BIOMEDICAL HISTORY


ARTICLE


The Great Pox: a history of syphilis and its treatment


In 1492 Christopher Columbus sailed west and found an undiscovered New World. On his return, he and his companions brought back many strange tales and treasures and, it is widely believed, syphilis – The Great Pox.


In the decades following the return of Christopher Columbus and his men from the New World, the infection we now know as syphilis spread like wildfire throughout the known world and was, for over four centuries, the HIV/AIDS of its day. It was feared, took no account of the race, creed or social standing of its victims, and destroyed the lives, well- being and reputations of millions of people. Only the use of penicillin for the treatment of this infection from the mid-1940s allowed medical science the opportunity to treat, cure and bring this scourge under control. This article provides a brief insight into the history of the disease, the role of biomedical science and scientists in the elucidation of the cause, and its diagnosis and treatment.


WHAT’S IN A NAME? Syphilis has been called ‘The Scourge of the Renaissance’. It was a disease greatly feared by the Tudors, who called it The Great Pox to differentiate it from The Small Pox. In 1530 an Italian pathologist, Hieronymus Fracastorius/Girolamo Fracastoro, wrote a poem entitled Syphilis Sive Morbus Gallicus (On Syphilis, or the French Disease), which described the plight of a mythical shepherd lad named Syphilis afflicted with the disease as a punishment for cursing the gods. The


‘The earliest documented treatment of syphilis involved the use of mercury, from the early part of the 17th century onwards’


DECEMBER 2013


poem recognised the venereal nature of the infection and was a compendium of the knowledge of the time regarding the disease. Paracelsus called the new venereal disease


‘French gonorrhoea’ and suggested that it arose through sexual intercourse between a leprous Frenchman and a prostitute with gonorrhoea. It has been called the ‘great mimic’ because its symptoms are similar to those of many other diseases. In fact, before the introduction of specific bacteriological and immunological tests, many physicians believed that ‘whoever knows all of syphilis knows all of medicine’.


The disease had many names, most of


which were xenophobic: for example, the Germans and English called it the French pox, the French called it the Neapolitan sickness, and a Persian physician call it the Armenian sore or the Frankish pox.


HISTORICAL TREATMENT OF SYPHILIS The earliest documented treatment of the pox (syphilis) involved the use of mercury, from the early part of the 17th century onwards. There are accounts of ointments and balms, almost certainly of a mercurial base, being used by Arab physicians to treat ‘yaws’ at the time of the Crusades in the 12th century. Treatment of leprosy with mercury


preparations was known at this time, and possibly syphilis also. There are numerous descriptions of topical and oral preparations being administered, some of the effects of the treatment being as hideous as the disease itself. The other treatment described alongside mercury in the 16th century was gaiac. Gaiac is powdered wood from the Guaiacum officinale, a tropical tree found in the Caribbean and Central American regions. The powdered wood is made into a potion by boiling it down to a decoction, which is administered in large doses after the patient has previously been given purgatives and dieted on a meagre ration over several weeks. This treatment took place in a heated room with the patient wrapped in blankets to induce sweating until ‘the sickness had been rooted out’. There was strong opinion for and


Treponema pallidum spirochetes in a tissue sample (silver impregnation method). THE BIOMEDICAL SCIENTIST 719


CDC/Dr Edwin P Ewing Jr


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