Infectious and Epidemic Disease in History
Department of History
University of California, Irvine
Instructor: Dr. Barbara J. Becker
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Department of History
University of California, Irvine
Instructor: Dr. Barbara J. Becker
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Supplementary readings for Week 5's lectures include:
Syphilis manifests itself in a maddeningly wide array of ways. Overt symptoms of the disease (genital sores, swollen lymph nodes, overall rash, bone degeneration ...) appear in discrete stages interrupted by lengthy periods of latency that mask the fact that they are all connected and attributable to the same cause. It was not until 1905 that two German researchers -- Eric Hoffman (1868-1959) and Fritz Schaudinn (1871-1906) -- isolated and identified a corkscrew-shaped bacterium, Treponema pallidum, as syphilis's infecting agent. In 1906, August von Wassermann (1866-1925) developed a diagnostic blood test to detect the presence of antibodies to this spirochete. Despite these advances, there was still no "cure" for syphilis. Treatments involved exposing victims to toxic compounds of mercury, bismuth, or arsenic which carried their own risks of injury and death. Were the remedies more dangerous than the disease itself?More information was needed about syphilis and its long-term effects. In 1929, a Norwegian researcher published a retrospective review of the case histories of two thousand untreated syphilis victims who had been examined in an Oslo clinic between 1891 and 1910. In 1932, the United States Public Health Service launched its own investigation into the progress of untreated syphilis: a prospective longitudinal study of 616 African American men -- 412 of whom were diagnosed as having syphilis, and 204 controls -- to be conducted at the teaching hospital of the Tuskegee Institute in Alabama. Forty years later, in July 1972, the study's report -- "The Tuskegee Study of Untreated Syphilis in the Negro Male" -- received national attention after a news story by Associated Press reporter Jean Heller appeared on the front page of the July 25 edition of the Washington Evening Star bearing the eye-catching headline "Syphilis Patients Died Untreated". The public outrage sparked by this report led to Congressional hearings, new legislation, and the creation of a special commission to study and remedy questionable biomedical and behavioral research practice. In 1979, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research issued a guide for conducting research on human subjects, entitled "Ethical Principles and Guidelines for the Protection of Human Subjects of Research," or "The Belmont Report." In response to the recommendations of the Tuskegee Syphilis Study Legacy Committee, President Bill Clinton issued an apology in May 1997 on behalf of the Nation to the survivors and families of the men who had served as subjects in the Tuskegee study. Experimentation on human subjects is fraught with serious ethical concerns. At what point do the interests of science and humanity in general supersede those of a handful of human subjects?After penicillin became available as a safe and effective treatment for syphilis, continuing the Tuskegee Study could be considered illegal, unethical, or just plain "bad science." Did the ends justify the means? Was the Tuskegee Study of such a value to society that the suffering of a small group of individuals could be ignored? In January 2010, Wellesley College professor Susan Reverby announced her discovery of long-hidden records of medical experiments performed by U.S. researchers on Ecuadorian prisoners between 1946 and 1948. No attention was drawn to this discovery, however, until October 2010, when the news sparked public outrage and official response. |
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