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

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

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

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


A biography of an unsung South Carolinian's role in responding to a deadly scourge, told against the backdrop of mental health history

During the early twentieth century thousands of Americans died of pellagra before the cause—vitamin B3 deficiency—was identified. Credit for ending the scourge is usually given to Dr. Joseph Goldberger of the U.S. Public Health Service, who proved the case for dietary deficiency during 1914–1915 and spent the rest of his life combating those who refused to accept Southern poverty as the root cause. Charles S. Bryan demonstrates that between 1907 and 1914 a patchwork coalition of American asylum superintendents, local health officials, and practicing physicians developed a competence in pellagra, sifted through hypotheses, and set the stage for Goldberger's epic campaign.

Leading the American response to pellagra was Dr. James Woods Babcock (1856–1922), a physician and superintendent of the South Carolina State Hospital for the Insane from 1891 to 1914. It was largely Babcock who sounded the alarm, brought out the first English-language treatise on pellagra, and organized the National Association for the Study of Pellagra, the three meetings of which—all at the woefully underfunded Columbia asylum—were landmarks in the history of the disease. More than anyone else, Babcock encouraged pellagra researchers on both sides of the Atlantic. Bryan proposes that the early response to pellagra constitutes an underappreciated chapter in the coming-of-age of American medical science.

The book also includes a history of mental health administration in South Carolina during the early twentieth century and reveals the complicated, troubled governance of the asylum. Bryan concludes that the traditional bane of good administration in South Carolina, excessive General Assembly oversight, coupled with Governor Cole Blease's political intimidation and unblushing racism, damaged the asylum and drove Babcock from his post as superintendent. Remarkably many of the issues of inadequate funding, political cronyism, and meddling in the state's health care facilities reemerged in modern times.

Asylum Doctor describes the plight of the mentally ill during an era when public asylums had devolved into convenient places to warehouse inconvenient people. It is the story of an idealistic humanitarian who faced conditions most people would find intolerable. And it is important social history for, as this book's epigraph puts it, "in many ways the Old South died with the passing of pellagra."


This book traces back to 1944−1946 when I was a toddler living with relatives in Anderson, South Carolina, where my uncle ran a textile mill. a silver bowl of tan-colored tablets sat on the mahogany dining table. I snitched them by the handful. I loved the taste—brewer’s yeast.

When my father came back from the war we returned to Columbia, where he resumed his dermatology practice at 1515 Bull Street. the older boys in the neighborhood teased us incessantly: “Bull Street … Bull Street!” When I went off to grammar school I kept it a secret that Dad’s office was on Bull Street.

During the summer of 1961 my best friend was Arthur Simons. I never went to his house without admiring a pair of crossed racing oars. the inscriptions marked races won and Arthur said they’d been his grandfather’s.

Unwittingly, I followed a path blazed by the oarsman.

I went north, rowed on the Charles River as an undergraduate (albeit in a wherry, not a racing shell), studied medicine, and, after missing out on my era’s racial excitement (the dismantling of Jim Crow), returned home to spend my career within a three-mile radius of where the oarsman spent his— the old asylum on Bull Street and, later, the Waverley Sanitarium. I learned more about the oarsman through articles by my late friends William S. Hall (“Psychiatrist, Humanitarian, and Scholar: James Woods Babcock, M.D.”) and S. Hope Sandifer (“Pellagra in South Carolina”). Like the oarsman I found myself, because of my chosen medical specialty, in the vanguard against a mysterious, highly-lethal, new disease (HIV/AIDS) that affected nearly every organ system and caused among the general public great concern . . .

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