Belated Valentine’s Day Special: A Brief History of Syphilis

By Jack R. Johnson 04.2020

When I was in third grade, they gave out these little boxes of candies on Valentine’s Day. The candies were shaped like hearts and because the hearts were so small they could not spell out the long phrase “Valentine’s Day”, so they just shortened it to two letters. VD.

I thought that was kind of a cool short hand. So I took to wishing everyone Happy VD day. My teacher didn’t like that. She wouldn’t explain why. She just looked miserable and said, “Jack, please, just stop calling it VD day. Okay?”
Ever since that time, venereal disease and Valentine’s Day have been—for me—inextricably linked. I blame the candy.

From the very beginning, VD has gotten a bad rap. Especially syphilis. According to the Journal of Medicine, “In 1495, every country whose population was affected by syphilis blamed neighboring countries for the outbreak.”  Nobody wanted to own this thing.

So, the inhabitants of Italy, Germany and United Kingdom named syphilis ‘the French disease’, the French named it ‘the Neapolitan disease’, the Russians assigned the name of ‘Polish disease’, the Polish called it ‘the German disease’, The Danish, the Portuguese and the inhabitants of Northern Africa named it ‘the Spanish/Castilian disease’ and the Turks coined the term ‘Christian disease’. Moreover, in Northern India, the Muslims blamed the Hindus for the outbreak of the affliction. And, of course, the Hindus blamed the Muslims, and in the end everyone blamed the Europeans.”
The original name “syphilis” comes from an Italian book by Girolamo Fracastoro, a poet and medical personality in Verona, Italy. His work was entitled “Syphilis, sive Morbus Gallicus” which loosely translates to “Syphilis, or the French Disease.”

In his story, Syphilus is a shepherd who gets torqued at Apollo for burning off all the water that feeds his flock. He vows not to worship Apollo. Bad move. Apollo curses him with a disease named Syphilis after the shepherd’s own name and the affliction spreads to the whole population including the King! A nymph counsels the inhabitants to offer Apollo sacrifices, one of which was Syphilus himself, and to try some herbal cures including something called Guaiac.

Now, it just so happens that Fracastoro was a doctor himself who also treated local cases of syphilis with—you got it -- Guaiac.

These treatments were relatively ineffective, but the use of Guaiac was interesting. Guaiac was only recently available, because it came from the same place that syphilis came from –according to the popular theory of origin: Hispaniola, or The New World.

There are two popular theories for the origin of the disease. One is long and complicated and basically unproven. The other, called the Columbian theory, has some decent evidence to support it. The Columbian theory in a nutshell: Columbus brought syphilis back from his travels in the New World.

There’s significant skeletal evidence to back the theory up, and it’s further confirmed by two physicians who were present at the moment when Christopher Columbus returned from America.
One of them, a doctor named Ruy Diaz de Isla wrote that syphilis was “unknown disease, so far not seen and never described.”  He apparently witnessed the onset of the disease first hand in Barcelona in 1493. You might recall that Columbus returned from his adventures in Hispaniola and arrived in Spain in 1493, as well. 

Here’s where it gets ugly. Many of the crew members who served on Columbus’ voyage later joined the army of King Charles VIII in his invasion of Italy in 1495. This probably resulted in spreading the disease across Europe and as many as five million deaths.
As Jared Diamond 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. Some findings suggest Europeans could have carried the non-venereal tropical bacteria home, where the organisms probably mutated into the more deadly European form.
Whatever the case, Syphilis was a major killer in Europe during the Renaissance. In the 16th century, it was sometimes called the "great pox" in order to distinguish it from smallpox. Because in its early stages, syphilis (or the great pox) produced a rash similar to smallpox. There are other terms that were used to describe syphilis as well, such as Lues venerea, Latin for "venereal plague"; and "Cupid's disease." 

There were originally no effective treatments for syphilis, although a number of remedies were tried. Some methods included blood-letting, laxative use, and bathing in wine and herbs or olive oil as if you were a lightly tossed salad.

Mercury was a common, long-standing treatment for syphilis, maybe because it had positive effects in the treatment of leprosy, which was thought to be related to syphilis. Like leprosy, in severe cases of syphilis, body parts fell off, fingers, noses, etc… 

None of these so called cures were especially effective, and syphilis had its way with the West. It scarred and disfigured faces, leading to what was sometimes called "nasal collapse." Artificial noses were used to improve appearances as well as heavy makeup and the occasional ‘beauty marks’ to the hide the pustules or poxes.

Curiously, some patients who developed high fevers were cured of syphilis. Because of this, for a brief time, malaria –which produces high fevers—was used as treatment for syphilis. This was considered an acceptable risk, the logic being that malaria could later be cured with quinine, which was available at that time.
Believe it or not, in 1927 Dr. Julius Wagner-Jauregg won a Nobel Prize for Medicine for using malaria as a treatment for syphilis.

In fact, the struggle to discover a cure for the disease has been almost as awful as the disease itself. You might recall the “Tuskegee Study of Untreated Syphilis in the Negro Males” that occurred between 1932 and 1972 by the US Public Health Service. The ostensible purpose of the study was to observe the natural history of untreated syphilis; the African-American men in the study were only told they were receiving free health care from the United States government. Some of the men were actively infected with the disease without their knowledge, then left untreated for 40 years even though penicillin was commonly available for treatment shortly after World War II. The same type of experiments were also conducted in Guatemala from 1946 through the mid-1950s by the United States, by the same doctor who also helped with the Tuskegee Study. His name was Dr. John Charles Cutler.

In Guatemala, he and other doctors deliberately infected healthy people with the disease. The researchers paid prostitutes infected with syphilis to have sex with prisoners, while other subjects were infected by directly inoculating them with the bacterium. Through intentional exposure to gonorrhea, syphilis, and chancroid, a total of 1,308 people were involved in the experiments. Many died brutal and unnecessary deaths.

In October 2010, the U.S. government finally apologized.  A commission concluded nine months later that the experiments "involved gross violations of ethics as judged against both the standards of today and the researchers' own understanding"

Once penicillin was formally introduced as a cure, the main threat of syphilis was greatly diminished for all of mankind, but the disease had left millions dead or ravaged in its wake. Great minds like Nietzsche and Oscar Wilde and even Beethoven were lost to it; and less likable personalities as well: Al Capone and Adolf Hitler probably suffered from it, to name just a few.
But perhaps there’s one name that should be added to balance out this story.
At the time of his death, his symptoms included arthritic pain, mental confusion and instability, inflammation of the eyes, and gout - all of which are consistent with undiagnosed and untreated syphilis. His name was Christopher Columbus, the person who brought syphilis from the New World in the first place likely died from it in the end.

A little poetic justice, after all.

Happy belated VD day everyone!