The Real History of B Vitamins Part 1
Some time around 2600 BC, a Chinese medical text described an illness we would now recognise as beriberi
It set out the symptoms, observed that the disease followed a diet of polished rice, and noted that it could be prevented by eating the rice with its bran left on.
There was no laboratory and no company that stood to profit; there was only a physician who watched what happened to people, worked out what was missing and wrote it down, more than four and a half thousand years before Merck existed.
Certainly before the pharmaceutical industry existed and before anyone had coined the word “vitamin”, built a fermentation tank or filed a patent.
Over the course of May, Medicine Girl published a six-part series on the B vitamins. The argument running through all six articles is, in essence, that deficiency diseases were invented.
That the symptoms were really caused by toxins, poverty, or industrial poisoning; that opportunistic scientists then isolated cheap chemicals, gave them names, synthesised them in factories, and sold them back to a frightened public as the cure for an illness the industry had largely manufactured.
Thiamine, in her telling, “never existed in nature.” The whole edifice of fortification and supplementation rests, she argues, on a founding fraud.
It is a tidy story, and parts of it are true. Industrial food did strip nutrients from the diet, fortification did become a profitable and mandated business, and some of the modern supplement industry really is shovelling cheap synthetic compounds into people who would do better eating actual food.
None of that is in dispute here.
But the founding fraud never happened. The trouble with beginning the story in a Merck laboratory is that the story does not begin in a Merck laboratory. It begins with physicians, many of them working against the commercial and institutional grain of their own time, watching people sicken and recover, and being ignored, ridiculed, or punished for what they reported.
The real history of the B vitamins is not the history of an industry inventing disease; it is very nearly the opposite. It is the history of an establishment refusing, sometimes lethally, to believe that disease could come from something as unprofitable as a missing piece of food.
Nowhere is this clearer than in the case that ought to have settled the question half a century before the first vitamin was crystallised.
The Admiral Who Was Right, and the Army That Buried Him
In the early 1880s, beriberi was devastating the Imperial Japanese Navy. Crews and lower-ranking officers went down in their hundreds with the weakness, nerve damage, swelling and heart failure that characterised the disease, while the officers who ate a more Western diet largely escaped it.
Kanehiro Takagi, the Navy’s senior medical officer, drew the obvious inference — that something in the diet was responsible — and in 1884 he did something about it.
He ran an experiment. A battleship had recently completed a voyage on the standard polished-rice ration during which 169 of 376 men developed beriberi and 25 died.
Takagi sent another ship on a comparable nine-month voyage, this time with the diet changed to include more protein: bread and meat, and later barley mixed in with the rice.
On that voyage, 16 of 333 men developed beriberi and not one died. The few cases that did occur were traced to men who had refused the new food. The Navy adopted the changed diet, and beriberi in the fleet effectively disappeared after 1885.
Takagi did not have the full explanation. He believed the missing element was protein, and the real answer, a single micronutrient in the discarded bran, would not be named for another fifty years.
But he had proved the thing that mattered to the men dying on those ships: change the diet and the disease goes away. He had a controlled comparison, a dramatic result, and a fleet restored to health. By any reasonable standard the question was answered.
However, the Imperial Japanese Army did not accept the answer. Its medical establishment, led by men trained in the German bacteriological tradition then sweeping medicine, was convinced that beriberi was an infectious disease, a germ waiting to be found.
Takagi’s dietary evidence was dismissed as crude empiricism, the work of a naval officer who lacked a proper theory to explain his results. Chief among the sceptics was Mori Rintaro, the Army’s senior medical authority, today better remembered as Mori Ogai, one of Japan’s great novelists.
Mori held the line on the bacterial theory and against dietary reform with a tenacity that proved catastrophic.
When the Russo-Japanese War came in 1904 and 1905, the Army fed its soldiers polished rice. Beriberi tore through the ranks. By the most cited figures, around 250,000 Japanese soldiers contracted the disease and roughly 27,000 of them died of it, not from Russian guns but from the want of something the Navy had already shown how to prevent twenty years earlier.
The barley ration that would have saved them was known, available, and proven. It was refused because it did not fit the theory.
The Chickens That Disproved the Toxin Theory
While Takagi was changing naval diets, a Dutch physician was stumbling toward the same conclusion from a different direction. Christiaan Eijkman had been sent to the Dutch East Indies to find the bacterium he assumed was causing beriberi.
He was a student of the German school too, and he expected a germ. What he found instead, in 1897, was a flock of laboratory chickens that developed a beriberi-like paralysis when fed leftover polished rice from the military hospital, and recovered when the supply changed back to ordinary unpolished rice.
The toxin theory that Medicine Girl presents as a hidden truth is not hidden and is not new, it was the first thing these researchers thought of. Eijkman himself initially suspected a toxin.
He proposed that something in the starchy white rice was poisonous, and that a substance in the silver-coloured bran layer neutralised it. A toxin in the grain, an antidote in the bran. It was a reasonable guess, although it was wrong, and the person who showed it was wrong was Eijkman’s own assistant.
In 1901 Gerrit Grijns took the work further and ran the experiment that settled it. If beriberi were caused by a toxin in rice, then animals fed no rice at all should stay well. Grijns fed chickens on meat that had been heated for long enough to break down whatever it might contain, and they developed the disease anyway.
The problem could not be a poison in the rice, because the disease appeared without any rice. The only explanation that fit was that the birds were being starved of something essential that normal food contained and that heat and processing destroyed.
Grijns had described, in 1901, what we now call a deficiency disease.
The toxin idea was not buried by a pharmaceutical conspiracy. It was tested by the very scientists investigating the disease, found wanting, and replaced by a better explanation because the better explanation accounted for the evidence and the toxin theory did not.
That is the ordinary, unglamorous machinery of science working as it should. When Medicine Girl revives the storage-toxin explanation more than a century later and presents it as the suppressed real cause of beriberi, she is not exposing a cover-up.
She is re-proposing a hypothesis that was already on the table in the 1890s and that the next experiment knocked down.
Goldberger and the Disease Nobody Wanted to Own
The same pattern played out on the other side of the world, with a different vitamin and a different establishment, and it is the clearest example of all.
Pellagra, we now know, is a deficiency of niacin (vitamin B3). The American South was eating a diet built on cornmeal, and corn is famously low in available niacin unless it has been treated with alkali, the way Indigenous Mesoamerican cooks had been doing with their tortillas for thousands of years.
European colonisers exported the crop without the preparation method, and gave themselves a deficiency disease the people who had grown corn for millennia knew how to avoid.
In the early twentieth century, pellagra was killing people across the American South in enormous numbers. Over the first half of the century it produced something like three million cases and killed perhaps a hundred thousand people.
The disease announced itself with the “four Ds”: dermatitis, diarrhoea, dementia and death. And the medical consensus, once again, was that it must be an infection.
In 1914 the US government sent Joseph Goldberger to investigate. He looked at who was getting pellagra and who was not, and noticed something a germ could not explain. In orphanages and asylums, the inmates went down with pellagra while the staff, breathing the same air and drinking the same water, did not.
Infections do not respect the line between an inmate and an employee, diets do. The institutionalised poor ate a monotonous diet built on cornmeal and little else; the staff ate better. Goldberger concluded that pellagra was a disease of diet, not of contagion.
He proved it the hard way. He induced pellagra in prison volunteers by feeding them the restricted Southern diet, and he tried to give it to himself and his colleagues by injecting and swallowing the blood, secretions and waste of pellagra patients, the so-called “filth parties.”
They did not get sick.
A disease you cannot catch by deliberately consuming a patient’s bodily fluids is not an infectious disease. It was about as decisive a demonstration as medical ethics would ever again permit, and much of the establishment still resisted it, partly because admitting that pellagra came from poverty and poor diet meant admitting something uncomfortable about the conditions of the Southern poor.
Naming a Thing Is Not the Same as Inventing It
By the 1910s the shape of the answer was clear, even if its chemistry was not. In 1912 Casimir Funk coined the word “vitamine,” from “vital amine,” for the class of essential dietary factors whose absence caused these diseases.
The same year, the Polish-born biochemist’s coinage and Frederick Hopkins’s feeding experiments in Cambridge established the idea of “accessory food factors” that the body needed in tiny amounts and could not make for itself.
The substance behind beriberi was concentrated from rice bran by Umetaro Suzuki in Japan in 1910 and by Funk in London in 1911, working independently. It was finally crystallised in Java in 1926 and its structure worked out and confirmed by synthesis by Robert Williams in 1936.
Only at that last step, decades into the story, did the molecule acquire the name thiamine.
This sequence is fatal to one of the series’ central claims. Medicine Girl states flatly that thiamine “never existed in nature.” It plainly did, and does.
It exists in rice bran, which is exactly why removing the bran caused the disease and restoring the bran cured it. It exists in pork, in legumes, in barley, in sunflower seeds, in nutritional yeast.
The whole reason the disease tracked so precisely with polished rice is that polishing strips away the part of the grain where the thiamine lives.
What happened in 1936 was not that Williams conjured thiamine into existence in a laboratory, it was that he identified the structure of a molecule that had been in our food all along, and then reproduced it.
Isolating a compound from food and giving it a name does not make the compound synthetic. This is a point we will come back to in detail later in the series, because the difference between a nutrient as it occurs in food and the cheapest industrial form of that nutrient is one the responsible end of the supplement world takes seriously.
But “we can now make it in a factory” is not the same statement as “it never existed in nature,” and the second does not follow from the first.
What the History Shows
Step back and look at the shape of the four stories.
A naval doctor proves that diet causes beriberi and is dismissed by an army that prefers its theory, and tens of thousands die. A Dutch researcher and his assistant test the toxin explanation and disprove it, and describe a deficiency disease before the word for it exists.
An American investigator proves pellagra is dietary by methods that beggar belief, and meets resistance because the truth is socially inconvenient. And the nutrient at the centre of it all turns out to have been sitting in rice bran, liver and yeast the entire time.
This is not the history of an industry inventing diseases to sell cures. In every one of these cases the disease was real, the cause was nutritional, and the obstacle to recognising it was an establishment wedded to a more comfortable theory.
If there is a villain in the early history of the B vitamins, it is not the lone researcher who saw that food was the answer. It is institutional certainty: the conviction, held by powerful and credentialed people, that they already knew what caused these diseases and did not need to look at the evidence in front of them.
Medicine Girl’s series asks us to treat institutional consensus as proof of a cover-up, and her as the lone voice of the brave teller of suppressed truth. But the actual history of this field is not so flattering to the lone contrarian who insists the deficiency is a fiction.
In the real story, the contrarians who turned out to be right were the ones pointing at the missing food.
The people insisting the deficiency was not real, that it was really an infection, really a toxin, really anything but the un-glamorous absence of a nutrient, were the establishment.
They were wrong, and people died because of their incorrect certainty.
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