Solomon Carter Fuller works in his lab. (Meta Warrick Fuller photograph collection/New York Public Library)
By Ray Cavanaugh
As the world’s population ages, the number of people suffering from dementia — 50 million in 2020 — is expected to nearly double every 20 years.
Alzheimer’s, the most prevalent form of dementia, understandably commands the most attention, as does the doctor, Alois Alzheimer, for whom it is named.
The history of Alzheimer’s, however, has one curiously neglected figure: Solomon Carter Fuller, a neurologist, the first U.S. psychiatrist of African descent — and the person who, in the early stages of Alzheimer’s research, arguably did the most to reveal the true nature of the disease.
Fuller was born in 1872 in the Liberian capital of Monrovia. His paternal grandfather had been enslaved in the United States and immigrated to Liberia after purchasing his freedom; his maternal grandparents were medical missionaries who served in Liberia.
This #BlackHistoryMonth, we are highlighting people who have made a difference in the fight to #ENDALZ. Today we honor Dr. Solomon Carter Fuller, a pioneer in dementia research who worked alongside Dr. Alois Alzheimer.
In 1889, Fuller moved to the United States and enrolled at Livingstone College in Salisbury, N.C. He pursued his medical studies at the Long Island College Hospital in Brooklyn and then at Boston University, where he received his MD in 1897.
Following an internship at the Westborough Insane Hospital (later known as Westborough State Hospital) in Massachusetts, he began working as a pathologist there in 1899, the same year he joined the faculty of the Boston University School of Medicine as an instructor of pathology.
In 1904, Fuller was one of five foreign research assistants selected by Alois Alzheimer to work in his laboratory at the Royal Psychiatric Hospital in Munich.
At this cutting-edge facility, Fuller helped conduct seminal research on physically observable abnormalities in the brains of victims of the disease that a few years later would become known as Alzheimer’s.
In 1905, Fuller returned to Westborough Hospital, where he resumed his duties as a pathologist with a special focus on Alzheimer’s. Using his proficiency with the German language, he also produced the first English-language translation of much of Alzheimer’s work.
As a pathologist, Fuller performed numerous autopsies, which enabled him to make observations — none of them more pivotal than the neurofibrillary tangles and miliary plaques he encountered while examining the brain tissue of deceased people who had had dementia.
Fuller reported on the significance of neurofibrillary tangles five months before Alzheimer did, and his discovery identified a physically observable basis for this affliction, which so decimated the memories of its victims.
Ultimately, the results of Fuller’s research helped to confirm that the condition known as Alzheimer’s was not the result of insanity but rather a physical disease of the brain. He also went on to publish the first comprehensive review of this disease.
A close up of a human brain affected by Alzheimer’s disease on display at the Museum of Neuroanatomy at the University at Buffalo in 2003. (David Duprey/AP)
As a leading Alzheimer’s expert, Fuller was invited to speak at the historic 1909 Clark University Conference in Worcester, Mass., which drew such guests as nuclear physicist Ernest Rutherford and psychoanalytical gurus Sigmund Freud and Carl Jung.
Fuller sought to mitigate racial disparities in mental health care by training young Black psychiatrists to treat Black veterans of World War I. But he couldn’t overcome the medical profession’s racial inequities in his own life.
As a professor at Boston University, he was paid less than his White colleagues. And despite carrying out the duties of the head of the neurology department, he never received the title of chair or even a full professorship. He once remarked, “With the sort of work that I have done, I might have gone farther and reached a higher plane had it not been for the color of my skin.”
In 1933, Fuller retired from Boston University, after a White junior colleague was promoted over him to become the official head of the neurology department. He continued to practice neurology and psychiatry, until diabetes robbed him of his eyesight.
On Jan. 16, 1953, Fuller died at 80 of complications related to diabetes and gastrointestinal cancer.
Although he received an honorary doctorate from his alma mater, Livingstone College, Fuller’s contributions were largely neglected by academia.
He finally received posthumous recognition when, in 1974, the Black Psychiatrists of America established the Solomon Carter Fuller Program for aspiring Black psychiatrists. That same year the Solomon Carter Fuller Mental Health Center in Boston was established.
The American Psychiatric Association presents the annual Solomon Carter Fuller Award to an individual who has done pioneering work to improve the lives of Black people.
More than a century after Fuller’s most significant work, much about Alzheimer’s remains unknown. Among the mysteries is that Black people have significantly higher rates of Alzheimer’s than Caucasians. Solving these enigmas — and finding a long-elusive cure — will require a 21st-century Fuller.