Asylum Doctor: James Woods Babcock and the Red Plague of Pellagra

6. So Near, So Far: Funk Was Right but Few Listened

173 C h a p t e r 6 So Near, So Far Funk Was Right but Few Listened In 1912 Casimir Funk, a 28-year-old Polish-born chemist working in London,proposed the vitamin-deficiency hypothesis for pellagra.Among those who took him seriously were Surgeon General Rupert Blue of the U.S. Public Health Service, and Fleming Sandwith of London. On the evening of October 3, 1912, at Babcock’s invitation, Blue and Sandwith separately brought up Funk’s hypothesis at the second triennial meeting of the National Association for the Study of Pellagra held at the South Carolina asylum. Babcock and Carl Alsberg of the U.S. Department of Agriculture commented on its reasonableness. However, Claude Lavinder and Joseph Siler, their respective agencies’ point men for pellagra, missed or dismissed the significance of Funk’s hypothesis. Louis Sambon’s version of the infection hypothesis appealed to many but not most participants at the 1912 meeting. Nicotinic acid and also tryptophan were well known in 1912, but it would be another quarter of a century before researchers established that niacin deficiency causes pellagra.Thousands died before Funk’s ideas and observations were put to practical use. Casimir Funk and the “Vitamine” Hypothesis No discrete historical event explains “the discovery of the vitamins.”Each of the now clinically important vitamins—vitamin A, the B vitamin complex, and vitamins C, D, E, and K—has its unique history.1 The idea of vitamins as substances that must be present in the diet because the body cannot make them in sufficient quantities began to take shape during the late nineteenth century when researchers experimented with measured quantities of proteins, sugars, and fats. They found that something else was necessary for health; So Near, So Far Funk Was Right but Few Listened 174 Asylum Doctor hence, the idea of “accessory food factors.”2 Precise chemical identification of the vitamins was a twentieth-century development. It began with beriberi, known mainly for its effects on the nervous system.3 Asian physicians had long suspected monotonous diet.During the late nineteenth century the germ theory prompted enthusiasm for an infectious cause of beriberi. Among the researchers was a young Dutch military physician named Christiaan Eijkman, who attempted to cause beriberi in rabbits by injecting them with a recently discovered bacterium. He decided to try chickens since they were cheaper to buy and keep.In 1890 the chickens in one batch staggered, couldn’t perch, lost weight, and died. Autopsies showed degenerative changes in the nerves of the legs similar to those of human beriberi. Eijkman suspected bacterial or toxin contamination of his chickens.By chance he learned that the chickens’keeper had been skimping on their feed to save money.He had given them leftover cooked rice instead of feed-grade unpolished rice.Eijkman’s scientific impulse led him to prove that the substitution of polished for unpolished rice caused “fowl polyneuritis.”Caught up in the germ theory, he concluded that beriberi was “linked”to the substitution of polished for unpolished rice but not necessarily “caused” by it.4 He missed the full significance of his discovery: an animal model for beriberi. Japanese physicians and two Americans—Drs. Edward B. Vedder and Robert R.Williams—used every means at their disposal to identify the key substance(s) in “extract of rice polishing.” In 1912 Vedder and Williams returned to the United States only to learn that Casimir Funk had beaten them to the punch.5 Casimir Funk was born in Warsaw, the son of a dermatologist. At age 16 his father sent him to college in Geneva to study biology.He transferred to Berne, got a doctorate in chemistry at age 20, worked for a while at the Pasteur Institute in Paris, and in 1906 moved to Berlin with a letter of introduction to the Nobel laureate Emil Fischer.6 In 1910 the young chemist’s wanderlust took him to London and a job at the Lister Institute of Preventative Medicine. One day a middle-aged man showed up in the laboratory and suggested that he and the ill-at-ease newcomer stroll along the Thames Embankment.The man, who did not introduce himself at first, was the institute’s director, Dr. (later Sir) Charles James Martin. Martin made Funk a Scholar of the Lister Institute and told him of some work being done on beriberi in the British colonies. Martin suspected beriberi might be caused by deficiency of an amino acid contained...