From Wikipedia, the free encyclopedia History of syphilis
History of syphilis
The first written records of an outbreak of syphilis in
Europe occurred in 1494/1495 in Naples, Italy, during a
French invasion.[3][5] Due to it being spread by return-
ing French troops, the disease was known as “French dis-
ease”, and it was not until 1530 that the term "syphilis"
was first applied by the Italian physician and poet Giro-
lamo Fracastoro.[5] The causative organism, Treponema
pallidum, was first identified by Fritz Schaudinn and Erich
Hoffmann in 1905.[5] The first effective treatment (Sal-
varsan) was developed in 1910 by Paul Ehrlich which was
followed by the introduction of penicillin in 1943.[5]
Many famous historical figures including Franz Schubert,
Arthur Schopenhauer, and Edouard Manet are believed
to have had the disease.[5]
Origin
The exact origin of syphilis is unknown.[2] Two primary
theories have been proposed. It is generally agreed upon
by historians and anthropologists that syphilis was pre-
sent among the indigenous peoples of the Americas be-
fore Europeans traveled to and from the New World.[3]
Portrait of Gerard de Lairesse by Rembrandt van Rijn, ca. However, whether strains of syphilis were present in the
1665–67, oil on canvas. De Lairesse, himself a painter and art entire world for millennia, or if the disease was confined
theorist, suffered from congenital syphilis that severely de- to the Americas in the pre-Columbian era, is debated. [3]
formed his face and eventually blinded him.[1] • The "Columbian Exchange theory" holds that
syphilis was a New World disease brought back by
The history of syphilis has been well studied, but the Columbus and Martin Alonso Pinzon. Columbus’s
exact origin of syphilis is unknown.[2] There are two pri- voyages to the Americas occurred three years before
mary hypotheses: one proposes that syphilis was carried the Naples syphilis outbreak of 1494.[3] This theory is
from the Americas to Europe by the crew of Christopher supported by genetic studies of venereal syphilis and
Columbus, the other proposes that syphilis previously related bacteria, which found a disease intermediate
existed in Europe but went unrecognized.[3] These are re- between yaws and syphilis in Guyana, South
ferred to as the "Columbian" and "pre-Columbian" hy- America.[6][7]
potheses respectively.[3] • The "pre-Columbian theory" holds that syphilis was
In late 2011 newly published evidence suggested that present in Europe before the discovery of the
the Columbian hypothesis is the valid one.[4] Americas by Europeans. Some scholars during the
18th and 19th centuries believed that the symptoms
"Skeletal evidence that reputedly showed signs of of syphilis in its tertiary form were described by
syphilis in Europe and other parts of the Old World Hippocrates in Classical Greece.[8] Skeletons in pre-
before Christopher Columbus made his voyage in Columbus Pompeii and Metaponto in Italy with
1492 does not hold up when subjected to standard- damage similar to that caused by congenital syphilis
ized analyses for diagnosis and dating, according have also been found,[9][10] although the
to an appraisal in the current Yearbook of Physical interpretation of this evidence has been disputed.[11]
Anthropology. This is the first time that all 54 pre- Douglas Owsley, a physical anthropologist at the
viously published cases have been evaluated sys- Smithsonian Institution, and other supporters of this
tematically, and bolsters the case that syphilis idea, say that many medieval European cases of
came from the New World." leprosy, colloquially called lepra, were actually cases
of syphilis. Although folklore claimed that syphilis
was unknown in Europe until the return of the
1
From Wikipedia, the free encyclopedia History of syphilis
diseased sailors of the Columbian voyages, "syphilis
probably cannot be "blamed"—as it often is—on any
geographical area or specific race. The evidence
suggests that the disease existed in both
hemispheres from prehistoric times. It is only
coincidental with the Columbus expeditions that the
syphilis previously thought of as "lepra" flared into
virulence at the end of the 15th century."[12] Lobdell
and Owsley wrote that a European writer who
recorded an outbreak of "lepra" in 1303 was "clearly
describing syphilis."[12]
Historian Alfred Crosby suggests both theories are partly
correct in a "combination theory". Crosby says that the
bacterium that causes syphilis belongs to the same phy-
logenetic family as the bacteria that cause yaws and sev-
eral other diseases. Despite the tradition of assigning the
homeland of yaws to sub-Saharan Africa, Crosby notes
that there is no unequivocal evidence of any related dis-
ease having been present in pre-Columbian Europe,
Africa, or Asia. Crosby writes, "It is not impossible that
the organisms causing treponematosis arrived from Amer-
ica in the 1490s...and evolved into both venereal and non-
venereal syphilis and yaws."[13] However, Crosby con-
siders it more likely that a highly contagious ancestral
species of the bacteria moved with early human ances-
tors across the land bridge of the Bering Straits many
thousands of years ago without dying out in the original
source population. He hypothesizes that "the differing
ecological conditions produced different types of tre-
ponematosis and, in time, closely related but different
diseases."[13] However, in late 2011 the Yearbook of Phys-
ical Anthropology published an appraisal by George
Armelagos of Emory University, Molly Zuckerman and
Kristin Harper of previous studies that the "skeletal data
bolsters the case that syphilis did not exist in Europe be-
fore Columbus set sail."[14]
European outbreak
The first well-recorded European outbreak of what is
now known as syphilis occurred in 1495 among French
troops besieging Naples, Italy.[3] It may have been trans-
mitted to the French via Spanish mercenaries serving
King Charles of France in that siege.[12] From this centre,
the disease swept across Europe. As Jared Diamond de-
scribes it, "[W]hen syphilis was first definitely recorded
in Europe in 1495, its pustules often covered the body
from the head to the knees, caused flesh to fall from peo- A medical illustration attributed to Albrecht Dürer (1496) de-
ple’s faces, and led to death within a few months." The picting a person with syphilis. Here, the disease is believed to
disease then was much more lethal than it is today. Dia- have astrological causes.
mond concludes,"[B]y 1546, the disease had evolved into
the disease with the symptoms so well known to us to- Researchers concluded that syphilis was carried from
day."[15] The epidemiology of this first syphilis epidemic the New World to Europe after Columbus’ voyages. Many
shows that the disease was either new or a mutated form of the crew members who served on this voyage later
of an earlier disease. joined the army of King Charles VIII in his invasion of
Italy in 1495, resulting in the spreading of the disease
2
From Wikipedia, the free encyclopedia History of syphilis
across Europe and as many as five million deaths.[7] The cury".[24] It was administered in various fashions, includ-
findings suggested Europeans could have carried the ing by mouth,[citation needed] by rubbing it on the skin,[ci-
nonvenereal tropical bacteria home, where the organ- tation needed] and by injection.[25] One of the more curious
isms may have mutated into a more deadly form in the methods was fumigation, in which the patient was placed
different conditions and low immunity of the population in a closed box with his head sticking out. Mercury was
of Europe.[16] Syphilis was a major killer in Europe during placed inside the box and a fire started under the box,
the Renaissance.[17] In his Serpentine Malady (Seville, causing the mercury to vaporize. It was a grueling
1539) Ruy Diaz de Isla estimated that over a million peo- process for the patient and the least effective for deliver-
ple were infected in Europe.[18] ing mercury to the body.[citation needed] The use of mercury
was the earliest known suggested treatment for syphilis.
Historical terms This has been suggested to date back to The Canon of
Medicine (1025) by the Persian physician Ibn Sina (Avicen-
The name "syphilis" was coined by the Italian physician na),[26] although this is only possible if syphilis existed
and poet Girolamo Fracastoro in his epic noted poem, in the Old World prior to Columbus (see Origins section).
written in Latin, titled Syphilis sive morbus gallicus (Latin Giorgio Sommariva of Verona is recorded to have used it
for "Syphilis or The French Disease") in 1530.[5] The pro- for this purpose in 1496.[citation needed]
tagonist of the poem is a shepherd named Syphilus (per- As the disease became better understood, more ef-
haps a variant spelling of Sipylus, a character in Ovid’s fective treatments were found. An antimicrobial used for
Metamorphoses). Syphilus is presented as the first man to treating disease was the organo-arsenical drug Salvarsan,
contract the disease, sent by the god Apollo as punish- developed in 1908 by Sahachiro Hata in the laboratory
ment for the defiance that Syphilus and his followers had of Nobel prize winner Paul Ehrlich. This group later dis-
shown him.[5] From this character Fracastoro derived a covered the related arsenical, Neosalvarsan, which is less
new name for the disease, which he also used in his med- toxic. Unfortunately, these drugs were not 100% effec-
ical text De Contagionibus ("On Contagious Diseases").[19] tive, especially in late disease, and were sometimes un-
Until that time, as Fracastoro notes, syphilis had been predictably toxic to patients.[citation needed] It was ob-
called the "French disease" in Italy, Poland and Germany, served that sometimes patients who developed high
and the "Italian disease" in France. In addition, the Dutch fevers were cured of syphilis. Thus, for a brief time
called it the "Spanish disease", the Russians called it the malaria was used as treatment for tertiary syphilis be-
"Polish disease", the Turks called it the "Christian dis- cause it produced prolonged and high fevers (a form of
ease" or "Frank disease" (frengi) and the Tahitians called pyrotherapy). This was considered an acceptable risk be-
it the "British disease". These "national" names are due cause the malaria could later be treated with quinine,
to the disease often being spread by foreign sailors and which was available at that time.[citation needed] Malaria as
soldiers during their frequent sexual contact with local a treatment for syphilis was usually reserved for late dis-
prostitutes.[citation needed] ease, especially neurosyphilis, and then followed by ei-
During the 16th century, it was called "great pox" in ther Salvarsan or Neosalvarsan as adjuvant therapy. This
order to distinguish it from smallpox. In its early stages, discovery was championed by Julius Wagner-Jauregg,[27]
the great pox produced a rash similar to smallpox (also who won the 1927 Nobel Prize for Medicine for his dis-
known as variola).[citation needed] However, the name is covery of the therapeutic value of malaria inoculation in
misleading, as smallpox was a far more deadly disease. the treatment of neurosyphilis. Later, hyperthermal cab-
The terms "Lues"[20] (or Lues venerea, Latin for "venereal inets (sweat-boxes) were used for the same purpose.[28]
plague") and "Cupid’s disease"[21] have also been used to These treatments were finally rendered obsolete by the
refer to syphilis. In Scotland, syphilis was referred to as discovery of penicillin, and its widespread manufacture
the Grandgore. The ulcers suffered by British soldiers in after World War II allowed syphilis to be effectively and
Portugal were termed "The Black Lion".[22] reliably cured.[29]
Historical treatments History of diagnosis
There were originally no effective treatments for In 1905, Schaudinn and Hoffmann discovered Treponema
syphilis. The Spanish priest Francisco Delicado wrote El pallidum in tissue of patients with syphilis.[5] One year
modo de adoperare el legno de India (Rome, 1525) about the later, the first effective test for syphilis, the Wassermann
use of Guaiacum in the treatment of syphilis. He himself test, was developed. Although it had some false positive
suffered from syphilis.[citation needed] Nicholas Culpeper results, it was a major advance in the detection and pre-
recommended the use of heartsease (wild pansy), an herb vention of syphilis.[citation needed] By allowing testing be-
with antimicrobial activities.[23] Another common reme- fore the acute symptoms of the disease had developed,
dy was mercury: the use of which gave rise to the saying this test allowed the prevention of transmission of
"A night in the arms of Venus leads to a lifetime on Mer- syphilis to others, even though it did not provide a cure
3
From Wikipedia, the free encyclopedia History of syphilis
for those infected. In the 1930s the Hinton test, devel- [6] Debora MacKenzie (15 January 2008). "Columbus
oped by William Augustus Hinton, and based on floccu- blamed for spread of syphilis". New Scientist.
lation, was shown to have fewer false positive reactions http://www.newscientist.com/article/
than the Wassermann test.[citation needed] Both of these dn13186-columbus-blamed-for-spread-of-syphilis-
early tests have been superseded by newer analytical .html.
methods. [7] ^ Harper, KN; Ocampo, PS; Steiner, BM; George,
While working at the Rockefeller University (then RW; Silverman, MS; Bolotin, S; Pillay, A; Saunders,
called the Rockefeller Institute for Medical Research) in NJ et al (January 2008). Ko, Albert. ed. "On the
1913, Hideyo Noguchi, a Japanese scientist, demonstrated Origin of the Treponematoses: A Phylogenetic
the presence of the spirochete Treponema pallidum in the Approach" (PDF). PLoS Neglected Tropical Diseases 2
brain of a progressive paralysis patient, associating Tre- (1): e148. doi:10.1371/journal.pntd.0000148.
ponema pallidum with neurosyphilis.[30] Prior to Noguchi’s PMC 2217670. PMID 18235852.
discovery, syphilis had been a burden to humanity in http://www.plosntds.org/article/
many lands. Without its cause being understood, it was fetchObjectAttachment.action?uri=info%3Adoi%2F10.1371%2Fjour
sometimes misdiagnosed and often misattributed to Lay summary – New Scientist (15 January 2008).
damage by political enemies. Felix Milgrom developed a [8] Bollaert, WM (1864), Introduction of Syphilis from the
test for syphilis. The Hideyo Noguchi Africa Prize, was New World, http://www.logoi.com/health/syphilis/
named to honor the man who identified the agent in as- syphilis_1.html
sociation with the late form of the infectious disease. [31] [9] Henneberg M, Henneberg RJ (1994).
"Treponematosis in an Ancient Greek colony of
Notable cases Metaponto, Southern Italy 580-250 BCE". In O
Dutour, G Palfi, J Berato, J-P Brun (eds). The Origin of
Main article: Notable cases of syphilis Syphilis in Europe, Before or After 1493?. Toulon-Paris:
Mental illness caused by late-stage syphilis was once a Centre Archeologique du Var, Editions Errance.
common form of dementia. This was known as the gener- pp. 92–98.
al paresis of the insane. Many famous historical figures, [10] Henneberg M, Henneberg RJ (2002).
including Charles VIII of France, Hernán Cortés of Spain, "Reconstructing Medical Knowledge in Ancient
Adolf Hitler, Benito Mussolini, and Ivan the Terrible, are Pompeii from the Hard Evidence of Bones and
alleged to have had syphilis or other sexually transmitted Teeth". In J Renn, G Castagnetti (eds). Homo Faber:
infections. Sometimes these allegations were false and Studies on Nature. Technology and Science at the Time
formed part of a political whispering campaign. In other of Pompeii,. Rome: "L’ERMA" di Bretschneider.
instances, retrospective diagnoses of suspected cases pp. 169–187.
have been made in modern times. [11] Rose M (January/February 1997). "Origins of
Syphilis". Archaeology 50 (1).
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[1] The Metropolitan Museum of Art Bulletin, Summer [12] ^ Lobdell J, Owsley D (August 1974). "The origin of
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[2] ^ Kent ME, Romanelli F (February 2008). doi:10.1080/00224497409550828. (via JSTOR)
"Reexamining syphilis: an update on epidemiology, [13] ^ Crosby, Alfred W.. The Columbian exchange:
clinical manifestations, and management". Ann biological and cultural consequences of 1492. New York:
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PMID 18212261. [14] The origin and antiquity of syphilis revisited: An
[3] ^ Farhi, D; Dupin, N (2010 Sep-Oct). "Origins of Appraisal of Old World pre-Columbian evidence for
syphilis and management in the treponemal infection. Kristin N. Harper, Molly K.
immunocompetent patient: facts and Zuckerman, Megan L. Harper, John D. Kingston,
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origins [16] John Noble Wilford (15 January 2008). "Genetic
[5] ^ Franzen, C (2008 Dec). "Syphilis in composers and Study Bolsters Columbus Link to Syphilis". The New
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[18] "Pox and Paranoia in Renaissance Europe". History [25] Walker, TJ (December 1869). "The Treatment of
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Mosby. ISBN 1-4160-2999-0. [26] Ozuah, Philip O. (March 2000). "Mercury
[21] Semple, David; Smythe, Robert (2009). Oxford poisoning". Current Problems in Pediatrics 30 (3):
handbook of psychiatry. Oxford, UK: Oxford 91–99 [91]. doi:10.1067/mps.2000.104054.
University Press. p. 160. ISBN 978-0-19-923946-7. [27] Raju T (2006). "Hot brains: manipulating body heat
[22] Rudy’s List of Archaic Medical Terms (2007-04-27). to save the brain". Pediatrics 117 (2): e320–1.
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Medical Dictionary – A Dictionary of Medical Science. treatment in the nineteenth and twentieth
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[23] Nicholas Culpeper. "A complete herbal". [29] Brown, Kevin (2006). The Pox: The Life and Near Death
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[24] Hanlon M (7 June 2007). "The magical properties of [30] "Noguchi, Hideyo". The Columbia Encyclopedia (Sixth
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Retrieved 2007-08-07.
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