BLACK HISTORY MONTH


Solomon Carter Fuller—the first African American Neuropsychiatrist

Submitted by Sheldon Benjamin, MD, DLFAPA, FAAN, FANPA



Many psychiatrists have heard the name, Solomon Carter Fuller.  There is a mental health center in Boston, an annual lectureship at the APA, and a middle school in Framingham, MA named for him. But did you know that apart from being America’s first Black psychiatrist that he was also a neuropsychiatrist (the first Black neuropsychiatrist as far as I know) and a student of Kraepelin and Alzheimer? 

Some years ago, I learned that Fuller was the neuropathologist and neuropsychiatrist at the Westborough Insane Hospital in Massachusetts from 1897 to 1919. The UMass Department of Psychiatry took over providing clinical and professional services at Westborough State Hospital sixty-seven years later in 1986. Having served as Westborough’s neuropsychiatrist from 1986 until its closure in 2010, I was interested to learn about the important contributions of Dr. Fuller, my predecessor so many years before at Westborough State Hospital.

Fuller was born in Monrovia, Liberia in 1872, the grandson of American slaves, his paternal grandfather having emigrated to Liberia after buying his and his wife’s freedom from slavery.  Fuller emigrated to the US in 1889, went to college and medical school, eventually graduating from Boston University Medical School in 1897, working as an elevator operator to earn his tuition. Only about half of medical school graduates took positions as “internes” in the 1890’s and those positions were typically closed to Jews, Blacks and women.  On the recommendation of a neurology professor at BU, however, Fuller was given a position as an “interne” in pathology at the Westborough Insane Hospital where he would eventually establish a neuropathology laboratory and become editor of the Westborough State Hospital Papers (research reports). Fuller was influenced by S. Weir Mitchell’s 1894 lecture to the American Medico-Psychological Association in which he took the field of psychiatry to task for failing to investigate mental illness using the tools of medical science.  In the aftermath of Mitchell’s lecture, state hospitals began opening pathology laboratories.  Westborough had one such laboratory. While at Westborough Fuller took a leave of absence to go to Munich from November 1904 to August 1905 to study neuropsychiatry under Emil Kraepelin at the Royal Psychiatric Hospital and joined Alois Alzheimer’s neuropathology group in Kraepelin’s department. As one of Alzheimer’s foreign research assistants, he studied and drew the extracellular plaques and intracellular neurofibrillary tangles that would be part of Alzheimer’s 1906 presentation of “an unusual disease of the cerebral cortex” (that Kraepelin would later name, Alzheimer’s Disease). The same year that Alzheimer published his paper, Fuller published his study of neurofibrils in neurodegenerative diseases (one of his drawings follows).


Fuller became one of America’s foremost experts on Alzheimer’s disease, was the first to translate Alzheimer’s work into English, and supported Alzheimer’s position that the dementia was not due to arteriosclerosis as had been believed. In 1912 he published the first comprehensive review of Alzheimer’s disease.  He also was an early proponent of the idea that dementia paralytica, known at the time as general paresis of the insane (now known as tertiary syphilis) was an organic disease and not an idiopathic psychiatric disorder as had been believed previously.


(photo from reference 16)

In 1909, on the occasion of the 20th anniversary of Clark University, Sigmund Freud visited Worcester to deliver lectures along with many other famous psychiatrists of the day, including Carl Jung, William James and Adolf Meyer (the neuropsychiatrist at the Worcester Insane Hospital and founder of the training program in 1895 that would become the UMass Psychiatry residency program 83 years later). On the program with Freud was Solomon Carter Fuller (upper right in the photo below), lecturing on Cerebral Histology with Special Reference to Histopathology of the Psychoses.


Fuller’s lab at Westborough State Hospital was considered by many to be the best place in the country to study the histopathology of the cerebral cortex and the latest pathological findings in severe mental illness.

In 1918, Fuller volunteered his services as a neuropsychiatrist to the war department. The response was frank but unsettling. They would be thrilled to have his expertise, but they could only commission him a lieutenant and not a captain as is the case for white physicians.  Fuller rescinded the offer feeling that he would not have the authority needed to carry out the research he felt would be needed.

Fuller, who lived in Framingham with his artist wife, Meta, joined the faculty of Boston University Medical School in the pathology and neurology departments in 1899 on completion of his internship at Westborough.  He eventually became head of BU Neurology but was never given the title of chair or promoted from associate to full professor. The only African American faculty member, he was paid less than his white colleagues doing similar work. The last straw came after several years as head of neurology when BU hired a junior neurologist as chair and promoted that neurologist to full professor in 1933.  Despite his over 30 years of research and educational leadership at BU and his tremendous contributions to neurology and neuropsychiatry, he was passed over for promotion. Fuller continued to treat psychiatric patients for many years at his home in Framingham, even after he became blind from diabetes, until his death in 1953.  Fuller’s granddaughter, Meta, named for his wife, became the special programs coordinator for the Secretary of the Army. On the morning of September 11, 2001, she was killed when the plane hit the Pentagon, a sad coda to the life of Solomon Carter Fuller.

References

  • 1.     Cobb WM, Solomon Carter Fuller 1872-1953, Journal of the National Medical Association, 46(5) 370-372, 1954.
  • 2.     Fuller SC, Four Cases of Pernicious Anemia among Insane Subjects. New Eng. Med. Gaz., 1901.
  • 3.     Fuller SC, The Effects of Belladonna Upon Animal Tissue. Chap. VII, in Bellows HP, Test Drug Proving, 0 0 and I. Society, 1906.
  • 4.     Fuller SC, A Study of the Neurofibrils in Dementia Paralytica, Dementia Senilis Chronic Alcoholism, Cerebral Lues and Microcephalic Idiocy. Amer J. Insanity. 1907, 63(4):415-481.
  • 5.     Fuller SC, Report of a Case of Delirium Tremens, with Autopsy, Proc. Soc. Neurol. Psychiat, 1907.
  • 6.     Fuller SC, An Analysis of 100 Cases of Dementia Precox in Men. Proc. Soc. Neurol. Psychiat, 1908.
  • 7.     Fuller SC, Preliminary Report of Four Cases of Aphasia,with Serial Sections throughout the Entire Brain in Three. New Eng. Soc. Psychiat. 1909.
  • 8.     Fuller SC, Involutional Melancholia, New Eng. Soc. Psychiat. 1910.
  • 9.     Fuller SC, Neurofibrils in Manic-Depressive Insanity. Manic-Depressive Symposium. New Eng. Soc. Psychiat. 1910.
  • 10.  Fuller SC, An Analysis of 3,140 Admissions to Westborough State Hospital, with Reference to the Diagnosis of Involutional Melancholia. Proc. Soc. Neurol. Psychiat. 1911.
  • 11.  Fuller SC, A Study of the Miliary Plaques found in Brains of the Aged. Proc. Amer. Medico-Psycholog. Assn. (Monograph) 1911.
  • 12.  Fuller SC, Klopp HI, Further Observations on Alzheimer’s Disease, Amer J Insanity,69:17-29, 1912
  • 13.  Fuller SC, Alzheimer’s Disease (senium praecox): The report of a case and review of published cases, J Nerv Ment Dis, 440-455, 1912.
  • 14.  Fuller SC, Histopathological Alteration in Cellular Neuroglia and Fibrillary Mesoblastic Components of Cerebral Cortical Interstitium, Boston Med. & S. J., v. 190, pp. 314-322, 1929.
  • 15.  Kaplan M, Solomon Carter Fuller: Where My Caravan Has Rested, University Press of America, Lanham, MD, 2005.
  • 16.  Kaplan M, Henderson AR, Solomon Carter Fuller, M.D. (1872-1953): American Pioneer in Alzheimer’s Disease Research, J Hist Neurosci, 9(3) 250-261, 2000.
  • 17.  Mohammed H, Recognizing African-American contributions to neurology: The role of Solomon Carter Fuller (1872–1953) in Alzheimer’s disease research, Alzheimer’s and Dementia, 12/15/20, 2020, 1-5.

To read more about the life of Solomon Carter Fuller I suggest Mary Kaplan’s excellent book, reference # 15.



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