The Tuskegee Syphilis Experiment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rory Faust

 

Theo 300-11

 

Mr. Sciuto

 

April 18, 2006

            Syphilis is a venereal disease found worldwide that is caused by the bacteria Treponema pallidum.  It is spread through sexual intercourse between humans among other sex acts and thus has the ability to spread very quickly among the race.  The disease is divided into early and late stages of infection with the first stage beginning with the contraction of the disease.  About 10-90 days after the contraction, the first and main symptom appears; an ulcer or, chancre.  This solitary chancre forms at the sight of infection and is generally harmless.  The ulcer then usually disappears without treatment after a few weeks.  Meanwhile, the bacteria is multiplying and spreading from the chancre throughout the host’s bloodstream.  If the disease continues to go untreated, internal organs such as bones, liver, heart and sometimes brain begin to be eaten away by the bacteria.  At this stage of the syphilis progression, the victim’s life is threatened.[i]  The period of “latency that may last from a few weeks to thirty years” is perhaps its most dangerous aspect.[ii]  Affected people see that the physical symptoms of the disease are gone and think they have been cured of their disease, but in truth, the syphilis bacterium still reside in their blood and thus they can spread the disease to other people without knowing that they are also infecting the person they are engaging with.  There is not much known about the initial cause or origin of syphilis and in hopes of learning more about the disease and its late stage effects, “the U.S. Public Health Service conducted a study of syphilis in Tuskegee, Alabama.”[iii] 

            The Tuskegee Syphilis Experiments, or, a “deliberate failure to treat a group of male Negroes in Macon County (near Tuskegee), Alabama” began in 1932 and continued for ten decades until its secrecy was uncovered publicly in 1972.[iv]  Macon County was one of five areas designated for the Public Health Service to observe and control syphilis, however, Macon County was different from the other four places of syphilis control.  While all centers were located in mainly African American dominated areas, Macon County held the most blacks and was a very poor place.  The Great Depression had hit the sharecropping County hard, and many people had little or no money.  Hardly any family could afford a good education or visits to the doctor.  For these Great Depression years, Alabama ranked lowest nationally on the amount of money spent per pupil on education.[v]  The syphilis control demonstration in Macon County was going to end in 1932 when major supporter and financial backer, the Rosenwald Fund, withdrew from the project, but Dr. Taliaferro Clark, head of the control project, hoped to continue the study in a new way proposing “the study of the effect untreated syphilis.”[vi]  There was a large population of syphilis infected Negro males in Macon County, most of which had never sought treatment due to their lack of care or money; “36%, which should be compared to the national average for Caucasians of only 0.4%.”[vii]  The long term effects of untreated syphilis were well known in white males, but it was the general thought of the time period that African Americans reacted differently to different diseases and thus, the study backed by the U.S. Public Health Service was begun on African American males in Macon County, Alabama.

            The physicians of the U.S. Public Health Service set up their testing and observation headquarters at the centrally located John A. Andrew Memorial Hospital.  It was well equipped and quite competent for carrying out the PHS examinations.  Blacks were lured into participating in the experiments with several tempting offers.  Test subjects were offered free rides to and from the test facilities, hot meals when at the facilities, and burial insurance for their funerals, which usually amounted to fifty dollars.[viii]  Some of these guarantees were attractive to the poor blacks of Tuskegee and they took the offers.  Macon County was a very poor place especially during the Great Depression that had its effects felt decades after the 1930s.  Perhaps what also attracted the subjects was “a mark of distinction for many of the men who enjoyed waving to their neighbors as they drove by” on the way to their appointments.[ix]  Men who lined up for the offer were tested for syphilis through a simple blood test and those that were positive for the disease set up a contract with PHS.  Out of the first 300 males to inquire, about 17% tested positive and were kept for observation.  Once the 399 subjects and 201 blacks to act as controls were acquired, the Tuskegee Syphilis Experimentations had begun. 

While testing and observation was the real goal of the project, the group was required by the agreement made with state health officials to “provide a minimum program of therapy for every syphilitic case they diagnosed.”[x]  However, the subjects were only given a number of injections of neoarsphenamine and mercury “less than half the amount recommended by the Public Health Service to cure syphilis.”[xi]  Even ineffective treatment was expensive however, and the state government provided little help in purchasing supplies.  Therefore, the treatments were inadequate and just provided the physicians with more cases of severe, late stage syphilis to observe.  One doctor, Dr Vonderlehr, claimed to have “uncovered a perfect gold mine of cardiovascular syphilis.”[xii]  The same doctor even “practiced fraud on the subjects by offering a painful lumbar puncture as a ‘free special treatment’ when in fact the procedure was purely diagnostic” and only to the benefit of the PHS medical researchers.[xiii]  When syphilis attacks the heart the results are traumatic as the aortic valve expands when the bacteria infects it and eventually bursts, ending in sudden death.  The black males who were regularly observed in the study thought that they had a case of “bad blood.”  This was one of and the most common excuse given to blacks for the numerous tests and observations being done on them.  The term “bad blood” evolved from the constant blood sampling of subjects necessary to determine whether the subject was still inflicted with syphilis.  Because the subjects were not only not informed of their disease but also told that is was not syphilis they were inflicted with caused the disease to spread in Macon County as the subjects infected other women or even their wives. 

As the first few subjects began to die on account of their untreated syphilis ailments, the Tuskegee Experimentation group and the PHS decided to expand the experiment by performing autopsies on the deceased.  This made the various doctors, physicians, and staff of the Tuskegee Study curious as to how long the experiments would last.  The study was not meant to be permanent but no plans were made to stop experimenting. 

After several years of experimenting, several men had died and others had run off and given up on the supposed treatment of their “bad blood” disease.  New men were needed, and an effort was made to find new recruits.  African American men were stopped while walking down the road and asked to volunteer and also, letters were sent to “all of the examined patients urging them to tell their friends that the clinic is being enlarged and we are optimistically hoping to screen out 150 more suitable candidates.”[xiv]  In 1943, the U.S. Public Health Service began using penicillin to treat syphilis and in 1953, “penicillin became generally available.”[xv]  Despite this new, safe, and effective treatment, the Tuskegee Syphilis Study continued to use the arsenic injections as treatment.  Besides not giving test subjects penicillin, the PHS made lists of subjects and giving them to local Macon County physicians, instructed them “not to give penicillin to these subjects.”[xvi] 

            The Tuskegee Syphilis Experimentations lasted for 40 years and was continued for so long perhaps because people thought it was of some value.  The public thought that the Study was acquiring details about syphilis that would benefit society.  Also, people were so isolated from the small town of Tuskegee, Alabama to care enough to figure out the morality behind the project.  Eventually the experimentations, observations, and studies of blacks in Macon County were ended in 1972.  Peter Buxtun, a venereal disease interviewer and investigator for the PHS, heard rumors about the Tuskegee Study at work in 1965.  He investigated the rumors and finding them to be for the most part true, he decided that what the PHS was doing was morally wrong and that he had to do something about it.  With help from a friend and reporter of the Associated Press in San Francisco Edith Lederer, he was able to delve further into the Experiment.  Lederer sent their materials to fellow reporter Jean Heller in Washington, D.C.  Heller was able to attain all the information she needed from the Center for Disease Control about the Tuskegee Syphilis Experiments. 

The story uncovering all of the mystery of the Experiments and the procedures of the PHS in Macon County hit the news the next day that caused investigations of the operations and evaluations of the project and its eventual end.  Everyone was reading Heller’s story and questioning the U.S. government’s role in the study.  Thanks to Heller’s story and the concern of the country, the Tuskegee Syphilis Experiment ended and “at least 28 and perhaps as many as 100 men had died as a direct result of complications caused by syphilis.”[xvii]

Many people feel that the experiments and observations on blacks were shameful and immoral.  In 1973 for example, “the National Association for the Advancement of Colored People (NAACP) filed a class-action lawsuit.  A $9 million settlement was divided among the study’s participants.”18  Because of these government tests, many people lost their sense of trust in the government, especially African Americans.  The Tuskegee Experiments were subject of many moral discussions and most people thought that what the government had done was wrong.  A Tuskegee Syphilis Study Legacy Committee was formed around 1996 to discuss why the government had done the experiments and what the effects of the study were.  The Committee urged President Clinton to apologize for the Tuskegee Experiments and in 1997, Clinton “delivered the apology, saying what the government had done was deeply, profoundly, and morally wrong.”19