BRIEF: Explore the history of syphilis, from its mysterious origins to modern treatments. Learn about its impact on history and the ongoing struggle to eradicate this ancient disease.
One Night with Venus, and a Lifetime with Mercury
Causative organism – Treponema pallidum (pale twisted thread)
Syphilus Past
Syphilis first struck in Europe in the late 15th century after Naples (under Spanish rule) fell to the French in 1495. This followed with an onslaught of names for the new disease [9]:
AKA The French Disease by the English, Germans, and Italians
AKA The Disease of Naples by the French
AKA The Spanish Pox by the French
AKA The Russian Disease by the Polish
AKA The Christian Disease by the Turks
AKA The Chinese Pox by the Japanese
Is it possible that Syphilis might have been one of the few diseases that the indigenous natives in the New World gave to the Europeans, unlike smallpox and a host of others that the Europeans brandished on the Aboriginals?
In 1530 the Italian physician, Girolamo Fracastoro, published a poem entitled Syphilis sive morbus Gallicus (“Syphilis, or the French Disease”). The poem tells the story of a shepherd named Syphilis who for insulting the sun god Apollo, is punished with a horrible pestilence that brings out “foul sores” on his body.
General Paralysis of the Insane and Malariatherapy
In 1927 Dr. Julius von Wagner-Jauregg, an Austrian neurologist, was awarded the Nobel Prize for his novel discovery of using one disease to fight another. “Malaria therapy” was given to thousands of GPI (late stage “general paralysis of the insane”) patients all over the world. Malarial disease seemed to slow the progression of dementia and other late-stage symptoms. [9] Patients subjected to malaria were then treated with quinine “after treatment was completed”. Luckily, penicillin came soon thereafter.
Historic Treatments for Syphilis
Mercury
Malaria
Arsenical compound salvarsan
Penicillin
Famous Victims
Henri de Toulouse-Lautrec, Paul Gaugin, and Edouard Manet are known to have died from syphilis as well as classic author Oscar Wilde and mobster Al Capone.
Syphilis Present
Syphilis is a systemic bacterial infection caused by the spirochete Treponema pallidum. In 2023, the CDC reported there were 209,253 cases of syphilis in the U.S., an increase of 84% from 2018, and the highest number of cases reported since 1950.[1,2] The WHO estimated that in 2022 there were eight million infections world-wide.[3]
A syphilis vaccine has so far eluded scientists.[4]
The treatment for uncomplicated primary and secondary syphilis in non-pregnant adults remains a single dose of benzathine penicillin G. For penicillin-allergic non-pregnant patients, doxycycline is recommended. Although azithromycin has in the past been effective in treating syphilis, due to increasing resistance, it is no longer recommended.[5]
Pregnant women who are allergic to penicillin should undergo desensitization for penicillin G prior to treatment.[5,6,7] The treatment of pregnant women with syphilis differs from non-pregnant women and clinicians are advised to use the link below to get more information.
There was a benzathine penicillin G shortage in early 2024 at which time the CDC recommended treating only pregnant women and neonates with congenital syphilis with benzathine penicillin. The recommendation was to treat everyone else with doxycycline, but as of September 2024 the shortage had ended and benzathine penicillin G is again the recommended antibiotic for all.[5,8]
Syphilis is also mentioned in the free CME on this website in the article "What’s New in Adult Sexually Transmitted Infections Management and Prevention for 2024"
References
[1] Sexually Transmitted Infections (STIs). CDC. Last Reviewed: January 30, 2024 Retrieved from: https://www.cdc.gov/std/statistics/2022/default.htm
[2] National Overview of STIs in 2023. CDC. November 12, 2024. Retrieved from: https://www.cdc.gov/sti-statistics/annual/summary.html
[3] Syphilis. WHO. 21 May 2024. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/syphilis
[4] Kojima N, Konda KA, Klausner JD. Notes on syphilis vaccine development. Front Immunol. 2022;13:952284. Published 2022 Jul 28. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365935/
[5] Primary and Secondary Syphilis. CDC Sexually Transmitted Infections Treatment Guidelines, 2021. Last Reviewed: July 22, 2021. Retrieved from: https://www.cdc.gov/std/treatment-guidelines/p-and-s-syphilis.htm
[6] Syphilis During Pregnancy. CDC Sexually Transmitted Infections Treatment Guidelines, 2021. Last Reviewed: July 22, 2021. Retrieved from: https://www.cdc.gov/std/treatment-guidelines/syphilis-pregnancy.htm
[7] Syphilis. CDC. Last Reviewed: October 3, 2024. Retrieved from: https://www.cdc.gov/std/treatment-guidelines/syphilis.htm
[8] Bachmann LH, Mena L. Clinical Reminders during Bicillin L-A® Shortage. CDC. February 26, 2024, updated September 9, 2024. Retrieved from: https://www.cdc.gov/sti/php/from-the-director/2023-07-20-mena-bicillin.html
[9] Dobson, M. Disease. The Extraordinary Stories Behind History’s Deadliest Killers. Published by Quercus. 2007. www.quercusbooks.co.uk
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