Dietary change and epidemic disease: fame, fashion and expediency in the Italian pellagra disputes, 1852-1902

The case of the dietary deficiency disease known as pellagra provides an example of how dietary change, in this case the shift to mass maize cultivation and consumption in nineteenth-century northern Italy, led to directly to disease, in this case the very man-made epidemic of pellagra. There was evidently something potentially very unhealthy about maize: by the middle of the nineteenth century all the medical actors in Italy involved agreed on the link between maize subsistence and pellagra. What they disagreed on was the exact causal nature of that link, propounding two divergent, indeed mutually exclusive, explanatory models. How the cultural dominance of one explanatory model, at the expense of another, came about; what it tells us about the nature of Italian medical science in the last few decades of the nineteenth century; and what its dominance meant for pellagra sufferers, is the subject of this chapter.