Pellagra: The Mystery Disease that Brought Monsters to Europe

Pellagra is a disease of which most people have never heard. It is understood today, and treatment is straightforward; in fact, nobody needs to suffer form it at all. But it deserves a mention as a historical footnote because of what it did to Europe, and as an interesting study in how legends are formed.

European folklore can be broadly divided into two sections, both of which are monstrous. Most such tales involve the ancient monsters of the wilds, usually playful rather than outright dangerous but still potentially deadly to the unwary. 

These types of creatures are the manifestations of how dangerous the world can be away from the safety of community and civilization. These monsters are everything you might expect: they cannot harm you if you stay on the path, they are more dangerous in the winter than the summer, they are elusive and most people never even see them.

But the other type of folklore, the monsters that live among us, are not so easily understood. These are the vampires and werewolves of Europe, the creatures who take on a human form and who are based on witness evidence, not giving human traits to natural processes. 

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These come from direct experience of individual cases, and this is what makes them fundamentally different. It is relatively straightforward to see how forest spirits come to be, but less so to understand stories of the dead rising from their graves.

In these instances the legends are always based upon multiple cases, all of which add something to the myth until it gains a life of its own and becomes much more than any one story. Werewolves for example exist as a loose collection of stories from around the world of animal predation, cannibalism and madness, all of which contribute to the myth in part, but never in full.

Vampires are the same, and it can be an interesting exercise in unpicking where these tales arise. Before the high gothic of Stoker’s strange Count Dracula, before the rumours of noblewomen bathing in human blood, the vampire in its original form shares a lot with the zombie, a shambling undead figure on the fringes of society.

Such individuals are not cursed but most often diseased and misdiagnosed. A while werewolves and vampires date back beyond the medieval period to the European Dark Ages, for Renaissance Europe at least we have a solid understanding of where such instances came from.

And it starts with the New World, and a disease called pellagra.

Poison in Your Food

The New World had many bounteous treasures to share with Europe. Its foodstuffs and other flora wildly expanded our staples: these were the lands of the potato, of tobacco and of maize.

And of these it may be the last which casts the longest shadow today. Maize is among the most cultivated crops on the planet, more than wheat or rice, a product which finds its way into almost every culinary culture. It is hardy, it grows quickly, and it produces a corn rich in nutrients.

This was quickly recognized by European traders who took advantage of the new routes to the New World. Maize was brought back the Europe where it thrived, its value as a cheap crop seeing it become a standard foodstuff for the poor.

But hidden within the maize was a killer, something of which Europe was not aware. Corn had a fatal flaw, a hidden gap in its nutrients which could prove deadly for those who depended on it too much in their diet. This disease was known as pellagra.

Pellagra is clearly understood today, it derives from a lack of niacin in the body. Niacin, also known as Vitamin B3, comes from two places: either it is ingested directly from a wide variety of foodstuffs or synthesized within the body by the amino acid tryptophan. 

What was not known to Renaissance Europe was that niacin was only present in small quantities in maize. Furthermore, maize is additionally a poor source of tryptophan, and therefore those who relied on maize for a majority of their caloric intake would develop pellagra.

Pre-Columbian societies of the New World understood this, and also understood how to prevent pellagra. Corn in South and Central American countries was specially treated using a process called nixtamalization.

Maize was soaked in an alkaline solution before being prepared as a foodstuff. This caustic mixture acts to partially break down the corn, and as a result the niacin within the grain can be accessed by the human body. Maize treated in this way is entirely safe to eat.

But the Europeans did not know about the need for nixtamalization. They brought this new foodstuff back with them unaware of its potential dangers. And for centuries they were none the wiser.

So, where does the link to folklore and monsters fit in? Well, here are some of the symptoms of pellagra: facial swelling, especially around the tongue, skin damage particularly to the hands, sleeplessness, uncharacteristic aggression and disorientation, and an aversion to light. Not hard to see what that sounds like.

There are even symptoms which provide a neat, and gothic touch. Perhaps the most consistent and diagnostic symptom is a distinctive rash around the collar. Is it too far a stretch to see this as proof of something unholy, blistered skin exactly where a crucifix is ordinarily worn?

Nor does pellagra kill quickly: sufferers can live for years before it destroys them. These disfigured people would spend that time either in seclusion, or more likely outcasts from society, living on the edges by whichever means they could.

Here are our monsters, here are the werewolves and vampires shunning the light and preying on the weak simply to survive. Here are the creatures from myth, newly apparent in the poorest societies where dependence on maize was at its highest.

This is, of course, not to say that such sufferers were truly monsters. It is however clear that the disease was misunderstood, and that those that saw the afflicted would have made the link to existing folklore: why look for a new explanation when you have evidence for an existing one?

The link between pellagra and maize took centuries to be established. Although the symptoms were isolated and described in the 18th century, debate as to the cause was still ongoing over a century later. 

Some believed pellagra to come from an insect, like malaria, or to be an undetected disease in maize itself, or to even be entirely unrelated. France managed to eliminate it by banning maize production, but it remained endemic in much of the rest of Europe, particularly northern Italy, for centuries.

Perhaps the worst single outbreak occurred however in the United States. A pellagra epidemic swept through the southern states at the start of the 20th century, persisting as late as 1940 and with millions of sufferers. Only when it was realized that the Pre-Columbian cultures did not suffer in the same way was the solution, finally, found.

Today pellagra is easily resolved with a niacin supplement, but this has not removed either the disease nor its sufferers. There are still people afflicted with pellagra on the fringes of society, typically in African or Asian countries. Such people may not even realize what it is that afflicts them.

It would see that the vampires and werewolves of folklore haunt us still.

Header Image: The symptoms of pellagra may well have given rise to legends of werewolves and vampires in Europe. Source: Unknown Author / Public Domain.