160 Convent Ave, New York, NY 10031, United States
Joseph entered the College of the City of New York in 1890 as an engineering student.
Gallery of Joseph Goldberger
550 1st Avenue, New York, NY 10016, United States
In 1892 Goldberger became a student at the Bellevue Hospital Medical School (now New York University School of Medicine), graduating second in his class three years later.
In 1892 Goldberger became a student at the Bellevue Hospital Medical School (now New York University School of Medicine), graduating second in his class three years later.
Joseph Goldberger was an American epidemiologist who served at the United States Public Health Service. He was the first who showed that pellagra was the result of a nutritional deficiency.
Background
Joseph Goldberger was born on July 16, 1874, in Girált, Kingdom of Hungary (now Giraltovce, Slovakia). 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.
Education
Joseph 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 (now New York University School of Medicine), graduating second in his class three years later.
After placing first on the highly competitive Bellevue internship examination, Joseph 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 United States Public Health Service. Appointed in 1899, he remained in the Public Health Service until his death.
Public health was then dominated by 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.
Goldberger decided, almost as soon as he had been put to work on the problem, that pellagra was a consequence of improper diet. By 1917 he 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.
Goldberger decided 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.
Connections
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.