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Syphilis (previously called lues) is a sexually transmitted disease (STD)
that is caused by a spirochaete bacterium, Treponema pallidum.
The route of transmission is almost invariably by sexual contact; however,
there are examples of direct contact infections and of congenital syphilis.
Primary syphilis is manifested after an incubation period of 10-90 days (the
average is 21 days) with a primary sore. The sore, called a chancre, is
localized at the point of initial exposure to the bacterium, often on the
penis, vagina or rectum.
Secondary syphilis is characterized by rashlike skin lesions that appear 1-6
months after the primary infection. A patient with syphilis is most
contagious when he or she has secondary syphilis. Other symptoms common at
this stage include fever, malaise, anorexia and enlarged lymph nodes.
Tertiary syphilis occurs from as early as one year after the initial
infection but can take up to ten years to manifest. This stage is
characterised by gummas which can occur almost anywhere in the body.
Complications affecting the neurological and cardiovascular system are
common in this stage.
In the United States, about 36,000 cases of syphilis are reported each year,
and the actual number is presumed to be higher. About three-fifths of the
reported cases occur in men.
If not treated, syphilis can cause serious effects such as damage to the
nervous system, heart, or brain. Untreated syphilis can be fatal. If you
think you might have syphilis, or if you find out that a sex partner had or
might have had syphilis, see a doctor as soon as possible.
Syphilis can be treated with penicillin or other antibiotics.
Health care professionals suggest that safer sex practices such as the use
of condoms should always be used in sexual activities, but they should by no
means be considered an absolute safeguard. The best suggestion is to avoid
sexual activities with anyone known to have a sexually transmissible
disease, and indeed anyone whose disease-negative status you aren't certain of.
The origins of syphilis are not known, though it does appear to have been
documented by Hippocrates in Classical Greece in its venereal/tertiary form.
This form was known in a Greek city of Metaponto in Italy about 600BC, and
also at Pompeii where additional archaeological evidence of uniquely
grooved-teeth of the children of mothers with syphilis has been found.
Evidence of syphilis in medieval Europe has been found at the site of a
13-14th century Augustine Friar in North East English port of Kingston upon Hull.
This friary provided medical care including palliative care and burial rites
for "wretched souls". The discovery at this first Augustine friary in
England, which was destroyed in 1539, of skeletons carbon dated throught the
friary existence bear bone lesions typical of tertiary venereal syphilis
casts further doubt on the New World origin theory of syphilis.
Examination of the friary site revealed bone lesions on two/thirds of the
skeletons examined, including those closest to the alter, a position
reserved for richer and most generous patrons of the order.
This suggests the privileged of Hull had had syphilis for a long time. At
that time, Hull was the second largest port of England after London and was
a sophisticated metropolitan international port.
Another school of thought has it that syphilis was brought back to Europe
from the New World by the crew of Christopher Columbus's first voyage. The
evidence is weak and circumstantial, and based on the fact that the first
recognized outbreak was at Naples in 1494 where a number of Spaniards from
the Columbus crew participated in the army of Charles VIII of France. This
theory is challenged by evidence of syphilis in the 14th century North East
British port of Hull.
Because of the outbreak in the French army, it was first called morbus
gallicus, or the French disease. In that time it is noteworthy that the
Italians also called it the "Spanish disase", the French called it the
"Italian" or "Neapolitan disease", the Russians called it the "Polish
disease", and the Arabs called it the "Disease of the Christians". The name
"syphilis" was first applied by Girolamo Fracastoro in 1530 from the name of
a shepherd in a poem by Leonardo da Vinci.
A number of famous historical personages, beginning with Charles VIII
himself, have been alleged to have had syphilis. Guy de Maupassant and
Friedrich Nietzsche are both thought to have been driven insane and
ultimately killed by the disease. Al Capone contracted syphilis as a young
man. By the time he was incarcerated at Alcatraz, it reached its third
stage, neurosyphilis, making him confused and disoriented. The painter Paul
Gauguin is also said to have suffered from syphilis.
The insanity caused by late-stage syphilis was once one of the more common
forms of dementia; this was known as the general paresis of the insane.
Syphilis in art and literature
There are references to syphilis in William Shakespeare's play Measure for
Measure, particularly in a number of early passages spoken by the character
Lucio, whose name, suggesting light and truth, is meant to indicate that he
is to be taken seriously. For example Lucio says "[...] thy bones are
hollow"; this is a reference to the brittleness of bones engendered by the
use of mercury which was then widely used to treat syphilis.
In Charlotte Bronte's novel Jane Eyre, the character Edward Rochester's
first wife, Bertha, is characterised as suffering from the advanced stages
of syphilitic infection, general paresis of the insane, and there is plenty
of corroborative evidence within the text to substantiate this view.
Henrik Ibsen's controversial (at the time) play Ghosts has a young man who
is suffering from a mysterious unnamed disease. Though it is never named,
the events of the play make it plain that this is syphilis, an inheritance
from his dissolute father.
The artist Kees van Dongen produced a series of illustrations for the
anarchist publication L'Assiette au Beurre showing the descent of a young
prostitute from poverty to her death from syphilis as a criticism of the
social order at the end of the 19th century.
Testing and treatment
Originally, there were no effective tratments for syphilis. The commonest in
use were guiacum and mercury: the use of mercury gave rise to the saying "A
night in the arms of Venus leads to a lifetime on Mercury".
It was only in the twentieth century that effective tests and treatments for
syphilis were developed.
In 1906, 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 prevention of syphilis. By allowing testing before the acute
symptoms of the disease had developed, this test allowed the prevention of
the transmission of syphilis to others, even though it did not provide a
cure for those infected.
As the disease became better understood, effective treatments began to be
found, beginning with the use of the arsenic-containing drug Salvarsan from
1910. One treatment that was tried was the use of malaria; the intense fever
produced by a malarial attack raising the body temperature sufficiently to
kill off the spirochaetes. Though this did leave the patient with a malaria
infection, it was considered to be preferable to the long term effects of syphilis.
These treatements were finally rendered obsolete by the discovery of
penicillin, and its widespread manufacture after World War II allowed
syphilis to be effectively cured for the first time.
In one of the more shameful episodes of the twentieth century, the Tuskegee
syphilis study continued to study the lifetime course of syphilis in a group
of black Americans, long after effective treatments for syphilis were available.
In the July 17, 1998 issue of the journal Science, a group of biologists
reported the sequencing of the genome of T. pallidum.
People identified as probably syphilitic
Though diagnoses arrived at in retrospect from purely historical data are
always open to question, it has been seriously suggested that the following
figures are likely to have had syphilis:
* Idi Amin
* Al Capone
* Georges Feydeau
* Paul Gauguin
* Adolf Hitler
* King Charles VIII of France
* King Edward VI
* Queen Elizabeth I
* King Henry VIII and five of his wives
* Mary I of England, known as Bloody Mary
* Guy de Maupassant
* Henry Miller
* Friedrich Nietzsche
* Arthur Rimbaud
* Franz Schubert
* Robert Schumann
A limerick on syphilis
Quite a good description of how one might have suffered from syphilis back
in the days before modern antibiotics. It starts out with him having a
chancre; he goes on to develop secondary syphilis, losing his hair to
secondary syphilis; following which he has all the common complications of
tertiary syphilis before he ends up mad from neurosyphilis. The limerick
also mentions his wife catching it from him and then passing it on to his
There was a young man of Back Bay,
Who thought syphilis just went away,
And felt that a chancre,
Was merely a canker,
Acquired in lascivious play.
Now first he got acne vulgaris,
The kind that is rampant in Paris,
It covered his skin,
From forehead to shin,
And now people ask where his hair is.
With symptoms increasing in number,
His aorta's in need of a plumber,
His heart is cavorting,
His wife is aborting,
And now he's acquired a gumma.
Consider his terrible plight,
His eyes won't react to the light,
His hands are apraxic,
His gait is ataxic,
He's developing gun-barrel sight.
His passions are strong, as before,
But his penis is flaccid, and sore,
His wife now has tabes
And sabre-shinned babies,
She's really worse off than a whore.
There are pains in his belly and knees,
His sphincters have gone by degrees,
With all its concomitants,
Brings on quite unpredictable pees.
Though treated in every known way,
His spirochetes grow day by day,
He's developed paresis,
Converses with Jesus,
And thinks he's the Queen of the May.