Syphilis is a disease frequently shrouded in many levels of mystery. It appeared suddenly in Europe in the late 1400s as a highly virulent and often fatal disease, a disease that could give Ebola a run for its money when it comes to sheer grotesque-ness. Victims may be covered with pustules from head to toe, diseased flesh peeled from their bodies, and patients may be in agonizing pain for weeks or months prior to death. However, after this inauspicious beginning, syphilis seems to have become less virulent, and instead shifted in presentation to more of the chronic disease that we know it as today.
Syphilis is caused by a bacterium called a spirochete: a twisted corkscrew-like organism named Treponema pallidum. The disease itself has been known by many names over the centuries, including “Morbus Gallicus” (“The French Disease”) and the Great Pox, to distinguish it from other diseases such as smallpox. It’s also known as “The great imitator,” due to the non-specific symptoms it frequently causes.
Illness caused by T. pallidum is typically divided into three stages: primary, secondary, and tertiary. Shortly after initial infection, a lesion may appear on the genitalia; typically, these will resolve on their own in another few weeks’ time. During the secondary phase, which can occur weeks or months later, a rash may appear on the body, typically over the extremities and frequently including the palms of the hands and soles of the feet. Myriad other manifestations may also present at this point, making the diagnosis of syphilis (especially without the characteristic rash) difficult in the centuries prior to identification of the causative spirochete. Tertiary syphilis, then, would frequently manifest a year to ten years (but sometimes as long as 50) after the initial infection. This also was difficult to definitively diagnose, as symptoms could include effects in a number of bodily systems, including the cardiovascular, digestive, and nervous system. The best-known tertiary effect include late stages of neurosyphilis, which can result in blindness, dementia, and paralysis.
In times gone by, just like today, acquisition of sexually transmitted diseases carried a stigma. This stigma, combined with the difficulty of making an accurate syphilis diagnosis (especially prior to the 1900s, but even after identification of the causative organism, diagnostic tests could still show false negatives), has resulted in quite a bit of rumors swirling around famous historical figures: had they been infected with syphilis? Hitler is but one of the historical figures investigated in Deborah Hayden’s Pox: Genius, Madness, and the Mysteries of Syphilis. More below…
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