Originally posted by GregBaron
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First, that he was not syphilitic in 1886. Syphilis was a known quantity, where insanity was not. Had he been symptomatic when he went in 1886, they would have kept him, assuming his problems stemmed from neurosyphilis. Had he not been symptomatic, but he had told them he had syphilis they would have made the same assumption.
The problem with this is that he was in for a year. So that doesn't get him infected until 1887 or 1888. Which works for a motive, but not disease progression. There no way he wastes away to uncontrollable insanity in two or three years. I mean, it can happen but it doesn't.
Second option is that he was syphilitic, but managed to keep it a secret from the hospital. It would fit the timing, and it would explain why they released him. It would however mean that he had a mental illness and syphilis at the same time, which kind of makes you wonder why he wasn't institutionalized more. But his 1886 illness could not have been related to syphilis. Neurosyphilis is an end stage thing, and people don't live more than 2 years with it. If it had been neurosyohilis he wouldn't have lived to commit the murders.
Third option is that he never had syphilis, that he had a mental illness. If he had been misdiagnosed, they would have treated him with mercury. Assuming he got the standard dosage he would have been dead of mercury poisoning in a year and a half. Which actually happens to be how long he lived in the hospital after his diagnosis of tertiary syphilis. But he would only have lived about that long without mercury if he had syphilis. So then what are the odds he didn't actually have syphilis? Well, the telling bit would be the birth dates of his children. If there isn't a long interruption between kids, then his wife didn't have it, and one child was born in this time frame, maybe more. But I can't imagine how a doctor would screw that up, unless he was lied to during the case history.
Anyway syphilitic madness is an end stage thing. Coming in before insanity are balance problems, loss of sensation, numbness, loss of equilibrium, shakes... There is almost no chance that someone with neurosyphilis can wield a knife. So if JtR was killing people over syphilis, he was doing it well before it affected his brain.
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