By Elise Knutsen
If such a thing is possible, 1921 was a good year in the leprosy unit at Kalihi Hospital in Honolulu. Hundreds of patients who had been rounded up, quarantined, and exiled to the Hawaiian leprosy center were actually showing progress after receiving a new treatment.
“The morale of the patients in the hospital is excellent and in striking contrast to that of former days when a leperous person was doomed to a long term of isolation, in most cases to be terminated only by death,” observed the U.S. Surgeon General’s annual report that year.
The treatment, engineered in the chemistry laboratory at the University of Hawaii, was known as the Dean Method after Dr. Arthur Dean, president of the university.
The Dean Method, however, is not Dean’s at all. The key research behind the treatment was conducted by Alice Ball, a brilliant African American chemist whose name has been all but scrubbed from the history of medicine.
Alice Augusta Ball was born in 1892 in Seattle, the daughter of Laura Howard Ball, a photographer, and J.P. Ball, a prominent lawyer and newspaper editor. “It cannot be denied that our people, through force of circumstance, occupy a peculiar status in this country. We are not thoroughly known,” wrote Ball in the first issue of his newspaper, the Colored Citizen. Sadly, his words would be markedly germane to the life of his daughter.
After excelling in the sciences throughout high school, Alice Ball graduated from the University of Washington in 1914 with degrees in both chemistry and pharmacy. Out of the 237,000 residents in Seattle when Ball enrolled at UW, only 2,200 were African American. The vast majority of them were relegated to work as domestic servants, waiters, and elevator attendants for their white peers.
Overcoming prevailing prejudices which cast women and non-whites as intellectually inferior, Ball published an article in the Journal of American Chemical Society as an undergraduate and won scholarships for master’s programs at both the University of California, Berkeley and the University of Hawaii.
Fortuitously, she chose the University of Hawaii where she conducted research into the chemical components of the kava root. A century before it became the favored tipple of left coast millennials, kava tea was used by leprosy patients to ease pain associated with the disease.
After earning her degree — the first woman and the first African American to receive an MS from the University of Hawaii — Ball was asked to stay on as a chemistry instructor where she co-taught classes with Dean. In addition to being the university’s president, he was a chemist who studied at Harvard and Yale.
Ball’s work caught the attention of Dr. Harry Hollmann, an assistant surgeon at the Kalihi Hospital and Receiving Station in Honolulu.
Over the course of nearly a century, thousands of leprosy patients were “received” at Kalihi Hospital. Individuals suspected of having leprosy, overwhelmingly native Hawaiians, were captured by sheriffs and policemen and detained at Kalihi Hospital. If their condition was deemed to be too advanced for treatment, patients were exiled to a colony set up by the Board of Health on the isolated Hawaiian island of Molokai.
Kalihi Hospital was known by Hawaiians as “the land of the living dead,” according to a former patient. Leprosy victims in Hawaii and elsewhere suffered the double injustice of social stigma and the painful effects of the disease, including ulcers, facial lesions, and deformed limbs. Living in forced isolation from their families, patients received a variety of experimental treatments, some of them painful and ineffective.
At the time, Ball was working on her master’s thesis, a new treatment derived from the chaulmoogra tree oil was being developed as a possible cure for leprosy. Used as an ointment, the oil had limited efficacy. Administered orally, patients were stricken with nausea so severe one told a US Public Health Service employee, “Doctor, I’d rather have leprosy than take another dose.”
Hollmann was on the hunt for an injectable form of the oil and brought Alice Ball on board in 1915. Within one year she had developed a new method to render the active agents in chaulmoogra oil water soluble, allowing for the possibility of an injectable leprosy treatment.
“After a great deal of experimental work, Miss Ball solved the problem for me by making ethyl esters of the fatty acids found in chaulmoogra oil,” Hollmann wrote in a medical journal years later.
Eighty-four leprosy patients would be “paroled” from Kalihi Hospital after receiving treatment derived from Ball’s discovery, according to Hollmann.
In 1916, before the results of her research could be published, Ball died suddenly at the age of 24, most likely after inhaling chlorine gas during a lab accident.
Dean, however, continued Ball’s research after her death. In a series of reports he published in the early 1920s, Dean fails to mention Ball’s key contribution to his work. Despite Hollmann’s protestations that the “Ball Method” was the real medical breakthrough, the public soon forgot about Ball and lavished praise on Dean and his cure.
A report by the Department of the Interior in 1920 lauds the use of treatment based on “Dean derivatives,” the ethyl esters which Ball herself had discovered. Within months, newspapers across the country were circulating sound-bites from scientists and doctors who extolled Dean and his “Dean derivatives” as the cure for a disease which had haunted humanity for millennia.
“A wonderful transformation has taken place,” a doctor visiting Hawaii said after visiting Kalihi hospital in 1921. “Credit for the development of the chaulmoogra oil is due to Dr. Arthur Dean, president of the University of Hawaii, and a chemist of great ability.”
By 1921, Dean was mass-producing the injectable leprosy treatment, shipping it to doctors, professors, and government agencies in places as far afield as Venezuela and South Africa.
The Dean method would be the primary treatment of leprosy for the next two decades, before it was replaced by a modern antibiotic treatment in the 1940s.
It wasn’t until decades later that the scant archival trail of Alice Ball was rediscovered. Dr. Kathryn Takara, a poet and scholar who studied at the University of Hawaii and Stan Ali, a retiree who stumbled across Ball’s name in a book published in 1932, are to thank for revisiting the historical record and insisting that Ball’s name be given the prominence it deserves.
In 2000, a plaque was installed at the University of Hawaii commemorating Ball’s accomplishments. Just around the corner, presiding over a sweeping lawn, lies the stately Dean Hall.