Syphilis and PTSD

[tamiwell]

Hi everyone,

I'm writing up a story (biography for a community project) on a soldier who was sent home due to 'debility post syphilitic'.    His symptoms in hospital were described as:

feeling nervy, experiencing weakness, shortness of breath and palpitations on exertion, anaemia, and weight loss

His family have suggested that he actually had PTSD and that it may have been misdiagnosed as syphilis, does anyone know much about that?  I have heard that mental health was often undiagnosed/unrecognised with the poor soldiers of WW1 and attributed to other illnesses instead.  I'd love to learn a bit more if anyone has any info regarding that?  

I don't doubt that he actually had syphilis, as he received treatment for the same in hospital, but just wondering if it might have been more than that for him, and curious about the situation in general.

Thanks,

Tam 

[ss002d6252]

They had a specific test for Syphilis so it was unlikely to be have been wrongly diagnosed as being present.

There may have been additional psychological issues on top of the Syphilis but Syphilis itself can cause neurological issues similar to a lot of ptsd symptoms so differentiating one from the other may be difficult.

Craig

[Matlock1418]

46 minutes ago, tamiwell said:

I'm writing up a story (biography for a community project) on a soldier who was sent home due to 'debility post syphilitic'.    His symptoms in hospital were described as:

feeling nervy, experiencing weakness, shortness of breath and palpitations on exertion, anaemia, and weight loss

His family have suggested that he actually had PTSD and that it may have been misdiagnosed as syphilis, does anyone know much about that?  I have heard that mental health was often undiagnosed/unrecognised with the poor soldiers of WW1 and attributed to other illnesses instead.  I'd love to learn a bit more if anyone has any info regarding that?  

I don't doubt that he actually had syphilis, as he received treatment for the same in hospital, but just wondering if it might have been more than that for him, and curious about the situation in general.

As you, discretely, haven't given any details of the soldier - perhaps a place for you to look might be the WFA/Fold3 Pension record cards to see if any/what disability was recorded.

:-) M

[TEW]

I have some details on a man admitted to Seale Hayne (Shell Shock Hospital). Once they determined he actually had cerebral syphilis (now neurosyphilis?) he was discharged to a more appropriate hospital.

His syphilis must have been pretty advanced by then but presumably not diagnosed as such.

 

Another case with a twist shown in every TV documentary on shell shock. Often the footage is slowed down and soft violins play. His condition in fact is a result of syphilis treatment with Salvarsan a toxic organoarsenic compound. He had a GSW to leg, was treated and returned to command depot from there he went AWOL for almost a year contracting syphilis along the way. When caught he was treated with the Salvarsan but claimed to be shell shocked and arrived at Netley just in time to be filmed.

 

Move slider to 11:25. Pathe Link.

TEW

[AndrewSid]

Presumably you have his name and therefore perhaps his unit.  You may wish to consider seeing where he served.  For example was he front line infantry for 2 years on the western front or further back from the line?   You would need his Battalion, details of when he went to france and then you can download the relevant war diary. 

As an aside and from reading 20 or 30 war diaries.  Shell  shock was well known about and it seems a recognised condition that resulted in men (and officers) being taken off the line.  I’m sure units varied in their approach but it was a recognised condition.  Others  will no doubt take a view.  

What makes the family think he had PTSD?  Evidence of some kind or an assumption?

Edited 27 July , 2021 by AndrewSid

[TEW]

I'm wondering if the debility post syphilitic relates to the treatment of the syphilis which could account for the other symptoms. And/or how advanced the syphilis was.

Unless he has a record that mentions shell shock, neurasthenia or psychasthenia you're going to be hard pressed to make that link based on the info so far. That doesn't mean he wasn't shell shocked etc. just that it can only be supposition not fact.

Such a diagnosis depends on the year in question, the understanding of shell shock by frontline, rear and UK medics he saw. It could be partly luck or bad luck as to which CCS he was first admitted and their protocol towards shell shock, again depends on the year.

I have a record of a man diagnosed with shell shock who had never been near the frontline. Another RE man working in a port diagnosed with neurasthenia due to a fear of catching VD (not actually having VD).

Incidently, despite main stream media claims PTSD & shell shock are not one and the same thing.

TEW

[AndrewSid]

5 minutes ago, TEW said:

diagnosis depends on the year in question

I’m sure your right -  my reading has been for later in the war 17/18.  

[Matlock1418]

4 hours ago, tamiwell said:

I don't doubt that he actually had syphilis, as he received treatment for the same in hospital, but just wondering if it might have been more than that for him, and curious about the situation in general.

There can, perhaps often, be an assumption that syphilis was caught during the war but it was quite commonly a case of caught earlier in civilian life and only presenting in military life or afterwards when more chronic and neurological symptoms started to show.

Chronic syphilis had devastating effects on the men and likely often their families too. 

Though I'm not a medic - I believe the chronic infection commonly was a course of subsequent infant mortality amongst offspring, pre- and post-birth.  Having looked at one man, a pre-war seaman, and his family in detail it seems likely to have been the cause of early family tragedy as demonstrated by many his children dying very young, including after the war [I don't know about any other conceptions/miscarriages/still births - though perhaps mortality tapering off over time and for the younger children - and in my case study it was the few youngest children born after the war that survived out of a large total number born before/during/after the war].  It would appear likely that his wife was infected.  Worth looking in these areas too.

Ultimately if not effectively treated the neurological aspect could extend to severe neurological disorders for the man and potentially general paresis/general paralysis of the insane/paralytic dementia could follow and then death.  Have you details of when and of what cause he died?

So perhaps worth looking at the wider picture too.

:-) M

[kenf48]

The total number of cases of VD treated during the war was about 400,000; syphilis accounted for 24% of the total, say 100,000 cases. Salvarsan was manufactured in Germany and supplies rans short in the early stages of the war.  Burroughs and Wellcome produced an identical chemical compound which they called kharsivan.

Compared to VD cases of neurasthenia or war neuroses were relatively few and were not such a concern as venereal disease for the Army as a cause of 'wastage' until after 1916. 

Figures, other than battle casualties are difficult to come by especially as many conscripts may have been suffering from pre-existing mental conditions, but in February 1921 65,000 men were receiving a pension for neurasthenia and allied causes.

Source: Official History Medical Services Diseases of the War Vol II Macpherson

 

[Matlock1418]

2 hours ago, kenf48 said:

Salvarsan

As a treatment for syphilis Salvarsan was only discovered c.1908 and introduced c.1910 so chronic syphilis could easily have been established before the war only to emerge with neurological effects during it.

:-) M

Edit; Though there is a lot about it on the web I have just come across this about Salvarsan - short and sweet :-/

***** Warning! - graphic content - photos of syphilitic condition and descriptions of condition & treatment *****

Injection treatment sounded very painful and fraught = For sure, something for the needy and/or desperate ... Ouch!

Of Syphilis and Salvarsan: The danger and promise of cure https://artsci.case.edu/dittrick/2013/11/08/of-syphilis-and-salvarsan-the-danger-and-promise-of-cure

Edited 27 July , 2021 by Matlock1418
Edit

[tamiwell]

Thank you so much everyone for your responses!  I didn't know much about Salvarasan and the effects of these medications so it has been very interesting.  This man had 3 injections of Salvarsan and also 6 injections of Mercury.  He stated that he had caught Syphilis when he was in Egypt Dec 1915.  He served in Gallipoli but due to his poor health never re-joined his battalion in France and was sent home to Australia.  

Tam : )

[Dai Bach y Sowldiwr]

16 minutes ago, tamiwell said:

This man had 3 injections of Salvarsan and also 6 injections of Mercury. 

At the time, Salvarsan represented a great leap forward in the treatment of syphilis.
Its toxicity  was significantly less than the neurotoxicity of Mercury.
An old adage from the pre-Salvarsan days went:

"A night with Venus, a lifetime with Mercury..."

[Matlock1418]

40 minutes ago, tamiwell said:

This man had 3 injections of Salvarsan and also 6 injections of Mercury.

ANZAC records - always so full of detail!

40 minutes ago, tamiwell said:

He stated that he had caught Syphilis when he was in Egypt Dec 1915.

"He stated"  Don't know how old he was so can't really comment on possible earlier infection or duration.  Seems a bit early for neurological symptoms though - I think!

Obviously depends if he had the symptoms before or after treatment but now we have @Dai Bach y Sowldiwr onboard perhaps he could comment further on this aspect - medical matters being significantly more his field than mine I think.  And/or perhaps on the PTSD alternative. ??

:-) M

Edited 27 July , 2021 by Matlock1418

[Dai Bach y Sowldiwr]

I honestly think that without a comprehensive set of medical records, trying to question a diagnosis at this distance in time is impossible.

As TEW has correctly stated, Shell-shock isn't the same thing as PTSD.

Both conditions , as well as neurosyphilis and many other diseases can produce neuro-psychiatric symptoms and signs, but a diagnosis can only be made with the patient in front of you. 

We don't know how the diagnosis was arrived at. It might have been made clinically - Specialist doctors of that era were very good at clinical diagnosis - they still are. He might have had a blood test like the WR test (OK not 100 % specific, but what is?). Clinicians might have been able to see the spirochaetes on dark ground microscopy of his serum.

Somebody somewhere made a good faith diagnosis. On the balance of probability, they were probably correct.  Yes, there's a possibility they might have been wrong.

You can speculate as much as you like, but at the end of the day, it will still be speculation and you will never be able to prove that the diagnosis was unreasonable, let alone prove it was incorrect. As for proving it was something else entirely, without records - forget it.

[rksimpson]

Hi

 

Being an Australian he will have medical records, they are not online but should be recorded in the NAA site and are usually available to view at the state archive site.

 

regards

Robert

[Guest]

Mate,

 

Not to be techencal, but cause and effect?

Many AIF soldiers picked up the problem in Egypt, before Gallipoli, this caused many to be sent home for discharge, only later was a cure made in country instead of sending them home.

That said, Egypt and the UK, where known by the AIF as VD ridden.

By Dec 1915, most AIF soldiers were not sent home, but stayed in country to be fixed, not many were sent home so he must of had other problems or a very bad case?

As a fellow suffer of PTSD, I can say one does not follow the other, while one can cause the sufferer to go places to get the other?

There;s no way to clear this up without his records, 

S.B

 

 

 

[TEW]

I googled the side effects of Salvarsan & symptoms of mercury poisoning, apart from weakness there seems little connection between the syphilis treatments and his symptoms. Symptoms of later stage syphilis can include flu-like symptoms including tiredness but there doesn't (to me) seem much connection to his feeling nervy, experiencing weakness, shortness of breath and palpitations on exertion, anaemia, and weight loss.

I have no idea of the treatment time scale for 3 injections of Salvarsan & 6 of the mercury compound. Would they have been trying the mercury route first and then switched to Salvarsan, which seems to be of less effect in the later stages or vice verse?

If he caught syphilis in Dec 1915, when are these treatments dated?

Think I'd be a bit nervy and have palpitations just at the thought of more treatment.

No doubt that many men with shell shock were labelled malingerers at some stage and many malingerers got away with pretending to be shell shocked, for a while at least.

Your ANZAC man could have been run down by syphilis the syphilis treatment and generally war weary.

TEW

 

[ss002d6252]

34 minutes ago, TEW said:

feeling nervy, experiencing weakness, shortness of breath and palpitations on exertion, anaemia, and weight loss.

Syphilis can have many of those issues (as can be seen in the end days of Al Capaone),

Quote

Asymptomatic neurosyphilis means that neurosyphilis is present, but the individual reports no symptoms and does not feel sick.  Meningeal syphilis can occur between the first few weeks to the first few years of getting syphilis.  Individuals with meningeal syphilis can have headache, stiff neck, nausea, and vomiting.  Sometimes there can also be loss of vision or hearing. Meningovascular syphilis causes the same symptoms as meningeal syphilis but affected individuals also have strokes.  This form of neurosyphilis can occur within the first few months to several years after infection.  General paresiscan occur between 3 – 30 years after getting syphilis.  People with general paresis can have personality or mood changes.  Tabes dorsalis is characterized by pains in the limbs or abdomen, failure of muscle coordination, and bladder disturbances.  Other signs include vision loss, loss of reflexes and loss of sense of vibration, poor gait, and impaired balance.

Tabes dorsalis is the result of an untreated syphilis infection. Symptoms may not appear for some decades after the initial infection and include weakness, diminished reflexes, unsteady gait, progressive degeneration of the joints, loss of coordination, episodes of intense pain and disturbed sensation, personality changes, dementia, deafness, visual impairment, and impaired response to light.

 

Quote

Other symptoms you may have can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue (feeling very tired).

Craig

[David Tattersfield]

On 27/07/2021 at 11:37, tamiwell said:

Hi everyone,

I'm writing up a story (biography for a community project) on a soldier who was sent home due to 'debility post syphilitic'.    His symptoms in hospital were described as:

feeling nervy, experiencing weakness, shortness of breath and palpitations on exertion, anaemia, and weight loss

His family have suggested that he actually had PTSD and that it may have been misdiagnosed as syphilis, does anyone know much about that?  I have heard that mental health was often undiagnosed/unrecognised with the poor soldiers of WW1 and attributed to other illnesses instead.  I'd love to learn a bit more if anyone has any info regarding that?  

I don't doubt that he actually had syphilis, as he received treatment for the same in hospital, but just wondering if it might have been more than that for him, and curious about the situation in general.

Thanks,

Tam 

This may help >>> 

https://www.westernfrontassociation.com/world-war-i-articles/and-bert-s-gone-syphilitic-the-real-tragedies-behind-the-cane-hill-hospital-memorial-at-croydon/