According to the Diagnostic and Statistical Manual: Mental Disorders-IV, standard nomenclature, Al Capone’s disorder could be classified under Chronic Brain Disorders, which are disorders due to or that are associated with an infection. The diagnosis, from the review of symptoms suffered by Al Capone, could be termed as being a Meningovascular Chronic Brain Disorder (DSM-IV, 2000).One of several sexually transmitted diseases, syphilis is caused by spirochetal bacterium, Treponema Pallidum. Syphilis has several symptoms and progresses, if left untreated, from its primary to the secondary and finally the tertiary stage.This progress varies from patient to patient depending on a number of factors.
The symptoms of the tertiary stage of syphilis tend to be confused with those of other diseases(Barnes, 1912) .Neurosyphilis is the reference made when the site infected by syphilis is the central nervous system that progresses through four stages: asymptomatic, meningovascular, general paresis and the last stage, Tabes dorlasis (Timmerman & Carr, 2004).Meningovascular syphilis has been determined to occur from a few months after infection to ten years after, with the average being at seven years after the primary infection.Menignovascular syphilis has got both prodromal symptoms, which can go up to a couple of weeks before the commencement of focal deficits. The prodromal symptoms are such as: the occurrence of numbness in the lower limbs, vertigo, psychiatric abnormalities, depression, fatigue and changes in personality (Barnes, 1912).If syphilis is checked and treated in its initial stages with the appropriate antibiotics, the chances of it progressing to the full blown later stages of neurosyphilis are greatly minimized.
Over the years, the number of patients diagnosed with primary syphilis whose infection progress to tertiary syphilis have dropped drastically because the appropriate preventive measures are taken in good time (Timmerman & Carr, 2004).In the later stages of neurosyphilis, general paresis tends to set in with the ultimate result being death. The symptoms of paresis are loss of memory, the patient having poor judgment as well as a slow but progressive change in personality and behavior. In the extreme though there is a lower occurrence of these, there can be incidences of psychosis, depression or even mania(Timmerman & Carr, 2004).
Al Capone led a normal life, at least in medical terms and did not show any signs of mental imbalance in his earlier years (Lorizzo, 2003). It was only much later during his prison years that he developed what can be termed as a mental disorder.It was in 1939 when Capone was serving prison time that there were definite symptoms of his illness was observed. Capone, who had always had a short temper (Lorizzo, 2003), became almost intolerable in his years of incarceration. He was easily irritable, quick to anger and could not cope with almost all of the other inmates.
In his later prison years, Capone had the standard symptoms that are associated with tertiary syphilis. He suffered from bouts of confusion and depression, as well as noted mental decline. So much so that upon his release, he could not go back to his active role in organized crime but was forced into retirement (Lorizzo, 2003).He was found to be greatly irritable had bouts of fatigue and poor muscle function.
All these were indicators of the ravages of poorly treated mningovascular syphilis(Timmerman & Carr, 2004).It can be said that Capone’s condition had deteriorated to general paresis. In his last year of confinement in prison, he was seen walking and talking to himself, and no one could make out his ravings. This was symptomatic of his steady mental decline and psychosis(Barnes, 1912) .
At the time of his release from prison in 1946, at the age of forty six, Capone’s health had undergone tremendous decline. He had suffered weight loss and his mind, as noted by those around him, was not as sharp as it used to be (Lorizzo, 2003).It had not worked in his favor that while in custody he had limited access to the needed medication that might have arrested the progress of the disease. When in custody, he had to stay a year in hospital and was termed as being befuddled and disoriented (Lorizzo, 2003).
There was also the manifestation of cognitive changes that are generally associated with general paresis. He suffered from euphoric mania, extreme paranoia, having hallucinations and bouts of delusion.This progressed steadily with time to the point where Capone had almost lost complete sense of himself as an individual. This is in line with the cognitive changes that are associated with neurosyphilis (Timmerman & Carr, 2004).
The medical treatment he must have gotten in prison could not have been adequate to his needs as a patient, hence the decline in his health was not checked in time.Capone’s health continued to deteriorate with the manifested symptoms growing worse. His condition was confounded when he got pneumonia shortly after his apoplectic stroke. Stroke is another symptom of general paresis which comes in the later stages of meningovascular syphilis(Timmerman & Carr, 2004).