COLONEL (DR.) EDWARD VEDDER:
The Shoulders of a Giant

N. H. Johnson
Fairfax VA 22030
Nathan.Johnson@dtra.mil

 

Colonel Edward Bright Vedder (1878-1952), better known for his work in chemical warfare, was one of the pioneers of vitamin deficiency research. His early work with thiamine deficiency was key to conquering beriberi, a disease that killed millions in Asia. Vedder’s research was instrumental to several groundbreaking advances in nutritional biochemistry. Choosing a military career, Vedder consistently demonstrated service to others over self. Vedder’s influence was far-reaching, both military and civilian. He published one of the first books on Medical Aspects of Chemical Warfare in 1925.

 

Phillipines, 1908

The summer seemed hotter than ever. It always seemed hot in the Philippines. With sweat dripping off his forehead, Captain Edward Vedder peered down into the eyes of another local infant at his makeshift clinic. After working a full day carrying out his military duties, the last thing a weary medical corps officer wanted to see was a dying child. This was not his first, and certainly not the last, to be seen. Although exhausted, Captain Vedder could not put his important work aside. His mind wandered, thinking back to his childhood and hearing his father talk about the importance of “works” and the Kingdom of Heaven belonging to little children. Vedder could not give up on these children now. The restless young boy was almost one year old but weighed only 11 pounds. Captain Vedder had hoped his experimental treatment for beriberi would have been ready for use by now. If only he had more time to work on it. The hardest part of this public service was telling the boy’s mother, who did not look well herself, that her son would soon die. When the last child was seen, Captain Vedder slowly walked back to camp, put his medical equipment away, and returned to the laboratory for another long night of experimentation. The quest for a cure for beriberi did not allow Vedder the pleasures of elective sleep.

Beriberi is caused by a deficiency of thiamine and the manifestations of beriberi vary and can occur at any age. [Williams and Spies 1938; Williams 1961] It must be noted that beriberi caused thousands of deaths at the time of Vedder. [Williams 1961] Though beriberi has been known for almost 3,000 years, it is more prevalent in the Far East. Early work into the etiology and treatment of beriberi focused upon food and this theory was logical since scurvy was understood to be diet related. [Vedder 1913; Carter 1977] In Vedder’s time, a few scientists had begun to believe that a nutritional deficiency was responsible for beriberi. However, this view was in the minority. [Itokawa 1976; Carpenter 2000]

During the 19th century, Pasteur, Lister, and other bacteriologists had a tremendous impact upon the medical community. To the current reader, it may be tempting to overlook the change in paradigms that acceptance of the germ theory generated. However, with tuberculosis, cholera, and diphtheria validated by the germ theory, it would have been difficult for this theory not to dominate. Bacteriology soon became the chief cornerstone of medical education. “All young physicians were so imbued with the idea of infection as the cause of disease that it presently came to be accepted as almost axiomatic that disease could have no other cause.” This would have been Vedder’s learning environment. By 1913, Vedder reported in his seminal work on beriberi, eighteen different individuals had “proven” microorganisms were responsible for beriberi. [Williams 1961]

Christian Eijkman, the Nobel-prize winning physician, was definitely influenced by the germ theory. A Dutch military physician assigned to the East Indies, he saw firsthand the problems that beriberi presented. Eijkman was assigned to isolate and identify the beriberi-causing organism that had been “discovered.” [Williams 1961; Carpenter 2000] While conducting experiments with chickens, Eijkman accidentally discovered those eating polished rice developed a condition similar to beriberi, which he named polyneuritis gallinarum. [Williams 1961; Carpenter 2000] Eijkman thought this condition was due to toxins or bacteria. He did not acknowledge it to be a deficiency until years later. Eijkman’s primary contribution was the establishment of an animal model for beriberi. Eijkman left the Far East ten years before Vedder’s arrival. Gerrit Grijns followed Eijkman’s work and proved that several nutritional components (i.e., fats) were not protective and stated the lack of “a protective substance” caused the disease. Others noted that epidemiological evidence supported food, specifically white rice, in the development of beriberi. (Williams 1961) The cause and treatment of beriberi was still a contentious matter during the time Vedder’s assignment in the Philippines. [Williams 1961]

Captain Vedder had first arrived in the Philippines eight years earlier at the age of 22. The allure of the Philippines, with its unusual diseases and potential for medical research, captivated young Vedder. His scientific mentor, Dr. Simon Flexner, had previously spent time in the Philippines where he discovered a strain of dysentery causing bacillus that became known as Shigella flexneri. [Kohler 2000] Vedder’s tour in the Philippines was exciting as he served three years with General Pershing in the war against the Moros. [Williams 1962] It was during this time that Vedder first encountered beriberi, a disease that ravaged the Philippines. After a return to the United States to conduct medical research, Vedder reassumed his work in the Philippines in 1909. Beriberi was one of many diseases that accosted soldiers in the Philippines along with dysentery, parasitic infections, dengue, smallpox, malaria, beriberi, plague, among others. [Gillett 1995] The importance of keeping the fighting men healthy was considered to be of such importance that a tropical disease board was commissioned to study and research the diseases affecting both humans and animals in the Philippines. Great strides were made by these boards. [Williams 1961] One disease for which there were few with experience was beriberi. Captain Vedder, reflecting back on his earlier experiences with beriberi, took it upon himself to tackle this disease. Previous military physicians had attributed beriberi to bacteria. [Gillett 1995] Vedder was not convinced. This is remarkable given his training with Flexner and indoctrination with germ theory. Vedder engrossed himself with beriberi literature and quickly became the local expert. [Williams 1961]

By 1910, Vedder was ready to begin experimentation to determine the cause and find a practical cure for beriberi. He was particularly impressed with the recent work of Henry Fraser and AT Stanton. [Williams 1961] They had provided the strongest proof of a deficiency occurring in beriberi by demonstrating the alcoholic extract of rice was effective in treating beriberi. [Williams 1961; Swazey, Reeds, et al. 1978] Fraser and Stanton presented their work at the first Far Eastern Association of Tropical Medicine meeting. [Swazey, Reeds, et al. 1978] Luckily, Vedder was in attendance. He was sufficiently impressed by this presentation, along with the work of Eijkman and Grijns, to start his personal war on beriberi. Vedder was also convinced, unlike his peers, that polyneuritis and beriberi had a common etiology. With this newfound enthusiasm, Vedder went to the Bureau of Science for assistance in isolating the “curative” agent he thought was in the extract of rice polishings. The director pointed him in the direction of a new addition to his staff, a young chemist named Robert Williams. Before meeting Vedder, Williams had no clear direction in his professional direction. [Williams 1961] This was about to dramatically change.

Vedder had a clear vision. He knew he could save thousands of lives if he could isolate the beriberi-preventing substance. [Williams 1961] Vedder was also concerned about the health of the military personnel stationed in the Philippines. The American troops were not affected severely by beriberi. [Williams 1961; Bayne-Jones 1968] However, Vedder knew how beriberi ravaged the military of other countries. [Williams 1961; Itokawa 1976; Carpenter 2000] Without knowing the causative or protective agents, the disease could afflict American forces. The health of Filipino scouts, whose job it was to provide security for American forces, was greatly damaged by beriberi; as many as one in every 300 individuals of Manila died each year of beriberi. [Williams 1961; Bayne-Jones 1968]

Williams worked with Vedder for one year before returning to the United States. Vedder and Williams suspected the compound was a nitrogenous substance that was effective in treating polyneuritis and beriberi. Working long hours in the laboratory, Vedder and Williams developed a exquisite method for extracting a “protective extract of rice polishings” that proved to cure those affected by beriberi. The impact was immediate and dramatic. Individuals with beriberi improved in a matter of hours after administration of Vedder’s extract. The effectiveness of Vedder’s concoction was so noted that it was still in use in the Philippines decades later, after the synthetic vitamin thiamine was introduced. [Williams 1961] In this way, Vedder saved tens of thousands of lives. [Vedder 1929; Williams 1961; Carpenter 2000) Vedder’s work also clearly established the deficiency theory of beriberi.¹ Williams returned to the Philippines a year later to be told by Vedder that Casimir Funk had published a paper on beriberi preventing substances. In reality, Funk’s substance was nicotinic acid, but Vedder and Williams had been beaten to publication. [Williams 1961] Vedder left the Philippines in 1913.
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¹ Statement
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Vedder saw a great need to share his work with beriberi. The text of primary use to students of beriberi in Vedder’s day was published by Leonard Braddon. [Williams 1961] While a leap forward in many respects, Braddon theorized that a toxin caused beriberi. [Fraser 1998] In 1913, Vedder published a text that was surprisingly complete and thorough considering his short time working with beriberi. [Vedder 1913; Williams 1961; Bayne-Jones 1968] Williams states: "This publication was influential among medical circles in the East because of its careful analysis of the evidence and because Vedder himself had been a moving spirit in eradicating beriberi from the Philippine Scouts by introducing unpolished rice into their ration”. Vedder’s text became the reference of choice. [Williams and Spies 1938] This book, along with his publications, was the turning point for convincing the scientific community that beriberi was due to a deficiency. [Williams 1961] It also drew the attention of researchers in the United States. [Gillett 1995] Vedder returned for a third tour in the Philippines in the late 1920s and was able to see the fruit of his earlier work.

Vedder was also one of the first individuals to propose the existence of vitamins. Funk is credited with coining the term "vitamine". Who actually first described vitamins is debatable. Hopkins used the term "accessory food factors" in 1906. [Carpenter 2000] Vedder used his own term calling the substance that which is "necessary to life". Funk’s simpler term had more appeal and therefore was adopted. [Williams 1961] This does not negate the foresight of Vedder in his proposed terminology.

Vedder laid the groundwork for the isolation of thiamine that occurred fifteen years later. Vedder's contribution was substantial. He demonstrated the substance was not fat soluble, adsorbed strongly to bone charcoal, and crystalloidal in nature. These were significant advances. Williams stated: “All the quite marvelous developments of chromatography in recent years and outgrowths of the knowledge of adsorbents which in a true sense began with Vedder in 1910”. Vedder also demonstrated that fowl with no apparent clinical symptoms of vitamin deficiency had neurological damage to the sciatic nerve. This demonstrated the different degrees of vitamin deficiency and the possibility of sub-clinical vitamin deficiency. By 1929, Vedder had published the most complete clinical guide of beriberi. [Williams 1961]

Vedder also had an enormous impact upon the physicians and personnel who surrounded him. A careful examination of the literature of the early twentieth century is replete with references to his work. [Williams 1962] Vedder was also a lifelong advocate of military medicine and used every opportunity to talk about careers in military medicine. It was common for Vedder to spend many hours mentoring younger military physicians. Vedder touched the lives of many military medical leaders of the mid-twentieth century while at the Army School of Medicine. The Army thought so highly of Vedder that a movie was made about his early career entitled “The Modest Miracle” [personal communication, Martha Vedder]. The life that Vedder lived was the inspiration for many.

It is surprising that Colonel Vedder has not received recognition from the medical community for his work with beriberi. It should be noted that he receives an abundance of credit for his work with chemical warfare. [Sidell, Takafuji, et al. 1997] A review of modern beriberi literature rarely mentions Vedder. [Bailey 1968] Those in the first half of the twentieth century were not sparse with their praise. [Carpenter, Harper, et al. 1997] Most of the early works concerning beriberi that were written after 1913 reference his text or some other aspect of his research. In fact, Eijkman mentioned Vedder’s work in his Nobel lecture. There are several factors that explain Vedder’s understated contributions. Humility was the first reason for his lack of recognition. This was his most noted characteristic [personal communication, Martha Vedder]. An example can be taken from his work with Vitamin C. The synthesis of Vitamin C was extremely difficult. Both the medical and civilian communities knew that the person who successfully accomplished this feat would receive great notoriety. [Vedder 1932; Williams 1961] Working for years in his spare time, Vedder reported his synthesis just a few weeks after Glen King. [Vedder 1932; Williams and Spies 1938; Williams 1961] Although not the first to synthesize Vitamin C, Vedder’s work was independent, ingenuous, and significant. [Williams and Spies 1938] It would be understandable for Vedder to be bitter for his shortcoming in this race and the previous losses. He could have been angry because his primary military duties retarded his progress and that multiple assignments, with the upheaval of laboratories and the transfer of key assistants, invariably created lost time. However, the grace and dignity with which he reported his findings in The Military Surgeon is most commendable. In fact, Vedder went to great lengths to support the findings of King, the individual who first reported Vitamin C synthesis. [Vedder 1932]

Another reason Vedder does not get the proper credit was his selfless military service. While beriberi was important, other issues were more pressings after his return to the United States. Interest in chemical warfare rightly preoccupied the Army Medical Service in the early part of the twentieth century. [Sidell, Takafuji et al. 1997] His work after his return centered on topics that held more military than civilian relevance. Vedder’s vitamin work was done in his “spare” time. Unlike his peers, Vedder could not dedicate full time to nutritional research. Often, it was a case of finishing or publishing his work too late to capture the glory that might have been his.

A final reason may very well be what made him such a great scientific investigator, his keen inquisitive nature. Vedder was interested in such a wide array of topics that it is possible these “side-interests” could have taken away from his primary areas of expertise. The multi-faceted nature of his experiences and knowledge were what made him an influential man of medicine who impacted so many lives.

In the history of the Military Medical Service, there are few physicians who have made the combination of military-specific and civilian medical breakthroughs. A noted communicator, scientist, and officer, Vedder made significant contributions to many projects. Vedder’s often-overlooked work with the nutritional aspects of medicine was crucial to the eradication of beriberi and laid the foundation for other scientific discoveries. Vedder’s life was a living example of the contributions that are possible by military physicians of the Armed Services.

 

References

 

Bailey, H. (1968). The Vitamin Pioneers. Emmaus, PA, Rodale Books.

Bayne-Jones, S. (1968). “The evolution of preventive medicine in the United States Army, 1607-1939”. Washington, Office of the Surgeon General Dept. of the Army; for sale by the Supt. of Docs. U.S. Govt. Print. Off.

Carpenter, K. J. (2000). “Beriberi, white rice, and vitamin B : a disease, a cause, and a cure.” Berkeley, University of California Press.

Carpenter, K. J., A. E. Harper, et al. (1997). "Experiments that changed nutritional thinking. Proceedings of a minisymposium. Atlanta, Georgia, April 1995 and Washington, DC, April 1996." J Nutr 127(5 Suppl): 1017S-1053S.

Carter, K. C. (1977). "The germ theory, beriberi, and the deficiency theory of disease." Med Hist 21(2): 119-36.

Fraser, D. W. (1998). "Vitamins and vitriol: W.L. Braddon's epidemiology of Beriberi." Am J Epidemiol 148(6): 519-27.

Gillett, M. C. (1995). “The Army Medical Department, 1865-1917.” Washington, D.C., Center of Military History U.S. Army: For sale by the Supt. of Docs. U.S. G.P.O.

Itokawa, Y. (1976). "Kanehiro Takaki (1849-1920)--a biographical sketch." J Nutr 106(5): 581-8.

Kohler, W. (2000). "Zentralblatt fur Bakteriologie--100 years ago: the isolation of Shigella." Int J Med Microbiol 290(1): 5-6.

Sidell, F. R., E. T. Takafuji, et al. (1997). “Medical aspects of chemical and biological warfare.” Washington, D.C.

Swazey, J. P., K. Reeds, et al. (1978). “Today's medicine, tomorrow's science : essays on paths of discovery in the biomedical sciences.” Washington, U.S. Dept. of Health Education and Welfare Public Health Service National Institutes of Health: for sale by the Supt. of Docs. U.S. Govt. Print. Off.

Vedder, E. B. (1913). “Beriberi”. New York,, William Wood.

Vedder, E. B. (1929). “Medicine; its contribution to civilization.” Baltimore, The Williams & Wilkins Company.

Vedder, E. B. (1932). "A study of the antiscorbutic vitamin." Military Surgeon: 505-515.

Williams, R. R. (1961). “Toward the conquest of beriberi.” Cambridge,, Harvard University Press.

Williams, R. R. (1962). "Edward Bright Vedder - A Biographical Sketch." The Journal of Nutrition 77: 1-6.

Williams, R. R. and T. D. Spies (1938). “Vitamin B1 (Thiamin) and its use in medicine.” New York, The Macmillan Company.