HSCI 130: CASE EXAMPLE OF DISEASE FRAMING
QUESTIONS AND ANSWERS
disease refers to... - Answers - Diagnosed or diagnosable pathologies → meaning some
kind of medical condition that can be identified through medical knowledge or tests.
what is Pellagra caused by? - Answers - Pellagra is caused by niacin (vitamin B3)
deficiency.
what is the 4 Ds of Pellagra - Answers - Dermatitis → skin inflammation/rash
Diarrhea → digestive issues
Dementia → neurological/mental symptoms
Death → if untreated, it can be fatal
why does paradigms matter in the case of pellagra? - Answers - For a long time,
doctors believed pellagra was an infectious disease (caused by germs). Because of this
paradigm, they focused on sanitation and contagion control. In reality, it was a
nutritional deficiency. Once the paradigm shifted to considering diet, the real cause was
found, and the disease could be prevented through nutrition.
Why did a new disease, termed "pellagra" emerge in 17th/18th century Europe? -
Answers - New crops altered the diet of the population.
Explanation:
Pellagra emerged in Europe when maize (corn) was introduced from the Americas in
the 17th/18th centuries.
Corn became a staple food for poorer populations because it was cheap and easy to
grow.
However, maize is low in niacin (vitamin B3) and also contains compounds that make
niacin harder for the body to absorb, leading to widespread nutritional deficiency.
Because people relied heavily on corn without enough dietary diversity, pellagra (the "4
D's") appeared.
What did they think was the first causality of PELLAGRA IN EUROPE FROM 17TH
CENTURY - Answers - 1735 Casal: A physician to the Spanish king was one of the first
to describe pellagra, calling it "mal de la rosa"(disease of the rose), likely because of the
red skin rash.
Causality they noticed:
It was associated with poverty (poor people had limited diets).
Pellagrins (patients) ate mostly corn + very little meat.
The disease increased during spring, probably when diets were at their weakest.
Early theory: Instead of recognizing nutritional deficiency, doctors thought the cause
was spoiled corn producing toxins.
, why were records done bye physicians so important in 18th century Europe? - Answers
- By the 18th century, pellagra was becoming widespread in Europe, especially in areas
where corn was a staple food.
Physicians were beginning to record cases and symptoms systematically, as shown in
this Latin text.
These records are important because they demonstrate how medicine was trying to
make sense of a new disease—but without knowledge of vitamins or nutrition,
explanations were limited.
Early texts often focused on describing symptoms and mortality, but they misinterpreted
the cause, leaning on theories like spoiled corn, toxins, or poor sanitation.
. In 1907, Dr. Searcy documented 88 pellagra cases at Mount Vernon Hospital in
Alabama. Most cases were: - Answers - women
What was the main setting for early pellagra outbreaks in the U.S.? - Answers -
Orphanages, mental hospitals, and prisons
Which factor explains why pellagra was especially concentrated in the Southern U.S.? -
Answers - Corn-heavy diets linked to poverty
Pellagra epidemics in the U.S. were especially concentrated in: - Answers - Southern
states
How did the media describe pellagra in early 1900s America? - Answers - As an "awful
disease" and a "new menace to America," spreading panic.
What does the headline "Interest Widespread" tell us about the medical response? -
Answers - That pellagra was seen as a major crisis, leading to large medical
conferences and national attention.
How did media framing reinforce the wrong paradigm? - Answers - By treating pellagra
as if it were contagious, which delayed recognition of the real nutritional cause.
What does the term "pellagrophobia" mean? - Answers - The fear and stigma
surrounding pellagra, fueled by media and public panic.
Who was Dr. Joseph Goldberger, and why was he important in the history of pellagra? -
Answers - He was a U.S. Public Health Service physician who investigated pellagra in
the South and proved it was caused by poor diet (niacin deficiency), not infection.
Why did Goldberger's investigations matter for shifting paradigms? - Answers - His work
disproved infection theories and introduced a nutritional paradigm for disease.
QUESTIONS AND ANSWERS
disease refers to... - Answers - Diagnosed or diagnosable pathologies → meaning some
kind of medical condition that can be identified through medical knowledge or tests.
what is Pellagra caused by? - Answers - Pellagra is caused by niacin (vitamin B3)
deficiency.
what is the 4 Ds of Pellagra - Answers - Dermatitis → skin inflammation/rash
Diarrhea → digestive issues
Dementia → neurological/mental symptoms
Death → if untreated, it can be fatal
why does paradigms matter in the case of pellagra? - Answers - For a long time,
doctors believed pellagra was an infectious disease (caused by germs). Because of this
paradigm, they focused on sanitation and contagion control. In reality, it was a
nutritional deficiency. Once the paradigm shifted to considering diet, the real cause was
found, and the disease could be prevented through nutrition.
Why did a new disease, termed "pellagra" emerge in 17th/18th century Europe? -
Answers - New crops altered the diet of the population.
Explanation:
Pellagra emerged in Europe when maize (corn) was introduced from the Americas in
the 17th/18th centuries.
Corn became a staple food for poorer populations because it was cheap and easy to
grow.
However, maize is low in niacin (vitamin B3) and also contains compounds that make
niacin harder for the body to absorb, leading to widespread nutritional deficiency.
Because people relied heavily on corn without enough dietary diversity, pellagra (the "4
D's") appeared.
What did they think was the first causality of PELLAGRA IN EUROPE FROM 17TH
CENTURY - Answers - 1735 Casal: A physician to the Spanish king was one of the first
to describe pellagra, calling it "mal de la rosa"(disease of the rose), likely because of the
red skin rash.
Causality they noticed:
It was associated with poverty (poor people had limited diets).
Pellagrins (patients) ate mostly corn + very little meat.
The disease increased during spring, probably when diets were at their weakest.
Early theory: Instead of recognizing nutritional deficiency, doctors thought the cause
was spoiled corn producing toxins.
, why were records done bye physicians so important in 18th century Europe? - Answers
- By the 18th century, pellagra was becoming widespread in Europe, especially in areas
where corn was a staple food.
Physicians were beginning to record cases and symptoms systematically, as shown in
this Latin text.
These records are important because they demonstrate how medicine was trying to
make sense of a new disease—but without knowledge of vitamins or nutrition,
explanations were limited.
Early texts often focused on describing symptoms and mortality, but they misinterpreted
the cause, leaning on theories like spoiled corn, toxins, or poor sanitation.
. In 1907, Dr. Searcy documented 88 pellagra cases at Mount Vernon Hospital in
Alabama. Most cases were: - Answers - women
What was the main setting for early pellagra outbreaks in the U.S.? - Answers -
Orphanages, mental hospitals, and prisons
Which factor explains why pellagra was especially concentrated in the Southern U.S.? -
Answers - Corn-heavy diets linked to poverty
Pellagra epidemics in the U.S. were especially concentrated in: - Answers - Southern
states
How did the media describe pellagra in early 1900s America? - Answers - As an "awful
disease" and a "new menace to America," spreading panic.
What does the headline "Interest Widespread" tell us about the medical response? -
Answers - That pellagra was seen as a major crisis, leading to large medical
conferences and national attention.
How did media framing reinforce the wrong paradigm? - Answers - By treating pellagra
as if it were contagious, which delayed recognition of the real nutritional cause.
What does the term "pellagrophobia" mean? - Answers - The fear and stigma
surrounding pellagra, fueled by media and public panic.
Who was Dr. Joseph Goldberger, and why was he important in the history of pellagra? -
Answers - He was a U.S. Public Health Service physician who investigated pellagra in
the South and proved it was caused by poor diet (niacin deficiency), not infection.
Why did Goldberger's investigations matter for shifting paradigms? - Answers - His work
disproved infection theories and introduced a nutritional paradigm for disease.
