Trouble in Mind: Syphilis (1930s)

Felix Underwood testified before Congress in 1938 regarding his experiences managing Mississippi’s Board of Health. One patient murdered his wife and his mother-in-law then killed himself. Tragic–yes. Even more tragic because the man had lost his mind due to syphilis (1).

What did doctors know in the 1930s?

• Caused by the corkscrew bacteria spirochaeta pallida
• Spread through contact with sores
• Higher percentage of cases found in cities
• Rates of infection for Negros was higher than Whites
• Prostitution played a larger role in its spread
• Treatment took 6 months to a year but it didn’t guarantee a cure
• Children were not treated for congenital syphilis (2)

Stages:

1. Primary: A chancre develops after several weeks at the initial infection site. There may be only one, or several, or simply not visible. The chancre is painless and heals roughly between 3-6 weeks.

1. Secondary: Several months after the chancre heals, a rash appears all over the body and may include fever, aches, and swollen lymph nodes. These symptoms may last several weeks or on and off for over a year.

1. Latent: Considered the ‘silent stage’ where the bacteria lays dormant for years or awakened to destroy other areas of the body

1. Tertiary: 15%-30% of those infected develop damages to ocular, neurological, or pulmonary issues from the disease (3)

Diagnosis:

Wassermann Test:

First developed in 1906 as a means to diagnosis 80% of primary stage syphilis cases. Blood was drawn from a possibly infected patient and examined under a microscope. However, the rate of diagnosis plummeted after the patient moved out of the primary stage (4). The cost to administer and have the blood tested was $25.00, which put a simple diagnosis out of reach for many (5).

Kahn Test:

Developed in the mid 1920s by a immunologist working for the Michigan Department of Health. It was another means to test syphilis (6). The test didn’t prove any better at diagnosing second stage syphilis anymore than the Wassermann Test did (7).

If the blood test returned a positive result, the patient had several options:

1. Mabel Dodge Luhan, a famous patroness of the arts in New Mexico, swore off sex all together after becoming infected for a third time by her third husband (8). Let’s be honest, not everyone would devote themselves to celibacy
2. Do nothing (run the risk of infecting children, spouse, or other sexual partners)
3. Wear a condom
4. Option for Cure

Condoms:

Danny McGoorty hated wearing condoms. He equated it to, “jacking off with boxing gloves.” Prophylactics could be purchased for around $ .25 and came in a little tin. Mary Crosby’s boyfriend didn’t share Gooty’s sentiment and preferred Merry Widows. However, during post-coital bliss, Mary recounted her boyfriend holding the spent condom up to the light (she was never sure if he was marveling at his ejaculation or checking for leaks) (9).

Condoms by the 1930s were made with varying degrees of rubber and fell under the radar of government regulation. The wearer had to basis their purchase on trial and error. However, by 1937 the federal government shed its reluctance and got into bed with the condom industry.

Option for a Cure:

The 1930s saw a dramatic rise in reported syphilis cases. FDR appointed a Surgeon General with his main focus in eradicating syphilis through education, diagnosis, and treatment (10).

The first part was easy. Surgeon General Parran wrote a book and flooded local newspapers with articles from 1936 to 1937 making readers even more aware of the S.T.D. Diagnosis in the late 1930s became free to anyone willing to take the Wassermann Test. (11) Treatment, however, was not.

Treatment didn’t guarantee a cure. It was also long (six months to two years depending on the type of treatment). And pricy (running anywhere from $50.00 to $500.00) (12). One had to hope they could trust their doctor to cure them and not gouge their pocket book.

Arsenic/Mercury:

One received 20 injections over a twenty month period supplemented with mercury, creams, and sodium bismuth. Side effects included constant pain at the injection site, vomiting, and headaches (13).

Salvaran:

A hypo-thermotic treatment where the solution was highly unstable when exposed to air, needed to be refrigerated, and diluted with water before usage. Possible side effects were kidney failure, seizures, rash, infections, and death. It’s cousin, Neo-Salvaren was more stable and offered up the same side effects. Both were ineffective in treatment of second stage sphyilis. (14)

Fever:

Also called the Wagner-Jauregg Cure developed in 1917. It amounted to getting the body to 103-107 degrees to kill the bacteria. The means could be done via a machine or giving a patient malaria to induce the high level of constant fever. It was also ineffective with treating anything beyond first stage syphilis (15).

Penicillin:

Did not become in steady use for the curing of syphilis to the masses until WWII even though it was first discovered in 1928 (16). Danny McGoorty said, “Think how easy it is today. The doctor just gives you a shot of penicillin and you don’t have clap or syph [sic] anymore. Kids today don’t know what hell is.” (17)

IOWA

By 1937 Iowa had 7,500 reported syphilis cases (18). The state of Iowa in 1937 did not require a blood test as a perquisite for getting a marriage license. Many couples in Illinois simply hoped the boarder to get one (19). The Wassermann Test was still the basis and the results were sent to the University of Iowa laboratories for testing. Results were then sent privately to a physician who would share the results and discuss treatment with the patient (20).

SOURCES:

1. Lord, Alexandra D. Condom Nation. The Johns Hopkins University Press, 2010, 52.
2. Even the Assistant Surgeon General to the United States couldn’t help but play the race card when trying to explain his reasoning behind Iowa’s lower syphilis rates when compared to other states (“Syphilis Rate Low in State.” Des Moines Register, 29 Apr. 1936, p. 3). His superior left out race in his “The Reasons for War on Syphilis.” Des Moines Register, 31 Jan. 1937, p. 16; Do a google search on Tuskegee Syphilis experiment and you’ll see how race bias controlled how doctors justified the spread and treatment of syphilis. 
3. “Syphilis.” Mayo Clinic. 2021. Accessed: 18 April 2021. Location:
4. Hemarajata, Dr. Peera. “A Brief History of Laboratory Diagnostic for Syphilis.” America Society for Microbiology. 6 January 2020. Accessed: 18 April 2021. Location:
5. Poirier, Suzanne. Chicago’s War on Syphilis, 1937-1940. Chicago: University of Illinois, 1995, 62.
6. Shapiro-Shapin, Carolyn. “‘In the Course of Routine Analysis’: Re-Envisioning Research in State Departments of Health, 1920–1940.” Journal of the History of Medicine and Allied Sciences, vol. 70, no. 3, 2015, pp. 333–364.
7. Osmond, T. E., and Douglas McClean. “A Comparison Of The Kahn And Wassermann Tests On 500 Serums.” The British Medical Journal, vol. 1, no. 3301, 1924, pp. 617–618. 
8. Ropper, Ph.D., Allan H. How the Brain Lost Its Mind. Peguin Random House, 2019, 130.
9. Both Danny McGoorty and Mary McCarthy recount their experiences with sex in the 1920s and 1930s. Byrne, Robert. McGoorty: A Pool Room Hustler. Broadway Books, 2004, pp. 23, 24; McCarthy, Mary. How I Grew. Harcourt, Brace, Joranovich, Inc., 1987, pp. 77-78.
10. Lord, Alexandra D. Condom Nation. The Johns Hopkins University Press, 2010, pp. 49, 52, 56, 67.
11.  “The Reasons for War on Syphilis.” Des Moines Register, 31 Jan. 1937, p. 16. Newspapers.com accessed 17 April 2021, displayed 252 articles combined in The Tribune and The Des Moines Register referencing syphilis from January 1, 1936 to December 31, 1937. Articles ranged anywhere from what Iowa was doing as well as neighboring states, doctors, symptoms, cures, testing, statistics, and editorials regarding syphilis.
12. Poirier, Suzanne. Chicago’s War on Syphilis, 1937-1940. Chicago: University of Illinois, 1995, p. 52.
13. Ropper, Ph.D., Allan H. How the Brain Lost Its Mind. Peguin Random House, 2019, p. 131.
14. Ibid, pp. 119, 123, 130, 131.
15. Ibid, p. 139.  Grant, Donald. “Fever Device to Fight Two Diseases.” Des Moines Register, 14 Oct. 1936, p. 3.
16. Firth, John. “Syphilis — It’s Early History and Treatment Until Penicillin and the Debate on its Origins.” History, 4. Volume 20. Accessed: 18 April 2021.
17. Byrne, Robert. McGoorty: A Pool Room Hustler. Broadway Books, 2004, p. 27.
18. “New Cases of Syphilis in Iowa.” Des Moines Register, Morning, 27 Sept. 1937, p. 10.
19. Poirier, Suzanne. Chicago’s War on Syphilis, 1937-1940. Chicago: University of Illinois, 1995, pp. 55, 67.
20. Owens, Herbert G. “Calhoun County Drive Against Syphilis.” Des Moines Tribune, 9 Dec. 1937, p. 20.