History of syphilis
The first recorded outbreak of syphilis in Europe occurred in 1494/1495 in Naples, Italy, during a French invasion.[1][2] Because it was spread geographically by French troops returning from that campaign, the disease was known as "French disease", and it was not until 1530 that the term "syphilis" was first applied by the Italian physician and poet Girolamo Fracastoro.[2] The causative organism, Treponema pallidum, was first identified by Fritz Schaudinn and Erich Hoffmann in 1905 at the Charité Clinic in Berlin.[2] The first effective treatment, Salvarsan, was developed in 1910 by Sahachiro Hata in the laboratory of Paul Ehrlich. It was followed by the introduction of penicillin in 1943.[2]
Many well-known figures, including Scott Joplin, Franz Schubert, Friedrich Nietzsche, Al Capone, and Édouard Manet are believed to have contracted the disease.[2]
Origin[edit]
The history of syphilis has been well studied, but the exact origin of the disease remains unknown.[3] There are two primary hypotheses: one proposes that syphilis was carried to Europe from the Americas by the crew(s) of Christopher Columbus as a byproduct of the Columbian exchange, while the other proposes that syphilis previously existed in Europe but went unrecognized.[1] There has been a recent skeletal discovery in the Yucatan Peninsula dating over 9,900 years ago of a 30 year old woman who had Treponema peritonitis, a disease related to syphilis.[4] "There is also evidence for a possible trepanomal bacterial disease that caused severe alteration of the posterior parietal and occipital bones of the cranium."[5] Syphilis was the first "new" disease to be discovered after the invention of printing. News of it spread quickly and widely, and documentation is abundant. For the time, it was "front page news" that was widely known among the literate. It is also the first disease to be widely recognized as a sexually transmitted disease, and it was taken as indicative of the moral state (sexual behavior) of the peoples in which it was found. Its geographic origin and moral significance were debated as had never been the case with any other illness. European countries blamed it on each other. Somewhat later, when the significance of the Western Hemisphere was perceived, it has been used in both pro- and anti-colonial discourse.
Historical terms[edit]
The name "syphilis" was coined by the Italian physician and poet Girolamo Fracastoro in his pastoral noted poem, written in Latin, titled Syphilis sive morbus gallicus (Latin for "Syphilis or The French Disease") in 1530.[2][44] The protagonist of the poem is a shepherd named Syphilus (perhaps a variant spelling of Sipylus, a character in Ovid's Metamorphoses). Syphilus is presented as the first man to contract the disease, sent by the god Apollo as punishment for the defiance that Syphilus and his followers had shown him.[2] From this character Fracastoro derived a new name for the disease, which he also used in his medical text De Contagione et Contagiosis Morbis (1546) ("On Contagion and Contagious Diseases").[45]
Until that time, as Fracastoro notes, syphilis had been called the "French disease" (Italian: mal francese) in Italy, Malta,[46] Poland and Germany, and the "Italian disease" in France. In addition, the Dutch called it the "Spanish disease", the Russians called it the "Polish disease", and the Turks called it the "Christian disease" or "Frank (Western European) disease" (frengi). These "national" names were generally reflective of contemporary political spite between nations and frequently served as a sort of propaganda; the Protestant Dutch, for example, fought and eventually won a war of independence against their Spanish Habsburg rulers who were Catholic, so referring to Syphilis as the "Spanish" disease reinforced a politically useful perception that the Spanish were immoral or unworthy. However, the attributions are also suggestive of possible routes of the spread of the infection, at least as perceived by "recipient" populations. The inherent xenophobia of the terms also stemmed from the disease's particular epidemiology, often being spread by foreign sailors and soldiers during their frequent sexual contact with local prostitutes.[47]
During the 16th century, it was called "great pox" in order to distinguish it from smallpox. In its early stages, the great pox produced a rash similar to smallpox (also known as variola). However, the name is misleading, as smallpox was a far more deadly disease. The terms "lues"[48] (or Lues venerea, Latin for "venereal plague") and "Cupid's disease"[49] have also been used to refer to syphilis. In Scotland, syphilis was referred to as the Grandgore or Spanyie Pockis.[50] The ulcers suffered by British soldiers in Portugal were termed "The Black Lion".[51]
History of diagnosis[edit]
In 1905, Fritz Schaudinn and Erich Hoffmann discovered Treponema pallidum in tissue of patients with syphilis.[2] One year later, the first effective test for syphilis, the Wassermann test, was developed. Although it had some false positive results, it was a major advance in the detection and prevention of syphilis. By allowing testing before the acute symptoms of the disease had developed, this test allowed the prevention of transmission of syphilis to others, even though it did not provide a cure for those infected. In the 1930s the Hinton test, developed by William Augustus Hinton, and based on flocculation, was shown to have fewer false positive reactions than the Wassermann test.[67] Both of these early tests have been superseded by newer analytical methods.
While working at the Rockefeller University (then called the Rockefeller Institute for Medical Research) in 1913, Hideyo Noguchi, a Japanese scientist, demonstrated the presence of the spirochete Treponema pallidum in the brain of a progressive paralysis patient, associating Treponema pallidum with neurosyphilis.[68] Prior to Noguchi's discovery, syphilis had been a burden to humanity in many lands. Without its cause being understood, it was sometimes misdiagnosed and often misattributed to damage by political enemies. It is called "the great pretender" for its variety of symptoms. Felix Milgrom developed a test for syphilis. The Hideyo Noguchi Africa Prize was named to honor the man who identified the agent in association with the late form of the infectious disease.[69]