biochemist Casimir Funk, had suggested that pellagra might be the consequence of an inadequate or unbalanced diet. The idea was hardly novel in itself. Clinicians had known empirically for many years of the role of diet in the etiology of scurvy, beri beri, and possibly rickets as well. F. G. Hopkins’ and E. Willcocks’ demonstration in 1906 of the pathological effects of specific amino acid deficiencies was well known to knowledgeable American workers; only a year or so before Goldberger began his pellagra work, two American laboratories had almost simultaneously discovered the presence of an accessory food substance in butterfat (vitamin A).

Goldberger decided, almost as soon as he had been put to work on the problem, that pellagra was a consequence of improper diet. (The well-attested immunity of staff and administrators at pellagra-ridden asylums and orphanages seems to have been the most significant factor in determining his conviction; it has been pointed out that such immunity would have been difficult for a survivor of typhus and yellow fever to have ignored.) Goldberger then proceeded with great care and ingenuity to prove his original intuition. In three major steps he succeeded by 1916 in marshaling extremely strong evidence for his position. By supplementing diets in particular institutional populations, Goldberger almost completely eliminated the disease. In a critical experiment, moreover, he was able to induce symptoms of pellagra in five of eleven Mississippi prison-farm volunteers by providing them with an abundant but protein-deficient diet. (The other prisoners served as a control group.) In a final and almost dismayingly heroic experiment Goldberger and co-workers were unable to produce symptoms of pellagra in themselves through ingestion and injection of excreta, vomitus, nasal secretions, and material from the skin lesions of pellagrins.

By 1917 Goldberger had convinced America’s medical elite of the correctness of his views. Indeed, as early as November 1915 the Public Health Service had issued a press release reporting the Mississippi prison-farm experiment and urging that pellagra could be prevented by an appropriate diet; yet throughout the 1920’s many practicing physicians, especially in the American South, were unwilling to accept diet as a more than predisposing cause of pellagra. Chronic resentment toward the East and the well-financed Public Health Service seems to have contributed to this incredulity.

In the decade after World War I, Goldberger turned his efforts toward the identification of the constituent or constituents lacking in a pellagra-producing diet; it seemed to him most likely that the substance he sought was some amino acid component of such protective foods as meat and yeast. Influenced by earlier work on protein chemistry, he experimented with the use of particular amino acids, including even tryptophan, in experimental therapeutic trials. It is significant that Goldberger’s efforts were guided not only by the biochemist’s desire to isolate a particular substance or substances but also by the pragmatic epidemiologist’s desire to find an inexpensive and readily available food which might prove effective in preventing the disease.

The most striking aspect of Goldberger’s antipellagra work was its flexibility and sensitivity to social and economic context. Goldberger and his coworkers, most prominently statistician and economist Edgar Sydenstricker, exhaustively studied conditions in a number of self-contained mill villages, in several of which the incidence of pellagra was atypically high. They explored every environmental factor which might shape the daily life of the villagers; diet, they assumed, was a function both of custom and of economics. For example, mill communities in diversified farming areas without urban markets or good transportation would naturally have a more varied food supply than villages in cotton-growing areas with ready access to railroads and roads, facilities which would tend to siphon off none-too-abundant truck crops and fresh meats to towns and cities. In the scale and complexity of their work, in their dependence on team techniques and interdisciplinary studies, Goldberger and his co-workers were forerunners of a new idiom in the social approach to disease, one appropriate to the problems and techniques of the twentieth century.

On 19 April 1906 Goldberger married Mary Humphreys Farrar, the daughter of a prominent New Orleans family; they had four children. With a salary never adequate for comfort and a father gone for long periods on field investigations, the Goldbergers’ domestic life was often troubled. Goldberger died of cancer on 17 January 1929.

BIBLIOGRAPHY

A well-selected collection of Goldberger’s most important papers has been reprinted with a brief intro.: Goldberger on Pellagra, edited, with intro., by Milton Terris (Baton Rouge, La., 1964). The most important source for Goldberger’s life and work is his papers, deposited at the Southern Historical Collection, University of North Carolina Library, Chapel Hill. The collection contains many letters exchanged between Goldberger and his wife while he was on assignments in the field. The General Subject File of the U.S. Public Health Service, RG 90, boxes 150-155 in the National Archives, are devoted to the Service’s pellagra work and provide a detailed record of Goldberger’s place in their antipellagra campaign.

There is a full-length, popular biography: Robert P. Parsons, Trail to Light. A Biography of Joseph Goldberger (Indianapolis-New York, 1943); although largely uncritical, it does utilize the Goldberger papers extensively. See also Solomon R. Kagan, “Joseph Goldberger,” in Medical Life, 40 (1933), 434-445; W. H. Sebrell, “Joseph Goldberger (July 16, 1874-January 17, 1929),” in Journal of Nutrition, 55 (1955), 3-12; James M. Phalen, “Joseph Goldberger,” in Dictionary of American Biography, VII(New York, 1931), 363-364. For Goldberger’s pellagra work in perspective, see E. V. McCollum, A History of Nutrition. The Sequence of Ideas in Nutrition Investigations (Boston, 1957), pp. 296-317. For a clear presentation of the social assumptions which Goldberger held but never formally articulated, see Edgar Sydenstricker, Health and Environment (New York-London, 1933).

Charles Rosenberg

Goldberger, Joseph

American physician
1874–1929

Often considered a significant contributor to the field of nutrition science, Joseph Goldberger was born to a Jewish family in Girald, Austria-Hungary. When he was six years old, Goldberger and his family emigrated to the United States, settling on Manhattan's East Side.

Goldberger enrolled in City College in New York at the age of sixteen, determined to study engineering. At the end of his second year, Goldberger decided to switch to medicine after attending a lecture at Bellevue Hospital Medical College. In 1895, he obtained his medical degree from Bellevue and began private practice in a small Pennsylvania city. Bored after two years, Goldberger decided to take a competitive exam to enter the Marine Hospital Service, and he joined its ranks in 1899. The Marine Hospital Service, responsible for caring for sick merchant seamen and for fighting epidemics, was renamed the Public Health Service in 1902.

Goldberger married Mary Farrar in 1906. Because his marriage to a non-Jewish woman was unusual in his day, there were religious-based objections from both families.

During his time at the Public Health Service, Goldberger specialized in preventive medicine , infectious diseases , and nutrition. He fought tropical fevers, typhus , typhoid , and other infectious outbreaks throughout the United States and the Caribbean. In 1914, impressed with Goldberger's success, the Surgeon General of the United States appointed him to study the disease pellagra, which was becoming prevalent in the southern United States. Pellagra is characterized by skin rashes, mouth sores, diarrhea, and, if untreated, mental deterioration.

At the time, pellagra was thought to be an infectious disease. However, as Goldberger traveled throughout the South observing those with pellagra, he never contracted the disease. He noticed that poor people were more likely to get pellagra, and that their diet was restricted to cornbread, molasses, and a little pork fat. Institutions such as prisons, asylums, and orphanages also had higher levels of pellagra, and residents of these institutions also had limited diets. Based on this evidence, Goldberger concluded that pellagra had a dietary cause and was not infectious.

In 1915, Goldberger conducted a study with inmates at a Mississippi prison, who received a pardon in exchange for their participation. Inmates at this prison had a fairly balanced diet, and the volunteers were given the poor Southern diet that Goldberger associated with pellagra. Within months, the volunteers developed pellagra—and the pellagra symptoms disappeared when they were fed meat, fresh vegetables, and milk. Goldberger and his researchers also tried to catch the disease from infected inmates, but they were unsuccessful. This conclusive evidence proved Goldberger's theory that pellagra is caused by dietary factors and cannot be transmitted from one person to another.

Due to political and social circumstances, however, Goldberger had difficulty convincing others of this theory. In 1926, he reported that the lack of one of the B vitamins was responsible for pellagra, though he was unable to identify the specific vitamin.

Goldberger died of kidney cancer in 1929, at the age of fifty-four. In 1937, Conrad Elvehjem at the University of Wisconsin discovered that nicotinic acid, better known as niacin (vitamin B₃), prevented and healed pellagra.

see also Pellagra.

Karen Bryla

Bibliography

Akst, Daniel (2001). "Forgotten Plague." American Heritage, December/January, 72–79.

Koppman, Lionel (1986). Guess Who's Jewish in American History. New York: Steimatzky.

Internet Resources

National Institutes of Health, Museum of Medical Research. "Dr. Joseph Goldberger and the War on Pellagra." Available from <http://www.nih.gov/od/museum>

Science Odyssey. "People and Discoveries: Pellagra Shown to Be a Dietary Disease." Available from <http://www.pbs.9org/wgbh>

Vanderbilt University Medical Center, Eskind Biomedical Library Historical Collection. "Pellagra." Available from <http://www.mc.vanderbilt.edu>

GOLDBERGER, JOSEPH

In the pantheon of epidemiologists, Joseph Goldberger (1874–1927) ranks high. An Austrian immigrant, he grew up in New York, attended Bellevue Hospital Medical College, and began working with the U.S. Public Health Service in 1899. He had a distinguished career, investigating yellow fever with Milton Rosenau, typhoid in the Potomac River basin, dengue in Texas, louse-borne typhus, and other infectious diseases of public health importance.

In 1914, Goldberger turned his attention to pellagra, which was then prevalent in the southern United States. As Milton Terris has pointed out, Goldberger's achievement in unraveling the true nature of this previously mysterious disease equals John Snow's groundbreaking work on cholera. Pellagra causes a characteristic symptom cluster of skin eruptions, loose bowel movements, wasting of body mass, and in severe cases, mental and intellectual damage. When Goldberger began his investigation, a government commission had recently concluded that pellagra was an infectious disease of unknown nature, perhaps aggravated by a protein-deficient diet. Based on logical conclusions from three basic facts, Goldberger showed the infection hypothesis to be wrong. Goldberger knew that staff in institutions where pellagra was common among inmates did not get the disease; that it was much commoner in isolated rural regions than in cities, where people were in closer contact; and that it was associated with poverty. Goldberger concluded that pellagra must be due to a dietary deficiency.

His subsequent investigations, often in collaboration with Edgar Sydenstricker and others, included experiments with rhesus monkeys; a dietary survey of affected and unaffected families; and experiments using himself, his colleagues, and his own wife, in which they subjected themselves to ingestion and inhalation of bodily secretions. None of his investigations revealed evidence of a transmissible agent. The final stage of the investigation was another human experiment done on the residents of orphanages (without the ethical approval such studies would require now). This identified the pellagra-preventing factor, which was found to be associated with foods containing high concentrations of vitamin B. Unfortunately, Goldberger died before this factor, nicotinic acid, or niacin, was isolated and chemically identified.

John M. Last

(see also: Nutrition; Snow, John; Sydenstricker, Edgar )

Bibliography

Terris, M. (1964). Goldberger on Pellagra. Baton Rouge: Louisiana State University Press.

GOLDBERG, RUBE

GOLDBERG, RUBE (1883–1970), U.S. cartoonist. Reuben Lucius Goldberg, satirist of American folkways and creator of improbable and outlandish devices and inventions, was born in San Francisco, Calif. His father insisted he go to college to become an engineer. After graduating from the University of California at Berkeley, Goldberg went to work for the San Francisco Water and Sewers Department. After six months, Goldberg joined the sports department of a San Francisco newspaper and kept submitting drawings and cartoons to its editor, until he was finally published. He moved to New York, drawing daily cartoons for The Evening Mail. At first he was a sports cartoonist and sportswriter, but one day, with a little space left over from his cartoon, he filled it with "Foolish Question No. 1," which showed a man who had fallen from the Flatiron Building being asked if he was hurt. "No, I jump off this building every day to limber up for business," he replied. The Foolish Question caught on, and Goldberg wound up doing thousands of them. Many of his ideas came from readers, fascinated with the nearly probable. As comic strips grew in popularity, Goldberg conceived the character Boob McNutt, a simple-looking fellow who was in love with a beautiful girl named Pearl. Their blunder-filled courtship went on from 1916 to 1933. Goldberg also created the strip Lala Palooza, about a woman of ample girth. His most enduring creation was Professor Lucifer Gorgonzola Butts, the inventor of marvelously complicated contraptions designed to accomplish fairly simple ends. An exhibition of these nonexistent and zany gadgets opened at the National Museum of History and Technology of the Smithsonian Institution in Washington in 1970. The Goldbergs of yesterday were catalogued under the show title "Do It the Hard Way: Rube Goldberg and Modern Times." There were cartoons, comic strips, and oddly ingenious doodads that might have been invented by Goldberg himself. The cartoonist's ludicrous inventions became so widely known that Webster's Third International Dictionary listed the adjective "rube goldberg" and defined it as "accomplishing by extremely complex roundabout means what actually or seemingly could be done simply."

In the middle 1930s, comic strips declined in popularity and at the age of 55 Goldberg embarked on a career as an editorial cartoonist for The New York Sun and later the New York Journal-American, for which he drew 5,000 cartoons. One of his cartoons, "Peace Today," warning of the perils of atomic weapons, which appeared in The Sun, won a Pulitzer Prize in 1948.

[Stewart Kampel (2^nd ed.)]

GOLDBERGER, JOSEPH

GOLDBERGER, JOSEPH (1874–1929), U.S. physician and public health specialist. Goldberger, who was born in Giralt, Hungary, immigrated to the U.S. at an early age. From 1899 until his death he served in the U.S. Public Health Service in Washington, d.c. Goldberger's greatest contribution was his discovery of the etiology and therapy of pellagra and his introduction of nicotinic acid as a means of preventing the disease. He also made significant contributions in the study of infectious diseases and public health, particularly in the field of welfare of the poor.

bibliography:

S.R. Kagan, Jewish Medicine (1952), 549; Biographisches Lexikon der hervorragenden Aerzte, 1 (1932), s.v.

[Suessmann Muntner]