The Chemist Behind a Medical Revolution
Alice Augusta Ball
In the realm of science, there are pioneers whose contributions remain undervalued or overlooked despite their profound impact on society. Alice Augusta Ball, a pioneering chemist of the early 20th century, falls into this category. Her groundbreaking work in the treatment of leprosy, a disease shrouded in fear and stigma, transformed the lives of countless individuals afflicted by this debilitating condition. Before the emergence of sulfone antibiotics in the 1940s, the "Ball Method" stood as a prominent treatment for leprosy, a disease that impacts the nerves and skin, often resulting in significant deformities of the extremities.
Born on July 24, 1892, in Seattle, Washington, Alice Augusta Ball was the third child among four siblings, with two elder brothers named William and Robert, and a younger sister named Addie. Born into a middle-class family, Alice Ball's father, James Ball Jr. held multiple professions—he was a newspaper editor for The Colored Citizen, a photographer, and a lawyer. Her mother, Laura Louise Ball also contributed to the family income as a photographer. Photography ran in the family's bloodline, as Alice's grandfather, James Ball Sr., was an early pioneer in photography, utilizing the daguerreotype method to print photographs on metal plates. Some researchers speculate that Alice's affinity for chemistry may have been influenced by her family's involvement in photography, where they worked with substances like mercury vapors and iodine-sensitized silver plates in the photo development process.
Despite being active members and supporters of the African-American community, both of Ball's parents were listed as "White" on her birth certificate. This decision might have been motivated by a desire to shield their daughter from the prejudice and discrimination prevalent in society, potentially facilitating her ability to assimilate into white communities. In 1902, Alice Ball and her family relocated from Seattle to Honolulu, where she enrolled at 'Central Grammar School'. Their move to Hawaii was prompted by the hope that the warmer climate would alleviate her grandfather's arthritis. However, he passed away shortly after their arrival and they returned to Seattle in 1905 after spending only a year in Hawaii.
Encouraged by her family to pursue higher education, she excelled academically and earned a bachelor's degree in pharmaceutical chemistry from the University of Washington in 1912. Recognizing her exceptional aptitude, Ball continued her studies at the College of Hawaii (now the University of Hawaii), where she became the institution's first African American and first female chemistry professor. It was during her tenure at the College of Hawaii that Ball made her seminal contribution to medical science. In 1915, she developed the "Ball Method," a revolutionary technique for extracting the active compound from the chaulmoogra tree, long used in traditional medicine to treat leprosy. Ball's method involved isolating ethyl esters from the fatty acids present in chaulmoogra oil, rendering the treatment more soluble and thus more effective in combating the symptoms of leprosy. She pioneered the reconfiguration of an oil extract from the chaulmoogra tree for combating leprosy, delving into the plant’s acids, solubility, and resins to develop an injectable treatment for various medical conditions.
The significance of Ball's discovery cannot be overstated. Leprosy, also known as Hansen's disease, has plagued humanity for centuries, causing disfigurement, nerve damage, and social ostracization. From 1866 to 1969, over 8,000 leprosy patients, predominantly Native Hawaiians were forcibly relocated to the isolated peninsula of Kalaupapa. Hemmed in by towering 2,000-foot cliffs, the isolated settlement could only be reached by boat, mule, or on foot, with later access by plane. Initially, the living conditions were austere, with patients lacking adequate housing and supplies. However, with the help of Board of Health workers, Christian missionaries, and dedicated volunteers known as na kokua, the leprosarium evolved into a thriving community. They built churches, a bar, a store, a theater, and a social hall where dances were held. Some residents found employment as clerks, waitresses, fishermen, or hospital orderlies. Despite these developments, the grim reality remained that patients were forcibly relocated to Kalaupapa—sometimes by bounty hunters tasked with tracking down leprosy patients across the islands—and were expected to spend the rest of their lives there.
Relatives were permitted to visit their loved ones, albeit in separate housing, where communication took place through a chicken wire screen. Escapees from Kalaupapa faced pursuit by bounty hunters and potential arrest. Life in the settlement was heavily regulated, with rules even forbidding residents from raising children. Thousands of infants born to leprosy patients in Kalaupapa were seized by the government, placed for adoption, and their origins concealed to evade the stigma attached to the disease.
Initial efforts to develop a viable drug for leprosy were unsuccessful due to the oil's insolubility in water. Attempts to administer the drug via injection led to painful abscesses or lumps at the injection site. The oil consists of two primary components: chaulmoogric acid and hydnocarpic acid. These carboxylic acids are solid in their pure forms and exhibit insolubility in water due to their lengthy, non-polar hydrocarbon chains.
Alice faced a challenge in making the drug water-soluble since most of the human body comprises water. To address this, she sought a method to render the active ingredients soluble in water for effective circulation. One approach involves converting the carboxylic acids present in the chaulmoogra tree into water-soluble salts using a base like sodium hydroxide. However, this alteration led to a soap-like behavior in the molecules, causing hemolysis—the breakdown of red blood cell membranes—when injected. While this method solved the solubility issue, the resulting side effects were undesirable.
To overcome the obstacle, Alice transformed the lengthy carboxylic acids into ethyl esters. This was achieved through a reaction involving carboxylic acid and ethanol, facilitated by another acid as a catalyst. Despite the simplicity of the components involved, this process was a breakthrough, rendering the resulting drug injectable and water-soluble. Remarkably, Alice accomplished this feat within a year—a feat that had proven elusive to even the most skilled researchers in state-of-the-art laboratories worldwide.
Ball's method not only enhanced the efficacy of chaulmoogra oil but also paved the way for the development of modern treatments for leprosy, transforming it from an incurable scourge into a manageable condition. Alice's breakthrough was so groundbreaking that for a short time, there was a halt in sending new patients to Kalaupapa; individuals could receive treatment at Kalihi Hospital and then reunite with their families. Regrettably, the victory over this dreaded ailment was short-lived as the bacterium developed resistance to Ball's chaulmoogra oil. Consequently, ships resumed ferrying both newly diagnosed patients and those previously cured back to the island. Despite this setback, and with no viable alternatives, chaulmoogra oil remained the primary treatment until the advent of sulfonamide drugs—sulfur-containing antibiotics—in the 1940s.
Tragically, Alice Ball's life and career were cut short prematurely. She passed away on December 31, 1916, at the young age of 24, shortly after her groundbreaking discovery. It is believed that she may have been exposed to chlorine gas while teaching a chemistry class, which caused her to fall ill. According to a 1917 report by the Pacific Commercial Advertiser, this exposure likely occurred while Alice was demonstrating the correct use of a gas mask in preparation for potential gas attacks during World War I. She sought treatment in Seattle but unfortunately succumbed to her illness. However, the precise cause of her death remains uncertain, as her original death certificate was later amended to indicate tuberculosis.
Following Alice's passing, her research fell into the hands of Arthur L. Dean, a chemist who later served as president of the University of Hawaii. Dean not only continued Alice's work but also published her findings under his name, claiming credit for himself. He even went to the extent of naming the technique after himself—the Dean Method. While Dean received recognition from the scientific community for purportedly discovering a cure for the disease, Hollmann attempted to rectify the record, albeit in vain. Alice's significant contribution to science might have faded into obscurity if not for Hollmann, who acknowledged her work in a 1922 medical journal, referring to the technique as The Ball Method. Her achievements remained largely overlooked for decades following her death. This oversight can be attributed to the prevailing racial and gender biases of the time, which marginalized women and people of color in the scientific community.
However, in recent years, efforts have been made to rectify this historical injustice and to ensure that Ball receives the recognition she deserves. In 2000, the University of Hawaii posthumously honored Alice Ball with the Regents' Medal of Distinction, the institution's highest award. Additionally, in 2007, the Hawaii State Legislature declared February 29th "Alice Ball Day" to commemorate her contributions to science and medicine. These tributes serve as a testament to Ball's enduring legacy and as a reminder of the importance of acknowledging and celebrating the achievements of underrepresented scientists. On the eastern side of the University of Hawaiʻi at Mānoa’s campus stands a towering 25-foot tree adorned with long, slender leaves and velvety brown fruit. This remarkable tree serves as a tribute to her, to commemorate her groundbreaking research on leprosy.
Today, Alice Ball's story serves as an inspiration to aspiring scientists and advocates for diversity and inclusion in the scientific community. Her groundbreaking research exemplifies the power of perseverance, ingenuity, and compassion in the pursuit of scientific discovery. Moreover, her legacy underscores the importance of recognizing and amplifying the voices of marginalized scientists whose contributions have often been overlooked or marginalized. Half a century prior to the integration of women into most Ivy League institutions, Alice Augusta Ball accomplished a remarkable feat by obtaining a master’s degree at the University of Hawai‘i. She carved her place in history as the inaugural female—and the first African-American woman—to achieve this milestone. Notably, Ball became the pioneering female instructor in the chemistry department at UH. Her groundbreaking research in 1916 heralded the development of the initial treatment for Hansen’s disease, offering a ray of hope to countless patients who had hitherto endured only desolation.
Alice Ball's remarkable achievements as a chemist have left an indelible mark on the history of medicine. Her pioneering work in the treatment of leprosy revolutionized the field of pharmaceutical chemistry and transformed the lives of countless individuals afflicted by this debilitating disease. Although her life was tragically cut short, Ball's legacy endures as a testament to the power of scientific innovation and the enduring impact of compassion and empathy in the quest to alleviate human suffering.
References:
Wong, K. M. (2022, March 23). The trailblazing black woman chemist who discovered a treatment for leprosy. Smithsonian Magazine. https://www.smithsonianmag.com/history/the-trailblazing-black-woman-chemist-who-discovered-a-treatment-for-leprosy-180979772/
“The Ball Method” trailer introduces Alice Bell, chemist who discovered leprosy treatment. (2020, April 22). Science vs Hollywood. https://sciencevshollywood.com/the-ball-method-trailer-introduces-alice-ball-who-discovered-treatment-for-leprosy/
Alice Ball. (2020, February 12). Wikipedia. https://en.wikipedia.org/wiki/Alice_Ball
Tracey, L. (2020, February 26). The Chemist Whose Work Was Stolen from Her. JSTOR Daily. https://daily.jstor.org/the-chemist-whose-work-was-stolen-from-her/
Parascandola, J. (2003). Chaulmoogra oil and the treatment of leprosy. Pharmacy in history, 45(2), 47-57.
Mushtaq, S., & Wermager, P. (2023). Alice Augusta Ball: The African-American chemist who pioneered the first viable treatment for Hansen's Disease. Clinics in Dermatology, 41(1), 147-158.
