Syphilis at war: Protecting male shame at the expense of women in the 19th century

One of the most dangerous accelerators of death during the U.S. Civil War had almost nothing to do with bullets. In a recent talk with Faculty Research Fellows at the Clayman Institute, Associate Professor of History Kathryn Olivarius expanded on her research concerning syphilis, shame, and the Civil War. Her talk centered on the phenomenon that was the outbreak of syphilis in the 19th century, which was able to spread at such high rates mainly due to the fear and stigma attached to it at that time. 

According to Olivarius, the duration and strength of syphilis is dangerously arbitrary, which is why people can go years without showing major symptoms, yet still be contagious. About 30% of people infected in the 19th century – before effective treatments were discovered – eventually developed tertiary syphilis, a point in the disease when essential organs, including the brain, heart, and joints, are damaged. Olivarius’ project grapples with the acts through which syphilis is transmitted, and the immense individual and communal suffering that are caused. Before the discovery of penicillin, all it took was one tryst, which could “somehow bestow a life sentence, or even a death sentence.”

Some struggles Olivarius has faced in looking into this disease, particularly its effects in the 19th century, are that historians tend to focus on later decades, when countermeasures were on the horizon, as well as when official data was more systematic. Before 1900, the only extant data was city-based, gathered by individual health officers and doctors. Syphilis is also very hard to diagnose retroactively, unlike yellow fever, the history of which Olivarius has studied at length.

Treatment for syphilis in the 19th century, like mercury, could cost upwards of $150, which was well beyond the average person’s means, and likewise did nothing to alleviate the disease’s symptoms. In fact, the treatment was often just as deadly, and frequently resulted in hair or teeth loss. It was in many cases also prescribed as a cure for syphilophobia, the fear of syphilis. Abraham Lincoln himself was actually administered this “cure” for his syphilophobia. 

Due to social stigma, doctors either outright refused to treat patients or avoided the term “syphilis” directly in order to protect their patients from enduring the shame that came with a diagnosis. Because of this, there is a staggering lack of honest, first-person accounts of people living with syphilis. Olivarius noted, “Victorian wisdom held that syphilis came only from promiscuity and moral failing.” Thus, no one willingly admitted to having contracted the disease, in contrast with yellow fever, smallpox, or cancer – diseases that have historically garnered sympathy. They instead did all they could to keep it a secret, and oftentimes deluded themselves into believing the disease would not progress to its most fatal and debilitating stages. This phenomenon did not exclude doctors. In medical schools, physicians were trained to keep the “medical secret,” concealing a husband’s diagnosis from his wife, despite the dangers that came with doing so.

This placed women at a great disadvantage as they were typically left in the dark regarding their own health in favor of their husband’s self-preservation. Many of the pregnant women afflicted experienced miscarriages and stillbirths. If mothers were able to carry their pregnancies to term, “congenital syphilis” was easily transmissible to fetuses, and resulted in infant deformities, including blindness, deafness, and death. So, while many of these women might not have seen battle in the traditional sense, they were faced with a different threat altogether upon the soldiers' return from the Civil War, one they were ill-equipped to fight. Moreover, female sex workers fared no better. Olivarius noted that few attempts were made to curb enlisted men’s sexual behavior, and that brothel and sex worker numbers grew exponentially, thereby encouraging the propagation of high-risk sex. 

This suffering continued well after the war ended, when the soldiers had already returned home. Eventually it became widely understood that syphilis was a “plague of veterans” and would always be seen as such despite their sacrifice and contributions to the war. In this way, the Civil War persisted long after Appomattox. Syphilis continued to wreak havoc on people’s health, and was responsible for even more deaths and declining birth rates in the years that followed.