What was it like to have terminal syphilis in the US in the 1920s?
August 22, 2017 5:23 PM   Subscribe

My father's father, an middle class Irish-American, died of syphilis in the midwest in 1924 when my father was about 14 years old. Since everyone with direct knowledge is long gone, I don't have any relatives I can ask about this episode in family history. I'm interested in informed comments and/or citations to works of fiction or nonfiction that would shed light on what that experience was like for my grandfather, my grandmother, my father and his younger brother, the family unit as a whole and the larger community.

Some time ago, my late sister discovered an old family secret when she read on my grandfather's death certificate that he had died of syphilis. This fits perfectly with the only fact my father ever told me about his father's demise, as he said he was out of his mind at the end.

I do not know who in the family, if anyone, knew this. I do know that opinions toward STDs then were very different in significant ways from many people's attitudes as the AIDS crisis wore on. Unlike the 1980s and 1990s, there were no syphilis demonstrators in the 1920s acting up to remind people that silence = death.

I am interested in all aspects of how suffering from an incurable sexually-transmitted disease in the first two decades of the 20th century probably affected my grandfather and those closest to him. He was a self-employed produce salesman. Since my grandmother lived on for several decades and died of something else, I assume she was not the source of the infection that killed my grandfather. I think it's likely he picked up the infection when he was on the road.

In the early 1900s, how much time typically elapsed between an individual became infected from syphilis and when the person succumbed to it?

I've come across a 1921 publication that states my grandfather was away from work for an unspecified period due to an unspecified illness, but had recovered and was working again. Could that have been due to the syphilis?

What symptoms would my grandfather have experienced that prevented him from working?

What sort of medical treatment did individuals with late-stage syphilis receive in the 1920s, and where was it provided?

Given the conventions of the day, is it likely my grandfather or his doctors would have disclosed his diagnosis to my grandmother?

What was life like then for a patient with tertiary syphilis?

Assuming my grandmother knew her husband's condition, would she have shared that information with anyone, perhaps a parish priest? What would the church's attitude toward the situation have been?

What would my father have been told about his father's health?

My grandfather likely experienced a period of incapacity followed by his death. My father would have been 10 to 15 years old then. What likely harmful psychosocial effects could this series of events have have had on my father, particularly as it might relate to his own parenting skills and abilities? I ask because my father was a terrible parent to me. I used to think it was because I was too obviously gay and he didn't know what to about it, but knowing he lost his father under such terrible circumstances might also explain his parenting deficits.

Is there anything else should know that I haven't thought of?
posted by A. Davey to Society & Culture (12 answers total) 7 users marked this as a favorite
Jesus that is not a fun way to die. I know that because of the paleopathology class I finished last year and we did a whole unit on treponemal disease. We saw skulls and one memorable photograph of a fellow with late stage syphilis who was literally missing parts of his scalp and skull- you could see his brain. Generally it can take up to 30 years (sometimes less) for a syphilis infection to go tertiary. When the disease first appeared in Europe in the renaissance it killed very quickly- within a year, but it settled down into the modern pattern long before your poor grandpa would have contracted it. It's not really a sexual disease so much as a skin disease that has evolved to transmit sexually- if that makes any sense. It's indistinguishable under a microscope from Yaws and Bejel- but Syphilis is much worse.

Most likely he was infected when younger, from a girlfriend or a sex worker, and then in its initial stage he would have had a chancre on his member that could have been really nasty, or unnoticeable. That's the primary stage when it is most contagious. If he didn't have sex with your grandmother or only after, then you are absolutely right- she most likely didn't have it, and was a very lucky woman. Some time later, after the chancre had heard he would have developed secondary syphilis, when he would have gotten a bad skin condition most likely on his shins, but also maybe on his arms or even his face. This would have sucked, it would have been maybe really bad- but again, could have been mild. At this point- the disease is still curable. Afterwords- he was doomed.

Tertiary syphilis is where the effects of the disease can really be seen in bone, especially the skull. gummatous lesions would have been present through the secondary stage, but by the tertiary stage they would have been erupting, healing and scaring, and possibly erupting again on the skull. This is also when the really messed up mental symptoms would have appeared. He would have been disturbed, maybe even violent, like the worst case of dementia. His physics appearence would have suffered, if he was really unlucky, like the fellow in the photograph I saw, there would be holes in his skull, and damage to his facial bones, people used to lose noses. At this point, there is no cure but palliative measures Even in tertiary patients today! Which is why using condoms and getting treated at the first sign of a chancre is so so so important!

I'm a bone person, not a psychologist, but so would guess the effect on your father would be of any child whose parent suffers from dementia or Alzheimer's. Confusion- pain- not knowing why father was acting this way.

Syphilis is a terrible way to go. Get tested kids!
posted by Homo neanderthalensis at 5:40 PM on August 22, 2017 [29 favorites]

Don't google image search gummatous lesions or gummatous syphilis unless you want some premium nightmare fuel- just FYI.
posted by Homo neanderthalensis at 5:43 PM on August 22, 2017 [6 favorites]

Treatment would have most likely been arsenic, as Penicillin wasn't discovered until 1943. This article has an entire history of treatments.
posted by SyraCarol at 5:52 PM on August 22, 2017 [2 favorites]

The first part of Deborah Hayden's Pox: Genius, Madness, And The Mysteries Of Syphilis delves into a number of your questions in terms of how syphilis was experienced during this period. There could be anywhere from a few years to a few decades of latency between the original infection and the tertiary (late) stage. There could be such a wide array of symptoms that until the first effective test for syphilis was developed around 1905, sufferers were sometimes misdiagnosed for years with other diseases (it was sometimes called "the great pretender" for this reason). Physical symptoms could include everything from severe headaches, joint pain, nerve pain, diarrhea/abdominal pain, light sensitivity, jaundice, severe rashes, seizures, trouble walking, and loss of hearing. Then there are the psychological/behavioral symptoms: severe mania, hallucinations, paranoia, sudden violence, etc.

For treatment, mercury (itself highly toxic) was probably the most widely used compound into the early 20th century. Salvarson, which was essentially the first chemotherapy drug, was introduced to treat syphilis in the early 1910s. So-called fever therapy (using malaria) was also sometimes used, starting around 1917 (for which Julius Wagner-Jauregg won a Nobel Prize in 1927). Penicillin wasn't used until its discovery in the early 1940s.
posted by the return of the thin white sock at 6:00 PM on August 22, 2017 [4 favorites]

(content warning: derogatory term for sex workers)
Al Rose, in his 1974 Storyville, New Orleans: Being an Authentic, Illustrated Account of the Notorious Red-Light District, reported that the introduction of Salvarsan didn't keep quacks from
continuing to treat syphilitics, to whom they promised the kind of quick, one-shot cure that did not actually become possible until decades later when penicillin treatments were developed. With their fake cures, the quacks contributed almost as much as the harlots to the epidemic tertiary syphilis that Thomas Sancton alluded to in the [defunct since 1958] New Orleans Item: "... It was a day when victims of the shadow-plague walked the streets of New Orleans and the other great cities, living corpses, eyelids drooping in early paralysis, hands and body shaking with a palsy not caused by age."
posted by virago at 6:35 PM on August 22, 2017 [2 favorites]

For a fictional though vivid and realistic early-1900s syphilitic depiction, try The Knick.
posted by glibhamdreck at 6:35 PM on August 22, 2017 [6 favorites]

There are a million little interactions that make us who we are as people (and as parents) and it seems kind of reductive to try and pin your father's failings on one particular element (no matter how traumatic) of his upbringing.

I definitely think this is true. But I also think it's true that understanding the effects of syphilis, and the wider familial/social context of suffering from syphilis in the early 20th century, may yield some important information or insight for the OP. Syphilis was marked by extreme levels of shame and secrecy, and I don't think it would be unusual if its traumatic effects on a family could ripple out through generations. (In her book, Hayden points out that there's still an intense stigma around raising even the possibility that certain historical figures might have died of syphilis.)

The taboos around discussing syphilis were so intense that women who may have been infected by their husbands weren't always even told by their doctors what they were being tested or treated for. (Supposedly there were even mercury-laced chocolates that a syphilitic husband could give to his wife to treat her while maintaining the secret of his own illness!)
posted by the return of the thin white sock at 6:53 PM on August 22, 2017 [14 favorites]

^^^Yes -- the stigma and secrecy would have been immense.

Case in point:

"My father really died from the effects of syphilis -- although that's not what it said in his lengthy obituary in the Picayune," a man born in 1888 -- pseudonymously called "Rene" and described as "the scion of an old and prosperous New Orleans family" -- told Al Rose when interviewed in the early 1960s for Storyville.
posted by virago at 7:19 PM on August 22, 2017

Bad Blood is nonfiction about the Tuskegee syphilis experiment.
posted by brujita at 9:35 PM on August 22, 2017 [1 favorite]

To a little research on Al Capone. He supposedly contracted it at about the age of 18 and lived his whole life as a gangster with it. But in the end he went from the biggest tough guy in America to a withered, destroyed, shell of a man.
posted by Lord Fancy Pants at 4:37 AM on August 23, 2017

You might be interested in this 1937 (and a bunch of others) vintage educational film on YouTube. I watched a handful of these public health and military videos one day a while ago and they are fascinating and horrifying. They show a lot about how it was regarded back then, their understanding of the disease, and the treatments used. Of course, the time period is a bit later, but at least some of them go into the history. (I'm at work, so I'm not certain if the linked video does, but it's one of the longest and earliest ones I found, there are other shorter ones from various times as well.)
Syphilis is a terrible disease, and even after they started using penicillin in the '40s, the treatment itself was terrible to go through. I know at least one video goes into detail about what were basically sanitarium/work farms where young women were sent for treatment for up to several years. It's all very interesting and disturbing to learn about.
posted by catatethebird at 10:35 AM on August 23, 2017

Two famous people who died of Syphilis are Scott Joplin and Al Capone. A quick Google reveals that lot's of people have had a morbid fascination with the details of Capone's decline. I read a biography of Joplin that had no specific details but which included some general information. I believe they both were eventually institutionalized in places equipped to deal with the mentally incompetent.
posted by SemiSalt at 11:12 AM on August 23, 2017

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