Jobling and Peterson (10) arrived from their studies of the disease in Nashville at a similar conclusion as to the transmissibility of pellagra. They were led by their observations to conclude that the disease attacked those who were domiciled in parts of the city which were either without sewage disposal or where it was inadequate. Pellagra could be correlated with unscreened houses, and access of flies to human excreta and to human habitations.

With regard to diet, they stated that the inhabitants of the South consume excessive amounts of carbohydrates and fats, but pointed out that in Nashville the people of the class in which pellagra occurred most frequently, eat during the spring and summer, a great deal of potatoes, fruits and other fresh foods. This led them to the belief that pellagra cannot be due to a deficiency of a "vitamin" in the sense that beri-beri is. They stated in this connection: "It seems strange, if this theory is correct, that pellagra should be so rare in winter when green foods are scarce, and so frequent in the spring and summer when green foods and fruits are plentiful and cheap." Gold-berger felt that this very fact that the scarcity of fresh fruits and vegetables, especially green foods, in winter, was significant as an argument in favor of the hypothesis that the disease was the result of a faulty diet. It is reasonable to suppose that any effect on health which might follow the adherence to a faulty diet, would, under such circumstances, appear at the end of winter, and the effect of a more satisfactory diet in spring and summer would not necessarily become apparent for a time in persons who had been seriously injured by several months restriction to a faulty diet. It may require several months to induce scurvy or beri-beri in man through the agency of a defective diet, and recovery is slow, even when the diet is modified so as to contain everything which is physiologically essential.