But in a family in which an older sibling has died of congenital syphilis, the younger siblings may well be at risk, as in James's case. Many children born with congenital syphilis have only a mild form of the disease and live for decades. Some of these offspring eventually develop what is known as neurosyphilis, in which the disease attacks the brain, causing problems such as seizures. James began in his twenties to suffer from seizures that grew progressively worse, leading him to collapse on the floor for periods of time. His personality also changed in these years, transforming him from an energetic, exuberant, and outgoing young man into a moody, ill-tempered person in middle age.
Personality changes are another symptom of neurosyphilis.
Without blood tests, it is impossible to determine whether syphilis lay behind James's condition. But the disease may have contributed to the family's troubles. Examining Butch's background, the doctors at Rockland found a terrible plenitude of reasons for his behavior. There is evidence that the father beat him unmercifully on many occasions. This boy was practically devoid of any affection from either his mother or from his father.