Syphilis – a grim and painful history!

Over one in ten people in the east end of London were estimated to be syphilitic, according to an article in The Daily Telegraph, in 1916. For centuries, this sexually transmitted disease terrified millions of people around the world. But finally, in the 20th century, science provided a cure. A way of conquering the disease. Bringing to an end a grim and painful history. Though syphilis has not gone away…

The majority of those in London’s east end who had contracted syphilis got it “quite innocently”, according to the Telegraph. What it meant was that the disease had been transferred from a parent to a baby. Congenital syphilis was a life sentence for an infected baby. It could impair them physically and mentally. The composer Beethoven has often been held up as a possible example of a congenital syphilitic.

Untreated syphilis goes through a primary, secondary, latent, and tertiary stage. The primary stage involves “chancres”, painless sores that disappear within a few weeks. The sufferer may assume the problem has gone but that’s just the beginning. Then the secondary phase with lesions all over the body but in the old days, people ignored these symptoms. They went away as well and there was a period of latency – with nothing happening. But the person was still highly infectious and the disease was bedding down for the finale!

The tertiary phase is the most devastating and what horrified the world for centuries. It can take decades to manifest itself in full so sufferers could lead a normal life for many years. But then syphilis attacks the brain, heart, eyes, ears, and in some circumstances leads to the collapse of the nose. Dementia and madness are the closing act.

Syphilis – not our disease!

Throughout history, syphilis was always blamed on other countries. In the English speaking world, it was often referred to as the French pox. The French called it a Neapolitan disease – from the Italian city of Naples in other words. Russians said it was a Polish affliction. The Portuguese blamed their bigger neighbour Spain – calling it the Spanish or Castilian pox. For the Ottoman Turks, it was a Christian import. And in northern India, Hindus and Muslims pointed accusingly at each other.

The French army was believed to have brought it to Italy in 1495 when they invaded Naples. This could well have been true. But not because the French are nature’s syphilis carriers – I jest. All armies at this time were made up of mercenaries from across Europe and with protracted wars came rape and prostitution – ideal for spreading syphilis.

Jewish people were accused of spreading syphilis, even though their plight was mainly caused by Iberian Catholic rulers. In 1492 – a key year for the disease – King Ferdinand of Aragon and Queen Isabella of Castille expelled all the Jews from what is now Spain. Many turned up at the gates of Rome. Forbidden entry and camped outside the walls, they were stricken with an outbreak of syphilis from which an estimated 30,000 may have died.

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Where did syphilis come from?

Some have argued that syphilis only appeared for the time in Europe at the end of the 15th century. They blame Christopher Columbus and his crew for bringing it back from the New World. Others think syphilis was already in the Old World long before Columbus accidentally discovered America. These are the main theories for the origin of syphilis:

  1. Pre-Columbian hypothesis – Syphilis was widespread all over the world for thousands of years but often mistaken for conditions like leprosy. Bacteria that lead to similar end results to syphilis had been infecting humans since 15,000BC but it was around 3,000BC with lower temperatures in the post-glacial era that sexually transmitted syphilis emerged from south-west Asia. Initially a mild condition, it mutated into something way more virulent by the 15th century CE.
  2. Unitarian hypothesis – Syphilis is spread by what’s called a “treponema” type bacteria, spiral-shaped and responsible for other non-venereal diseases as well like Yaws and Pinta. Syphilis is part of a family of diseases caused by treponema which adapts according to local conditions. Yaws started in western and central Africa and most likely spread to Spain and Portugal with the beginning of slavery, decades before Columbus. It then modified to become syphilis.
  3. Columbian hypothesis – Christopher Columbus is to blame, according to this popular theory. Rejected by the two previous schools of thought. Supported by documents from two Spanish physicians present when Columbus returned from his long voyage: Fernandez de Oviedo and Ruy Diaz de Isla. Oviedo went to the New World and reportedly saw syphilis among the indigenous peoples who were already treating it with their own methods. De Isla reported that Barcelona was the first city badly affected in 1493, a year after the Columbus discovery. He believed it originated in the Galapagos Islands.

More dubious theories included the view of the physician and alchemist Paracelsus (1493-1541) that syphilis was created by a French prostitute with gonorrhoea having sex with a leper!

“For a night with Venus – a life with Mercury”

However, Paracelsus (real name: Phillipus Von Hohenheim) would influence the treatment of syphilis with his endorsement of mercury as a potential cure. This was based in a large part on Islamic medicine. The thinking was based on medieval approaches to curing disease that tended to emphasise bleeding and sweating the illness out. Mercury, in toxic doses, provokes salivation and urination. That was convincing enough for a 16th century doctor. Right up until the 20th century, poisonous mercury was the recommended treatment.

Paracelsus believed that for mercury treatment to be effective, three pints of saliva had to be barfed up by the patient. The amount of mercury needed to achieve that would eventually lead to the patient’s death. It was administered through salts or vapours.

Opposition to mercury came early from a monk-turned-knight, Ulrich von Hutten (1488-1523). He contracted syphilis and objected to mercury treatment after it resulted in him losing all his teeth. However, his views were condemned by the Vatican after he became a supporter of the Protestant reformer, Martin Luther. So – Paracelsus won out and mercury persisted!

The rich and famous get syphilis

As with AIDS in the 1980s, syphilis was used to discriminate against groups of people. They were essentially blamed for bringing it upon themselves and transferring it to others. The reality is that syphilis was so widespread that it proved the bacteria didn’t care who it infected. It just wanted to find a home!

Even the rich and famous succumbed to the disease. Famous syphilitics included the philosopher Friedrich Nietzche; the gangster Al Capone; the writer Leo Tolstoy; the poet Keats; and the French novelist Guy de Maupassant. Oscar Wilde believed he was infected with syphilis but may not have been. While President Abraham Lincoln very like was infected but his biographers hushed it up.

Victorian anti-vaxxers and syphilis

Ever since vaccinations were introduced two hundred years ago, there were those arguing fervently against it. Most of their thinking was wrongheaded but highly influential at times. In 1893, the findings of a Royal Commission into vaccines in the United Kingdom convinced some that compulsory jabs were a sure fire way to spread syphilis. There were similar anxieties in the 1980s with AIDS that dentists and doctors were inadvertently spreading the virus.

And obviously with Covid and some of the crazy conspiracy theories about vaccines, these kinds of ideas persist.

Racism and syphilis

In the United States, racist views about syphilis circulated widely. Even though Columbus had encountered the disease – we think – among indigenous peoples 500 years ago, there were white supremacists in the 1920s claiming that all African-Americans were spreaders of both syphilis and tuberculosis (TB). This idea of certain groups – refugees, asylum seekers, etc – being disease carriers still persists today. What this does is to derail effective solutions and lead to blind hatred.

Between 1919 and 1939, The Chicago Whip was an African-American newspaper that addressed these questions boldly. In a November 1920 editorial, Dr. Troy Smith made the entirely reasonable point that syphilis did not respect wealth or care about racial division. Shockingly, he pointed out that “white doctors” were spreading the myth that black people in the U.S. had syphilis and TB.

He took a militant position arguing that white people had passed syphilis on to black people. But at the same time criticised his community for not being vigilant enough and taking the modern treatments available.

Image above: The Chicago Whip counters racist views on syphilis

Science to the rescue!

The scientific revolution of the last 200 years has brought many fantastic achievements. Curing syphilis is a neglected one. But we should reflect on just how widespread this disease was up until the first half of the 20th century. My mother worked on the medical staff in a psychiatric hospital in the post-war era in London and one of her patients was a woman who sadly had advanced to tertiary stage syphilis. It really was a major killer until recent times.

In 1884, Bismuth salts were introduced and were way less toxic than mercury. In 1908, the Nobel Prize went to Paul Ehrlich for discovering Salvarsan, a drug that bound itself to the bacteria and killed it. But it was based on arsenic, so still rather poisonous. Mercifully after 1940, we got Penicillin, discovered in 1928, as the recommended treatment.

Image above: Science to the rescue!

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