In 1735, Spanish physician Don Gaspar Casal identified pellagra among peasants in Spain's Asturia region, labeling it "mal de la rosa." This ailment exhibited classic symptoms like dermatitis, diarrhea, and dementia, often resulting in fatality. Casal's posthumous work in 1762 extensively elaborated on the condition, using a Spanish term that echoed the characteristic sunburn-like skin erythema associated with pellagra.
The initial documented cases of the disease in 1755 and 1762 provided an accurate description, linking it to spoiled maize. Pellagra emerged in Italy approximately 50-100 years later, persisting widely in the country during the nineteenth century, with Lombardy reporting 39,000 cases in 1862. Serbia and Southern Russia grappled with the disease in the early 20th century.
The term "pellagra" likely made its debut in 1771 in Milan, Italy, coining the name that denotes "rough skin." Frappoli in 1771 proposed the term, possibly tracing its origins to the "pellarella" documented in Milan in 1578.
In the first half of the 19th century, societal aspects of pellagra gained attention, particularly in Liberali's 1831 studies on the manic dementia linked to the condition. Pellagra vanished from Southern France around 1880, and by 1916, it had nearly disappeared in Italy for reasons that remain unclear.
In 1922, Goldberger and Tanner suggested that pellagra resulted from an amino-acid deficiency. Joseph Goldberger, an American physician and epidemiologist, is acclaimed in American clinical epidemiology for his pellagra studies in the early 20th century.
The 1937 discovery that pellagra is caused by a deficiency in niacin (nicotinic acid), a B vitamin, highlighted that the body's synthesis of this vitamin depends on the availability of the essential amino acid tryptophan, found in milk, cheese, fish, meat, and eggs.
Pellagra: History and Discovery
