Solomon Carter Fuller (CAMED 1897), the first Black psychiatrist in the United States, studied the pathology of the brain under Professor Alois Alzheimer, identifier of Alzheimer’s disease. Public Domain Image

BLACK HISTORY MONTH

Why the Story of Solomon Carter Fuller Matters to BU—and for Black History Month

The first Black US psychiatrist’s pivotal role in discovering Alzheimer’s disease is too often forgotten

When you hear the name Alois Alzheimer, you don’t ever wonder who he was or what he discovered or invented. His name tells you all you need to know.

How about when you hear the name Solomon Carter Fuller? Not quite the same reaction.

It’s time for a little Boston University history lesson in honor of Black History Month, and in further recognition of the advancement of research about Alzheimer’s disease. 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.

• Solomon Carter Fuller (CAMED 1897) was born in Monrovia, the capital of Liberia, in 1872. When he was 17, he moved to the United States to attend college at Livingstone College in North Carolina, and he went on to study medicine at Long Island College Hospital in Brooklyn.

• In the mid 1890s, he came to Boston to attend what was then the Boston University School of Medicine, graduating with an MD in 1897. Two years later, he joined the faculty of BU’s medical school as a full-time instructor in pathology. He would later become an associate professor of pathology and neurology.

• He furthered his work as a neurologist and a pathologist in the early 1900s, and he became the first Black US psychiatrist.

• From Boston, he went on to pursue more research in Europe. When Alois Alzheimer was searching for five foreign research assistants to join his Royal Psychiatric Hospital lab at the University of Munich in 1904, Fuller was among those selected. It was a pivotal achievement in his life.

• As the Washington Post would write: “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.” Armed with a wealth of knowledge about this new and mysterious disease, he returned to the United States in 1905, resuming his post as pathologist at Westborough State Hospital in Massachusetts, where his research focus remained on Alzheimer’s disease, and continuing to teach at BU. Until that point, it was widely assumed that Alzheimer’s was caused by insanity.

• Because he was fluent in German, Fuller wrote the first translation from German to English of much of Alois Alzheimer’s work. In 1919, he resigned from Westborough State Hospital to become an associate professor of pathology at BU’s School of Medicine and two years later, was appointed an associate professor of neurology. At the time, he was the only African American on the faculty. 
• Fuller’s work as a pathologist on Alzheimer’s was truly groundbreaking. Through autopsies he performed on people who suffered from dementia, he discovered and reported on so-called neurofibrillary tangles in their brain tissue. These tangles were significant in advancing the understanding of Alzheimer’s and how it impacts people’s memories, and Fuller is known to have reported on it months before Alois Alzheimer. His work also helped reframe the conversation around the disease, so that doctors and others recognized that it was not caused by insanity, but by the physical decaying of the brain.

• In a seminal paper he wrote in 1912, Fuller described a 56-year-old man who had suffered for two years with memory impairment, receptive dysphasia, and apraxia. According to a 2020 paper in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, Fuller’s “autopsy revealed ‘regional cerebral atrophies,’ a degree of large vessel arteriosclerosis, extensive plaque presence, and ‘intracellular Alzheimer degeneration,’” comprising a “tangled mass of thick, darkly staining snarls and whirls of the intracellular fibrils,” reflective of neurofibrillary tangles.

• Fuller eventually published what is regarded as the first comprehensive review of Alzheimer’s.

• His relationship with BU, unfortunately, did not end well. Fuller was paid less than his fellow professors who were white. For five years, he served as acting chair of the department of neurology, without ever getting the title. When he retired in 1933, it was because a white junior assistant professor had been promoted to full professorship and named department chair. Fuller was unhappy, and said so: “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 colour of my skin,” he wrote.

• Eventually, Fuller did get the title of emeritus professor of neurology at Boston University, and he later put his energy into training Black psychiatrists so they could treat Black World War I veterans.

• Fuller, who died in 1953 at the age of 81, after battling diabetes, was recognized posthumously in 1974 when the Black Psychiatrists of America established the Solomon Carter Fuller Program, to assist young Black psychiatrists. In Boston that same year, the Solomon Carter Fuller Mental Health Center opened. And today, the American Psychiatric Association gives out an annual Solomon Carter Fuller Award to an honoree for pioneering work to improve the lives of Black people.