Plagues and Peoples
Syphilis (Text. Chpt.12, C.R. 1025-1032)
Chapter 12: The Great Pox Syphilis (255)
- Tuskegee Syphilis Study: 1932, US Public Health Service enlisted 399 poor, black males in
Macon County, Alabama, all with latent syphilis. They were offered financial incentives (ex: free
burial if agreed to autopsy) free physical exams, and aspirin when needed. Men and family not told
they had syphilis. They were deprived of treatment for their syphilis. 28 men died of syphilis, 100
others died of related complications, 40 wives infected, and 19 children. Designed to document the
natural history of syphilis, but went terribly wrong.
A Look Back
- From 1493 onward swept over Europe and the rest of the world.
-1494: King Charles Vlll of France invades Italy. During the attack, his troops, fell ill with the Greart
Pox, and this forced their withdrawal. Following this, the disease spread throughout Europe and
spread to the rest of the world.
- Theory: Brought to Naples by the Spanish troops sent to support against attack from King Charles
- The French called this pox “the disease of Naples”, blaming the Italians for it, and the Italians
called it ”the French Disease”. In England called it the “Spanish Disease”
- Symptoms: fevers, open sores, disfiguring scars, disabling pains in the joints, and gruesome deaths.
- Two theories of how Charles VII’s men caught the disease: Columbian and pre-Columbian/anti-
- Columbian Theory: Introduced to Europe from the New World – Columbian Theory
Skeletal remains from the Americas
The pattern of spread of the disease
- pre-Columbian Theory/Anti-Columbian: holds that syphilis was present in Europe before the
discovery of the Americas by Europeans.
Unitarian versus non-unitarian theory
Many populations of native Americans themselves were
decimated by syphilis in the 16th century after the arrival of the Europeans
- Theories for the rapid outbreak of syphilis: (1) kissing (because that was the greeting in England),
shared drinks, canker on lips misunderstood to be cold sore.
- Tried Mercury for the treatment; either applied directly to sores or taken in the form of a drink.
Treatment known as “salivation”.
Spirochete Discovered (260)
- Girolamo Fracastoro called disease syphilis after a fictitious shepherd, named Syphilis, who got it
by cursing the gods.
- Frit Schaudinn and Erich Hoffman identified slender, spiral-shaped bacterium, a spirochete, in the
syphilitic chancres (a dull red, hard, insensitive lesion that is the first manifestation of syphilis).
- Baciteria: Treponema pallidum
- Can be growin in lab animals such as rabbits and guinea pigs, but humans are the only natural
- Took so long to discover bacteria because syphilis was confused with gonorrhoea at the time.
The Disease Syphilis (262)
Plagues and Peoples
Syphilis (Text. Chpt.12, C.R. 1025-1032)
- STDs such as syphilis were once known as venereal disease because Venereal refers to Roman
goddess of Love.
- Syphilis also known as “the great imitator”
- The chancre stage is the earliest clinical sign of disease.
- After initial infection, a painless pea-sized ulcer – a chancre – appears at the site of spirochete
- The chancre is a local tissue reaction and can occur on the lips, fingers, or genitals.
- At this stage, the infection can be spread by kissing or touching a person with active lesions on the
lips, genitalia, or breasts and through breast milk.
- The secondary or disseminated stage usually develops 2 to 12 weeks after the chancre stage;
however, this stage may be delayed for more than a year.
- Skin rash occurs in 90% of the cases. The skin rash may be mistaken for measles or smallpox.
- The patient then enters the latent stage, where there are no clinical signs. This is the most
dangerous time because the infected individual can still transmit to others.
- After about 2 years, the late latent or tertiary stage develops. At this point the individual is no
longer infectious. Tertiary syphilis occurs in one in 1/3 of untreated individuals. The disease then
becomes chronic. Can result in insanity, paralysis, seizures.
“Catching” Syphilis (264)
-Syphilis can be transmitted from the mother to the developing fetus via the placental blood supply,
resulting in congenital syphilis.
- Child can have same symptoms as mother or have deformities, deafness, or blindness OR suffer
from Hutchinson’s triad: deafness, impaired vision, and a telltale groove across peg-shaped teeth.
The Pre-Columbian Origin of Syphilis (265)
- All of the treponemes that cause the human diseases yaws, pinta, and syphilis are identical in their
morphology and differ very little genetically.
Syphilis and Its Social Context
- Cerebral damage due to syphilis caused the death or affected the lives of Charles VII and Francis I,
Pope Alexander Borgia.
Diagnosing Syphilis (267)
- Examination of fluid from lesion are basis for disease determination.
- Blood test
Treating Syphilis (268)
- Pencillin (Sir Alexander Fleming): Treatment will kill the syphilis bacterium and prevent further
damage, but it will not repair damage already done
Syphilis and the Social Reformers (268)
- In history, the victims of syphilis were those who “deserved” the disease and brought it on
themselves by immoral behaviour.
Tuskegee syphilis study: 1932, us public health service enlisted 399 poor, black males in. They were offered financial incentives (ex: free burial if agreed to autopsy) free physical exams, and aspirin when needed. Men and family not told they had syphilis. They were deprived of treatment for their syphilis. 28 men died of syphilis, 100 others died of related complications, 40 wives infected, and 19 children. Designed to document the natural history of syphilis, but went terribly wrong. From 1493 onward swept over europe and the rest of the world. 1494: king charles vlll of france invades i taly. During the attack, his troops, fell ill with the greart. Following this, the disease spread throughout europe and spread to the rest of the world. Theory: brought to naples by the spanish troops sent to support against attack from king charles.