The Tuskegee Syphilis Study was a clinical study conducted between 1932 and 1972 by the U.S. Public Health Service to study the natural progression of untreated syphilis in rural African American men in Alabama. Over 600 men were enrolled in the study, with 399 having syphilis and 201 serving as controls. The men were never informed they had syphilis and were not treated even after penicillin became the standard treatment for syphilis in 1947. By the end of the study in 1972, 28 of the original 399 men with syphilis had died of the disease and 100 more were dead of related complications; additionally, 40 wives had been infected and 19 children were born with congenital syphilis

1. Tuskegee Syphilis Study

2. Syphilis overview
Treponema Pallidum (subspecies Pallidum)- spirochete
bacteria
Syphilis sores are called chancres and can appear on the
mouth, genitals, anus, or rectum.
Three stages
1. Appearance of small chancre which clears up on its
own. First appears 10-90 (average 21) days after
infection and lasts for 1-5 weeks.
2. A rash appears on palm of hands and bottom of the
feet. Scales can appear over the body. Moist warts
appear in the groin. Lasts for 2-6 weeks
3. Latent Stage - The bacteria remains in the body and will
damage the patients internal organs: brain, nerves,
eyes, heart, blood vessels, liver, bones, and joints
Bicillin will cure syphilis if the patient has had it <1 year. If the
patient has had it longer they will need longer treatment.

5. 1930
Doctors were treating syphilis in black sharecroppers with the
Tuskegee medical Center using money from the Rosenwald
Fund.
1928 - 35% of black males in Macon county were positive for
syphilis. The disease burden was incredibly high. Patients were
treated using Mercury and Bismuth with a cure rate of only 30%
and deadly side effects.
1929 - Beginning of the Great Depression
1931 - Money dried up following the Wall Street crash.

6. “Tuskegee Study of Untreated Syphilis in the Negro Male.”
https://www.cdc.gov/tuskegee/timeline.htm
1932 - Dr. Taliaferro Clark was initially planning to follow untreated black
males with syphilis for 6 mos to 1 year and then perform treatment.
600 men were included in the study- ~400 with syphilis and ~200 man
control group
White doctors Dr. Taliaferro Clark and Dr. Wenger promised prestige and
jobs to the interns and nurses trained by the Tuskegee Medical Center.
Because of the dire need for employment Dr. Dibble approved and did not
ask questions. Nurse Rivers was assigned to the task
Community members were bribed with the promise of free medical care.
Everyone who was not a black male, positive with syphilis, and older than
25 was told they were well and turned away. The selected 400 were told
they were being treated for “bad blood”.
The initial study went on for 6 mos. After the first examination Dr.
Vonderlehr (the on-site doctor in charge of the experiments procedures) did
not find signs of mental degradation (___) and insisted to bring all the
subjects back for a painful lumbar puncture. The men were told they were
getting a shot.

7. New management
Dr. Clark returned to Washington where he took over as the
head of the US Public Health Service. He immediately
restarted the program. This time he intended to watch the
subjects until they died of late stage syphilis. The study
intended to mirror a similar study of syphilis done in Norway
to see if the belief that in black men the disease had more
cardiovascular rather than neural effects.
Within weeks the first patient died from their condition.
1936 - Dr. Vonderlehr urged local physicians are requested
to not treat test subjects with syphilis.
1945 - Penicillin is found to be an effective treatment for
syphilis. However, the patients continued to be untreated
and were actually advised not to go to the widespread
treatment centers where others were getting treatment.

8. Questions raised
1966, 1968 - Peter Buxton writes letters to the CDC in Atlanta and raises
questions at the conference for venereal disease in Washington. The rest of the
physicians insist the value of the information to science outweighs the ethical
obligation of obtain “informed consent.” These physicians claimed that by
obtaining the consent of the local physicians in the area they satisfied their moral
duty.

10. Reveal Party
1970 - Buxton meets Jean Heller at a party
while in law school and informs the news.
1972 - News reveals the study to the public.
It is worth noting the study was well known
in the medical community and the results
were being published in medical journals for
years. The study ends.

12. As much justice as you could hope for in the 70s I guess
1974 - Initially the government did not
want to give money. They first agreed
to only give free medical care to the
study victims. Attorney Fred D. Gray
took the government to court in Pollard
v United States and reached a
$10million dollar settlement to be paid
to the victims and their descendants.
1972 - 74 subjects are still alive. 28
subjects of the 399 died of syphilis. 100
died of related complications. 40 of
their wives had been infected and 19 of
their children had been born with
congenital syphilis.