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

Contents

ix C o n t e n t s Illustrations xiii Preface xvii Prologue xxiii Chapter 1 Jimmie 1 A Chester Boyhood 1 Phillips Exeter Academy 4 Harvard College—and the Race of His Life 6 Harvard Medical School 12 McLean Asylum 17 Coming Home against Better Judgment 21 Chapter 2 Superintendent 25 Psychiatry in the Late Nineteenth Century 25 The South Carolina Lunatic Asylum 27 Taking Charge—More or Less 32 Kate Guion 37 Benjamin Ryan Tillman and the Sea Islands Hurricane 40 Tuberculosis in Asylums 45 “The Colored Insane” 48 Race and Gender 51 Dumping Ground 58 Restless Man 65 Alienist 68 Citizen 74 C o n t e n t s x Contents Chapter 3 Founder of the Movement 77 What We Know Now 77 What They Knew Then 81 First Cases 88 Travels with Tillman 92 The First Pellagra Conference—Columbia, South Carolina, 1908 96 The First Statistics and the First Laboratory, 1909 102 The First National Conference on Pellagra, 1909 105 Chapter 4 How Bad It Was 113 The Allegations 113 Niels Christensen, Jr. 115 Eight Days of Testimony 119 The Majority Report 126 The Minority Report 137 Showdown 138 Aftermath 141 Chapter 5 Sambon’s Obsession 143 Marie’s Pellagra 143 An American Competence in Pellagra 147 Historian of the Movement 149 Epidemiologist, Clinician, and Teacher 152 Lavinder and Siler Stake Out Positions 159 Joseph Siler and the Two Commissions 162 Claude Lavinder and the U.S. Public Health Service 166 Chapter 6 So Near, So Far 173 Casimir Funk and the “Vitamine” Hypothesis 173 The 1912 Triennial Conference—Sandwith Comes Close 176 Did Babcock and Carl Alsberg Almost Get It Right? 182 Sambon’s Spash in Spartanburg 186 Paradigms, Personalities, and the Tragedy of Casimir Funk 188 Contents xi Chapter 7 A Plain Farmer’s Daughter 193 State Park 194 Nora Saunders and Cole Blease 197 Dr. Saunders, Dr. Cooper, and the Wassermann Test 203 “Like Burnished Steel” 208 The Higher Tribunal 211 Vindication 219 Resignation 220 Chapter 8 The Blind Men of Hindustan 223 A New Start 224 Joseph Goldberger goes South 224 The 1915 Triennial Conference—“The Diet of the Well-to-Do” 233 Sambon’s Sad Legacy 241 “The Dreams of our Youth” 250 Postscripts 253 Perspective: Asylum Doctor 259 Babcock as Administrator 260 Babcock as Leader in Response to the Pellagra Epidemic 261 Babcock as Exemplar of Character Traits Worthy of Emulation 262 Asylum Doctor 264 Appendix 1 Mortality and Full Recoveries (as Percentages of Patients Treated) by Race, South Carolina State Hospital for the Insane, 1891–1914 265 Appendix 2 Parallels in the Histories of Beriberi and Pellagra 267 Appendix 3 A Chronology of Pellagra and Niacin 269 xii Contents Appendix 4 Summary of the Four Major Pellagra Conferences held at the South Carolina State Hospital for the Insane, 1908–1915 277 Notes for Researchers 279 Abbreviations Used in Notes 283 Notes 285 Bibliography 355 Index 389 ...