In my researching of Lou Graham, the somewhat notorious (and often maligned) Seattle madame, one of the aspects that made me bubble over with rage was the way that people clearly didn’t - and still don’t - understand syphilis. In fact, they seem almost opposed to learning anything about it at all.
Graham, who ran a bordello in Seattle and was by all accounts fantastically wealthy, died unexpectedly in 1903 when she was in her 40s. Her death, which occurred while she was in a kind of exile in San Francisco, came after a short but painful bout of illness.
All of this is true, but most of the records about her didn’t go much further in detail. This lack of a clearly stated cause of death naturally has led curious folks to fill in the gaps on their own. And because people are, by and large, not very good at filling in informational gaps on their own, that means anyone who’s ever been interested in Graham and her history has joined a gnat-like swarm of people who just kind of posit things into the atmosphere and somehow those things become true.
And so the rumor that persists is that Graham died of syphilis. After all, she ran a brothel, so she must have been a diseased old bag of VD herself, right? There’s literally no other explanation for a relatively youthful death at a time when cosmetics contained lead, water contained thriving bacterial colonies, and there was little to no regulation about what could be sold and consumed as “food”!
Yes, many people have died of syphilis. And yes, at the turn of the 20th century (and before and after) many sex workers did contract that man many other diseases, which is an expected consequence of laws based on narrow morals and a vacuum of public health outreach and information. But a death by syphilis was rarely short and seldom unexpected. Instead, syphilis has lead to the long, slow, and gruesome decline of some of history’s favorite mental ill people. Because while some of us are born with it (THIS GUY!), others contract the old Brain Scramblies later in life, sometimes due to our nocturnal proclivities.
A Quick Primer on Syphilis
The thing you need to know about syphilis is that it will eventually kill you if you don’t get it treated, but that in These Modern Times, it’s actually pretty easy to treat. It’s caused by a bacteria, so a bit of penicillin can pretty much knock it out. And if you’re practicing safer sex, you can cut your risk significantly.
But back before latex condoms, Jonas Salk, and, you know, basic understanding of how disease got from one body to another, obviously it was a lot more common and harder to treat. That’s because the first symptoms - painless sores, which seems like an oxymoron to me? - were pretty easy to shrug off.
The second stage, though, is when it gets a little more real. In the secondary stage of syphilis, the symptoms before a lot more noticeable. I’ll spare you the details, but basically you get flu-like symptoms and additional sores and stuff. Gross. These symptoms also go away on their own, which is why a lot of people wouldn't go to a doctor/barber/family friend/local healer/snake oil nomad.
Then, the syphilis becomes latent and it just kind of hangs around in the body. It can do this for years - like 10 to 30 years - before it finally decides to turn up the heat and go all out. At this stage, the bacteria can impact multiple organs, including the brain, and the joints and muscle.
What it does not do if give you catastrophic stomach pain. To die like Graham died - writhing in gut pain that couldn’t be treated by any regular remedies - doesn’t really speak to a syphilitic death because she would have had to have a bunch of other terrible symptoms first. And actually, I found her medical records for this time in my research and found that it was way more likely that she either had a perforated bowel or some kind of undiagnosed stomach cancer.
The trouble with “syphilitic insanity”
The thing about syphilis as a disease is that it was really easy to ignore right up until you could definitely not ignore it any longer because it was ravaging your whole-ass body and also your brain. Unfortunately, before penicillin, there wasn’t really a super-reliable treatment. Instead, doctors would try any number of stuff they had lying around including - wait for it - mercury.
So once again, if the disease didn’t make you crazy, the treatment just might.
And those teenaged syphilis symptoms really were bad. Dementia, “melancholia,” and an inability to function in normal life were all described by contemporary doctors, who had observed “gummy tumors” on the brain and spinal column from the bacteria’s attack on the nervous system.
Interestingly, we knew a lot about syphilis long before we knew how to truly cure it. We also knew that it presented very real challenges with regard to proper care.
In a 1901 paper called “Mental Symptoms of Cerebral Syphilis,” Dr. James McBride wrote that “syphilis may be the cause, either immediate or remote, of every form of disease of the nervous system, from neurasthenic conditions to coarse brain disease, or insanity.”
He went on to express concern about diagnoses, stating that because late-state syphilis could look so much like other diseases of the mind, “syphilitic insanity may mimic every known form of mental derangement,” including “acute mania, ordinary melancholia, terminal dementia.” As a result, he worried that “experts may differ in their diagnosis.”
It’s not as though the treatments were super-specific, though, or that it would have mattered. Caught early, there was hope. But by the time the mental symptoms appeared, there wasn’t enough mercury in the world. Plenty of people with syphilis were put into an asylum or sanitarium not because they were born with poorly-wired brains, but because the syphilis had destroyed theirs and there wasn’t much to be done but wait for them to die.
Stars: They aren’t safe from syphilis
And now, an incomplete list of people whose mental decline was theorized to be the result of syphilis or was definitely confirmed to be syphilis:
Christopher Colombus
Blackbeard
Charles VIII
Abe and Mary Todd Lincoln
Charles Baudelaire
Hitler
Al Capone
Vincent Van Gogh
Leo Tolstoy
And many more!
So there you have it, now you know more about syphilis and you can correctly armchair diagnose it among your friends. I mean, you shouldn’t do that because armchair diagnoses are bad, but like…at least you’ve got a little bit more info now.
xox HBO