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

5. Sambon’s Obsession: Pellagrins, Pellagrologists, and Pellagraphobia

143 C h a p t e r 5 Sambon’s Obsession Pellagrins, Pellagrologists, and Pellagraphobia Between the first (1909) and second (1912) national conferences at the South Carolina State Hospital, pellagra became epidemic in the Southeast and a concern throughout the nation. American physicians established a competence in the disease. Louis Sambon’s version of the infection hypothesis replaced Cesare Lombroso’s version of the spoiled-corn hypothesis as the most popular explanation. Babcock and Claude Lavinder of the U.S. Public Health and Marine Hospital Service tracked the epidemiology and brought out the first comprehensive English language treatise on pellagra. Numerous Americans taught their colleagues through journal articles, meetings, and conferences. Two well-funded groups of American investigators—the Illinois Pellagra Commission and theThompson-McFadden Pellagra Commission—claimed their data largely eliminated diet as the cause.Both groups favored an infectious cause despite the paucity of hard evidence. Lavinder with Babcock’s assistance tracked the epidemiology of pellagra,tried to transmit the disease to animals, and became progressively discouraged. Marie’s Pellagra William Osler, having written in the sixth edition (1907) of his bestselling textbook that pellagra did not occur in the United States,revised the seventh edition (1910) to read: “Searcy, Babcock, Wood, and Bellamy have shown (1907–1908) that it is not an uncommon disease in the southern parts of Sambon’s Obsession Pellagrins, Pellagrologists, and Pellagraphobia 144 Asylum Doctor the United States; many of the cases are acute.”Osler embraced Lombroso’s version of the spoiled-corn hypothesis; the “measures to be employed are change in diet, removal from the infected district, and, as a prophylaxis, proper ripening and preservation of the corn, the toxic changes in which are apparently due to the action of a special organism.”1 The medical literature on pellagra in English consisted mainly of papers by Fleming Sandwith. Babcock and Lavinder hesitated to write a textbook from scratch, since their “comparatively limited experience” posed the problem of credibility.2 They decided to translate a then-new French text, La Pellagre (1908) by Armand Marie,which was in turn an abridgement and translation of Lombroso’s massive Trattato Profilattico e Clinico della Pellagra (1892). Lavinder expressed doubts “whether we could get it published.”3 Who would buy a book about pellagra? The project became more than a translation. They added numerous observations by themselves,other Americans,and Sandwith.They included twenty full-page photographs.4 They prepared an English language bibliography .5 Lavinder, who had tried unsuccessfully to find a national publisher, told Babcock: “We could have made a better book with less work, and it makes me angry to think that Marie’s name must be put on what he deserves no credit for whatever.”6 Babcock’s family complained when Lavinder’s name went first on the title page.They felt Babcock had done most of the work.Babcock answered that he “did not need the recognition the book would bring but the other man [Lavinder] did.”7 He had overcome whatever reservations he may have had about a government agency’s stealing his thunder, and he wanted to promote Lavinder as the best-qualified American pellagra researcher. Babcock told Surgeon General Walter Wyman that Lavinder “has a better insight into the whole pellagra problem than anyone else in America” and urged that “plans now under consideration for Dr. Lavinder’s further investigation of pellagra at home and abroad be carried out.”8 Babcock may have had another reason for not insisting on first authorship : a patient at the asylum did most of the actual translating.9 George W. Manly came from a prominent South Carolina family, was an accomplished linguist,had a doctorate from the University of Leipzig,and was still studying abroad when he developed “signs of intense nervous strain.” His family brought him home and consulted Babcock. Manly became devoted to Babcock and his family and even lived with them for a while in the superintendent’s house.Eventually he acquired his own quarters in the Main Building (or New Building; now the Babcock Building). According to one of Babcock’s daughters, Manly did “literally mounds of translations from Sambon’s Obsession 145 French, German & especially Italian for Daddy.”10 Manly helped prepare the manuscript and oversee its publication in 1910 by The State Company in Columbia, South Carolina.11 Babcock and Lavinder reviewed the various hypotheses.They recounted how in 1810 Marzari “believed...