When syphilis is treated with mercury, do the teeth turn silver?

There are two TV shows that we are following right now that have mercury-as-a-cure-for-syphilis embedded in the story line. The first is The Alienist; the second is The Frankenstein Chronicles. Both are set in the 19th century.

It is a fact that, for centuries, syphilis was treated with mercury either by ingesting it, by rubbing it on sores or by inhaling it. It is, of course, toxic and many patients died from the treatment rather than from syphilis.

In The Alienist, the serial killer was described as a man with a “silver smile” in earlier episodes. It was theorized that the silver teeth might be the result of mercury treatment for syphilis. In Episode 5, the face of the serial killer was revealed and his teeth were indeed silver.

Do the teeth turn silver as a result of mercury treatment for syphilis?

I searched and searched for information but found nothing to support that proposition. I did find references, however, to the use of a mixture of mercury, silver, tin and copper as dental amalgam—with about 50% of the mixture consisting of elemental mercury. “Dental amalgam” is the term for the filling for tooth cavity.

It might be more reasonable to suppose that since mercury treatment often resulted in tooth decay and loss, the serial killer in The Alienist had lost his teeth, partially or wholly, and had been replaced by dental amalgam.

Photo by Thought Catalog on Unsplash

In The Frankenstein Chronicles, Inspector John Marlott (Sean Bean) notices a sore on his hand and goes to a doctor who gives him mercury pills. He has taken them before, he says, and he did not like its side effects of bad dreams and visions. The doctor says it gets worse than that but Marlott does not really have a choice.

The mercury is shown as round blue pills—an accurate depiction—which Marlott takes orally. Although I have been unable to find references to bad dreams and visions as side effects of mercury treatment, it does seem reasonable to assume that they were manifestations of mercury poisoning.

Does Syphilis Cause Death? Is It Especially Fatal to Pregnant Women?

John Marlott suffered from syphilis and unknowingly passed it on to his wife who, along with their three-month-old child, died. Marlott blamed himself for their death which leads to the obvious question if it was the syphilis that caused the wife’s and child’s death. Does syphilis inevitably cause death? How fast? Is it especially fatal to pregnant women?

Mulling the question in my head, I recalled the Meryl Streep film, Florence Foster Jenkins, which was based on the biography of a New York socialite who liked to sing but did not have the voice for the performances that she loved to give. Jenkins had syphilis, I remembered. But didn’t she die when she was already an old woman?

The case of Florence Foster Jenkins

Florence Foster Jenkins was born in 1868 and contracted syphilis from her husband at age 18. She and her husband eventually separated although no divorce was ever documented. In her early 40’s, she met actor St. Clair Bayfield (played by Hugh Grant in the film) who became her “husband” and manager. Because she was suffering from syphilis, she and Bayfield did not share the same bed. They did not even live in the same house. Bayfield had an apartment where he kept a mistress.

To treat her syphilis, Jenkins was given the usual mercury and arsenic by her doctors. Penicillin as a treatment for syphilis would not become available to the public until 1942. By then, Jenkins’s syphilis was in the tertiary stage and would have been unresponsive to penicillin. She died of heart attack at age 76 in 1944.

The case of Karen Blixen

Another biopic and Meryl Streep starrer was Out of Africa. Karen Blixen, on whose memoir the 1985 film directed by Sidney Pollack was based, contracted syphilis from her husband in 1915 at age 30 and died in 1962 at age 77. Like Jenkins, she took mercury and arsenic but no penicillin treatment either.

I did a little Googling.

According to the CDC website untreated syphilis will continue to be contagious, but:

Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death.

So, no, Inspector Marlott. Your guilt is misplaced. It is more likely that complications resulting from childbirth killed your wife and child. Or, perhaps, medieval medical practices.

Syphilis can stay in the body for a long, long time and be a threat to sexual partners but unless it reaches the tertiary level, a person suffering from syphilis can live to a ripe old age.