title: Treatment and diagnostic accuracy of neurosyphilis at Boston City Hospital's Neurological Unit, 1930-1979.
abstract: The twentieth century was marked with frequent advances in the treatment and diagnosis of neurosyphilis. Once considered one of the most serious human diseases, neurosyphilis was paramount to a death sentence often preceded by agonizing pain and/or diminishing mental capacities. Since the introduction of penicillin in 1943, however, the prevalence of neurosyphilis has declined dramatically and the prognosis of the few still affected has been greatly improved. We examined patient records from Boston City Hospital's (BCH) Neurologic Unit from 1930 to 1979 to obtain primary data on treatment modalities for neurosyphilis during this period, with particular attention to the use of malarial therapy. We also evaluated these same records to determine whether the "great imitator" moniker that was applied to neurosyphilis may have in part been due to systematic errors in diagnostic criteria and false positive tests. The BCH neurologists used all available treatment compounds, including arsenicals, bismuth, iodides, malaria, and typhoid. The data also suggest that the wide diversity of symptoms attributed to neurosyphilis was probably accurate.
authors: Department of Anatomy and Cell Biology, Indiana University School of Medicine, Fort Wayne, IN 46805, USA. dpatter4@ohiohealth.com
authors: Diana
authors: D
authors: Patterson
authors: Joel A
authors: JA
authors: Vilensky
authors: Wendy M
authors: WM
authors: Robertson
authors: Joseph
authors: J
authors: Berger
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D001900:Boston; D005189:False Positive Reactions; D005260:Female; D049673:History, 20th Century; D006757:Hospital Units; D006761:Hospitals / Q000266:history*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000266:history*; D009494:Neurosyphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000266:history / Q000628:therapy*; D010406:Penicillins / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials; D010406:Penicillins; D001729:Bismuth