Sickle Cell Anemia

Sickle Cell Anemia. A genetically transmitted blood disease most commonly found in persons of African‐American ancestry. In late‐twentieth‐century America an estimated 72,000 persons had sickle cell disease and approximately 8 percent of the African‐American population carried the sickle cell genetic trait.

In 1910 James B. Herrick published an article describing a twenty‐year‐old Grenadian dental student in Chicago with “sickle‐shaped and crescent‐shaped” red blood cells. This was the first fully documented description of sickle cell anemia (SCA). The condition, which had existed for centuries in Africa and the southern Mediterranean, had been transported by black slaves to North and South America. Sickle cell genes were thus present among blacks in early America, where white planters and physicians noted that blacks often appeared immune to malaria. Racial theories regarding medical differences between whites and blacks arose around such observations and became incorporated into the pro‐slavery arguments of antebellum America. (Today it is known that people carrying at least one sickle cell gene are resistant to the most virulent form of malarial parasite.)

Other case reports followed Herrick's, and by the mid‐ to late 1920s medical investigators were identifying SCA as a genetic disease usually seen in blacks. In 1933 L.W. Diggs of Memphis demonstrated the existence of both the asymptomatic sickle‐cell trait and the actual disease SCA. In 1949, when Linus Pauling revealed that SCA was caused by an alteration in the usual structure of the hemoglobin molecule, a new era in SCA research and molecular biology began.

Until the civil rights movement of the 1960s and 1970s, neither physicians nor community health leaders paid much attention to SCA, although SCA was occasionally used as a reason for segregating blood supplies or as a test for racial “whiteness.” Government funding for testing and research remained low. When public‐health officials attempted to institute genetic screening for sickle cell carriers, some African‐Americans suspected their motives.

By the end of the twentieth century, sickle cell anemia was the subject of extensive research. Treatment included pain control; regular blood transfusion; and, in rare instances, bone‐marrow transplant. To facilitate early identification and treatment, a number of states required sickle cell screening of all newborns. Through government pamphlets, the Internet, and other means, much information was available to persons with the disease or the genetic trait. The Georgia Comprehensive Sickle Cell Center at Grady Health Systems in Atlanta was a major research and information center.
See also Disease; Medicine: From the 1870s to 1945; Medicine: Since 1945; Public Health; Race, Concept of.

Bibliography

Todd L. Savitt , The Invisible Malady: Sickle Cell Anemia in America, 1910–1970, Journal of the National Medical Association 73 (1981), 739–746.
Keith Wailoo , Drawing Blood: Technology and Disease Identity in Twentieth‐Century America, 1997.

Todd L. Savitt