EP 029: Go Ask Alice

What did the innocent words in a high school yearbook foreshadow for one of the world's oldest and most stigmatized diseases? If you aren't thinking of Alice Ball, this one is for you. Today we talk leprosy, stolen credit, and why people in old photographs never smile. 

Here at Historycal, we’re taking the winding route through stories that have shaped the world, and today is no different. We have torment, we have tragedy, and we have stolen scientific formulas – everything it takes to make a cracking piece of fiction, except in this case, we also have a whole lot of truth.

In 1910, Seattle High School published their annual yearbook. On the graduates’ page was a small picture of an earnest young woman, one Alice Ball, captioned by the words “I work and work and still it seems I have nothing done.”

This, of course, was already far from the truth, but within a few years, it would be almost ludicrously understated. By the time she reached the decrepit old age of twenty-four, Alice Ball would have earned herself a bachelor’s degree in pharmaceutical chemistry from the University of Washington, and then another one, for good luck, in the science of pharmacy. She would have joined the ranks of only a handful of women, and even fewer African-American women, to have work published in the Journal of the American Chemical Society. Then, not one to slow down, she would become the first woman, and the first African-American, to earn a master’s degree in chemistry from the University of Hawaii, and the first African American “research chemist and instructor” at the same University’s chemistry department.

And then, to top it all off, she went and cured leprosy.

For someone of such prodigious skill and extensive achievements, Alice Ball was a women of equal but inverse stature. The Smithsonian attributes this to her chronic asthma, but by all accounts she more than made up for it in presence and personality. Born in 1892, she was the third of four children, and one can only assume that hard work and diligence was a family trait. Her father was the editor of a newspaper called The Coloured Citizen, but also worked as a lawyer – two professions that, famously, require rather a lot of time and energy, not to mention intelligence and experience, and which are generally taken one at a time. In his free time, whenever that was, he worked as a photographer, as did her mother. This pursuit definitely was a family trait – in fact, on her paternal side, Alice came from a long line of photographers. Some historians (and, frankly, fans) speculate that this may be where her fascination with chemistry originated. In a world of Instagram filters and instant uploads, this might seem like a bit of reach, but photography in the early 1900s was a far more scientific process than the way most of us take #selfies today.

Alice’s grandfather had been one of the first African American photographers to use the Daguerreotype method. Daguerreotype was the first commercially successful photographic process, and it remained the predominant method in photography for quite some time. It was quite an involved chemical undertaking. First, a sheet of metal, usually copper, had to be plated with silver, and then polished to a high sheen. Not to put too fine a point on it, but the phrase mirror-sheen is usually bandied about by those trying to describe it. The shininess was directly related to the level of success, much like 8 year-olds with glitter, or shallow women and engagement rings. Once you could see your wrinkles in the surface, it was treated with gaseous fumes. Not just any – in case you were thinking of DIYing this with a plate of baked beans – but usually halogen or chlorine. The plate was then put into a camera and pointed at the subject, and then exposed to light. This was the part where you had to remain ludicrously still, which is one of the reasons why people in old pictures never smile, and also look like they’re trying to digest a poker. An invisible, latent image would form on the plate, which – depending on the level of exposure – could take anywhere from a few seconds to several minutes,  and then the camera would be re-shuttered. The plate was developed by being exposed to mercury fumes until the image emerged, and then was fixed in place with a solution of sodium thiosulfate, which removed the unexposed silver halide. In case anyone is wondering – yes, mercury fumes are very toxic, and yes, this was actually pretty well known by this time in history, and no, most people didn’t really bother with PPE anyway.

But the thing to appreciate in all of this is the sheer volume of chemical processes the young Alice would have been exposed to – if you’ll excuse the turn of phrase. And I don’t think I’m alone in thinking that this kind of photography, in that particular time period, would have seemed almost magical. Frankly, it still sounds like an improbable illusion to me. So perhaps it’s no wonder that Alice found herself up to the elbows in scientific curiosity, and chemistry in particular.

Alice picked, for her Master’s thesis, a study into the chemical makeup and active principle of Piper methysticum, or the kava plant. And this led to her greatest scientific breakthrough. Still aged only 23, she was contracted by Dr. Harry T. Hollmann at Kalihi Hospital in Hawaii. Hollmann was looking for a researcher to assist him in finding a treatment for leprosy, and boy did Alice hit the brief.

At the time, leprosy – or Hansen’s disease as it was already being called – was treated with chaulmoogra oil. It was, then, the most effective treatment available, if you use the word ‘effective’ with excessive generosity. Basically, it was just the least ineffective treatment. It was too sticky to be applied topically to the skin, and too acrid to be ingested without being chucked straight back up, and when it was injected it wasn’t absorbed properly, and more often that not caused the patients skin to look like bubble wrap, as little pockets of the oil created blisters under the skin.

Alice got straight to work isolating ester compounds in the oil and chemically modifying them, so that it could be injected and absorbed.

Now its worth noting that leprosy itself has a long and colourful history. Unfortunately, it’s quite hard to follow all of this history, because there wasn’t always consensus on what actually fell under the umbrella of leprosy, and most of what got lumped in there actually wasn’t what we consider leprosy – or Hansen’s disease – today. In the years before the medical and scientific fields really took off, a number of other skin conditions were misdiagnosed and misidentified. Interestingly, most of the descriptions of leprosy from religious texts don’t really match up with any of the clinical symptoms of Hansen’s disease at all, and most scholars agree that the leprosy of the bible was, in fact, something else entirely. One of the most notable discrepancies is that many of these texts describe a highly contagious and quick-spreading ailment, whilst Hansen’s disease can take up to 20 years to start presenting, and isn’t that contagious at all. In fact, almost 95% of the world’s population has a natural immunity to it. Nevertheless, the misunderstanding with which it was treated, and the number of other illnesses that were lumped into the word, made it one of the most stigmatized diseases in the world, arguably until the arrival of HIV Aids. Those who had been given a diagnosis of leprosy were often ostracized and shunned, forced to live on the fringes of society or in separate colonies or institutions. Often they were stripped of many human dignities, forced to wear clothing that identified them, or stick to particular side of the street, or ring a bell to announce their presence. In some cases, they would have to shout ‘unclean’ if anyone came near them, which has its roots in the idea that leprosy was a punishment meted out by God. That, by the way, wasn’t always a Christian god – similar stories appear from religions all over the world.

Even here though, there are some interesting nuances in the ways people were treated. For example, in medieval Catholicism, the prayers of an afflicted person were considered to be far more potent than anyone else’s, because Jesus famously took some time out to heal a bro from leprosy. Consequently, anybody wanting to fast track themselves through Purgatory on the fastest train possible would often ensure that the local leprosarium was well funded and comfortable, in the hopes of receiving a divine reward.

Now these are not exactly noble motivations, but the result was probably better than a few centuries later when people had abandoned enough religion to stop funding the institutions in return for prayer, but not enough of their superstitions to actually treat the sick like actual human beings. The stigma was still rife at the time of Alice Ball’s breakthrough, and – incidentally – continues to this day. Which, you don’t need me to tell you, is awful, and must change.

Returning, then, to Alice Ball. I mentioned the young Alice a few minutes ago, which was perhaps a bit of a misnomer. As a matter of fact,  she never got to be anything else. She died at the age of 24, so shortly after her breakthrough that she never even got to publish the results. Instead, Arthur Dean, a fellow chemist and, in fact, Alice’s graduate study advisor, conducted several more trials after her death. He then published the findings and named the process the ‘Dean method’ – and managed to do all of this without so much as mentioning her name.

Hollmann, clearly seething at the injustice of this, tried to come to the posthumous rescue with a paper of his own, in which he pointed out rather acerbically that:

I cannot see that there is any improvement whatsoever over the original technic as worked out by Miss Ball. The original method will allow any physician in any asylum… in the world, with a little study, to isolate and use the ethyl esters of chaulmoogra fatty acids in treating his cases

Despite his valiant attempt, Alice Ball disappeared from history, almost as quickly and effortlessly as she had arrived. Only in the 1970’s did two professors at the University of Hawaii discover her original research, and start trying to get her the recognition she so clearly deserved. The London School of Hygiene and Tropical Medicine placed her on their main frieze alongside Florence Nightingale and Marie Curie, in 2019. On November 6, 2020, a satellite named in her honour was sent into space. And, just this year, in 2022, the 28th of February was named Alice Augusta Ball day.

Which all just proves what my mother told me so many years ago: Never cheat off of other people’s work. Someone will always find out.

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