The Salmon Patty Cure: Appalachia’s Forgotten Epidemic

The Salmon Patty Cure: Appalachia’s Forgotten Epidemic

In the hollers of Eastern Kentucky and across Appalachia in the early 1900s, folks weren’t dying from old age or a bad fall off a ridge; they were dying from corn.

Or more specifically, a diet that revolved almost entirely around it.

This wasn’t the corn's fault, bless it. It was the fact that nothing else was on the plate.

What the Hell Is Pellagra?

Pellagra is a niacin (vitamin B3) deficiency. It shows up with four unforgettable D’s: dermatitis, diarrhea, dementia, and death.

Sounds like a bad week at summer camp, but this disease hit hard, especially in poor, rural communities whose meals were mostly cornmeal, biscuits, and not much else.

Between 1900 and 1940, pellagra killed over 100,000 Americans, many in the South and Appalachian regions.

Enter the Salmon Patty (a.k.a. The Pink Pill of the Mountains)

Canned salmon was cheap, shelf-stable, and loaded with niacin. In the 1930s, a Mississippi doctor named Joseph Goldberger famously connected pellagra to malnutrition and started promoting diet changes as the cure.

His prescription? More protein, more nutrients, and yes, more salmon.

That led to canned fish being sold in dry goods stores across Appalachia.

Somewhere between desperation and innovation, the salmon patty was born.

It was a survival meal: mashed fish, flour, egg, and onion, fried in a cast-iron pan. Fancy? No. Delicious? Surprisingly, yes. A medical marvel? You bet your cast iron.

The Legacy Lives On

What started as a food-as-medicine moment turned into a regional staple.

These days, salmon patties are served at church potlucks, Grandma’s kitchens, and roadside diners across Eastern Kentucky; not because folks are dodging disease, but because they still taste like home.

So, the next time you pan-fry a few for dinner, remember that you're not just eating fish; you're eating a forgotten chapter of Appalachian resilience.

Want to feel the heritage? Serve ‘em with beans and cornbread and hold the fried egg.