Blue Fugates

Ancestry

Martin Fugate, a Frenchman, and Elizabeth Smith married and settled near Hazard, Kentucky around 1820. Both were carriers of the rare recessive methemoglobinemia (met-H) gene. Four of their nine children were born with blue skin. Continued reproduction within the limited local gene pool, combined with poor transportation infrastructure, caused many descendants to inherit the condition. Luna Stacy, considered the bluest of the blue Fugates, had 13 children and lived to age 77. Descendants carrying the gene continued to live near Troublesome Creek and Ball Creek into the 20th century. Hematologist Madison Cawein III, with nurse Ruth Pendergrass, studied the family's condition and ancestry. Based on a 1960 report by public health physician E. M. Scott about a similar phenomenon among native Alaskans, Cawein concluded that a deficiency of the enzyme diaphorase caused an oxygen deficiency in red blood cells, making the blood appear brown and the skin appear blue. He treated the family with methylene blue, easing symptoms and reducing the blue coloring. His findings were published in the Archives of Internal Medicine in 1964. Benjamin Stacy, born in 1975, was the last known descendant born with the characteristic blue color, though he soon lost it, retaining only blue tinges on his lips and fingertips when cold or agitated.