Sexually Transmitted Diseases

Further advances occurred quickly. August von Wassermann (1866–1925) developed a blood test for syphilis in 1906, making testing for syphilis a simple procedure for the first time. Just four years later in 1910, the first effective therapy for syphilis was introduced in the form of Salvarsan, an organic arsenical compound. The compound was one of many effective compounds introduced by the German physician Paul Ehrlich (1854–1915), whose conviction that specific drugs could be effective against microorganisms has proven correct. The drug is effective against syphilis, but it is toxic and even fatal to some patients.

The development of Salvarsan offered hope for individuals with syphilis, but there was little public understanding about how syphilis was transmitted in the early twentieth century. In the United States this stemmed in part from government enforcement of laws prohibiting public discussion of certain types of sexual information. One popular account of syphilis from 1915 warned that one could develop syphilis after contact with whistles, pens, pencils, toilets and toothbrushes.

The United States government exploited the ignorance of the disease among the general public as late as the mid-twentieth century in order to study the ravages of untreated syphilis. The Tuskegee Syphilis Study was launched in 1932 by the U.S. Public Health Service. The almost 400 black men who participated in the study were promised free medical care and burial money. Although effective treatments had been available for decades, researchers withheld treatment, even when penicillin became available in 1943, and carefully observed the unchecked progress of symptoms. Many of the participants fathered children with congenital syphilis, and many died. The study was finally exposed in the media in the early 1970s, and thus ended one of the more egregious instances of racist public health policy in the United States. When the activities of the study were revealed, a series of new regulations governing human experimentation were passed by the government.

A more public discussion of sexually transmitted disease was conducted by the military during World Wars I and II. During both wars, the military conducted aggressive public information campaigns to limit sexually transmitted disease among the armed forces. One poster from World War II showed a grinning skull on a woman dressed in an evening gown striding along with Adolf Hitler and Emperor Hirohito. The poster's caption reads "V.D. Worst of the Three," suggesting that venereal disease could destroy American troops faster than either of America's declared enemies.

Concern about the human cost of sexually transmitted disease helped make the production of the new drug penicillin a wartime priority. Arthur Fleming (1881–1955), who is credited with the discovery of penicillin, first observed in 1928 that the penicillium mold was capable of killing bacteria in the laboratory; however, the mold was unstable and difficult to produce. Penicillin was not ready for general use or general clinical testing until after Howard Florey (1898–1968) and Ernst Boris Chain (1906–1979) developed ways to purify and produce a consistent substance.

The introduction of penicillin for widespread use in 1943 completed the transformation of syphilis from a life-threatening disease to one that could be treated easily and quickly. United States rates of cure were 90-97% for syphilis by 1944, one year after penicillin was first distributed in the country. Death rates dropped dramatically. In 1940, 10.7 out of every 100,000 people died of syphilis. By 1970, it was 0.2 per 100,000.

Such progress infused the medical community with optimism. A 1951 article in the American Journal of Syphilis asked, "Are Venereal Diseases Disappearing?" By 1958, the number of cases of syphilis had dropped to 113,884 from 575,593 in 1943, the year penicillin was introduced.