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The book examining the Tuskegee is basically divided into three major parts. These parts aims at describing some of the compelling issues that made the study possible, why it continued, and the histories and stories told after it ended. The title of this book, the infamous syphilis study and its legacy gives a reader some insights about what the book contains.  It basically describes a study done in America whereby the blacks were used as subjects and controls of an experiment which was done to find out the possible cure to syphilis. This book therefore explores the nature of racism during the syphilitic era. It incorporates the medical aspect, economic aspect and racism

At the introduction part, the author successfully explores the whole book by describing what the three sections would talk about. The reader would therefore be in a position to easily understand that the "Testimony" section, which constitutes the first section of the book, is designed to clearly introduce Tuskegee Institute (now Tuskegee University) and the PH S and explores how the concern with syphilis renewed a relationship developed more than a decade before the study. Furthermore, the author has managed to briefly explain the contents of each section by summarizing its chapters. For example, we get to understand that the opening chapter of the section "Testifying" describes the men who became the study's subjects and controls and also the culling analysis from their words and those of their families and the qualitative and quantitative information their medical records provides. We also get to know that the next three chapters explain the study from the viewpoints of some of the white public health service physicians, the black doctor who supported the study in Tuskegee, and the black nurse who has been the subject of much speculation and concern.

Additionally, in the introduction section, the author of the book has given us a long personal description. Although such personal description may be important especially when the reader needs to know the kind of the author and how he is committed to his or her work, we realize that the author is too wordy. Believing that we have get the insights about the introduction section of the book, the next section of this work would focus on how the author manage to explore the main theme of the study from all the three sections.

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The introduction part of the "Testimony" section begins by describing the setting of the study. The author successfully gives us important description of the relationship between Tuskegee Institute and the federal government over health care and disease in the black community. This section also gives us an insight about the genesis of racism in Tuskegee. The author narrates for example that "......In the 1840s, when the Indian wars ended with treaties that were broken over and over, Native American peoples were driven out and their land was given to whites, but not before they left their legacy behind in the bloodlines of both blacks and whites and in the names of towns like Tuskegee and Tallassee."

The fact that Tuskegee constituted a lot of African American is also clearly expressed ".....By 1860, those identified as black Americans (both free and slave) outnumbered Whites in Macon County". These facts are important as it enables the reader understand why the study actually took place in the Tuskegee institute. The rest section of this part, "Testimony" basically describes various developments that took place in the medical section. It describes various medical institutes that came up. However, the author is keen to mention the fact that even despite advancement in the medical care, the issue of racism was still common. For example the author quoted in the subsection "syphilis a sanitary sin" a racists statement As the PH S's Raymond A. Vonderlehr put it clearly in 1938 in his racialist terms: "Our present information indicates definite biologic differences in the disease in Negroes and whites."87 The obsessive concern with both the danger of "Negro blood" and the hidden dangers of syphilis combined to make the disease a presumed racial menace.

This information gave the white a reason to contempt and blames the African Americans even more. This fact is evidenced in various section of this book. In Medical Association meeting of 1915, a Texas physician for example declared "the negro a menace to the health of the white race." Another physician concluded that "the Negro must bear the largest share of responsibility." The author of the book manages to bring out the fact that treatment of syphilis was limited by racial as well as economic factors "As always; the PH S had to balance medical need, southern race relations, and economic reality. The PH S hoped to get funds to treat those workers who were infectious; anything more seemed impossible." The rest chapters of this first section generally describe how situation of the Macon County in terms of the infrastructures as well as the standards of living of the blacks.

Although there was a project meant to assist the blacks, Rosenwald Fund Demonstration Project, we find out that such projects were not actually willing to offer real assistance. This is shown by how the organizers view it and how the black physician views it. For example, the author bring out how the two parties view it Even though the syphilis treatment program fell short of its goals, the entire Rosenwald Fund Demonstration Project was deemed a success by its organizers: prevalence could be determined and treatment begun. But Dr. H. L. Harris, a black physician sent into Macon County by the Rosenwald Fund, was not convinced. He knew the project could not begin to provide the services of a real rural health program, and the more crucial. Illnesses that came from lack of food and failures of sanitation concerned him.

In section two "Testifying" the author has extensively discussed on two black medical officers the author clearly give us information about the black doctors and nurses who actually did their best during the study.  Eugene Heriot Dibble Jr. For example is depicted as areal son of the south who struggle throughout his profession as a medical doctor to reduce racism and ensure equality. The author seems to be too wordy as he gives too much account of dibble.

Eunice Verdell Rivers is another nurse Negro whose life and contribution to the study is extensively accounted for. From her accounts, we get to learn more about the treatment in which the African America got and learn why the study focus on the blacks alone despite the fact that the whites were also infected. This knowledge enables us to understand the fact that the study really had racialism in it because it comes to us that the blacks were actually being used to test the effectiveness of various drugs.

Ironically, the last section of this book talks about the bioethics. The author has highlighted some of the important guidelines which were supposed to constitute the first consideration to be taken before the study begun. We get to learn how unethical the study was especially to the blacks who were used as the subjects.

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