Reaching for Harrison’s and the Tuskegee Study of Untreated Syphilis

Abstract

T he Tuskegee Study of Untreated Syphilis (TSUS) was the 1932-1972 study of approximately 600 Black men, 400 with active syphilis and 200 presumably without syphilis, in rural Macon County, Alabama. The study evolved from a oneevaluation datapoint to a longitudinal study with detailed case histories and autopsies. These parameters assessed the presence or absence of syphilis-related damage. 1 It ended in scandal in 1972, as reported in the media. 2 The media frequently focuses on race-related disparities with the coronavirus disease 2019 infection-ie, higher prevalence, morbidity, and mortality rates in Black Americans. 3 Blaming the TSUS as the reason for the etiology of disparity-related mistrust in Black communities is common; however, what often is cited about the TSUS is wrong or incomplete, historically, scientifically, and/or medically. 4 This is where an effective medicine textbook, such as Harrison's Principles of Internal Medicine, 5,6 which contains accurate TSUS information, becomes an important tool for doctors and other health professionals to educate, motivate, and recruit communities at risk toward clinical trials, safe and effective treatment, and better health. For 13 editions, Harrison's included the TSUS and the Oslo Study (a nontherapeutic experiment in Norway that also studied untreated syphilis). That much of the information in the public domain about the TSUS is wrong, a brief commentary on the history of Harrison's textbook as it relates to the TSUS and Oslo Study is in order.