The Tuskegee Syphilis Study and the scientific concept of racial nervous resistance

Journal of the History of Medicine and Allied Sciences

Volumn 67, Issue 2, 2012, Pages 244-280

  Crenner, Christopher ^a  

^a UNIVERSITY OF KANSAS SCHOOL OF MEDICINE   (United States)

Author keywords

African American; Alabama; eugenics; nervous resistance; public health; race; social Darwinism; syphilis; Tuskegee

Indexed keywords

AFRICAN AMERICAN; ATTITUDE TO HEALTH; ETHICS; ETHNOLOGY; HISTORY; HUMAN; MALE; REVIEW; SOCIAL PSYCHOLOGY; SYPHILIS; TREATMENT WITHDRAWAL; UNITED STATES;

AFRICAN AMERICANS; ALABAMA; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HISTORY, 20TH CENTURY; HUMANS; MALE; PREJUDICE; SYPHILIS; WITHHOLDING TREATMENT;

EID: 84859482222     PISSN: 00225045     EISSN: 14684373     Source Type: Journal    
DOI: 10.1093/jhmas/jrr003     Document Type: Review

References (150)

1. Susan M. Reverby, Examining Tuskegee: The Infamous Syphilis Study and Its Legacy (Chapel Hill: University of North Carolina Press, 2009);
2. James H. Jones, Bad Blood: The Tuskegee Syphilis Experiment, new and expanded ed. (New York: The Free Press, 1993).
3. Reverby, Examining Tuskegee, 29-85, 216-30;
4. Jones, Bad Blood, 91-150.
5. Allan M. Brandt, "Racism and Research: The Case of the Tuskegee Syphilis Study," in Tuskegee's Truths: Rethinking the Tuskegee Syphilis Study, ed. Susan M. Reverby (Chapel Hill: University of North Carolina Press, 2000), 15-33.
6. Jones, Bad Blood, 109, 120-25, 140.
7. see Reverby, Examining Tuskegee, 230-34;
8. Thomas G. Benedek and Jonathan Erlen, "The Scientific Environment of the Tuskegee Study of Syphilis, 1920-1960," Perspect. Biol. Med., 1999, 43, 1-30;
9. Robert M. White, "Unraveling the Tuskegee Study of Untreated Syphilis," Arch. Intern. Med., 2000, 160, 585-98. (Pubitemid 30140408)
10. Paul A. Lombardo and Gregory M. Dorr, "Eugenics, Medical Education, and the Public Health Service: Another Perspective on the Tuskegee Syphilis Experiment," Bull. Hist. Med., 2006, 80, 291-316. (Pubitemid 44022290)
11. Jenny Reardon, Race to the Finish: Identity and Governance in an Age of Genomics (Princeton: Princeton University Press, 2005), 17-44.
12. Samuel Theobald, "Remarks on Interstitial or Syphilitic Keratitis, with Report of Cases," Am. J. Med. Sci., 1873, 132, 419-30;
13. see David McBride, From TB to AIDS: Epidemics among Urban Blacks since 1900 (Albany: State University of New York Press, 1991), esp. 9-22.
14. George M. Frederickson, The Black Image in the White Mind: The Debate on Afro-American Character and Destiny, 1817-1914 (Hanover, New Hampshire: Wesleyan University Press, 1987), 256-319;
15. John S. Haller, Jr., Outcasts from Evolution: Scientific Attitudes of Racial Inferiority, 1859-1900 (Chicago: University of Illinois Press, 1971);
16. see Martin Summers, "'Suitable Care of the African when Afflicted with Insanity': Race, Madness, and Social Order in Comparative Perspective," Bull. Hist. Med., 2010, 84, 58-91.
17. Mary O'Malley, "Psychoses in the Colored Race: A Study in Comparative Psychiatry," Am. J. Insanity, 1914, 71, 309-37;
18. S. S. Hindman, "Syphilis among Insane Negroes," Am. J. Pub. Health, 1915, 5, 218-24;
19. and Kenneth M. Lynch, "Concerning Syphilis in the American Negro," South. Med. J., 1915, 8, 450-56.
20. Daniel David Quillian, "Racial Peculiarities as a Cause of the Prevalence of Syphilis in Negros," Medical Era (St. Louis), 1911, 20, 416-18;
21. William Lee Howard, "The Negro as a Distinct Ethnic Factor in Civilization," Medicine (Detroit), 1903, 9, 423-26;
22. and Thomas W. Murrell, "Syphilis and the American Negro," J. Am. Med. Assoc., 1910, 54, 846-49.
23. Frederick L. Hoffman, Race Traits and Tendencies of the American Negro (New York: Macmillan, 1896);
24. see Margaret Humphreys, Malaria: Poverty, Race, and Public Health in the United States (Baltimore: Johns Hopkins University, 2001), 58-60;
25. Leon F. Litwack, Trouble in Mind: Black Southerners in the Age of Jim Crow (New York: Alfred A. Knopf, 1998);
26. and C. Vann Woodward, The Strange Career of Jim Crow (New York: Oxford University Press, 2002), 67-109.
27. see Litwack, Trouble in Mind: Black Southerners in the Age of Jim Crow, 17, 25;
28. see McBride, TB to AIDS, 22-30.
29. Prince P. Barker, "Obscure Syphilitic Manifestations," J. Natl. Med. Assoc., 1929, 21, 57-61;
30. and John Fordyce, "Some Problems in the Pathology of Syphilis," Am J. Med. Sci., 1915, 149, 781-809.
31. D'Orsay Hecht, "Tabes in the Negro," Am. J. Med. Sci., 1903, 126, 705-20.
32. A. Eschner, "Conjugal Tabes Dorsalis," J. Am. Med. Assoc., 1911, 56, 1797-98;
33. Editor, "Current Medical Literature," J. Am. Med. Assoc., 1906, 46, 831-42;
34. E. M. Hummel, "The Rarity of Tabetic and Paretic Conditions in the Negro," J. Am. Med. Assoc., 1911, 56, 1645-46;
35. William Egbert Robertson and Joseph V. Klauder, "Various Types of Lues: A Clinical and Laboratory Study," J. Am. Med. Assoc., 1915, 64, 199-203;
36. W. M. Bevis, "Psychological Traits of the Southern Negro with Observations as to Some of his Psychoses," Am. J. Psych., 1921, 78, 69-78;
37. Roy L. Keller, "Syphilis and Tuberculosis in the Negro Race," Texas State J. Med., 1924, 19, 495-98;
38. James Edgar Paullin, Hal M. Davison, and R. Hugh Wood, "The Incidence of Sypyhilitic Infection among the Negroes in the South," Bost. Med. S. J., 1927, 197, 345-50.
39. Hideyo Noguchi and J. W. Moore, "A Demonstration of Treponema pallidum in the Brain in Cases of General Paralysis," J. Exp. Med., 1913, 17, 232-38;
40. and Claude Quétel, The History of Syphilis, trans. Judith Braddock and Brian Pike (Baltimore, Maryland: Johns Hopkins University Press, 1992), 133-34, 160-64.
41. Hummel, "Rarity of Tabetic and Paretic Conditions," 1645-46.
42. Julian Herman Lewis, The Biology of the Negro (Chicago: University of Chicago Press, 1942), 178-79 and note 101.
43. Bevis, "Psychological Traits," seems to connect low cerebral syphilis with high visceral syphilis in blacks, 76.
44. L. D. Hubbard, "A Comparative Study of Syphilis in Colored and in White Women with Mental Disorder," Arch. Neurol. Psych., 1924, 12, 198-205, quotation on 201-2;
45. with similar arguements in E. M. Green, "Psychoses among Negroes-A Comparative Study," J. Nerv. Ment. Dis., 1914, 41, 697-708;
46. O'Malley, "Psychoses in the Colored Race," 309-37.
47. Matthew Gambino, "'These Strangers within our Gates': Race, Psychiatry and Mental Illness among Black Americans at St Elizabeths Hospital in Washington, DC, 1900-40," Hist. Psych., 2008, 19, 387-408.
48. Elmer E. Southard and H. C. Solomon, Neurosyphilis: Modern Systematic Diagnosis and Treatment, Presented in One Hundred and Thirty-Seven Case Histories (Boston: W. M. Leonard, 1917), 76;
49. Bevis, "Psychological Traits," 69-78;
50. John H. Stokes, Modern Clinical Syphilology: Diagnosis, Treatment, Case Studies (Philadelphia: W. B. Saunders, 1926), 24-26;
51. H. Houston Merritt, Raymond D. Adams, and Harry C. Solomon, Neurosyphilis (New York: Oxford University Press, 1946), 15-17.
52. see Sander Gilman, The Jew's Body (New York: Routledge, 1991), 124-26;
53. see Mitchell B. Hart, Social Science and the Politics of Modern Jewish Identity (Stanford: Stanford University Press, 2000), 96-138.
54. Editorial, "Paresis among Jews," J. Am. Med. Assoc., 1900, 35, 1285;
55. Christopher Crenner, Private Practice: In the Early Twentieth-Century Medical Office of Dr. Richard Cabot (Baltimore: Johns Hopkins University Press, 2005), 163-82.
56. Emil Kraepelin, General Paresis, trans. J. W. Moore (New York: Journal of Nervous and Mental Disease, 1913), 161-62.
57. see Daniel Pick, The Faces of Degeneration: A European Disorder (New York: Cambridge University Press, 1989);
58. Charles E. Rosenberg, "The Bitter Fruit: Heredity, Disease, and Social Thought," in No Other Gods: On Science and American Social Thought (Baltimore: Johns Hopkins University Press, 1997), 25-53.
59. Hideyo Noguchi, "A Method for the Pure Cultivation of Pathogenic Treponema pallidum," J. Exp. Med., 1911, 14, 99-108;
60. Hideyo Noguchi, "Morphological and Pathogenic Variations in Treponema pallidum," J. Exp. Med., 1912, 15, 201-4;
61. Henry J. Nichols, "Observations on a Strain of Spirochaeta pallidum Isolated from the Nervous System," J. Exp. Med., 1914, 19, 362-71;
62. and Mathew A. Reasoner, "Some Phases of Experimental Syphilis, with Special Reference to the Question of Strains," J. Am. Med. Assoc., 1916, 67, 1799-805.
63. Francis X. Dercum, "The Clinical Forms Presented by Nervous Syphilis: Significance of and Necessity for Their Differentiation," New York Med. J., 1913, 98, 745-47;
64. and Jay Frank Schamberg, "The Present Status of the Treatment of Syphilis," Pa. Med. J., 1919, 22, 220-25.
65. Frederick W. Mott, "Modern Methods of Diagnosis and Treatment of Syphilis of the Nervous System," Lancet, 1923, 1, 1-4;
66. Colonel F. J. Lambkin, "Syphilis in the Uganda Protectorate," J. Royal Army Med. Corps, 1908, 11, 149-63.
67. see Darlene Clark Hine, "Black Professionals and Race Consciousness: Origins of the Civil Rights Movement, 1890-1950," J. Am. Hist., 2003, 89, 1279-94;
68. and more pointedly, Thomas J. Ward, Jr., Black Physicians in the Jim Crow South (Fayetteville: University of Arkansas Press, 2003), 261-63.
69. However, see J. J. France, "Cardio-Vascular Syphilis," J. Natl. Med. Assoc., 1922, 14, 151-53.
70. Mary Kaplan, Solomon Carter Fuller: Where My Caravan Has Rested (New York: University Press of America, 2005).
71. William Augustus Hinton, Syphilis and Its Treatment (New York: Macmillan Co., 1936), 10-11;
72. and Anonymous, "Book Notices: Syphilis and Its Treatment, by William A. Hinton," J. Am. Med. Assoc., 1936, 107, 1157.
73. Kaplan, Solomon Fuller, 18, 56.
74. Vanessa Northington Gamble, Making a Place for Ourselves: The Black Hospital Movement, 1920-1945 (New York: Oxford University Press, 1995), 89, 102, 184-86;
75. Reverby, Examining Tuskegee, 18-19;
76. Ward, Black Physicians in the Jim Crow South, 169-70.
77. Charles H. Wesley, Henry Arthur Callis: Life and Legacy (Baltimore, Maryland: Foundation Publishers, 1997);
78. and Henry Arthur Callis, "Primary Syphilis," J. Natl. Med. Assoc., 1929, 21, 37-42.
79. George C. Branche, "Syphilis of the Brain and Spinal Cord," J. Natl. Med. Assoc., 1929, 21, 52-57;
80. and T. T. Tildon, "Cardiovascular Syphilis: A Summary of Its Outstanding Features," J. Natl. Med. Assoc., 1929, 21, 42-45.
81. see Ernest L. Zimmerman, "A Comparative Study of Syphilis in Whites and in Negroes," Arch. Derm. Syphilol., 1921, 4, 75-88;
82. Alfred Keidel, "Studies in Asymptomatic Neurosyphilis IV: The Apparent Role of Immunity in the Genesis of Neurosyphilis," J. Am. Med. Assoc., 1922, 79, 874-84;
83. Jarold E. Kemp and Allan K. Poole, "Familial Neurosyphilis IV. Incidence of Neurosyphilis among Parents of Congenitally Neurosyphilitic Children," J. Am. Med. Assoc., 1925, 84, 1395-98;
84. Thomas B. Turner, "The Race and Sex Distribution of the Lesion of Syphilis in 10,000 Cases," Bull. Johns Hopkins Hosp., 1930, 46, 159- 84;
85. and Joseph E. Moore, James H. Danglade, and John C. Reisinger, "Treatment of Cardiovascular Syphilis: Results Obtained in Fifty-Three Patients," Arch. Intern. Med., 1932, 49, 879-924.
86. see Raymond A. Vonderlehr, "The Mass Control of Syphilis," South. Med. J., 1937, 30, 281-86;
87. Joseph E. Moore, "Studies in Asymptomatic Neurosyphilis III: The Apparent Influence of Pregnancy on the Incidence of Neurosyphilis in Women," Arch. Intern. Med., 1922, 30, 548-54;
88. and Zimmerman, "Syphilis in Whites and in Negroes," gives the figure of 60 percent black patients, 75-88.
89. Joseph E. Moore, "The Genesis of Neurosyphilis," Arch. Derm. Syphilol., 1921, 4, 55-61.
90. Joseph E. Moore and Alfred Keidel, "Studies in Familial Neurosyphilis I: Conjugal Neurosyphilis," J. Am. Med. Assoc., 1921, 77, 1-7;
91. Joseph E. Moore and Alfred Keidel, "Studies in Familial Neurosyphilis II: Familial Neurosyphilis from Various Extrafamilial Sources," J. Am. Med. Assoc., 1923, 80, 818-20;
92. Joseph E. Moore and Jarold E. Kemp, "Studies in Familial Neurosyphilis III: Conjugal Neurosyphilis," Arch. Intern. Med., 1923, 32, 464-82.
93. Joseph E. Moore, "Studies in Asymptomatic Neurosyphilis II: The Classification, Treatment and Prognosis of Early Asymptomatic Neurosyphilis," Bull. Johns Hopkins Hosp., 1922, 33, 231-46;
94. Keidel, "Asymptomatic Neurosyphilis IV," 874-84;
95. Joseph E. Moore and Mildred Faupel, "Asymptomatic Neurosyphilis V: A Comparison of Early and Late Asymptomatic Neurosyphilis," Arch. Derm. Syphilol., 1928, 18, 99-108;
96. Joseph E. Moore, "The Relation of Neurorecurrences to Late Syphilis: A Clinical Study of Eighty-One Cases," Arch. Neurol. Psych., 1929, 21, 117-36;
97. and Joseph E. Moore and H. Hanford Hopkins, "Asymptomatic Neurosyphilis VI: The Prognosis of Early and Late Asymptomatic Neurosyphilis," J. Am. Med. Assoc., 1930, 95, 1637-41.
98. Zimmerman, "Syphilis in Whites and in Negroes," 75;
99. Moore and Faupel, "Asymptomatic Neurosyphilis V," 102, 108;
100. Moore and Keidel, "Familial Neurosyphilis II," 818, 820: noting "racial predisposition to nervous system damage" in white patients; Moore, "Asymptomatic Neurosyphilis II," 237.
101. see Moore, "Asymptomatic Neurosyphilis III," 549;
102. see Moore, "Asymptomatic Neurosyphilis II," 231-46, esp. 239-40;
103. Zimmerman, "Syphilis in Whites and in Negroes," 75, 86;
104. Keidel, "Asymptomatic Neurosyphilis IV," discussion following the paper;
105. Moore, "Neurorecurrences," 119, 136;
106. and Moore and Hopkins, "Asymptomatic Neurosyphilis VI," 1637.
107. Turner, "10,000 Cases," 176.
108. Moore, "Asymptomatic Neurosyphilis II," 232.
109. Henry M. Thomas, Jr., "Memorial: Joseph Earle Moore, M.D.," Trans. Am. Clin. Climatol. Assoc., 1960, 71, xlix-l;
110. Reverby, Examining Tuskegee, 136-39.
111. Moore, Danglade, and Reisinger, "Cardiovascular Syphilis," 879-924, quote 884.
112. John Parascandola, Sex, Sin, and Science: A History of Syphilis in America (Westport, Connecticut: Praeger, 2008), 78-79.
113. Joseph E. Moore, Harry M. Robinson, and Richard S. Lyman, "The Results of Tryparsamide Therapy in Neurosyphilis," J. Am. Med. Assoc., 1924, 83, 888-91;
114. Paul A. O'Leary, "Malaria as an Adjunct in the Treatment of Neurosyphilis," Int. Clin., 1925, 35, 103-8;
115. Udo Wile and Harther Keim, "The Effect of Treatment on Spinal Fluid in Cerebrospinal Syphilis," J. Am. Med. Assoc., 1925, 85, 1269-71;
116. John H. Stokes and Loren W. Shaffer, "Clinical Management and Response of Tabetic Patient," J. Am. Med. Assoc., 1925, 85, 1271-75;
117. Joseph E. Moore et al., "Cooperative Clinical Studies in the Treatment of Syphilis: Latent Syphilis," Vener. Dis. Inf., 1932, 13, 371-79;
118. see especially Harry M. Marks, The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900-1990 (New York: Cambridge University Press, 1997), 53-60.
119. Reverby, Bad Blood, 109.
120. Jones, Bad Blood, noted this strategic use, 138.
121. Herbert Rattner, "In Memoriam: Paul A. O'Leary, M.D., 1891-1955," Arch. Dermatol., 1955, 72, 211-19.
122. For examples, see Jones, Bad Blood, 81, 107.
123. Moore and Faupel, "Asymptomatic Neurosyphilis V," 102-3;
124. Moore and Hopkins, "Asymptomatic Neurosyphilis VI," 1637;
125. Joseph E. Moore, The Modern Treatment of Syphilis (Baltimore: Charles C. Thomas, 1933), 218.
126. James Jones, Bad Blood, 122-31;
127. W. Montague Cobb, "The Physical Constitution of the American Negro," J. Negro Edu., 1934, 3, 340-88.
128. George C. Branche, "Tryparsamide Therapy of Neurosyphilis in Negroes," Med. Bull. US Veteran's Bureau, 1931, 7, 476-80.
129. George C. Branche, "Therapeutic Quartan Malaria in the Treatment of Neurosyphilis among Negroes," J. Nerv. Ment. Dis., 1936, 83, 177-88;
130. T. T. Tildon, George C. Branche, and P. P. Barker, "Facts of Interest in Connection with the Veterans Administration Facility, Tuskegee, Alabama," J. Natl. Med. Assoc., 1941, 33, 81-82.
131. Reverby, Examining Tuskegee, 161-62.
132. Paul A. O'Leary and Marque O. Nelson, "The Significance of Normal Spinal Fluid in Cases of Neurosyphilis," J. Am. Med. Assoc., 1925, 85, 1276-81.
133. Stokes, Clinical Syphilology, 24-26, 900, quote on 24.
134. Jay F. Schamberg and Carroll S. Wright, Treatment of Syphilis (New York: D. Appleton, 1932), 481, 473-74, 515,
135. Moore, Treatment of Syphilis, 5, 37, 217-18, 438,
136. Lauren C. Tantalo, Sheila A. Lukehart, and Christina M. Marra, "Treponema pallidum Strain-Specific Differences in Neuroinvasion and Clinical Phenotype in a Rabbit Model," J. Infect. Dis., 2005, 191, 75-80. (Pubitemid 40041403)
137. Raymond A. Vonderlehr et al., "Untreated Syphilis in the Male Negro: A Comparative Study of Treated and Untreated Cases," J. Am. Med. Assoc., 1936, 107, 856-60.
138. see Turner, "10,000 Cases," 197;
139. and see Charles C. Dennie, Syphilis: Acquired and Heredosyphilis, Harper's Medical Monographs (New York: Harper & Bros., 1928), 160;
140. John H. Musser and A. E. Bennett, "The Incidence of Syphilis of the Aorta with Interstitial and Parenchymatous Neurosyphilis," Arch. Intern. Med., 1924, 34.
141. Branche, "Syphilis of the Brain and Spinal Cord," 52.
142. Vonderlehr et al., "Untreated Syphilis," 858.
143. The Gift of Columbus (Kansas City, Missouri: Brown-White Co., 1936).
144. Green, "Psychoses among Negroes," 697-708.
145. Vonderlehr et al., "Untreated Syphilis," 859.
146. Michelle Brattain, "Race, Racism, and Antiracism: UNESCO and the Politics of Presenting Science to the Postwar Public," Am. Hist. Rev., 2007, 112, 1386-413;
147. Reardon, Race to the Finish;
148. also see comparable analysis of the declining fortunes of eugenics in Alexandra Minna Stern, Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America (Berkeley: University of California, 2005);
149. and Wendy Kline, Building a Better Race: Gender, Sexuality, and Eugenics from the Turn of the Century to the Baby Boom (Berkeley: University of California, 2001).
150. Brattain, "Race, Racism, and Antiracism," 1386-413.