Alice Ball and the Treatment of Leprosy

In the early 1900s, Hansen’s Disease – commonly known as leprosy – was a little-understood condition infecting thousands of people across the United States. While understood to be the result of a bacteria known as Mycobacterium leprae, in an era before antibiotics there were few reliable treatments the disease. Patients with Hansen’s Disease were forced to endure not only debilitating pain, paralysis, and even the loss of limbs and extremities, but also suffered social stigma and isolation under the common – but largely false – belief that leprosy was highly contagious.

World Health Organization; Source: Research; Research date: 07/24/2015

In Hawaii, thousands of patients with Hansen’s Disease – mostly native Hawaiian islanders – were forced into exile in a secluded “leper’s colony” on the remote island of Molokai, where they were prevented from seeing their families as their condition slowly deteriorated. It was in this context that Alice Ball, a young Black chemist, and the first female graduate of the University of Hawaii, invented a transformative new treatment for Hansen’s Disease that would go on to improve thousands of lives during the early 20th century.

Alice Augusta Ball was born in 1892 in Seattle, Washington to a middle-class family of lawyers and photographers, but grew up in Hawaii. After completing degrees in pharmacy and chemistry at the University of Washington, Ball became the first woman to achieve a masters degree in chemistry at the College of Hawaii (today’s University of Hawaii). Ball was an exceptionally gifted student, and at only 23 years old was offered a teaching and research position at the institution, becoming the college’s first female chemistry professor.

It was around this time that Ball caught the attention of Dr. Harry T. Hollmann, a doctor treating leprosy patients at the Molokai colony who was looking into new ways to treat the condition. At the time, the most prevalent treatment option involved chaulmoogra oil, a traditional remedy for leprosy dating back to ancient India and China that was mildly effective at reducing leprosy symptoms. However, the oil was notoriously difficult to administer: its taste caused patients to vomit up the oil when ingested, and its sticky and non-water soluble nature caused intense pain when injected, as the oil would “bubble” beneath the skin, forming painful blisters. Hollmann believed that there could be a better way to treat leprosy, and saw Ball as the mind capable of making this new treatment a reality.

Ball quickly got to work, inventing a new technique known today as the “Ball Method”, which managed to separate the ethel ester compounds – the compounds necessary to treat the disease – from the fatty acid that caused painful injections. The result was in the first effective treatment for leprosy, a monumental triumph of medicine to fight a disease that had plagued humans for thousands of years. Ball’s work was featured in 1914 and 1917 in the Journal of the American Chemical Society, and she is believed to be the first Black person to be published in that journal. Her method would go on to be the most widely used leprosy treatment until the invention of antibiotics in the 1940s. Her work had a more immediate impact for the residents of Molokai, allowing 78 patients to be released after being treated with the injections by 1918. Across Hawaii, meanwhile, patients with leprosy were able to be treated in hospitals or their own homes rather than forced into exile on Molokai.

However, in an experience familiar for women and Black scientists especially at the time, Ball’s name was left off the method, and she risked fading into obscurity. Soon after her untimely death at the age of 24, likely from complications stemming from a lab accident involving chlorine gas, the president of the College of Hawaii, Arthur L. Dean, took credit for the discovery, even going so far as to label it the “Dean method”. It was only years later, when Ball’s former colleague Hollmann spoke out and unequivocally gave credit to the method to Ball that she was given the credit she deserved.

Ball’s name has nevertheless remained obscure until recently, when scientists and historians have begun to look back on the contributions of women and Black scientists whose names have been historically neglected. In 2000, then-lieutenant governor Maize Hirono labeled February 29 “Alice Ball Day”, while the University of Hawaii honored the pioneering chemist with a bronze plaque mounted at the base of a chaulmoogra tree, the same tree whose oil she used to treat patients. More recently, Ball has been the subject of a historical short film, “The Ball Method”, and in 2017 became the namesake of the Alice Augusta Ball fund, which offers scholarships to students pursuing degrees in chemistry or biology at the University of Hawaii.

Ball’s most lasting impact, however, will be in the transformative step her method took to ending the health crisis of leprosy. Until 1999, the “Ball Method” was still in use to treat patients in remote areas, and in 2000, the World Health Organization declared leprosy to be eliminated as a global health problem, due to the range of effective treatments available for those suffering the condition – treatments that first began under Ball.

For more information:

Science Friday: Meet Alice Ball, Unsung Pioneer In Leprosy Treatment

New Scientist – Alice Ball Pioneered Leprosy Treatment, Then Had Her Work Stolen

University of Hawaii Foundation – A Woman Who Changed the World

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