History of syphilis
Encyclopedia
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
is unknown. There are two primary hypotheses: one proposes that syphilis was carried from the Americas
Americas
The Americas, or America , are lands in the Western hemisphere, also known as the New World. In English, the plural form the Americas is often used to refer to the landmasses of North America and South America with their associated islands and regions, while the singular form America is primarily...
to Europe by the crew of Christopher Columbus
Christopher Columbus
Christopher Columbus was an explorer, colonizer, and navigator, born in the Republic of Genoa, in northwestern Italy. Under the auspices of the Catholic Monarchs of Spain, he completed four voyages across the Atlantic Ocean that led to general European awareness of the American continents in the...
, the other proposes that syphilis previously existed in Europe but went unrecognized. These are referred to as the "Columbian" and "pre-Columbian" hypotheses respectively. The Columbian hypothesis is best supported by the available evidence. The first written records of an outbreak of syphilis in Europe occurred in 1494/1495 in Naples, Italy
Naples
Naples is a city in Southern Italy, situated on the country's west coast by the Gulf of Naples. Lying between two notable volcanic regions, Mount Vesuvius and the Phlegraean Fields, it is the capital of the region of Campania and of the province of Naples...
, during a French invasion. Due to it being spread by returning French troops, 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
Girolamo Fracastoro
Girolamo Fracastoro was an Italian physician, poet, and scholar in mathematics, geography and astronomy. Fracastoro subscribed to the philosophy of atomism, and rejected appeals to hidden causes in scientific investigation....
. The causative organism, Treponema pallidum, was first identified by Fritz Schaudinn
Fritz Schaudinn
Fritz Richard Schaudinn was a German zoologistBorn in Röseningken, East Prussia, he co-discovered, with Erich Hoffmann in 1905, the causative agent of syphilis, Spirochaeta pallida...
and Erich Hoffmann
Erich Hoffmann
Erich Hoffmann was a German dermatologist who was a native of Witzmitz, Pomerania. He studied medicine at the Berlin Military Academy, and was later a professor at the Universities of Halle and Bonn....
in 1905. The first effective treatment (Salvarsan) was developed in 1910 by Paul Ehrlich
Paul Ehrlich
Paul Ehrlich was a German scientist in the fields of hematology, immunology, and chemotherapy, and Nobel laureate. He is noted for curing syphilis and for his research in autoimmunity, calling it "horror autotoxicus"...
which was followed by the introduction of penicillin
Penicillin
Penicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V....
in 1943. Many famous historical figures including Franz Schubert
Franz Schubert
Franz Peter Schubert was an Austrian composer.Although he died at an early age, Schubert was tremendously prolific. He wrote some 600 Lieder, nine symphonies , liturgical music, operas, some incidental music, and a large body of chamber and solo piano music...
, Arthur Schopenhauer
Arthur Schopenhauer
Arthur Schopenhauer was a German philosopher known for his pessimism and philosophical clarity. At age 25, he published his doctoral dissertation, On the Fourfold Root of the Principle of Sufficient Reason, which examined the four separate manifestations of reason in the phenomenal...
, and Edouard Manet
Édouard Manet
Édouard Manet was a French painter. One of the first 19th-century artists to approach modern-life subjects, he was a pivotal figure in the transition from Realism to Impressionism....
are believed to have had the disease.
Origin
The exact origin of syphilis is unknown. Two primary theories have been proposed. It is generally agreed upon by historians and anthropologists that syphilis was present among the indigenous peoples of the AmericasIndigenous peoples of the Americas
The indigenous peoples of the Americas are the pre-Columbian inhabitants of North and South America, their descendants and other ethnic groups who are identified with those peoples. Indigenous peoples are known in Canada as Aboriginal peoples, and in the United States as Native Americans...
before Europeans traveled to and from the New World
New World
The New World is one of the names used for the Western Hemisphere, specifically America and sometimes Oceania . The term originated in the late 15th century, when America had been recently discovered by European explorers, expanding the geographical horizon of the people of the European middle...
. However, whether strains of syphilis were present in the entire world for millennia, or if the disease was confined to the Americas in the pre-Columbian era, is debated.
- The "Columbian ExchangeColumbian ExchangeThe Columbian Exchange was a dramatically widespread exchange of animals, plants, culture, human populations , communicable disease, and ideas between the Eastern and Western hemispheres . It was one of the most significant events concerning ecology, agriculture, and culture in all of human history...
theory" holds that syphilis was a New WorldNew WorldThe New World is one of the names used for the Western Hemisphere, specifically America and sometimes Oceania . The term originated in the late 15th century, when America had been recently discovered by European explorers, expanding the geographical horizon of the people of the European middle...
disease brought back by ColumbusChristopher ColumbusChristopher Columbus was an explorer, colonizer, and navigator, born in the Republic of Genoa, in northwestern Italy. Under the auspices of the Catholic Monarchs of Spain, he completed four voyages across the Atlantic Ocean that led to general European awareness of the American continents in the...
and Martin Alonso Pinzon. Columbus's voyages to the Americas occurred three years before the Naples syphilis outbreak of 1494. This theory is supported by genetic studies of venereal syphilis and related bacteria, which found a disease intermediate between yawsYawsYaws is a tropical infection of the skin, bones and joints caused by the spirochete bacterium Treponema pallidum pertenue...
and syphilis in GuyanaGuyanaGuyana , officially the Co-operative Republic of Guyana, previously the colony of British Guiana, is a sovereign state on the northern coast of South America that is culturally part of the Anglophone Caribbean. Guyana was a former colony of the Dutch and of the British...
, South America.
- The "pre-ColumbianPre-ColumbianThe pre-Columbian era incorporates all period subdivisions in the history and prehistory of the Americas before the appearance of significant European influences on the American continents, spanning the time of the original settlement in the Upper Paleolithic period to European colonization during...
theory" holds that syphilis was present in Europe before the discovery of the Americas by Europeans. Some scholars during the 18th and 19th centuries believed that the symptoms of syphilis in its tertiary form were described by HippocratesHippocratesHippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
in Classical GreeceClassical GreeceClassical Greece was a 200 year period in Greek culture lasting from the 5th through 4th centuries BC. This classical period had a powerful influence on the Roman Empire and greatly influenced the foundation of Western civilizations. Much of modern Western politics, artistic thought, such as...
. There are other suspected syphilis findings for pre-contact Europe, including at a 13–14th century Augustinian friary in the northeastern English port of Kingston upon HullKingston upon HullKingston upon Hull , usually referred to as Hull, is a city and unitary authority area in the ceremonial county of the East Riding of Yorkshire, England. It stands on the River Hull at its junction with the Humber estuary, 25 miles inland from the North Sea. Hull has a resident population of...
. This city's maritime history, with its continual arrival of sailors from distant places, is thought to have been a key factor in the transmission of syphilis. Carbon-dated skeletons of monks who lived in the friary showed bone lesions that supporters say are typical of venereal syphilis, although this is disputed by critics of this theory. Skeletons in pre-Columbus PompeiiPompeiiThe city of Pompeii is a partially buried Roman town-city near modern Naples in the Italian region of Campania, in the territory of the comune of Pompei. Along with Herculaneum, Pompeii was destroyed and completely buried during a long catastrophic eruption of the volcano Mount Vesuvius spanning...
and MetapontoMetapontoMetaponto is a small town of about 1,000 people in the province of Matera, Basilicata, Italy. Administratively it is a frazione of Bernalda.-History:The town is best known for the ruins of the ancient Greek city of Metapontum...
in Italy with damage similar to that caused by congenital syphilis have also been found, although the interpretation of this evidence has been disputed. Douglas Owsley, a physical anthropologist at the Smithsonian InstitutionSmithsonian InstitutionThe Smithsonian Institution is an educational and research institute and associated museum complex, administered and funded by the government of the United States and by funds from its endowment, contributions, and profits from its retail operations, concessions, licensing activities, and magazines...
, and other supporters of this idea, say that many medieval European cases of leprosy, colloquially called lepra, were actually cases of syphilis. Although folklore claimed that syphilis was unknown in Europe until the return of the 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." Lobdell and Owsley wrote that a European writer who recorded an outbreak of "lepra" in 1303 was "clearly describing syphilis."
Historian Alfred Crosby
Alfred Crosby
Alfred W. Crosby is a historian, professor and author of such books as The Columbian Exchange and Ecological Imperialism...
suggests both theories are partly correct in a "combination theory". Crosby says that the bacterium that causes syphilis
Treponema pallidum
Treponema pallidum is a species of spirochaete bacterium with subspecies that cause treponemal diseases such as syphilis, bejel, pinta and yaws. The treponemes have a cytoplasmic and outer membrane...
belongs to the same phylogenetic family as the bacteria that cause yaws
Yaws
Yaws is a tropical infection of the skin, bones and joints caused by the spirochete bacterium Treponema pallidum pertenue...
and several other diseases. Despite the tradition of assigning the homeland of yaws to sub-Saharan Africa
Sub-Saharan Africa
Sub-Saharan Africa as a geographical term refers to the area of the African continent which lies south of the Sahara. A political definition of Sub-Saharan Africa, instead, covers all African countries which are fully or partially located south of the Sahara...
, Crosby notes that there is no unequivocal evidence of any related disease having been present in pre-Columbian Europe, Africa, or Asia. Crosby writes, "It is not impossible that the organisms causing treponema
Treponema
Treponema is a bacterial genus. The major species is Treponema pallidum, whose subspecies are responsible for diseases such as syphilis and yaws.The species Treponema hyodysenteriae and Treponema innocens have been reclassified into Serpula....
tosis arrived from America in the 1490s...and evolved into both venereal and non-venereal syphilis and yaws." However, Crosby considers it more likely that a highly contagious ancestral species of the bacteria moved with early human ancestors 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 treponema
Treponema
Treponema is a bacterial genus. The major species is Treponema pallidum, whose subspecies are responsible for diseases such as syphilis and yaws.The species Treponema hyodysenteriae and Treponema innocens have been reclassified into Serpula....
tosis and, in time, closely related but different diseases."
European outbreak
Naples
Naples is a city in Southern Italy, situated on the country's west coast by the Gulf of Naples. Lying between two notable volcanic regions, Mount Vesuvius and the Phlegraean Fields, it is the capital of the region of Campania and of the province of Naples...
, Italy. It may have been transmitted to the French via Spanish mercenaries serving King Charles of France in that siege. From this centre, the disease swept across Europe. As Jared Diamond
Jared Diamond
Jared Mason Diamond is an American scientist and author whose work draws from a variety of fields. He is currently Professor of Geography and Physiology at UCLA...
describes 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 people's faces, and led to death within a few months." The disease then was much more lethal than it is today. Diamond concludes,"[B]y 1546, the disease had evolved into the disease with the symptoms so well known to us today." The epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
of this first syphilis epidemic shows that the disease was either new or a mutated form of an earlier disease.
Researchers concluded that syphilis was carried from the New World to Europe after Columbus
Christopher Columbus
Christopher Columbus was an explorer, colonizer, and navigator, born in the Republic of Genoa, in northwestern Italy. Under the auspices of the Catholic Monarchs of Spain, he completed four voyages across the Atlantic Ocean that led to general European awareness of the American continents in the...
' voyages. Many of the crew members who served on this voyage later joined the army of King Charles VIII
Charles VIII of France
Charles VIII, called the Affable, , was King of France from 1483 to his death in 1498. Charles was a member of the House of Valois...
in his invasion of Italy in 1495, resulting in the spreading of the disease across Europe and as many as five million deaths. The findings suggested Europeans could have carried the nonvenereal tropical bacteria home, where the organisms may have mutated into a more deadly form in the different conditions and low immunity of the population of Europe. Syphilis was a major killer in Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
during the Renaissance
Renaissance
The Renaissance was a cultural movement that spanned roughly the 14th to the 17th century, beginning in Italy in the Late Middle Ages and later spreading to the rest of Europe. The term is also used more loosely to refer to the historical era, but since the changes of the Renaissance were not...
. In his Serpentine Malady (Seville, 1539) Ruy Diaz de Isla estimated that over a million people were infected in Europe.
Historical terms
The name "syphilis" was coined by the Italian physician and poet Girolamo FracastoroGirolamo Fracastoro
Girolamo Fracastoro was an Italian physician, poet, and scholar in mathematics, geography and astronomy. Fracastoro subscribed to the philosophy of atomism, and rejected appeals to hidden causes in scientific investigation....
in his epic
Epic poetry
An epic is a lengthy narrative poem, ordinarily concerning a serious subject containing details of heroic deeds and events significant to a culture or nation. Oral poetry may qualify as an epic, and Albert Lord and Milman Parry have argued that classical epics were fundamentally an oral poetic form...
noted poem, written in Latin
Latin
Latin is an Italic language originally spoken in Latium and Ancient Rome. It, along with most European languages, is a descendant of the ancient Proto-Indo-European language. Although it is considered a dead language, a number of scholars and members of the Christian clergy speak it fluently, and...
, titled Syphilis sive morbus gallicus (Latin
Latin
Latin is an Italic language originally spoken in Latium and Ancient Rome. It, along with most European languages, is a descendant of the ancient Proto-Indo-European language. Although it is considered a dead language, a number of scholars and members of the Christian clergy speak it fluently, and...
for "Syphilis or The French
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
Disease") in 1530. The protagonist of the poem is a shepherd
Shepherd
A shepherd is a person who tends, feeds or guards flocks of sheep.- Origins :Shepherding is one of the oldest occupations, beginning some 6,000 years ago in Asia Minor. Sheep were kept for their milk, meat and especially their wool...
named Syphilus (perhaps a variant spelling of Sipylus, a character in Ovid
Ovid
Publius Ovidius Naso , known as Ovid in the English-speaking world, was a Roman poet who is best known as the author of the three major collections of erotic poetry: Heroides, Amores, and Ars Amatoria...
's Metamorphoses). Syphilus is presented as the first man to contract the disease, sent by the god Apollo
Apollo
Apollo is one of the most important and complex of the Olympian deities in Greek and Roman mythology...
as punishment for the defiance that Syphilus and his followers had shown him. From this character Fracastoro derived a new name for the disease, which he also used in his medical text De Contagionibus ("On Contagious Diseases").
Until that time, as Fracastoro notes, syphilis had been called the "French disease" in Italy, Poland and Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
, and the "Italian disease" in France. In addition, the Dutch
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...
called it the "Spanish disease", the Russians
Russians
The Russian people are an East Slavic ethnic group native to Russia, speaking the Russian language and primarily living in Russia and neighboring countries....
called it the "Polish disease", the Turks
Ottoman Empire
The Ottoman EmpireIt was usually referred to as the "Ottoman Empire", the "Turkish Empire", the "Ottoman Caliphate" or more commonly "Turkey" by its contemporaries...
called it the "Christian disease" or "Frank disease" (frengi) and the Tahiti
Tahiti
Tahiti is the largest island in the Windward group of French Polynesia, located in the archipelago of the Society Islands in the southern Pacific Ocean. It is the economic, cultural and political centre of French Polynesia. The island was formed from volcanic activity and is high and mountainous...
ans called it the "British
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
disease". These "national" names are due to the disease often being spread by foreign sailors and soldiers during their frequent sexual contact with local prostitutes
Prostitution
Prostitution is the act or practice of providing sexual services to another person in return for payment. The person who receives payment for sexual services is called a prostitute and the person who receives such services is known by a multitude of terms, including a "john". Prostitution is one of...
.
During the 16th century, it was called "great pox" in order to distinguish it from smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...
. 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" (or Lues venerea, Latin for "venereal plague") and "Cupid
Cupid
In Roman mythology, Cupid is the god of desire, affection and erotic love. He is the son of the goddess Venus and the god Mars. His Greek counterpart is Eros...
's disease" have also been used to refer to syphilis. In Scotland
Scotland
Scotland is a country that is part of the United Kingdom. Occupying the northern third of the island of Great Britain, it shares a border with England to the south and is bounded by the North Sea to the east, the Atlantic Ocean to the north and west, and the North Channel and Irish Sea to the...
, syphilis was referred to as the Grandgore. The ulcers suffered by British soldiers in Portugal were termed "The Black Lion".
Historical treatments
There were originally no effective treatments for syphilis. The Spanish priest Francisco DelicadoFrancisco Delicado
Francisco Delicado was a Spanish writer and editor of the Renaissance. Little is known about his life. He was born in Cordoba, Spain and, by uncertain reasons, he moved to Rome, where he became vicar and Italianized his surname to Delicado...
wrote El modo de adoperare el legno de India (Rome, 1525) about the use of Guaiacum
Guaiacum
Guaiacum, sometimes spelled Guajacum, is a genus of flowering plants in the caltrop family Zygophyllaceae. It contains five species of slow-growing shrubs and trees, reaching a height of approximately but are usually less than half of that...
in the treatment of syphilis. He himself suffered from syphilis. Nicholas Culpeper
Nicholas Culpeper
Nicholas Culpeper was an English botanist, herbalist, physician, and astrologer. His published books include The English Physician and the Complete Herbal , which contain a rich store of pharmaceutical and herbal knowledge, and Astrological Judgement of Diseases from the Decumbiture of the Sick ,...
recommended the use of heartsease
Heartsease
Viola tricolor, known as Heartsease, is a common European wild flower, growing as an annual or short-lived perennial. It has been introduced into North America, where it has spread widely, and is known as the Johnny Jump Up...
(wild pansy), an herb with antimicrobial activities. Another common remedy was mercury
Mercury (element)
Mercury is a chemical element with the symbol Hg and atomic number 80. It is also known as quicksilver or hydrargyrum...
: the use of which gave rise to the saying "A night in the arms of Venus leads to a lifetime on Mercury". It was administered in various fashions, including by mouth, by rubbing it on the skin, and by injection. One of the more curious methods was fumigation, in which the patient was placed in a closed box with his head sticking out. Mercury was placed inside the box and a fire started under the box, causing the mercury to vaporize. It was a grueling process for the patient and the least effective for delivering mercury to the body. The use of mercury was the earliest known suggested treatment for syphilis. This has been suggested to date back to The Canon of Medicine
The Canon of Medicine
The Canon of Medicine is an encyclopedia of Galenic medicine in five books compiled by Ibn Sīnā and completed in 1025. It presents a clear and organized summary of all the medical knowledge of the time...
(1025) by the Persian physician Ibn Sina
Avicenna
Abū ʿAlī al-Ḥusayn ibn ʿAbd Allāh ibn Sīnā , commonly known as Ibn Sīnā or by his Latinized name Avicenna, was a Persian polymath, who wrote almost 450 treatises on a wide range of subjects, of which around 240 have survived...
(Avicenna), although this is only possible if syphilis existed in the Old World prior to Columbus (see Origins section). Giorgio Sommariva of Verona is recorded to have used it for this purpose in 1496.
As the disease became better understood, more effective treatments were found. An antimicrobial used for treating disease was the organo-arsenical
Arsenic
Arsenic is a chemical element with the symbol As, atomic number 33 and relative atomic mass 74.92. Arsenic occurs in many minerals, usually in conjunction with sulfur and metals, and also as a pure elemental crystal. It was first documented by Albertus Magnus in 1250.Arsenic is a metalloid...
drug Salvarsan
Arsphenamine
Arsphenamine, also known as Salvarsan and 606, is a drug that was used beginning in the 1910s to treat syphilis and trypanosomiasis...
, developed in 1908 by Sahachiro Hata
Sahachiro Hata
was a Japanese bacteriologist who developed the Arsphenamine drug in 1909 in the laboratory of Paul Ehrlich.Hata was born in Tsumo Village, Mino District, Shimane , and completed his medical education in Kyoto...
in the laboratory of Nobel prize
Nobel Prize
The Nobel Prizes are annual international awards bestowed by Scandinavian committees in recognition of cultural and scientific advances. The will of the Swedish chemist Alfred Nobel, the inventor of dynamite, established the prizes in 1895...
winner Paul Ehrlich
Paul Ehrlich
Paul Ehrlich was a German scientist in the fields of hematology, immunology, and chemotherapy, and Nobel laureate. He is noted for curing syphilis and for his research in autoimmunity, calling it "horror autotoxicus"...
. This group later discovered the related arsenical, Neosalvarsan
Neosalvarsan
Neosalvarsan is a synthetic chemotherapeutic that is an organoarsenic compound. It became available in 1912 and superseded the more toxic and less water-soluble salvarsan as an effective treatment for syphilis...
, which is less toxic. Unfortunately, these drugs were not 100% effective, especially in late disease, and were sometimes unpredictably toxic to patients. It was observed that sometimes patients who developed high fevers were cured of syphilis. Thus, for a brief time malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
was used as treatment for tertiary syphilis because it produced prolonged and high fevers (a form of pyrotherapy
Pyrotherapy
Pyrotherapy is a method of treatment by raising the body temperature or sustaining an elevated body temperature . In general, the body temperature was maintained at 41° Celsius. Many diseases were treated by this method in the first half of the 20th century...
). This was considered an acceptable risk because the malaria could later be treated with quinine
Quinine
Quinine is a natural white crystalline alkaloid having antipyretic , antimalarial, analgesic , anti-inflammatory properties and a bitter taste. It is a stereoisomer of quinidine which, unlike quinine, is an anti-arrhythmic...
, which was available at that time. Malaria as a treatment for syphilis was usually reserved for late disease, especially neurosyphilis, and then followed by either Salvarsan or Neosalvarsan as adjuvant therapy. This discovery was championed by Julius Wagner-Jauregg
Julius Wagner-Jauregg
Julius Wagner-Jauregg was an Austrian physician, Nobel Laureate, and Nazi supporter.-Early life:...
, who won the 1927 Nobel Prize for Medicine for his discovery of the therapeutic value of malaria inoculation in the treatment of neurosyphilis. Later, hyperthermal cabinets (sweat-boxes) were used for the same purpose. These treatments were finally rendered obsolete by the discovery of penicillin
Penicillin
Penicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V....
, and its widespread manufacture after World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...
allowed syphilis to be effectively and reliably cured.
History of diagnosis
In 1905, SchaudinnFritz Schaudinn
Fritz Richard Schaudinn was a German zoologistBorn in Röseningken, East Prussia, he co-discovered, with Erich Hoffmann in 1905, the causative agent of syphilis, Spirochaeta pallida...
and Hoffmann
Erich Hoffmann
Erich Hoffmann was a German dermatologist who was a native of Witzmitz, Pomerania. He studied medicine at the Berlin Military Academy, and was later a professor at the Universities of Halle and Bonn....
discovered Treponema pallidum in tissue of patients with syphilis. One year later, the first effective test for syphilis, the Wassermann test
Wassermann test
The Wassermann test or Wassermann reaction is an antibody test for syphilis, named after the bacteriologist August Paul von Wassermann, based on complement-fixation.-Method:...
, 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
William Augustus Hinton
William Augustus Hinton was a black bacteriologist, pathologist and educator. Hinton was the first black professor in the history of Harvard University...
, and based on flocculation
Flocculation
Flocculation, in the field of chemistry, is a process wherein colloids come out of suspension in the form of floc or flakes by the addition of a clarifying agent. The action differs from precipitation in that, prior to flocculation, colloids are merely suspended in a liquid and not actually...
, was shown to have fewer false positive
Type I and type II errors
In statistical test theory the notion of statistical error is an integral part of hypothesis testing. The test requires an unambiguous statement of a null hypothesis, which usually corresponds to a default "state of nature", for example "this person is healthy", "this accused is not guilty" or...
reactions than the Wassermann test. Both of these early tests have been superseded by newer analytical methods.
While working at the Rockefeller University
Rockefeller University
The Rockefeller University is a private university offering postgraduate and postdoctoral education. It has a strong concentration in the biological sciences. It is also known for producing numerous Nobel laureates...
(then called the Rockefeller Institute for Medical Research) in 1913, Hideyo Noguchi
Hideyo Noguchi
, also known as , was a prominent Japanese bacteriologist who discovered the agent of syphilis as the cause of progressive paralytic disease in 1911.-Early life:...
, a Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
ese scientist, demonstrated the presence of the spirochete Treponema pallidum
Treponema pallidum
Treponema pallidum is a species of spirochaete bacterium with subspecies that cause treponemal diseases such as syphilis, bejel, pinta and yaws. The treponemes have a cytoplasmic and outer membrane...
in the brain of a progressive paralysis patient, associating Treponema pallidum with neurosyphilis. 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. Felix Milgrom
Felix Milgrom
Felix Milgrom was a Polish immunologist known for the development of a simple test for syphilis that could be performed on a drop of dried blood.-References:*, University of Buffalo official statement...
developed a test for syphilis. The Hideyo Noguchi Africa Prize
Hideyo Noguchi Africa Prize
The honors men and women "with outstanding achievements in the fields of medical research and medical services to combat infectious and other diseases in Africa, thus contributing to the health and welfare of the African people and of all humankind." The prize, officially named "The Prize in...
, was named to honor the man who identified the agent in association with the late form of the infectious disease.
Notable cases
Mental illness caused by late-stage syphilis was once a common form of dementiaDementia
Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging...
. This was known as the general paresis of the insane
General paresis of the insane
General paresis, also known as general paralysis of the insane or paralytic dementia, is a neuropsychiatric disorder affecting the brain and central nervous system, caused by syphilis infection...
.
Many famous historical figures, including Charles VIII of France
Charles VIII of France
Charles VIII, called the Affable, , was King of France from 1483 to his death in 1498. Charles was a member of the House of Valois...
, Hernán Cortés
Hernán Cortés
Hernán Cortés de Monroy y Pizarro, 1st Marquis of the Valley of Oaxaca was a Spanish Conquistador who led an expedition that caused the fall of the Aztec Empire and brought large portions of mainland Mexico under the rule of the King of Castile in the early 16th century...
of Spain, Adolf Hitler
Adolf Hitler
Adolf Hitler was an Austrian-born German politician and the leader of the National Socialist German Workers Party , commonly referred to as the Nazi Party). He was Chancellor of Germany from 1933 to 1945, and head of state from 1934 to 1945...
, Benito Mussolini
Benito Mussolini
Benito Amilcare Andrea Mussolini was an Italian politician who led the National Fascist Party and is credited with being one of the key figures in the creation of Fascism....
, and Ivan the Terrible, are alleged to have had syphilis or other sexually transmitted infections. Sometimes these allegations were false and formed part of a political whispering campaign. In other instances, retrospective diagnoses of suspected cases have been made in modern times.