Controversial research programs, unethical experimentation, and human trials have been
part of the medical field for centuries.
It doesn’t make it any less wrong, but certain scientists with questionable ethics have gotten
away with a lot in the name of, well, science.
The more (in)famous examples of wayward science include eugenics sterilization, electroshock
therapy, ionizing radiation experiments, and the CIA program MKULTRA.
But the government sponsored Tuskegee syphilis experiment, a program that ran for forty years
in Macon County, Alabama during the mid-20th century, is one of the more appalling and
deceitful of the bunch.
In 1932, the medical community still did not know a whole lot about treating syphilis.
This was the case despite documentation of the disease dating all the way back to just
after Columbus made his famous jaunt across the big blue.
According to the Oxford Journal, syphilis was a “cultural embarrassment” and had
many different names that exemplified prejudices of different nationalities.
The German and English called it the “French Pox.”
The Russians referred to it as the “Polish sickness” and the Poles as the “German
sickness.”
The Japanese called it the “Chinese ulcer.”
In the 16th century, Europe experienced a syphilis epidemic likely caused by the abundance
of sailors traveling from sea port to sea port and doing what sailors do when they come
into port.
In fact, there is some evidence that points to Columbus and his crew being the ones who
brought syphilis back from the new world.
Either way, despite the disease being around for at least 450 years (and some evidence
points to longer than that), there was no one, true, successful treatment for it.
One popular remedy for several centuries was the use of mercury, which is quite poisonous
in it’s own right, either by ingestion or rubbing it on the skin.
This led to the popular saying “a night in the arms of Venus leads to a lifetime on
Mercury.”
In 1908, Japanese scientist Sahachiro Hata (working in Germany) discovered the drug Salvarsan
was somewhat effective as a treatment for syphilis.
It was also quite toxic, as it came from the arsenic family.
There were instances of patients losing limbs after taking the drug.
Eventually, in 1912, Hata and Nobel Prize winner Paul Ehlric developed a easier-to-administer,
but still toxic, drug called Neosalvarsan—which became the standard treatment for syphilis
until the late 1940s.
Tuskegee University was established in 1881 as a school for former slaves to pursue higher
education after the Civil War.
It was the brainchild of Lewis Adams, a former slave, and George W. Campbell, a former slaveholder.
A year later, in 1882, the great Booker T. Washington became president of the school
and expanded the University by buying the grounds of a former plantation near by.
The school was located in Tuskegee, Alabama, which was part of Macon County.
As stated by Tuskegee.edu, this region was often referred to as the “Black Belt”
because of “its rich soil and vast number of black sharecroppers who were the economic
backbone of the region.”
In the early 20th century, the United States Public Health Service (PHS) was in charge
of monitoring, identifying, and figuring out ways to treat ailments, diseases, and conditions
that were impacting all US citizens.
They were divided into divisions, with one division completely focused on venereal diseases.
In 1957, this particular division would be transferred over the Center for Disease Control
(CDC), but in 1932 the PHS covered sexual transmitted diseases.
Between 1929-1931, the Rosenwald Fund, an organization that promoted the education and
health care of poor African-American farmers, sponsored a study with the PHS to identify
the Southern counties with the highest rate of syphilis among African-American males.
Their original intention was to identify and treat the disease.
Macon County, Alabama had the highest rate, with over thirty five percent of the male
population infected with the disease.
By 1931, the Great Depression was at it’s height and the Rosenwald Funds were short.
Despite the need to continue research, the Rosenwald Fund stopped operating in this capacity.
So, the PHS approached the Tuskegee Institute (located in Macon County) about forming a
research group in order to study the effects of untreated syphilis on a black male population
for a duration of six to nine months and then follow-up with a treatment plan.
The Institute agreed, along with the head of the University’s hospital Dr. Eugene
Dibble, and was complacent through the first year, thinking treatment was the ultimate
goal.
Later, they would claim they were deceived themselves and just as much victimized as
the men in the study.
The study, during the first year, was led by Dr. Taliafero Clark.
The PHS enrolled six hundred Macon County men, 399 with syphilis and 201 who weren’t
infected, to be part of the study.
None of the men actually knew what the study was for.
They were lured in with the promise of “free health care,” something that none of them
had, and treatment of “bad blood,” a general localized term that encompassed several different
afflictions, including anemia, fatigue, and other venereal diseases.
The men were told that they were going to get free medical exams, meals, and burial
insurance.
For those who actually had syphilis, they were never informed of their diagnosis nor
given any treatment for it.
Additionally, very painful and unnecessary spinal taps were performed on many in the
study.
It was said that the reason for the deception was that it would be the only way the men
would stay in the study and the researchers wanted to closely observe the course of the
disease over a large sample-size to see the effects as the disease progressed, even to
death.
But not to worry, as long as the ones that died allowed autopsies to be performed, their
funeral expenses were covered…
It was actually not an uncommon practice at the time of taking the government’s consent
in medical manners, rather than the individual.
But in part, the deception seemed to result from the lack of respect the doctors had for
the men’s intellectual capabilities (most were illiterate, which the researchers thought
was helpful as it would be harder for the subjects to figure out what was going on);
there was also less than subtle hints of racial prejudice.
In a letter to a colleague, according to a Michigan State 2005 medical ethics curriculum,
Dr. Clark wrote that “these negroes are very ignorant and easily influenced by things
that would be of minor significance in a more intelligent group.”
Dr. Raymond Vonderlehr was the on-site director of the study.
He actually supported partial treatment for the men for the sole purpose of making sure
they remained in the study (as in, stayed alive).
He was the one who gained “consent” of the men for the painful spinal taps by framing
them as a “special free treatment.”
In letters he sent to the men with the header from the Macon County Health Department, it
read,
You will now be given a last chance for a second examination.
This examination is a very special one and after it is finished you will be given a special
treatment if it is believed you are in condition to stand it.
The study, originally only intended to go nine months, went beyond a year and then,
due to breakthroughs, extended.
In 1934, two years after the study began, the first major medical paper was published
detailing health effects on untreated syphilis.
By 1936, according to the CDC, a medical paper was published criticizing the treatment plan
for the men.
1940, once again according to the CDC website, brought efforts “to hinder the men (in the
study) from getting treatment ordered under the military draft effort.”
You see, about 250 of them had registered for the draft and been found to have syphilis
and ordered to be treated.
In 1928, Nobel laureate Alexander Fleming discovered penicillin.
1930 was the first recorded medicinal use of penicillin to treat infections.
After penicillin was used to treat the survivors of the Boston Cocoanut Grove fire in 1942,
it became the medicine of choice for the United States military for infections.
By 1945, penicillin was the accepted treatment for syphilis.
Despite this, the subjects of the Tuskegee Syphilis Experiment were never administered
nor offered penicillin as treatment.
The study administrators wanted to watch the progression of the disease as the men got
sick and, in many cases, died for the forty years the study went on even though for much
of it a relatively effective treatment was available.
All total it’s estimated that 128 of the men died either directly from syphilis or
complications related to it, 40 infected their wives (and in some cases possibly others),
and there were 19 of the men’s children born with congenital syphilis.
Finally, on July 25, 1972, Jean Heller of the Associated Press broke the story that
uncovered the truth about the study.
A government panel ruled that the study was “ethically unjustified” and it ended.
In the summer of 1973, attorney Fred Grey filed a class-action suit on behalf of the
men against the PHS and it ended with nine million dollars (about fifty million dollars
today) being handed out to the participants as settlement.
In a similar study, this time to test penicillin’s effectiveness in treating syphilis and other
STDs, researchers led by Dr. John Charles Cutler from the United States (funded by the
Public Health Services, the Pan American Health Sanitary Bureau, and the National Institutes
of Health) headed to Guatemala in 1946 and found prostitutes who had syphilis, getting
them to then give it to unsuspecting Guatemalan soldiers, mental health patients, and prisoners.
They also directly infected certain individuals by “…direct inoculations made from syphilis
bacteria poured into the men’s penises and on forearms and faces that were slightly abraded
… or in a few cases through spinal punctures.”
It isn’t known how many people died as a result of this as the results from the study
were never published.
Syphilis is a sexually transmitted disease, and one of the symptoms is marks on the hands
and face of the infected person.
These marks could often be found during this time on Catholic priests, cardinals, and a
pope.
It showed that celibacy couldn’t be policed and was not always followed.
For reference, Catholic priests were first required to be celibate in 304 AD thanks to
the Council of Elvira, which resulted in Canon 33 stating: “bishops, presbyters, and deacons
and all other clerics… [must] abstain completely from their wives…”
However, this wasn’t widely adopted at this time and it wasn’t until the Second Lateran
Council of 1139 when priests were forbidden to marry.
In 1563, the Council of Trent once again affirmed this stance on celibacy and against marriage.
The priests are still human, however.
Martin Luther said it best when he stated, “Nature never lets up…
We are all driven to the secret sin.
To say it crudely but honestly, if it doesn’t go into a woman, it goes into your shirt.”