page_title: Tuskegee Syphilis Study
section_title: Study details
hierarchical_section_title: Tuskegee Syphilis Study / History / Study details
caption_attribution_description: Examination, Tuskeegee study
context_page_description: The Tuskegee Syphilis Study, also known as the Tuskegee Syphilis Experiment, Tuskegee Study of Untreated Syphilis in the Negro Male, U.S. Public Health Service Syphilis Study at Tuskegee, or Tuskeegee Experiment, was a clinical study conducted between 1932 and 1972 by the United States Public Health Service. The purpose of this study was to observe the natural history of untreated syphilis; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.
  The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University, a historically black college in Alabama. Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama. Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected. As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS, who disguised placebos, ineffective methods, and diagnostic procedures as treatment.
context_section_description: In 1928, the “Oslo Study of Untreated Syphilis” had reported on the pathologic manifestations of untreated syphilis in several hundred white males. This study was a retrospective study, since investigators pieced together information from the histories of patients who had already contracted syphilis but remained untreated for some time. 
  The U.S. Public Health Service Syphilis Study at Tuskegee group decided to build on the Oslo work and perform a prospective study to complement it. The researchers involved with the experiment reasoned that they were not harming the men involved in the study, under the presumption that they were unlikely to ever receive treatment. However, at the study’s commencement, major medical textbooks had recommended that all syphilis be treated, as the consequences were quite severe. At that time, treatment included arsenic therapy and the "606" formula. The researchers reasoned that the knowledge gained would benefit humankind; however, it was determined afterward that the doctors did harm their subjects by depriving them of appropriate treatment once it had been discovered. The study was characterized as "the longest non-therapeutic experiment on human beings in medical history." 
  The U.S. Public Health Service Syphilis Study at Tuskegee began as a 6-month descriptive epidemiological study of the range of pathology associated with syphilis in the Macon County population. At that time, it was believed that the effects of syphilis depended on the race of those affected. Physicians believed that syphilis had a more pronounced effect on African-Americans’ cardiovascular systems than on their central nervous systems. Initially, subjects were studied for six to eight months and then treated with contemporary methods, including Salvarsan ("606,") mercurial ointments, and bismuth. These mildly effective, highly toxic treatments were provided only to quell any suspicions on the part of the participants.
  Eunice Rivers played a crucial role in the study because she served as the direct link to the regional African-American community. Vonderlehr considered her participation to be the key to gaining the trust of the subjects and promoting their participation. As a part of "Miss Rivers' Lodge,” participants would receive free physical examinations at Tuskegee University, free rides to and from the clinic, hot meals on examination days, and free treatment for minor ailments. Rivers was also key in convincing families to sign autopsy agreements in return for funeral benefits. As the study became long-term, Rivers became the chief person who provided continuity to the participants. She was the only study staff person to work with participants for the full 40 years.
  To ensure that the men would show up for the possibly dangerous, painful, diagnostic, and non-therapeutic spinal taps, doctors sent participants a misleading letter titled "Last Chance for Special Free Treatment.” Many participants were lied to and given placebo treatments so that researchers could observe the full, long-term progression of the fatal disease.
  The U.S. Public Health Service Syphilis Study at Tuskegee published its first clinical data in 1934 and issued its first major report in 1936. This was prior to the discovery of penicillin as a safe and effective treatment for syphilis. The study was not secret, since reports and data sets were published to the medical community throughout its duration.
  During World War II, 250 of the men registered for the draft. They were consequently diagnosed as having syphilis at military induction centers and ordered to obtain treatment for syphilis before they could be taken into the armed services. PHS researchers attempted to prevent these men from getting treatment, thus depriving them of chances for a cure. A PHS representative was quoted at the time saying: "So far, we are keeping the known positive patients from getting treatment." 
  
  By 1947, penicillin had become standard therapy for syphilis. The U.S. government sponsored several public health programs to form "rapid treatment centers" to eradicat
caption: Subject blood draw, c. 1953
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